The detection and delineation of spinal tumors by magnetic resonance imaging (MRI) after intravenous administration of gadolinium (Gd)-diethylenetriaminepenta-acetic acid (DTPA) is demonstrated in eight cases of neurinoma or meningioma. The advantages of Gd-DTPA-enhanced MRI over other MRI techniques used in more than 100 cases of spinal cord diseases are described.
In modern magnetic resonance imaging (MRI) gradient echo (GE) sequences have been shown to be superior to conventional spin echo (SE) sequences in characterising renal masses and staging renal tumours. In this study MRI was carried out in patients with renal masses (n = 97, histologically proven n = 43) using a fast GE-sequence (multislice technique, TR/TE 80/5 ms) and an i.v. bolus application of gadolinium (Gd)-DTPA mostly in axial, in selected cases additionally in coronal slice orientation. MRI findings were compared with those of contrast-enhanced CT (n = 56). The results demonstrated that MRI under Gd-DTPA has a reliably good image quality and can characterise renal masses safely. Compared with CT in multislice MRI problems of partial volume effects can be reduced; complex renal cysts can be differentiated more safely from solid tumours with unclear CT findings due to a significantly higher contrast enhancement in MRI.
T I values and T2 values (CPGM-sequence) of neurinomas and meningiomas were determined, and showed values close to those of white and grey matter or, in regressive cystic neurinomas, near the cerebrospinal fluid (CSF). By this overlapping in relaxation times, as well as by crossover and boundary effects, small tumors may be obscured. The application of gadolinium-DTPA allows easier identification even of small lesions, by the high contrast achieved on the T I weighted imaging sequences, which also avoids crossover and boundary effects with the adjacent parenchyma and CSF. This is demonstrated in intrameatal acoustic neurinomas, vascular tumors, small and en plaque growing meningiomas, and tumors of the spinal canal.
Bladder tumors were staged preoperatively before and/or after M-VEC polychemotherapy using transrectal ultrasonography and magnetic resonance imaging in 46 patients. The resultant findings were each compared with histomorphologic results. The sensitivity of both methods compared with pathohistology was 88%. Using this technique, the degree of tumor invasion of the bladder wall could be evaluated and the appropriate therapy selected. Further applications included the monitoring of transurethral resection determine its adequacy as a treatment modality.
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