Lumbar interspinous bursitis (Baastrup disease) is uncommon but not infrequent in symptomatic patients undergoing lumbar spine MRI. Patients with MRI evident Baastrup disease tend to be older, have central canal stenosis, bulging discs, and anterolisthesis. Further investigations determining the clinical significance of this finding are necessary.
Background Computed tomography (CT) is often used to confirm the diagnosis of encapsulating peritoneal sclerosis (EPS) but there is no consensus on specific CT abnormalities. To establish CT findings characteristic for EPS, we compared CT findings between EPS patients and long-term peritoneal dialysis (PD) patients without EPS. Methods We included as cases all EPS patients in our center from 1996 to 2008 that underwent a CT scan at the time of diagnosis. Controls were all other long-term PD patients (PD duration ≥ 4 years) without EPS that had a CT scan for different reasons. The CT scans were blindly and independently reviewed by 3 radiologists: 2 abdominal radiologists with PD knowledge (Observers 1 and 2) and 1 radiologist without PD experience (Observer 3). Results We included 15 EPS patients and 16 controls. Observer 1 found 6 CT findings that were significantly more often present in EPS than in controls ( p ≤ 0.05): peritoneal enhancement, thickening, and calcifications; adhesions of bowel loops; signs of obstruction; and fluid loculation/septation. Observer 2 scored almost identically but Observer 3 scored differently. The sensitivity and specificity of a combination of specific CT findings were, respectively, 100% and 94% for Observers 1 and 2, and 79% and 88% for Observer 3. Conclusion CT scans showed characteristic abnormalities that were significantly more often present in EPS patients compared to long-term PD control patients. CT can be used to confirm the diagnosis of EPS when experienced radiologists apply a combination of specific CT findings.
Abstract. Mammographic features such as small vague densities, indefinable microct subtle architectural distortions, alone or in combination, are non-specific appearances ior breast cancer. These features sometimes precede malignancy and a decisive strategy on how to deal with non-specific minimal signs in a breast cancer screening programme is studying the prevalence of these signs in a Dutch Breast Cancer Screening Centre and estimating the risk of participants with these signs acquiring breast cancer within 2 years, we have such a strategy. Non-specific minimal signs were seen on the mammograms of 53 of 500 (10.6%) participants, aged 50-70 years, in this programme. After retrospective analysis of the mammograms of 254 patients with screen-detected or interval carcinoma, non-specific minimal signs were detected in 77 cases. Combining the incidence of breast cancer with the difference between the expected num ber of non-specific minimal signs in the screening programme and its actual occurrence in previous mammograms of patients with breast cancer, the risk of cancer in women with these signs, additional to that of screened women in general (additional risk), is calculated as being 0.5%. Invasive breast cancer in women with previously detected non-specific minimal signs dem on strated a favourable stage at diagnosis (axillary metastasis in 23% vs 37% in cancers without these previous signs, ¿><0.05). Our strategy for follow-up in case of non-specific minimal signs remains unchanged because of the low additional risk and favourable staging, and is restricted to an invitation for the next screening round in 2 years time.
Purpose:To evaluate the combined use of carbon dioxide (CO 2 ) and a gadolinium-based blood-pool agent for magnetic resonance angiography (MRA). Materials and Methods:After an initial intravenous injection of the blood-pool agent Gadomer (Schering AG, Germany), repeated transcatheter CO 2 injections were performed in the aorta and the renal arteries of two fully-anesthetized pigs. Real-time images were acquired using a true fast imaging with steady-state precession (FISP) sequence.Results: During the CO 2 injections, the Gadomer-enhanced blood was totally replaced, resulting in an immediate, temporary, total signal loss in the vessel lumen. Susceptibility artifacts during the injections or catheter manipulations rarely occurred. Conclusion:Due to T1-shortening, the circulating bloodpool agent prevents flow artifacts during catheter manipulations because the steady-state is reached much earlier. Therefore, this double-contrast MRA method improves catheter conspicuity and might be helpful for guiding and controlling intravascular procedures during interventional MRI. ACCURATE VISUALIZATION of target vessels and continuous confirmation of vessel patency is essential during intravascular interventions.Most non-contrast-enhanced MR angiography (MRA) sequences, such as time-of-flight and phase-contrast angiography, have limitations when used for guidance of vascular interventions due to their acquisition times of longer than one second. Contrast-enhanced angiography techniques are much faster but require repeated injections due to their very short intravascular retention time. Because large quantities of gadolinium-based contrast agents increase the background signal intensity over the course of the procedure, alternatives are needed.One solution is the use of a real-time bright-blood MR steady-state free precession (SSFP) sequence such as true fast imaging with steady-state precession (true FISP) (1). In addition to the excellent vessel conspicuity, true FISP imaging offers exceptionally high signal with a short repetition time, thus making it an ideal imaging method to guide interventional procedures (2). However, in order to assess blood flow distal to an interventional device such as a catheter or stent, the use of a dark blood agent, like gaseous CO 2 , would be advantageous (3,4). In order to prevent distorting artifacts during catheter manipulation during the SSFP sequences, as suggested by other researchers, we injected a bloodpool agent (5). The T1-shortening caused by the circulating blood-pool agent is known to prevent flow artifacts because the steady state is reached much earlier.The aim of our study is to test the feasibility of the combined use of CO 2 and an intravascular blood-pool agent (Gadomer; Schering AG, Berlin, Germany) for MRA and to discuss its potential use in interventional MRI.
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