| 1. |
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| 2. |
- Aurell, Y, et al.
(författare)
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Ultrasound anatomy in the neonatal clubfoot
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:10, s. 2509-2517
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Tidskriftsartikel (refereegranskat)abstract
- Our objective was to assess clubfoot anatomy by US in newborn babies before and in the early phase of treatment. Reproducible US projections and measurements were carried out on 30 untreated clubfeet in 22 children, consecutively included in the study. The position of the navicular in relation to the head of the talus was visualised in all feet. The mean distance between the medial malleolus and the navicular was significantly shorter in the clubfeet than in normal feet. There was a tendency to medial displacement of the cuboid. Soft tissue thickness at the medial side of the foot was increased in all deformed feet. The measurements showed an acceptable intra- and inter-observer reliability for the different variables assessed (r=0.71-0.96, Pearson's correlation coefficient). With US it is possible to obtain well-defined planes of investigation that give important information about the clubfoot deformity concerning the talo-crural, the talonavicular and the calcaneo-cuboid joints. The method is simple enough to be used in everyday clinical practice and we recommend it as a guide during the non-operative treatment and for preoperative planning.
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| 3. |
- Aurell, Y, et al.
(författare)
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Ultrasound anatomy in the normal neonatal and infant foot: an anatomic introduction to ultrasound assessment of foot deformities
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:9, s. 2306-2312
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to establish guidelines for US assessment of the talo-crural, the talo-navicular and the calcaneo-cuboid joints during the first year of life, which could serve as a reference while studying foot deformities. The feet of 54 healthy children were examined at birth and at the age of 4, 7 and 12 months by using three easily defined and reproducible US projections. With a medial projection the relation of the navicular in relation to the medial malleolus and the head of the talus was studied. A lateral projection revealed the calcaneo-cuboid relationship and a dorsal projection the talo-navicular alignment in the sagittal plane. Normal values for measurements of these cartilaginous relationships were established for the different age groups. Intra- and interobserver reliability was assessed and found to be acceptable (r=0.53-0.90, Pearson correlation coefficient). With US it is possible to obtain reproducible planes of investigation that give reliable information about the talo-crural, the talo-navicular and the calcaneo-cuboid relationships during the first year of life.
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| 5. |
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| 7. |
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| 8. |
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| 9. |
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| 10. |
- Cwikiel, Wojciech, et al.
(författare)
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Non-traumatic vascular emergencies: imaging and intervention in acute arterial conditions
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:11, s. 2619-2626
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Tidskriftsartikel (refereegranskat)abstract
- Methods of imaging and intervention in acute non-traumatic vascular arterial conditions has changed substantially during recent years. Computed tomography, MRI angiography and, more recently, intravascular ultrasonography (IVUS) have replaced to a large extent conventional diagnostic angiography. An increasing number of patients are treated by endovascular interventions and numerous new treatment methods have been evaluated. Technical development of new equipment and instruments, increasing skill of interventional radiologists and better understanding of events following interventions improve continuously results of the treatment. Radiologic diagnosis and intervention have important roles in the treatment of acute non-traumatic vascular arterial conditions.
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| 11. |
- Einarsdottir, H, et al.
(författare)
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Diffusion-weighted MRI of soft tissue tumours
- 2004
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Ingår i: European radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 14:6, s. 959-963
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Tidskriftsartikel (refereegranskat)
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| 12. |
- Eklund, K., et al.
(författare)
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Are digital images good enough? A comparative study of conventional film-screen vs digital radiographs on printed images of total hip replacement.
- 2004
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 14:5, s. 865-869
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the inter- and intra-observer variability and to find differences in diagnostic safety between digital and analog technique in diagnostic zones around hip prostheses. In 80 patients who had had a total hip replacement (THR) for more than 2 years, a conventional image and a digital image were taken. Gruen's model of seven distinct regions of interest was used for evaluations. Five experienced radiologists observed the seven regions and noted in a protocol the following distances: stem-cement; cement-bone; and stem-bone. All images were printed on hard copies and were read twice. Weighted kappa, kappa(w), analyses were used. The two most frequently loosening regions, stem-cement region 1 and cement-bone region 7, were closely analyzed. In region 1 the five observers had an agreement of 86.75-97.92% between analog and digital images in stem-cement, which is a varied kappa(w) 0.29-0.71. For cement-bone region 7 an agreement of 87.21-90.45% was found, which is a varied kappa(w) of 0.48-0.58. All the kappa values differ significantly from nil. The result shows that digital technique is as good as analog radiographs for diagnosing possible loosening of hip prostheses.
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| 13. |
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| 14. |
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| 15. |
- Frennby, Bo, et al.
(författare)
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Contrast media as markers of GFR
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:2, s. 475-484
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Tidskriftsartikel (refereegranskat)abstract
- Determination of the glomerular filtration rate (GFR) is generally considered as the most important parameter of quantifying renal function. The GFR is determined as renal or plasma clearance of an ideal filtration marker which is freely filtered by the kidney, does not undergo metabolism, tubular secretion or absorption. Markers that fulfil these demands are inulin, 51Cr-EDTA, 99mTc-DTPA, labelled or unlabelled contrast media. The renal clearance of inulin is the classic reference method for estimation of the GFR. This method is however not practical for routine clinical purposes. Radionucleids have therefore been used as alternative filtration markers since the 60s. Drawbacks related to radiation exposure especially in children and pregnant women and the safety in handling radiolabelled markers have led to an increasing interest in using non-radioactive markers. The development of simple and reliable methods to determine the concentration of contrast media in plasma and urine, such as high-performance liquid chromatography (HPLC) and X-ray fluorescence analysis have made this possible. The non-ionic low osmolar contrast medium iohexol has become the most commonly used contrast medium for GFR measurements in Europe. However, other contrast media with similar pharmacokinetics may be equally suitable as GFR markers.
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| 16. |
- Geijer, Håkan, et al.
(författare)
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Digital Radiography of Scoliosis with a Scanning Method : Radiation Dose Optimization
- 2003
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 13:3, s. 543-551
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was optimization of the radiation dose–image quality relationship for a digital scanning method of scoliosis radiography. The examination is performed as a digital multi-image translation scan that is reconstructed to a single image in a workstation. Entrance dose was recorded with thermoluminescent dosimeters placed dorsally on an Alderson phantom. At the same time, kerma area product (KAP) values were recorded. A Monte Carlo calculation of effective dose was also made. Image quality was evaluated with a contrast-detail phantom and Visual Grading. The radiation dose was reduced by lowering the image intensifier entrance dose request, adjusting pulse frequency and scan speed, and by raising tube voltage. The calculated effective dose was reduced from 0.15 to 0.05 mSv with reduction of KAP from 1.07 to 0.25 Gy cm2 and entrance dose from 0.90 to 0.21 mGy. The image quality was reduced with the Image Quality Figure going from 52 to 62 and a corresponding reduction in image quality as assessed with Visual Grading. The optimization resulted in a dose reduction to 31% of the original effective dose with an acceptable reduction in image quality considering the intended use of the images for angle measurements.
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| 17. |
- Geijer, Håkan, et al.
(författare)
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Image quality vs radiation dose for a flat-panel amorphous silicon detector : a phantom study
- 2001
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 11:9, s. 1704-1709
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the image quality for a flat-panel amorphous silicon detector at various radiation dose settings and to compare the results with storage phosphor plates and a screen-film system. A CDRAD 2.0 contrast-detail phantom was imaged with a flat-panel detector (Philips Medical Systems, Eindhoven, The Netherlands) at three different dose levels with settings for intravenous urography. The same phantom was imaged with storage phosphor plates at a simulated system speed of 200 and a screen-film system with a system speed of 160. Entrance surface doses were recorded for all images. At each setting, three images were read by four independent observers. The flat-panel detector had equal image quality at less than half the radiation dose compared with storage phosphor plates. The difference was even larger when compared with film with the flat-panel detector having equal image quality at approximately one-fifth the dose. The flat-panel detector has a very favourable combination of image quality vs radiation dose compared with storage phosphor plates and screen film.
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| 18. |
- Geijer, Håkan, et al.
(författare)
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Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI) : I. Experimental studies
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:10, s. 2571-2581
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to evaluate the influence on image quality and dose to the patient and operator of various equipment settings for percutaneous coronary intervention (PCI), and to optimize the set-up. With an Alderson phantom, different settings, such as projection, protective screens, filtration, image intensifier size and collimation, were evaluated. Kerma-area product (KAP) was recorded as a measure of patient dose and scattered radiation was measured with an ionization chamber. Effective dose for a standardized PCI procedure was measured with thermoluminescent dosimeters inside the phantom. Image quality was evaluated with a contrast-detail phantom. Based on these findings, the equipment set-up was optimized to a low fluoroscopy dose rate with a sufficient image quality. Several operating parameters affected dose, particularly scattered radiation. The optimization reduced the fluoroscopy KAP rate from 44 to 16 mGy cm2/s using 15 cm of acrylic. The effective dose was reduced from 13 to 4.6 mSv for a standardized PCI procedure. Radiation dose to patient and operator in PCI is heavily dependent on both equipment set-up and operating parameters which can be influenced by the operator. With a careful optimization, a large reduction of radiation dose is possible.
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| 19. |
- Geijer, Håkan, et al.
(författare)
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Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI) : II. Clinical evaluation
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:11, s. 2813-2819
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Tidskriftsartikel (refereegranskat)abstract
- In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm2/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm2 before and 69.1 Gy cm2 after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff.
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| 20. |
- Geijer, H, et al.
(författare)
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Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access
- 2004
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 14:9, s. 1674-1680
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate radiation dose and patient discomfort/pain in radial artery access vs femoral artery access in percutaneous coronary intervention (PCI). Dose-area product (DAP) was measured non-randomised for 114 procedures using femoral access and for 55 using radial access. The patients also responded to a questionnaire concerning discomfort and pain during and after the procedure. The mean DAP was 69.8 Gy cm2 using femoral access and 70.5 Gy cm2 using radial access. Separating the access site from confounding factors with a multiple regression, there was a 13% reduction in DAP when using radial access (p=0.038). Procedure times did not differ (p=0.81). Bed confinement was much longer in the femoral access group (448 vs 76 min, p=0.000). With femoral access, there was a significantly higher patient grading for chest (p=0.001) and back pain (p=0.003) during the procedure and for access site (p=0.000) and back pain (p=0.000) after the procedure. Thirty-two femoral access patients (28%) were given morphine-type analgesics in the post-procedure period compared to three radial access patients (5%, P=0.001). DAP does not increase when using radial instead of femoral access and the patients grade discomfort and pain much lower when using radial access. Radial access is thus beneficial to use.
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| 21. |
- Hannesson, P H, et al.
(författare)
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Transhepatic intravascular ultrasound for evaluation of portal venous involvement in patients with cancer of the pancreatic head region.
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:5, s. 1150-1154
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the ability of intravascular ultrasound to diagnose tumor involvement of the portal and the superior mesenteric veins using the preoperative percutaneous, transhepatic approach, and to compare the findings with those made at concomitant direct portography, surgery, and histopathological examination. Ten patients with a preoperative diagnosis of a resectable tumor in the pancreatic head region were examined with percutaneous transhepatic portography (PTP) and intravascular ultrasound (IVUS). The surgeon's intraoperative evaluation and the histopathological examination in combination revealed tumor involvement of the portal or superior mesenteric veins in six of the ten patients. Percutaneous transhepatic portography suggested tumor involvement of the veins in six patients but two of the examinations were false positive and another two were false negative. Intravascular ultrasound showed signs of tumor involvement in eight patients. The examination was, however, false positive in two patients, but there were no false negatives. Complications of the percutaneous transhepatic procedure occurred in six patients including severe pain, bleeding, and related death. Percutaneous transhepatic IVUS of the portal vein may be a useful tool in the preoperative selection of the subgroup of patients with tumor of the pancreatic head region that could benefit from surgery. There is a need for technical improvement as well as studies with larger patient series to definitely decide the role of the technique.
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| 22. |
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| 23. |
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| 24. |
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| 25. |
- Leander, Peter, et al.
(författare)
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A new liposomal liver-specific contrast agent for CT: first human phase-I clinical trial assessing efficacy and safety
- 2001
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 11:4, s. 698-704
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Tidskriftsartikel (refereegranskat)abstract
- In this first clinical trial liposome-encapsulated iodixanol, CT particles (CTP) were studied. The aims of the present trial were to assess the efficacy of CTP in CT and to determine the safety of different doses of CTP. A total of 47 healthy volunteers were enrolled in the present study. The CTP was administered at doses 10, 30, 70 and 100 mg encapsulated I/kg bw. Efficacy was assessed using single-slice CT of the abdomen and evaluated by dose-response attenuation curves over time in liver, spleen, and abdominal vessels. Safety was assessed by blood tests, clinical examinations and recording of subjective adverse events (AE). The attenuations in liver tissue increased with the dose and maximal values above baseline were 20, 39 and 45 HU at the doses 30, 70 and 100 mg encapsulated I/kg bw, respectively. Maximal increases were seen 12.5 min after contrast administration. As for liver, the attenuations in spleen increased with the dose, but higher attenuations were obtained. In early images clinically significant enhancement was seen in abdominal vessels. Mild and moderate subjective AE were encountered at the doses 70 and 100 mg encapsulated I/kg bw. The CTP is efficacious in enhancing hepatic and splenic tissues and in early imaging of abdominal vessels. Adverse event precludes a clinical use of CTP in the current formulation.
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| 26. |
- Leander, Peter, et al.
(författare)
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MR imaging following herniography in patients with unclear groin pain
- 2000
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 10:11, s. 1691-1696
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to assess if MRI gives the same diagnostic information as herniography concerning the presence of hernias and reveals other causes of groin pain. The prospective study enrolled 20 patients referred for herniography, 6 women and 14 men, mean age 48 years. After herniography the patients underwent MRI using T1-weighted, fat-suppressed inversion recovery (STIR), and magnetic resonance cholangiopancreaticography (MRCP) pulse sequences. No contrast medium was administered at MRI. Herniography revealed 11 hernias and MRI depicted 8 of these. Magnetic resonance imaging depicted well the anatomy in the groins. In 3 patients where hernias were not revealed, MRI revealed inflammatory changes in the symphysis region as a possible cause of groin pain. The primary diagnostic tool for diagnosing hernias is herniography. If the herniogram is normal, MRI may reveal other causes of groin pain and may also better visualize related structures in the groin.
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| 27. |
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| 28. |
- Perlet, C, et al.
(författare)
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Multicenter study for the evaluation of a dedicated biopsy device for MR-guided vacuum biopsy of the breast
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:6, s. 1463-1470
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this multicenter study was to determine the accuracy and clinical value of a dedicated breast biopsy system which allows for MR-guided vacuum biopsy (VB) of contrast-enhancing lesions. In five European centers, MR-guided 11-gauge VB was performed on 341 lesions. In 7 cases VB was unsuccessful. This was immediately realized on postinterventional images or direct follow-up combined with histopathology-imaging correlation; thus, a false-negative diagnosis was avoided. Histology of 334 successful biopsies yielded 84 (25%) malignancies, 17 (5%) atypical ductal hyperplasias, and 233 (70%) benign entities. Verification of malignant or borderline lesions included re-excision of the biopsy cavity. Benign histologic biopsy results were verified by retrospective correlation with the pre- and postinterventional MRI and by subsequent follow-up. Our results indicate that MR-guided VB, in combination with the dedicated biopsy coil, offers the possibility to accurately diagnose even very small lesions that can only be visualized or localized by MRI.
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| 29. |
- Persliden, Jan, et al.
(författare)
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Dose and image quality in the comparison of analogue and digital techniques in paediatric urology examinations.
- 2004
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 14:4, s. 638-644
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Tidskriftsartikel (refereegranskat)abstract
- In paediatric radiology it has been recognised that children have a higher risk of developing cancer from the irradiation than adults (two to three times); therefore, increased attention has been directed towards the dose to the patient. In this study the effect on patient dose and image quality in replacing the exposure in micturating cystourethrography (MCUG) examinations with the stored fluoroscopy image has been investigated. In the intravenous urography (IVU) examination we compared analogue and digital image quality, but the dose measurements were performed on a phantom. Standard clinical X-ray equipment was used. Sixty-eight patients in each of two centres were studied for the MCUG. Doses were measured with a dose-area product (DAP) meter and the image quality was scored. A non-parametric statistical analysis was performed. For the IVU, a phantom was used in the dose measurements but clinical images were scored in the comparison between analogue and digital images. For the MCUG, replacing the exposure with stored fluoroscopy images lowered the DAP value from 0.77 to 0.50 Gy cm2. The image quality did not show any difference between the techniques; however, if reflux was to be graded, exposure was needed. For the IVU, the doses could be lowered by a factor of 3 using digital techniques. The image quality showed no statistical difference between the two techniques. There is a potential for a substantial dose reduction in both MUCG and IVU examinations using digital techniques.
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| 30. |
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| 31. |
- Prat, X, et al.
(författare)
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European quadricentric evaluation of a breast MR biopsy and localization device: technical improvements based on phase-I evaluation
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:7, s. 1720-1727
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Tidskriftsartikel (refereegranskat)abstract
- Our purpose was to report about technical success, problems and solutions, as experienced in a first multicentre study on MR-guided localisation or vacuum biopsy of breast lesions. The study was carried out at four European sites using a dedicated prototype breast biopsy device. Experiences with 49 scheduled localisation procedures and 188 vacuum biopsies are reported. Apart from 35 dropped indications, one localisation procedure and 9 vacuum biopsies were not possible (3 times space problems due to obesity, 2 times too strong compression, 3 times impaired access froth medially, 2 times impaired access due to a metal bar). Problems due to too strong compression were recognised by repeat MR without compression. During the procedure problems leading to an uncertain result occurred in eight vacuum biopsies, two related to the procedure: one limited access, and one strong post-biopsy enhancement. Improvements after phase-I study concerned removal of the metal bar, development of an improved medial access, of a profile imitating the biopsy gun, optimisation of compression plates and improved software support. The partners agreed that the improvements answered all important technical problems.
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| 32. |
- Robertson, F, et al.
(författare)
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Radiology of the spleen
- 2001
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 11:1, s. 80-95
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Tidskriftsartikel (refereegranskat)abstract
- The spleen is generally not considered a challenge to the radiologist. Most often it poses a problem by anomalies or an irregular but normal contrast enhancement; however, a variety of inflammatory, infectious and neoplastic diseases may involve the spleen. CT and ultrasonography are screening modalities for the spleen. For problem solving, MR imaging can be helpful, especially due to its free choice of the imaging plane and because of the high resolution in contrast MR imaging. Splenic angiography as a diagnostic tool has generally been replaced by CT, ultrasound, or MR and is now used as an interventional method, e. g., in non-surgical management of patients with chronic idiopathic thrombocytopenia or in patients with splenic trauma. This article reviews the radiology of the spleen, including anatomy, embryology, splenomegaly, splenic injury, infarction, cysts, tumors, abscesses, sarcoidosis, and AIDS. Knowledge about the use of different imaging modalities and underlying gross and microscopic pathologic features leads to a better understanding of the radiologic findings.
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| 33. |
- Sandborg, Michael, 1961-, et al.
(författare)
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Evaluation of patient-absorbed doses during coronary angiography and intervention by femoral and radial artery access
- 2004
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 14:4, s. 653-658
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the radiation dose to patients during coronary angiography (CA) and coronary intervention (percutaneous transluminal coronary angioplasty, PTCA) by the femoral or radial artery access routes. A plane-parallel ionisation chamber, mounted on an under-couch X-ray tube (Siemens Coroskop TOP with an optional dose reduction system), recorded the dose-area product (DAP) to the patient from 40 coronary angiographies and 42 coronary interventions by the femoral route. The corresponding numbers for radial access were 36 and 24, respectively. Using a human-shaped phantom, conversion factors between maximum entrance surface dose and DAP were derived for CA and CA plus PTCA, respectively. The dose to the staff was measured with TL dosimeters for 22 examinations. Fluoroscopy time and DAP were significantly (p=0.003) larger using the radial access route for coronary angiography (7.5 min, 51 Gy cm2) than the corresponding values obtained from femoral access route (4.6 min, 38 Gy cm2. For CA plus PTCA the fluoroscopy time and DAP were larger for radial access (18.4 min, 75 Gy cm2) than for femoral access (12.5 min, 47 Gy cm2, p=0.013). In our experience, radial access did significantly prolong the fluoroscopy time and increase the patient doses.
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| 34. |
- Scharitzer, M, et al.
(författare)
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Morphological findings in dynamic swallowing studies of symptomatic patients
- 2002
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 12:5, s. 1139-1144
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to assess the role of videofluoroscopy in the detection of structural abnormalities of the pharynx and esophagus in patients with different symptoms of impaired deglutition. Dynamic radiographic recording of deglutition was performed in 3193 consecutive patients (1578 men, 1615 women; mean age 54 years) suffering from dysphagia, suspicion of aspiration, globus sensation, and non-cardiac chest pain. We assessed different structural lesions from the oral cavity to the esophagus and classified them into eight categories. Their frequency and association with the different clinical symptoms were evaluated. Videofluoroscopy revealed 1040 structural abnormalities in 833 patients (26%) including mass lesions from the oral cavity to hyoid/larynx (n=66), pharyngeal diverticula (n=181), pharyngeal masses (n=78), other pharyngeal narrowings (n=71), webs (n=98), masses (n=39), and other narrowings (n=73) of the upper esophageal sphincter, esophageal diverticula (n=80), esophageal webs, rings and strictures (n=194), and intrinsic and extrinsic esophageal lesions (n=160). There was a considerable variance of findings for different symptoms. In a large proportion of symptomatic patients videofluoroscopy detects morphological abnormalities along pharynx and esophagus often combined with functional disorders. This fact underlines the role of videofluoroscopy as a diagnostic test for function as well as morphology.
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| 35. |
- Smedby, Örjan, 1956-, et al.
(författare)
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Functional imaging of the thoracic outlet syndrome in an open MR scanner
- 2000
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Ingår i: European Radiology. - 0938-7994 .- 1432-1084. ; 10:4, s. 597-600
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Tidskriftsartikel (refereegranskat)abstract
- Symptoms due to thoracic outlet syndrome may present only in abduction, a position that cannot be investigated in conventional MR scanners. Therefore, this study was initiated to test MRI in an open magnet as a method for diagnosis of thoracic outlet syndrome. Ten volunteers and 7 patients with a clinical suspicion of thoracic outlet syndrome were investigated at 0.5 T in an open MR scanner. Sagittal 3D SPGR acquisitions were made in 0 and 90 degrees abduction. In the patients, a similar data set was also obtained in maximal abduction. To assess compression, the minimum distance between the first rib and the clavicle, measured in a sagittal plane, was determined. In the neutral position, no significant difference was found between patients and controls. In 90 degrees abduction, the patients had significantly smaller distance between rib and clavicle than the controls (14 vs 29 mm; p < 0.01). On coronal reformatted images, the compression of the brachial plexus could often be visualised in abduction. Functional MR examination seems to be a useful diagnostic tool in thoracic outlet syndrome. Examination in abduction, which is feasible in an open scanner, is essential for the diagnosis.
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| 36. |
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| 37. |
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| 38. |
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| 39. |
- Thorelius, Lars, 1956-
(författare)
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Contrast-enhanced ultrasound : beyond the liver.
- 2003
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 13, s. 91-108
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Tidskriftsartikel (refereegranskat)
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| 40. |
- Thorelius, Lars, 1956-
(författare)
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Contrast-enhanced ultrasound in trauma
- 2004
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Ingår i: European Radiology. - 0938-7994 .- 1432-1084. ; 14, suppl 8, s. 43-52
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Tidskriftsartikel (refereegranskat)
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Wikström, Johan, et al.
(författare)
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The importance of adjusting for differences in proximal and distal contrast bolus arrival times in contrast-enhanced iliac artery magnetic resonance angiography
- 2003
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Ingår i: European Radiology. - : Springer Science and Business Media LLC. - 0938-7994 .- 1432-1084. ; 13:5, s. 957-963
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Tidskriftsartikel (refereegranskat)abstract
- We tested the hypothesis that differences in proximal and distal contrast bolus arrival times may result in insufficient vascular signal in the distal part of the aortoiliofemoral territory with routinely used timing techniques. The difference in arrival time of the contrast medium bolus between the aorta and the common femoral arteries was measured in 14 patients undergoing magnetic resonance angiography of the aortoiliac arteries. A dual-station test bolus technique adjusting for this difference was evaluated. The variation coefficient of the signal intensity in six defined locations and signal intensities (SI) normalised to fat were calculated. Comparisons were made with findings in 13 patients examined with a fluoroscopically triggered timing technique (BolusTrak, Philips Medical Systems, Best, The Netherlands). The difference in bolus arrival time between proximal and distal vessels was 0-7 s. In 3 of 14 patients it was 5.6-7 s. There was a tendency towards a lower mean variation coefficient in the dual-station group ( p=0.10). With both techniques, significantly lower SIs were measured in the femoral arteries compared with SIs in the superior part of the abdominal aorta. In two cases in the BolusTrak group, a distal vessel could not be delineated but was shown to be patent on a delayed scan. Differences in contrast medium arrival time along the vessel may be large enough to preclude visualisation of distal vessels unless there is compensation. A dual-station test bolus technique taking this into account was found to be feasible.
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