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- Abul-Kasim, Kasim, et al.
(author)
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Neuroradiologi
- 2009
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Book (pop. science, debate, etc.)abstract
- Neuroradiologi är den första läroboken i sitt slag i Skandinavien och erbjuder en heltäckande inblick i diagnostiken av sjukdomar inom hjärna, rygg samt huvud- och halsregion med neuroanatomi och differentialdiagnostik, illustrerat med ett unikt bildmaterial. Bokens första tre delar innefattar 150, 80 respektive 80 diagnoser. De diagnoser som inte ryms i de första tre delarna hittar man i bokens fjärde del (Del IV, Neuroencyklopedi). I denna del finns en kort sammanfattad beskrivning av olika sällsynta diagnoser, syndrom och anatomiska begrepp. Del V och VI omfattar över hundra differentialdiagnoser med mycket detaljerad och deskriptiv neuroanatomi. Boken som innehåller 4 267 bilder är upplagd som en uppslagsbok, vilket underlättar för läsaren att hitta den sökta diagnosen. Under varje diagnosrubrik finns en kortfattad beskrivning av etiologi, patologi, klinik, behandling och prognos samt detaljerad beskrivning av de radiologiska fynden. Neuroradiologi är en lättläst lärobok i neuroradiologi. Just neuroradiologi utgör en mycket stor del av såväl den akuta som den planerade radiologiska verksamheten och är under snabb utveckling med kontinuerlig introduktion av nya metoder. Boken vänder sig i första hand till radiologer och neuroradiologer, inte minst de som är under utbildning. Flera andra kliniska specialister såsom neurologer, neurokirurger, ortopeder, öronläkare, allmänläkare kommer att ha gott stöd av boken. Övrig vårdpersonal kan ha stor nytta av boken som ett uppslagsverk.
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- Akeson, P, et al.
(author)
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MR imaging in recurrent pain after back surgery. A comparative study using standard and high doses of gadolinium contrast agents
- 1996
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In: Acta Radiologica. - 1600-0455. ; 37:6, s. 858-858
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Journal article (peer-reviewed)abstract
- PURPOSE: To compare the diagnostic results following injection of (a) a high dose (0.3 mmol/kg b.w.) of gadodiamide injection and (b) the standard dose (0.1 mmol/kg b.w.) of Gd-DTPA, in patients with recurrent symptoms after surgery for lumbar disc herniation. MATERIAL AND METHODS: Twenty patients with recurrent or sustained symptoms after surgery for lumbar disc herniations were examined. MR imaging (0.3 T) was first performed before and after Gd-DTPA at 0.1 mmol/kg b.w., and then within one month (17 patients) or within 3 months (3 patients) before and after gadodiamide injection at 0.3 mmol/kg b.w. The examinations were first evaluated by 2 neuroradiologists blinded to dose but not to patient as the images were presented in pairs. Six months later the same investigators evaluated the examinations again, this time blinded to both dose and patient. RESULTS: At the evaluation in pairs (with the investigators blinded to dose only) the high-dose examinations were considered the most informative (p=0.05). However, at the later evaluation (with the investigators blinded both to dose and patient) no significant difference between high and standard dose was found regarding diagnosis or diagnostic certainty. CONCLUSION: In this study the high-dose contrast enhancement of MR imaging at 0.3 T did not increase the diagnostic information for differentiating between scar and recurrent hernia. The high-dose images were considered more informative when evaluated in pairs, but gave no additional or different information when evaluated separately. The study also indicated that comparisons in pairs should be interpreted with caution.
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- Albeck, Michael J, et al.
(author)
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A controlled comparison of myelography, computed tomography, and magnetic resonance imaging in clinically suspected lumbar disc herniation
- 1995
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In: Spine. - 0362-2436. ; 20:4, s. 443-448
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Journal article (peer-reviewed)abstract
- STUDY DESIGN. A controlled prospective blinded study. OBJECTIVES. To compare the diagnostic power of myelography, computed tomography and magnetic resonance imaging in the diagnosis of low lumbar disc herniation. METHODS. Eighty patients with monoradicular sciatica were examined by myelography, computed tomography, and magnetic resonance imaging, and all underwent subsequent surgery. The images were evaluated twice in a blinded fashion, and the diagnostic power of the modalities was expressed by a decision-analytic regret function. RESULTS. In 57 patients (71%) a disc herniation at the expected level was disclosed at surgery. The largest amount of diagnostic information was gained from computed tomography, followed by magnetic resonance imaging and myelography. Both computed tomography and magnetic resonance imaging were significantly informative, whereas this was not the case for myelography. CONCLUSION. The results indicate that computed tomography or magnetic resonance imaging should be the first choice for imaging in patients with suspected lumbar disc herniation.
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- Albeck, M J, et al.
(author)
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Billeddiagnostik ved mistanke om lumbal diskusprolaps. En kontrolleret sammenligning af myelografi, CT og magnetisk resonans-billeddannelse
- 1996
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In: Ugeskrift for Læger. - 0041-5782. ; 158:10, s. 1362-1362
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Journal article (peer-reviewed)abstract
- Eighty patients with monoradicular sciatica were examined by myelography, computed tomography (CT) and magnetic resonance imaging (MRI) and all had subsequent surgery. The images were evaluated by a decision-analytic regret function. The largest amount of diagnostic information was gained from CT followed by MRI and myelography. Myelography was not significantly informative. The results suggest that CT or MRI should be the first choice examination in patients with suspected lumbar disc herniation.
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- Annertz, Mårten, et al.
(author)
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Isthmic lumbar spondylolisthesis with sciatica. MR imaging vs myelography
- 1990
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In: Acta Radiologica. - 1600-0455. ; 31:5, s. 449-453
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Journal article (peer-reviewed)abstract
- Seventeen patients with sciatica and isthmic lumbar spondylolisthesis were studied with magnetic resonance (MR) imaging. In 13, myelography was also performed: 5 had dural sac deformation and root sleeve shortening, 2 had deformation with unilateral root sleeve shortening, one had bilateral root sleeve shortening only, and one had sac deformation only. In 4, myelography was normal. On sagittal MR examinations the neural foramen had an altered shape bilaterally with the long axis horizontal in all cases. In addition to altered shape the following was found in the 33 foramina evaluated. I: normal nerve (n = 8); II: compressed nerve (n = 16); III: disappearance of fat, nerve not possible to identify (n = 9). In patients with unilateral sciatica, the degree of foraminal stenosis correlated well with the side of symptoms. Coronal views showed the course of the nerve and pedicular kinking. Eight patients underwent decompressive surgery which revealed nerve compression by hypertrophic fibrous tissue and pedicular kinking, which correlated well with the findings on MR. Since the site of nerve compression often was peripheral to the root sleeves, myelography did not give complete information.
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- Annertz, Mårten, et al.
(author)
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MR imaging as the primary modality for neuroradiologic evaluation of the lumbar spine. Effects on cost and number of examinations
- 1996
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In: Acta Radiologica. - 1600-0455. ; 37:3 Pt 1, s. 373-380
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Journal article (peer-reviewed)abstract
- PURPOSE: To evaluate the effects on cost, and number of primary and supplementary neuroradiologic examinations, after introducing MR imaging as the primary modality in the evaluation of the lumbar spine. MATERIAL AND METHODS: Two 5-month periods were compared: period 1--before MR; and period 2--after introduction of a 2nd MR device. In period 1, patients were examined with myelography and/or CT after referral from specialists only, whereas in period 2 both specialists and general practitioners could refer patients for MR imaging. The direct cost (neuroradiologic methods and hospitalization) and indirect cost (sick-leave and estimated loss of production caused by the diagnostic procedure) were estimated. RESULTS AND CONCLUSION: In period 1, investigations were started in 75 patients (62 myelographies and 13 CT examinations); in period 2, in 227 patients (198 MR, 21 CT, and 8 myelographies). The estimated total cost increased from SEK 825,000 to 1,265,000 (53%), the cost per investigated patient decreasing from 11,000 to 5565 (50%), and the cost of preoperative investigation per operated patient decreasing from 8616 to 5563 (35%). The number of supplementary examinations was unchanged.
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| 8. |
- Annertz, Mårten, et al.
(author)
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No relationship between epidural fibrosis and sciatica in the lumbar postdiscectomy syndrome. A study with contrast-enhanced magnetic resonance imaging in symptomatic and asymptomatic patients
- 1995
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In: Spine. - 0362-2436. ; 20:4, s. 449-453
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Journal article (peer-reviewed)abstract
- STUDY DESIGN. Symptomatic patients were retrospectively analyzed and compared with a control group from an ongoing prospective and consecutive study. OBJECTIVES. To determine the presence and extent of epidural fibrosis in patients with and without recurrent sciatic pain after previous lumbar discectomy, contrast-enhanced magnetic resonance images were evaluated and correlated with surgical findings in the symptomatic patients. Recurrent hernia and bony stenosis were ruled out as the probable causative agent, as well as any morphologic explanation other than fibrosis. SUMMARY OF BACKGROUND DATA. Repeat surgical results for patients with the lumbar postdiscectomy syndrome with epidural fibrosis alone are often unfavorable. The pathogenic role of epidural fibrosis, however, has not been established. METHODS. The magnetic resonance images of eight patients with recurrent or persistent sciatic pain after lumbar discectomy were compared with those of eight asymptomatic patients constituting a control group. All were examined with magnetic resonance imaging on a 0.3 T unit before and after intravenous injection of gadolinium-DTPA, and clinically, 6 months to 4 years after surgery. The symptomatic patients subsequently underwent reoperation. RESULTS. Fourteen patients had focal or diffuse epidural fibrosis around the nerve root and/or the thecal sac at the operated level, whereas the postoperative findings for two patients were "normal," one in the operated and one in the control group. No difference between the groups regarding mass effect or affection of the nerve roots or thecal sac was noted. At reoperation of the eight symptomatic patients, fibrosis was the only pathologic finding in all cases except one, in which surgery confirmed the normal finding on magnetic resonance imaging. Six of the eight operated patients had recurrent or persistent symptoms within a year of the reoperation. CONCLUSION. No differences regarding the presence and extent of epidural fibrosis between the symptomatic and asymptomatic patients could be demonstrated with contrast-enhanced magnetic resonance imaging. The role of epidural fibrosis as the causative agent in the lumbar postdiscectomy syndrome is questioned.
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| 9. |
- Annertz, Mårten, et al.
(author)
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Serial MRI in the early postoperative period after lumbar discectomy
- 1995
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In: Neuroradiology. - 1432-1920. ; 37:3, s. 177-182
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Journal article (peer-reviewed)abstract
- The aim of this study was to determine MRI findings in patients successfully operated upon for lumbar disc herniation. We investigated 20 patients with a successful outcome after L4-5 or L5-S1 disc operations clinically and with MRI preoperatively, and at 5 days, 6 weeks, and 4 months after surgery. Postoperatively, T1- and T2-weighted images were obtained. At 4 months gadolinium-enhanced images were added. Pronounced intraspinal MRI changes were seen during follow-up. Deformation of the dural sac was seen in 13 patients preoperatively, in 19 at 5 days after operation, in 15 at 6 weeks, and in 12 at 4 months. Nerve root involvement was seen in all cases both preoperatively and at 5 days after operation, in 17 at 6 weeks, and in 15 at 4 months. No correlation between symptoms or the straight leg raising test and the size or nature of the abnormal tissue in the spinal canal postoperatively could be demonstrated. It was concluded that early postoperative MRI after lumbar discectomy must be interpreted carefully, and that oedema and scar formation are probable reasons for difficulties in interpretation.
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