Subject(s)
Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Ischemia/diagnostic imaging , Ischemia/etiology , Mesenteric Arteries/diagnostic imaging , Aged , Diagnosis, Differential , Humans , Intestine, Small/diagnostic imaging , Male , Radiography , Torsion Abnormality/complications , Torsion Abnormality/diagnostic imagingABSTRACT
BACKGROUND: Hydrocolonic ultrasonography--abdominal ultrasonography in conjunction with the retrograde instillation of water into the colon--has been advocated as an alternative to colonoscopy for detecting colorectal polyps and cancer. We conducted a prospective, blinded trial to evaluate the procedure further. METHODS: Fifty-two consecutive patients (50 men and 2 women; average age, 62 years) who were referred for colonoscopy underwent hydrocolonic ultrasonography followed by colonoscopy. The physicians performing colonoscopy were blinded to the ultrasound results. Patients who had a history of colonic polyps or tumors or who had previously undergone flexible sigmoidoscopy or colonoscopy were excluded. RESULTS: Twenty-two patients had normal results on colonoscopy, 26 had polyps, 3 had cancer and polyps, and 1 had cancer alone. Twenty patients had polyps less than 7 mm in diameter, eight had polyps 7 mm or more in diameter, and one had a polyp of unknown size. Hydrocolonic ultrasonography did not detect any cancers and detected only one polyp > or = 7 mm and one polyp < 7 mm in diameter. The overall sensitivity of ultrasonography for identifying any polyp was 6.9 percent, and for identifying a polyp > or = 7 mm, it was 12.5 percent. Ultrasonography suggested the presence of five masses and five polyps that were not confirmed by colonoscopy. Six patients had incomplete ultrasound studies because of discomfort or the inability to retain water. There were two complications: one patient had two vasovagal episodes, and another had diaphoresis. CONCLUSIONS: Hydrocolonic ultrasonography was less useful than colonoscopy for detecting colorectal polyps and cancers. The usefulness of the technique in screening for colonic polyps and tumors appears to be limited.
Subject(s)
Colonic Neoplasms/diagnostic imaging , Colonic Polyps/diagnostic imaging , Ultrasonography, Interventional , Colonic Polyps/diagnosis , Colonic Polyps/surgery , Colonoscopy , False Positive Reactions , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
PURPOSE: To compare magnetic resonance angiography (MRA) with duplex Doppler ultrasound (US) and x-ray angiography (XRA) in the evaluation of the carotid bifurcation. METHODS: The carotid arteries of 61 patients were studied using MRA, US, or XRA; 31 of the patients underwent all three examinations. MRA included both 2D and 3D time-of-flight sequences. Internal and external carotid artery origins were graded normal, mild, moderate, severe, or critical stenosis, or complete occlusion by each of the three studies. RESULTS: Spearman rank correlations of both internal and external carotid artery grades were 0.85 (MRA and XRA), 0.69 (MRA and US), and 0.73 (XRA and US). For internal carotid artery origins only, the correlations were 0.94 (MRA and XRA), 0.85 (MRA and US), and 0.82 (XRA and US). Of discrepancies in internal carotid artery interpretation greater than one grade, seven resulted from US error, three from MRA error, and one from XRA error. A 2-cm partially thrombosed aneurysm detected by US and MRA was missed by XRA. Of 16 possible ulcers on XRA, 11 were noted by MRA, none by US. CONCLUSIONS: MRA and XRA are similar in assessment of carotid bifurcation stenosis. MRA, like US, permits direct visualization of plaque. This preliminary study suggests that MRA may be used to clarify equivocal findings of US, or replace XRA in presurgical planning.
Subject(s)
Carotid Stenosis/diagnosis , Aged , Aged, 80 and over , Angiography , Carotid Stenosis/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Ultrasonics , UltrasonographyABSTRACT
High resolution magnetic resonance imaging (MRI) of the brain was performed on 18 male schizophrenic patients and 15 male normal control subjects using an identical imaging protocol. The number and size of T2 hyperintense foci were clinically quantified by an academic radiologist. Large foci (greater than or equal to 3 mm in diameter) were observed more frequently on patient images (7/18) than on control images (1/15). The imaging protocol detected high rates of focal hyperintensities, but no differences between patients and controls were noted in the total affected brain area (sum of focal areas) or in the presence or absence of foci.
Subject(s)
Brain Damage, Chronic/diagnosis , Cerebral Cortex/pathology , Magnetic Resonance Imaging , Neurocognitive Disorders/diagnosis , Schizophrenia/diagnosis , Schizophrenic Psychology , Adult , Brain Damage, Chronic/psychology , Dyskinesia, Drug-Induced/diagnosis , Dyskinesia, Drug-Induced/psychology , Fatty Acids, Volatile , Humans , Male , Middle Aged , Neurocognitive Disorders/psychology , Neurologic Examination , Psychiatric Status Rating ScalesABSTRACT
Magnetic resonance imaging (MRI) of the brains of 32 patients who met the DSM-III criteria for obsessive-compulsive disorder and of 14 normal subjects frequently revealed abnormalities, but none was specific to obsessive-compulsive disorder. Spin-lattice relaxation time (T1) for right frontal white matter was prolonged in the patients compared to the control subjects, and the patients had greater right-minus-left T1 differences for frontal white matter. Right-minus-left T1 differences in the orbital frontal cortex were strongly correlated with symptom severity in the unmedicated patients and in the patients with family histories of obsessive-compulsive disorder.
Subject(s)
Brain/pathology , Magnetic Resonance Spectroscopy , Obsessive-Compulsive Disorder/diagnosis , Adult , Female , Frontal Lobe/pathology , Functional Laterality , Humans , Male , Middle Aged , Obsessive-Compulsive Disorder/genetics , Obsessive-Compulsive Disorder/pathology , Psychiatric Status Rating ScalesABSTRACT
Magnetic resonance imaging did not diagnose neuropathology in 15 autistic patients. Measurements of the midsagittal area and volume of the fourth ventricle did not differ between these patients and matched control subjects.
