Hepatic lesions: detection with ferumoxide-enhanced T1-weighted MR imaging.

PURPOSE: To compare the use of ferumoxide-enhanced T1-weighted gradient-echo (GRE) MR imaging with that of spiral computed tomography during arterial portography (CTAP) and T2-weighted Turbo spin-echo (SE) MR imaging in detection of lesions and of segmental involvement in patients with liver metastases. MATERIALS AND METHODS: Twenty-two candidates for metastasectomy of the liver underwent spiral CTAP, ferumoxide-enhanced GRE MR imaging, and T2-weighted Turbo SE MR imaging. A total of 176 liver segments were evaluated (57 with and 119 without metastases). The reference standard was laparoscopic sonographic findings. Diagnostic performance of the imaging modalities was assessed for lesion detection and determination of segmental involvement. RESULTS: The sensitivity for lesion detection with spiral CTAP, ferumoxide-enhanced MR imaging, and T2-weighted MR imaging was 0.96, 0.83, and 0.71, respectively; for segmental analysis, the sensitivity was 0.96, 0.84, and 0.75, respectively, and the specificity was 0.80, 0.99, and 0.92, respectively. All comparisons between sensitivities and specificities were statistically significant (P < .05). CONCLUSION: Ferumoxide-enhanced T1-weighted GRE MR imaging is superior to T2-weighted SE MR imaging for preoperative detection of lesions and segmental involvement in patients with liver metastases.

Differentiation between portal-systemic encephalopathy and neurodegenerative disorders in patients with Wilson disease: H-1 MR spectroscopy.

PURPOSE: To investigate the extent to which neurodegeneration and metabolic changes caused by portosystemic shunting occur in Wilson disease. MATERIALS AND METHODS: Twenty-two adult patients with biochemically proved Wilson disease underwent magnetic resonance (MR) imaging, hydrogen-1 MR spectroscopy, neurologic and psychometric testing, and ultrasound evaluation of the liver. In addition, 13 age-matched adult control subjects underwent MR imaging and H-1 MR spectroscopy. For MR spectroscopy, the authors used a single-voxel technique with a repetition time of 2,000 msec and an echo time of 31 msec. The volume of interest included the right and left globi pallidus, which are the most common sites of lesions in Wilson disease. RESULTS: N-acetylaspartate-creatine and choline-creatine ratios were decreased in patients with Wilson disease versus control subjects (P < .001 for N-acetylaspartate-creatine ratio, P < .05 for choline-creatine ratio). Also, patients with Wilson disease and portosystemic shunting had lower myo-inositol-creatine ratios than did patients with Wilson disease and no portosystemic shunting (P < .05). CONCLUSION: Reductions in N-acetylaspartate indicate neuronal loss consistent with the neurodegenerative pattern associated with Wilson disease. In addition, H-1 MR spectroscopy shows metabolic abnormality in the brain, as decreased myoinositol, caused by portosystemic shunting.

Wilson disease: findings at MR imaging and CT of the brain with clinical correlation.

PURPOSE: To describe the spectrum of brain abnormalities in Wilson disease (hepatolenticular degeneration) as depicted at magnetic resonance (MR) imaging and computed tomography (CT) and to relate these findings to neurologic and hepatologic abnormalities. MATERIALS AND METHODS: Fifty patients with Wilson disease participated in the cross-sectional study: Patients underwent cerebral MR imaging (n = 49), CT (n = 44), abdominal duplex ultrasound (US) (n = 46), and neurologic examination (n = 50) within a week. Relative risk and the Fisher exact test were used for statistical analysis. RESULTS: Supratentorial and infratentorial abnormalities in the gray and white matter were found in the pyramidal and extrapyramidal system. In Wilson disease, an abnormal striatum depicted on MR images correlated with pseudoparkinsonian signs, an abnormal dentatothalamic tract correlated with cerebellar signs, and an abnormal pontocerebellar tract correlated with pseudoparkinsonian signs. The presence of portosystemic shunt was strongly associated with abnormality of the globus pallidus. CONCLUSION: MR imaging findings were of some use in the clinical treatment of patients with Wilson disease.

Cranial MR in Wilson disease: abnormal white matter in extrapyramidal and pyramidal tracts.

PURPOSE: To describe abnormal white matter in the brain on MR in Wilson disease and to compare with anatomic location of white matter tracts. METHODS: Forty-six patients with Wilson disease were examined. Axial T1-weighted inversion-recovery, axial T2-weighted spin-echo, and coronal T2*-weighted gradient-echo MR images were performed. Imaging studies were compared with clinical data. RESULTS: Seventeen patients showed abnormalities in the region coinciding with the following white matter tracts: corticospinal tract (24%, n = 11), dentatorubrothalamic tract (24%, n = 11), and pontocerebellar tract (17%, n = 8). CONCLUSION: Abnormal extrapyramidal and pyramidal white matter tracts are part of the neuroimaging spectrum of Wilson disease. No significant correlation was found with neurologic groups and individual white matter tracts affected.

Nodular form of intra-abdominal panniculitis: sonographic features.

Sonography of a patient with acute upper abdominal pain demonstrated an encapsulated hyperechoic mass which indented the stomach. Fine-needle biopsy produced atypical cells; the diagnosis of nodular intra-abdominal panniculitis was made at surgery. Sonography probably has a role in the detection and follow-up of this benign lesion.

The effects of nasal drops and their additives on human nasal mucociliary clearance.

A method for measurement of nasal mucociliary clearance in vivo is described. A drop, containing saccharine sodium and indigo carmine is placed on the edge of the ciliary epithelium in the entrance to the nose. The time between placement and the sensing of the sweet taste as well as the appearance of a blue line in the nasopharyngeal cavity is measured and called the transport time. Two preservatives, two nasal drops and one viscosity-increasing substance have been investigated and the results are compared with their effects on the ciliary beat frequency of chicken embryo tracheas in vitro. The more the transport time is increased by a compound the more the ciliary beat frequency is decreased. Chlorbutol 0.5% increases transport time more and decreases ciliary beat frequency more than benzalkonium chloride 0.006% + EDTA 0.1%. Otrivin 0.1% increases transport time more and decreases ciliary beat frequency more than Rhinoguttae xylometazolini 0.1% (F.N.A.). These results support those obtained with the photo-electric registration device applicated on chicken embryo tracheas and human adenoids as described in earlier publications.