MR imaging of the central pulmonary arterial tree in conotruncal malformation.

Successful MR imaging of the central pulmonary arterial tree was performed in four cases of conotruncal malformation and in one case of pulmonary arterial banding. Angiography performed near the time of MR imaging in three cases and 15 years earlier in two other cases did not visualize the central pulmonary arterial tree. Multiplanar imaging was necessary to fully visualize the anatomy of complex congenital defects of the pulmonary arterial tree; the choice of imaging plane varied depending on the portion of the pulmonary artery to be evaluated.

MRI of corpus callosal syndromes.

Six patients, 6 to 13 years old, with corpus callosal abnormalities diagnosed by electroencephalography or CT were studied with a 0.15 T MR imager to determine the effectiveness of MRI in evaluating midline anomalies. Spin-echo images in the coronal, axial, and sagittal planes were obtained in two patients with Aicardi's syndrome and partial agenesis of the corpus callosum, in one patient with Dandy-Walker syndrome, and in two patients with septooptic dysplasia. Inversion recovery and spin-echo images were obtained in one patient with lipoma of the corpus callosum. Partial agenesis of the corpus callosum was seen in septooptic dysplasia, an association that has not been reported previously in the radiologic literature. Direct sagittal and coronal MRI provided better anatomic visualization of the brain and ventricles than did reformatted CT. T1-weighted images are sufficient to diagnose and delineate the extent of midline cerebral abnormalities. The unique capability of direct sagittal imaging makes MRI the best procedure for evaluating corpus callosal and other midline abnormalities.

MRI of radiation injury to the brain.

Nine patients with a history of radiation of 2400-6000 rad (24-60 Gy) to the brain were examined by magnetic resonance imaging (MRI) and computed tomography (CT). MRI demonstrated abnormalities in the periventricular white matter in all patients. The abnormal periventricular signal was characterized by a long T2 and was demonstrated best on coronal spin-echo (SE) 1000/80 images. A characteristic scalloped appearance at the junction of the gray-white matter was seen on MR images of seven patients, and represented extensive white-matter damage involving the more peripheral arcuate fiber systems. This differs from transependymal absorption, which is seen best on SE 3000/80 images and has a smooth peripheral margin. Cranial CT demonstrated white-matter lucencies in six cases but generally failed to display the extent of white-matter injury demonstrated by MRI. MRI is uniquely suited to detect radiation injury to the brain because of its extreme sensitivity to white-matter edema.

Hyperbaric oxygen therapy for radiation myelitis.

Radiation therapy may damage healthy tissues adjacent to tumor. Hyperbaric oxygen therapy (HBO) is useful in treating soft tissue and osteoradionecrosis. In addition, HBO has been recommended to treat radiation-induced myelitis. We used radiation to induce a predictable myelitis in the spinal cords of rats who were randomized into treatment (HBO) and control groups 8 wk after irradiation. Serial neurologic examination showed no benefit or harm as a result of HBO. This small pilot study did not demonstrate any clinically significant benefit of HBO for radiation myelitis in rats.

MR evaluation of Chiari I malformations at 0.15 T.

Twelve patients with known or presumed Chiari I malformations and two with clinical diagnoses of multiple sclerosis were examined by magnetic resonance (MR) imaging. MR confirmed or established the diagnosis of Chiari I malformation in all 14 cases. The spin-echo technique with a short time to echo (TE = 40 msec) and a short time to recover (TR = 1000 msec) provided optimum imaging of tonsillar position, hydromyelia cavities, and cervicomedullary "kinking." Long TE (greater than 80 msec) and TR (greater than 2000 msec) increase the signal intensity of cerebrospinal fluid and may obscure the pathology. Sagittal, transaxial, and coronal images provided complementary data; sagittal and coronal views best imaged the abnormal spinal cord and tonsils, but slitlike cavities were best seen on transaxial images. Cervicomedullary kinking was found in 10 (71%) of 14 patients and in 90% of the hydromyelic patients. This high incidence suggests that in other radiologic techniques tonsillar herniation masks the kinking. Symptoms of the Chiari I malformation overlap those of demyelinating diseases and brain tumors. Our early experience suggests MR is the preferred noninvasive procedure for identifying Chiari I malformation. Moreover, the ability to portray the variable cavity morphology of hydromyelia directly offers the potential for improved shunt placement.

Chronic seizure disorders: contribution of MR imaging when CT is normal.

One hundred consecutive patients with complex partial seizures were studied by magnetic resonance (MR) imaging and computed tomography (CT). Thirty-four patients had seizures of more than 5 years' duration, yet neurologic examinations and previous pre- and postinfusion CT scans had been normal. MR imaging demonstrated surgical lesions of potentially therapeutic significance in four of these 34 patients. Two patients underwent surgery with removal of a thrombosed arteriovenous malformation and a glioma. Although CT has been found to detect structural abnormalities, its yield of therapeutically significant abnormalities has been low.

Results of nuclear magnetic resonance with cerebral glioma. Comparison with computed tomography.

Our experience using nuclear magnetic resonance (NMR) in eight patients with abnormalities on computed tomography (CT) scans suggesting glioma is reported. Three patients underwent biopsies. Two patients had grade II astrocytomas. Difficulty was encountered confirming the diagnosis of astrocytoma on frozen sections in one patient, and permanent sections were required for diagnosis in the other. The third patient to undergo biopsy had a grade III anaplastic mixed glioma. Biopsy of subsequent patients with probable gliomas was not done because of the risk of producing neurological deficit. The NMR images suggest that lower-grade astrocytomas are well circumscribed, whereas higher-grade gliomas affect adjacent association bundles by direct extension of tumor cells or vasogenic edema.

Alteration of gallium-67 distribution in tumor-bearing mice following treatment with methotrexate: concise communication.

The effect of methotrexate (MTX) treatment upon Ga-67 distribution was investigated. Tumor bearing mice were injected with Ga-67 citrate at varying time intervals following MTX treatment administered either as a single dose or in multiple doses. Altered Ga-67 distribution was observed following MTX therapy, the general pattern showing decreased levels in blood and increased uptake in bone. MTX therapy decreased Ga-67 uptake in liver, tumor, and muscle. The effects of MTX are related to the dose and time interval between the administrations of MTX and Ga-67. The serum of MTX-treated mice had lower unsaturated iron-binding capacities and higher levels of unbound Ga-67. Serum iron and iron binding in rats determined 20 hr after MTX therapy showed significantly higher levels of serum iron and lower levels of Ga-67 in blood, and the percent transferrin saturation was approximately 95%. These observations suggest that MTX inhibition of erythropoiesis elevates serum iron levels and decreases the availability of gallium-binding sites in serum, resulting in altered Ga-67 tissue distribution.

Ultrasonic enhancement of cancer radiotherapy.

Ultrasound treatment (1.5 W/cm2, 1.9 MHz, C.W.) for 15 minutes either before or after x irradiation reduced the TCD50 of sarcoma-180 by approximately 40% while similar ultrasound treatment for up to 30 minutes did not reduce the TCD50 of the C3HBA mammary adenocarcinoma. Water bath heating (44.5 degrees C for 15 minutes) after x irradiation reduced the TCD50 of both tumors. Ultrasound alone for up to 30 minutes had no effect on growth or cure rate of either tumor.

Influence of dose rate on carcinogenesis resulting from x-ray, 113In, and 198Au irradiation.

The potential hazards from internally administered radionuclides used in nuclear medicine are usually compared with one another and with diagnostic x-rays on the basis of the absorbed dose in rads, with no regard to the dose rate of the radiation. This study compared the carcinogenic potential of a dose of 250 rads delivered at different dose rates to rat livers by x-ray, 113mIn, and 198Au. The chemical carcinogen N-2-fluorenyldiacetamide was administered after irradiation to reduce the latent period and increase the number of radiogenic liver tumors. No significant difference in tumor incidence was observed among groups of animals treated with either 198Au, 113mIn, or x-irradiation.

Biological detection of reduction in dose at the surface of volume sources containing beta emitters.

Dosimetry theory related to volume sources containing uniformly distributed beta-emitting radionuclides predicts a rapid drop in dose at the outer surface to approximately one half of the maximum dose within the volume. The purpose of this study was to determine if this reduction in surface dose could be observed using a measurable biological endpoint. In this study rats were injected with radiocolloids of either 198Au, 113In-m or 99Tc-m, to produce liver irradiation from their decay, or their livers were treated with external X-irradiation. After irradiation, a portion of the liver was surgically removed to stimulate cell division in the liver remnant revealing radiation damage in the form of chromosomal aberrations. The percentages of dividing cells with bridges were scored in the outer edges (0.45 mm) of the tissue sections and were compared to levels obtained from the central portion of the liver lobe. No significant difference was observed with X-irradiation or from 99Tc-m irradiation. However, irradiation with 198-Au and 113In-m (which emit large numbers of energetic electrons) produced significantly fewer aberrations in the outer layer when compared to the central portion. These differences in the distribution of biological damage allowed us to detect the predicted dose reduction at the surface of volume sources containing beta emitters.