A comparison of conventional spin-echo and fast spin-echo in the detection of multiple sclerosis.

Fast spin-echo (FSE) pulse sequences enable T2-weighted imaging in a fraction of the time required for T2-weighted conventional spin-echo (CSE) imaging. Due to concerns that the altered contrast characteristics of FSE may interfere with the visualization of multiple sclerosis (MS) lesions, the sensitivity of T2-weighted FSE sequences was compared to comparably weighted CSE sequences in the imaging of the brain in 100 patients with clinically suspected MS. The proton-density FSE sequence revealed more MS lesions than its CSE counterpart, while the T2-weighted CSE sequences were found to be more sensitive than the T2-weighted FSE sequence. Contrast-to-noise ratios and signal-to-noise ratios compared favorably between sequences. Overall, there was little difference in the specificity between FSE and CSE in the diagnosis of MS. The higher sensitivity and the reduction in time attainable through the use of FSE warrants its replacement of CSE when imaging the brain in patients with clinically suspected MS. J. Magn. Reson. Imaging 2001;13:657-667.

Effect of hyoscine butylbromide on gastroesophageal reflux in barium studies of the upper gastrointestinal tract.

Hyoscine butylbromide (Buscopan) is an intravenously administered hypotonic agent that significantly reduces pressure in the lower esophageal sphincter and may therefore artificially induce gastroesophageal reflux during barium examination of the upper gastrointestinal tract. This study was performed to test this hypothesis. The presence or absence and severity of gastroesophageal reflux before and after intravenous injection of 20 mg Buscopan were evaluated in 112 consecutive patients undergoing biphasic upper gastrointestinal examination. Gastroesophageal reflux was seen in 49 (44%) of the patients. Reflux was evident both before and after the injection of Buscopan in 35 (31%) of the patients, before injection only in 10 (9%) and after injection only in 4 (4%). The magnitude of reflux after injection of Buscopan was reduced or the same in 108 of the patients (96%) and increased in 4 (4%). There was no significant difference in the overall occurrence (p = 0.41) or degree (p = 0.81) of gastroesophageal reflux before and after injection of Buscopan (chi 2 test). The authors conclude that the routine use of Buscopan is unlikely to spuriously increase the frequency or degree of gastroesophageal reflux observed on upper gastrointestinal barium studies.

Iliac artery aneurysms arising in patients having had resections of abdominal aneurysms.

We report the angiographic, computed tomographic, and ultrasonographic findings in two patients with iliac artery aneurysms detected several years after undergoing vascular graft surgery to the aorta. These lesions are often silent until serious complications occur, and they should be treated even when asymptomatic. Radiologists should be familiar with this complication so that it may be more readily diagnosed.