Fast method for longitudinal relaxation time and water content mapping of the human brain on a clinical MR scanner.

BACKGROUND: Longitudinal relaxation time (T(1)) map generation from human brain slices renders possible the in vivo follow-up of the changes in T(1) values during the course of several pathologies such as stroke, multiple sclerosis, traumatic brain injury etc. T(1) values can be converted to water contents, thus brain oedema reducing therapy can be non-invasively evaluated. The purpose of the study was to work out a fast and simple MRI method to obtain T(1) and water maps of the human brain. METHOD: The T(1) values of Gadolinium solutions with different concentrations were determined by means of MRI methods at a clinical MR scanner operating at 1 Tesla. In order to validate these measurements, T(1) values of the same Gadolinium solutions were also quantified with a relaxometer operating at the same field strength. T(1) and water maps from the brains of healthy volunteers were obtained with an inversion prepared spoiled gradient echo sequence (turbo-FLASH). FINDINGS: The T(1) values of Gadolinium solutions measured with the relaxometer showed a strong correlation (r > 0.999) with those determined with MRI sequences on the whole body scanner. The fastest MRI method to produce T(1) and consequent water maps from human brain was the inversion prepared turbo-FLASH sequence. CONCLUSIONS: The implemented turbo-FLASH method can produce T(1) and water map of a single virtual brain slice within 2 minutes. However, brain tissue containing haemorrhage should be excluded from the measurement due to the large influence of excessive haemoglobin concentration on longitudinal relaxation. The proposed method is available on most of the MR scanners, thus T(1) and water mapping of human brain can be routinely performed.

Occurrence of osteopenia among adolescent girls with oligo/amenorrhea.

The occurrence of reduced bone mineral density (BMD) among adolescent girls with oligomenorrhea or secondary amenorrhea, due to 'pure' dysfunction of the hypothalamo-pituitary-ovarian (HPO) axis (without anorexia nervosa, excessive sport or ballet, slimming diet, etc.) was examined. The study group consisted of 19 adolescent girls (age 16-18 years) with oligo/amenorrhea. Clinical (height, weight, age at menarche, duration of amenorrhea, body mass index (BMI)), hormonal (follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, prolactin), and ion (calcium, sodium, potassium, phosphate, chloride) parameters and the BMD of the lumbar spine were investigated. Correlations between BMD and other parameters were also examined. Twenty healthy volunteers (same age and regular cycles) served as controls. Three girls had osteoporosis, with a BMD below -2 standard deviations (SD). Ten showed osteopenia, with a BMD value between -1 and -2 SD. Only six of the study group had a normal BMD within +/- 1 SD. A positive correlation was observed between the BMD and the BMI (r = 0.73; p < 0.05). All the controls had normal hormonal, ion and BMD parameters. 'Pure' dysfunction of the HPO axis in adolescents, causing oligomenorrhea or secondary amenorrhea, might result in reduced BMD and, consequently, lower peak bone mass. Treatment of menstrual cycle disorders is necessary for the prevention of osteoporosis.

[Lower bone density (osteopenia) in adolescent girls with oligomenorrhea and secondary amenorrhea]. / Alacsonyabb csontsürüség (osteopenia) raromenorrhoeás és szekunder amenorrhoeás serdülö lányok körében.

Occurrence of reduced BMD among adolescent girls and young women due to certain specific oligomenorrhea or amenorrhea (anorexia nervosa, excessive sport or ballet, etc.) is well known. However the prevalence of osteopenia among 16-18 years old girls with the cycle disorders mentioned above--caused by "pure" hypothalamo-pituitary-ovarian insufficiency--is not yet sufficiently examined. The hormonal (FSH, LH, prolactin, LH/FSH, estradiol. testosterone, progesterone) and ion (Ca++,PO4(3-),Na+,K+,Cl-) parameters and the bone mineral density (BMD) of the lumbar spine of 19 girls age 16-18 with oligomenorrhea or secondary amenorrhea, due to hypothalamo-pituitary-ovarian axis insufficiency were investigated, and correlation were searched for among them. In 3 of the case significant BMD reduction was found with a value lower than the -2 SD. compared to the age, sex and race matched control values, showing definite osteoporosis. The BMD of 10 girls was between the -2.SD. and -1 SD.: they had osteopenia. Only 6 of them had normal BMD ranging from the -1 SD. to the +1 SD. Neither the ion or hormonal values, nor the clinical parameters (height, weight age, age at menarche, duration of amenorrheic period) showed correlation with the BMD values, except of the body mass index (BMI), which showed a loose positive linear correlation. The measured low BMD values have a significance, referring to a possible reduction in the peak BMD. Patients having low peak BMD have an inclination for earlier, and more sever osteoporosis and fractures in the climacteric decades. These results emphasize the need of effective and early treatment of adolescent bleeding disorders from the point of view of prevention of osteoporosis as well.

[The role of computerized tomography in the staging of lung cancer]. / A komputertomográfia helye a tüdódaganatok stádiumba sorolásánál.

Staging of lung cancer place significant role in the prognosis and treatment of the disease. Beside bronchoscopy, CT one of the important method for the tumor staging. 135 CT examinations with diagnosis of suspected lung cancer were evaluated and radiologic diagnosis was compared with the cyto-histological and surgical results. In 112 cases both CT and histological diagnosis were performed: both method revealed malignant tumors in 108 cases. Five lesions were regarded as tumour by CT but histological result proved aspergilloma, or specific processes. Abnormal lymph nodes were recognised at 98 tumours patients. There was a good correlation-regarding the number, size measurement-between CT and surgery. Histological diagnosis proved that all of the lymph nodes larger, then 2 cm of diameter contained metastic cells. In the 1-2 cm size almost all of the lymph nodes were metastatic. In addition tumour cells were found in some lymph nodes smaller, than 1 cm, too. This gives warning sign: smaller lymph nodes need more attention than we assumed. CT prove to be confident method for the evaluation, measurement and localisation of the tumours and lymph nodes in the chest.

[Sedation and sleep induction instead of anesthesia in infants and young children during CT and MRI examinations]. / Narkózis nélküli nyugtatás és altatás csecsemök és kisgyermekek CT és MR vizsgálatakor.

The authors recommend a simple, safe method to the CT and MR examinations of babies and young children instead of general anaesthesia. They performed 51 examinations (CT: 23, MRI: 28 cases, skul: 36, spine: 3, hip: 2, chest: 1, abdomen: 9) with this method and give an account of favourable results.

[First experiences with intraperitoneal chemotherapy]. / Elsö tapasztalataink intraperitonealis chemotherapiával.

Four patients suffering from malignant ascites were treated with the following method: peritoneal lavage and consequent injection of Mitomycin-C (20 mg/body surface m2) was performed for six hours via a catheter put into the peritoneal cavity according to Seldinger's method. One patient died three weeks later because of involvement of other organs by the disease. The other patients have been followed-up ever since for 7, 4 and 3 months now. In their case there was no need for repeated intraperitoneal chemotherapy. There were no side-effects nor complications detected.

[Experiences with the use of ioxithalamate (Telebrix)]. / Erfahrungen mit der Anwendung des Ioxitalamat (Telebrix).

The effects of Ioxitalamate/Telebrix-BYK GULDEN were tested for excretion urography and various angiographic applications and in animal experiments (selective renal angiography in 36 dogs). The contrast medium was well tolerated and the radiographs were of good quality. Significant effects were not detected, neither in blood pressure, heart rate and ECG, nor in Se-creatinine, nor in UN-, SGOT and Se-bilirubin values. In 4 cases transient proteinuria was observed. In the kidneys of the dogs no mentionable effects, histological or ultrastructural, were found. The use of Ioxitalamate seems advisable for investigations that require contrast media with low osmotic pressure.

[Significance of low osmolarity contrast media in state of the art roentgen diagnosis]. / Alacsony ozmotikus nyomású kontrasztanyagok jelentösége a korszerü röntgendiagnosztikában.

The authors used low-osmolality contrast material intravascularly in 546 patients, in 371 cases ioxaglate, in 80 patients iopamidol and in 95 iohexol. On each occasion good detail-rich pictures were obtained. Sensation of heat was indicated only by 1 patient (iopamidol), pain by 7 patients (ioxaglate 4, iohexol 2, iopamidol 1). The blood pressure, pulse rate and the UN, SGOT and SeBiru values showed no significant changes. The experiments were carried out on 101 dog kidneys. Selective renal angiography was done with the aforementioned materials and compared with the conventional, high-osmolality materials (iodamide, metrizoate). The histological changes were only slight, of small extent, and reversible when the new materials were used. Use of the new, low-osmolality contrast materials is justified whenever they must be given intravascularly, but it is imperative in the examination of children, patients of high risk groups and sensitive organs (nervous system, kidney, coronary vessels).

Experience with low osmolar contrast media a clinical and experimental study.

Low-osmolar contrast media were used in 546 patients: 371 with ioxaglate, 80 with iopamidol, 95 with iohexol. The image quality was good in all cases. Heat was observed in one patient (iopamidol) and pain was observed in 7 patients (ioxaglate: 4, iopamidol: 1, iohexol: 2). Blood pressure, heart rate as well as the parameters, BUN, SGOT and serum bilirubin showed no significant changes. Our experimental investigations were performed on 101 dog kidneys. Selective renal angiography was performed with 10 ml of contrast media metrizamide, ioxaglate, iopamidol, or iohexol. Comparative preparations were the high-osmolar contrast media iodamide and metrizoate. Untreated kidneys and kidneys given saline constituted baseline controls. Histological examination of tissues 3 and 24 hours after the injections showed moderate reversible changes (metrizamide 15/21, ioxaglate 5/17, iopamidol 2/18, iohexol 2/26). Electronmicroscopy (6 iohexol) showed no significant changes.

Transcatheter embolization for the control of posttraumatic hemobilia.

Angiography is the definitive diagnostic procedure for the patient with haemobilia. As well as giving precise localisation of the source of the haemorrhage, it provides an effective alternative to surgery for its control. In a case discussed, the bleeding sites were identified by angiography, and the bleeding was controlled by transcatheter embolisation.

[Value of angiography in hemangiopericytomas]. / Wert der Angiographie bei Hämangioperizytomen.

Haemangiopericytoma is a rare type of tumour which mostly develops in the soft parts. The article reports on the manifestations of one tumour each in the thigh and pelvis. The angiogram shows displacement of the major arteries, the tumour-supplying vessels penetrate into the growth by means of one or several peduncles, and intensive coloration takes place during the parenchyma phase. However, the "typical angiographic image" was seen in one of the two cases only.