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  • Magnetic resonance imaging
  • 2000-2004  (158)
  • 1990-1994  (493)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 33 (1990), S. 974-976 
    ISSN: 1530-0358
    Keywords: Constipation ; Defecography ; Magnetic resonance imaging ; Anterior ectopic anus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 25-year-old nulliparous woman with adult onset constipation and slight anterior displacement of the anus underwent pelvic magnetic resonance imaging and was diagnosed with congenital hemiabsence of the levator ani sling. Impaired defecation was confirmed by anorectal function studies and defecography demonstrated an anterior rectocele, perineal descent at the upper limit of normal, and partial obstruction of defecation, which appeared related to the levator sling abnormality. To our knowledge, this combination of findings has not been previously described as a cause of adult onset constipation.
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  • 2
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Preoperative staging ; Endoluminal ultrasound ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to compare the value of endoluminal ultrasonography (ELUS) with magnetic resonance imaging (MRI) for preoperative staging of rectal carcinoma. METHODS: Thirty-seven consecutive patients were examined by ELUS and MRI. Imaging results were compared with pathohistologic studies. A tumor extending beyond the bowel wall was considered to be “positive” and one within the bowel wall was considered “negative.” Lymph node involvement was considered present if nodes equal to or greater than 5 mm in diameter were found in the perirectal tissue. For evaluating the differences between the two methods, the Mc Nemar test was performed. RESULTS: T-Staging was correct in 88.2 percent (30/34) of patients by ELUS and in 82.3 percent (28/34) by MRI (difference not significant). N-Staging was correct in 80 percent (20/25) by ELUS and in 60 percent (15/25) by MRI (difference of borderline significance). A comprehensive preoperative staging (T + N) was made correctly in 68 percent (17/25) by ELUS and in 48 percent only (12/25) by MRI (difference not significant). CONCLUSIONS: We suggest that ELUS and MRI must be evaluated within the framework of established parameters when treatment modalities such as preoperative radiation therapy and local or radical surgical approach must be decided.
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  • 3
    ISSN: 1530-0358
    Keywords: Anterior rectocele ; Defecography ; Magnetic resonance imaging ; Clinical assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to devise a measuring method for an anterior rectocele on standardized defecographies and magnetic resonance images (MRI) to quantify anterior rectocele and to test whether this could substantiate clinical decision making for operative treatment for anterior rectocele. METHODS: Quantitative analysis by the measuring method as proposed was compared with qualitative scores on defecographies and MRI from the same patients. Thirty-eight patients with symptoms compatible with an anterior rectocele were subjected to physical examination in the left decubitis position and supine position and to defecography. Findings on defecography were compared with findings on physical examination. Thirteen patients were examined before and after surgical correction of the anterior rectocele for a total of 51 qualitative and quantitative examinations. The group of operated patients was analyzed for treatment results. Nineteen controls were included. RESULTS: Sixtysix radiographs of 33 defecographies were qualified in three grading classes and quantified with the proposed method by two observers. The mean measured value of the anterior rectocele in the three subjective grading classes is significantly different (P 〈 0.001). Anterior rectoceles qualified as severe had a measured value of 20 mm or more in 96 percent of the radiographs. Lower gradings were never 〉20 mm. On MRI severe anterior rectoceles were not scored and measured values did not correlate with qualitative scores. When findings on physical examination were compared with defecographic measurement, the coefficient of correlation (r)between the radiologic assessment and clinical examination in the left decubitis position is r = 0.87, for the examination in the supine position,r = 0.77. All 15 cases scored as severe anterior rectocele in the left decubitis position had a measured anterior rectocele of ≥20 mm. In the 13 cases that received surgery, there was a significant reduction of the anterior rectocele (P 〈 0.001) and clinical improvement. Patients with small or moderate anterior rectocele on physical examination with a size ≥20 mm on defecography were cured by surgical correction. None of the controls had an anterior rectocele on physical examination or an anterior rectocele ≥20 mm on defecography. CONCLUSIONS: An anterior rectocele with a size of 20 mm or more corresponds with a qualitative score of “severe” on Radiographic defecography. Physical examination for anterior rectocele in the left decubitis position corresponds best with quantitative Radiographic assessment and anterior rectocele with a size ≥20 mm on defecography is pathologic. Patients with complaints compatible with anterior rectocele can be assessed in objective and quantitative terms by radiography and can be successfully surgically treated, even if at physical examination the anterior rectocele is not classified as large, provided that dynamic defecography shows an anterior rectocele of ≥20 mm. The potential of dynamic MRI with regard to anterior rectoceles presently seems absent.
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  • 4
    ISSN: 1530-0358
    Keywords: Magnetic resonance imaging ; Fistula-in-ano
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Successful management of anal fistulas depends upon accurate assessment of the primary tract and any secondary extensions. Preoperative imaging has, to date, been disappointing. METHODS: A prospective study of 35 patients with a clinical diagnosis of fistula-in-ano was performed comparing magnetic resonance imaging with the independently documented operative findings. Magnetic resonance imaging was also compared with anal endosonography in 20 patients. RESULTS: Magnetic resonance imaging is accurate and demonstrates pathology missed at surgery by experienced coloproctologists. Magnetic resonance imaging is superior to anal endosonography. CONCLUSIONS: Magnetic resonance imaging is advocated as the method of choice when imaging is required for anal fistulas.
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 37 (1994), S. 777-781 
    ISSN: 1530-0358
    Keywords: Anal ultrasound ; Magnetic resonance imaging ; Internal anal sphincter ; External anal sphincter
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: A recent application of endosonography in the evaluation of anal sphincter morphology has led to controversy about the possibility of precisely assessing the diameter of external and internal anal sphincter muscles. On the other hand, magnetic resonance imaging (MRI) has been proposed to allow a more detailed view of the anatomy of the pelvic floor. However, both techniques have not yet been compared directly. METHODS: Eight healthy volunteers (age range, 25–40 years; 5∶3, male∶female) participated. Anal ultrasound was performed using a 7.5-MHz rectal transducer which produced a transversal panorama display of 360, allowing an image perpendicular to the anal canal. Imaging of the diameter of the internal and external anal sphincter muscles was performed with the transducer placed in the midanal canal, and measurement was always performed by the same investigator in dorsal projection. MRI was performed using a 1.5 Tesla Magnetom (Siemens, Erlangen, Germany) to obtain sagittal and angled axial (perpendicular to the anal canal) planes for consecutive 3-mm slices which were evaluated by four independent raters. RESULTS: Muscle thickness of the sphincter muscles in dorsal projection was 1.96±0.61 mm for the internal sphincter and 6.35±1.07 mm for the external sphincter using ultrasound. It was 1.72±0.13 mm and 3.99±0.99 mm, respectively, using MRI. When both measures were compared, only the internal sphincter data correlated significantly (r=0.818,P=0.0023) between both measures. Sagittal resonance imaging of the anal canal did not allow for differentiation of both muscles at all. Differentiation among mucosa, submucosa, and internal anal sphincter is not possible with MRI but may well be performed with high-resolution ultrasound. CONCLUSION: Anal ultrasound carries the potential of becoming a routine clinical procedure for evaluation of the anal anatomy and morphology in defecation disorders, but current MRI assessment of the anal anatomy is elaborate, costly, and does not provide any further insights.
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  • 6
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Staging ; Transrectal ultrasound ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The efficiency of magnetic resonance imaging (MRI) and that of transrectal ultrasound (TRUS) were compared in preoperative staging of 15 patients with rectal cancer and in postoperative follow-up of 12 patients. Thirteen of the 15 patients evaluated for preoperative staging were operated on. Preoperative staging and pathologic finding were identical in 11 patients (84.6 percent) examined by TRUS and in 10 patients (76.9 percent) examined by MRI. Recurrent cancer was detected in 3 of 12 patients in the follow-up group. MRI was able to diagnose correctly 10 of 12 patients (83.2 percent), one patient was misdiagnosed, and in one patient the MRI could not distinguish between fibrous tissue and recurrent cancer. TRUS diagnosed correctly only 5 of 12 patients (41.6 percent). One was falsely diagnosed, and, in 6 patients (50 percent), this examination could not differentiate between fibrous tissue and recurrent tumor. According to our results, both MRI and TRUS have a place in the preoperative staging of patients with rectal cancer. The main differences between the two methods were in the differential diagnoses of fibrous tissue and recurrent cancer. MRI being more specific in detection of recurrence.
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  • 7
    ISSN: 1436-2813
    Keywords: Key words Lung lobectomy ; Magnetic resonance imaging ; Left ventricular geometry ; Mediastinum ; Diaphragm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The thoracic cage after a lung resection is filled by the remaining lobes, the elevated diaphragm, the diminished thoracic cage, and by mediastinal shifting. The changes in the thorax after a lung resection were quantified using magnetic resonance imaging. The study group consisted of 39 patients who had undergone a lobectomy, four who had undergone a pneumonectomy, and 14 controls. The left ventricular angle, ascending aortic angle, mediastinal shift, longitudinal length of the thoracic cage, the distance between the thoracic apex and the level of the aortic valve, and diaphragmatic elevation were all measured. After a right lower lobectomy, the mediastinum shifted more rightward than after a right upper lobectomy. The diaphragm became more greatly elevated after a right upper lobectomy than after a right lower lobectomy. When a chest wall resection was added to a right upper lobectomy, the mediastinal anatomical changes decreased. After a left upper lobectomy, the degree of mediastinal shifting was greater than after a left lower lobectomy. A left upper lobectomy shifted the mediastinum at the level of the right atrium. This method is easily reproducible and was found to be effective for quantifying the changes in the thorax after a lung resection.
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Mund-, Kiefer- und Gesichtschirurgie 4 (2000), S. S270 
    ISSN: 1434-3940
    Keywords: Schlüsselwörter ; Röntgendiagnostik ; Panoramaschichtaufnahme ; Strahlenexposition ; Computertomographie ; Kernspintomographie ; Key words ; X-ray diagnostics ; Panoramic X-ray ; Radiation exposure ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A vital X-ray imaging technique in oral and craniomaxillofacial surgery is the panoramic X-ray. Due to its variety of special projections, including imaging of the transversal level and low exposure to radiation, it is suitable for answering many clinical questions and for diagnostics of various findings. It has become possible to minimize the necessary doses by further development of technology and devices, as well as of X-ray films and by new detection systems, such as sensors or screens. In some clinical cases, the diagnostic deficiencies of conventional imaging techniques make computed tomography (CT) and magnetic resonance (MR) imaging indispensable. Although MR is particularly suitable for soft tissue imaging, it has also become helpful in finding cortical changes by shorter measuring times. In certain cases, e. g., changes to bone metabolism, differentiated methods of nuclear medicine make image-aided analysis of function possible.
    Notes: Zusammenfassung Zentrale Aufnahmeart in der Röntgendiagnostik der Mund-, Kiefer- und Gesichtschirurgie ist die Panoramaschichtaufnahme. Mit ihren zahlreichen Spezialprojektionen einschließlich der Abbildung der Transversalebene ist sie für die Abklärung zahlreicher Fragestellungen mit geringer Strahlenexposition geeignet. Die Verringerung des Dosisbedarfs ist weiterhin durch Fortentwicklungen der Gerätetechnik, der Röntgenfilme und durch neue Detektionssysteme wie z. B. Sensoren oder Speicherfolien möglich geworden. Diagnostische Unzulänglichkeiten der konventionellen Aufnahmearten machen bei zahlreichen klinischen Fragestellungen der Mund-, Kiefer- und Gesichtschirurgie eine Bildgebung mittels Computertomographie und Kernspintomographie unumgänglich. Obgleich die Kernspintomographie v. a. für die Weichteildiagnostik vorrangig geeignet ist, erlaubt sie mittlerweile, aufgrund der Verkürzung der Messzeiten, auch Veränderungen der Kortikalis abzubilden. Bei bestimmten Fragestellungen, wie z. B. Veränderungen des Knochenmetabolismus, ermöglichen differenzierte nuklearmedizinische Verfahren eine abbildungsunterstützte Funktionsanalyse.
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 14 (1992), S. 159-167 
    ISSN: 1279-8517
    Keywords: Magnetic resonance imaging ; Liver ; Topographic anatomy ; Oblique sections
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les auteurs poursuivent une étude anatomique du foie appliquée à l'IRM, basée sur la confrontation de coupes cadavériques et de coupes en résonance magnétique. Cette étude concerne ici les coupes obliques par rapport à un plan sagittal ou frontal dont l'orientation est déterminée suivant des repères visibles sur les coupes transversales. Des coupes obliques ont été effectuées sur 10 cadavres, selon une méthode originale. Des coupes transversales jointives du tronc en congélation ont d'abord été réalisées et deux repères ont été reconnus sur ces coupes: la direction de la veine hépatique moyenne et l'orientation de la division du tronc de la veine porte. Les coupes transversales ont été ensuite empilées. Le bloc, ainsi reconstitué, a été à nouveau congelé puis débité en coupes obliques jointives, orientées soit selon le plan de la veine hépatique moyenne (coupes sagittales-obliques) soit selon le plan de la division du tronc de la veine porte (coupes frontalesobliques). Des coupes obliques en résonance magnétique ont été effectuées chez 15 volontaires sains, en général selon les mêmes repères veineux et parfois selon d'autres repères visibles sur les coupes transversales. Les coupes obliques en résonance magnétique peuvent être réalisées dans le plan de n'importe quel élément anatomique repéré sur les coupes transversales, pour préciser sa disposition. Les coupes basées sur des repères identiques mais orientés différemment d'un sujet à l'autre, doivent permettre de reconnaître l'anatomie individuelle du foie exploré. Les coupes frontales-obliques montrent bien l'orientation du tronc de la veine porte et les confluents des veines hépatiques avec la veine cave. Les coupes sagittales-obliques sont surtout intéressantes pour explorer la partie la moins épaisse du foie gauche et sans doute le lobe caudé. En outre, les coupes obliques font découvrir sous des aspects inhabituels certains viscères voisins du foie, en particulier le pancréas. Grâce aux coupes obliques, le trajet des veines qui participent à la formation du tronc de la veine porte peut être suivi à distance du foie. Les nouvelles techniques d'IRM, en réduisant considérablement certains artéfacts propres à l'exploration de l'abdomen, devraient permettre de tirer le meilleur parti possible des coupes obliques.
    Notes: Summary The authors have appplied magnetic resonance imaging (MRI) to the anatomic study of the liver by comparing cadaveric sections with those obtained with MRI. This study deals with sections oblique in relation to a sagittal or frontal plane, whose orientation is determined from landmarks visible on transverse sections. Oblique sections were made in 10 cadavers using an original method. First, adjacent transverse sections were made of the frozen trunk and two landmarks were located in these sections: the course of the middle hepatic v. and the direction of the division of the portal venous trunk. The transverse sections were then stacked and the block so reconstituted was refrozen and then cut in adjacent oblique sections oriented either along the plane of the middle hepatic v. (sagittal oblique sections) or along the plane of division of the portal venous trunk (frontal oblique sections). Oblique MRI sections were made in 15 healthy volunteers, mainly based on the same venous landmarks but sometimes on other landmarks visible on the transverse sections. Oblique MRI sections can be made in the plane of any anatomic structure located in the transverse sections in order to define its position. Sections based on identical landmarks differently oriented in different subjects allow for definition of the individual anatomy of the liver investigated. The frontal oblique sections clearly show the course of the trunk of the portal v. and the junctions of the hepatic vv. with the inferior vena cava. The sagittal oblique sections are particularly useful for investigating the thinnest part of the left side of the liver and also the caudate lobe. Moreover, these oblique sections reveal certain organs adjacent to the liver, notably the pancreas, from unusual angles. The oblique sections also make it possible to follow the curse of the veins participating in formation of the portal trunk remote from the liver. The new MRI techniques considerably decrease certain artifacts associated with study of the abdomen and should allow the most profitable use of oblique sections.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Surgical and radiologic anatomy 14 (1992), S. 241-249 
    ISSN: 1279-8517
    Keywords: Hip musculature ; Cross-sectional anatomy ; Magnetic resonance imaging ; Three-dimensional reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé L'IRM associée à une reconstruction 3-D est particulièrement intéressante pour étudier l'appareil musculo-squelettique humain in vivo de façon précise et détaillée. L'IRM offre la possibilité d'étudier tant les structures superficielles musculaires que profondes sous contrainte in vivo. Les os, les muscles, les tendons et le tissu adipeux sont nettement visibles. On peut également au sein d'un muscle distinguer ses différentes portions. Après reconstruction des images 2-D, on peut visualiser la forme des muscles et de leur portions sous différents angles. Ceci permet une meilleure compréhension de la biomécanique et de l'anatomie fonctionnelle du système de l'appareil locomoteur du corps humain. Dans cette étude, la morphologie des muscles péri articulaires de la hanche a été étudiée chez trois sujets in vivo à partir de reconstructions 3-D des images 2-D obtenues en résonance magnétique.
    Notes: Summary MRI in combination with three-dimensional reconstruction is pre-eminently suitable for the study of the human musculoskeletal system in vivo in an accurate and detailed way. MRI provides the possibility of studying superficial as well as deep muscles under tension in the living state. Bones, muscles, tendons and adipose tissue are clearly visible. Parts can also be distinguished within a muscle. After reconstruction of the 2-D images the geometry of the muscles and muscle parts can be visualized from different angles. This leads to a deeper understanding of the biomechanics and functional anatomy of the musculoskeletal system of the human body. In this paper the morphology of the muscles around the hip was studied in three subjects in vivo on the basis of three-dimensional (3-D) reconstructions of two-dimensional (2-D) MR images.
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