ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThe results of 4504 0.3 T magnetic resonance (MR) examinations, of which 3262 had clinical follow up are described. The overall true positive rate of MR imaging was 72%, with a range of 69–100%. While the best results were obtained for evaluation of spinal cord syrinx and normal cerebral examinations, 31% of patients with cerebral demyelination were incorrectly diagnosed. The false positive rate was relatively low (3–5% in most cases), but a significant 17% of patients considered to have normal cerebral examinations were later shown to have pathology.While the true positive rate of magnetic resonance imaging was greater than that of the suspected clinical diagnosis (37% correct), the results of this assessment at 0.3 T are significantly poorer than those previously published at 1.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYA review of 2000 consecutive magnetic resonance imaging (MRI) brain studies identified 18 (0.9%) patients with lesions that satisfied MRI criteria for cavernous haemangiomas. The clinical, computed tomography (CT) and MRI findings in 23 patients with probable cavernous haemangiomas were compared. Thirty‐three lesions were identified with multiple lesions in five (22%) patients. In 19 (82%) patients the neurological presentation corresponded to a cavernous haemangioma. The presenting symptoms were: seizures in 11 patients (48%); progressive neurological symptoms and signs in four (17%); and acute symptoms and signs due to haemorrhage in four (17%). T2 weighted images suggested the diagnosis in all cases, with 24 (73%) lesions showing the typical appearance of an area of mixed signal intensity with a rim of low signal intensity.In the absence of acute haemorrhage, CT demonstrated well circumscribed, round or oval hyperdense lesions without significant mass effect and with normal surrounding brain tissue in the majority of cases. Although not diagnostic, these CT features are strongly suggestive of cavernous haemangioma

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00039.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThe computed tomography (CT) scans of 110 consecutive patients who presented, over a 4.5‐year period, following spontaneous subarachnoid haemorrhage (SAH), were reviewed. All 110 patients also had one or more 4‐vessel digital subtraction cerebral angiograms. The CT scans were reviewed in each case without knowledge of the angiographic result. In nine patients (8%), SAH was confined to the perimesencephalic area, interpeduncular cistern and/or prepontine region at CT. All nine patients had at least two, and some as many as four, negative cerebral angiograms. Eighteen of the 110 patients (16%) ultimately had negative angiography. Hence, the patients with isolated perimesencephalic haemorrhage (PMH) accounted for 50% of the negative angiograms. There was a significant association between isolated PMH and negative angiography (X2= 50.1,P<0.005). The specificity of PMH for negative angiography was 100% (95% confidence interval (CI) = 97–100%) and the sensitivity of PMH for a negative study was 50% (95% CI = 16–84%). Six of the 110 patients had basilar artery aneurysms demonstrated angiographically as the cause of their SAH but none of these six had isolated PMH at CT.All patients with isolated PMH were alive and well at follow up and none had suffered repeat SAH or vasospasm‐related ischaemic cerebral injury. Perimesencephalic haemorrhage should be distinguished from SAH in general, because of the good prognosis associated with it and the doubtful need for repeat cerebral angiography after an intitial negat

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00040.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThe variable magnetic resonance imaging appearances of central nervous system haemorrhage, both intra‐ and extra‐axial, are described. These will vary with the type of image contrast (T1 or T2 weighting), the nature of the imaging sequence (spin‐echo or gradient‐echo) and the time from onset of haemorrhage. Magnetic resonance imaging is a useful technique for imaging haemorrhage in the central nervous system as it yields temporal information about haematoma development, and it is the only non‐invasive means of imaging intraspinal haemorrhage. It is, however, limited in the imaging of haematomas within 24 h of onset and in subarachnoid haemorrhage where computed tomography is the investigation

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00041.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYFollowing the introduction of a carotid colour duplex Doppler service, a retrospective survey of the second 100 patients examined was undertaken to determine the accuracy of the examination compared with angiography and surgery, and to assess the clinical efficacy of the results with a review of the final diagnosis, how that diagnosis was achieved and whether the test had helped assess the patient's illness or altered the medical management and/or the outcome of the patient's illness. The results indicated the expected accuracy of over 94% and that the examination helped assess the patient's illness in 92%, altered the management plan in 40% and altered the outcome of the patient's illness in 14% where the disease prevalence was 16%.

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00042.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYDuring a 9 month period, 50 consecutive children were evaluated by ultrasound to determine the size, location (mesentericvspara‐aortic), number, shape and texture of abdominal lymph nodes in a normal paediatric population. High resolution linear array transducers were used with graded compression. Nodes ranging from 10 to 20 mm were recorded in the majority of subjects. In all cases mesenteric lymph nodes were larger and more numerous than para‐aortic nodes. Para‐aortic lymph nodes were not seen in isol

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00043.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThis is a retrospective study to evaluate the ability of arterial chemo‐embolization with Adriamycin, Lipiodol and Gelfoam to relieve symptoms, primarily abdominal pain, and to prolong survival in patients with hepato‐cellular carcinoma.Twenty patients were referred from 1986 to 1991 and in 18 the chemo‐embolization procedure was successful. In the follow‐up period to March 1992, 17 patients had died. Their survival times were not found to be significantly different from the reported rates of survival in patients given no therapy. In only one of 10 patients followed with computed tomography was a reduction in tumour size seen.Nine of 11 patients with pain reported significant relief from pain following treatment. Six patients had repeat embolizations that successfully relieved recurrent pain. In the authors’experience chemo‐embolization was helpful in relieving pain, but did not p

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00044.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThree symptomatic non‐parasitic liver cysts in three patients were treated by the technique of percutaneous aspiration followed by sclerosis of the cyst lining by irrigation with absolute alcohol. In two patients the treatment was fully successful, with partial success in the third case. Two cysts underwent two separate treatments. The technique, which is reviewed, was shown to be a safe and effective alternative to conventional surgical managemen

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00045.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SUMMARYThe sonographic appearance of intra‐peritoneal air collection has been studied in 46 patients. In 30 patients (group I), a pneumoperitoneum had been iatrogenically induced either during aspiration of ascitic fluid or during laparoscopy. Three normal volunteers (group II) had been subjected to graded intraperitoneal air injection to quantify the smallest amount of air detectable by ultrasound (US). In eight patients (group III) the sonographic demonstration of free intraperitoneal air led to a diagnosis of hollow visceral perforation; whereas in another five patients (group IV) the sonographic findings reinforced the clinical suspicion of a ‘sealed off’perforation in the presence of negative roentgenograms. In all patients intraperitoneal air was seen as an echogenic line with a posterior reverberation or ring down arte‐fact. In patients with free air, this was best seen in the perihepatic spaces with the patient in the supine, left lateral decubitus or prone position. As little as 5 mL of air could be consistently detected in all three volunteers (group II). Artefacts leading to a pseudopneumoperitoneum on US included; (i) the artefacts distal to an overlying rib; (ii) ring‐down artefact from air in the adjacent lungs; and (iii) hepatodia‐phragmatic interposition of colon. With proper sonographic technique and principles of interpretation these can be distinguished from true intraperitoneal air.Although sonography may be more informative than conventional radiology in patients with hollow visceral perforation, we did not find it more sensitive than conventional roentgenograms in detecting free intraperitoneal air. Sonography, however, is distinctly superior in patients with a sealed off perforation in whom conventional roentgenograms are frequent

ISSN:0004-8461    

DOI:10.1111/j.1440-1673.1993.tb00046.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY