European radiology
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Comparative Study
Magnetic resonance epidurography with gadolinium-DTPA.
The aim of this study was to evaluate and describe MRI epidurography as a new imaging tool. Five volunteers and one patient were investigated with MR epidurography after injection of 20 ml Gd-DPTA solution (1:250/1 ml Gd-DPTA/250 ml normal saline). Magnetic resonance epidurography is possible. ⋯ Using the multiplanar capability of MRI with MR epidurography coronal and sagittal projections similar to conventional epidurography, axial slices comparable to CT epidurography can be obtained. Magnetic resonance epidurography is superior to conventional and CT epidurography. Presently, due to high costs as compared with conventional and CT epidurography, MRI is not suitable for the routine monitoring of peridural catheters, but it may have a place in the future with decreasing costs for MRI and for the evaluation of patients with spine pathology, especially in describing epidural processes.
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Comparative Study
Standardized CT examination of the multitraumatized patient.
The aim of this study was to develop a standardized non-helical-CT protocol including head, body and proximal extremities in order to achieve a good time efficiency and diagnostic accuracy in the initial radiological evaluation of the multitraumatized patient. A total of 111 circulatory stable blunt trauma patients, brought in to a trauma level II-III hospital, were examined according to a standardized CT protocol. After examining the head with contiguous 10-mm slices without i.v. contrast medium injection, the trunk was examined with 10-mm slices every 30 mm through thorax-abdomen-pelvis with i.v. contrast medium enhancement (occasionally modified). ⋯ A standardized non-helical-CT examination of the head and body may be achieved in 20 min. Its diagnostic accuracy was high, except for vertebral column injuries, which is why we recommend it as the method of choice for initial radiological examination of multitraumatized patients. When available, helical scanning would improve both examination speed and accuracy.
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The aim of our study was to compare gradient-spin-echo (GRASE) to fast-spin-echo (FSE) sequences for fast T2-weighted MR imaging of the brain. Thirty-one patients with high-signal-intensity lesions on T2-weighted images were examined on a 1.5-T MR system. The FSE and GRASE sequences with identical sequence parameters were obtained and compared side by side. ⋯ Fatty tissue was less bright on GRASE. With current standard hardware equipment, the FSE technique seems preferable to GRASE for fast T2-weighted routine MR imaging of the brain. For the assessment of hemosiderin or ferritin depositions, GRASE might be considered.
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We present two cases of a rare entity: pharyngeal perforation caused by blunt external neck trauma. In both cases the patients were asymptomatic for the first 24 h and the results of laryngoscopic study were negative, and it was only possible to demonstrate rupture through the radiologic findings. Early diagnosis is essential as delay in treatment increases morbidity and mortality.
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Case Reports
MRI, CT, US and ERCP in the evaluation of bile duct hamartomas (von Meyenburg complex): a case report.
A case of multiple bile duct hamartomas (von Meyenburg complex) of the liver accompanied by exudative and in part necrotizing pancreatitis is presented. Magnetic resonance imaging (fat suppressed, T2-weighted images with prolonged echo time) could exclude diffuse tumor infiltration of the liver, which had not been possible with CT, sonography, or ERCP. To our knowledge, no comparable case has been reported.