European radiology
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The purpose of this retrospective study was to demonstrate the MRI features of cerebral manifestations in patients with fat embolism syndromes in comparison with cerebral CT (CCT). Magnetic resonance imaging was performed according to standard protocols revealing multiple small non-confluent hyperintense intracerebral lesions larger than 2 mm on proton-density and T2-weighted images to various extents in three of four patients with clinically suspected cerebral fat embolism. ⋯ Our findings confirm that MRI can detect cerebral fat embolism with a higher sensitivity than CCT. Thus, MRI should be the first choice for imaging of cerebral fat embolism.
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Comparative Study
Study of susceptibility-induced artefacts in GRASE with different echo train length.
The aim of this study was to evaluate the sensitivity of gradient-and-spin-echo (GRASE) sequences to susceptibility effects. GRASE sequences with 21 and 33 echoes per echo train were compared with a T2-weighted FSE sequence with an echo train length of 5 by means of MRI in phantoms, volunteers (n = 10), and patients (n = 19) with old hemorrhagic brain lesions. All experiments were performed on a 1.0-T clinical MR system (Impact Expert, Siemens AG, Erlangen, Germany) with constant imaging parameters. ⋯ FSE with an ETL of 5 demonstrated significantly stronger susceptibility effects than their GRASE counterpart with an ETL of 21. The results demonstrate that GRASE sequences do not necessarily compensate for the reduced sensitivity of FSE to susceptibility effects. The complex signal behavior of GRASE makes conventional SE, gradient echo, or FSE sequences containing shorter echo trains preferable when patients with intracranial hemorrhage are clinically evaluated.
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Case Reports Comparative Study
Acute abdomen due to torsion of wandering spleen: CT diagnosis.
Two adults and a child with acute abdomen and surgically confirmed torsion of wandering spleen are presented. Computed tomography provided a spectrum of findings including an ovoid or comma-shaped abdominal mass, hypertrophy of the liver's left lobe, a whirled appearance of hyperdense, nonenhancing splenic vessels, and an enlarged spleen, exhibiting minimal or no enhancement. Computed tomography also indicated the point of torsion and the viability of splenic parenchyma.
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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.