Correlation between MRI results and intraoperative findings in patients with silicone breast implants.

Background: Silicone gel breast implants may silently rupture without detection. This has been the main reason for magnetic resonance imaging (MRI) of the augmented or reconstructed breast. The aim of the present study was to investigate the accuracy of MRI for implant rupture.

Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications.

Rheumatoid arthritis (RA) is a chronic systemic disease of unknown origin that predominantly involves synovial tissue. RA affects 0.5%-1.

Cardiovascular magnetic resonance: current clinical practice and future potential.

Cardiovascular magnetic resonance (CMR) is playing an increasing role in the noninvasive assessment of the cardiothoracic patient. It provides rapid, high-resolution anatomical coverage, and accurate functional cardiovascular assessment without the need for ionizing radiation. In this article, we discuss the fundamental principles of CMR and outline the established and newer indications for its use.

Clinical and ultrasound evaluation of donor site morbidity after tram-flap for breast reconstruction.

The TRAM-flap has become a well-established method for breast reconstruction. Even though the aesthetic result is superior to implant reconstruction, a main disadvantage is the potential risk to create weakness of the abdominal wall. For evaluation of abdominal wall function, an imaging method has to be used which is able to prove functional properties of the remaining muscle.

Benign breast lesions: minimally invasive vacuum-assisted biopsy with 11-gauge needles patient acceptance and effect on follow-up imaging findings.

Purpose: To evaluate patient acceptance of stereotactic or ultrasonographically (US) guided directional vacuum-assisted 11-gauge needle biopsy of breast lesions and short- and long-term changes at mammography and US resulting from the procedure.

Materials And Methods: For 91 benign lesions that had been sampled at either stereotactic or US-guided directional vacuum-assisted breast biopsy performed with 11-gauge needles, clinical, mammographic, and US changes were evaluated 1 week after biopsy; 6-month follow-up findings were available for 74 lesions. The subjective outcome of the procedure and patient satisfaction were assessed on the basis of a patient-completed questionnaire that incorporated a multistage scoring system.

Value of ultrasound and magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses.

Background: The stage of ovarian carcinoma at diagnosis directly affects prognosis. Thus, thorough pretreatment evaluation is basic to the successful management of suspected ovarian masses. Among currently available imaging techniques in characterization of suspected ovarian neoplasms, sonography (US) is indisputedly the primary imaging approach.

Osseous metastases in breast cancer: radiographic monitoring of therapeutic response.

Background: Standard radiographs are primary means of evaluation of therapy-induced changes of the skeletal structure in patients with breast cancer metastatic to the bone, but objective quantitation has been difficult to standardize.

Materials And Methods: Serial radiographs of therapy-induced changes in the structure of bone metastases secondary to breast cancer were analyzed in 274 patients over a period of 10 years and roentgenologic signs of tumor response evaluated with regard to a defined principal metastasis.

Results: Indicators of regression were recalcification/reossification of primary osteolysis (11.

Low-grade mucosa-associated lymphoma of the breast: radiological-pathological correlation.

Primary breast lymphoma generally is a rare disease. We present a case of a low-grade mucosa-associated (MALT) lymphoma of the breast in a 32-year-old woman, a distinctive type of localized non-Hodgkin's lymphoma (NHL), which is very seldom located in the breast. We performed differential diagnosis and radiological-pathological correlation with regard to typical microscopic criteria and clinical relevance that apply for that special entity.

Real-time spatial compound imaging in breast ultrasound.

To determine the role of real-time spatial compound imaging in breast ultrasound (US), 38 patients with a total of 50 benign changes (fibroadenomas, cysts, lactiferous duct dilatation) underwent both conventional B-mode US and real-time spatial compound imaging under standardized examination settings. Subsequently, images were reviewed independently by three readers experienced in breast US and evaluated according to a multistage scoring system with regard to the presence of artefacts, delineation of boundaries and depiction of internal structures. With significant reader concordance, real-time spatial compound imaging was found to produce speckle reduction with improvement of tissue differentiation, increased conspicuity of low-contrast lesions, enhanced delineation of capsular margins and ducts, and improved depiction of internal architecture of solid lesions, as well as clearer visualization of cystic contents due to clutter reduction.

Fibroadenomas: computer-assisted quantitative evaluation of contrast-enhanced power Doppler features and correlation with histopathology.

We aimed to evaluate whether the histopathologic variability of fibroadenomas accounts for their varied appearance in contrast enhanced power Doppler (PD). Forty patients with fibroadenomas (aged 19 to 61 years) underwent power Doppler ultrasound (US) prior to and following IV bolus injection of a microbubble contrast agent. A 3-min computer-assisted assessment of the color pixel density (CPD) was used for objective evaluation of the increase in color Doppler signals.

[Tissue harmonic imaging sonography. Is the image quality in routine abdominal ulstrasound improved?].

Purpose: Evaluation and statistical analysis of the influence of THI with pulse-inversion technology on image quality in abdominal ultrasound in comparison to conventional sonography.

Material And Methods: In 25 patients 398 ultrasound images of the abdomen were evaluated in a prospective, double blind study. 49% of the images were obtained with THI sonography, 51% with conventional sonography, respectively.

[Vascularization of fibroadenomas: contrast harmonic imaging compared with contrast-enhanced power doppler].

Purpose: To compare contrast material-enhanced harmonic power Doppler ultrasonography (CHI) with conventional contrast-enhanced power Doppler ultrasound (CPD) in depicting the vascularity of fibroadenomas.

Materials And Methods: Forty patients with fibroadenomas (aged 19-61 years) underwent conventional contrast-enhanced and harmonic power Doppler US. According to a standardized examination protocol, serial dynamic scans were obtained before and at 30, 90 and 150 seconds after injection of contrast agent.

Contrast-enhanced power Doppler harmonic imaging--influence on visualization of renal vasculature.

To compare contrast-enhanced power Doppler (PD) harmonic imaging (CHI) with contrast-enhanced power Doppler fundamental imaging (CPD) in the depiction of renal cortical vessels, 20 healthy volunteers were subjected to PD imaging and HI assessment of the kidney after bolus injection of Levovist(R) (SH U 508A). System settings were standardized and the pulse-repetition frequencies (PRF) systematically toggled from 750 to 500 and 250. Videotapes were independently reviewed by three readers with regard to the presence of artefacts, the degree of Doppler signal enhancement, demarcation of vessels and the extent of visualization.

Ultrasonographic tissue characterization in monitoring tumor response to neoadjuvant chemotherapy in locally advanced breast cancer (work in progress).

A program of computer-assisted texture analysis was applied to evaluate its usefulness for objective description of changes in tumor architecture due to primary medical treatment in patients with locally advanced breast cancer. Changes in values of parameters of the statistical pattern recognition technique were compared to ultrasonographically depictable, subjectively recorded changes in echogenicity and echotexture (brightness, homogeneity) and reviewed with regard to histopathologic evaluation of tumor regression. Characteristic trends of defined quantitative texture parameters (mean gradient, mean gray value, contrast from the co-occurrence matrix) corresponded to visually depictable changes of the B-mode image and underlying histopathologic changes.

Locally advanced breast carcinoma: evaluation of mammography in the prediction of residual disease after induction chemotherapy.

Background: We aimed to assess the mammographic features of locally advanced breast carcinoma treated with neoadjuvant chemotherapy and to evaluate morphological criteria that determine the value of mammography in therapy monitoring.

Materials And Methods: We reviewed the pre- and post-therapeutic mammograms of 44 patients with stage III-breast carcinoma with regard to tumor characteristics and malignant calcifications and compared to histopathological results.

Results: Delineation of the tumor proved to be the most significant criterion.

Chronic lower back pain due to sarcoma.

We describe a 74-year-old woman with extensive pelvic leiomyosarcoma presenting with uncharacteristic musculoskeletal pain of the lumbosacral region and left lower extremity. Hemipelvectomy was considered the treatment of choice, and a model for a pelvic prosthesis was constructed based on imaging analysis. However, the tumour (and the complaints) responded surprisingly well to a combined treatment regimen including superselective arterial catheter embolization, which led to tumour regression to such a degree that aggressive surgical treatment became unnecessary.

Magnetic resonance imaging of Achilles tendon in patients with rheumatoid arthritis.

Rationale And Objectives: The authors characterize the appearance of the Achilles tendon in patients with rheumatoid arthritis and differentiate this appearance from degenerative tendinopathy in patients with chronic pain of the heel using magnetic resonance (MR) imaging.

Methods: Thirty patients with rheumatoid arthritis and 28 patients with chronic pain of the heel underwent MR imaging of the ankle and foot. Three radiologists independently assessed the MR images with respect to size, shape, and intratendinal signal characteristics of the Achilles tendon.

Rheumatoid arthritis of the craniocervical region by MR imaging: detection and characterization.

Objective: The purpose of our study was to evaluate the potential of contrast-enhanced MR imaging to detect and to characterize craniocervical rheumatoid arthritis in a large population group, to compare MR imaging with clinical and conventional radiographic findings, and to examine the relationship between the histopathologic and MR imaging findings in seven patients.

Subjects And Methods: We performed contrast-enhanced MR imaging using T2-weighted gradient-echo sequences and T1-weighted spin-echo sequences in 136 patients with rheumatoid arthritis. Sequential T1-weighted images were obtained before, 3 min after, and 15 min after injection of contrast material.

Magnetic resonance imaging in the preoperative evaluation of suspected ovarian masses.

Meticulous pretreatment evaluation is basic to the successful management of suspected ovarian masses. Among currently available imaging techniques, sonography and computerized tomography are the most important diagnostic modalities. The purpose of our study was to determine whether magnetic resonance imaging provided additional information on masses in the true pelvis.

[Radiographic changes of the calcaneus in the framework of chronic polyarthritis].

Plain films of the calcaneus of 768 patients with confirmed rheumatoid arthritis were examined retrospectively with reference to inflammatory rheumatic changes. 42 patients (5.5%) showed an erosion of the posterior upper calcaneal margin related to an Achilles bursitis.

[Recurrent venous thromboses in hypoplasia of the vena cava inferior and factor XII deficiency].

The cause of recurrent pelvic and leg venous thromboses in a 24-year-old man was found to be a combination of two rare anomalies, hypoplasia of the hepatic, prerenal segment of the inferior vena cava and factor XII deficiency (factor XII activity 38%, its antigen 39% of normal), the latter considered a risk factor for thromboembolism. Subsequent fibrinolysis was not successful. No thromboembolic phenomena occurred during the following 16 months of oral anticoagulation with phenprocoumon.