Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer.

Contrast enhanced magnetic resonance imaging (CE MRI) is the most sensitive tool for screening women who are at high familial risk of breast cancer. Our aim in this study was to assess the cost-effectiveness of X-ray mammography (XRM), CE MRI or both strategies combined. In total, 649 women were enrolled in the MARIBS study and screened with both CE MRI and mammography resulting in 1881 screens and 1-7 individual annual screening events.

MRI findings following laparoscopic sacrocolpopexy.

Sacrocolpopexy is a surgical procedure that provides effective treatment for pelvic prolapse. The surgical technique and complications of laproscopic sacrocolpopexy are described. This review presents experience of MRI for postoperative assessment and illustrates normal and abnormal findings.

The UK national study of magnetic resonance imaging as a method of screening for breast cancer (MARIBS).

The UK national study of magnetic resonance imaging as a method of screening for breast cancer (MARIBS) is in progress. The study design, accrual to date, and related research projects are described. Revised accrual rates and expected recruitment are given.

Identification of inguinal lymph node metastases from vulval carcinoma by magnetic resonance imaging: an initial report.

Aim: Magnetic Resonance Imaging (MRI) has the potential to assess inguinal lymph nodes more accurately than palpation and less invasively than surgical exploration. The objective of this study was to measure the accuracy of MRI in identifying inguinal metastases by demonstrating abnormal lymph node morphology.

Materials And Methods: 10 women with vulval malignancy underwent T1- and fat-suppressed T2-weighted surface coil MRI of both groins before surgery.

The assessment of irradiated bladder carcinoma using dynamic contrast-enhanced MR imaging.

Aim: To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (DCEMRI) in distinguishing residual or recurrent tumour from radiation change in patients with bladder carcinoma.

Materials And Methods: Forty patients with biopsy proven bladder carcinoma were imaged before and at 4 and 12 months after radiotherapy (XRT) using conventional and dynamic contrast-enhanced magnetic resonance imaging at 0.5 Tesla.

Magnetic resonance imaging of actinomycosis presenting as pelvic malignancy.

Pelvic actinomycosis is associated with long-standing use of an intrauterine contraceptive device and may present with clinical signs and symptoms of pelvic malignancy. Diagnostic imaging can confirm the presence of a pelvic mass and tissue infiltration but findings are often non-specific. We present a case of pelvic actinomycosis with tubo-ovarian abscess in which magnetic resonance imaging demonstrated lower signal intensity tissue on T2 weighted sequences than would be typical for pelvic malignancy or infection and was useful in confirming regression of pelvic disease in response to antibiotic therapy.

Quantitative dynamic contrast enhanced MRI of recurrent pelvic masses in patients treated for cancer.

Recurrent tumour and post-treatment inflammatory masses may be difficult to differentiate on T2 weighted and post-contrast T1 weighted MR sequences. The purpose of this study was to assess the value of quantitative analysis of enhancement patterns in improving the separation of tumour recurrence from benign post-treatment masses in the pelvis. 32 patients with a total of 44 benign or malignant pelvic masses arising more than 6 months after treatment by surgery and/or radiotherapy were studied.

Predictive value of clinical examination, transrectal ultrasound and magnetic resonance imaging prior to radiotherapy in carcinoma of the cervix.

The objectives of this study were to compare tumour staging and volume assessment by examination under anaesthesia (EUA), transrectal ultrasound (TRU) and magnetic resonance imaging (MRI) in patients with invasive carcinoma of the cervix, and to correlate findings with long-term outcome following treatment by radiotherapy. Tumour staging was performed on 60 patients immediately before starting radiotherapy. Clinicians and radiologists performing EUA, TRU or MRI were blinded to the results of other investigations.

CT and MRI appearances of sarcomatous change in chronic pelvic endometriosis.

Endometriosis is a relatively common condition in pre-menopausal women. Rarely, endometrial malignancy may arise in and co-exist with endometriosis. In this case report, the findings on CT and MRI which indicated this development are described.

Contrast-modified gradient echo imaging using rotary echo preparatory pulses.

The use of on-resonance 121 binomial composite pulses in two- or three-dimensional magnetization-prepared gradient-recalled echo magnetic resonance imaging experiments generates rotary echoes, leading to an increase in contrast range that is, in part, determined by the ratio of T2 to T1. In comparison with other fast gradient-recalled echo imaging techniques designed for enhanced T2 contrast, this method is more robust with respect to radiofrequency field inhomogeneity and less sensitive with respect to motion artifacts. Three-dimensional parametric images may be calculated using least-squares fitting based on a simple model for steady-state longitudinal magnetization during the imaging sequences.

MR angiography and MR imaging of symptomatic vascular malformations.

Purpose: To define the appearance of peripheral vascular malformations at magnetic resonance angiography (MRA) and assess the role of magnetic resonance imaging (MRI) and MRA in the investigation of these lesions.

Patients And Methods: Fourteen patients (aged 8-51 years) with clinical evidence of a vascular malformation were referred for MRI and MRA, performed on a 0.5T GE Vectra superconducting system (International General Electric, Slough, UK).

Skin: MR imaging findings at middle field strength.

Skin tumors were staged at magnetic resonance (MR) imaging on a 0.5-T (middle-field-strength) system, with use of a 2-cm-diameter receive-only surface coil. T1- and T2-weighted spin-echo (SE), fast SE, or three-dimensional (3D) spoiled gradient-recalled imaging were performed in three volunteers and in 13 patients with skin tumors (nine, basal cell carcinoma).

Superparamagnetic iron oxide imaging of focal liver disease.

The use of iron oxide as a superparamagnetic contrast agent for magnetic resonance imaging of the liver has been described previously. When administered intravenously, superparamagnetic iron oxide (SPIO) is sequestered by the reticuloendothelial system causing significant shortening of the T2-relaxation time. The majority of the contrast is taken up by the reticuloendothelial tissue of the liver.

Off-resonance binomial composite pulses in 2D and 3D fat/water imaging at 0.5 T.

A new method of acquiring two-dimensional (2D) and three-dimensional (3D) fat/water decomposed images on a 0.5 T magnetic resonance (MR) imaging system is described. The method uses a gradient-recalled echo (GRE) sequence incorporating a composite 121 pulse, originally used for magnetization transfer contrast (MTC) experiments, for frequency-selective pre-saturation.

Magnetic resonance image synthesis using a flexible model.

Image synthesis methods are based on the hypothesis that a magnetic resonance (MR) image with optimized contrast can be reproduced by synthesis from three calculated basic images of T1, T2 and spin density. This method, however, is limited by noise due to uncertainties in the initial measurements. The principal component analysis (PCA) method is based on an information theory approach that decomposes MR images into a small set of characteristic feature images.

Staging, volume estimation and assessment of nodal status in carcinoma of the cervix: comparison of magnetic resonance imaging with surgical findings.

Pre-operative magnetic resonance imaging (MRI) was carried out in 50 women scheduled for operative treatment of invasive carcinoma of the cervix. The extent of the primary tumour (stage), its dimensions and the presence of lymph node enlargement were assessed and compared with findings at surgery and/or histopathological examination of the resected uterus. In 45 patients undergoing radical hysterectomy, accuracy of MRI staging of the primary tumour was 84.

Clinical evaluation of fast spin echo sequences for cranial magnetic resonance imaging at 0.5 tesla.

Fast spin echo (FSE) sequences enable T2-weighted MR scans to be obtained in a fraction of the time necessary for conventional SE sequences with long TR and long TE. Comparison has been made of a FSE sequence (TR = 4000 ms, effective TE = 100 ms, 2 NEX) with the T2-weighted SE sequence (TR = 2000 ms, TE = 90 ms, 1-2 NEX) normally used in 35 patients referred for cranial MRI. Contrast-to-noise ratios (CNR) for grey:white matter and brain:CSF on the FSE sequence compared favourably with variable echo (VE) sequences which take up to three times as long to acquire.

Transverse myelitis as the presentation of Jo-1 antibody syndrome (myositis and fibrosing alveolitis) in long-standing ulcerative colitis.

A 32-yr-old woman with long-standing ulcerative colitis developed paraesthesiae, sensory loss and muscle weakness shown by magnetic resonance scan to be due to transverse myelitis in the cervical spinal cord. More than 12 months later, she developed dermatomyositis and fibrosing alveolitis and was found to have the Jo-1 antibody. Her condition worsened despite high dose oral prednisolone but improved following intravenous methylprednisolone, immunosuppressive therapy and plasma exchange.

Magnetic resonance imaging with Gadolinium-DTPA for assessment of bladder carcinoma and its response to treatment.

Magnetic Resonance Imaging (MRI) with intravenous Gadolinium-DTPA (Gd-DTPA, Magnevist, Schering-AG) was performed in 44 patients, 32 with primary bladder carcinoma and 12 with suspected recurrence after treatment. Gd-DTPA often increased diagnostic confidence in the identification and staging of tumours confined to the bladder wall and was necessary to assess depth of bladder wall invasion when T2-weighted images were suboptimal. Enhancement after Gd-DTPA enabled distinction between necrotic and viable tumour and blood clot.