Ferumoxide-enhanced magnetic resonance imaging techniques in pre-operative assessment for colorectal liver metastases.

Aim: The objective was to evaluate whether contrast-enhanced magnetic resonance imaging (MRI) techniques used in a pre-operative assessment protocol for colorectal liver metastases are as accurate as spiral computer tomography during arterial portography (CTAP). Pre-operative accuracy and clinical consequences of MRI are described and compared with CTAP. Moreover, post-operative survival rate and tumour recurrence were studied.

Controlled introduction of the sentinel node biopsy in breast cancer in a multi-centre setting: the role of a coordinator for quality control.

Aims: It is proposed that sentinel node biopsy should replace axillary lymph-node dissection. We analysed the role of a coordinator in the introduction of the sentinel node biopsy in breast cancer in a multi-centre setting to assure standardization and quality control.

Methods: We included 232 operable breast cancer patients.

Lymphedema and lymphocysts following lymphadenectomy may be prevented by omentoplasty: A pilot study.

Objectives: Pelvic lymph node dissection as part of the staging surgery for cervical carcinoma interrupts the afferent lymphatics, so the lymph drains retroperitoneally. New surgical techniques designed to leave the peritoneum open after the retroperitoneal dissection, in particular the application of a pedicled omentoplasty along the dissection route, have been advocated to prevent the formation of lymphocysts and lymphedema. We investigated the possible benefit of pedicled omentoplasty in preventing lymphocysts and lymphedema following pelvic lymph node dissection.

The value of ultrasound with ultrasound-guided fine-needle aspiration biopsy compared to computed tomography in the detection of regional metastases in the clinically negative neck.

Purpose: Head and neck oncologists have not reached consensus regarding the role of contemporary imaging techniques in the evaluation of the clinically negative neck in patients with head and neck squamous cell carcinoma (HNSCC). The purpose of the present study was to compare the accuracy of ultrasound with guided fine-needle aspiration biopsy (UGFNAB) and computed tomography (CT) in detecting lymph node metastasis in the clinically negative neck.

Methods And Materials: Sixty-four neck sides of patients with HNSCC were examined preoperatively by ultrasound/UGFNAB and CT at one of five participating tertiary care medical centers.

CT-guided bone biopsy in a cancer center: experience with a new apple corer-shaped device.

In this article we report our experience with CT-guided bone biopsy (CTGBB) using a new nondisposable bone biopsy device with in a uniform protocol for all lesions and compare our results with data from bone biopsies obtained with other techniques. With this biopsy device, the specimen is collected in a 20 x 2 mm chamber of an apple corer-shaped needle. In 46 consecutive cancer patients that were candidates for bone biopsy, 50 CTGBB procedures were performed and analyzed.

Regional metastasis in head and neck squamous cell carcinoma: revised value of US with US-guided FNAB.

Purpose: To verify the acclaimed accuracy of ultrasound (US) combined with US-guided fine-needle aspiration biopsy (FNAB) in the detection of lymph node metastasis in the neck and to evaluate the interobserver variability.

Materials And Methods: In a prospective, multicenter study of 185 patients with head and neck squamous cell carcinoma, US (n=238 neck sides) with US-guided FNAB (n=178 neck sides) was used for evaluation of the lymph node status of the neck. Findings were correlated with those of histopathologic examination in 238 neck sides.

Biopsy of nonpalpable cervical lymph nodes: selection criteria for ultrasound-guided biopsy in patients with head and neck squamous cell carcinoma.

This article is designed to find an appropriate policy to select nonpalpable cervical lymph nodes in head and neck squamous cell carcinoma patients for ultrasound-guided aspiration biopsy (USB). According to the literature, generally used selection criteria are width of nodes > 10 mm, length-to-width ratio > 2 and absent echo-rich hilum. In 562 nonpalpable nodes of 355 patients (mean age 60 y, range 20-92 y) with head and neck squamous cell carcinoma, a USB procedure was carried out.

Anterior rectocele: assessment with radiographic defecography, dynamic magnetic resonance imaging, and physical examination.

Purpose: The aim of this study was to devise a measuring method for an anterior rectocele on standardized defecographies and magnetic resonance images (MRI) to quantify anterior rectocele and to test whether this could substantiate clinical decision making for operative treatment for anterior rectocele.

Methods: Quantitative analysis by the measuring method as proposed was compared with qualitative scores on defecographies and MRI from the same patients. Thirty-eight patients with symptoms compatible with an anterior rectocele were subjected to physical examination in the left decubitis position and supine position and to defecography.

Renal masses: value of duplex Doppler ultrasound in the differential diagnosis.

In a prospective study, 84 nonanechoic renal masses were examined with duplex Doppler ultrasound with a 3.5 mHz. transducer.

Solid breast neoplasms: differential diagnosis with pulsed Doppler ultrasound.

In this prospective study, duplex Doppler ultrasound was used in 95 consecutive patients with solid breast masses to evaluate the presence of neovascular flow. A positive Doppler signal, i.e.

Defecography and anorectal manometry.

In a prospective study anorectal manometry was performed in 160 consecutive patients who were referred for defecography. Leakage of contrast material of standardized viscosity, the anorectal angle (ARA), anal resting pressure (Pr) and squeeze pressure (Ps) were measured and analyzed. This was done to investigate the role of ARA on rectal continence during defecography and to investigate whether relevant findings of manometry can be predicted from findings at defecography as part of the diagnostic work-up in selected patients in order to avoid manometry in these patients.

Vascularization of left kidney by single vessel originating from splenic artery.

According to the literature, sole renal arteries always originate from the aorta. In multiple renal arteries, the origin of an accessory renal artery may be expected from the splenic artery on theoretical basis. This origin, however, never is described.

The effect of posterior rectopexy on fecal continence. A prospective study.

Twenty-three patients with rectal prolapse or intussusception were studied to specifically focus on the effect of posterior rectopexy on fecal continence, anal pressure, and rectal capacity. Before operation, five patients were fully continent (A), 10 were continent for solid stools (B) and eight patients were fully incontinent (C). Group A remained fully continent; continence was regained nine times in group B and in group C, three patients regained full continence, two became continent for solid stools, three patients remained incontinent.

Normal anorectum: dynamic MR imaging anatomy.

In this study, the anatomy of the anorectum in relation to the surrounding structures and the anorectal angle were analyzed with magnetic resonance (MR) imaging at rest, during perineal contraction, and during straining in 10 asymptomatic subjects. The intra- and inter-observer and intra- and interpatient variations in the measurements of the anorectal angle, position of the anorectal junction, and position of the plica of Kohlrausch in the rectum were established at rest, during perineal contraction, and during straining. The values for the anorectal angle and position of the anorectal junction obtained with MR imaging were compared with standard radiography defecography findings.

Kock pouch urinary diversion: follow-up by ultrasound.

In the post-operative follow-up of 24 patients who received a continent Kock pouch for urinary diversion, several complications were encountered, including hydronephrosis, stone formation and valve dysfunction, resulting in reflux and/or urinary incontinence. After comparing findings on ultrasound with those obtained by Koch pouch cystography, intravenous urography, plain abdominal radiography, Kock pouch endoscopy and operation, we consider ultrasound to be an important technique in the follow-up, especially in non-symptomatic patients. All cases of hydronephrosis and pouch calculi were detected by ultrasound and no false positive findings were encountered in either group.

Renovascular hypertension and digital subtraction analysis.

Intravenous digital subtraction angiography (DSA) is a good imaging modality for the renal arteries and their main branches. Using an anterior-posterior beam direction, a considerable reduction in X-ray exposition is achieved, and by taking 3 runs with the patient in prone position, the renal arteries are adequately visualized in a high percentage. Nevertheless we advocate arterial DSA as a screening procedure for renovascular hypertension, especially in younger patients, because of the higher diagnostic output and the possibility of taking therapeutic action in the same session in about 1 out of 3 patients.