Novel variant of reversed midgut rotation - retro-arterial proximal jejunum and transverse colon: a case report and review of the literature.

Background: Reversed rotation of the midgut is the rarest variation of midgut malrotations, which are congenital disorders that result from aberrant rotation and fixation of the midgut during embryological development. Common complications of these disorders are small bowel obstruction by volvulus or peritoneal bands, usually occurring in early infancy.

Case Presentation: A 23-year-old Caucasian woman presented with recurrent abdominal pain.

Treatment of progressive multifocal leukoencephalopathy associated with natalizumab.

We describe the clinical and therapeutic course of a 52-year-old patient with multiple sclerosis in whom progressive multifocal leukoencephalopathy (PML) developed after 12 months of therapy with natalizumab. The patient was hospitalized 2 months after the onset of neurologic and psychiatric symptoms and was treated with plasma exchange and immunoadsorption to eliminate natalizumab. After a brief improvement, he became critically ill with an apparent episode of immune reconstitution inflammatory syndrome.

Combined TACE and PEI for palliative treatment of unresectable hepatocellular carcinoma.

Aim: To assess whether the effectiveness of a combination of transarterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) in the treatment of unresectable hepatocellular carcinoma (HCC) is superior to TACE alone a randomized controlled trial was performed.

Methods: The effect of combination therapy on long-term survival rates and duration of hospitalization was evaluated in 52 previously untreated HCCs, randomly allocated to TACE-PEI (27 pts) or TACE alone (25 pts).

Results: The cumulative survival rate of the TACE group was 75.

Small hepatocellular carcinoma in cirrhosis: randomized comparison of radio-frequency thermal ablation versus percutaneous ethanol injection.

Purpose: To compare the effectiveness of radio-frequency (RF) thermal ablation with that of percutaneous ethanol injection (PEI) for the treatment of small hepatocellular carcinoma (HCC) in patients with cirrhosis.

Materials And Methods: A series of 102 patients with hepatic cirrhosis and either single HCC 5 cm in diameter or smaller or as many as three HCCs each 3 cm or smaller (overall number of lesions, 142) randomly received either RF ablation (n = 52) or PEI (n = 50) as the sole first-line anticancer treatment. Mean follow-up was 22.

MR imaging of autopsy-proved paraneoplastic limbic encephalitis in non-Hodgkin lymphoma.

We report the case of a 26-year-old man with precursor T-cell acute lymphoblastic leukemia who developed paraneoplastic limbic encephalitis that was diagnosed on the basis of MR imaging findings and was proved post mortem. In our MR imaging studies, fluid-attenuated inversion recovery images and diffusion-weighted echo-planar images clearly depicted bilateral involvement of the medial temporal lobes and multifocal involvement of the brain, whereas T2-weighted turbo spin-echo images failed to show the changes.

Retrobulbar irradiation for thyroid-associated orbitopathy: double-blind comparison between 2.4 and 16 Gy.

Purpose: Retrobulbar irradiation is used as a standard therapy for thyroid-associated orbitopathy. The evidence of its effectiveness is, however, scarce. Doses from 2.

[Relevance of magnetic resonance imaging for the staging and follow up of lymph node pathologies in adults with primary malignant lymphomas].

Lymph node histology and staging with cross sectional imaging remains basis for the treatment planning in primary malignant lymphoma. Contrast enhanced computed tomography is considered to be gold standard. However, MRI is equally able to provide staging and follow up in the same quality as helical CT, as several studies and clinical experience show.

Assessment of pulmonary perfusion with ultrafast projection magnetic resonance angiography in comparison with lung perfusion scintigraphy in patients with malignant stenosis.

Rationale And Objective: The aim of this study was to demonstrate and measure perfusion deficits caused by central bronchogenic carcinoma and to compare magnetic resonance angiography (MRA) perfusion data with data of perfusion scintigraphy. The diagnostic value of 2D MRA in detection of malignant pulmonary artery stenosis in comparison with conventional DSA was investigated.

Materials And Methods: Eighteen patients were included in the study.

Myelodysplastic syndrome in transformation to acute myeloid leukemia presenting with diabetes insipidus: due to pituitary infiltration association with abnormalities of chromosomes 3 and 7.

A 31-yr-old woman with myelodysplastic syndrome (MDS) in transformation to acute myeloid leukemia (AML) presented with initial symptoms of polyuria and polydipsia. Cytogenetics revealed monosomy 7 and translocation (3;3)(q21;q26). The initial symptoms, in conjunction with a low serum level of anti-diuretic hormone (ADH) and magnetic resonance imaging (MRI) findings demonstrating loss of the "bright spot" of the neurohypophysis, indicated diabetes insipidus (DI), e.

Magnetic resonance imaging for supraspinatus muscle atrophy after cuff repair.

Between 1998 to 2000, the shoulders of 17 patients with rotator cuff tears were examined using magnetic resonance imaging preoperatively, and 6 and 12 months after open surgical repair. To assess the course of the supraspinatus muscle atrophy, the easily reproducible magnetic resonance imaging parameters occupation ratio and tangent sign in the Y-shaped view of the supraspinous fossa were evaluated and compared with the clinical examination. Occupation ratio is a quantitative parameter that reflects the area ratio, expressed as a percentage of the supraspinatus muscle belly to the supraspinous fossa.

Pulmonary sequestration: demonstration of blood supply with 2D and 3D MR angiography.

Pulmonary sequestration is a relatively rare but clinically significant congenital anomaly. This disease is a spectrum of disorders involving the pulmonary airways, the arterial supply to the lungs, the lung parenchyma and its venous drainage. Traditionally, the diagnosis of pulmonary sequestration has been made definitively with arterial angiography.

Diagnosis of the hypothenar hammer syndrome by high-resolution contrast-enhanced MR angiography.

Our objective was to describe the imaging features of hypothenar hammer syndrome using minimally invasive contrast-enhanced MR angiography in comparison with oscillography study. In five patients with hypothenar hammer syndrome Gd-BOPTA-enhanced elliptically reordered 3D pulse sequence MR was compared with oscillography findings and clinical symptoms focusing on angiographic appearance of vessel injury, distribution pattern of hand vasculature and joining branches between the radial and ulnar artery supply. All patients showed segmental occlusion at the site of trauma impact with varying involvement of the superficial palmar arch, common volar digital arteries.

Benign course of central pontine myelinolysis in a patient with anorexia nervosa.

Central pontine myelinolysis is a rare neurologic disorder defined by symmetric demyelination of the central base of the pons. Until recently its outcome was considered invariably poor if not fatal. We report a 15-year-old female patient with severe anorexia nervosa who acutely developed a locked-in syndrome.

CT-based study on potential mediastinal lymph node spread of patients with lung cancer. Contribution to 3-D treatment planning for adjuvant radiotherapy of the mediastinum.

Aims: To provide a schematized and graduated CT reference series of the mediastinum showing CT-detectable lymph node areas of lung cancer patients to support 3-D treatment planning and documentation for adjuvant irradiation of the mediastinum.

Patients And Methods: Cross sections of mediastinal structures from one male individual were schematized and overlaid with a 1 cm2 reference grid. Mediastinal CT scans of 100 consecutive patients with histologically proven lung cancer and CT-detectable lymph nodes were evaluated.

Imaging findings in the rare catastrophic variant of the primary antiphospholipid syndrome.

We report imaging findings in a case of the rare catastrophic variant of antiphospholipid syndrome (CAPS) characterized by widespread microvascular occlusions, which may lead to multiple organ failure. We present a case of a 66-year-old woman with bone marrow necrosis, acute acalculous cholecystitis (AAC), focal liver necrosis, subtle patchy splenic infarctions, and bilateral adrenal infarction. The demonstration of multiple microvascular organ involvement (three or more) is crucial for the diagnosis of the catastrophic variant of APS.

MRI characteristics in focal hepatic disease before and after administration of MnDPDP: discriminant analysis as a diagnostic tool.

The aim of this study was to determine if different types of focal hepatic lesions can be differentiated by specific quantitative and qualitative imaging characteristics pre- and post-Mangafodipir trisodium (MnDPDP) administration using a computerized multivariable, discriminant analysis (DA). In a multicenter trial, 151 patients with focal liver disease were studied at 1.5 and 1.

Contrast enhanced MR angiography in the assessment of relevant stenoses in occlusive disease of the pelvic and lower limb arteries: diagnostic value of a two-step examination protocol in comparison to conventional DSA.

Introduction/objectives: Contrast-enhanced MRA (ce-MRA) has been claimed by many authors as a replacement of conventional angiography evaluating peripheral arterial occlusive disease. However, reliable detection of relevant stenoses (>70%) has to be provided for planning vascular interventions. Only few data in the literature focuses on this crucial problem.

Gadolinium-enhanced elliptically reordered three-dimensional MR angiography in the assessment of hand vascularization before radial artery harvest for coronary artery bypass grafting: first experience.

Rationale And Objectives: To assess the suitability of contrast-enhanced magnetic resonance angiography (MRA) in the preoperative evaluation of hand vasculature in potential candidates for radial artery bypass grafting.

Methods: In 21 patients, gadobenate dimeglumine-enhanced, three-dimensional gradient-echo sequences of both hands were performed, as well as a Doppler ultrasound study with radial artery compression. Doppler findings were correlated with MRA, focusing on the assessment of anastomoses between the vascular bed of the ulnar and radial arteries.

VHL c.505 T>C mutation confers a high age related penetrance but no increased overall mortality.

Background: Germline mutations of the VHL gene cause von Hippel-Lindau syndrome (VHL). In southern Germany, a specific mutation in this gene, c.505 T>C, is one of the most frequent alterations owing to a founder effect.

Cardiac phase contrast gradient echo MRI: characterization of abnormal left ventricular wall motion in patients with ischemic heart disease.

Purpose: In our patient study, we examined the clinical usefulness of phase contrast velocity mapping for the detection and characterization of localized abnormalities of left ventricular motion.

Materials And Methods: Velocity encoding is based on the fact that motion in the presence of a magnetic field gradient causes a change of the phase of the MRI signal that is proportional to the velocity of tissue motion. Left ventricular motion was characterized by parameters describing rotation and contraction/dilatation, respectively.

Neurovascular contact of the brain stem in hypertensive and normotensive subjects: MR findings and clinical significance.

Background And Purpose: About 20 years ago, a theory was put forward that neurovascular contact of the root entry zone (REZ) of the ninth and 10th cranial nerve is responsible for elevated blood pressure in patients with essential hypertension. To test this hypothesis, we used MR tomography and MR angiography to evaluate the presence and degree of neurovascular contact of the REZ of the ninth and 10th cranial nerves in patients with essential hypertension as compared with patients with renal parenchymal hypertension and normotensive healthy volunteers.

Methods: Patients with essential hypertension (group 1; n = 33), renal parenchymal hypertension (group 2; n = 30), and normotensive healthy volunteers (group 3; n = 25) underwent high-resolution (axial and coronal) brain stem MR imaging and MR angiography.

Optimization of contrast-enhanced MR angiography of the hands with a timing bolus and elliptically reordered 3D pulse sequence.

Our objective was to optimize bolus administration and sequence setting in gadolinium-enhanced magnetic resonance (MR) angiography of the hands. Elliptically reordered three-dimensional (3D) spoiled gradient-echo sequence with non-slab-selective radio frequency excitation was optimized according to the measurements of arterial and venous time-signal curves in 21 patients. Great variations in bolus arrival time and arterio-venous transit time could be observed.

Differentiation of vascular birthmarks by MR imaging. An investigation of hemangiomas, venous and lymphatic malformations.

Purpose: To evaluate the use of MR imaging using standard sequences in the differentiation of common vascular birthmarks of soft tissues in childhood.

Material And Methods: Forty-three lesions in 37 children (median age 33 months) with hemangiomas (n=25), venous (n=8) and lymphatic (n=10) malformations were retrospectively studied. Images were obtained with a 0.

[Preoperative examination of potential kidney transplantation donors: value of gadolinium-enhanced 3D MR angiography in comparison with DSA and urography].

Purpose: To assess a contrast-enhanced standardized MRA protocol for the presurgical evaluation of potential renal transplant donors.

Methods: Twenty-three potential donors for renal transplantations were examined with gadolinium-enhanced, two-phase MR angiograms (1.5 T) and DSA/urography for the number of renal arteries, the presence of aberrant arterial and venous branches, renal artery stenoses and anatomy of the renal collecting system and ureters.

Cardiac phase contrast gradient echo MRI: measurement of myocardial wall motion in healthy volunteers and patients.

A number of methods have been proposed for the noninvasive measurement of myocardial wall motion. The paper describes a strategy for assessing myocardial motion based on the sensitivity of the phase of the MR-signal to motion using a breath-hold phase contrast technique. A motion-sensitized and a motion-compensated MR-signal are measured during successive scans.