Magnetic resonance imaging examinations of gluteal decubitus ulcers in spinal cord injury patients.

The purpose of our study was to use magnetic resonance imaging (MRI) to determine deep changes in soft tissues and bones underlying decubitus ulcers which occur in spinal cord injury (SCI) patients. By diagnosing these deep changes adjacent to decubitus ulcers, MRI can facilitate proper clinical management and prevent contraindicated surgery. MRI evaluation was performed on 37 male SCI patients for a total of 44 diagnostic studies.

Lymphoma in a pelvic spleen: CT features.

A case of recurrent lymphoma presenting as a pelvic mass on CT is described. At surgery this proved to represent an ectopic spleen with lymphomatous infiltration.

Magnetic resonance imaging of brain anatomy in severe developmental dyslexia.

The brain anatomy of ten men (aged 18 to 28 years) with persistent, severe developmental dyslexia was examined with magnetic resonance imaging to explore the possibility of visualizing pathology not seen in previous computed tomographic scan studies. Nine of the ten examinations were clinically normal. One showed a focal finding thought to be incidental to dyslexia.

Tumors and arteriovenous malformations of the spinal cord: assessment using MR.

Thirty-three patients with either primary spinal cord tumors (n = 18), intradural tumors excavating into the cord (n = 9), or spinal arteriovenous malformations (AVM) (n = 6) were studied with magnetic resonance (MR) imaging. In 25 of 38 examinations (66%) (five patients were studied twice), MR provided more information than that provided by other neuroradiologic procedures. In several cases, MR affected patient management decisions.

MR imaging of the liver in primary hepatocellular carcinoma.

In 10 patients with hepatoma, magnetic resonance (MR) and CT of the liver were subjectively compared and correlated with surgical or autopsy findings. In five cases MR defined the extent of the tumor better. Magnetic resonance was particularly useful in differentiating the tumor from otherwise abnormal areas of the liver, mostly focal cirrhosis.

Improved detection of focal lesions with computerized tomographic examination of the liver using ethiodized oil emulsion (EOE-13) liver contrast.

A prospective study of computerized tomography (CT) of the liver using a liver contrast agent compared to conventional CT was undertaken. CT scanning without contrast agents (NC-CT), CT with water-soluble contrast (WSC-CT), and CT with ethiodized oil emulsion (EOE-CT) were performed on patients with possible or probable hepatic metastases. The findings on these three examinations were compared to the objective findings at surgery in 53 patients.

Assessment of perfusion patterns during hepatic artery infusion chemotherapy: EOE-13 CT and 99mTc-MAA scintigraphy.

Hepatic perfusion patterns were evaluated in five patients receiving hepatic artery infusion chemotherapy. All patients underwent 99mTc macroaggregated albumin (99mTc-MAA) scintigraphy and CT with EOE-13. In each case, the diagnostic agent was administered through the infusion catheter at 0.

CT of the liver and spleen with EOE-13: review of 225 examinations.

EOE-13 is an experimental liver-spleen-specific computed tomographic (CT) contrast agent developed at the National Institutes of Health. Experience with this agent in 225 clinical examinations is described. On average, use of EOE-13 increases the attenuation of normal liver by 32.

Rate of growth of intraabdominal metastases from colorectal cancer.

Monitoring the progression or regression of intraabdominal metastatic disease is required for knowledgeable management of chemotherapeutic regimens designed to treat metastases. Computerized tomography (CT) and CT with EOE-13, a liver contrast agent, allowed precise measurement of metastatic disease. The tumor doubling time of colorectal metastases in four patients was determined from serial CT scans of individual patients.

Direct infusion of EOE-13 into the hepatic artery. Experimental evaluation of safety in monkeys.

Ethiodized Oil Emulsion 13 (EOE-13) is an intravenous liver-spleen specific CT contrast agent. We infused EOE-13 directly into the hepatic arteries of five rhesus monkeys. Normal saline was administered in the same fashion in two control animals.

Intraarterial administration of EOE-13 for the CT evaluation of hepatic artery infusion chemotherapy.

EOE-13 was infused directly into the hepatic artery through a surgically implanted hepatic artery infusion pump in a patient with liver metastases. A computed tomographic scan obtained after EOE-13 infusion accurately showed the perfusion pattern of the implanted catheter. It also demonstrated the hepatic metastases more clearly than scintigraphy with 99mTc-macroaggregated albumin.

Right upper quadrant abdominal masses mimicking hepatic tumours: an approach to management.

Four patients with large right upper quadrant tumour masses of non-hepatic origin are presented. On initial clinical and radiological assessment, all cases were misinterpreted as either having a primary liver tumour or extensive invasion of the liver by an extrinsic tumour. Although angiography and CT scanning are most likely to yield an accurate diagnosis, they can be misleading.

Segmental hyperlucent defects in the liver.

When lucent defects in the liver have a segmental configuration, they may be on an ischemic basis and related to decreased vascular perfusion. Portal venous inflow, by virtue of its low pressure, is particularly susceptible to diversion by focal intrahepatic masses, intravenous thrombi, or external compression. Innovative operative techniques for tumor enucleation may also result in lucent defects that can be confused with, or conceal, pathology.

Experimental evaluation of five liver-spleen specific CT contrast agents.

We tested five experimental liver-spleen specific computed tomography (CT) contrast agents, all of which are aqueous emulsions of iodinated vegetable oils. These compounds were compared with ethiodized oil emulsion 13 (EOE-13) and with a 5% dextrose in water control. We evaluated three animal/dose level models with both histology and CT to determine the best screening method for compounds of this type.

Detection of hepatic metastases: comparison of EOE-13 computed tomography and scintigraphy.

Accurate detection of hepatic metastases is necessary to properly stage and follow many malignancies. Nineteen patients underwent computed tomographic (CT) examination with ethiodized oil emulsion 13 (EOE-CT) and liver scintigraphy within 1 month of an exploratory laparotomy. The sensitivity, specificity, and accuracy of these two imaging procedures were evaluated statistically.

Nuclear magnetic resonance (NMR) imaging of the brain in systemic lupus erythematosus.

Nuclear magnetic resonance (NMR) and X-ray computed tomographic (CT) imaging of the brain were performed on nine patients with clinical evidence of cerebral involvement by systemic lupus erythematosus (SLE). Focal lesions were demonstrated in eight patients by NMR and in six by CT. The examinations with both techniques were negative in one patient and showed essentially identical pathological conditions in three patients.

Biodistribution study of Ethiodized Oil Emulsion 13 for computed tomography of the liver and spleen.

Biodistribution studies were conducted with a new intravenous lipoid contrast material currently undergoing clinical trials in four hospitals. The contrast material selectively opacifies the liver and spleen for computed tomographic examination. The experiments were performed on rats with 125I-labeled ethiodized oil emulsion.

EOE-13 in the detection of hepatosplenic lymphoma.

Thirty-nine patients with lymphoma were evaluated prospectively to determine the usefulness of Ethiodol-Oil-Emulsion-13 (EOE-13) in the detection of hepatosplenic lymphoma by computed tomography. The detection rate in the spleen increased from 8% (before EOE-13 infusion) to 92% (after EOE-13 infusion). In ten of 39 patients (25%) in this series, lymphomatous disease was recognized only on the postinfusion computed tomographic scan.

Computed tomography of the liver and spleen with intravenous lipoid contrast material: review of 60 examinations.

In 60 computed tomographic examinations of the liver and spleen in 55 patients, a new intravenous lipoid contrast material, Ethiodized Oil Emulsion 13, was used. This organ-specific contrast material, retained by the reticuloendothelial cells of the liver and spleen, caused marked increase in the attenuation of the liver and spleen, but did not appreciably change the attenuation of the tumor involving these organs, thereby significantly increasing the density differential between normal and abnormal tissue. Toxicity was considered to be well within tolerable limits with the most frequently noted untoward side effects of chills, fever, headaches, and foul metallic taste.

The risk of hepatic artery embolization in the presence of obstructive jaundice.

Rhesus and cynomolgus monkeys were used as experimental subjects to determine the extend to which the presence of biliary obstruction increases the risk of hepatic necrosis following hepatic artery embolization. It was found that peripheral hepatic artery embolization without biliary obstruction resulted in acute hepatic swelling and dysfunction and chronic focal infarction with bile cyst formation. However, massive hepatic necrosis and bile lakes were not seen.