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Rationale and objectives The authors describe the magnetic resonance (MR) imaging characteristics in patients with gestational trophoblastic disease (GTD) before and after therapy and to correlate these findings with human gonadotropin levels and the specific histology of GTD. Methods Thirteen women (mean age, 30.1 years) with elevated human chorionic gonadotropin (HCG) levels and histologically proven GTD underwent MR examinations of the pelvis. Magnetic resonance imaging was performed on a 1.5-tesla unit. Axial and sagittal proton density-weighted and T2-weighted and sagittal T1-weighted sequences were obtained. Four patients underwent follow-up studies after 4 and 8 weeks to monitor the response to therapy. Gestational trophoblastic disease was histologically proven with curettage in 11 patients and with hysterectomy in two cases. Results Nine patients had a diffusely enlarged uterus with pathologic signal intensities. In four patients, a focal tumor mass was observed. All patients showed loss of the zonal anatomy of the uterus in at least one local area. In 11 patients, no uterus zones could be identified throughout the entire uterus. Pathologic dilated tumor vessels were evident in all patients. In all four cases in which follow-up imaging studies were obtained, uterus size, signal intensities, identification of uterus zones, and uterus vessels returned to normal. Conclusion Magnetic resonance imaging shows trophoblastic tumor infiltration as diffuse uterus enlargement, focal tumor masses, loss of zonal anatomy of the uterus, and pathologic uterine vasculature; this seems to be the most reliable MR imaging finding in patients with GTD. No correlation was found between MR imaging changes and HCG levels or specific histologic types of GTD.

The authors differentiate acute tubular necrosis from transplant rejection in patients with delayed kidney graft function using gadolinium (Gd)-DTPA enhanced magnetic resonance (MR) imaging.Twenty-four patients after renal transplantation (10 with normal graft function, 14 with delayed graft function) underwent conventional and Doppler sonography and MR imaging examination after bolus application of Gd-DTPA. Within a time period of 512 seconds, 39 single-slice MR images were obtained. Measurements of signal intensity in three regions of interests (cortex, medulla, renal pelvis) resulted in a graphic description of the dynamics of the contrast enhancement. The time between the start of the scan and the peaks of the curves was measured.In patients with normal graft function the curves reached the peaks between 39 and 55 seconds (cortex), 44 and 61 seconds (medulla), and between 161 and 318 seconds (renal pelvis). Six patients with acute tubular necrosis showed normal values for the curves 1 and 2 but markedly prolonged time for curve 3 (between 420 and 512 seconds). In all patients with histologically proven transplant rejection, the peaks of all curves were not reached before the ends of the scans.The authors' preliminary results suggest that MR imaging seems to be a sensitive, noninvasive diagnostic tool to differentiate acute tubular necrosis from transplant rejection in the critical early postoperative period.

During childhood, serum melatonin concentrations drop by approximately 80%, but the 24-h melatonin excretion is stable. Arrest of pineal growth after the end of infancy has been proposed as one possible mechanism underlying that phenomenon. To test this hypothesis, we reviewed 332 magnetic resonance imaging brain studies, classified as normal, of endocrine-normal children, aged 1 day to 15 yr, and estimated the pineal and pituitary sizes. The pineal was identified in 277 of 332 magnetic resonance imaging studies (83%). The average size (mean +/- SEM) of the pineal gland (transaxial diameter, 5.6 +/- 2.1; midsagittal diameter, 5.0 +/- 2.4; planimetric area, 28.5 +/- 17.8) did not differ with age. A total of 74 of 277 pineals with cysts (26.7%) were found. The occurrence of pineal cysts was equally distributed among the different age groups (chi 2 = 11.6; df = 14; P = 0.7). Ten pineals showed more than 1 cyst (3.6%). The pituitary was identified in 325 of 332 brain images (97.9%). The average pituitary size increased by some 100% from 1 to 15 yr of age [transaxial diameter: F = 2.2; P = 0.005 (by two-way analysis of variance); midsagittal diameter: F = 3.7; P = 0.0001; planimetric area: F = 7.1; P = 0.0001]. The pituitary was slightly larger in females than in males [midsagittal diameter: F = 8.8; P = 0.003 (by two-way analysis of variance); planimetric area: F = 7.9, P = 0.005]. The data presented indicate a lack of a discernible pineal growth after age 1 yr, which contrasts with pituitary development in the same individuals. The data are in agreement with a hypothesis suggesting a growth arrest of the pineal after infancy.

On October 27 and 28, 1990, approximately 100 somatosensory neurobiologists met in St. Louis, Missouri to discuss the current state of inquiry into the organization of the somatosensory system, emphasizing those portions of the system devoted to processing of inputs from digitized cutaneous organs, such as the rodent mystacial vibrissae. Given the homeomorphic relationship between the vibrissae and cortical and subcortical barrels, a large number of laboratories now employ this model to ask fundamental questions about central processing of sensory inputs, mechanisms controlling topographic pattern formation, and substrates for injury-induced neuronal reorganization. The focus of the third annual Barrels Symposium (Barrels III) was on behavioral aspects of the whisker sense, cholinergic regulation of cortical modules, and genetic and peripheral determinants of barrel development.

The authors evaluate the accuracy of magnetic resonance (MR) imaging with body coil and endorectal surface coil techniques in the staging of cervical carcinomas and compare these results with those obtained with clinical staging (International Federation of Gynecology and Obstetrics [FIGO] classification) and postsurgical histopathology.Fifteen patients (average age, 48.6 years) with biopsy-proved cervical cancer were included in the study. After clinical staging (FIGO classification), MR imaging with body coil (BCMR) and subsequently with endorectal surface coil (ECMR) was performed. Using a 1.5-Tesla unit, axial and sagittal proton density weighted and spin echo T2-weighted and fast spin echo T2-weighted sequences were obtained with body and endorectal surface coil. During imaging analysis, special attention was paid to the uterine zones, the vaginal fornix, and the parametrial tissue. Ten patients were treated surgically (postsurgical histopathology was considered the gold standard), five patients, all clinically staged IIIb, underwent primary radiation therapy.Clinical staging with FIGO classification was accurate in 12 of 15 patients, and understaged in 2 and overstaged in 1 patient. Body coil MR showed accurate staging in 13 of 15 patients. Using this technique, understaging of 2 patients, both with only minimal tumor infiltration depth (8 mm), was performed. Endorectal surface coil MR was accurate in 14 of 15 patients missing minimal parametrial tumor infiltration in 1 patient. Histopathology (n = 10) revealed 3 patients with tumor stage T1b, 2 with stage T2a, and 5 patients with stage T2b.Although suggested by only a small number of patients, ECMR appears to be the most accurate modality for staging cervical carcinomas but seems to be unreliable in the detection of minimal tumor infiltration.

A 28-year-old asymptomatic woman was diagnosed to be heterozygous for adrenoleukodystrophy (ALD) by elevated very long-chain fatty acids in serum and fibroblasts after ADL had been diagnosed in her son. A year later she had transient unilateral blurred vision. Evoked potentials and brain magnetic resonance imaging showed further separate cerebral white matter lesions suggesting multiple sclerosis (MS). MS-like syndromes in women heterozygous for ALD may be more frequent than previously recognized.

A case of Dandy-Walker-syndrome is presented, comparing the value of sonography and CT in intrauterine diagnosis. Together with a review of the literature of the subject, pathogenesis, morphology and prognosis in regard to the psychomotoric development are discussed.

In a retrospective analysis the relative signal intensities in recurrent tumours of gynaecological origin (n = 16) and in areas of pelvic fibrosis (n = 24) were evaluated. MRI was able to assess biopsy-proven recurrences in 15/16 patients. In one female MRI was false-negative (submucosal tumour spreading), in another case false-positive (reactive lymphnode hyperplasia). Early fibroses (1-12 months following tumour treatment) were of higher signal intensity that late fibroses (time interval since treatment more than 12 months). Differentiation of recurrent disease from post-treatment fibrosis was optimized by long TR (2500 msec), long TE (80-100 msec) spinechopulse sequences.

An intraspinal extradural foreign-body granuloma following surgical removal of herniated intervertebral disc is demonstrated by myelography, spinal computed tomography and transabdominal spinal sonography. The radiologic findings and differential diagnoses are discussed.