Search

Background: The aim of the research was a comprehensive analysis of Cho concentration and Cho/Cr, NAA/Cho, NAA/Cho+Cr ratios for the purposes of the diagnostics and differentiation of brain tumours (the type of the pathological lesion in patients with brain tumours) with the use of HMRS technique. Material/Methods: The HMRS examinations were performed with the use of the MRI Signa Excite 1.5T system, in PRESS technique (TR=1500 ms, TE=35 ms) and involved 100 patients with brain tumours (age range: 18 to 81 yrs, mean age 50.61). Spectra were taken from three different locations: tumour centre, the tumour edge and contralateral unchanged cerebral tissue. All patients underwent surgery followed by histopathological analysis, on the basis of which two groups were separated (benign tumours, malignant tumours -50 cases each). Additionally, 30 healthy volunteers in the age of 20 to 79 years (mean age 40.8) were examined. Results: The comparison of the examined patients with the control group revealed significantly higher Cho concentrations in patients with brain tumours. The analysis of Cho concentration was also performed with consideration of the age factor (under and over 60 years of age). Significantly lower mean Cho concentrations were discovered in a group of patients under 60 years of age. The analysis of Cho concentrations and Cho/Cr ratios reveled statistical significance for two factors: voxel location factor and the type of the pathological lesion. The average of Cho concentration and Cho/Cr ratios were higher in the group of patients with malignant tumours. The highest Cho concentrations and Cho/Cr ratios were observed in the tumour centre. The relative NAA/Cho and NAA/Cho+Cr ratios were statistically significant when taking into consideration the voxel location factor only. The results received from contralateral normal cerebral tissue (the internal model) were compared with control group (the external model). Mean values of Cho concentration were slightly (insignificantly) increased in the internal model, especially in the group of patients with malignant brain tumour. Conclusions: Cho is an important metabolite, useful in the diagnostics of brain tumours and differentiation of the type of brain tumour.

Background: The relations of the crowns of impacted maxillary canines and the roots of adjacent incisors are difficult to evaluate on conventional radiographs due to superimposition of shadows of these structures. The aim of this study was to analyse the relations between the crowns of impacted canines and the roots of adjacent incisors with the use of computed tomography. Material/Methods: The study involved a group of 65 patients suspicious for an impacted maxillary permanent canine. All the patients underwent pantomography. In 44 individuals in the age of 13-31 years (mean age 17.1±4.5) the examination revealed shadows of the impacted crowns superimposed on the roots of incisors. These patients were subjected to CT. On the basis of those CT examinations (including multiplanar and three-dimensional reconstructions) we defined the location of the impacted canines as buccal, palatal and horizontal. Likewise, the relations between the crowns of impacted canines and the roots of lateral or/and central incisors were studied. Results: From among 54 impacted maxillary canines, 41 (75.9%) were located palatally, 10 (18.5%) buccally, and 3 (5.6%) horizontally. In 14 cases (29.5%), the impacted canine remained in various kind of contact with both adjacent incisors. In addition to those aforementioned 14 cases, the impacted maxillary canine remained in contact with adjacent root of the lateral incisor in 34 cases (in total: 48 cases of contact). We found 17 cases (35.4%) of adherence without features of root resorption and 31 cases (64.4%) of resorption. Among the cases of resorption, there were 18 instances of deep resorption (58.1%) and 13 instances of light resorption (41.9%). There were also 18 cases (33.3%) of contact between the impacted canine and the root of the central incisor, including 10 instances (55.6%) of adjacency without root resorption and 8 cases (44.4%) of resorption. Conclusions: Computed tomography allows for a precise localisation of the impacted teeth and evaluation of their influence on the adjacent anatomical structures.

Purpose Methods and Materials Results Conclusions, Purpose: Angiography systems have undergone substantial technological process over the last decade. One of the new techniques is DynaCT application. It enables to perform CT-like images with use C-arm angiography system. Imaging data are acquired during...

Purpose Methods and Materials Results Conclusions, Purpose: The objective of the research was to assess the effect of ethyl alcohol on the central nervous system used the HMRS...

Background: Breast MR examination is capable of detecting suspected lesions that are not visualized by other imaging techniques, such as mammography or ultrasonography. In all cases such lesions should be verified histopathologically by MR-guided core biopsy. The aim of the study was the determination of effectiveness of MR-guided breast core biopsy in detection of breast pathologies. Material/Methods: Twelve women with suspected lesions detected by MR (GEMS Signa Excite 1.5 T with 4-channel open breast coil manufactured by MRI Devices Corporation) were qualified to MR-guided breast biopsy. Obtained image data were transferred to DYNACAD workstation for calibration, lesion localization, and automatic calculation of target coordinates for MR-guided intervention. Biopsy was performed using automated 14G biopsy needle. Results: MR-guided breast biopsy was performed in 9 women and confirmed lobular and ductal carcinoma in 2 patients respectively, lobular carcinoma in situ (LCIS) in 1, intraductal papilloma in 2, and intraductal hyperplasia without atypia. In 3 patients histopathologic examination revealed benign fibrocystic lesions. Three women were disqualified from biopsy because pre-biopsy MR sequences did not reveal the lesion in 1 case, and due to the target localization out of reach of the biopsy needle in other 2 cases. Conclusions: All non-palpable lesions visualized by MR (contrast-enhanced signal in dynamic examination) should be verified by MR-guided breast biopsy. In each case histopathologic

Background: The correctness of CT performed with the use of a double-scan technique is the basis for achieving proper quality of 3D reconstructions of the maxilla or mandible and subsequent virtual planning of dental implant placement. The aim of this study was the presentation of the methodology of computed tomography scanning and own experience with the use of the double-scan technique. Material/Methods: The study group included 26 individuals who underwent MDCT with a double-scan technique using a MDCT scanner SOMATOM Sensation (Siemens, Germany). The parameters of the examination: slice-collimation 10x0.75 mm, slice-thickness 0.75 mm. The first CT scan in the procedure was the scan of the patient wearing a radiological prosthesis and occlusal index, which was followed by a separate scan of the radiological prosthesis. These two CT scans were copied and transferred to PC with Procera Software program (Nobel Biocare, Sweden) where dental implant placement was virtually planned. Results: In all 26 patients, precise three-dimensional reconstructions of the anatomical structure were obtained. In 11 patients, on the basis of the virtual planning, the implant placement was performed, 5 patients were referred to preparatory procedures, that is, restoration of the alveolar process, otolaryngological treatment of the maxillary sinuses. The remaining 10 patients did not qualify to the procedure because of unfavorable anatomical conditions. Conclusions: Correct computed tomography with double-scan technique enables virtual planning of dental implant placement, on the basis of which the real procedure of implantation can be performed.

Background: The aim of this work was to assess the usefulness of MR imaging in the evaluation of temporomandibular lateral disc displacement in patients with posterior occlusion and the significance of the results of MRI in the diagnosis and treatment of posterior occlusion. Material/Methods: Imaging evaluation was performed to 80 temporomandibular joints in 40 patients with posterior occlusion, of both sexes, at the age of 16-35, prior to orthodontic treatment. The imaging technique used for the evaluation of temporomandibular joints was magnetic resonance using the Signa Horizon 1.5 T System (GEMS) during rest occlusion. The evaluation was focused on bony structures of the joint and its posterior ligament. The type of joint was defined as intermediate in case of the articular tuberculum of a semicircular shape, shallow - in case of horizontally elongated ellipse, and deep - in case of vertically elongated ellipse. The symmetry of the articular space as well as the alignment of the articular disc in the frontal plane was also evaluated. The obtained data were presented in form of figures and graphs and analysed using the statistics software - BMDP New System 2.0. Results: In patients with posterior occlusion, the so-called intermediate type of temporomandibular joint was found to be the most common, whereas the symmetrical articular space occurred in 33.7% of cases. The rate of narrowed retrodiscal region was 61.2%, which was a statistically significant difference in comparison with the control group. The assessment of position of the disc in the frontal plane during occlusion revealed 12.6% of medial displacement and 6.2% of lateral displacement. Statistically significant differences between the study group and the control group were found concerning the disc position during occlusion assessed in the frontal plane (χ2=9.564; p=0.008). Statistically significant differences were confirmed concerning the width and symmetry of the articular space between the two groups - the persons with posterior occlusion and the control group (χ2=24.174; p=0.0001). In persons with posterior occlusion no significant correlation was found between the type of the joint and the position of the articular disc during occlusion in the frontal plane, that is the lateral and medial displacement (χ2=2.529; p=0.640). Correlation was found between the type of the joint and its symmetry, narrowed or widened articular space in the retrodiscal region (χ2=15.54; p

Background: The aim of the study was to determine the effectiveness of mammotome biopsy (MB) in detecting preclinical breast pathologies. Material/Methods: The material consisted of 847 women, of whom, based on mammography and ultrasound, 349 patients were referred to have stereotactic mammotome biopsy (SMB) guided by digital mammography and 498 women were subjected to hand-held mammotome biopsy (HHMB) guided by US. Results: Ultimately, MB was done in 819 women. In all cases where breast carcinoma or atypical ductal hyperplasia (ADH) were detected, the patients were operated on and postoperative histopathology was treated as the reference for post-biopsy histopathology. Patients in whom post-MB histopathology detected benign lesions were subjected to a strict long-term follow-up using imaging studies. Ultimately, thanks to MB, 94 cases of breast cancer (12%) were detected as well as 725 (88%) cases of benign lesions, which corresponds to a sensitivity of 98.9% and 100% specificity. Conclusions: MB is an alternative to surgical biopsy in differentiating preclinical breast lesions. It is associated with a minimal risk of complications and may be successfully performed in an outpatient setting.

Background: Management of patients with intracranial tumor depends on accurate diagnosis of its histology. The aim of this study was to identify the accuracy with which radiologists were able to diagnose the tumor type on CT or MRI. Material/ Methods: Two groups of patients with definitive histopathological diagnoses and with complete radiological documentation were included into the study. The first group contained 85 of 110 patients operated on because of posterior cranial fossa tumor between Jan. 1, 2001, and Feb. 30, 2003. The second group comprised 63 of 100 patients operated on because of supratentorial tumor between Jan. 1 and June 30, 2002. Cases with multiple cerebral metestases or recurrent brain tumors were excluded. Accuracy, sensitivity, and specificity were calculated. Results: In the first group the histological diagnoses were as follows: 25 neurilemmomas, 19 metastases, 16 meningiomas, 10 hemangioblastomas, 7 gliomas, and in the remaining 8 other types. The sensitivities of the radiological diagnoses for the above-mentioned histological types were, respectively, 92%, 89%, 81%, 70%, 86%, and 25%. The general accuracy was 80%. In the second group, 19 were high-grade gliomas, 16 meningiomas, 10 metastases, 7 low-grade gliomas, 7 hypophyseal adenomas, and the remaining 4 were others. The sensitivities of radiological diagnoses were, respectively, 84%, 100%, 70%, 57%, 86%, and 50%. The general accuracy was 81%. Conclusions: CT with contrast, supplemented by MRI in more difficult cases, has high histological diagnostic sensitivity in

Background: Morphological MR imaging using endorectal coil has high sensitivity but insufficient specificity in the detection of prostatic cancer. Higher specificity may be obtained by combining morphological MR with data on local metabolic disturbances in MR spectroscopy. The aim of our study was to assess the diagnostic accuracy of combined morphological MR and 3D proton spectroscopy using endorectal coil in prostate cancer detection. Material/Methods: Morphological MR and 3D proton MR spectroscopy were performed in 20 patients with suspicion of prostate cancer on the basis of DRE, TRUS and/or PSA levels, finally verified in biopsy after MR. The examinations were performed with a 1.5 T GE Signa Excite scanner using an endorectal coil. We used axial, coronal and sagittal T2 FSE, axial T1 SE and 3D PROSE (PROstate Spectroscopy and imaging Examination) sequences. The diagnostic accuracy of combined morphological and spectroscopy assessment was compared to the accuracy of morphological MR alone. Results: The specificity, PPV, and NPV of MR imaging using endorectal coil in the detection of prostatic cancer were higher in combined morphological and spectroscopic assessment compared to morphological assessment alone. Conclusions: 3D MR spectroscopy, in comparison to morphological MR imaging, provides additional data concerning metabolic disturbances in prostate cancer foci. The use of combined morphological MR and MR spectroscopy can improve the specificity of prostate cancer detection.

Aim. The aim of the study was imaging of the central nervous system activity with the fMRI method during hypnosis as well as confirmation of the observations linking subjective effects of suggested analgesia with the functional changes on the neurophysiological level. Method. At first volunteers (7 female, 7 male) were examined with fMRI in the resting state and then four times during application of painful stimuli such as pricking of the right hand. Four experimental conditions were associated with this stimulation: only nociceptive stimulation, after analgesic suggestion, after hypnotic induction and after consecutive analgesic suggestion in hypnosis. In the fifth condition, concentration of attention was an experimental condition, while the control condition was distraction of attention (e.g. free associations). The contrast differences between measurements in the consecutive phases of the experiment were analysed. Results. Decreases of activity of regions known for contributing to pain reception were found, probably as an effect of analgesic suggestion. This effect was seen especially in the area of L-thalamus. Suggestion (more precisely - the reception of its content) was related mainly to the R-ACG area activity growth. Hypnotic induction was correlated with increasing activity of the L-orbitofrontal gyrus. Concentration of attention was linked with activity increase within inferior parietal lobule, occipital middle/superior gyri; in the left hemisphere in the orbital frontal gyri and insula/frontal operculum. Conclusion. Both hypnosis and reception of analgesic suggestion are linked with increasing activity in particular brain areas, whereas the effect of analgesic suggestion demonstrates itself in the fMRI mainly by diminishing the reaction on painful stimuli.

Background: The aim of the study was to find an optimal method of bronchial tree examination using CT virtual bronchoscopy and to evaluate the method for its diagnostic accuracy in the assessment of lung malignancies. Additionally, diagnostic accuracy of the used CT system was analyzed. Material/Methods: The examination was conducted in 154 patients from the University Hospital in Cracow and the University Hospital in Leuven (Belgium). The first group of patients was examined using single detector-row HeliCat Flash CT scanner (Philips Medical Systems) in the Department of Radiology of the University Hospital in Cracow. The second group of patients was examined using 16-detectorrow Mx8000 IDT 16 CT scanner (Philips Medical System) in the University Hospital in Leuven, Belgium. Lung lesions were evaluated by their central and segmental localization in bronchial tree and the degree of bronchial tree stenosis was assessed subsequently. Results: It was shown that singleslice CT virtual bronchoscopy allows a reliable evaluation of the lesions with central localization in bronchial tree, while diagnostic accuracy of multislice CT virtual bronchoscopy is comparable with bronchofiberoscopy in the evaluation of lesions with central and segmental localization. Conclusions: As a result of the study it was concluded that type of the used CT system affected the obtained results. Multislice CT is more accurate in assessing the lesions localized in bronchial tree in considerably shorter time.

Background: The aim of the study is to present the technique of making medical models, describe the process of accomplishing this using stereolithography, a Rapid Prototyping method, and report our own preliminary experiences using this technology. Material/Methods: Nine medical models were made at the Faculty of Mechanical Engineering of the Rzeszów University of Technology using stereolithography technology. An SLA 250 device by 3D Systems and SL-5170 resin were used. Images from CT and MR examinations performed in the Radiology Department of the Collegium Medicum Jagiellonian University served as the data defining the physical models. Results: Medical models were made with the help of stereolithography technology using equipment available in Poland. Qualitative evaluation of the models showed very good correspondence with the imaged anatomical elements. Conclusions: Using Rapid Prototyping technology in medicine may be beneficial for both physicians and patients. However, for wide-spread use of this me

Background: DICOM created a common software platform enabling communication between devices from different vendors. This allows the creation of a PACS (Picture Archiving and Communication System) - a hospital network of imaging modalities, graphics workstations, film printers, and archiving devices. The aim of this study was to show the practical aspects of using a heterogeneous PACS, composed of equipment from several vendors. Both advantages and problems in the cooperation of theoretically "DICOM compatible" devices are presented. Material/Methods: A heterogeneous PACS was gradually created in our department between 1998 and 2003, currently consisting o f a Siemens CT multi-row scanner, a GE MRI scanner, a GE rotational angiograph, Siemens, GE, Marconi, and eFilm Medical graphics workstations, and Agfa thermal printers. DICOM 3.0 was used as a common protocol and the 100 Mb Ethernet as the hardware solution. Connectivity and interoperability in such a system were tested. Results: Using the DICOM protocol, it was possible to transfer images from the modality of one vendor to the graphics workstation of another vendor and then use sophisticated software for image processing. It was also possible to use storage devices such as CD recorders for images from modalities without a built-in storage option. In spite o f theoretical DICOM compatibility, in some cases it was not possible to achieve correct communication in practice. Conclusions: DICOM enables the gradual creation of a PACS with devices from different vendors, thus reducing implementation costs. Using a PACS, many different imaging modalities may use the same graphic workstations and digital printers. Usually one could expect full compatibility o f all DICOM devices; however, in practice cooperation is sometimes limited or erroneous, reducing the benefits of the standard. Archiving data on CD-ROMs is a solution which greatly reduces the operational costs of a radiology department.