Endometriosis: appearance and detection at MR imaging

Article Abstract:

Endometriosis is a condition in which endometrial tissue (the lining of the uterus) is found outside of the uterus. About 25 percent of women between 30 and 40 years of age are affected by this condition. Laparoscopy, an invasive diagnostic procedure, is commonly used to classify endometriosis and monitor the patient's response to treatment. Magnetic resonance (MR) imaging, a noninvasive diagnostic method, has been suggested as a replacement for laparoscopy for evaluating endometriosis. A study evaluating the accuracy of MR imaging exams of women with endometriosis, as compared to laparoscopy, was conducted in a study of 31 female patients. Tests showed that MR imaging can not substitute for laparoscopy in defining endometriosis because the MR image is not pathognomonic (capable of identifying specific symptoms of the disease), nor can MR imaging identify the small, scattered lesions that are important indicators of the early stages of the disease. Researchers believe that the use of MR will be in monitoring treatment response for patients who have already been diagnosed, via laparoscopy, as having endometriosis. An important finding of the study was that MR can be used to identify disease not visible to the laparascopist. Therefore, MR imaging may be useful in patients with extensive, advanced stages of the disease. MR imaging for the detection of recurrent disease might also be useful.

Women, Diseases, Comparative analysis, Endometriosis, Endometrium, Uterine diseases, Pelvis, Laparoscopy

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Hepatic tumors: comparison of CT during arterial portography, delayed CT, and MR imaging for preoperative evaluation

Article Abstract:

The anatomic localization of liver tumors, either originating in the liver or from distant tumors (metastatic tumors), is essential information for surgeons planning to remove the tumors. While in the past right or left hepatic lobe resection was often required, it is now possible to restrict the surgical procedure to a much more limited physiologic segment of the liver. This paper surveys various radiologic imaging techniques, including computed tomography (CT), magnetic resonance imaging (MRI) and arterial portography (CTAP), and compares the results to the surgical findings. CT uses X-rays to produces anatomic views of the abdomen which appear as if the patient were sectioned. CTAP uses the CT to view the distribution of a dye injected into the hepatic artery via a catheter (a small tube passed into the patient's arterial blood system). MRI is a noninvasive techniques that images the inside of the abdomen by the application of a magnetic field to detect changes induced by the magnet on the chemical structure of the body. No single method was able to give a perfect localization of structures as expressed as a sensitivity; however CTAP (85 percent) was significantly more sensitive than the other methods. Combining information from two modalities further increased the sensitivity: CTAP plus MRI (96 percent); CTAP plus CT (85 percent); and MRI plus CT (77 percent).

Liver, Cancer, PET imaging, Positron emission tomography, Liver cancer, Cancer diagnosis

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Sanguinary efforts

Article Abstract:

The ability of magnetic resonance (MR) to present evidence of acute hemorrhage within the skull (intracranial) has been the center of great and continued controversy. Before the advent of MR, computed tomography (CT) had been used to diagnose acute intracranial hemorrhage. The biophysical mechanism that allowed CT to pinpoint such lesions was understood and shown to relate to the nature of the protein portion of the molecule hemoglobin (the red oxygen-carrying pigment of blood). The emergence of MRI (MR imaging) brought with it the emergence of a new underlying biophysical mechanism but the technology has also been criticized for its inability to detect acute hemorrhage, although chronic hemorrhage could be seen. Recently, significant advances in the use of MRI technique have lead to adequate visualization of acute intracranial hemorrhage. There is still more to learn about imaging of these lesions and the underlying physics which may be exploited by the clinician.

Brain, Hemorrhage, Brain hemorrhage, Cerebrovascular disease, Cerebrovascular disorders, Diagnosis, Radioscopic, Radioscopic diagnosis, editorial

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