35 patients with a total number of 53 AVN were examined with conventional radiographs (n = 53), radionuclide scans (n = 37), CT (n = 19) and MRI (n = 53). Findings were classified according to FICAT (stage 0-IV). With a sensitivity of 96.2% and a specificity of 98.1% MRI proved to be the most accurate imaging modality especially in early stages. CT proved to be a reliable technique, too, although accuracy was less compared with MRI. Radionuclide scanning was of minor value with a sensitivity of 62.1% and a specificity of 59.5%. Typical findings with plain radiographs, radionuclide scans, CT and MRI in different stages of AVN are described.

Magnetic resonance (MR) imaging may distinguish transient osteoporosis of the hip from more severe hip diseases. 12 patients with transient osteoporosis of the hip underwent MR imaging. The initial and follow-up studies included T1- and T2-weighted images in coronal, transverse or sagittal planes. There were revealed 3 stages: diffuse-, focal-, and residual stage. This syndrome is characterized by hip pain, limping, and osteoporosis of the femoral head with preservation of the joint space. The clinical symptoms and abnormalities on MR images disappeared completely within 6-10 months.

Among the available imaging techniques such as conventional radiography, radionuclide bone scan, and computed tomography (CT), magnetic resonance imaging (MRI) has made significant contributions to the diagnosis of acute hip joint disease in adults by enabling early differentiation between such conditions as idiopathic avascular femoral head necrosis, septic coxitis, degenerative disease, and tumors. In this study we investigated the use of MRI for evaluation of patients with transient osteoporosis (TO). MRI with T1- and T2-weighted sequences in coronal, transverse, and sagittal sections was performed in 12 patients with retrospectively confirmed TO, both at the onset of the disease and later as a follow-up procedure. MRI revealed three typical stages of TO: a diffuse stage, a focal stage, and a residual stage. Characteristic symptoms of TO are hip pain and a need for protective splinting of the hip joint. Conventional radiographs show demineralization of the hip joint without joint space narrowing. Clinical, radiologic, and MRI findings normalize within 6–10 months, indicating that TO has a good prognosis with complete restoration of bone density.

Die von P. Schilder 1912, 1913 und 1924 mitgeteilten Fälle von „Enzephalitis periaxialis diffusa“stellen kein einheitliches Krankheitsbild dar, vielmehr handelte es sich im 2. Fall wohl um eine Adrenoleukodystrophie und im 3. Fall um eine subakute sklerosierende Panenzephalitis. Lediglich die erste Patientin erfüllt aus heutiger Sicht die Kriterien der myelinoklastischen diffusen Sklerose, einer seltenen, besonders im Kindesalter vorkommenden Verlaufsform der multiplen Sklerose, die von der häufigeren Adrenoleukodystrophie abgegrenzt werden muß (Poser 1956). Wir berichten im Folgenden über einen bioptisch gesicherten Fall bei einem 11jährigen Mädchen.

Atypical early manifestations of multiple sclerosis (MS) are common in children and young adults. 6 patients (aged 5 to 33 years) were examined by MR because of confusing neurological manifestations. In addition to small MS lesions there were also large intracerebral lesions which, however, did not occupy additional space but which looked more like tumours or abscesses. The lesions were sharply demarcated cystic formations with margins that enhanced with contrast. The diagnosis of these lesions presents difficulties, the differential diagnosis including MS and its variants, neoplastic, infectious and vascular processes. MR can provide valuable diagnostic information.

Atypical early manifestations of multiple sclerosis (MS) are common in children and young adults. 6 patients (aged 5 to 33 years) were examined by MR because of confusing neurological manifestations. In addition to small MS lesions there were also large intracerebral lesions which, however, did not occupy additional space but which looked more like tumours or abscesses. The lesions were sharply demarcated cystic formations with margins that enhanced with contrast. The diagnosis of these lesions presents difficulties, the differential diagnosis including MS and its variants, neoplastic, infectious and vascular processes. MR can provide valuable diagnostic information.

A new and simple method for precise determination of lateral opposed treatment portals was developed and used in 17 patients. Compared to CT, MRI led to significant changes of portals in 59% (1017) of cases. Individual shielding blocks could be precisely designed by use of our new method. MRI is the procedure of choice in local radiation therapy planning of brain tumors.

Lateral displacement of the femoral head and slight flattening are typical radiological signs of early Legg-Calvé-Perthes disease. There is the value of magnetic resonance imaging (MRI) in demonstrating the congruity of the acetabular and femoral articular surfaces, the cartilage, the femoral head containment, intracapsular joint effusion, and hypertrophy synovium without using any ionizing radiation. Loss of containment because of lateralisation seems to be the result of medial hypertrophy of the femoral head cartilage. The hips show a characteristic low-intensity signal in T1-weighted images representative of necrotic areas of the capital epiphysis. The extent of involvement and revascularisation can be identified in Legg-Calvé-Perthes disease.

Lateral displacement of the femoral head and slight flattening are typical radiological signs of early Legg-Calve-Perthes disease. There is the value of magnetic resonance imaging (MRI) in demonstrating the congruity of the acetabular and femoral articular surfaces, the cartilage, the femoral head containment, intracapsular joint effusion, and hypertrophy synovium without using any ionizing radiation. Loss of containment because of lateralisation seems to be the result of medial hypertrophy of the femoral head cartilage. The hips show a characteristic low-intensity signal in T1-weighted images representative of necrotic areas of the capital epiphysis. The extent of involvement and revascularisation can be identified in Legg-Calve-Perthes disease.

A case of a 50-year-old female with an intrasellar and suprasellar cysticercus cyst, which was pre-operatively misinterpreted as a macroadenoma of the adenohypophysis is described. Cranial computed tomography revealed a homogeneous hyperdense intrasellar and suprasellar lesion. In T1-weighted magnetic resonance images, a spotty hyperintense tumor of the sellar region was shown.

MR-Imaging is well established as the most sensitive method for the diagnosis of avascular necrosis of the femoral head. In this paper preliminary results are analyzed in an attempt to clarify whether as in a vascular necrosis of the femoral head. MR changes after trauma or surgery allow conclusions concerning the vitality of the bone. Comparison of clinical, MR and histological findings revealed that we cannot yet differentiate between fibrosis of the bone marrow with sustained vitality of the osteocytes and bone necrosis. Therefore, conclusions with implications for therapy should be drawn with extreme care.

Twenty-three patients with Graves ophthalmopathy who underwent radiation therapy were monitored by means of magnetic resonance (MR) imaging. T2 relaxation times of extraocular muscles and orbital fat, areas of extraocular muscles, and degree of exophthalmos were measured by means of MR imaging at the beginning, at the end, and 3 months after completion of radiation therapy. As a result, patients with primarily elevated T2 times of extraocular muscles showed a better therapy response regarding muscle thickening than patients with primarily normal T2 times. Elevated T2 times, which probably represent acute inflammatory changes, were markedly decreased at the end of therapy. Therefore, quantitative MR imaging favors the choice of anti-inflammatory therapy regimens in patients with elevated T2 times of extraocular muscles. However, the clinical response (activity scores) to the low-dose treatment protocol that was used did not correlate well with primarily elevated T2 times. Furthermore, T2 times increased again after cessation of therapy. Whether a higher radiation dose or a different fractionation scheme leads to better results must be clarified by means of further study.

Relaxation processes observed with magnetic resonance imaging (MRI) originate from magnetic interactions between protons and their biochemical environment. The MR tissue parameters (T1, T2, and proton density, PD) are true physical characteristics of biological tissues but do not necessarily directly express histochemical arrangements.

When MRI first came into clinical use it was reported that malignant tumors display a prolongation of proton relaxation times. At that time there was great hope that three measurable tissue parameters, T1 and T2 relaxation times and proton density, would provide better specificity than other imaging modalities. While image quality has improved remarkably, results of studies investigating the value of MR tissue parameters have been contradictory.

Magnetic resonance (MR) imaging may distinguish transient osteoporosis of the hip from more severe hip diseases. 12 patients with transient osteoporosis of the hip underwent MR imaging. The initial and follow-up studies included T1- and T2-weighted images in coronal, transverse or sagittal planes. There were revealed 3 stages: diffuse-, focal-, and residual stage. This syndrome is characterized by hip pain, limping, and osteoporosis of the femoral head with preservation of the joint space. The clinical symptoms and abnormalities on MR images disappeared completely within 6-10 months.

This study reports the results of MRI analysis of the spinal cord in 83 patients with myelomeningocele. 63 patients had a "tethered cord" or a "suspected tethered cord". In 14 cases we found a "hydro-/syringomyelia". In only 2 cases there were no pathological findings. The influence especially of the "tethered cord" and the "hydro-/syringomyelia" on the development of deformities of the locomotor apparatus is discussed. Concerning this problem the experience reported in the literature is not sufficient enough to make final statements. However, in cases of deterioration of the neurological status in patients with myelomeningocele the influence of intraspinal anomalies should be considered giving rise to further diagnostic examinations.

The cervical spine is the second most common location for manifestation of rheumatoid arthritis (RA). Symptoms are typically related to involvement of the craniocervical junction. Unfortunately, conventional radiographic examination is often unable to demonstrate that RA is the cause of such symptoms. Magnetic resonance imaging (MRI) provides an unique opportunity to visualize nerves, connective tissue, and bone in all planes without the use of contrast agents. These features suggest that MRI could provide important information related to RA of the cervical spine. The possibilities and limitations of MRI were therefore evaluated in 60 patients with cervical RA. The main objective of this study was to correlate symptoms and clinical findings with MRI results to establish indications for this imaging procedure.

The objectives of our study were to investigate in vivo the effects of therapeutic brain radiation on the MR tissue parameters, spin-lattice (T1) and spin-spin (T2) relaxation times, and proton density and to confirm the correlation between tumor size and radiation dose.