PURPOSE:The purpose of this study was to determine the type and frequency of characteristic bone and soft tissue changes on MRI of patients with a clinical diagnosis of plantar fasciitis.MATERIALS AND METHODS:28 patients with a clinical diagnosis of plantar fasciitis underwent MR imaging. Besides T1- and T2-weighted sequences, short-tau-inversion-recovery sequences were used routinely. In 27 patients T1-weighted images after intravenous contrast injection were acquired additionally. As a control group the images of 15 patients without clinical signs for plantar fasciitis were evaluated.RESULTS:In 25 of 28 cases (89%) the clinical diagnosis of plantar fasciitis was established by MR imaging. The most common finding was a peritendinous edema at the calcaneal insertion site which was found in all 25 patients. In 19 of 25 cases (76%) a bone marrow edema of the calcaneus was present. In 14 of 25 cases (56%) an intratendinous signal intensity increase of the plantar fascia could be observed which showed contrast enhancement in 12 cases. Compared to the control group (mean thickness 3.3 mm) the plantar fascia showed significant thickening in the 25 MR positive patients (mean thickness 6.72 mm).DISCUSSION:Besides thickening of the plantar fascia and intratendinous signal intensity increase with contrast enhancement to some extent, bone marrow edema of the calcaneus and peritendinous edema close to the plantar fascia are characteristic signs of plantar fasciitis on MRI. Both signs can reliably be seen on STIR sequences only.

200 patients with blunt abdominal trauma were scanned by ultrasound primarily. 152 showed a normal sonographic examination. In 24 patients an organic injury was visualised. These 20 splenic injuries, 2 lesions of the kidney, 1 splenic and renal lesion and 1 hepatic and splenic rupture were confirmed by CT in 9 cases, by laparotomy in 9 cases, by sonographic follow-up in 2 cases. 23 patients showed an intraabdominal fluid collection, in 16 patients a decrease was seen by ultrasound. 7 patients were directly operated on because of a visible increase of intraabdominal fluid. The lesions consisted of 3 hepatic ruptures, 2 retroperitoneal bleedings. Ultrasound is a reliable tool in the diagnosis of blunt abdominal trauma on the day of admittance and in the evaluation of injuries in respect of operative or conservative management.

AIM:To assess the value of high-resolution ultrasound in the diagnosis of breast lesions.METHOD:Fifty women with a clinically suspicious breast mass were examined with mammography, conventional and high-resolution sonography. Ultrasound was performed with a linear-array 7.5-mHz transducer and an annular-array 13.0 MHz transducer.RESULTS:Histology showed carcinoma in 28 patients, fibrocystic changes in 20 and fibroadenoma in 2. High-resolution ultrasound characterized 18 lesions more accurately than conventional ultrasound, including 13 carcinomas, 3 fibrocystic changes and 2 fibroadenomas. The size of 8 carcinomas was measured more accurately with high-resolution ultrasound than with conventional ultrasound.CONCLUSION:High-resolution ultrasound is more valuable in the differentiation and size determination of breast lesions than conventional ultrasound.

Purpose: The purpose of this study was to determine the type and frequency of characteristic bone and soft tissue changes on MRI of patients with a clinical diagnosis of plantar fasciitis. Materials and Methods: 28 patients with a clinical diagnosis of plantar fasciitis underwent MR imaging. Besides T-1- and T-2-weighted sequences, short-tau-inversion-recovery sequences were used routinely, In 27 patients T-1-weighted images after intravenous contrast injection were acquired additionally. As a control group the images of 15 patients without clinical signs for plantar fasciitis were evaluated. Results: In 25 of 28 cases (89%) the clinical diagnosis of plantar fasciitis was established by MR imaging. The most common finding was a peritendinous edema at the calcaneal insertion site which was found in all 25 patients. In 19 of 25 cases (76%) a bone marrow edema of the calcaneus was present, In 14 of 25 cases (56%) an intratendinous signal intensity increase of the plantar fascia could be observed which showed contrast enhancement in 12 cases. Compared to the control group (mean thickness 3.3 mm) the plantar fascia showed significant thickening in the 25 MR positive patients (mean thickness 6.72 mm). Discussion: Besides thickening of the plantar fascia and intratendinous signal intensity increase with contrast enhancement to some extent, bone marrow edema of the calcaneus and peritendinous edema close to the plantar fascia are characteristic signs of plantar fasciitis on MRI. Both signs can reliably be seen on STIR sequences only.

PURPOSE:The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltration patterns in multiple myeloma, in order to develop a fast and cost effective screening method.MATERIALS AND METHODS:In a prospective study, 50 patients with histologically proven multiple myeloma were examined with the following standardised sequences: T1-weighted SE, T2-weighted FSE, opposed phase GRE, FSE STIR, T1-weighted SE post gadopentate dimeglumine without and with fat saturation. The images were evaluated in a ROC analysis by three radiologists in consensus with a 5-grade scale separatively for diffuse and focal involvement. The gold standard was bone marrow histology in cases of diffuse infiltration and the combination of all sequences with the staging system according to Durie and Salmon.RESULTS:For focal bone marrow involvement the area under curve was greatest for FSE STIR sequences, in cases of diffuse infiltration the area under curve was superior for unenhanced T1-w SE-Sequenz images. The sensitivity can be increased by contrast material application and signal intensity measurements. A combined focal and diffuse infiltration and a "salt and pepper" pattern can be diagnosed with the combination of T1-w SE-Sequenz and FSE STIR sequences.CONCLUSION:With T1-weighted SE-Sequenz sequences pre- and post-contrast and FSE STIR all therapeutical relevant infiltration patterns of plasmocytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.

The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltration patterns in multiple myeloma, in order to develop a fast and cost effective screening method.In a prospective study, 50 patients with histologically proven multiple myeloma were examined with the following standardised sequences: T1-weighted SE, T2-weighted FSE, opposed phase GRE, FSE STIR, T1-weighted SE post gadopentate dimeglumine without and with fat saturation. The images were evaluated in a ROC analysis by three radiologists in consensus with a 5-grade scale separatively for diffuse and focal involvement. The gold standard was bone marrow histology in cases of diffuse infiltration and the combination of all sequences with the staging system according to Durie and Salmon.For focal bone marrow involvement the area under curve was greatest for FSE STIR sequences, in cases of diffuse infiltration the area under curve was superior for unenhanced T1-w SE-Sequenz images. The sensitivity can be increased by contrast material application and signal intensity measurements. A combined focal and diffuse infiltration and a "salt and pepper" pattern can be diagnosed with the combination of T1-w SE-Sequenz and FSE STIR sequences.With T1-weighted SE-Sequenz sequences pre- and post-contrast and FSE STIR all therapeutical relevant infiltration patterns of plasmocytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.

Purpose: The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltration patterns in multiple myeloma, in order to develop a fast and cost effective screening method. Materials and methods: In a prospective study, 50 patients with histologically proven multiple myeloma were examined with the following standardised sequences: T-1-weighted SE, T-2-weighted FSE, opposed phase GRE, FSE STIR, T-1-weighted SE post gadopentate dimeglumine without and with fat saturation. The images were evaluated in a ROC analysis by three radiologists in consensus with a 5-grade scale separatively for diffuse and focal involvement. The gold standard was bone marrow histology in cases of diffuse infiltration and the combination of all sequences with the staging system according to Durie and Salmon. Results: For focal bone marrow involvement the area under curve was greatest for FSE STIR sequences, in cases of diffuse infiltration the area under curve was superior for unenhanced T-1-w SE-Sequent images. The sensitivity can be increased by contrast material application and signal intensity measurements; A combined focal and diffuse infiltration and a "salt and pepper" pattern can be diagnosed with the combination of T-1-w SE-Sequent and FSE STIR sequences. Conclusion: With T-1-weighted SE-Sequent sequences pre-and post-contrast and FSE STIR all therapeutical relevant infiltration patterns of plasmocytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.

Cysts are common around joints. On the basis of the presence or absence of a synovial lining of the cyst wall, they are histologically divided into synovial cysts and ganglia. Paraarticular cysts may communicate with the adjacent joint and are often associated with underlying joint disorders. The goals of imaging paraarticular cysts are to define the benign cystic nature of the lesions, assess the location and size of the cysts, define their relationship to surrounding structures, demonstrate or exclude communication with the joint, and detect related joint disease. Imaging examinations that offer the most information regarding paraarticular cysts are arthrography, ultrasound, and MR imaging. Generally, cysts present as well-delineated, smoothly bordered, homogeneous mass lesions with preserved adjacent soft-tissue planes. Arthrography might be the best imaging technique to demonstrate communication of the cyst with the joint; however, it is semi-invasive and adds little information in patients with noncommunicating cysts. Ultrasound is a relatively inexpensive screening modality and is best suited to demonstrate the cystic nature of the lesion. In cases of debris, hemorrhage, or inflammation, however, echogenic cyst content may simulate a solid lesion. Moreover, the value of ultrasound for assessing paraarticular cysts is limited by its low accuracy for detecting associated intraarticular abnormalities. MR imaging is the imaging modality that offers most information in assessing paraarticular cysts. Because of the high amount of free water protons, most cysts demonstrate low signal intensity on T1-weighted and high signal intensity on T2-weighted MR images. When debris, hemorrhage, or high protein content is present, signal intensity may increase on T1-weighted and decrease on T2-weighted images. Associated joint abnormalities include meniscal tears, ligamentous injury, degeneration, and inflammation and are well demonstrated on MR images.

Objective. To present the magnetic resonance (MR) imaging findings in patients with labral cysts adjacent to the acetabulum and to examine their association with hip pathology. Design. MR images and conventional radiographs of seven patients with paralabral cysts were retrospectively reviewed by three musculoskeletal radiologists. Patients. The patients included three men and four women with hip pain, ranging in age from 29 to 82 years. Two patients had developmental dysplasia of the hip and six had a history of remote trauma/dislocation. Clinical history and follow-up were obtained in all patients. Surgery was performed on one patient. Results and conclusions. Paralabral cysts were located in the posterosuperior aspect of the hip joint in five patients and in the anterior aspect in two patients. A tear of the adjacent acetabular labrum was confirmed surgically in one patient, and in all patients the MR features suggested the presence of an abnormal labrum. Osteoarthritis was observed in three patients and there was associated subchondral cyst formation in the acetabulum adjacent to the cyst in three patients. The paralabral cyst of the hip is well visualized on MR imaging and is seen in patients with a predisposition to labral pathology.

Para-articular cysts frequently are seen on routine imaging examinations. They may be clinically asymptomatic or may cause pain, swelling, or impaired joint function. They often are associated with underlying joint disorders, such as trauma, degeneration, or inflammation. This article discusses the cause, symptoms, and appearance of para-articular cysts on various imaging examinations including arthrography, ultrasound, CT scan, and MR imaging. Specific attention is focused on these cystic masses appearing around the hip, knee, ankle and foot, shoulder, elbow, wrist and hand, spine, temporomandibular joints, and periosteum.

A 36-year-old man was admitted to the hospital because of advanced germ cell tumor. The diagnosis of germ cell tumor was proven histologically after radical orchiectomy. Abdominal CT disclosed multiple masses adjacent to the aorta and vena cava. Four courses of chemotherapy consisting of 800 mg carboplatin per day were given. After chemotherapy, contrast-enhanced abdominal CT disclosed multiple masses with a total diameter of 15 x 7.5 x 16 cm adjacent to the aorta and vena cava. The masses extended from the iliac arteries to both renal hilars. The back muscles were unremarkable (Fig. la). Four weeks after the last course of chemotherapy, the patient underwent radical retroperitoneal lymph node dissection with removal of the residual masses. In order to remove these masses extending from both iliac vessels to both renal hilars, the lumbar arteries were ligated on both sides. The pathologic studies showed necrotic tumor and fibrotic changes without evidence of viable tumor.

PURPOSE:To determine the efficacy of fast MRI techniques using a tailored imaging design (breathhold and array-surface coil), conventional T1-, T2-weighted spin-echo (SE) sequences and breathhold gradient-echo (GRE) T1- and breathhold fast SE T2-weighted images were compared.METHODS:20 patients with proven focal liver lesions were studied on a 1.5 Tesla system. Conventional SE T1- and T2-weighted imaging, as well as GRE T1- and fast SE T2-weighted imaging was performed. Fast imaging was done during breathhold using an array-surface coil. For all sequences signal-to-noise ratios (S/N) and liver-to-lesion-contrast ratios (L/L) were measured and statistically compared. In addition, two blinded readers qualitatively evaluated all images, using a score system regarding artifacts (breathing, pulsation), number of lesions, and over-all image quality.RESULTS:Regarding image quality parameters, S/N and L/L, there was no significant (p > 0.05) difference between the conventional and fast imaging techniques. However, GRE imaging was superior (84.8%) to conventional imaging for breathing and pulsation artifacts, while fast SE T2 imaging was equal regarding breathing artifacts, but superior (51.5%) regarding pulsation artifacts. The number of detected hepatic lesions was identical in all sequences.CONCLUSION:The fast MRI techniques demonstrated a superiority to conventional imaging regarding image quality and presence of artifacts. Therefore, fast imaging techniques can replace conventional techniques, at least in patients that can sufficiently sustain breathing.

50 patients with a history of distortion injury of the cervical spine were examined with static and functional MRI. Functional MRI consisted of different patient's positions from maximal extension to maximal flexion (30 degrees, 0 degrees, 25 degrees, 40 degrees, 50 degrees). T2*-weighted gradient echo sequences were performed in a sagittal view for the different positions. Ligamentous instabilities and disc protrusions were seen only in functional MRI in 17 patients. These findings correlated with the neurological symptoms. Two patients were treated by operative fusion because of these findings.