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Jurg Nussberger - One of the best experts on this subject based on the ideXlab platform.
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:AbstractA total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid we...
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:A total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid were elevated, a finding that may be explained by the renal origin of the Lymph. Marsupialization is a kidney preserving measure that reverses all symptoms of large pararenal cysts, including Page kidney hypertension.
Anke Schwarz - One of the best experts on this subject based on the ideXlab platform.
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:AbstractA total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid we...
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:A total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid were elevated, a finding that may be explained by the renal origin of the Lymph. Marsupialization is a kidney preserving measure that reverses all symptoms of large pararenal cysts, including Page kidney hypertension.
Jianrong Xu - One of the best experts on this subject based on the ideXlab platform.
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chronic lower extremity Lymphedema a comparative study of high resolution interstitial mr Lymphangiography and heavily t2 weighted mri
European Journal of Radiology, 2010Co-Authors: Qing Lu, Jianrong XuAbstract:Abstract Purpose To assess the role of heavily T2-weighted image and interstitial MR Lymphangiography (MRL) for the visualization of Lymphatic vessels in patients with disorders of the Lymphatic circulation. Methods Forty lower extremities in 31 patients (9 bilateral and 22 unilateral) with primary Lymphedema were examined by heavily T2-weighted image and indirect MRL. Maximum-intensity projection (MIP) was used to reconstruct the images of the Lymphatic system. Two experienced radiologists analyzed the images with regard to the differences in image quality, number of Lymphatic vessels, its maximum diameter and two other findings: accumulated Lymph Fluid in the tissue and honeycombing pattern. Results The beaded appearance of the affected vessels in 73 leg segments of 40 lower extremities were present on both modalities 3D MIP. Larger amount of the dilated Lymphatic vessels were visualized on heavily T2-weighted image than that on MRL (p = 0.003) and the maximum diameter of it was 4.28 ± 1.53 mm on heavily T2-weighted image, whereas 3.41 ± 1.05 mm on MRL (p Conclusion The heavily T2-weighted imaging has greater sensitivity and the MRL image has higher legibility for detecting the pathologically modified Lymphatic vessels and accompanying complications non-invasively. Combining these two MR techniques can accurately access the pathological changes in the lower extremity with Lymphedema.
Shinji Naganawa - One of the best experts on this subject based on the ideXlab platform.
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cochlear Lymph Fluid signal increase in patients with otosclerosis after intravenous administration of gadodiamide
Magnetic Resonance in Medical Sciences, 2016Co-Authors: Shinji Naganawa, Hisashi Kawai, Michihiko Sone, Toshiaki Taoka, Kojiro Suzuki, Shingo Iwano, Hiroko Satake, Mitsuru IkedaAbstract:PURPOSE Increased cochlear Lymph Fluid signals on three-dimensional Fluid-attenuated inversion recovery (3D-FLAIR) images obtained several minutes after intravenous administration of a single dose of gadolinium-based contrast agent (IV-SD-GBCA) in a patient with severe retrofenestral type otosclerosis had been reported. This increase was thought to represent breakdown of the blood-labyrinthine barrier. The purpose of this study was to evaluate cochlear Lymph signal on heavily T2-weighted 3D-FLAIR (HF) images obtained 4 hours after IV-SD-GBCA in patients with otosclerosis, Meniere's disease, and healthy subjects. MATERIALS AND METHODS Twenty-two ears from 12 patients with otosclerotic plaques determined by computed tomography (CT), 16 ears from 8 healthy volunteers, and 10 ears from 9 Meniere's disease patients with significant endoLymphatic hydrops on magnetic resonance (MR) images were retrospectively analyzed. Images were obtained 4 hours after IV-SD-GBCA. Patients and healthy volunteers underwent MR cisternography (MRC) for anatomical reference of the Fluid space and HF at 3T. The region of interest (ROI) was manually drawn on MRC images around the scala tympani in the basal cochlear turn. The reference ROI was set in the cerebellum. ROIs were copied onto HF images and the signal intensity ratio (SIR) of cochlear periLymph to cerebellum was measured. Differences in the SIR on HF images among the three groups were tested by one-way analysis of variance (ANOVA). RESULTS The mean SIR was 24.0 ± 10.1 in otosclerosis patients, 7.9 ± 1.5 in volunteers, and 11.6 ± 3.9 in Meniere's disease patients. The mean SIR was significantly higher in the otosclerosis group than in the other groups (P < 0.001). In the otosclerosis group, there was a significant difference in the SIR between the retrofenestral type and the fenestral type (P = 0.033). CONCLUSIONS In patients with otosclerosis, the SIR was higher than in Meniere's disease patients or in healthy volunteers. The SIR was higher in the retrofenestral type than in the fenestral type.
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heavily t2 weighted 3d flair improves the detection of cochlear Lymph Fluid signal abnormalities in patients with sudden sensorineural hearing loss
Magnetic Resonance in Medical Sciences, 2016Co-Authors: Shinji Naganawa, Hisashi Kawai, Michihiko Sone, Toshiaki Taoka, Kojiro Suzuki, Shingo Iwano, Hiroko Satake, Mitsuru IkedaAbstract:PURPOSE To compare the signal increase in cochlear Lymph Fluid on three-dimensional Fluid-attenuated inversion recovery (3D-FLAIR) in patients with sudden sensorineural hearing loss (SNHL) between regular contrast 3D-FLAIR (FL) and heavily T2-weighted 3D-FLAIR (HF). METHODS Twenty-five patients with unilateral sudden SNHL and eight healthy volunteers were included. Patients were divided into two groups: the mild group consisted of 9 patients, with an average hearing level of 60 dB or less; the severe group consisted of 16 patients, with an average hearing level of more than 60 dB. All patients and healthy volunteers underwent magnetic resonance (MR) cisternography for anatomical reference of the Fluid space with FL and HF at 3 T. The region of interest (ROI) was manually drawn on the mid-modiolar section of the MR cisternography around the cochlea. The ROI for noise was drawn within the air space. ROIs were copied onto the FL and HF images. The contrast-to-noise ratio (CNR) between the affected and non-affected ear was measured in the patient group and the CNR between the right and left ear was also measured in the control group. Differences in the CNR on FL and HF images among the three groups were tested by one-way analysis of variance (ANOVA). RESULTS There was a statistically significant difference in mean CNR on HF among the three groups (P < 0.001). Furthermore, based on pairwise comparisons, there was a statistically significant difference between them in mean CNR on HF (P < 0.05). There was no statistically significant difference in mean CNR on FL among the three groups (P = 0.074). CONCLUSIONS HF is more sensitive to signal alterations in cochleae with sudden SNHL than FL.
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ratio of vestibular endoLymph in patients with isolated lateral semicircular canal dysplasia
Magnetic Resonance in Medical Sciences, 2015Co-Authors: Shinji Naganawa, Hisashi Kawai, Michihiko Sone, Mitsuru IkedaAbstract:PURPOSE Isolated vestibular-lateral semicircular canal dysplasia (LSCCD) is one of the most common anomalies of the inner ear. However, endoLymphatic size in LSCCD is unknown. We measured the size of the endoLymph in the vestibule of patients with LSCCD and compared it with that measured in patients without LSCCD. METHODS We extracted 1102 magnetic resonance (MR) studies for the evaluation of endoLymphatic hydrops (EH) from our database of radiology reports. Among these, we found 15 ears from 11 patients with LSCCD; 4 patients had bilateral abnormalities. Seven of the 15 ears demonstrated aplasia and 8 ears, hypoplasia of the lateral semicircular canal (LSCC). The control group consisted of 26 ears from 13 randomly selected patients without LSCCD. We measured the area of endoLymph in the vestibule (ELA), total area of vestibular Lymph Fluid (TLA), and area of the central bony island (CBI) of the LSCC from axial MR images obtained after intratympanic or intravenous administration of gadolinium-based contrast material. The ratio of endoLymphatic area to total Lymphatic area (%EL) was defined as %EL = ELA/TLA × 100.We evaluated the correlation between %EL and the area of the CBI and compared age, %EL, degree of cochlear EH, hearing level, and presence of rotating vertigo among the 3 groups (aplasia, hypoplasia, control). RESULTS The mean %EL was 76.7% in the aplasia group, 50.0% in the hypoplasia group, and 27.8% in the control group (P 0.05). CONCLUSION The size of vestibular endoLymph was larger in the groups with aplasia or hypoplasia than the control group. Thus, the current diagnostic cut-off value for significant vestibular EH (>50%) might not be appropriate for ears with LSCCD.
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contrast enhancement of the anterior eye segment and subarachnoid space detection in the normal state by heavily t2 weighted 3d flair
Magnetic Resonance in Medical Sciences, 2011Co-Authors: Shinji Naganawa, Masahiro Yamazaki, Hisashi Kawai, Michihiko Sone, Tsutomu NakashimaAbstract:Purpose: Fluid-attenuated inversion recovery (FLAIR) has been reported more sensitive than T1-weighted images in detecting low concentration gadolinium-based contrast media (GBCM) in Fluid, and heavily T2-weighted (hT2W) 3-dimensional (3D) FLAIR has recently been reported even more sensitive than conventional 3D FLAIR. We investigated whether high signal of the anterior eye segment (AES) and subarachnoid space (SAS) in various locations as well as cerebrospinal Fluid (CSF) in cisterns and ventricles can be detected on hT2W 3D FLAIR images obtained 4 hours after intravenous administration of GBCM in subjects without eye and SAS diseases. Methods: Ten patients suspected of having Meniere's disease underwent hT2W 3D FLAIR 4 hours after intravenous administration of single-dose GBCM to evaluate endoLymphatic hydrops. We evaluated signal intensity of AES, SAS surrounding the optic nerve, SAS in Meckel's cave, CSF in the internal auditory canal, CSF in the prepontine cistern, CSF in the lateral and fourth ventricles, and Lymph Fluid in the cochlea by comparison with non-contrast images obtained in a separate group of 5 patients. The signal intensity of each structure was normalized by that of the pontine parenchyma. Results: We observed no signal difference in images of the pontine parenchyma obtained before and after enhancement. Significant signal difference was seen in all structures except the lateral and fourth ventricles. Conclusion: Four hours after intravenous injection, GBCM can be detected by hT2W 3D FLAIR in various Fluid-containing spaces, such as the AES and various SAS and CSF spaces.
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magnetic resonance imaging of the endoLymphatic duct and sac in meniere s disease
Auris Nasus Larynx, 1992Co-Authors: Toru Suzuki, Shinji Naganawa, Tsutomu Nakashima, Noriyuki YanagitaAbstract:We compared the morphology of the endoLymphatic duct (ED) and the endoLymphatic sac (ES) in patients with Meniere’s disease with that of normal individuals. The use of a high-resolution magnetic resonance (MR) imaging system made it possible to visualize the ED and ES, which consisted of soft tissue and Lymph Fluid. In normal individuals, the ED and ES were relatively well visualized, but visibility of ED and ES in 19 ears in the 10 Meniere’s patients was significantly reduced. In unilateral Meniere’s disease, visibility of the ED and ES in the affected ear was poorer than in the unaffected ear, but there was no significant difference between them. Improvement in imaging methods and hardware for MR imaging systems will make it possible to apply morphological investigation of the ED and ES to the diagnosis, staging, and prediction of prognosis of Meniere’s disease, and will be helpful in determining the need for endoLymphatic sac surgery.
Tomas Lenz - One of the best experts on this subject based on the ideXlab platform.
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:AbstractA total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid we...
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hygroma renale pararenal Lymphatic cysts associated with renin dependent hypertension page kidney case report on bilateral cysts and successful therapy by marsupialization
The Journal of Urology, 1993Co-Authors: Anke Schwarz, Tomas Lenz, Rudiger Klaen, G Offermann, Ulrich Fiedler, Jurg NussbergerAbstract:A total of 42 cases of large symptomatic parapelvic or pararenal Lymphatic cysts has been reported since 1890, of which 54% were associated with hypertension and 14% were bilateral. We report on a patient in whom during a 3-month period abdominal pain and distention developed successively on both sides associated with hypertension. Initially, ultrasound and computerized tomography revealed a large multicystic pararenal Lymphatic mass on the right side and small parapelvic hilus lesions on the left side. Two months after resection and marsupialization of the large cyst on the right side the small hilus lesions on the left side developed into large pararenal cysts requiring the same therapeutic measures. Hypertension was reversible after surgery in both instances; at the second operation high preoperative and lower postoperative renin activity, active renin, total renin, aldosterone and atrial natriuretic factor in plasma were noted. Immunoreactive active and total renin levels in the Lymph Fluid were elevated, a finding that may be explained by the renal origin of the Lymph. Marsupialization is a kidney preserving measure that reverses all symptoms of large pararenal cysts, including Page kidney hypertension.
