January 1999

Terms Deleted in 1998 930

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 RADIOLOGY + RSNA INDEX TO IMAGING LITERA

VOLUME 211, NOUMBER 1, APRI 1999

Perspective!

1 Visual Expertise
Beverly P. Wood
Mastery of the ability to assess scientific fact and observation and to apply results quickly,
decisively, and appropriately to a situation is essential in medical action; however, radiology
is unusual in the requirement for the mastery of visual factors and the facility to translate
accurate observations into knowledge of disease states and their characteristics with the clinical
situation.

Editorial

5 Differentiating Benign from Malignant Enhancing Lesions Identified at MR
Imaging of the Breast: Are Time-Signal Intensity Curves an Accurate Predictor?
Susan Greenstein Orel

It is becoming increasingly clear that while most investigators have used either enhancement
kinetics or lesion morphology in an attempt to differentiate benign from malignant lesions
identified on contrast-enhanced MR imaging studies, the integration of both kinetic and
morphologic information may ultimately be needed to achieve optimal discrimination.

State of the Art

9 Deep Venous Thrombosis: Recent Advances and Optimal Investigation with US
]ames D. Fraser and David R. Anderson
Compression US is the imaging procedure of choice for patients with clinically suspected deep
venous thrombosis of the lower and upper extremities.

Ultra ionogrophy

25 Clinically Important Pulmonary Emboli: Does Calf Vein US Alter Outcomes?
Ronald H. Gottlieb, jani Widjaja, Sonu Mehro, and William B. Robinette
Routine evaluation of the calf with US or other diagnostic imaging studies to identify patients
at risk of developing clinically important pulmonary emboli is not indicated.

31 Staging of Rectal Cancer after Polypectomy: Usefulness of Endorectal US
]onathan B. Kruskal, Stephen M. Sentovich, and Robert A. Kane
Endorectal US is an accurate technique for localizing tumors to or beyond the rectal wall in
patients who have undergone diagnostic polypectomy.

Signs in Imaging

37 The Hyperattenuating Crescent Sign
Carin F. Consalves

The hyperattenuating crescent that is seen in association
with an abdominal aortic aneurysm represents an
intramural or mural thrornbus hemorrhage and is a CT
sign of acute or impending rupture.

Vascular and Interventional Radiology

39 Catheter-directed Thrombolysis for Lower
Extremity Deep Venous Thrombosis: Report of a
National Multicenter Registry
Mark W. Mewissen, Gary R. Seabrook, Mark H. Meissner,
]acob Cynamon, Nicos Labropoulos, and Signe H.
Haughton
Catheter-directed thrombolysis can be used to dissolve
thrombus safely and effectively from the deep veins in
identifiable groups of patients with symptomatic lower
limb deep venous thrombosis.

51 Hepatic Blood Supply: Comparison of Optimized
Dual Phase Contrast-enhanced Three-dimensional
MR Angiography and Digital Subtraction Angio-
graphy
Lars Kopka, jens Rodenwaldt, Rolf Vosshenrich, Uwe
Fischer, Beatrice Renner, Thomas Lorf, foachim
Graessner, Burckhardt Ringe, and Eckhardt Grabbe

[Optimized dual phase contrast-enhanced three-dim-
ensional MR angiographyl compares favorably with intra-
arterial digital subtraction angiography, especially for the
venous system, and may, in the future, replace the latter
invasive method for preoperative evaluation of the hepatic
vasculature.

59 Stepping-Table Gadolinium-enhanced Digital
Subtraction MR Angiography of the Aorta and
Lower Extremity Arteries: Preliminary
Experience

fames F. M. Meaney, fohn P. Ridgway, Sam Chakraverty,
lain Robertson, David Kessel, Aleksandra Radjenovic, Marc
Kouwenhoven, Andrea Kassner, and Michael A. Smith
In this preliminary study, stepping-table digital subtraction
gadolinium-enhanced MR angiography of the aorta and
outflow arteries with slow infusion of a gadolinium chelate
enabled high-definition, noninvasive imaging from the
aorta to the ankles, with high accuracy compared with
catheter techniques.

69 Single-Dose Breath-hold Gadolinium-enhanced
Three-dimensional MR Angiography of the Renal
Arteries

Vivian S. Lee, Neil M. Rofsky, Clenn A. Krinsky, David H.
Stemerman, and feffrey C. Weinreb

By using a test bolus of I mL of gadolinium-based contrast
material to achieve accurate timing, a single dose of
gadolinium-based contrast material can be used to achieve
preferential arterial enhancement relatively free of venous
enhancement.

Diagnosis Please

79 Case 13
Klaus D. Hagspiel, ). Fritz Angle, David f. Spinosa, Alan
H. Matsumoto

81 Case 9: Mycotic Pseudoaneurysm of the
Abdominal Aorta in Association with
Mycobacterial Psoas Abscess—A Complication of
BCG Therapy
Jeanne M. LaBerge, Robert K. Kerlan, )r, Linda M. Reilly,
and Timothy A. Chuter
Mycotic aneurysm and psoas abscess are rare complications ,
of bacille Calmette-Guerin therapy.
GenitOMinory lirtaging

87 Assessment of a Bolus-tracking Technique in
Helical Renal CT to Optimize Nephrographic
Phase Imaging
Bernard A. Bimbaum, I Hi E. f acobs, Curtis P. Langlotz,
and Parvati Ramchandani

The results of thjs study demonstrated that semiautomated
bolus-tracking software is feasible and is superior to our
regression model for qualitatively assessing the evolution
of the renal nephrograms and for triggering helical data
acquisition during the early nephrographic phase of renal
enhancement.

95 Complex Posttransplantation Abnormalities of
Renal Allografts: Evaluation with MR Imaging
Magdi G. Alt, Fergus V. Coakley, Hedvig Hricak, and Peter
N. Bretan
MR imaging often provides specific diagnostic information
in cases of complex posttransplantation abnormalities of
renal allografts.

Breast Imaging

101 Dynamic Breast MR Imaging: Are Signal Intensity
Time Course Data Useful for Differential Diagnosis
of Enhancing Lesions?
Christiane Katharine Kuhl, Peter Mielcareck, Sven Klaschik,
Claudia Leutner, Eva Wardelmann, furgen Gieseke, and
Hans H. Schild

Our results indicate that time-signal intensity curves
obtained from dynamic MR images of enhancing breast
lesions provide diagnostically useful information.


111 Developing Asymmetric Breast Tissue
Catherine W. Piccolo Stephen A. Feig, and ]uan P. Palazzo
Asymmetric breast tissue may be caused by histopathologic
findings, including fibrocystic changes, dense stromal
fibrosis, and/or pseudoangiomatous stromal hyperplasia,
and in the correct clinical and imaging settings, these
findings may be considered to be diagnostic.

119 Total-Body Echo-planar MR Imaging in the Staging
of Breast Cancer: Comparison with Conventional
Methods—Early Experience
Laura J. Horvath, Barbara A. Burtness, Shirley McCarthy,
and Kevin M. ]ohnson
The confirmation of metastatic disease in patients with
breast cancer almost always influences therapeutic
decisions, as was demonstrated in two patients in whom
total-body echo-planar MR imaging depicted otherwise
undiagnosed metastases.



129 Hypertrophic Cardiomyopathy: MR Measurement
of Coronary Blood Flow and Vasodilator Flow
Reserve in Patients and Healthy Subjects
Nanaka Kawada, Hajime Sakuma, Tetsu Yamakado, Kan
Takeda, Naoki Isaka, Takeshi Nakono, and Charles B.
Higgins
Breath-hold velocity-encoded cine MR imaging is a
noninvasive technique that can provide assessments of
altered coronary blood flow per gram of myocardial mass
and vasodilator flow reserve in patients with hypertrophic
cardiomyopathy and possibly other myocardial disease.

137 Suspected Non-Small Cell Lung Cancer: Incidence
of Occult Brain and Skeletal Metastases and Effec-
tiveness of Imaging for Detection—Pilot Study
Franklin Earnest IV, fay H. Ryu, Gary M. Miller, Patrick H.
Luetmer, Lee A. Forstrom, Omer L. Burnett, Charles M.
Rowland, Stephen f. Swensen, and David E. Midthun

Preoperative contrast-enhanced MR imaging of the brain
should be performed in patients with large pulmonary
lesions (>3-cm diameter or higher than Tl stage) that are
suggestive of non-small cell lung cancer and can demon-
strate asymptomatic cerebral metastases in a substantial
number of patients who harbor such lesions.

147 Parenchymal and Pleural Findings in Patients
with and Patients without Acute Pulmonary
Embolism Detected at Spiral CT
mi A. Shah, Sheila D. Davis, Gordon Gamsu, Lisa
Intrie re

Parenchymal abnormalities were present in the majority
of patients who underwent spiral CT for the clinical
suspicion of pulmonary embolism.

155 Crazy-paving Appearance at Thin-Section CT:
Spectrum of Disease and Pathologic Findings
Takeshi fohkoh, Harumi ltoh, Nestor L. Muller, Kazuya
Ichikado, Hironobu Nakamura, funpei Ikezoe, Masanori
Akira, and Tornofumi Nagareda

Although the "crazy-paving" pattern is nonspecific, the
various disease entities that cause this appearance can often
be distinguished by their clinical findings.


Experimental Studies

161 Hydrostatic Pulmonary Edema: Evaluation with
Thin-Section CT in Dogs
Pietro Sciltia, Marion Delcroix, Philippe Lejeune, Chnstiari
Melot,Julien Struyven,Robert Naeije, and Pierre Aiain
Gevenois

Thin-section CT can depict early hydrostatic pulmonary
edema as ground-glass opacification as soon as the effective
pulmonary capillary pressure is greater than the critical
pulmonary capillary pressure.

169 Polyethylene Terephthalate and Polyurethane
Coatings for Endovascular Stents: Preliminary
Results in Canine Experimental Arteriovenous
Fistulas
Frank Schellhammer, Michaei Walter, Ansgar Berlis,
Heinz-Georg Bloss, Eckhard Wellens, and Martin
Schumacher

The polyethylene terephthalate was easy to handle and
was used successfully in the occlusion of high-flow
experimental arteriovenous fistulas.

177 Changes in Rat Liver Microcirculation after
Experimental Hepatic Arterial Embolization:
Comparison of Different Embolic Agents
Tino Tancredi, Patricia A. McCuskey, Zuxing Kan, and
Sidney Wallace

Regardless of the size of the embolic agent particles, a
network of high-speed communicating channels, that is,
"transformed" sinusoids, bypassed the damaged paren-
chyma.

RinliMionOhCology

183 Primary Non-Hodgkin Lymphoma of the Small
Bowel
Chut S. Ha, Moon-fune Cho, Pamela K. Alien, Lillian M.
Fuller, Fernando Cabanillas, and fames D. Cox

Our limited data suggest that in terms of local-regional
control, patients with stage II disease might benefit most
from radiation therapy even after complete resection of
the primary lesion.

Gastrointestinol Imaging

189 Evaluation of a IO-minute Comprehensive MR
Imaging Examination of the Upper Abdomen
Richard C. Semelka, N. Cem Baici, Bart Op de Beeck, and
Caroline Reinhold

A short MR protocol with breath-hold and breathing-
independent sequences has results in close agreement with
those of a long MR protocol with breathing-averaged
sequences.

197 Modified Small-Bowel Follow-through: Use of
Methylcellulose to Improve Bowel Transradiance
and Prepare Barium Suspension
Hyun K. Ha, ji H. Shin, Sung E. Rha, Yang S. Lee, Kwang
B. Park, Moon-G Lee, Pyo N. Kirn, and Yong H. Auh

The use of 40% wt/vol barium suspension in methyl-
cellulose (MC) is effective for improving image quality in
modified small-bowel follow-through performed with oral
administration of MC.

203 CT Features of Systemic Lupus Erythematosus in
Patients with Acute Abdominal Pain: Emphasis
on Ischemic Bowel Disease

Jae Young Byun, Hyun Kwon Ha, Sue Yun Yu, fun Ki Min,
Sung Hwan Park, Ho Youn Kim, Kyung Ah Chun, Kyu Ho
Choi, Byung Hee Ko, and Kyung Sub Shinn

[In patients with systemic lupus erythematosus and acute
abdominal pain,] CT is useful for detecting the primary
cause of gastrointestinal symptoms, planning treatment,
and monitoring for possible infarction or perforation.

211 Colon Cancer at Barium Enema Examination
and Colonoscopy: A Study from the County of
Hordaland, Norway
Eivind Str0m and fohn L. Larsen

Routinely performed barium enema examinations are
effective in the diagnosis of colon cancer and can in this
respect compete with colonoscopy.

215 Rectal Carcinoma: Thin-Section MR Imaging for
Staging in 28 Patients

Gina Brown, Catherine ). Richards, Robert G. Newcombe,
Nicholas S. Dalfimore, Andrew G. Radcliffe, Declan P.
Carey, Michael W. Bourne, and Geraint T. Williams

Thin-section MR imaging of the pelvis by using the four-
element surface coil and axial images of the tumor enables
noninvasive, accurate, preoperative assessment of the stage
and depth of extramural tumor infiltration in rectal cancer.

223 Evacuation Proctography: A Prospective Study of
Diagnostic and Therapeutic Effects
Christopher j. Harvey, Steve Haltigan, Clive i. Bartram,
Nicholas Hotiings, Anjou Sahdev, and Kate Kingston

Of the 47 clinicians who participated, 44 (94%) generally
thought evacuation proctography to be of major or
moderate use, the majority using it to confirm their leading
diagnosis.

Pediotric imaging

229 Liver Disease in Children with Cystic Fibrosis:
US-Uiochemical Comparison in 195 Patients

Heidi Patriquin, Catherine Lenaerts, Lesley Smith, Gilies
Perreauft, Andree Grignon, Denis Filiatrauit, facques
Boisvert, Claude C. Roy, and Andree Rasquin-Weber

Abnormal liver architecture (especially signs of portal
hypertension and nodular liver architecture) is related to
abnormal function (particularly, abnormal -y-glutamyl-
transferase, alanine aminotransferase, and aspartale
aminotransferase levels).

233 Chronic Avulsive Injury of the Deltoid Insertion
in Adolescents: Imaging Findings in Three Cases
Lane F. Donnelly, Clyde A. Helms, and George S. Bisset Hi

In cases of chronic avulsion of the deltoid insertion, which
may be encountered as a source of pain or seen incidentally,
MR imaging can be helpful both in excluding findings of
malignancy and in localizing the abnormality to the
deltoid insertion.

Musculoskeletal Imaging

237 Incomplete Intertrochanteric Fractures: Imaging
Features and Clinical Management
Efizabeth Schultz, Theodore T. Miiier, Scott D. Boruchov,
Eric B. Schmelt, and Baruch Toledano

Incomplete intertrochanteric fractures are a distinct
subtype of intertrochanteric fractures that can be diagnosed
with certainty only with MR imaging.

241 Muscle Infarction in Patients with Diabetes
Mellitus: MR Imaging Findings
James S. felinek, Mark D. Murphey, Albert ). Aboulafia,
Robert G. Dussault, Phoebe A. Kaplan, and William N.
Snearly

Diabetic muscle infarction is suggested in a diabetic patieni
with sudden onset of severe pain in the thigh or calf ano
with MR imaging findings of diffuse edema and swelling
of multiple thigh or calf muscles, often in more than one
compartment.

Nuclear Medicine

249 Germ Cell Tumor: Differentiation of Viable Tumor,
Mature Teratoma, and Necrotic Tissue with FDG
PET and Kinetic Modeling
Yoshifumi Sugawara, Kenneth R. Zasadny, H. Barton
Grossman, Isaac R. Francis, Michaei F. Ciarke, and
Richard L Wahl

Although both mature teratomas and necrosis or scar have
low FDG uptake, FDG transport (Kl) and the net rate of
FDG phosphorylation (K) for mature teratomas are signifi-
cantly higher than those for necrosis or scar.

Neurorodiology

257 Brain: Gadolinium-enhanced Fast Fluid-attenuated
Inversion-Recovery MR Imaging
Vincent P. Mathews, Karen S. Caldemeyer, Mark f. Lowe,
Stacy L. Greenspan, David M. Weber, and {ohn L. Ulmer

Gadolinium-enhanced fluid-attenuated inversion-recovery
MR imaging is a potentially useful tool for the radiologist
and should be considered when findings at gadolinium-
enhanced Tl-weighted imaging of the brain are incon-
clusive.

265 Carotid Arteries: Maximizing Arterial to Venous
Contrast in Fluoroscopically Triggered Contrast-
enhanced MR Angiography with Elliptic Centric
View Ordering

John Huston II), Sean B. Fain, Stephen j. Riederer, Alan H.
Wilman, Matt A. Bernstein, and Reed F. Busse

Real-time MR fluoroscopic triggering has been shown to
be a timing technique that, in conjunction with a centric
view order, consistently provides high-quality, venous-
suppressed, contrast-enhanced three-dimensional MR
angiograms of the carotid arteries and aortic arch.

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RADIOLOGY + RSNA INDEX TO IMAGING LITERA
Volume 211 , Number 3, June 1999



president's Address
Medical Education and the RSNA 597
David B. Eraser
The current RSNA Board of Directors is laying the groundwork to make certain your Society
continues to effectively support education well into the future.



Perspectives
Decision Making in Radiology 601
Beverly P. Wood
It is not so much errors due to lack of knowledge or omission that lead to diagnostic failure as
it is errors in judgment or interpretation applied to the hypotheses we create.



Editorial
Statistical Methods for Comparative Qualitative Analysis 605
Richard Tello and Thomas Ptak
The use of scoring schemes in radiologic studies is not new, but the recognition that the
averaging of scores is not valid is rarely realized in the imaging literature.



State of the art
Obstetric MR Imaging 606
Deborah Levine, Patrick D. Barnes, and Robert R. Edelman
MR imaging is a valuable complement to US when additional information is needed to make
treatment decisions during pregnancy.



Cenitourinary Imaging
Ureterolithiasis: Value of the Tail Sign in Differentiating Phleboliths from 619
Ureteral Calculi at Nonenhanced Helical CT
IHya C Boridy, Paul Nikolaidis, Akira Kawashima, Stanford M. Goidman, and Carl M. Sandle
When a suspicious calcification is associated with a positive tail sign, the odds are strong that
it represents a phlebolith rather than a ureteral calculus.




Renal Volume Measurements: Accuracy and Repeatability of US Compared with 623
That of MR Imaging
feannette Bakker, MarcoOlree, Robert Kaatee, Eduard E. de Lange, Karel G. M. Moons, jaap
J. Beutler, and Frederik f. A. Beek
The results of this in vivo study in humans indicate that renal volumes calculated with the
ellipsoid formula applied to US images can result in a considerable systematic underestimation
of the renal volume and have large intra- and interobserver variations.




Ultrofonogrophy
Liver Tumors: Utility of Characterization at 629
Dual-Frequency US
Graham Sommer, Eric W. Olcott, and Lisa Tai
Dual-frequency processing may prove a valuable addition
to conventional US examinations and may provide
improved characterization of lesions in the liver and
perhaps other parts of the body as well.



Deep Venous Thrombosis: Complete Lower 637
Extremity Venous US Evaluation in Patients
without Known Risk Factors—Outcome Study
facques Comuz, Steven D. Pearson, and foseph F. Polak
The results of a venous US examination that includes an
evaluation of the calf veins in symptomatic patients
without risk factors for deep venous thrombosis can help
exclude the presence of important thromboembolic
disease.




VufculMond Interventional Radiology
Radio-frequency Ablation of Hepatic Metastases: 643
Postprocedural Assessment with a US
Microbubble Contrast Agent—Early Experience
Luigi Solbiati, S. Nahum Goldberg, Tiziana lerace,
Marina Dellanoce, Tito Uvraghi, and C. Scott Gazelle
Contrast-enhanced US may enable both immediate
imaging of the ablation procedure and detection of residual
unablated tumor in many cases.




Percutaneous Gastrostomy and 651
Gastrojejunostomy with Gastropexy:
Experience in 701 Procedures
Christian L. Dewald, Paul 0. Hiette, Luke f. Sewall,
Patrick G. Fredenberg, and Aubrey M. Palestrant
Fluoroscopically directed percutaneous placement of
gastrostomy and gastrojejunostomy catheters with routine
gastropexy is a safe procedure and effectively provides a
route of enteric access for feeding or upper gastrointestinal
tract decompression.




Malignant Pleural Mesothelioma: US-guided 657
Histologie Core-Needle Biopsy
Arne Heilo, Anna Elisabeth Stenwig, and 0yvin Pleym
Solheim
When radiologists and other physicians become more
familiar with US of the chest and the biopsy technique in
general, US-guided core-needle biopsy of possible
malignant pleural mesothelioma may become the method
of choice owing to its high accuracy, ease of performance,
safety, and low cost.



Craniofacial Arteriovenous Malformation: 661
Preoperative Embolization with Direct Puncture
and Injection of n-Butyl Cyanoacrylate
Moon Hee Han, Su Ok Seong, Hong Dae Kim, Kee-Hyun
Chang, Kyung Mo Yeon, and Man Chung Han
Direct-puncture embolization with n-butyl cyanoacrylate
is an effective and safe technique for the preoperative
devascularization of a scalp or facial arteriovenous
malformation and, in cases of a superficial lesion, may
replace the transarterial technique.



Renal Arteries: Optimization of Three- 667
dimensional Gadolinium-enhanced MR
Angiography with Bolus-timing-independent
Fast Multiphase Acquisition in a Single Breath
Hold
Stefan 0. Schoenberg, Michael Bock, Michael V. Knopp,
Marco Essig, Gerhard Laub, Hans Hawighorst, Ivan
Zuna, Friedrich Kallinowski, and Gerhard van Kaick
Multiple fast (6-second) three-dimensional acquisitions
allow imaging of an early arterial phase of the renal
vasculature with minimal parenchymal and no venous
enhancement.


ucledr Medicine
Pharmacokinetic Imaging of (11) C Ethanol with 681
PET in Eight Patients with Hepatocellular
Carcinomas Who Were Scheduled for Treatment
with Percutaneous Ethanol Injection
Antonia Dimitrakopoulou-Strauss, Ludwig G. Strauss,
Frank Gutzier, Gisela lrngartinger, George Kontaxakis,
Duk Kyu Kim, Franz Oberdorfer, and Gerhard van Kaick
Tumor texture and drug dilution are the most important
factors in inhomogeneous drug distribution, which may
not sufficiently inhibit tumor growth.





Experimental studies
CT-monitored Percutaneous Cryoablation in a 687
Pig Liver Model: Pilot Study
Fred T. Lee, fr, Susan G. Chosy, Peter J. Uttrup, Thomas F.
Wamer, fanet E. Kuh l man, David M. Mahvi
Percutaneous cryoablation of the liver is technically
feasible and did not cause serious bleeding in this animal
model.



Plain and Covered Stent-Grafts: In Vitro 693
Evaluation of Characteristics at Three-
dimensional MR Angiography
Paul R. Hilfiker, Harald H. Quick, and forg F. Debatin
The short echo times inherent in fast three-dimensional
gradient-echo sequences limit susceptibility artifacts
sufficiently to permit assessment of the luminal patency
of selected commercially available stents with contrast-
enhanced three-dimensional MR angiography.



Measurement of the Distribution Volume of 698
Gadopentetate Dimeglumine at Echo-planar MR
Imaging to Quantify Myocardial Infarction:
Comparison with (99m) Tc-DTPA Autoradiography
in Rats
Häkan Arheden, Maythem Saeed, Charles B. Higgins,
Dong-Wei Gao, fens Bremerich, Rolf Wyttenbach,
Michael W. Dae, and Michael F. Wendland
The fractional distribution volumes of gadopentetate
dimeglumine in vivo at inversion-recovery echo-planar MR
imaging and of (99m) Tc-DTPA ex vivo with radioisotope
methods agreed well 'in both normal and reperfused
infarcted myocardium.



Diagnosh Please
Case 15 709
Gautham P. Reddy and Gary R, Caputo



Case II: Perforated Duodenal Diverticulitis 711
Patrick M. Rao
Perforated duodenal diverticulitis is an uncommon
abdominal condition that is rarely diagnosed clinically but
occasionally has characteristic CT findings, including an
extraluminal air collection and surrounding inflammation,
that can allow for a confident imaging diagnosis.





Orthotopic Liver Transplantation: Evaluation 715
with MR Cholangiography
Ann S. Fulcher and Mary Ann Turner
MR cholangiography provides a noninvasive alternative
to endoscopic retrograde cholangiography and percuta-
neous transhepatic cholangiography for demonstration of
the biliary tract after transplantation and is accurate for
detection of complications such as biliary obstruction,
stricture, and stones.




Expanded Gallbladder Fossa: Simple MR Imaging 723
Sign of Cirrhosis
Katsuyoshi lto, Donald C. Mitchell, Toshifumi Cabata,
and Shahid M. Hussain
The expanded gallbladder fossa sign on MR images of the
liver is a simple, frequently present, specific indicator of
cirrhosis, with a positive predictive value of 98%.



Acute Pancreatitis: Interobserver Agreement 727
and Correlation of CT and MR Cholangio-
pancreatography with Outcome
Robin Lecesne, Patrice Taourel, Patrice M. Bret, Mostafa
Atri, and Caroline Reinhold
Nonenhanced MR cholangiopancreatography is a
reproducible method for staging acute pancreatitis and
is at least as accurate as CT in establishing the prognosis
of disease.



Mesenteric, Omental, and Retroperitoneal Edema 737
in Cirrhosis: Frequency and Spectrum of CT
Findings
Shailendra Chopra, Gerald D. Dodd III, Kedar N.
Chintapalli, Christine C. Esola, and Abraham A. Chiatas
An awareness of these findings should allow more accurate
interpretations of the abdominal CT findings of patients
with cirrhosis.



The Accordion Sign at CT: a Nonspecific Finding 743
in Patients with Coionic Edema
Michael Macari, Emil f. Balthazar, and Alee ). Megibow
Although the accordion sign may be detected in a variety
of edematous and inflammatory conditions that affect the
colon, it has no cause-related specificity.





Bone Contusions of the Posterior Lip of the Medial 747
Tibial Plateau (Contrecoup Injury) and Associated
Internal Derangements of the Knee at MR Imaging
Phoebe A. Kaplan, Randall H. Gehl, Robert C. Dussault,
Mark W. Anderson, and David R. Diduch
A small contusion of the posterior lip of the medial tibial
plateau, which was identified in 25 of 215 consecutive
MR examinations performed for knee trauma, occurred in
association with MR imaging findings of a torn anterior
cruciate ligament in all cases and either an injury to the
meniscocapsular junction (pi = 14) or a tear of the outer
periphery of the posterior horn of the medial meniscus
(pi = 10) in 96% of the patients.






Posteromedial Tibial Plateau Injury including 754
Avulsion Fracture of the Semimembranous
Tendon Insertion Site: Ancillary Sign of Anterior
Cruciate Ligament Tear at MR Imaging
Karence K. Chan, Donald Resnick, Douglas Goodwin, and
Leanne L. Seeger
Our data, derived from an analysis of information from
10 patients, indicate that a fracture of the posteromedial
tibial plateau is predictive of an associated anterior cruciate
ligament tear, although the mechanism leading to this type
of bone injury is not clear.




Emergency Radiology
Cervical Spine Imaging in Patients witli Trauma: 759
Determination of Fracture Risk to Optimize Use
C Craig Blackmore, Scott S. Emerson, Frederick A. Mann,
and Thomas D. Koepsell
Simple clinical factors, including cause of injury, age, and
associated injuries, can be used to determine the probability
of cervical spine fracture and can, therefore, form the
foundation for development of evidence-based imaging
guidelines.



Pediatric imaging
Occult Lumbosacral Dysraphism in Children and 767
Young Adults: Diagnostic Performance of Fast
Screening and Conventional MR Imaging
L Santiago Medina, May Al-örfali, David Zurakowski,
Tina Young Poussaint, fames DiCanzio, and Patrick D.
Barnes
Conventional three-plane lumbosacral MR imaging in
children and young adults suspected of having occult
dysraphism provides better information than fast screening
two-plane MR imaging because of the higher specificity
and interobserver agreement of the former.




Sigm in Imaging
The Dense Metapliyseal Band Sign 773
Scott A. Raber
Whenever growing bone recovers from any pathologic
insult or becomes lead poisoned, exuberant calcium
deposition in the zone of provisional calcification yields
dense metaphyseal bands.



Head and Neck lmaging
Carotid Arterial Stenosis: Evaluation at CT Angio- 775
graphy with the Volume-rendering Technique
Claude D. Marcus, Viviane f. Ladam-Marcus, fean-Luc
Bigot, Claude Clement, Bernard Baehrel, and Bernard P.
Menanteau
Because the volume-rendering technique provides ex-
cellent visualization of the lumen in calcified vessels, it
allows for accurate assessment of high-attenuation
circumferential atheromatous plaques.



Computer Applicationx
Measurement of Brain Structures with Artificial 781
Neural Networks: Two- and Three-dimensional
Applications
Vincent A. Magnotta, Dan Heckel, Nancy C Andreasen,
Ted Cizadio, Patricia Westmoreland Corson, fames C
Ehrhardt, and William T. C Yuh
The purpose of this study was to apply an artificial neural
network method to the challenging problem of identifying
and measuring specific anatomic structures or regions
within the brain.



Glial Neoplasms: Dynamic Contrast-enhanced 791
T2*-weighted MR Imaging
Edmond A. Knopp, Soonmee Cha, Glyn ]ohnson, Avi
Mazurndar, fohn G. Golfinos, David Zagzag, Douglas C.
Miller, Patrick f. Kelly, and lrvin 1. Kricheff
We believe relative cerebral blood volume measurements
and the maximum-signal-intensity-decrease color overlay
will continue to play an important role in the preoperative
management of glial neoplasms by providing noninvasive,
functional information about tumor vascularity that may
have a profound effect on treatment strategies and on
monitoring the response to therapy.




Diffusion-weighted Imaging with Navigated 799
Interleaved Echo-planar Imaging and a
Conventional Gradient System
Roland Bammer, Rudolf Stollberger, Michael Augustin,
fosef Simbrunner, Hans Offenbacher, Hendrik Kooijman,
Stefan Popele, Peter Kapeller, Paul Wach, Franz Ebner,
and Franz Fazekas
Diffusion-weighted images can be obtained by using
standard clinical MR imaging units with conventional
gradient hardware.





MR Imaging Response of Brain Metastases after 807
Gamma Knife Stereotactic Radiosurgery
Arleen M. Peterson, Carolyn Cidis Meltzer E. jane
Evanson, john C Flickinger, and Doughs Konäziolka
Recognition of serial MR imaging findings after stereotactic
radiosurgery is important and will allow the practicing
radiologist to accurately interpret the response in patients
with stereotactic radiosurgery-treated brain metastases.



Special Report
Cross-sectional Nodal Atlas: A Tool for the 815
Definition of Clinical Target Volumes in Three-
dimensional Radiation Therapy Planning
Rafael Martinez-Monge, Patrick S. Femandes, Nilendu
Gupta, and Reinhard Gahbauer
The present nodal atlas is intended to assist radiation
oncologists who will use new three-dimensional virtual
clinical target definition and treatment planning programs.




Radiation Oncology
Cancer in Patients Aged 90 Years or Older: 829
Radiation Therapy
Norio Mitsuhashi, Kazushige Hayakawa, Michitaka
Yamakawa, Hideyuki Sakurai, Yoshihiro Saito, Masatoshi
Hasegawa, Tesuo Akimoto, Kayoko Hayakawa, and Hideo
NUbe
Age is not a limiting factor for radiation therapy in patients
aged 90 years or older.



Breast Imaging
Sentinel Lymph Node Biopsy after Percutaneous 835
Diagnosis of Nonpalpable Breast Cancer
Laura Liberman, Hiram S. Cody III, Arnold D. K. Hill, Paul
Peter Rosen, Samuel D. f. Yeh, Tim Akhurst, Elizabeth A.
Morris, Andrea F. Abramson, Patrick /. Borgen, and D.
David Dershaw
Sentinel lymph node biopsy was technically successful in
30 (91%) of 33 women with nonpalpable breast cancer
and obviated axillary dissection in 23 (70%).



BI-RADS Categorization As a Predictor of 845
Malignancy
Susan G. Orel, Nicole Kay, Carol Reynolds, and Daniel C
Sullivan
We must further educate our patients and our referring
physicians about the BI-RADS assessment categories and
the correlation between the various categories and
outcome so that tissue diagnosis is reserved for those lesions
that are indeterminate (BI-RADS category 4) or highly
suggestive of malignancy (BI-RADS category 5).



Pulmonary Emphysema: Subjective Visual 851
Grading versus Objective Quantification with
Macroscopic Morphometry and Thin-Section CT
Densitometry
Alexander A. Bankier, Viviane De Maertelaer, Caroline
Keyzer, and Pierre Alain Gevenois
Our results suggest that subjective visual grading should
be supplemented with more reliable objective methods
whenever a precise, reader-independent quantification of
emphysema is needed.



Acute Interstitial Pneumonia: Thin-Section CT 859
Findings in 36 Patients
Takeshi fohkoh, Nestor L. Müller, Hiroyuki Taniguchi,
Yasuhiro Kondoh, Masanori Akira, Kazuya Ichikado,
Masayuki Ando, osamu Hondo, Noriyuki Tomiyama, and
Hironobu Nakamura
A combination of ground-glass attenuation, airspace
consolidation, traction bronchiectasis, and architectural
distortion is seen in the majority of patients with acute
interstitial pneumonia.




Technical Developments
Pulmonary MR Angiography with Ultrasmall 865
Superparamagnetic Iron Oxide Particles as a
Blood Pool Agent and a Navigator Echo for
Respiratory Gating: Pilot Study
K. Häkan Ahlström, Lars O. fohansson, fohanne B.
Rodenburg, A. Sgrimur Ragnarsson, Per Äkeson, and Arve
Börseth
MR angiography with NC100150 Injection in combination
with respiratory navigator gating permits high-spatial-
resolution imaging of the pulmonary vasculature without
breath holding.



Abdominal Helical CT: Milk as a Low-Attenuation 870
Oral Contrast Agent
Susan L Thompson, Vassilios Raptopoulos, Robert L
Sheiman, Michelle M. f. McNicholas, and Panos
Prassopoulos
Presently in our practice, we use whole milk as an oral
contrast agent in evaluation of the urinary tract; in cases
of suspected pancreatic or other upper abdominal tumors;
and in special examinations including multiphasic
abdominal CT, especially of the liver, abdominal CT
angiography, CT cholangiopancreatography, and CT
urography.




Radiation Field Simulation of Gynecologic 876
Malignancies: Localization of the Cervix and
Vagina witli a Flexible Vaginal Localizer Contrast
Tampon
Geoffrey f. Weidner, Nina A. Mayr, Cheng B. Saw,
Weining Zhen, B-Chen Wen, and David H. Hussey
The contrast tampon used as a flexible vaginal localizer
caused no significant vaginal displacement during
simulation and therefore allowed reliable localization of
the vagina, vaginal cuff, and cervix representative of their
locations during actual radiation therapy.



Cervical Spine Tomography with an Angiographic 882
C-arm
Carfin A. Ridpath, Anthony f. Wilson, Steve G. Longer,
Frederick A. Mann, and fohn C Hunter
In our experience, digital imaging of the spine and linear
tomography with a C-arm unit have decreased the number
of table-to-bed transfers for our polytrauma patients and
have improved patient throughput in the emergency and
radiology departments.



Platinum Subdural Grid: MR Imaging Compati- 886
bility Testing
Emanuel Kanal, Carolyn Cidis Meltzer, P. David Adelson,
and Mark P. Scheuer
MR imaging examination of patients with an implanted
platinum subdural grid electrode is expected to result in
clinically insignificant temperature changes in the vicinity
of the grid electrode or its leads.



letter to the editor
Thoracic Aorat
john A. Elefteriades, john A. Rizzo, and Michael A, Coady 889


Invited Commentary 889
David M. Hovsepian



Howard C. Burkhead, MD 890
Arthur R. Crampton, MD


John D. McAllister, MD 890
R. A. D'Altorio, MD, and fohn D. McAllister, MD


Book Reviews
The Encyclopaedia of Medical Imaging. Vol 2, 604
Normal Anatomy


Patient Care in Radiography. 5th ed. 622


Gamma Knife Brain Surgery 660


New Radiotracers in Cardiac Imaging: Principles 680
and Applications



Differential Diagnosis in Pediatric Radiology 766


Radionuclide Imaging of the Breast 834


A Rabbit in the Pituitary Patch? 618


Humanoid 650


Question Mark 714



Deportments
Abstracts of Current Literature 891


Advertisers' Index 16A


Announcements and Books, Audiovisual 19A
Materials, and Software Received


Classified Services 65A

Continuing Medical Education 24A

Copyright and Certifications Agreement 36A

Publication Information for Authors 37A

Publishers' Row 43A

Radiology Business Information 33A

Radiology Manuscript Categorization Terms 41A

RSNA Bulletin Board 81A

RSNA Quick Reference 15A
______________________________

RADIOLOGY+RSNA INDEX TO IMAGING LITERA
Volume 212 , Number 1, July 1999



Eifitorhl

Pulmonary Emphysema: Imaging Assessment of Lung Volume Reduction Surgery 1
fohnH.M.Austin


Special Report
Paula J. Woodward, MD 4
Armed Forces Institute of Pathology 1999-2000 Distinguished Scientist
Melissa L.Rosado-de-Christenson



State of the Art
Tissue Characterization in the Female Pelvis by Means of MR Imaging 5
Evan S. Siegelman and Eric K. Outwater
The purpose of this article is to review the ability of MR imaging to help characterize tissue in
the female pelvis.




Genitourinory Imaging
Diagnosis and Staging of Ovarian Cancer: Comparative Values of Doppier and 19
Conventional US, CT, and MR Imaging Correlated with Surgery and Histopatho-
logic Analysis—Report of the Radiology Diagnostic Oncology Group
Alfred B. Kurtz, fohn V. Tsimikas, Clare M. C. Tempany, Ulrike M. Hamper, Peter H. Arger, Rob-
ert L Bree, Richard]. Wechsler, Isaac R. Francis, janet E Kuhlman, Evan S. Siegelman, Donald
G. Mitchell, Stuart G. Silverman, Douglas L. Brown, Sheila Sheth, Beverly G. Coleman, fames
H. El I is. Robertf. Kurman, Darylf. Caudry, and Barbaraf. McNeil
Because of the importance of not understaging abdominal malignancy as disease limited to
the pelvis, if stage III cancer is not detected at initial abdominal US, CT or MR imaging
should be performed because of their higher sensitivities in staging.




Renal Neoplasms Amenable to Partial Nephrectomy: MR Imaging 28
E. Scott Pretorius, Evan S. Siegelman, Parvati Ramchandani, Thomas Cangiano, and Marc P.
Banner
Contrast-enhanced, surface-coil MR imaging is well suited for evaluating renal lesions in
which partial nephrectomy is being considered.




Nuclear Medicine
Pheochromocytomas: Imaging with 2-[Fluorine-18]fluoro-2-deoxy-D-glucose PET 35
Barry L. Shulkin, Norman W. Thompson, Brahm Shapiro, Isaac R. Francis, and fames C. Sisson
FDG PET helps localize the majority of pheochromocytomas.


Obstetric imagin

Congenital Chest Lesions: Diagnosis and Charac- 43
terization with Prenatal MR Imaging
Anne M. Hubbard, N. Scott Adzick, Timothy M.
Cromblehoime, Beverly G. Coleman, Lori f. Howell, fohn C.
Haselgrove, and Saroosh Mahboubi
In this series, MR imaging helped further characterize the
fetal chest lesions and confirm or change the prenatal
diagnosis.



Thorocic Imaging
Advanced Emphysema: Preoperative Chest Radio- 49
graphic Findings as Predictors of Outcome Fol-
lowing Lung Volume Reduction Surgery
Daniel D. Maki, Wallace T. Miller,lr, fudith M, Aronchick,
Warren B. Gefter, Wallace T, Miller, Sr, Robert M. Kotloff,
and Gregory Tino
High disease heterogeneity on standard chest radiographs
is strongly predictive of a favorable outcome following
lung volume reduction surgery.



Lung Cancer Staging and Management: Compar- 56
ison of Contrast-enhanced and Nonenhanced
Helical CT of the Thorax
Edward F. Patz, fr, feremyf. Erasmus, H. Page McAdams,
fohn E. Connolly, Edith M. Marom, Philip C Goodman,
Richard A. Leder, Mary T, Keogan, and fames E. Herndon
Nonenhanced thoracic CT through the adrenal glands is
sufficient for successful radiologic staging in patients with
newly diagnosed lung cancer.


Detection Failures in Spiral CT Screening for Lung 61
Cancer: Analysis of CT Findings
Ryutaro Kakinuma, Hironobu Ohmatsu, Masahiro Kaneko,
Kenji Eguchi, Tsuguo Naruke, Kanji Nagai, Yutaka
Nishiwaki, Akira Suzuki, and Noriyuki Moriyama
Minute nodules of lung cancer that are near the threshold
of detectability may be overlooked at spiral CT screening.



Sigm in linaging
The Signet Ring Sign 67
Hugue Ouellette
The signet ring sign is a CT finding in patients with
bronchiectasis.


Cordioc
Pericardial Sinuses and Recesses: Findings at Elec- 69
trocardiographically triggered Electron-Beam CT
Reinhard Groell, Gottfried J. Schaffler, and Rainer
Rienmueller
Knowledge of the location of these structures [pericardial
sinuses and recesses] helps the radiologist avoid a
misdiagnosis of lymphadenopathy or other mediastinal
disease processes.



Ultrosonogrophy
Clinically Suspected Pulmonary Embolism: Use of 75
Bilateral Lower Extremity US as the Initial Exami-
nation—A Prospective Study
Robert G. Sheiman and Colin R. McArdle
If lower extremity US is contemplated as the initial
examination in patients suspected of having pulmonary
embolism, it should be applied only in those patients who
also have deep venous thrombosis symptoms or risk
factors.



Experimental Studies
Stenosis of the Main Artery Supplying an Organ: 79
Effect of End-Organ Vascular Resistance on the
Poststenotic Peak Systolic Velocity in an in Vitro
Hydraulic Model at Doppier US
Ronald 0. Bude, Ronald G. Larson, Wilmer W. Nichols,
and fonathan M. Rubin
Poststenotic peak systolic velocity decreases only mildly
with increasing vascular resistance distal to the stenosis
for stenoses at both ends of the hemodynamic spectrum
(low- and high-grade stenoses).



Shark Liver Oil-induced Lipoid Pneumonia in Pigs: 88
Correlation of Thin-Section CT and Histopatho-
logic Findings
Joon Beorn Seo, fung-Gi Lm, Woo Sun Kirn, Chang Kyu
Seong, jae Woo Song, and jin Haeng Chung
The serial thin-section CT findings of exogenous lipoid
pneumonia after a single endobronchial administration
of oil in pigs were ground-glass opacity and airspace
consolidation, followed by complete or incomplete
resolution with lobular volume loss and septal thickening.



Contrast Medium-induced Pulmonary Edema Is 97
Aggravated by Silicone Contamination in Rats
Toshiaki Senäo, Masaaki Hirakawa, Kaori Fujie, Yasufumi
Kataoka, and Ryozo Oishi
Although in this experiment it was not possible to match
conditions, such as the dose and rate of injection of
contrast medium, the results raise the possibility that the
incidence of pulmonary edema could be increased in
patients who are examined by using contrast medium
contaminated with silicone.




Mufculoskeletol Imaging
Iliotibial Band Friction Syndrome: MR Imaging 103
Findings in 16 Patients and MR Arthrographic
Study of Six Cadaveric Knees
Claus Mühle, foong Mo Ahn, LeeRen Yeh, Gabriefle A.
Bergman, Robert D. Boutin, Mark Schweitzer, fön A.
facobson, Parviz Haghighi, Debra f. Trudelt, and Donald
Resnick
With MR imaging, poorly defined signal intensity
abnormalities or a circumscribed fluid collection located
in a compartmentlike space medial to the iliotibial tract
with obliteration of the fatty layer distal to the vastus
lateralis muscle may allow the diagnosis of iliotibial band
friction syndrome in patients witli corresponding clinical
symptoms.




Bicipitoradial Bursitis: MR Imaging Findings 111
in Eight Patients and Anatomic Data from
Contrast Material Opacification of Bursae
Followed by Routine Radiography and MR
Imaging in Cadavers
Abdalla Y. Skaf, Robert D. Boutin, Robert Weiber M.
Dantas, Andrew W. Hooper, Claus Mühle, David S. Chou,
Nittaya Lektrakul, Debra f. Trudelt, Parviz Haghighi, and
Donald L Resnick
MR imaging is a useful diagnostic method for evaluating
bicipitoradial bursitis and its effect on adjacent structures.



Emergency Radiology

Cervical Spine Screening with CT in Trauma 117
Patients: A Cost-effectiveness Analysis
C. Craig Blackmore, Scott D. Ramsey, Frederick A. Mann,
and Richard A. Deyo
On the basis of our cost-effectiveness analysis, CT should
be considered as the primary cervical spine screening
modality in selected victims of major trauma who are
examined in high-volume urban emergency departments
and trauma centers.




Diagnosis
Case 16 126
Lawrence E. Ginsberg and Franco De Monte



Case 12: Mazabraud Syndrome 129
Mark J. Kransdorf and Mark D. Murphey
The identification of a well-defined soft-tissue mass with
a fluidlike signal intensity and multiple bone lesions
compatible with fibrous dysplasia established the diagnosis
of Mazabraud syndrome.



Central Nervous Pathway for Acupuncture Stimu_ 133
lation: Localization of Processing with Functional
MR Imaging of the Brain—Preliminary Experience
Ming-Ting Wu, jen-Chuen Hsieh, fing Xiong, Chien-Fang
Yang, Huay-Ban Pan, Yin-Ching Iris Chen, Guochuan Tsai,
Bruce R. Rosen, and Kenneth K. Kwong
Given that the hypothalamus and limbic system provide
multidimensional integration of neuroendocrinal and
autonomic homeostasis, our finding that acupuncture
activates the hypothalamus and limbic system also may
provide a basis for the versatility of acupuncture for use
in conditions other than pain disorders, such as
management of nausea and vomiting, asthma, and
substance addiction.



Stereotactic Radiosurgical Pallidotomy and Thal- 143
amotomy with the Gamma Knife: MR Imaging
Findings with Clinical Correlation—Preliminary
Experience
David P. Friedman, H. Warren Goidman, Adam L
Flanders, Stephen M. Gollomp, and Walter]. Curran, Jr
Findings in our pilot study show that radiosurgical
thalamotomy with the gamma knife is a promising
treatment for patients with medically refractory tremor.



MR Imaging of Intraventricular Silicone: 151
Case Report
Robert L WUCiams, Ranäali L. Beatty, Emanuel Kanal, and
lane L Weissman
MR imaging demonstrated, in a patient who was treated
for retinal detachment with intravitreous silicone,
intraocular and intraventricular silicone oil, as confirmed
by identical signal intensity characteristics and chemical
shifts in the two locations.



Radiation Oncology
Localization of the Apex of the Vagina: Implica- 155
tions for Radiation Therapy Planning
Choong R. Kirn, Beverly A, Eaton, and Kenneth R. Stevens, Jr
The vaginal rod causes displacement of the vaginal apex
during the simulation performed to establish the locations
of small boost irradiation fields.
Vascular and Interventionol Radiology




Transrectal versus Transvaginal Abscess Drainage: 159
Survey of Patient Tolerance and Effect on Activities
of Daily Living
David M. Hovsepian, foseph R, Steele, Colette Sugg Skin-
ner, and Eric S. Maiden
Prior to pelvic abscess drainage, especially by means of
the transvaginal route, patients and referring physicians
should be made well aware of the potential for discomfort
and severe limitations on activities of daily living.



Transthoracic Needle Aspiration Biopsy: Variables 165
That Affect Risk of Pneumothorax
foseph E. Cox, Caroline Chiles, Christopher M. McManus,
Suzanne L. Aquino, and Robert H. Choplin
The only factors that independently altered the risk of
pneumothorax were size of the lesion and presence of
emphysema.



Descending Thoracic Aortic Aneurysm: Thoracic 169
CT Findings after Endovascular Stent-Graft Place-
ment
Toyohiko Sakai, Michael D. Dake, Charles P, Semba,
Tetsuhisa Yamada, Akihiko Arakawa, Stephen T. Kee,
Nobushige Hayashi, Mahmood K, Razavi, and Daniel Y. Sze
Thoracic CT is useful in the treatment of patients after
stent-graft insertion for management of descending
thoracic aortic aneurysm.



Treatment of Hemodialysis-related Central Ven- 175
ous Stenosis or Occlusion: Results of Primary
Wallstent Placement and Follow-up in 50 Patients
Patrick Haage, Dierk Vorwerk, Werner Pi roth, Karl Schuer-
mann, and Rolf W. Guenther
Initial Wallstent deployment is effective in the treatment
of central venous stenosis or occlusion and shows improved
long-term patency rates as compared with those of other
therapeutic modalities (eg, percutaneous balloon angio-
plasty alone).



Health Policy and Practice
Core-Needle and Surgical Breast Biopsy: Compari- 181
son of Three Methods of Assessing Cost
Jeffrey H. Burkhardt and fonathan H. Sunshine
We calculated costs in three different ways—in terms of
input resource costs, actual payments, and billed charges-
and found remarkable consistency in relative costs among
the measures, with surgical biopsy, including needle
localization, uniformly costing two and a half to three
times as much as core-needle biopsy.


Breast Imaging
Follow-up of Breast Lesions Diagnosed as Benign 189
with Stereotactic Core-Needle Biopsy: Frequency of
Mammographic Change and False-Negative Rate
Carol H. Lee, Liane E. Philpotts, Laura J. Horvath, and
Irena Tocino
We believe that 6-month follow-up mammography for
cases with nonspecific benign diagnoses and routine
yearly screening mammography for cases with specific
benign histologic results is a reasonable management
strategy.



Computer Applications
Display Modes for CT Colonography 195
Part 1. Synthesis and Insertion of Polyps into
Patient CT Data
Chandu Karadi, Christopher F. Beaulieu, R. Brooke ]effrey,
Jr, David 5. Paik, and Sandy Napel
Our polyp synthesis and insertion method allows the
generation of a variety of realistic coionic polyps that
could not be distinguished from real lesions by
experienced observers and, therefore, can facilitate the
comparison of display techniques.





Display Modes for CT Colonography 303
Part II. Blinded Comparison of Axial CT and
Virtual Endoscopic and Panoramic Endoscopic
Volume-rendered Studies
Christopher F. Beaulieu, R. Brooke Jeffrey,Jr, Chandu
Karadi, David S. Paik, and Sandy Napel
Our panoramic rendering technique significantly
increased the sensitivity for polyp detection ahove that
of a display mode in which a conventional virtual camera
is used, by increasing the percentage of displayed surface
area.



Costrointestinal Imaging
Pancreatic Carcinoma versus Chronic Pancreatitis: 213
Dynamic MR Imaging
Pamela T. fohnson and Eric K, outwater
The similar gradual pattern of enhancement and overlap
in peak enhancement preclude distinction of the two
entities on the basis of gadolinium-enhanced MR findings.



Pancreatic CT Imaging: Effects of Different Injec- 219
tion Rates and Doses of Contrast Material
Tonsok Kirn, Takamichi Murakami, Satoru Takahashi,
Atsuya Okada, Masatoshi Hori, Yoshifumi Narumi, and
Hironobu Nakamura
Both a higher dose and a faster rate for the injection of
contrast material thus appear to increase the maximum
pancreatic enhancement.



Hepatic Iron Concentration: Noninvasive Estima- 227
tion by Means of MR Imaging Techniques
Herbert L Bonkovsky, Richard B. Rubin, Edward E. Cable,
Ashley Davidoff, Tarnmo H. Pels Rijcken, and David D.
Stark
Rapid gradient-recalled-echo MR imaging at high mag-
netic field strength is a sensitive, accurate, and non-
invasive modality for the estimation of hepatic iron
concentration and for ruling out clinically important
hepatic iron overload (ie, greater tlian three times the
upper limit of normal).



Hepatocellular Carcinoma: Association with 235
Increased Iron Deposition in the Cirrhotic Liver
at MR Imaging
Katsuyoshi lto, Donald G. Mitchell, Toshifumi Gabata, Hie-
Won L. Hann, Pyo N. Kirn, Takeshi Fujita, Hitomi Awaya,
Kazurnitsu Honjo, and Naofumi Matsunaga
The occurrence of hepatocellular carcinoma (HOC) may
be associated causally with iron deposition in large
regenerative nodules in patients with cirrhosis, and MR
imaging is a useful modality for assessing iron deposition
in these regenerative nodules as a possible risk factor for
the development of HCC.



Low-Grade Gastric Mucosa-associated Lymphoid 241
Tissue Lymphoma: Correlation of Radiographic
and Pathologie Findings
Young H. Kirn, Hyo K. Um, ]oon K. Han, Byung /. Choi, Yong
l. Kim, Won j. Lee, and Seung H. Kim
Low-grade gastric mucosa-associated lymphoid tissue
lymphomas manifested as mucosal nodularity, either
shallow or deep ulcers, and rugal thickening at upper
gastrointestinal examination and showed similar findings
to those of gastric carcinoma and Helicobacter pylori gastritis.




MR Cholangiography in the Evaluation of 249
Neonatal Cholestasis
Twei-Shiun faw, Yu-Ting Kuo, Gin-Chung Uu, Shaou-Hsium
Chen, and Chien-Kuo Wang
MR cholangiography can be used to depict the major
biliary structures of neonates and small infants, and it
can be used to accurately exclude biliary atresia as the
cause of neonatal cholestasis by allowing visualization of
the biliary tract.



Autoimmune Lymphoproliferative Syndrome: A 257
Syndrome Associated with Inherited Genetic De-
fects That Impair Lymphocytic Apoptosis—CT
and US Features
Nilo A. Avila, Andrew]. Dwyer, fanet K. Dale, Uri A.
Lopatin, Michael C Sneller, Elaine S. faffe, fennifer M.
Puck, and Stephen E. Straus
Patients with autoimmune lymphoproliferative syndrome
demonstrate nonspecific imaging findings of lympho-
proliferative disorders (adenopathy, splenomegaly, thymic
enlargement, and hepatomegaly); the stability of the
clinical findings over months to years and the pattern of
lymph node echogenicity may suggest the diagnosis.



Technical Developments
MR Colonography: Optimized Enema Composition 265
Wolfgang Luboldt, fohannes M. Fröhlich, Nicole Schneider,
Dominik Weishaupt, Franziska Landolt, and forg F. Debatin
Iron glycerophosphate seems to be a feasible alternative
to gadopentetate dimeglumine as a contrast enema in MR
colonography.


Volumetric Imaging with Ultrasonic Spiral CT 270
Haim Azhari and Didi Sazbon
Findings in this study demonstrate that spiral ultrasonic
CT is feasible.




Virtual CT Intravascular Endoscopy of the Aorta: 276
Pierced Surface and Floating Shape Thresholding
Artifacts
Emanuele Neri, Davide Carameffa, Fabio Falaschi, Paola
Sbragia, Clauäio Vignali, Eäoaräo Laiolo, Adriano Viviani,
and Carlo Bartolozzi
Knowledge about segmentation pitfalls can help avoid
the appearance of artifacts on virtual CT intravascular
endoscopic images, thus preventing wrong interpretations
of endoluminal findings.


Gadolinium-based Contrast Agents as an Alterna- 280
tive at Vena Cavography in Patients with Renal
Insufficiency: Early Experience
]ohn A. Kaufman, Stuart C Geller, Hasan Bazari, and
Arthur C Waltman
Findings in this small series suggest that gadolinium-based
contrast agents are suitable as an alternative at digital sub-
traction vena cavography in patients with renal insuf-
ficiency, particularly when a limited volume of contrast
agent is needed.



Head and Neck Cancer: Detection of Recurrence 285
with Three-dimensional Principal Components
Analysis at Dynamic FDG PET
Yoshimi Anza'i, Satoshi Minoshima, Gregory T. Wolf, and
Richard L Wahl
Findings in tllis study demonstrate improved distinction
of tumors in the head and neck regions with principal
components analysis images as compared to that with
conventional standardized uptake value images.





LetterstotheEditor
Can Inversion-Recovery Gradient- and Spin-Echo 291
T2-weighted MR Imaging Be an Alternative to Fast
Spin-Echo Imaging with Fat Suppression?
Masayuki Kanematsu and Hiroaki Hoshi




Reply 291
Martin N.J M. Wasser, Milan E. /. Pifl, Els L. van Persijn
van Meerten, fan-Willem C. Gratama, and fohan L
Bloem



Audience Preference for Scientific Presentation 292
Method
Edward 1. Bluth and Kent Nash


Book Review
Imaging in Oncology. 2 Vols. 42


Guidelines and Gamuts in Musculoskeletal 74
Ultrasound



Vascular Brachytherapy. 2nd ed. 164


PACS: Basic Principles and Applications 202

Interludes
Left Ventricular Mouse 142


Before Biopsy: A Worried Hepatocellular 226
Carcinoma



An Egg-ceptional Dissection of the Ascending Aorta 264



Departments
Abstracts of Current Literature 293

Advertisers' Index 16A

Announcements and Books, Audiovisual Materi- 19A
als, and Software Received



Associated Sciences Workshop 1999 2A

Classified Services 43A

Continuing Medical Education 24A

Copyright and Certifications Agreement 36A


Publication Information for Authors 37A

Radiology Business Information 63A

Radiology Manuscript Categorization Terms 41A

RSNA Bulletin Board 65A

RSNA Quick Reference 15A

_______________________________________

RADIOLOGY + RSNA INDEX TO IMAGING LITERA

VOL. 212, NO. NO. 2, AUGUST 1999


From the Editor

297 Radiology 1999: Left-Hand Pages
Anthony V. Proto

Special Communication

298 The Radiological Society of North America 85th Scientific Assembly and
Annual Meeting, Sunday, November 28 to Friday, December 3, 1999
McCormick Place, Chicago, Illinois
Seymour H. Levitt

Perspectives

301 The Future of Medicine and Radiology: Part I
Richard M. Friedenberg
Within the next 10 years, clinicians will have to collaborate with a variety of independent
and semiindependent practitioners loosely categorized as nonphysician clinicians.

Editorial

305 Old Problems, New Techniques: The Interventional Radiologist and the Lacrimal
Apparatus
fane L Weissman
The inclination to address epiphora, and other clinical problems, by modifying the existing
techniques of interventional radiology is ingenious and important.

State of the Art

307 Imaging of Acute Cerebral Ischemia
Norman /. Beauchamp, fr, Peter B. Barker, Paul Y. Wang, and Peter C M. vanZifl
This State of the Art describes the central role of the radiologist and neuroimaging in the
diagnosis and subsequent management of acute cerebral ischemia.


Neuroradiology

325 Hyperacute Stroke: Ultrafast MR Imaging to Triage Patients prior to Therapy
feffrey L Sunshine, Robert W. Tarr, Charles F. Lanzieri, Dennis M. D. Landis, Warren R. Selman,
and fonathan S. Lewin
Diffusion- and perfusion-weighted MR imaging can be performed within the time constraints
of an acute stroke protocol and provide valuable data to guide critical patient triage and
therapeutic decisions.


333 Acute Cerebral Infarction: Quantification of Spin-
Density and T2 Shine-through Phenomena on
Diffusion-weighted MR Images
fonathan H. Burdette, Alien D. Elster, and Peter E. Ricci



340 Moyamoya Disease: Evaluation with Diffusion-
weighted and Perfusion Echo-planar MR Imaging
Ichiro Yamada, Yoshiro Himeno, Tsukasa Nagaoka,
Hideaki Ak'imoto, Yoshiharu Matsushima, Toshihiko
Kuroiwa, and Hitoshi Shibuya
Diffusion-weighted and perfusion echo-planar MR
imaging are useful methods for evaluating cerebral
ischemia in patients with moyamoya disease.

348 Long-term Angiographic Follow-up of 169
Intracranial Berry Aneurysms Occluded with
Detachable Coils

Diognoxh Pfeme

357 Case 17
Noriko Salamon-Murayama, Eric J. Russell, and Barry M.
Rabin

359 Case 13: Polyarteritis Nodosa—Systemic Necrotiz-
ing Vasculitis with Involvement of Hepatic and
Superior Mesenteric Arteries
Klaus D. Hagspiel, I.Fritz Angle, David J. Spinosa, and
Alan H. Matsumoto

Vascular and Interventional Radiology

365 Dacryoliths: Nonsurgical Fluoroscopically Guided
Treatment during Dacryocystoplasty
Kai E. Wilhelm, Ulrich Hofer, Hans /. Textor, Thorsten Boker,
Holger M. Strunk, and Hans H. Schild

371 Iliofemoral Arterial Occlusive Disease: Contrast-
enhanced MR Angiography for Preinterventional
Evaluation and Follow-up after Stent Placement
fohann Link, fohann C. Steffens, foachim Brossmann,
foachim Graessner, Stephanie Hackethal, and Martin
Heller

378 Outcome and Cost Comparison of Percutaneous
Transluminal Renal Angioplasty, Renal Arterial
Stent Placement, and Renal Arterial Bypass
Grafting
Peiyu Xue, Michael A. Bettmann, David R. Langdon, and
Wayne A, Wivell


385 Secondary Postpartum Hemorrhage: Treatment
with Selective Arterial Embolization
fean-Pierre Pelage, Philippe Soyer, Danielle Repiquet, Denis
Herbreteau, Olivier Le Dref, Emmanuel Houdart, Denis
facob, Mourad Kardache, Patrick Schurando, lean-Bernard
True, and Roland Rymer

390 Postoperative Pelvic Lymphocele: Treatment with
Simple Percutaneous Catheter Drainage
fae-Kyu Kirn, Yong-Yeonfeong, Yun-Hyeon Kirn, Young-Chul
Kim, Heoung-Keun Kang, and Ho-Sun Choi
Cenitourinory Imaging

395 Role of MR Imaging in the Selection of Patients
with Early Cervical Carcinoma for Fertility-pre-
serving Surgery: Initial Experience
P. Delia Peppercorn, Arjun R. jeyarajah, Robert Woolas,
fohn H. Shepherd, David H. Oram, lan j. f acobs, Peter
Armstrong, David Lowe, and Rodney H. Reznek

Special Report

401 Ovarian Cancer: Comparison of Observer Perfor-
mance for Four Methods of Interpreting CT Scans
Patrick f. Fultz, Christina V. f acobs, W, fackson Hall,
Ronald Gottlieb, Deborah Rubens, Sacra M. S. Totterman,
Steven Meyers, Cynthia Angel, Giuseppe Del Priore, David
P. Warshal, Kelly H. Zou, and David L Shapiro


411 TIPS for Prevention of Recurrent Bleeding inPa-
tients with Cirrhosis: Meta-analysis of Random-
ized Clinical Trials
Angelo Luca, Gennaro D'Amico, Roberto La Galla,
Massimo Midiri, Alberto Morabito, and Luigi PagUaro

Emergency Radiology

423 Hemoperitoneum as the Sole Indicator of Ab-
dominal Visceral Injuries: A Potential Limitation
of Screening Abdominal US for Trauma
Kathirkamanathan Shanmuganathan, Stuart L Mirvis,
Caroline D. Sherbourne, William C. Chiu, and Aurelio
Rodriguez

Castrointestinol Imaging

431 Extravasation Detection Accessory: Clinical
Evaluation in 500 Patients
Bernard A. Birnbaum, Rendon C Nelson, fudith L.
Chezmar, and Seth N. Click

439 Recurrent Gallbladder Carcinoma along
Laparoscopic Cholecystectomy Port Tracks: CT
Demonstration
Corinne B. Winston, fune W. Chen, Yuman Fong,
Lawrence H. Schwartz, and David M. Panicek


445 Local Extension of Pancreatic Carcinoma: Assess-
ment with Thin-Section Helical CT versus with
Breath-hold Fast MR Imaging—ROC Analysis
Taiji Nishiharu, Yasuyuki Yamashita, Yasuko Abe, Katsuhiko
Mitsuzaki, Tadatoshi Tsuchigame, Yoshiharu Nakayama,
and Mutsumasa Takahashi


453 Fecal Incontinence: Endoanal US versus Endoanal
MR Imaging
Elena Rociu, faap Stoker, Marinus j. C. Eijkemans, W. Ruud
Schouten, and fohan S. Lameris


Experimental Studies

459 Effects of Superparamagnetic Iron Oxide on Radio-
frequency-induced Temperature Distribution: In
Vitro Measurements in Polyacrylamide Phantoms
and in Vivo Results in a Rabbit Liver Model
Elmar M. Merkle, S. Nahum Goldberg, Daniel T. Boll, Ajit
Shankaranarayanan, Travis Boaz, Gretta H. facobs,
Michael Wendt, and fonathan S. Lewin


467 Infarcted Myocardium in Pigs: MR Imaging
Enhanced with Slow-Interstitial-Diffusion
Gadolinium Compound P760
Lucia /. M. Kroft, joost Doornbos, Rob /. van der Geest,
Soraya Benderbous, and Albert de Roos


475 Delayed Vascular Injury after Single High-Dose
Irradiation in the Rat Brain: Histologic, Immuno-
histochemical, and Angiographic Studies
Marc W. Munter, Christian P. Karger, Wolfgang Reith,
H. Michael Schneider, Peter Peschke, and furgen Debus


483 Stent Placement versus Percutaneous
Transluminal Angioplasty of Human Carotid
Arteries in Cadavers in Situ: Distal Embolization
and Findings at Intravascular US, MR Imaging,
and Histopathologic Analysis
Hannu 1. Manninen, Heikki T. Rasanen, Ritva L Vanninen,
Pauli Vainio, Mikko Hippelainen, and Veli-Matti Kosma

Ultrosonogrophy

493 Assessment of Stenosis: Implications of
Variability of Doppler Measurements in
Normal-appearing Carotid Arteries
Vivian S. Lee, Barbara S. Hertzberg, Mark A. Kliewer, and
Barbara A. Carroll

Nuclear Medicine

499 Count-based PET Method for Predicting Ischemic
Stroke in Patients with Symptomatic Carotid
Arterial Occlusion
Colin P. Derdeyn, Tom 0, Videen, Nicholas R. Simmons,
Kent D. Yundt, Susanne M. Fritsch, Robert L Grubb, fr,
and William f. Powers

507 Pediatric Inflammatory Bowel Disease: Assess-
ment with Scintigraphy with (99m)Tc White Blood
Cells
Martin Charron, Fernando ]. del Rosario, and Samuel A.
Kocoshis

Pediotric Imaging

515 Splenic Injury Diagnosed with CT: US Follow-up
and Healing Rate in Children and Adolescents
Kathleen H. Emery, Diane S. Babcock, Andrea S. Borgman,
and Victor F. Garcia

519 Legg-Calve-Perthes Disease: MR Imaging
Evaluation during Manual Positioning of
the Hip—Comparison with Conventional
Arthrography
Diego laramillo, Tamara A. Gafen, Carl S. Winalski, james
DiCanzio, David Zurakowski, Robert V. Mulkern, Patricia
A. McDougaii, Ofga L. Villegas-Medina, Ferenc A. folesz,
and fames R. Kasser

Musculoskeletol Imaging

527 Idiopathic Bone Marrow Edema Lesions of the
Femoral Head: Predictive Value of MR Imaging
Findings
Bruno C. Vande Berg, facques /. Malghem, Frederic E.
Lecouvet, ]acques famart, and Baudouin L Maldague


537 Is a Subset of Wrist Ganglia the Sequela of Internal
Derangements of the Wrist Joint? MR Imaging
Findings
Khaled /. EI-Noueam, Mark E. Schweitzer, Roberto Blasbalg,
Aly A. Farahat, Randall W. Gulp, Lee A. Osterman, and
AmaarMalik

Signs in Imaging

541 The Double-Line Sign
fohn V. Zurlo

Breast Imaging

543 Breast MR Imaging in Patients with Axillary Node
Metastases and Unknown Primary Malignancy
Susan G. Orel, Susan P. Wein stein, Mitchelf D. Sch nail,
Carol A. Reynolds, Lynn M, Schuchter, Douglas L Fraker,
and Lawrence f. Solin

Computer Applications

551 Breast Cancer: Computer Simulation Method for
Estimating Optimal Intervals for Screening
fames S. Michaeison, Elkan Halpern, and Daniel B. Kopans


Thoracic Imaging

561 Small Pulmonary Nodules: Evaluation with
Repeat CT—Preliminary Experience
David F. Yankelevitz, Rajiv Gupta, Binsheng Zhao, and
Claudia /. Henschke


567 Lymphocytic Interstitial Pneumonia:
Thin-Section CT Findings in 22 Patients
Takeshifohkoh, Nestor L. Mulfer, Heather A. Pickford,
Thomas E. Hartman, Kazuya Ichikado, Masanori Akira,
Osamu Hondo, and Hironobu Nakamura


Cardiac Imaging

573 Composite Graft Replacement of the Ascending
Aorta: Leakage Detection with Gadolinium-
enhanced MR Imaging
Rossella Fattori, Benedetta Descovich, Paola Bertaccini,
Francesca Celletti, Ilaria Caldarera, Angelo Pierangeli, and
Giampaolo Gavelli

Technical Developirtents

579 Submillimeter Three-dimensional Coronary MR
Angiography with Real-time Navigator Correc-
tion: Comparison of Navigator Locations
Matthias Stuber, Rene M. Botnar, Peter C. Danias, Kraig
V. Kissinger, and Warren f. Manning


588 Lungs in Infants and Young Children: Improved
Thin-Section CT with a Noninvasive Controlled-
Ventilation Technique—Initial Experience
Frederick R. Long, Robert G. Castile, Alan S. Brody, Mark /.
Hogan, Robert L Flucke, David A, Filbrun, and Keren 5.
McCoy

594 Bowel Lesions: Percutaneous US-guided 18-gauge
Needle Biopsy—Preliminary Experience
Gareth R. Tudor, Peter M. Rodgers, and Kevin P. West

598 Thoracic Duct: Visualization at Nonenhanced MR
Lymphography—Initial Experience
Sanshin Hayashi and Mitsue Miyazaki

Letters to the Editor

601 MR Angiography in Acute Pulmonary Embolism
Mathias Goyen

601 Reply
Ashu Gupta and Christopher K. Frazer

601 CT Reinterpretation
Thomas I. White,Jr

602 Reply
Marcf. Gollub, David M. Panicek, Ariadne M. Bach, and
Ronald A. Castellino

Book Reviews

300 Neuroradiology Companion: Methods, Guide-
lines, and Imaging Fundamentals, 2nd ed.

422 Intraoperative, Laparoscopic, and Endoluminal
Ultrasound

550 Radiation Protection Dosimetry: A Radical
Reappraisal

interludes

358 Swaggering Aorta

400 Intestinal Worm

514 Patient with a Frog in His Throat

Departments

603 Abstracts of Current Literature

16A Advertisers' Index

19A Announcements and Books, Audiovisual
Materials, and Software Received

2A Associated Sciences Workshop 1999

43A Classified Services

27A Continuing Medical Education

36A Copyright and Certifications Agreement

37A Publication Information for Authors

31A Radiology Business Information

41A Radiology Manuscript Categorization Terms

61A RSNA Bulletin Board

15A RSNA Quick Reference



_______________________________________

RADIOLOGY + RSNA INDEX TO IMAGIN LITERA

VOL. 212, NO. 3, SEPTEMBER 1999


From the Editor

605 Radiology 1999: Revised Publication Information for Authors
Anthony V. Proto

Special Report

606 Diagnosis Please Certificate of Recognition Awarded to Sergio Julio
Moguillansky, MD
Anthony V. Proto

Special Communication

607 Radiology and Epcot Celebrate New Millennium with a Patient Education and
Information Exhibit
ferry P. Petasnick and Peggy 1. Fritzsche

Editorial

609 Molecular Imaging: Exploring the Next Frontier
Ralph Weissieder

State of the Art

615 Spiral CT Angiography of the Pulmonary Circulation
Martine Remy-lardin and facques Remy


Thoracic Imaging

637 Follicular Bronchiolitis: Thin-Section CT and Histologic Findings
Sarah f. Howling, David M. Hansell, Athol U. Wells, Andrew C. Nicholson, )ulia D. A. Flint, and
Nestor L Muller

643 Mucoepidermoid Carcinoma of the Tracheo-
bronchial Tree: Radiographic and CT Findings
in 12 Patients
Tae Sung Kirn, Kyung Soo Lee, foungho Hen, fung-G'i 1m,
]oon Beom Seo, ]oung Sook Kirn, Hyae Young Kirn, and
Sang Wook Han

649 Electrocardiographically Gated Thin-Section CT
of the Lung
U. foseph Schoepf, Christoph R. Becker, Roland D.
Bruening, Thomas Heimberger, Axel Staebler, Patricia
Leimeister, and Maximilian F. Reiser

Vascular and Interventional Radiology

655 Human Endothelium: Endovascular Biopsy and
Molecular Analysis
Lei Feng, David M. Stern, and john Pile-Spellman

665 Hepatic Intraarterial ^1 Iodized Oil for Treatment
of Hepatocellular Carcinoma in Patients with
Impeded Portal Venous Flow
Thierry de Baere, Patrice Taourel, fean Michel Tubiana,
Viseth Kuoch, Michel Ducreux, fean Lumbroso, and Alain I.
Roche

669 Multiple Fluid Collections: CT- or US-guided
Aspiration— Evaluation of Microbiologic Results
and Implications for Clinical Practice
foan P. Heneghan, Richard f. Everts, and Rendon C.
Nelson

673 CT Fluoroscopy-guided Abdominal Interventions:
Techniques, Results, and Radiation Exposure
Stuart G. Silverman, Kemal Tuncali, Douglass F. Adams,
Richard D. Nawfel, Kelly H. Zou, and Philip F. fudy


682 Primary Musculoskeletal Neoplasms: Effective-
ness of Core-Needle Biopsy
Lawrence Yao, Scott D. Nelson, Leanne L. Seeger, feffreyf.
Eckardt, and Frederick R. Eilber

687 Osteoid Osteoma: CT-guided Percutaneous
Resection and Follow-up in 38 Patients
Nicolas Sans, Denise Galy-Fourcade, facques Assoun,
Thierry farlaud, Helene Chiavassa, Paul Bonnev'ialle,
Nadine Railhac, facques Giron, Helene Morera-Maupome,
and fean-jacques Railhac

Mwctiloskeletol Imaging

693 Liposclerosing Myxofibrous Tumor: A Radiologic-
Pathologic-Distinct Fibro-osseous Lesion of Bone
with a Marked Predilection for the Inter-
trochanteric Region of the Femur
Mark f. Kransdorf, Mark D. Murphey, and Donald L Sweet


699 Glenohumeral Relationships during Physiologic
Shoulder Motion and Stress Testing: Initial
Experience with Open MR Imaging and Active
Imaging-Plane Registration
Christopher F. Beaulieu, Duncan K. Hodge, A. Gabrielle
Bergman, Kirn Butts, Bruce L. Daniel, Clay L Napper,
Robert D. Darrow, Charles L. Dumoulin, and Robert j.
Herfkens

Diognosh Please

706 Case 18
Peter L Choyke and john L. Doppman

708 Case 14: Intramedullary Osteosclerosis
Avinash R. A. Balkissoon and Curtis W. Hayes

Genitolirinary Imaging

711 Radiologic Staging in Patients with Endometrial
Cancer: A Meta-analysis
Karen Kinkel, Yasushi Kaji, Kyle K. Yu, Mark R. Segal, Ying
Lu, C. Bethan Powell, and Hedvig Hricak


719 Three-dimensional US of the Prostate: Early
Experience
Ulrike M. Hamper, Victoria Trapanotto, M. Robert Dejong,
Sheila Sheth, and Cynthia /. Caskey

Experimental Studies

725 Renal Blood Flow in Pigs: Changes Depicted with
Contrast-enhanced Harmonic Imaging during
Acute Urinary Obstruction
Michel Claudon, Carol f. Barnewolt, George A. Taylor,
Patricia S. Dunning, Rita Gobet, and Abdef-Basset Badawy

732 Effect of Downstream Cross-sectional Area of ar
Arterial Bed on the Resistive Index and the Earh
Systolic Acceleration
Ronald 0. Bude and Jonathan M. Rubin


739 Simultaneous Noninvasive Determination of
Regional Myocardial Perfusion and Oxygen
Content in Rabbits: Toward Direct Measurement
Myocardial Oxygen Consumption at MR Imagin
Scott B. Reeder, A. Alexander Holmes, Elliot R. McVeigh,
and fohn R. Forder

748 Brachytherapy for the Prevention of Stenosis in <
Canine Hemodialysis Graft Model: Preliminary
Observations
Scott 0. Trerotola, Timothy j. Carmody, Robert D.
Timmerman, Kathleen Ann Bergan, R. Gerald Dreesen,
Stephanie V. Frosty and Mitchell Forney

RtidiotlonOncology

755 Phases IB and II Multidose Trial of Gadolinium
Texaphyrin, a Radiation Sensitizer Detectable at
MR Imaging: Preliminary Results in Brain
Metastases
Juliette Viala, Daniel Vanel, Philippe Meingan, Eric Lartigau
Patrice Carde, and Markus Renschler

Signs in Imaging

761 The Radial Bands Sign
Timothy A. Bernauer

Neurorodiology

763 Motor Neuron Diseases: Comparison of Single-
Voxel Proton MR Spectroscopy of the Motor
Cortex with MR Imaging of the Brain
Stephen Chan, Dikoma C Shungu, Annette Douglas-
Akinwande, Dale f. Lange, and Lewis P. Rowland

770 Quantitative Diffusion-Tensor Anisotropy Brain
MR Imaging: Normative Human Data and
Anatomic Analysis
foshua S. Shimony, Robert C. McKinstry, Erbil Akbudak,
foseph A. Aronovitz, Abraham Z. Snyder, Nicolas F. Lori,
Thomas S. Cull, and Thomas E. Conturo

785 Human Acute Cerebral Ischemia: Detection of
Changes in Water Diffusion Anisotropy by Using
MR Imaging
A. Gregory Sorensen, Ona Wu, William A. Copen, Timothy
L. Davis, R. Gilberto Gonzalez, Walter 1. Koroshetz,
Timothy G. Reese, Bruce R. Rosen, Van f. Wedeen, and
Robert M. Weisskoff


793 Brain Lesions: When Should Fluid-attenuated
Inversion- Recovery Sequences Be Used in MR
Evaluation?
Tomoko Okuda, Yukunori Korogi, Yoshinori Shigematsu,
Takeshi Sugahara, Toshinori Hirai, Ichiro lkushima, Luxia
Liang, and Mutsumasa Takahash'i

Nuclear Medicine

799 Primary and Recurrent Early Stage Laryngeal
Cancer: Preliminary Results of 2-[Fluorine
18]fluoro-2-deoxy-D-glucose PET Imaging
Val J. Lowe, Han Kim, fames H. Boyd, lohn F. Eisenbeis,
Frank R. Dunphy, and fames W. Fletcher


803 Staging Non-Small Cell Lung Cancer with Whole-
Body PET
Edith M. Marom, H. Page McAdams, feremyf, Erasmus,
Philip C. Goodman, Donna K. Culhane, R. Edward Coleman^
fames E. Herndon, and Edward F. Patz, fr


Computer Application!

811 Brain Tumor Volume Measurement: Comparison
of Manual and Semiautomated Methods
Bonnie N. foe, Melanie B. Fukui, Carolyn Cidis Meltzer,
Qing-shou Huang, Roger S. Day, Phil f. Greer, and Michael
E. Bozik

817 Improvement of Radiologists' Characterization of
Mammographic Masses by Using Computer-aided
Diagnosis: An ROC Study
Heang-Ping Chan, Berkman Sahiner, Mark A. Helvie,
Nicholas Petrick, Marilyn A. Roubidoux, Todd E. Wilson,
Dorit D. Adier, Chintana Paramagul, foel S. Newman,
and Sethumadavan Sanjay-Gopal

Breast Imaging

829 Local Tumor Recurrence following Breast-Conser
vation Therapy: Correlation of Histopathologic
Findings with Detection Method and Mammo-
graphic Findings
Catherine S. Giess, Delia M. Keating, Michael P. Osborne,
and Ruth Rosenblatt


Pediotric Imaging

837 Anterior Chest Wall: Frequency of Anatomic
Variations in Children
Lane F. DonneKy, Donald P. Frush, )oseph N. Poss, Sara M.
O'Hara, and George S. Bisset III

841 Soft-Tissue Venous Malformations in Pediatric and
Young Adult Patients: Diagnosis with Doppler US
Isabelle Trop, fosee Dubois, Laurent Guibaud, Andree
Grignon, Heidi Patriqu'rn, Catherine McCuaig, and Laurent
A. Garel

847 Kyphomelic Dysplasia: Clinical and Radiologic
Long-term Follow-up of One Case and Review of
the Literature
Rosanna Pallotta, Tamara Ehresmann, Mario Roggini, and
Paola Fusilli

Caitrointestinal Imaging

853 Adult Intussusception Detected at CT or MR Imag-
ing: Clinical-Imaging Correlation
David M. Warshauer and foseph K. T. Lee

861 Tumorous Gastric Varices: Radiographic Findings
in 10 Patients
Laura R. Carucci, Marc S. Levine, Stephen L Rubesin, and
lgor Laufer

866 Hepatocellular Carcinoma and Intrahepatic
Peripheral Cholangiocarcinoma: Enhancement
Patterns with Quadruple Phase Helical CT—
A Comparative Study
Evelyne M. Loyer, Hsiao Chin, Ronelle A. DuBrow Cynthia
L David, Farzin Eftekhari, and Chusilp Charnsangavej

876 Abdominal MR Imaging with a Volumetric
Interpolated Breath-hold Examination
Neil M. Rofsky, Vivian S. Lee, Cerhard Laub, Michael A.
Pollack, Clenn A. Krinsky, David Thomasson, Michael M.
Ambrosino, and feffrey C Weinreb

Technical Developments

885 Cystic Fibrosis: Combined Hyperpolarized
He-enhanced and Conventional Proton MR
Imaging in the Lung—Preliminary Observations
Lane F. Donnelly, fames R. MacFalf, H. Page McAdams,
J. Marc Majure, lean Smith, Donald P. Frush, Paul
Bogonad, H. Cecil Charles, and Carl L Ravin

890 Pulmonary Perfusion: Respiratory-triggered
Three-dimensional MR Imaging with Arterial
Spin Tagging—Preliminary Results in Healthy
Volunteers
David A. Roberts, Warren B. defter, foshua A. Hirsch,
Rahim R. Rizi, Lawrence Dougherty, Robert L Lenkinski,
fohn S. Leigh, }r, and Mitchell D. Schnall

896 Pulmonary Arterial Resistance: Noninvasive
Measurement with Indexes of Pulmonary Flow
Estimated at Velocity-encoded MR Imaging—
Preliminary Experience
Elie Mousseaux, lean Pierre Tasu, Odile lolivet, Gerard
Simonneau, facques Bittoun, and fean-Cfaude Gaux

903 Pulsed Magnetization Transfer Imaging: Evaluate
of Technique
Simon 1. Graham and R. Mark Henkelman


letters to the Editor

911 ROC Curve Analysis in the Evaluation of Contrast-
enhanced Color Doppler US
Jonathan Winehouse, Michael Douek, and W'^iarn Lees
Reply
Sabine Huber, Ivan Zuna, and Stefan Dehrme

912 Erratum
In Memoriom

913 Harry W.Fischer,MD
lohn R. Thombury, MD.and Helen C Redman, MD

Book Reviews

724 Abdominal Plain Film with Correlative Imaging.

2nd ed.

760 Imaging in Oncology

810 Fog: A Collection of Backscatter

836 Mousy Type of Calcification in a Breast Fibro-
adenoma

846 Gastrointestinal Tract Bug

Departments

915 Abstracts of Current Literature

16A Advertisers' Index

119A Announcements and Books, Audiovisual Materials,
and Software Received

55A Classified Services

25A Continuing Medical Education

912 Erratum

38A Radiology Business Information

78A RSNA Bulletin Board

2A RSNA Quick Reference

22A Associated Sciences Workshop 1999

44A Revised Copyright and Certifications Agreement

45A Revised Publication Information for Authors

51A Revised Radiology Manuscript Categorization
Terms

17A Request for Printed Copy of the January 2000
RSNA Index to Imaging Literature

_______________________________________

RADIOLOGY + RSNA INDEX TO IMAGING LITERA

VOL. 213, NO. 1, OCTOBER 1999


From the Editor

1 Radiology 1999: New Feature-Viewpoint
Anthony V, Proto

Special communication

2 Congratulations to the 1999 Editorial Fellows
R. Nick Bryan

Perspectives

3 The Future of Medicine and Radiology: Part II
Richard M. Friedenberg
There is no question in my mind that radiology will continue to grow in the future-the
only question is, in which garden will the growth take place?

Editorial

7 New Digital Mammography Systems May Require Different X-ray Spectra and,
Therefore, More General Normalized Glandular Dose Values
Carolyn Ki m me-Smith
Articles such as Boone's can provide medical physicists with the tools to design or modify
digital mammography equipment without affecting mean glandular dose and can give
radiologists insights about the complex interactions that affect patient dose estimates.

Viewpoint

11 Probably Benign Breast Lesions: When Should Follow-up Be Recommended and
What Is the Optimal Follow-up Protocol?
Edward A. Sickles
The ratio of probably benign lesions that are followed up versus those that undergo tissue
diagnosis will depend on a variety of factors, including one's training and experience, how
frequently previous mammograms are available for comparison, locally accepted screening
guidelines, local costs for imaging examinations versus imaging-guided interventional
procedures, and how management recommendations are communicated to the patient and
referring clinician.

15 Six-month Follow-up: An Alternative View
Eva Rubin
A period of 12-month mammograpliic (and/or US) surveillance for at least 3 years is an alternative
to biopsy in the majority of women witli probably benign lesions diagnosed after adequate
work-up imaging.


19 Coininentary on Dr Rubiii^s Viewpoint
Edward A. Sickles


21 Conimentary on l)r Sickles' Viewpoint
Eva Rubin


Medical Physics

23 Glandular Breast Dose for Monoenergetic
and High-Energy X-ray Beams: Monte Carlo
Assessment
john M. Boone
This study was intended to provide clinical medical
physicists, as well as researchers, with the tools needed to
calculate glandular breast dose for any arbitrary x-ray
spectra in a simple but accurate manner.

Breast Imaging

39 Cost-effectiveness of MR Imaging and Core-
Needle Biopsy in the Preoperative Work-up of
Suspicious Breast Lesions
fanie M. Hrung, Curtis P. Langlotz, Susan C. Orel, Kevin R.
Fox, Mitchell D. Schnall, j. Sanford Schwartz
Preoperative testing was a cost-effective alternative to
excisional biopsy, but the choice between MR imaging
and core-needle biopsy was highly dependent on the
accuracy of each test and on patient preferences.

Nuclear Medicine
51 Ventilation perfusion lung scintisraphy as a
Guide for pulmonary Angiography in the
Localization of Pulmonary Emboli
Neil C. Davey, Tony P. Smith, Michael W. Hanson, Vivian
S. Lee, Daniel f. Stackhouse, and R. Edward Coleman
Ventilation-perfusion scintigraphy can provide an
accurate guide to the selection of the first side to study by
means of pulmonary angiography.

Signs in Imaging

59 The Fissure Sign
fugesh I. S. Cheema
The linear area of reduced or absent radionuclide uptake
along the distribution of the major and/or minor fissure
on a lung perfusion scan is referred to as the fissure sign.

Radiation Oncology

61 Cosmetic Outcome in Patients Receiving an Inter-
stitial Implant as Part of Breast-Conservation
Therapy
Bradley A, Kramer, Douglas W. Arthur, Kenneth Ulin,
Rupert K. A. Schmidt-Ullrich, Robert D. Zwicker, and David
E. Wazer

67 Resectable Esophageal Carcinoma: Local Control
with Neoadjuvant Chemotherapy and Radiation
Therapy
Mark A. Chidel, Thomas W. Rice, David f. Adelstein,
Patrick A. Kupelian, fohn H. Suh, and Mark Becker

Castrofn^ftinaf hfwgfitff

73 Posttransplantation Lymphoproliferative Disorder
of the Abdomen: CT Evaluation in 51 Patients
Perry f. Pickhardt and Marilyn f. Siegel


79 Mucinous versus Nonmucinous Rectal Carcinomas:
Differentiation with MR Imaging
Shahid M. Hussain, Eric K. Outwater, and Evan S.
Siegeiman

86 Liver Metastases: Comparison of Current MR
Techniques and Spiral CT during Arterial
Portography for Detection in 20 Surgically
Staged Cases
Richard C. Semetka, Witliam G. Cance, Hani B. Marcos,
and Matthew A. Mauro

92 Liver Metastases from Melanoma: Detection with
Multiphasic Contrast-enhanced CT
Simon P. Blake, Karen Weisinger, Michael B. Atkins, and
Vassilios Raptopoulos

97 Primary Melanoma of the Esophagus: Radiologic
and Clinical Findings in Six Patients
Marc f. Goflub and foan C. Prowda

Diagnoxh Please

101 Case 19
H. Wouter van Es and Rienk Sybrandy

102 Case 15: Congenitally Corrected Transposition of
the Great Arteries
Gautham P. Reddy and Gary R. Caputo

Ultrosonogrophy

107 Abdominal US for Diagnosis of Pancreatic Tumor:
Prospective Cohort Analysis
Britt-Marie Karlson, Anders Ekbom, Per Gunnar Undgren,
Vendela Kallskog, and fonas Rastad


Pediatric imaging

113 Gastric Retention of Zinc-based Pennies:
Radiographic Appearance and Hazards
Sara M. O'Hara, Lane F. Donnelly, Emit Chuang, William
H. Briner, and George S. Bisset III

118 Cyclic Cystography: Diagnostic Yield in Selected
Pediatric Populations
Michael I. Gelfand, Bemadette L Koch, Abdelhamid H.
Elgazzar, Victoria M. Gylys-Morin, Peter S. Gartside, and
Charles L. Torgerson


121 Defining and Categorizing Leukoencephalopa-
thies of Unknown Origin: MR Imaging Approach
Marjo S. van der Knaap, Steve N. Breiter, Sakkubai Naidu,
Augustinus A. M. Hart, and fakob Valk


Neurorodiology

135 Brain Tumors: Complications of Cerebral
Angiography Accompanied by Intraarterial
Chemotherapy
Miguel Gelman, Donald W. Ghakeres, and Herbert B.
Newton


141 CT Assessment of Cerebral Perfusion: Experimenta
Validation and Initial Clinical Experience
Darius G. Nabavi, Aleksa Genie, Rosemary A. Graen,
Adrian W. Gelb, John D. Bennett, Roman Kozak, and
Ting-Yim Lee




150 Acute Stroke: Improved Nonenhanced CT
Detection-Benefits of Soft-Copy Interpretation
by Using Variable Window Width and (renter
Level Settings
Michael H. Lev, feffrey Farkas, Joseph J. Gemmete, Syeda
T. Hossain, George J. Hunter, Walter J. Koroshetz, and R.
Gilberto Gonzalez

156 Comprehensive MR Imaging Protocol for Stroke
Management: Tissue Sodium Concentration as a
Measure of Tissue Viability in Nonhuman Primate
Studies and in Clinical Studies
Keith R. Thulborn, Tatyana S. Gindin, Denise Davis, and
Patricia Erb

Head and Neck Imaging

167 Asymptomatic Carotid Arterial Disease in Young
Patients following Neck Radiation Therapy for
Hodgkin Lymphoma
Leonard j. King, Salma N. Hasnain, fudith A. W. Webb,
fudith E. Kingston, Elizabeth A. Sh afford, T. Andrew Lister,
fonathan Shamash, and Rodney H. Reznek

Vascular and Interventional Radiology

173 Tl and T2 Lip Cancer: A Superselective Method
of Facial Arterial Infusion Therapy-Preliminary
Experience
Kazushi Kishi, Masahiro Matsunaka, Morio Sato, Tetsuo
Sonomura, Mikihisa Sakurane, and Koji Uede

180 Synthetic Dialysis Shunts: Thrombolysis with the
Cragg Thrombolytic Brush Catheter
Bart L Dolmatch, Flavio Casteneda, Thomas 0. McNamara,
Gerald Zemel, Michael Lieber, and Andrew H. Cragg

185 Thoracic Aorta: Rapid Black-Blood MR Imaging
with Half-Fourier Rapid Acquisition with Relax-
ation Enhancement with or without Electrocar-
diographic Triggering
David H. Stemerman, Glenn A. Krinsky, Vivian S. Lee, Glyn
fohnson, Ben M. Yang, and Neil M. Rofsky

192 Intraaortic Growth of Hydatid Cysts Causing
Occlusion of the Aorta and of Both Iliac Arteries:
Case Report
Suleyman Men, Cuneyt Yucesoy, Tahsin R. Edguer, and
Baki Hekimoglu

Emergency Radiology

195 Can Chest CT Be Used to Exclude Aortic Injury?
Debra S. Dyer, Ernest L Moore, Michael F. Mestek, Steven
M, Bernstein, Dave N. lkle, fanette D. Durham, Marsha j.
Heinig, Paul D. Russ, David L. Symonds, David A. Kumpe,
Edward /. Roe, Benjamin Honigman, Robert C. Mcintyre,
fr, and fohn Eule, fr

203 Acute Cervical Spine Injuries: Prospective MR
Imaging Assessment at a Level I Trauma Center
Richard W. Katzberg, Philip F. Benedetti, Christiana M.
Drake, Marija lvanovic, Richard A, Levine, Carol S. Beatty,
William R. Nemzek, Russell A. McFall, Francesca K. Ontell,
Dorene M, Bishop, Virginia C Poirier, and Brian W. Chong

Muscliloskeletol Imaging

213 Oblique Meniscomeniscal Ligament: Another
Potential Pitfall for a Meniscal Tear-Anatomic
Description and Appearance at MR Imaging in
Three Cases
Timothy C. Sanders, Ricardo C. Linares, Keith W. Lawhom,
Phillip F, /. Tirman, and Craig Houser


Experimental Studies

217 Histologic Evaluation of Platinum Coil Emboliza-
tion in an Aneurysni Model in Rabbits
David F. Kallmes, Gregory A. Helm, Sarah B. Hudson,
Talissa A. Altes, Huy M. Do, james W. MandeK, and Harry
J.Cloft

223 Endovascular Creation of an in Vivo Bifurcation
Aneurysm Model in Rabbits
Harry f. Cloft, Talisa A. Altes, William F. Marx, Robert f.
Raible, Sarah B. Hudson, Gregory A. Helm, fames W.
Mandell, Mary E. ]ensen, facques E. Dion, and David F.
Kallmes

229 Hemodynamics and Wall Mechanics after Stent
Placement in Swine Iliac Arteries: Comparative
Results from Six Stent Designs
Pierre H. Rolland, Ali-Baback Charifi, Caroline Verrier, Heidi
Bodard, Alain Friggi, Philippe Piquet, Guy Moulin, and
fean-Michel Bartoli

247 Reperfused Myocardial Infarction as Seen with
Use of Necrosis-specific versus Standard Extra-
cellular MR Contrast Media in Rats
Maythem Saeed, fens Bremerich, Michael F. Wendland,
Rolf Wyttenbach, Hanns-foachim Weinmann, and Charles
B. Higgins

258 Correlation between Renal Vascular Resistance,
Pulse Pressure, and the Resistive Index in Isolated
Perfused Rabbit Kidneys
Mitchell E. Tubim, Franklin N. Tessler, and Michael E.
Murphy

265 Prostate Cancer Tumor Grade Differentiation
with Dynamic Contrast-enhanced MR Imaging
in the Rat: Comparison of Macromolecular and
Small-Molecular Contrast Media-Preliminary
Experience
Axel Cossmann, Yoshitaka Okuhata, David M. Shames,
Thomas H. Helbich, Timothy P. L. Roberts, Michael F.
Wendland, Sabine Huber, and Robert C. Brasch

Cenitourinary

273 Autosomal Dominant Polycystic Kidney Disease
Types I and 2: Assessment of US Sensitivity for
Diagnosis
Carlos Nicolau, Roser Torra, Celia Badenas, Ramon Vilana,
LUIS Bianchi, Rosa Gilabert, Alejandro Darnel and
Goncepcio Bru

277 Pulmonary Nodules Resected at Video-assisted
Thoracoscopic Surgery: Etiology in 426