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The aim of this clinical study was to evaluate the use of high-resolution magnetic resonance imaging (MRI) in the diagnosis of facial haemiatrophy. A total of 14 patients with clinically suspected facial haemiatrophy were investigated using high-resolution MRI. The T1- (500/25) and T2- (2200/50) weighted images were analysed visually and numerically. The results of the affected skin portions were compared with the contralateral skin and correlated with the clinical results. The subcutis could not be delineated by high-resolution MRI in 9 patients with facial haemiatrophy. The dermis was not discernible in 6 cases and was “smooth” in a further 6 patients. The signal-to-noise ratio of affected skin portions and contralateral skin or clinical severity did not correlate. The higher the clinical severity, the more pronounced was the magnetic resonance ratio between dermis and subcutis thickness. Thus high-resolution MRI is a useful method for objective description of pathological changes in clinically suspected facial haemiatrophy. [ABSTRACT FROM AUTHOR]

Objective: Identifying potentially modifiable risk factors for ovarian cancer is essential for prevention because this cancer is predominantly detected at a late stage. Here, we estimated the relations of general adiposity and measures reflecting body fat distribution to the risk of epithelial ovarian cancer., Methods: We ascertained 683 ovarian epithelial cancers (343 high-grade serous, 141 non-high grade serous) among 145,575 women, aged 50-72 years (median follow-up 12.6 years), from the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study. Using Cox models, we estimated confounder-adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for associations of overall ovarian cancer, high-grade serous and non-high-grade serous carcinoma with body mass index, waist circumference, hip circumference, waist-hip ratio, waist-height ratio, body adiposity index, body shape index, and abdominal volume index., Results: Anthropometric measures were unrelated to overall ovarian cancer, high-grade serous cancer, and non-high-grade serous cancer. For example, the HR for overall ovarian cancer per standard deviation increment of body mass index at baseline was 0.98 (95% CI 0.88-1.10). Similar associations were observed with measurements of body fat distribution., Conclusion: These results do not indicate that adult adiposity is associated with ovarian cancer risk in post-menopausal women.

Obesity is a complex multifactorial phenotype that influences several metabolic pathways. Yet, few studies have examined the relations of different body fat compartments to urinary and serum metabolites. Anthropometric phenotypes (visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), the ratio between VAT and SAT (VSR), body mass index (BMI), waist circumference (WC)) and urinary and serum metabolite concentrations measured by nuclear magnetic resonance spectroscopy were measured in a population-based sample of 228 healthy adults. Multivariable linear and logistic regression models, corrected for multiple testing using the false discovery rate, were used to associate anthropometric phenotypes with metabolites. We adjusted for potential confounding variables: age, sex, smoking, physical activity, menopausal status, estimated glomerular filtration rate (eGFR), urinary glucose, and fasting status. In a fully adjusted logistic regression model dichotomized for the absence or presence of quantifiable metabolite amounts, VAT, BMI and WC were inversely related to urinary choline (ß = -0.18, p = 2.73*10-3), glycolic acid (ß = -0.20, 0.02), and guanidinoacetic acid (ß = -0.12, p = 0.04), and positively related to ethanolamine (ß = 0.18, p = 0.02) and dimethylamine (ß = 0.32, p = 0.02). BMI and WC were additionally inversely related to urinary glutamine and lactic acid. Moreover, WC was inversely associated with the detection of serine. VAT, but none of the other anthropometric parameters, was related to serum essential amino acids, such as valine, isoleucine, and phenylalanine among men. Compared to other adiposity measures, VAT demonstrated the strongest and most significant relations to urinary and serum metabolites. The distinct relations of VAT, SAT, VSR, BMI, and WC to metabolites emphasize the importance of accurately differentiating between body fat compartments when evaluating the potential role of metabolic regulation in the development of obesity-related diseases, such as insulin resistance, type 2 diabetes, and cardiovascular disease.

Reliable identification of features distinguishing biological groups of interest in urinary metabolite fingerprints requires the control of total metabolite abundance, which may vary significantly as the kidneys adjust the excretion of water and solutes to meet the homeostatic needs of the body. Failure to account for such variation may lead to misclassification and accumulation of missing data in case of less concentrated urine specimens. Here, different pre- and post-acquisition methods of normalization were compared systematically for their ability to recover features from liquid chromatography-mass spectrometry metabolite fingerprints of urine that allow distinction between patients with chronic kidney disease and healthy controls. Methods of normalization that were employed prior to analysis included dilution of urine specimens to either a fixed creatinine concentration or osmolality value. Post-acquisition normalization methods applied to chromatograms of 1:4 diluted urine specimens comprised normalization to creatinine, osmolality, and sum of all integrals. Dilution of urine specimens to a fixed creatinine concentration resulted not only in the least number of missing values, but it was also the only method allowing the unambiguous classification of urine specimens from healthy and diseased individuals. The robustness of classification could be confirmed for two independent patient cohorts of chronic kidney disease patients and yielded a shared set of 49 discriminant metabolite features. Graphical Abstract Dilution to a uniform creatinine concentration across urine specimens yields more comparable urinary metabolite fingerprints.

Background: Different measures of body fat composition may vary in their relations to parameters of chronic inflammation., Methods: We assessed the relations of visceral (VAT) and subcutaneous adipose tissue (SAT), BMI, and waist circumference (WC) to serum concentrations of high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), resistin, and adiponectin in 97 healthy adults using multivariate linear regression models, adjusted for age, sex, smoking, physical activity, menopausal status, and use of aspirin or non-steroidal anti-inflammatory drugs (NSAIDs). Parameters of chronic inflammation were mutually adjusted., Results: VAT (β = 0.34), SAT (β = 0.43), BMI (β = 0.40), and WC (β = 0.47) were all significantly associated with hs-CRP. BMI was additionally inversely related to adiponectin (β = -0.29). In exploratory subgroup analyses defined by gender, BMI, smoking, and use of aspirin or NSAIDs, VAT was the strongest indicator for increased levels of IL-6, SAT was the most consistent indicator for increased levels of hs-CRP, and BMI was the most consistent indicator for decreased levels of adiponectin. WC showed to be a weak indicator for increased levels of hs-CRP and decreased levels of adiponectin., Conclusion: VAT, SAT, BMI, and WC show distinct associations with parameters of chronic inflammation. Whether these differences reflect differential metabolic risks requires clarification by longitudinal studies., (© 2016 The Author(s) Published by S. Karger GmbH, Freiburg.)

Objective: Whether adiposity and lack of physical activity affect the risk for developing meningioma and glioma is poorly understood. Our objective was to characterize these associations in detail., Methods: We conducted a systematic review and meta-analysis of adiposity and physical activity in relation to meningioma and glioma using cohort and case-control studies published through February 2015. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines., Results: We identified 12 eligible studies of body mass index (BMI) and 6 studies of physical activity, comprising up to 2,982 meningioma cases and 3,057 glioma cases. Using normal weight as the reference group, overweight (summary relative risk [RR] = 1.21, 95% confidence interval [CI] = 1.01-1.43) and obesity (RR = 1.54, 95% CI = 1.32-1.79) were associated with increased risk of meningioma. In contrast, overweight (RR = 1.06, 95% CI = 0.94-1.20) and obesity (RR = 1.11, 95% CI = 0.98-1.27) were unrelated to glioma. Similarly, dose-response meta-analyses revealed a statistically significant positive association of BMI with meningioma, but not glioma. High vs low physical activity levels showed a modest inverse relation to meningioma (RR = 0.73, 95% CI = 0.61-0.88) and a weak inverse association with glioma (RR = 0.86, 95% CI = 0.76-0.97). Relations persisted when the data were restricted to prospective studies, except for the association between physical activity and glioma, which was rendered statistically nonsignificant (RR = 0.91, 95% CI = 0.77-1.07)., Conclusions: Adiposity is related to enhanced risk for meningioma but is unassociated with risk for glioma. Based on a limited body of evidence, physical activity is related to decreased risk of meningioma but shows little association with risk of glioma., (© 2015 American Academy of Neurology.)

Patients actively seek information about how to cope with their health problems, but the quality of the information available varies. A number of instruments have been developed to assess the quality of patient information, primarily though in English. Little is known about the reliability of these instruments when applied to patient information in German. The objective of our study was to investigate and compare the reliability of two validated instruments, DISCERN and EQIP, in order to determine which of these instruments is better suited for a further study pertaining to the quality of information available to German patients with eczema. Two independent raters evaluated a random sample of 20 informational brochures in German. All the brochures addressed eczema as a disorder and/or therapy options and care. Intra-rater and inter-rater reliability were assessed by calculating intra-class correlation coefficients, agreement was tested with weighted kappas, and the correlation of the raters' scores for each instrument was measured with Pearson's correlation coefficient. DISCERN demonstrated substantial intra- and inter-rater reliability. It also showed slightly better agreement than EQIP. There was a strong correlation of the raters' scores for both instruments. The findings of this study support the reliability of both DISCERN and EQIP. However, based on the results of the inter-rater reliability, agreement and correlation analyses, we consider DISCERN to be the more precise tool for our project on patient information concerning the treatment and care of eczema.

Background: Ultrasound represents a low-cost and widely available field method for assessing visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) but its measurement properties are uncertain. The aim of the current study was to examine the reproducibility and validity of ultrasound to quantify abdominal fat compartments., Methods: In two study centers, VAT and SAT thicknesses were quantified by ultrasound two times by two observers each among 127 adults aged 20-70 years. In a separate sample of 30 adults, the ultrasound method was validated by comparing VAT and SAT thicknesses with VAT and SAT areas at vertebrae L2/L3 as obtained by a single magnetic resonance imaging (MRI) slice., Results: For VAT, the intra-rater reproducibility values for observers 1 and 2 were r=0.996 (95% CI=0.994-0.997) and r=0.999 (95% CI=0.999-0.999), respectively. For SAT, the intra-rater reproducibility values were r=0.992 (95% CI=0.989-0.994) and r=0.993 (95% CI=0.990-0.995), respectively. The inter-rater reproducibility values for VAT and SAT were r=0.998 (95% CI=0.997-0.999) and r=0.990 (95% CI=0.986-0.993), respectively. For VAT and SAT, the correlation coefficients between ultrasound and MRI measurements were r=0.898 (P<0.001) and r=0.705 (P<0.001), respectively., Conclusion: Ultrasound provides reproducible and valid estimates of VAT and SAT and represents a useful method to assess abdominal fat in large scale epidemiologic studies., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Purpose: The superparamagnetic iron oxide (SPIO) Resovist is a contrast media with shortening of both T(1) and T(2) relaxation time. This study evaluates the impact of SPIO-enhanced T(1)- and T(2)-weighted images for the differentiation of liver lesions., Materials and Methods: SPIO-enhanced MRI examinations (1.5 T, Symphony Quantum) of 61 patients were analyzed. Thirty-seven patients had malignant liver lesions (metastases n = 32, HCC n = 5) proven by biopsy or laparotomy, 11 patients had benign liver lesions (FNH n = 2, hemangiomas n = 4, benign cysts n = 5, normal liver on laparoscopy n = 13). After unenhanced T(1)- and T (2)-weighted imaging, a bolus injection of 1.4 ml SPIO (Resovist) was given, followed by T(1)-weighted imaging at 20 s, 60 s, and 5 min and T(2)-weighted imaging at 10 min post injection. A score from 1 (benign) to 5 (malignant) was used by three blinded radiologist for the ROC analysis of the unenhanced T(1)-/T(2)-weighted images (set 1) and of the combinations of unenhanced T(1)/T(2)-weighted and SPIO T(1)-weighted images (set 2), unenhanced T(1)/T(2) and SPIO T(2)-w images (set 3) and all images (set 4)., Results: The accuracy of plain MRI (set 1: 56 %) was increased by SPIO-enhanced T(1)-weighted images (set 2: 81 %) and SPIO-enhanced T(2)-weighted images (set 3: 90 %). Best results were obtained using unenhanced T(1)-weighted, unenhanced T(2)-weighted and both SPIO T(1)-weighted and T(2)-weighted images (set 4: 93%). The accuracy of predicting histopathologic diagnosis was 91%., Conclusion: For the differentiation of liver lesions, SPIO-enhanced T(2)-weighted images had a greater impact on the accuracy of MRI than T (1)-weighted images, but SPIO-enhanced T(1)-weighted images provided additional information in some patients and should not be deleted.

Purpose: Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract with an increasing detection rate due to improved differentiating methods in current diagnostic pathology. This study evaluates the radiologic characteristics of these neoplasms to discover specific signs leading to an earlier diagnosis., Materials and Methods: As part of a randomized phase III clinical trial of the European Organization for Research and Treatment of Cancer (EORTC), 72 patients with advanced stage GIST were treated with the selective tyrosine-kinase-inhibitor imatinib (Glivec, Novartis, Switzerland). For initial staging, 60 patients underwent MRI and 12 patients underwent CT., Results: GISTs are mesenchymal tumors that grow submucosally and exophytically and become multiple, nodular or ovoid in the advanced stage. The predominant findings are peripheral solid structures with strong contrast enhancement and a central necrosis. Metastases are primarily located in the liver, where they appear as oval or round, sharply delineated solitary lesions with central necrosis. CT demonstrates the primary tumors and local recurrences as nearly isodense with the liver. On MRI, the lesions are hypointense on T 1 -weighted sequences and hyperintense on T 2 -weighted sequences, compared to the liver., Conclusion: Immunopathology now enables the exact histologic separation of GISTs from other mesenchymal tumors. The radiological morphology is not sufficiently specific to differentiate GISTs from other mesenchymal tumors. In view of new therapeutic options, cognizance of their typical manifestations is of increasing importance for radiologists.

Purpose: The purpose of this work was to describe the findings and the long term follow up of pathologically confirmed bronchus-associated lymphoid tissue lymphoma (BALTOMA) in 6 patients., Methods: CT examinations and conventional radiological examinations were reviewed and compared to describe typical radiological findings and patterns of pulmonary manifestations. It were described the number of lesions and characteristics like presence of airspace consolidation, ground-glass attenuation, bubble-like radiolucencies, air bronchogram, bronchial dilatation, Infiltration and the long term behaviour of the manifestations., Results: Lesions with a positive air bronchogram, no infiltration of extrapulmonary tissue or extrapulmonary manifestations were revealed as typical findings. Only a slow or no progression of disease was shown in most patients over a term of up to twelve years., Conclusions: The lymphoma of the bronchus-associated lymphoid tissue of the lung is a rare tumor. A positive air bronchogram, a multiplicity of disease, bilateral lesions, a fibrotic transformation of the lung tissue and no growth or only a slow groth over al long term of observation are typical radiological findings.

Purpose: Aim of the study was to compare the visualisation of small bowel tumours particularly lymphoma of the small bowel by enteroclysma, computed tomography (CT) and computed tomography following enteroclysma., Methods: We examined 97 examinations in 63 patients. Non Hodgkin's Lymphoma was the primary malignancy in 44 patients, metastasis of different malignancies in 8 patients, primary malignancies of the small intestine in 5 patients, mesenteric tumours in 4 patients and postoperative stricture in another 2 patients. CT following enteroclysma (CT Sellink) was performed as helical CT in 55 patients and as incremental CT in 42 patients. Examinations were evaluated by two radiologists. Evaluation criteria were small bowel distension, perceptibility of details and topographic correlation., Results: Manifestations of lymphoma were found in 32 patients, infiltration of bowel wall in 12 patients. In three patients metastases of melanoma were found. In three patients the suspicion for small bowel tumours was not verified in CT Sellink. The perceptibility of details was evaluated as ameliorated in 45.5% of examinations over all., Conclusions: CT Sellink offers remarkable advantages in the diagnosis of small bowel tumours compared with enteroclysma and "conventional" computed tomography under intra-venous and oral contrast media. CT Sellink was feasible over a time of 7 years now in clinical praxis. This examination represents an optimized standard in small intestine examination.

The aim of the study was to estimate the value of MRI for evaluation tumors of the shoulder girdle. We diagnosed respectively 13 patients with lesions in the shoulder region. The imaging has been done with a "Magnetom SP 63" (Siemens, Erlangen, Germany). The protocol consisted of T1- and T2-based SE-sequences in axial slice orientation, T1-based imaging in coronary respectively in sagittal slice orientation as well as T1-based sequences after application of contrast medium. The evaluation of the tumor expansion within the soft tissue was possible. The exact diagnosis in some individual cases--neurinoma, cyst of the synovia--could be found by MRI. Estimation of the dignity in the case of infiltrative growth was possible in most cases. To assess the exact type of tumor was often difficult. Especially the dignity of the cartilaginous tumors could not be precisely described.

Romberg disease, also known as progressive facial hemiatrophy (PFH), is an uncommon disease with progressive facial asymmetry as the major symptom. It is a atrophic process of the subcutaneous fatty tissue whose etiology is unknown. Skin, muscles and bones can be secondarily afflicted. With MRI evaluation we were able to show in 14 patients with PFH thinner subcutaneous fat, as well as flattening of the dermis in 12 of the 14. We divided the patients into three stages by the means of the MRI findings and found tendency towards concurrence between the MRI stage and the clinical stage.

In eleven patients with breast cancer the diagnosis was made by using ultrasound as the only method. In none of the patients could mammography show the malignoma. Although six of the patients underwent additional tube X-ray investigation, no radiological criteria of malignancy were found on the mammograms. In ten patients a lump of the breast was palpable and/or retraction of the skin was visible. In one woman, neither the clinical investigation nor the mammography could reveal the tumor. The ultrasound of the breast is a indispensable and useful method for diagnosing breast cancer.