BACKGROUND AND PURPOSE: The diagnosis of traumatic spinal dural tears is difficult to establish. The purpose of this study was to determine the reliable MR imaging findings suggesting dural tears in spinal burst fractures.
The authors investigated whether fatty acid emulsion affects the blood–brain barrier (BBB), whether disrupted BBB is reversible, and whether the fatty acid emulsion technique may be a model for BBB research. The fat emulsion was made with 0.05 mL of oleic acid or linoleic acid and 20 mL of normal saline. The internal carotid artery in 14 cats was infused with oleic acid emulsion (group 1) and with linoleic acid emulsion in 12 cats (group 2). Gd-enhanced T1-weighted (Gd-T1WI), diffusion-weighted (DWI), and additional apparent diffusion coefficient (ADC) map magnetic resonance imaging (MRI) was obtained at 1 hour, 1 and 4 days, and 1 week after infusion. MRI findings were evaluated qualitatively. Quantitatively, the signal intensity ratio (SIR) of the lesion to the contralateral hemisphere was measured on Gd-T1WIs. The SIRs were statistically analyzed using the student t test. The brain tissue was removed immediately for light and electron microscopy examination if the lesion showed no contrast enhancement and was isointense on DWIs and the ADC maps. The lesions appeared at 1 hour in both groups as contrast enhancement on Gd-T1WIs, as isointensity or mild hyperintensity on DWIs, and as isointensity on the ADC maps. On day 1, these MRI findings were decreased in group 1 and were not seen in group 2. At 1 hour, the SIRs of group 1 were significantly higher than those of group 2 (P = 0.016). On day 1, the SIRs of both groups approximated 1.0. Light microscopy findings revealed minor necrosis and demyelination in one cat from group 1 and in 3 cats from group 2. Electron microscopy examinations showed minimal findings in the cortical lesions in groups 1 and 2. Infusion of unsaturated fatty acid emulsion into the carotid artery of cats revealed vasogenic edema of the brain and reversible changes as depicted on MRI. This unsaturated fat emulsion technique may be used as a model for research on BBB disruption.
Rationale and Objectives: The purpose of this study was to determine whether cerebral fat embolism demonstrated reversible or irreversible findings in magnetic resonance (MR) imaging over time and to compare the features in MR images with histologic findings in a cat model. Materials and Methods: MR images were obtained serially at 2 hours, 1 and 4 days, and 1, 2, and 3 weeks after embolization with 0.05 mL of triolein into the internal carotid artery in 19 cats. Any abnormal signal intensity and change in the signal intensity were evaluated on T2-weighted images, T1-weighted images, diffusion-weighted images (DWIs; including apparent diffusion coefficient [ADC] maps), and gadolinium-enhanced T1-weighted images (Gd-T1WI) over time. After MR imaging at 3 weeks, brain tissue was obtained and evaluated for light microscopic (LM) examination using hematoxylin-eosin and Luxol fast blue staining. For electron microscopic examination, the specimens were obtained at the cortex. The histologic and MR findings were compared. Results: The embolization lesions showed hyperintensity on T2-weighted images, hyperintensity, or isointensity on DWIs, hypointensity, or isointensity on ADC maps and contrast enhancement on Gd-T1WIs at 2 hours. The T2-weighted hyperintensity extended to the white matter at day 1 and decreased thereafter. Contrast enhancement decreased continuously from day 1, and hyperintensity on DWI decreased after day 4. Hypointensity on ADC maps became less prominent after day 4. By week 3, most lesions had reverted to a normal appearance on MR images and were correlated with LM findings. However, small focal lesions remained in the gray matter of 8 cats and in the white matter of 3 cats on MR images, and this correlated with the cystic changes on LM findings. Electron microscopic examination of the cortical lesions that reverted to normal at week 3 in MR images showed that most of these lesions appeared normal but showed sporadic intracapillary fat vacuoles and disruption of the endothelial walls. Conclusions: The embolized lesions of the hyperacute stage were of 2 types: type 1 lesions, showing hyperintensity on DWIs and hypointensity on ADC maps, have irreversible sequelae, such as cystic changes; whereas type 2 lesions, showing isointensity or mild hyperintensity on DWIs and ADC maps, reverted to a normal appearance in the subacute stage.
In vivo rat kidney tissue metabolites of an anticancer drug, cisplatin (cis-diamminedichloroplatinum [II]) (CP) which is used for the treatment of testicular, ovarian, bladder, cervical, esophageal, small cell lung, head and neck cancers, have been identified and characterized by using liquid chromatography positive ion electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS) in combination with on line hydrogen/deuterium exchange (HDX) experiments. To identify in vivo metabolites, kidney tissues were collected after intravenous administration of CP to adult male Sprague-Dawley rats (n = 3 per group). The tissue samples were homogenized and extracted using newly optimized metabolite extraction procedure which involves liquid extraction with phosphate buffer containing ethyl acetate and protein precipitation with mixed solvents of methanol-water-chloroform followed by solid-phase clean-up procedure on Oasis HLB 3cc cartridges and then subjected to LC/ESI-HRMS analysis. A total of thirty one unknown in vivo metabolites have been identified and the structures of metabolites were elucidated using LC-MS/MS experiments combined with accurate mass measurements. Online HDX experiments have been used to further support the structural characterization of metabolites. The results showed that CP undergoes a series of ligand exchange biotransformation reactions with water and other nucleophiles like thio groups of methionine, cysteine, acetylcysteine, glutathione and thioether. This is the first research approach focused on the structure elucidation of biotransformation products of CP in rats, and the identification of metabolites provides essential information for further pharmacological and clinical studies of CP, and may also be useful to develop various effective new anticancer agents.
OBJECTIVE. The purpose of our study was to evaluate spinal MR images for extraforaminal disk herniation with or without foraminal disk herniation to determine the reliable MRI findings. MATERIALS AND METHODS. Thirty-five patients with extraforaminal with or without foraminal disk herniation confirmed at radiculography or surgery between March 2005 and July 2007 underwent spinal MRI. We assessed the morphologic features of the disk, changes in nerve root thickness, epidural fat obliteration surrounding the nerve root, and displacement of the nerve root in the foraminal and extraforaminal zones. RESULTS. Mixed disk herniation was found in 23 patients, and purely extraforaminal herniation was found in 12 patients. Focal eccentricity of the disk contour was identified in 32 patients (91%). Change in the nerve root thickness was found in 30 patients (86%). The nerve roots were displaced in 22 patients (63%), and the original location was maintained in nine patients (26%). Differentiation between the disk and the nerve root was poor in four of the 35 patients (11%). Obliteration of the epidural fat surrounding the nerve root was present in all patients. CONCLUSION. The presence of extraforaminal with or without foraminal disk herniation should be ascertained on the basis of the following MRI findings: focal eccentricity of the disk contour, obliteration of epidural fat surrounding the nerve root, change in the thickness of the nerve root, and displacement of the nerve root.