Imaging Methods Results In Better Care For Hand Problems

January 02, 1996

Magnetic resonance images of abnormal blood vessels in the hand can help determine the best treatment without invasive procedures or radiation, a study including Johns Hopkins concludes.

"Magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) were clearly effective in managing vascular malformations," says Kyle D. Bickel, M.D., a co-author of the 10-patient study and an assistant professor of plastic surgery and orthopedic surgery at Hopkins. The abnormal clusters of arteries and veins can be painful, unsightly and weaken the hand as they enlarge over time.

Results are published in the January issue of The Journal of Plastic and Reconstructive Surgery.

Using a powerful magnetic field to provide images, the MRI/MRA technique showed the inside of the growths, their connections to surrounding tendons, bones and muscles, and blood flow through arteries and veins in the growths. All 10 patients previously had undergone X-rays, bone scans, ultrasound and conventional angiography, in which blood vessels are filled with dye injected through a catheter and then X-rayed.

"The results let us determine which growths could be surgically removed and predict which patients would have long-term success," Bickel says. Four patients had surgery and six were treated with special garments that compressed the growths over a long period.

Other investigators in the study, which included the Raymond M. Curtis Hand Center at Union Memorial Hospital and the Towson Imaging Center, both in Baltimore, were Joseph J. Disa, M.D., Kevin C. Chung, M.D., Fouad E. Gellad, M.D. and E.F. Shaw Wilgis, M.D.

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Johns Hopkins Medicine

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