Βιογραφικό

Restoration of function and sensitivity utilizing a homodigital neurovascular island flap after amputation injuries of the fingertip

VARITIMIDIS SE, DAILIANA ZH, ZIBIS AH, et al.

JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME

30B (4): 338-342 AUG 2005

1. Kitidumrongsook P, Patradul A, Pataradool K Resurfacing the degloved thumb up to the interphalangeal joint level with twin extended neurovascular island flaps JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME 31B (5): 562-565 OCT 2006

KARACHALIOS T, HANTES M, ZIBIS AH, et al.

50 (3): 278-284 JUN 2004

1. Hadjigeorgiou GM, Malizos K, Dardiotis E, et al. Paraoxonase 1 gene polymorphisms in patients with osteonecrosis of the femoral head with and without cerebral white matter lesions JOURNAL OF ORTHOPAEDIC RESEARCH 25 (8): 1087-1093 AUG 2007

2. Hussain A, Young WB Steroids and aseptic osteonecrosis (AON) in migraine patients HEADACHE 47 (4): 600-604 APR 2007

Tsionos I, Karahalios T, Zibis AH, Malizos KN..

Acta Orthop Belg. 2004 Dec;70(6):612-5

1. Rhee P, Main C. Bilateral Posterior Fracture-Dislocation Of The Shoulder As A Presentation Of An Intracranial Tumor The Internet Journal of Orthopedic Surgery TM ISSN: 1531-2968

EUROPEAN JOURNAL OF RADIOLOGY

50 (3): 225-230 JUN 2004

1. Karachalios T, Karantanas AH, Malizos K Hip osteoarthritis: What the radiologist wants to know EUROPEAN JOURNAL OF RADIOLOGY 63 (1): 36-48 JUL 2007

2. Yates PJ, Calder JD, Stranks GJ, et al. Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee KNEE 14 (2): 112-116 MAR 2007

3. Messent EA, Ward RJ, Tonkin CJ, et al. Differences standard radiography, respectively OSTEO in trabecular structure between knees with and without osteoarthritis quantified by macro and ARTHRITIS AND CARTILAGE 14 (12): 1302-1305 DEC 2006

4. Bamac B, Ozdemir S, Sarisoy HT, et al. Evaluation of medial and lateral meniscus thicknesses in early osteoarthritis of the knee with magnetic resonance imaging SAUDI MEDICAL JOURNAL 27 (6): 854-857 JUN 2006

5. Conaghan P Is MRI useful in osteoarthritis? BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY 20 (1): 57-68 FEB 2006

6. Karantanas A Comments on Beattie et al: Abnormalities identified in the knees of asymptomatic volunteers using peripheral magnetic resonance imaging OSTEOARTHRITIS AND CARTILAGE 13 (9): 841-843 SEP 2005

1. Naraghi A, White L MRI evaluation of the postoperative knee: Special considerations and pitfalls CLINICS IN SPORTS MEDICINE 25 (4): 703+ OCT 2006

2. Thoreux P, Rety F, Nourissat G, et al. Bucket-handle meniscal lesions: Magnetic resonance imaging criteria for reparability ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 22 (9): 954-961 SEP 2006

3. Osinski T, Malfair D, Steinbach L Magnetic resonance arthrography ORTHOPEDIC CLINICS OF NORTH AMERICA 37 (3): 299+ JUL 2006

4. Kaura DR, Schweitzer ME, Weishaupt D, et al. Optimization of indirect arthrography of the knee by application of external heat: Initial experience JOURNAL OF MAGNETIC RESONANCE IMAGING 22 (6): 810-812 DEC 2005

5. Morrison WB Indirect MR arthrography: Concepts and controversies SEMINARS IN MUSCULOSKELETAL RADIOLOGY 9 (2): 125-134 JUN 2005

50 (3): 238-244 JUN 2004

1. Karantanas AH Acute bone marrow edema of the hip: role of MR imaging EUROPEAN RADIOLOGY 17 (9): 2225-2236 SEP 2007

2. Malizos KN, Karantanas AH, Varitimidis SE, et al. Osteonecrosis of the femoral head: Etiology, imaging and treatment EUROPEAN JOURNAL OF RADIOLOGY 63 (1): 16-28 JUL 2007

3. O'Connor PJ, Barron D MRI assessment of pelvic trauma SEMINARS IN MUSCULOSKELETAL RADIOLOGY 10 (4): 345-356 DEC 2006

4. Reppenhagen S, Kenn W, Reichert J, et al. Imaging of avascular necrosis of the femoral head in adults ORTHOPADE 36 (5): 430+ MAY 2007

5. Garzon JRG Consecutive bone scintigraphy in bilateral hip migratory transient osteoporosis CLINICAL NUCLEAR MEDICINE 30 (10): 677-679 OCT 2005

COMPUTERIZED MEDICAL IMAGING AND GRAPHICS

26 (3): 159-165 MAY-JUN 2002

1. Karagulyan GA Everywhere divergent Phi-means of Fourier series MATHEMATICAL NOTES 80 (1-2): 47-56 JUL-AUG 2006

2. Schroder RJ, Fischbach F, Unterhauser FN, et al. Value of various MR sequences using 1.5 and 3.0 Tesla in analyzing cartilaginous defects of the patella in an animal model ROFO-FORTSCHRITTE AUF DEM GEBIET DER RONTGENSTRAHLEN UND DER BILDGEBENDEN VERFAHREN 176 (11): 1667-1675 NOV 2004

3. Kornaat PR, Doornbos J, van der Molen AJ, et al. Magnetic resonance imaging of knee cartilage using a water selective balanced steady-state free precession sequence JOURNAL OF MAGNETIC RESONANCE IMAGING 20 (5): 850-856 NOV 2004

4. McGibbon CA, Trahan CA Measurement accuracy of focal cartilage defects from MRI and correlation of MRI graded lesions with histology: a preliminary study OSTEOARTHRITIS AND CARTILAGE 11 (7): 483-493 JUL 2003

5. Wacha H, Ross A The value of MRI in chronic and acute knee symptomatology - a study in 366 patients DEUTSCHE ZEITSCHRIFT FUR SPORTMEDIZIN 54 (4): 108-111 APR 2003

SKELETAL RADIOLOGY

30 (2): 67-71 FEB 2001

1. Fullerton GD, Rahal A Collagen structure: The molecular source of the tendon magic angle effect JOURNAL OF MAGNETIC RESONANCE IMAGING 25 (2): 345-361 FEB 2007

2. Wang YXJ, Bradley DP, Kuribayashi H, et al. Some aspects of rat femorotibial joint microanatomy as demonstrated by high-resolution magnetic resonance imaging LABORATORY ANIMALS 40 (3): 288-295 JUL 2006

3. Warden SJ, Brukner P Patellar tendinopathy CLINICS IN SPORTS MEDICINE 22 (4): 743+ OCT 2003

EUROPEAN RADIOLOGY

10 (9): 1507-1508 2000

1. Guermazi A, Mohr A, Genant HK Brodie abscess: another type of chronic posttraumatic osteomyelitis EUROPEAN RADIOLOGY 13 (7): 1750-1752 JUL 2003

1. Yoshioka H, Stevens K, Hargreaves BA, et al. Magnetic resonance imaging of articular cartilage of the knee: Comparison between fat-suppressed three-dimensional SPGR imaging, fat-suppressed FSE imaging, and fat-suppressed three-dimensional DEFT imaging, and correlation with arthroscopy JOURNAL OF MAGNETIC RESONANCE IMAGING 20 (5): 857-864 NOV 2004

IN VIVO BODY COMPOSITION STUDIES

ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 904: 621-624 2000

1. Mylona M, Leotsinides M, Alexandrides T, et al. Comparison of DXA, QCT and trabecular structure in beta-thalassaemia EUROPEAN JOURNAL OF HAEMATOLOGY 74 (5): 430-437 MAY 2005

COMPUTERIZED MEDICAL IMAGING AND GRAPHICS

24 (1): 37-42 JAN-FEB 2000

1. Takahashi N, Niitsu M, Yoshioka H, et al. Three-dimensional fast field echo MR myelography using water excitation COMPUTERIZED MEDICAL IMAGING AND GRAPHICS 28 (6): 363-369 SEP 2004

EUROPEAN RADIOLOGY

10 (1): 144-148 2000

1. Prevedello DMS, Cordeiro JG, Koerbel A, et al. Management of primary spinal chondrosarcoma - Report of two cases causing cord compression ARQUIVOS DE NEURO-PSIQUIATRIA 62 (3B): 875-878 SEP 2004

2. Motamedi K, Ilaslan H, Seeger LL Imaging of the lumbar spine neoplasms SEMINARS IN ULTRASOUND CT AND MRI 25 (6): 474-489 DEC 2004

3. Drevelegas A, Chourmouzi D, Boulogianni G, et al. Imaging of primary bone tumors of the spine EUROPEAN RADIOLOGY 13 (8): 1859-1871 AUG 2003

4. Bilgen IG, Yunten N, Demirtas E, et al. Hemangioblastoma causing cervical neural foraminal widening JOURNAL OF NEURORADIOLOGY 28 (3): 205-208 SEP 2001

5. Ekinci G, Baltacioglu F, Ozgen S, et al. Cervical neural foraminal widening caused by the tortuous vertebral artery CLINICAL IMAGING 25 (5): 320-322 SEP-OCT 2001

6. Schneider G, Ahlhelm F, Hennes P, et al. Intra-abdominal tuberculous peritonitis EUROPEAN RADIOLOGY 11 (7): 1263-1266 2001

AMERICAN JOURNAL OF ROENTGENOLOGY 172 (1): 251-251 JAN 1999

1. Nakayama E, Tabata O, Oobu K, et al. Gas phenomenon in the superior space of the temporomandibular joint: Report of a case JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY 62 (1): 107-111 JAN 2004

2. Stallenberg B, Madani A, Burnyh F, et al. The vacuum phenomenon: A CT sign of nonunited fracture AMERICAN JOURNAL OF ROENTGENOLOGY 176 (5): 1161-1164 MAY 2001

EUROPEAN RADIOLOGY

8 (9): 1581-1585 1998

1. Athiviraham A, Yen D, Scott C, et al. Clinical correlation of radiological spinal stenosis after standardization for vertebral body size CLINICAL RADIOLOGY 62 (8): 776-780 AUG 2007

2. Gulek B, Durgun B, Ozer HTE, et al. CT-based morphometric data of L3-L5 vertebrae: Anatomic and surgical approach NEUROSURGERY QUARTERLY 17 (2): 92-97 JUN 2007

3. Tong HC, Carson JT, Haig AJ, et al. Magnetic resonance imaging of the lumbar spine in asymptomatic older adults JOURNAL OF BACK AND MUSCULOSKELETAL REHABILITATION 19 (2-3): 67-72 2006

4. Taciser Kaya1, Nesrin Þen1, et.al THE RELATIONSHIP BETWEEN LUMBAR SPINAL CANAL DIMENSIONS AND SOMATOMETRIC PARAMETERS, CLINICAL FINDINGS AND DISABILITY LEVEL J PMR Sci 2006;9(1):1-5

5. Varol T, Iyem C, Cezayirli E, et al. Comparative morphometry of the lower lumbar vertebrae: Osteometry in dry bones and computed tomography images of patients with and without low back pain JOURNAL OF INTERNATIONAL MEDICAL RESEARCH 34 (3): 316-330 MAY-JUN 2006

6. Karakas P, Bozkir MGLumbar vertebrae: Anatomic and radiologic perspectives related to surgical procedures NEUROSURGERY QUARTERLY 16 (2): 81-84 JUN 2006

7. Tierärztliche Hochschule Hannover vorgelegt von Natalia Vollhardt aus Omsk Morphometrie und Gefäßdarstellung der Lendenwirbelsäule des Kaninchens –röntgenologische und kernspintomographischeUntersuchungen Inaugural-Dissertation zur Erlangung des Grades einer Doktorin der Veterinärmedizin (Dr. med. vet.) durch dieHannover 2005

8. Tacar O, Demirant A, Nas K, et al. Morphology of the lumbar spinal canal in normal adult Turks YONSEI MEDICAL JOURNAL 44 (4): 679-685 AUG 30 2003

9. Geraghty EM, Boone JM Determination of height, weight, body mass index, and body surface area with a single abdominal CT image RADIOLOGY 228 (3): 857-863 SEP 2003

10. Dora C, Walchli B, Elfering A, et al. The significance of spinal canal dimensions in discriminating symptomatic from asymptomatic disc herniations EUROPEAN SPINE JOURNAL 11 (6): 575-581 DEC 2002

11. Drugova B, Druga R, Chalupova M Sagittal diameters of the lumbar spinal canal CESKA A SLOVENSKA NEUROLOGIE A NEUROCHIRURGIE 64 (4): 219-224 2001

12. Nakano M, Matsui H, Ishihara H, et al. Serial changes of herniated intervertebral discs after posterior lumbar discectomy: The relation between magnetic resonance imaging of the postoperative intervertebral discs and clinical outcome JOURNAL OF SPINAL DISORDERS 14 (4): 293-300 AUG 2001

13. Ville Remes. Spine in Patients with Diastrophic Dysplasia - a clinical and radiological study Academic dissertation Helsinki 2000

Karantanas AH, Zibis A, Rousogiannis S, Velesiotou C, Lavdas E..

Radiologica Diagnostica 1994; 35:265-268.

1. V. Hingst A. Knaape, M. Schittkowski, K.H. Hauenstein, R. uthoff, Zur Methodik und Genauigkeit der MR-Volumetrie der Orbital The Methodology and Accuracy of MRI-Based Orbital Volume Calculations Klin Monatsbl Augenheilkd 2004; 221: 894-897DOI: 10.1055/s-2004-813357

σε παρένθεση ο δείκτης επιρροής  “ impact factor”)

ΣΥΝΟΛΙΚΟΣ ΔΕΙΚΤΗΣ ΕΠΙΡΡΟΗΣ – IMPACT FACTOR = 31,164

1. Zibis AH, Karantanas AH, Roidis NT, Hantes ME, Argiri P, Moraitis T, Malizos KN. The role of MR imaging in staging femoral head osteonecrosis. Eur J Radiol. 2007 Jul;63(1):3-9. Epub 2007 Jun 6. (IF= 1,745)

Reliability, accuracy and prognostic value of any classification system are important in evaluation and treatment of femoral head osteonecrosis. The purpose of the present study was to correlate the plain radiographs with MRI in femoral head osteonecrosis. Between 2000 and 2005, 115 hips (72 patients) were evaluated

and classified according to the ARCO classification criteria with the use of plain radiographs and additional application of MRI. Classification was performed by consensus between a musculoskeletal radiologist and an orthopaedic surgeon. Sensitivity (SEN), specificity (SP), positive (PPV) and negative (NPV) predictive value of X-rays were estimated. According to MRI, 17 hips were classified as stage I, 25 as stage II, 48 as stage III and 25 as stage IV. The SEN, SP, PPV and NPV of plain radiographs were for stage II 88%, 90.5%, 78.6% and 95%; for stage III 79.2% 82%, 80.8% and 87.2%; for stage IV 76%, 100%, 100% and 90.9%, respectively. The agreement between plain radiographs and MRI was 80.6% for staging the disease, 71.2% for recording the location of the osteonecrotic lesion, 67.1% for evaluating the size of the lesion, 79.2% for the presence of collapse of the articular surface and 56.3% for the degree of collapse. In conclusion, the ARCO classification could miss important information in stages II and III, where treatment aims at preservation of the hip joint integrity. The results of the present study suggest that MRI should be incorporated in the classification of osteonecrosis (stages II and III), to add accuracy and prognostic value.

2. Hadjigeorgiou GM, Malizos K, Dardiotis E, Aggelakis K, Dardioti M, Zibis A, Dimitroulias A, Scarmeas N, Tsezou A, Karantanas A. Paraoxonase 1 gene polymorphisms in patients with osteonecrosis of the femoral head with and without cerebral white matter lesions. J Orthop Res. 2007 Apr 27;  (IF= 2,72)

Cerebral white matter lesions (WML) are present in more than 50% of patients with osteonecrosis of the femoral head (ONFH). Paraoxonase 1 (PON1) gene product is a detoxifying and pesticide metabolizing enzyme. Genetic variants of the PON1 gene have been found to influence the occurrence and progression of WML. We examined whether two PON1 polymorphisms (M55L and R192Q) are associated with ONFH and influence the occurrence of WML. We studied 104 patients with ONFH and 113 healthy age- and sex-matched subjects. We used logistic regression models to examine associations and survival analyses (Cox proportional hazards models) to examine possible influence of alleles on age at onset of ONFH. We found no association of PON1 M55L alleles and genotypes with ONFH. The distribution of PON1 Q192R alleles (p = 0.001) and genotypes (QQ vs. QR/RR) (p = 0.004) were statistically different between controls and patients. Patients with QQ genotype had six times higher risk for WML at brain MRI (adjusted OR 5.95; 95% CI 1.30-27.03; p = 0.02). In Cox models, there was a significant association of allele Q with risk for ONFH indicating a possible dose effect (HR = 1.43; 95%CI = 1.04-1.97; p for trend = 0.03). We conclude that individuals with PON1 192QQ genotype may have increased risk for ONFH and WMLeOn..

3. Varitimidis SE, Dailiana ZH, Zibis AH, Hantes M, Bargiotas K, Malizos KN. Restoration of Function and Sensitivity Utilizing a homodigital Neurovascular Island Flap after Amputation Injuries of the Fingertip. J Hand Surg [Br]. 2005 Jun 1; (IF= 0,494)

Sixty-three fingertip amputations in 50 patients were reconstructed using a homodigital neurovascular island flap technique based on a single neurovascular pedicle without further shortening of the distal phalanx. The procedure was carried out under regional anaesthesia, using a tourniquet and magnifying loupes. All of the flaps survived and achieved normal or adequate two-point discrimination without any painful scar or cold hypersensitivity. Fifteen patients had some loss of distal interphalangeal joint extension. The technique is simple and presents an excellent method for fingertip reconstruction in Allen type II, III and IV injuries

4. Karachalios T, Hantes M, Zibis AH, Zachos V, Karantanas AH, Malizos KN. Diagnostic Accuracy of a New Clinical Test (the Thessaly Test) for Early Detection of Meniscal Tears. J Bone Joint Surg Am. 2005 May;87(5):955-62 (IF= 1,946)

BACKGROUND: Clinical tests used for the detection of meniscal tears in the knee do not present acceptable diagnostic sensitivity and specificity values. Diagnostic accuracy is improved by arthroscopic evaluation or magnetic resonance imaging studies. The objective of this study was to evaluate the diagnostic accuracy of a new dynamic clinical examination test for the detection of meniscal tears. METHODS: Two hundred and thirteen symptomatic patients with knee injuries who were examined clinically, had magnetic resonance imaging studies performed, and underwent arthroscopic surgery and 197 asymptomatic volunteers who were examined clinically and had magnetic resonance imaging studies done of their normal knees were included in this study. For clinical examination, the medial and lateral joint-line tenderness test, the McMurray test, the Apley compression and distraction test, the Thessaly test at 5 degrees of knee flexion, and the Thessaly test at 20 degrees of knee flexion were used. For all clinical tests, the sensitivity, specificity, false-positive, false-negative, and diagnostic accuracy rates were calculated and compared with the arthroscopic and magnetic resonance imaging data for the test subjects and the magnetic resonance imaging data for the control population. RESULTS: The Thessaly test at 20 degrees of knee flexion had a high diagnostic accuracy rate of 94% in the detection of tears of the medial meniscus and 96% in the detection of tears of the lateral meniscus, and it had a low rate of false-positive and false-negative recordings. Other traditional clinical examination tests, with the exception of joint-line tenderness, which presented a diagnostic accuracy rate of 89% in the detection of lateral meniscal tears, showed inferior rates. CONCLUSIONS: The Thessaly test at 20 degrees of knee flexion can be used effectively as a first-line clinical screening test for meniscal tears, reducing the need for and the cost of modern magnetic resonance imaging methods.

5. Tsionos I, Karahalios T, Zibis AH, Malizos KN. Combined anterior and posterior shoulder dislocation as a manifestation of a brain tumour. Acta Orthop Belg. 2004 Dec;70(6):612-5.

Seizures are sometimes the first manifestation of a brain tumour. They may give rise to shoulder fractures or fracture-dislocations. When bilateral, these lesions tend to be symmetrical. The patient reported here suffered from a previously undiagnosed brain tumour, the first manifestation of which were seizures, which provoked a bilateral shoulder dislocation in opposite directions. The posterior dislocation was recognized with a delay of 16 days. After an episode of seizures, shoulder dislocation can occur in either direction, and bilateral shoulder dislocations may not be symmetrical

6. Hadjigeorgiou GM, Karantanas AH, Zibis A, Dardiotis E, Aggelakis K, Papadimitriou A, Malizos K. Increased frequency of white matter lesions in patients with osteonecrosis(WMLeOn) of the femoral head. Eur J Radiol. 2004 Jun;50(3):278-84. (IF= 1,745)

White matter lesions (WML) are commonly seen in cerebral MR imaging in normal and demented elderly people or young people suffering from migraine. We present data showing that WML are detected in an unexpectedly high frequency (56.9%) in patients with non-traumatic osteonecrosis of the femoral head compared to age and sex-matched controls. We designated the coexistence of WML and osteonecrosis as white matter lesions in osteonecrosis (WMLeON). We examined the possible association of WMLeON with hyperlipidaemia and other risk factors for WML or osteonecrosis of the femoral head. The frequency of history of corticosteroid treatment was statistically lower in patients with WMLeON (58.6%) compared to those without it (90.1%) (P = 0.03). We found no association of WMLeON with diabetes, stroke, hyperlipidaemia, migraine, smoking, alcohol consumption, hypertension, atrial fibrillation, or systemic lupus erythematosus. Although, the clinical significance of WMLeON is still unknown, this finding supports, at least, the hypothesis that non-traumatic osteonecrosis is indeed a multisystem disorder rather than a disease of human skeleton.

7. Malizos KN, Zibis AH, Dailiana Z, Hantes M, Karahalios T, Karantanas AH. MR imaging findings in transient osteoporosis of the hip. Eur J Radiol. 2004 Jun;50(3):238-44. (IF= 1,745)

PURPOSE: The authors sought to describe the magnetic resonance (MR) imaging findings including perfusion imaging, in association with the course of acute bone marrow oedema syndrome (aBMEs), in a group of patients with acute hip pain and a final diagnosis of transient osteoporosis of the hip (TOH). MATERIALS AND METHODS: From 217 patients referred with a probable diagnosis of avascular necrosis (AVN) of the femoral head, we identified 42 patients who had clinical and radiographic findings not relevant to AVN. MR imaging examinations were performed on a 1.0T scanner. Perfusion imaging was performed in 20 patients. The bone marrow oedema (BME) was classified in four stages. In addition, the presence or absence of oedema in the subchondral area and the presence of other subchondral lesions were recorded. Acetabular bone marrow was also assessed for the presence of oedema. The quantitative measurements included: maximum size of the effusion, percentage of enhancement (PE) and time of peak enhancement of abnormal marrow compared to the first pass, on the perfusion images. RESULTS: Osteopenia was present on plain radiographs in 87% of cases. The most common pattern of BME was extending to the femoral head and neck. Acetabulum was involved in 16.6%. In 22.6% the BME spared the subchondral region of the femoral head. There were two cases (4.7%) with subchondral changes. A joint effusion was noted in 33 of the 42 patients. On perfusion imaging, a delayed peak enhancement was noted in 20 patients between 40 and 65 s after the first pass of contrast. No patient had any evidence of femoral head collapse or change in sphericity on follow-up MRI. None of the patients developed avascular necrosis in a time frame of 18 months from the onset of the acute hip pain. CONCLUSION: The aBMEs MR imaging pattern varies and is most commonly appearing on X-rays as osteopenia. Absence of subcondral lesions, delayed peak enhancement of the abnormal marrow on perfusion images, and sparing of subchondral zone from marrow oedema are MR imaging findings highly correlated to TOH.

8. Hantes ME, Zachos VC, Zibis AH, Papanagiotou P, Karahalios T, Malizos KN, Karantanas AH. Evaluation of meniscal repair with serial magnetic resonance imaging: a comparative study between conventional MRI and indirect MR arthrography. Eur J Radiol. 2004 Jun;50(3):231-7. (IF= 1,745)

OBJECTIVE: To prospectively investigate the healing process of meniscal repair with plain magnetic resonance imaging (MRI) and indirect MR arthrography and to compare the two methods. MATERIALS AND METHODS: Twenty patients with an arthroscopic meniscal repair without clinical symptoms underwent conventional and indirect MR arthrography of the affected knee, 3, 6 and 12 months after the index operation applying a T1-w Spin Echo sequence in three planes. The size of the tear gap was measured on transverse images. The signal-to-noise ratio and the configuration of the abnormal signal were evaluated in the coronal images. RESULTS: All patients demonstrated abnormal signal intensity at the side of the meniscal repair. The size of the gap at the previous tear side, reduced significantly by 45 and 40% on conventional MRI and indirect MR arthrography respectively, from 3 months to 1 year (P < 0.05). The signal-to-noise ratio of the intrameniscal abnormal signal reduced significantly and approximately 50% from 3 to 6 months and from 6 to 12 months postoperatively, as demonstrated with indirect MR arthrography. However, as opposed to normal meniscus, the signal-to-noise ratio of the abnormal area remains 5.5 times higher 12 months postoperatively. In contrast, the reduction of signal-to-noise ratio of the abnormal area at conventional MRI was not significant even from 3 to 12 months. In 90% of the cases, the indirect MR arthrography showed the intrameniscal abnormal signal on plain MRI, to extend to the articular surface as opposed to 25% on plain MRI. CONCLUSION: With indirect MR arthrography, the natural process of meniscal healing can be evaluated. Significant reduction of the size of the tear gap and significant reduction of the signal-to-noise ratio of the abnormal signal as well as its configuration are the main parameters interpretating the normal healing process.

9. Karachalios T, Zibis A, Papanagiotou P, Karantanas AH, Malizos KN, Roidis N. MR imaging findings in early osteoarthritis of the knee. Eur J Radiol. 2004 Jun;50(3):225-30. (IF= 1,745)

PURPOSE: To carry out a modern diagnostic survey among patients with a clinical and radiological diagnosis of early osteoarthritis of the knee. MATERIALS AND METHODS: A magnetic resonance imaging survey was performed on 70 patients (82 knees) with a mean age of 59 years. (range, 40-71 years) who had chronic knee pain, clinical diagnosis of early osteoarthritis of the knee and conventional knee radiographs classified as 1 and 2 on the Kellgren-Lawrence scale. RESULTS: A variety of different disorders was found; degenerative meniscal lesions with or without ruptures of the anterior cruciate ligament in 70.7% of the knees, osteonecrosis of the femoral and tibial condyles in 9.75%, osteophytes and degenerative articular cartilage lesions in 8.54%, transient osteoporosis in 2.44% and benign neoplasms and cysts in 6.1%. CONCLUSIONS: The existence of such a heterogenous group of disorders in these "early osteoarthritic knees" may explain failures in treatment and it may justify a modern MRI imaging approach to proper diagnosis

10. Hantes ME, Basdekis GK, Zibis AH, Karantanas AH, Malizos KN. Localized pigmented villonodular synovitis in the anteromedial compartment of the knee associated with cartilage lesions of the medial femoral condyle: report of a case and review of the literature. Knee Surg Sports Traumatol Arthrosc. 2004 Jan 29;  (IF= 1,182)

Localized pigmented villonodular synovitis (PVNS) of the knee is an uncommon entity, presenting with different clinical signs and symptoms. We report on a case of a 42-year-old woman who presented with a 3-year history of knee pain and mechanical problems such as locking. On examination she was found to have a palpable and painful mass over the anteromedial joint line. Magnetic resonance imaging (MRI) revealed a soft tissue mass in the anteromedial compartment of the knee joint. The lesion was completely resected arthroscopically, and histologic examination confirmed the diagnosis of localized PVNS. The patient was free of symptoms, and MRI examination showed no evidence of recurrence at 1-year follow-up.

11. Th. Karachalios, K. Bargiotas, T. Moraitis, A. Zibis, V. Zachos, A. Papachristos, K.N. Malizos. Intramedullary nailing for the treatment of femoral non-unions following multiple failed plate fixations. Osteo Trauma Care, Vol 11, S 97-100, 2003.

Goal: The evaluation of the clinical outcome of IM nailing for the treatment of femoral shaft pseudarthrosis in patients who had multiple failed plate osteosyntheses.

Method: From January 2000 till March 2002, 18 (17 male- 1 female, mean age 37) patients were treated because of femoral shaft non-union in our institution. All patients had two or more failed plate osteosyntheses. There were no septic non-unions in this group. There was no segmental bone loss. In all 18 patients the implants were removed  and intramedullary nailing  was  performed. There was extensive periosteal stripping and areas of osteonecrosis in the majority of the patients. The quality of the surrounding soft tissues was poor due to scaring. Eight femurs were grafted with autologous iliac crest bone graft. All patients were followed by serial x-rays until union.

Results: There was no postoperative complications All pseudarthroses were healed within an average of 10.7 months (6-14). Non-unions which received bone graft ( 8 out of 18) in day one, were healed faster than those which didn’t. There was no re-operations among these patients. Among the remaining 10 patients 6 were grafted five to six months postoperatively and three had had nail dynamization.

Conclusions: Intemedullary nailing for femoral shaft non-unions after multiple failed plate osteosyntheses is a safe and effective method of treatment. It looks that autologous bone graft reduces  healing  time and  re-operation rate.

12. Karantanas AH, Zibis AH, Kitsoulis P. Fat-suppressed 3D-T1-weighted-echo planar imaging: comparison with fat-suppressed 3D-T1-weighted-gradient echo in imaging the cartilage of the knee. Comput Med Imaging Graph. 2002 May-Jun;26(3):159-65.  (IF= 1.09)

OBJECTIVE: To assess the frequency of increased signal intensity in the patellar tendon using three-dimensional T1-weighted MRI pulse sequences. DESIGN AND PATIENTS: Sixty patients were examined with a 1.0 T scanner (15 mT/m gradient strength) using a quadrature coil. Three pulse sequences were applied in the sagittal plane: PD turbo spin echo (PD-TSE), 3D T1-weighted gradient echo with fat suppression (3D-T1-FFE-FS) and 3D T1-weighted echo planar imaging with fat suppression (3D-T1-EPI-FS). The high signal intensity areas were measured in their maximum length. The angle of the patellar tendon relative to the main field position was measured in the same slice. In eight patients with anterior knee pain, and in 11 with no anterior knee pain, a fourth T2-weighted TSE pulse sequence (T2-TSE) was obtained to rule out patellar tendinitis. RESULTS: The correlation of the high signal intensity areas with the relative position of the tendon was found to be significant with the 3D sequences (P = 0.03 for 3D-T1-FFE-FS and P = 0.003 for 3D-T1-EPI-FS). The length of the high signal intensity area in the tendon was 5.4 mm with 3D-T1-FFE-FS, 4.9 mm with 3D-T1-EPI-FS and 3.1 mm with PD-TSE images. No patellar tendinitis was demonstrated on the T2-TSE images. CONCLUSION: The magic angle effect is commonly observed in the 3D based T1-weighted pulse sequences with fat suppression. The presence of the above sign must be recognized by radiologists, so that misdiagnosis of patellar tendinitis is avoided.

13. Karantanas AH, Zibis AH, Papanikolaou N. Increased signal intensity on fat-suppressed three-dimensional T1-weighted pulse sequences in patellar tendon: magic angle effect? Skeletal Radiol. 2001 Feb;30(2):67-71. (IF= 0,88)

This study was conducted to compare a three-dimensional (3D) multi-shot echo-planar imaging (EPI) sequence with fat-suppression (FS) with the 3D-fat-suppressed gradient echo (GRE-FS) sequence in imaging the cartilage of the knee. One hundred sixty-nine patients were studied prospectively. The cartilage was imaged in the sagittal plane with: (a) 3D-T1-EPI-FS and (b) 3D-T1-GRE-FS sequences using a 1T MR scanner. The signal-to-noise ratio (SNR) of bone (b) and cartilage (c), and relative contrast (ReCon) between bone and cartilage and meniscus and cartilage were measured in 60 patients with arthroscopically normal cartilage. The imaging accuracy was assessed by comparing with linear regression analysis (length and depth) 32 defects in the cartilage of cadaveric (human and bovine) knees. The 3D-T1-EPI-FS provided better bone marrow signal suppression, better SNRc and better ReCon(bc) and ReCon(cm) (p<0.01). The 3D-T1-EPI-FS showed better accuracy concerning the depth of the defects and the 3D-T1-GRE-FS better accuracy concerning the length of the defects. In conclusion, the 3D-T1-EPI-FS pulse sequence could be included in the routine protocol in imaging the cartilage of the knee because it achieves high SNR of the cartilage and high ReCon compared to the surrounding structures, at a reduced scan time.

14. Karantanas AH, Zibis AH. Quiz case of the month. Brodie's abscess type III. Eur Radiol. 2000;10(9):1507-8. (IF= 2,364)

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15. Karantanas AH, Hytiroglou P, Zibis AH, Markonis A, Papadimitriou CS. Malignant fibrous histiocytoma of the spine causing spinal neural foramen widening. Comput Med Imaging Graph. 2000 Sep-Oct;24(5):329-32. (IF= 1,09)

A case with a clinical picture of a chronic low back pain radiating to both lumbar regions caused by malignant fibrous histiocytoma is reported. Radiological, surgical and histopathological findings and treatment of this rare case are discussed.

16. Karantanas AH, Zibis AH, Papanikolaou N. Comparison of echo planar imaging, gradient echo and fast spin echo MR scans of knee menisci. Comput Med Imaging Graph. 2000 Sep-Oct;24(5):309-16. (IF= 1,09)

In order to reduce the acquisition time, we compared a three-dimensional multi-shot echo-planar imaging (EPI) sequence with fat-suppression with two widely used sequences, the fat-suppressed gradient echo (GRE) and the proton-density weighted turbo spin-echo (FSE) in imaging the menisci of the knee. Sixty patients with various indications were studied prospectively with MRI. The menisci were imaged in the sagittal plane with all three sequences using a 1T MR scanner with 15mT/m gradients. The signal-to-noise ratio (SNR) of bone (b), cartilage (c), and meniscus (m) as well as contrast-to-noise ratio (CNR) and relative contrast (ReCon) between menisci and cartilage and between bone and cartilage were measured. A qualitative analysis was performed on grading of meniscal pathology (0-IV). The imaging accuracy of meniscal pathology was assessed compared to arthroscopy in 13 patients. The EPI provided the highest SNR in cartilage and meniscus (p<0.001), the highest CNR and the highest ReCon between bone and cartilage (p< or =0.001). MR grading of meniscal abnormalities showed overestimation compared to GRE and FSE. The EPI sequence could not be included in the routine protocol in imaging the menisci since the overestimation of meniscal abnormalities could lead to unnecessary arthroscopy.

17. Kalef-Ezra J, Zibis A, Chaliassos N, Hatzikonstantinou I, Karantanas A. Body composition in homozygous beta-thalassemia. Ann N Y Acad Sci. 2000 May;904:621-4. (IF= 1,381)

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18. Karantanas AH, Zibis AH, Papanikolaou N. Single-shot turbo spin-echo MR myelography: comparison with 3D-turbo spin-echo MR myelography and T2-turbo spin-echo at 1 T. Comput Med Imaging Graph. 2000 Jan-Feb;24(1):37-42. (IF= 1,09)

In order to reduce the acquisition time, we compared the single-shot-TSE-MR myelography (MRm) and 3D-TSE-MRm. The T2-TSE sequence was the standard of reference. Fifty patients with low back pain, sciatica or cervical radiculopathy were examined at 1.0 T. The shortest AP diameter of the spinal canal, signal-to-noise ratio (SNR) for CSF and cord, contrast-to-noise ratio (CNR) and relative contrast (ReCon) between CSF and cord were calculated. No statistically significant difference was found between the three sequences with regard to the AP diameter of the spinal canal. A significant difference was found in: (i) SNRcord; (ii) SNRCSF; (iii) SS-TSE-MRm (showed the highest CNR) and (iv) SS-TSE-MRm (showed higher ReCon compared to 3D-TSE-MRm). In conclusion, SS-TSE-MRm can be used alternatively to 3D-TSE-MRm reducing the acquisition time down to only 8 s per image.

19. Zibis AH, Markonis A, Karantanas AH. Unusual causes of spinal foraminal widening. Eur Radiol. 2000;10(1):144-8. Review. (IF= 2,364)

Spinal neural foraminal widening is usually caused by benign lesions, most commonly neurofibromas. Rare lesions can also cause spinal neural foraminal widening. Computed tomography and/or MRI are the modalities of choice for studying the spinal foraminal widening. The present pictorial review describes six rare lesions, namely a lateral thoracic meningocele, a malignant fibrous histiocytoma, a tuberculous abscess, an osteoblastoma, a chondrosarcoma and a malignant tumour of the lung which caused spinal neural foraminal widening

20. Zibis AH, Karantanas AH. Vacuum phenomenon in posttraumatic nonunion of pubic bone fracture. AJR Am J Roentgenol. 1999 Jan;172(1):251. (IF= 2,384)

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21. Karantanas AH, Zibis AH, Papaliaga M, Georgiou E, Rousogiannis S. Dimensions of the lumbar spinal canal: variations and correlations with somatometric parameters using CT. Eur Radiol. 1998;8(9):1581-5. (IF= 2,364)

The aim of this study was to investigate the correlation of vertebral dimensions with somatometric parameters in patients without clinical symptoms and radiological signs of central lumbar spinal stenosis. One hundred patients presenting with low back pain or sciatica were studied with CT. In each of the L3, L4 and L5 vertebra three slices were taken with the following measurements: 1. Slice through the intervertebral disc: (a) spinal canal area; (b) interarticular diameter; (c) interligamentous diameter. 2. Slice below the vertebral arcus: (a) dural sac area; (b) vertebral body area. 3. Pediculolaminar level: (a) anteroposterior diameter and interpedicular diameter of the spinal canal; (b) spinal canal area; (c) width of the lateral recesses. The Jones-Thomson index was also estimated. The results of the present study showed that there is a statistically significant correlation of height, weight and age with various vertebral indices. The conventional, widely accepted, anteroposterior diameter of 11.5 mm of the lumbar spinal canal is independent of somatometric parameters, and it is the only constant measurement for the estimation of lumbar spinal stenosis with a single value. The present study suggests that there are variations of the dimensions of the lumbar spinal canal and correlations with height, weight and age of the patient.

22. Karantanas AH, Zibis A, Rousogiannis S, Velesiotou C, Lavdas E. In vitro orbital volume measurement using computed tomography. Radiologica Diagnostica 1994;  35:265-268.

A method for measuring orbital volume using CT with contiguous 3mm axial sections is described. The accuracy of the method is 3.2% as demonstrated by comparing the CT volume measurements with those derived directly from cadaveric human skulls. The interindividual observer variation was 5.4% for the skulls and 2.6% for the CT measurements. The intraindividual observer variation was 2.2% for the CT measurements. Within the same individual, the right and left orbital volumes were found to be within 0.57cmJ of each other. The present study demonstrates that CT is a practical method of determining the orbital volume and could be used in the management of blow-out fractures and traumatic enophthalmos by predicting the volume of the diseased orbit from the normal one.

ΑΝΑΜΕΝΟΝΤΑΙ ΠΡΟΣ ΔΗΜΟΣΙΕΥΣΗ

Zibis AH, Segal LS. Mesenchymal Chondrosarcoma of the lumpar spine  in a child a case report and literature review (Υποβολή στο American J Orthop).

Zibis AH, Dailiana ZH, Papaliaga MN, Vragalas V, Mouzas OD, Malizos K.N.. Munchausen’s syndrome: a differential diagnostic trap for the orthopaedic surgeon. (Υποβολή στο Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery).