Bilaterale Unternehmenskooperationen im Tourismussektor: Ausgewählte Erfolgsfaktoren (mir-Edition) (
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Depending on the time interval between irradiation and examination various alterations in mammographic and sonographic patterns were evident. Of 14 biospy-confirmed local recurrences, 11 were diagnosed by mammography and 12 by sonography. Combined use of mammography and sonography should therefore lead to better results in the diagnosis of local recurrences and to a reduction of unnecessary biopsies. Diagnostic imaging of Klippel-Feil syndrome: Berlin Germany ; Schubeus, P. Berlin Germany ; Steinkamp, H.
Berlin Germany ; Menzhausen, L. In two patients with Klippel-Feil syndrome, type II radiographic findings of the malformation are shown in the cervical spine and the craniocervical junction. Conventional X-rays of the cervical spine in the AP and lateral view and conventional tomography as well as CT of the cervical spine were obtained in both patients. One of the two patients additionally underwent MR imaging. Findings of the different imaging modalities are compared with each other. Die Ergebnisse und Befunde der verschiedenen Untersuchungsverfahren werden einander gegenuebergestellt.
Image fusion as part of the correlative analysis for medical images has gained ever more interest and the fact that combined systems for PET and CT are commercially available demonstrates the importance for medical diagnostics, therapy and research oriented applications. In this work the basics of image registration, its different strategies and the mathematical and physical background are described. A successful image registration is an essential prerequisite for the next steps, namely correlative medical image analysis. Means to verify image registration and the different modes for integrated display are presented and its usefulness is discussed.
Possible limitations in applying image fusion in order to avoid misinterpretation will be pointed out. Radiological evaluation with Doppler sonography and multidetector CT angiography in congenital hepatic arteriovenous malformation in a newborn. Although hepatic arteriovenous malformations are rarely reported, they frequently have life-threatening complications such as cardiac failure and are associated with a high mortality rate.
Consequently, accurate prenatal and early postnatal diagnosis is important and therapeutic procedures depend on the imaging features. We report the early postnatal sonographic, Doppler sonographic, multidetector CT and CT angiography findings of a congenital hepatic arteriovenous malformation in a newborn. A prospective study in 66 patients. The aim of this study was to compare the sensitivity and specificity of plain abdominal films plus ultrasound, vs nonenhanced CT for the diagnosis of ureteral colic in patients with acute flank pain.
During a 4-month period, 66 patients mean age 48 years with acute flank pain were prospectively studied by means of plain abdominal film, US, and unenhanced CT. The presence of lithiasis and of obstructive uropathy signs were determined. The plain film was only used as a guide for the US exam. Clinical follow-up of all patients was obtained. Ureteral lithiasis was confirmed in 56 patients. The 11 lithiasis not detected by US were passed spontaneously 10 were CT with a lower sensitivity and radiation dose that has a good practical value.
Imaging diagnostics of the wrist: For tears of the triangular fibrocartilage, arthrography, arthro- CT , and MRI demonstrated a sensitivity and specificity of more than 0. Ulno-lunate and ulno-triquetral ligament defects were demonstrated more exactly by arthrography. Insgesamt Untersuchungen des Handgelenkes wurden fuer einen dreijaehrigen Beobachtungszeitraum retrospektiv ausgewertet.
Lediglich der positive Vorhersagewert differierte, allerdings nicht. MR-urography and CT -urography: Klinik fuer Radiologische Diagnostik.
Whilst in three of the patients parenchymal lesions were exclusively detected by sonography , no peripheral abnormalities could be discovered with either technique in five patients. Relevant injuries missed were an early splenic laceration and an early pelvic hematoma, both of which became clinically apparent several hours later. Standardisierte kuenstliche Emboli definierter Groesse und Geometrie wurden in Schweinelungen eingebracht. The purpose of our study was to compare the value of ultrasound, conventional X-ray diagnosis and CT in detecting skull fractures and intracranial haemorrhage in children suffering from a head injury. Sonography detected calculi in only 2 kidneys, and 2 bladders. Fuer jede der Gefaessregionen werden detaillierte Angaben zum Untersuchungsablauf, zu moeglichen Fehlerquellen und zu deren Vermeidung geboten.
Die Kombination mit niedrigdosiertem Furosemid mg i. In those patients with established carcinoma, a CT examination was also performed. SE sequences with long echo times detected prostatitis, adenoma and carcinoma of the prostate with a high degree of sensitivity. However, at present, differentiation between adenoma, prostatis and carcinoma is not possible with sufficient accuracy.
Reliable diagnosis of a prostate carcinoma still requires a biopsy. Because of the high soft tissue contrast and the possibility of selecting any orientation for the plane under investigation, however, MRI represents an improvement in the preoperative diagnosis of local spread. Sonography findings in tears of the extensor pollicis longus tendon and correlation with CT , MRI and surgical findings.
We present our experience in the diagnosis of extensor pollicis longus tendon tears using different imaging methods. In the past 2 years, 12 patients 7 males, 5 females with extension deficit of distal phalanx of thumb were diagnosed with extensor pollicis longus tendon EPL rupture by means of different imaging methods. The ultrasound pattern consisted of a gap between tendon stumps occupied by a continuous eight cases or discontinuous four cases attenuated hypoechoic string.
In nine cases, the tendon ends were identified as a thickened stump-like structure. In the other three cases, tendon stumps were attenuated and mixed with atrophic muscle or wrist subcutaneous fat. Optimierung der Aufnahme- und Rekonstruktionsparameter. Goettingen Germany ; Merten, H. To determine the optimal scan parameters in multislice helical CT MSCT of the facial bone complex for both axial scanning and multiplanar reconstructions. An anthropomorphic skull phantom was examined with a MSCT.
Axial scans were performed with continuously increasing collimations 4 x 1. Multiplanar reconstructions in coronal and parasagittal planes with different reconstruction increment and slice thickness were evaluated in terms of image noise, contour artifacts and visualisation of anatomical structures. The best image quality was obtained with a collimation of 4 x 1. A reconstruction increment of 0. With these parameters the bone structures were depicted in an optimal way without artifacts. The tube current could be reduced to 50 mA without significant loss of image quality.
Low-dose MSCT using thin collimation, low table speed and small reconstruction increments provides excellent data for both axial images and multiplanar reconstructions in patients with facial trauma. An additional examination in coronal orientation is therefore no longer necessary.
Ein anthropomorphes Schaedel-Phantom wurde in axialer Schichtfuehrung mit einem MSCT untersucht, wobei die Kollimation 1,25 - 2,5 mm , der Tischvorschubfaktor Pitch 3 - 6 und der Roehrenstrom 20 - mA systematisch variiert wurden. Aus den Volumendatensaetzen wurden jeweils koronare und parasagittale Sekundaerreformationen mit unterschiedlichen. CT and MRI in progressive multifocal leukoencephalopathy. Germany ; Heindel, W. Germany ; Schroeder, R. Germany ; Lackner, K. Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients 1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia were analysed retrospectively and correlated with clinical symptoms.
CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 65 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: Indikationen beim differenzierten Schilddruesenkarzinom und bei Lebertumoren.
Die diagnostische Genauigkeit dieser szintigraphischen Methode ist jedoch aufgrund limitierter raeumlicher Aufloesung begrenzt. Auch hier limitiert die begrenzte morphologische Information der Szintigraphie das Therapiemonitoring. Chronic inflammatory arthritis is recognized specifically by bone erosions, caused by characteristic pannus tissue. In the finger joints dynamic low-Tesla MRI is nearly double but not completely sensitive in the detection of erosions than conventional radiography, sonography takes an intermediate position.
Less specific signs of synovitis and tenosynovitis are shown with high sensitivity by both 3 2 -phase bone scintigraphy and ultrasound, MRI is less sensitive in this respect. However, standard situation of inflammation in bone scintigraphy - positive finding in early as well as late phase - is of surprisingly low sensitivity, any singular finding in the early or late phase has to be regarded as positive. Specificity of these singular findings is nevertheless sufficiently high, acute inflammatory joint changes and even erosions are also seen with MRI in obviously healthy persons. Only 2-phase bone scintigraphy is easily able to present a simultaneous survey of all joints of the body.
For this reason 2-phase bone scintigraphy is most suitable for exclusion but also for primary diagnosis of disease, specification must be done afterwards by other imaging modalities or by laboratory findings. For the first time, computed tomography was performed for further investigation of midface hypoplasia. The early diagnosis of SWS could be made by correlation of the radiological and clinical findings. For evaluation of progression, follow-up radiological examinations of the skeleton were performed in four children surviving infancy.
Skeletal radiographs revealed bowing of the long tubular bones, most pronounced at the lower extremities. Additional findings were internal triangular cortical diaphyseal thickening at the concave side of the bowing, wide metaphyses with abnormal trabecular pattern and radiolucencies. Four patients survived infancy. Clinically, they suffered from recurrent aspiration pneumonia and recurrent episodes of hyperthermia as well as form cutaneous and mucosal infections. The follow-up radiographs showed progressive bowing of the long tubular bones as well as progressive metaphyseal decalcification.
However, a close cooperation between radiologists, clinicians, and geneticists is required for correlation of clinical and radiological findings. The few cases that survive infancy have progressing orthopaedic problems. Die typischen radiologischen und CT -Befunde beim kongenitalen Stueve. Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography , surgical and pathological findings.
To assess whether dual phase helical computed tomography DPCT of the liver improves the detection of colorectal liver metastases compared with portal venous phase PVP imaging alone. DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1. Alternative-free response receiver operating characteristic AFROC methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology.
The mean observer sensitivities for malignant lesion detection were There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone P Clinical neuroanatomy and diagnostic imaging and evaluation of the brain. MRI and CT atlas. Atlas der Magnetresonanztomographie und Computertomographie. New features of this 3rd German edition are: Ihre Anzahl wurde nahezu verdoppelt. In den nun grossen Abbildungen konnte die Zahl der bezeichneten Hirnstrukturen wesentlich erhoeht werden. Neues Wissen wurde in den Text und in die Abbildungen aufgenommen.
Health Sciences Centre; Proeschild, A. The fusion of cross-sectional images - especially in oncology - appears to be a very helpful tool to improve the diagnostic and therapeutic accuracy. Though many advantages exist, image fusion is applied routinely only in a few hospitals. To introduce image fusion as a common procedure, technical and logistical conditions have to be fulfilled which are related to long term archiving of digital data, data transfer and improvement of the available software in terms of usefulness and documentation.
The accuracy of coregistration and the quality of image fusion has to be validated by further controlled studies. Trotz bestehender Vorteile hat die Bildfusion bisher nur in einzelnen Zentren Einzug in die nuklearmedizinische und radiologische Routinediagnostik gefunden. Um die Bildfusion allgemein einsetzen zu koennen, sind bestimmte technische und logistische Voraussetzungen notwendig. Dies betrifft die Langzeitarchivierung von diagitalen Daten, die Moeglichkeiten zur Datenuebertragung und die Weiterentwicklung der verfuegbaren Software, auch was den Bedienkomfort und die Dokumentation anbelangt.
Zudem ist es notwendig, die Exaktheit der Koregistrierung und damit die Qualitaet der Bildfusion durch kontrollierte Studien zu validieren. Early clinical phase of patient's management after polytrauma using 1- and 4-slice helical CT ; Fruehes klinisches Management nach Polytrauma mit 1- und 4-Schicht-Spiral- CT. In the early clinical phase the comprehensive imaging of patients with multiple trauma using helical CT is already established.
Aim of this study was to assess whether MSCT may improve the patient management and the diagnostic results. The procedure is designed as follows: Then the patient is moved to CT. After CT selected radiograms of the extremities were taken. Excluding 1 case death during 1-sl.
The change from 1slice-helical CT to 4 slice-helical CT allowed us to reduce the stay in the CT room from 28 to 16 min. Advantages for the patient arose from the standardized examination protocol using multislice CT. If integrated in an interdisciplinary management concept, it is a good compromise between examination time, comprehensive diagnostic imaging, life-saving therapeutic procedures, and therapy planning. Klinisch ausgewaehlte Extremitaetenaufnahmen wurden ergaenzt. Mediastinal fibrosis with pulmonary artery obstruction; diagnosis and investigation with helical CT imaging including 3-dimensional reconstructions; Pulomonalarterienstenose bei aggresiver Mediastinalfibrose; Diagnostik und 3D-Darstellung mittels helikaler CT -Untersuchung.
An aggressive mediastinal fibrosis was found in a year-old female, suffering from dysphagia, stabbing pain in the chest, and an unclear weight loss. In this case, the rare combination of esophageal involvement, bronchial narrowing, and pulmonary artery obstruction could easily be demonstrated with a barium study and a helical CT examination including three-dimensional reconstructions. Mittels klinischer und radiologischer Abklaerung konnte eine aggressive Mediastinalfibrose diagnostiziert werden.
Die seltene Kombination einer Oesophaguseinengung mit Pulmonalarterienstenosen sowie einer Bronchuskompression konnte nichtinvasiv mittels Oesophagogramm und helikaler CT -Untersuchung zuverlaessig und schnell dargestellt werden. Several radiologic features such as hematoma volume are related to poor outcome following an intracerebral hemorrhage and can be measured with transcranial duplex sonography. We sought to determine the prognostic value of transcranial duplex sonography in patients with intracerebral hemorrhage. We conducted a prospective study of patients diagnosed with spontaneous intracerebral hemorrhage.
Transcranial duplex sonography examinations were performed within 2 hours of baseline CT , and we recorded the following variables: We correlated these data with the CT scans and assessed the prognostic value of the transcranial duplex sonography measurements. We assessed early neurologic deterioration during hospitalization and mortality at 1-month follow-up. We included 35 patients with a mean age of Median baseline hematoma volume was 9.
A second regression analysis with CT variables also demonstrated that hematoma volume was associated with early neurologic deterioration and mortality. When we compared the rating operation curves of both models, their predictive power was similar. Transcranial duplex sonography showed an excellent correlation with CT in assessing hematoma volume and midline shift in patients with intracerebral hemorrhage. Hematoma volume measured with transcranial duplex sonography was an independent predictor of poor outcome.
New possibilities in the diagnosis of ischemia. Coronary CT -angiography CCTA plays an increasing role in the primary diagnostics of coronary artery disease CAD according to the present guidelines but also in clinical reality. The sensitivity and negative predictive value of CCTA is very high, but the specificity could still be improved.
CT urography in women with primary or recurrent pelvic tumors. Background and initial experiences; CT -Urographie bei Frauen mit primaeren oder rezidivierenden Beckentumoren. Hintergrund und erste Erfahrungen. German guidelines advocate diagnostic imaging for local recurrence and metastasis while there are no recommendations for primary tumors. As excretory urography has been replaced by the excretory phase of computed tomography urography CTU in many institutions, two independent observers retrospectively evaluated CTUs of primary or recurrent female pelvic tumors to rule out associations between CTU findings and subsequent urologic measures.
It appears that CTU is a sensible pre-therapeutic test for the urinary tract for primary and recurrent female pelvic tumors. Deutsche Leitlinien befuerworten bildgebende Untersuchungen bei Lokalrezidiven und Metastasen; fuer Primaertumoren gibt es keine einschlaegigen Empfehlungen. Da das Ausscheidungsurogramm durch die Ausscheidungsaufnahme der CT -Urographie CTU weitgehend abgeloest ist, wurde bei weiblichen Beckentumoren oder deren Rezidive der Zusammenhang zwischen CTU-Befunden und nachfolgenden operativen urologischen Massnahmen retrospektiv von 2 unabhaengigen Auswertern geprueft.
Volume-artifact reduction modality by helical CT of the anterior, middle and posterior carnial fossae. Vergleich mit der konventionellen kranialen CT. The object of this study was to determine the extent to which a new volume-artifact reduction VAR modality using helical CT was able to reduce artifacts in the anterior, middle and posterior fossae in comparison with conventional CT sequential mode.
The results were evaluated by three radiologists; influences on image quality where scaled between 1 no artifact and 4 not assessable. Eight regions of the anterior, middle and posterior fossae were evaluated. On average, artifacts were scaled at 2. Significant differences were seen at the eyeball, anterior to the petrosol bone, at the internal occipital crest, and at the level of the transverse sinus p CT with the VAR modality is superior to conventional, sequential CT in the area of the anterior, middle and posterior fossae.
Die Auswertung erfolgte durch drei Radiologen, die Bildqualitaet wurde in einer Skala zwischen 1 kein Artefakt und 4 Beurteilung der Region wegen Artefakten nicht moeglich angegeben. Acht anatomische Regionen in der vorderen, mittleren und hinteren Schaedelgrube wurden auf Beeintraechtigung durch Artefakte untersucht.
Three-Dimensional post-myelographic CT reconstruction in the diagnosis and therapy planning for spinal development disorders; Dreidimensionale postmyelographische CT -Rekonstruktion in der Diagnostik und Therapieplanung spinaler Entwicklungsstoerungen. Dysrhaphia is often associated with severe osseous aberrations of the spine such as, for example scoliosis, hemivertebra, and synostosis.
With the advanced possibilities of the post-processing of CT -data segmentation, three-dimensional reconstruction , post-myelo- CT is an excellent method for the evaluation of osseous structures and the myelon in preoperative planning. Mit den verbesserten Moeglichkeiten der Datennachbearbeitung Segmentierung, 3D-dimensionale Rekonstruktion stellt die postmyelographische Computertomographie vor allem bei komplexen Fehlbildungen ein geeignetes Verfahren zur praeoperativen Beurteilung der ossaeren Strukturen der Wirbelsaeule und des Myelons dar.
Clinical applications of imaging reconstruction by virtual sonography. One of the pitfalls in managing multiple liver tumors is the difficulty in identifying individual tumors on ultrasonography. Computed tomography CT -assisted virtual sonography has been shown to improve sonographic diagnosis, however it requires additional equipment and software. We have developed a simple reconstruction method of virtual sonography SRVS.
We reconstructed SRVS mimicking ultrasonographic images, utilizing a workstation software attached to a multi-detector row CT system without any additional program. We have performed SRVS in 32 patients with 41 liver tumors that could hardly be identify on ultrasonography. SRVS assisted the identification of malignant form non-pathologic ones and thereby contributed to the appropriate clinical strategy including radiofrequency ablation RFA 18 tumors , liver biopsy 2 tumors , other therapies 4 tumors and follow-up 17 tumors.
We have developed virtual sonography using conventional CT software. SRVS seems useful in the clinical practice in managing liver tumors. CT -guided percutaneous neurolysis methods. State of the art and first results; CT -gesteuerte Neurolysen. Stand der Technik und aktuelle Ergebnisse. Radiodiagnostik, Radiologische Universitaetsklinik Heidelberg Germany.
We used 21G or 22G fine needles. All CT -guided percutaneous neurolysis methods require a proper blood coagulation. Most common CT scanners are suitable for neurolysis if there is enough room for maintaining sterile conditions. This allows us to correct the position of the needle if we see improper distribution of the test block or unwanted side effects. Though inflammatory complications of the peritoneum due to puncture are rarely seen, we prefer the dorsal approach whenever possible.
Seven of 20 legs showed at least transient clinical improvement after CT -guided lumbar sympathectomies; 13 legs had to be amputated. Results of the methods in the literature differ. It was recently proved that sympathectomy not only improves perfusion of the skin but also of the muscle. The hypothesis of a steal effect after sympathectomy towards skin perfusion was disproved.
Modern aggressive surgical and interventional treatment often leaves patients to sympathectomy whose reservers of collateralization are nearly exhausted. We presume this is the reason for the different results we found in our patient group. For thoracic sympathectomy the clinical treatment depends very much on the indications. Results in celiac ganglia block also differ. Abdominal polytrauma and parenchymal organs; Abdominelles Polytrauma und Parenchymorgane.
Die Verletzungsmuster sind komplex und erfordern eine grosse Erfahrung, um sie in Minutenschnelle analysieren zu koennen. Im nachfolgenden Uebersichtsartikel werden die radiologische Diagnostik und die klinisch-radiologische Graduierung der Verletzungen von Milz, Leber, Pankreas und Nieren beschrieben.
Es wird der Stellenwert der Ultraschalldiagnostik bei der Abklaerung von Polytraumapatienten beschrieben. Fuer die oben genannten Organe werden die wichtigsten traumaassoziierten Veraenderungen in der Computertomographie beschrieben und in Form praegnanter Fallbeispiele veranschaulicht. Die Computertomographie hat sich als bildgebendes Standardverfahren zur Abklaerung von Polytraumapatienten etabliert.
Die Anwendung der MDCT ist traumaabhaengig, und die Klassifizierung des Verletzungsgrads der parenchymatoesen Organe ist letztendlich fuer die weitere Therapie und Prognose entscheidend. Diagnostic imaging in polytrauma: Conventional radiography consisted of chest and cervical, thoracic and lumbar spine in two views as well as pelvis. Three combinations of organ specific CT were chosen: CT examination of 1 head and cervical spine, 2 head, cervical spine and chest, 3 head, cervical spine and abdomen.
The ratio of radiation dose between whole-body MSCT and radiography was This ratio was reduced to 3: Whole-body MSCT in polytrauma compared to conventional radiography with organ-specific CT induces a threefold increased dose in unfavorable situations and no increased dose in favorable situations.
Nevertheless, routine use of whole-body MSCT should be critically evaluated and should be adapted to the clinical benefit. Fuer die organspezifischen CT -Untersuchungen wurden 3 Kombinationen ausgewaehlt: Accuracy of spiral CT and 3D reconstruction in the detection of acute pulmonary embolism - development of an animal model using porcine lungs and technical specimens.
Development of an animal model using porcine lungs and technical specimens; Diagnostik der akuten Lungenembolie mittels Spiral- CT und 3D-Rekonstruktion. Entwicklung eines Tiermodells und technischer Probekoerper im Ex-vivo-Experiment. Mainz Germany ; Konerding, M. Standardisierte kuenstliche Emboli definierter Groesse und Geometrie wurden in Schweinelungen eingebracht. Ausguesse der embolisierten Gefaessbaeume mit roentgenkontrastgebendem Kunstharz simulierten das CT -morphologische Vollbild einer Lungenembolie. Die Bilddaten wurden dreidimensional rekonstruiert und die Exaktheit der detektierten Emboluslokalisation durch Korrelation mit dem Originalpraeparat verifiziert.
Die Messungen der technischen Probekoerper ergaben deutliche Abweichungen in Abhaengigkeit von der Groesse, der Orientierung zur z-Achse und der Rekonstruktionstechnik. Hierbei traten Ueberschaetzungen von bis zu 4 mm, Unterschaetzungen von bis zu 2,2 mm auf. Bei Praeparaten mit Hoehen von mm traten Schwankungen in einer Groessenordnung von ca.
Die vorgestellten Ex-vivo-Modelle sind zur Simulation der akuten Lungenembolie gut geeignet. Die Genauigkeit der Embolusdetektion wird durch Lokalisation, Groesse, Orientierung und Rekonstruktionstechnik beeinflusst. Utility of CT after sonography for suspected appendicitis in children: To improve diagnosis of pediatric appendicitis, many institutions have implemented a staged imaging protocol utilizing ultrasonography US first and then computed tomography CT.
A substantial number of children with suspected appendicitis undergo CT after US, and the efficient and accurate diagnosis of pediatric appendicitis continues to be challenging. The objective of the study is to characterize the utility of CT following US for diagnosis of pediatric appendicitis, in conjunction with a clinical appendicitis score AS. Imaging studies of children with suspected appendicitis who underwent CT after US in an imaging protocol were retrospectively reviewed by three radiologists in consensus.
Chart review derived the AS range and obtained the patient diagnosis and disposition, and an AS was applied to each patient. Clinical and radiologic data were analyzed to assess the yield of CT after US. Studies of children mean age The positive threshold for AS was determined to be 6 out of Multi-modality imaging with SPECT- CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans.
The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT- CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants.
In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. All images were evaluated by 3 radiologists for image quality using a semiquantitative score score value 1: In addition, dose measurements and measurements of high contrast resolution were performed in comparison to conventional and low-dose spiral CT using a high contrast phantom Catphan, Phantom Laboratories. Adequate image quality mean score values could be achieved with an applied dose comparable to low-dose CT in smaller joints such as wrist, elbow, ankle and knee.
A remarkably inferior image quality resulted in imaging of the hip, lumbar and thoracic spine mean score values in spite of almost doubling the dose dose increased by 85 percent. The image quality of shoulder examinations was insufficient mean score value 1. ISO-C-3D images of the hip and axial skeleton show a decreased image quality, which does not seem to be sufficient for diagnosing subtle fractures. Siemens an Extremitaetengelenken und am Stammskelett.
Imaging in syndrome complex diabetes mellitus. Current standards and future perspectives; Bildgebung im Syndromkomplex Diabetes mellitus. Diabetes mellitus is a highly prevalent multisystemic disorder with numerous potential complications and substantial socioeconomic consequences. In many cases, the patient history, physical examination and laboratory tests are not sufficient for a comprehensive evaluation of complicating disorders. Imaging modalities, such as sonography , computed tomography CT and magnetic resonance imaging MRI are of major significance in the evaluation of complicating disorders of diabetes according to current guidelines.
Examples include assessment of coronary artery disease, peripheral artery disease, stroke and diabetic foot syndrome. Technical developments allow a substantial reduction in radiation dose and scan time in CT and MRI, respectively and could therefore justify a broader application in this patient population. Furthermore, they could also be used for risk stratification, e. Prior to widespread application of advanced imaging techniques in this patient population, improved outcomes with respect to survival, quality of life and cost-effectiveness need to be demonstrated.
Diagnostic imaging modalities for the evaluation of the syndrome complex of diabetic disorders should be used according to the current guidelines but the use is predicted to increase given the high potential in this population. Die Folgeerkrankungen koennen oft nicht abschliessend mittels Anamnese, koerperlicher Untersuchung und laborchemischen Verfahren evaluiert werden. Sonography for diagnosis of benign and malignant tumors of the nose and paranasal sinuses. The purpose of this study was to demonstrate the reliability of sonography for diagnosis of nose and paranasal sinus tumors.
Ninety-six consecutive patients with tumors underwent sonography and computed tomography CT before surgical treatment.
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Tumor detectability and imaging findings were evaluated independently and then compared with pathologic findings. Of 96 tumors, 75 were detected by sonography , for a detectability rate of By comparison, sonography showed a trend toward higher detectability of nasal vestibular tumors than CT Among the sonographic features, boundary, shape, internal echo, calcification, bone invasion, vascular pattern, and cervical lymph node metastasis all had significantly positive correlations with malignancy P benign and malignant tumors of the nose and paranasal sinuses.
Consequently, sonography has high value for diagnosis of benign and malignant tumors of the nose and paranasal sinuses, especially for nasal vestibular tumors and small lumps on the wing of the nose. This focused review describes the current use and future perspectives regarding transabdominal bowel sonography TABS. The technique for B-mode and Doppler is described and the use of ultrasound contrast and elastography is discussed. Pathology and subsequent imaging findings are focused on appe In conclusion we find that TABS is a fast, efficient, low-cost and non-ionization imaging technique without any patient discomfort Ultrasound-guided image fusion with computed tomography and magnetic resonance imaging.
Klinische Bedeutung fuer die bildgebende und interventionelle Diagnostik von Leberlaesionen. Abdominal ultrasound is often the first-line imaging modality for assessing focal liver lesions. Due to various new ultrasound techniques, such as image fusion, global positioning system GPS tracking and needle tracking guided biopsy, abdominal ultrasound now has great potential regarding detection, characterization and treatment of focal liver lesions.
Furthermore, these new techniques will help to improve the clinical management of patients before and during interventional procedures. This article presents the principle and clinical impact of recently developed techniques in the field of ultrasound, e. In diesem Artikel werden das Prinzip und die Anwendungsmoeglichkeiten dieser neuen Techniken anhand konkreter Beispiele in einem Kollektiv von 20 Patienten mit fokalen Leberlaesionen vorgestellt und erlaeutert.
Follow-up and prognosis of thyroid carcinoma; Nachsorge und Prognose der Schilddruesenkarzinome. The follow-up of patients with differentiated thyroid carcinoma is based on guidelines of the appropriate scientific societies like the German Society of Nuclear Medicine DGN. After successfull radioiodine treatment there are follow-up investigations in intervalls every [half] year, life-long including ultrasound, serum level of thyroglobulin, TSH, f T3, and f T4.
Individual prognosis can be assessed by different scoring systems including factors like age, sex, size, grading, and extent of the disease. The medullary carcinoma has a mediocre prognosis and similar follow-up intervals focusing on the tumor markers calcitonin and CEA and, if necessary, a variety of imaging methods. The anaplastic carcinoma with its bad prognosis needs individual palliative symptomatic follow-up. Die Prognose kann mittels diverser Scores bestimmt werden, die u.
Alter, Geschlecht, Grading, und Ausdehnung der Erkrankung beruecksichtigen. Das medullaere Karzinom hat bei mittlerer Prognose aehnliche Nachsorgeintervalle, orientiert sich an den Tumormarkern Kalzitonin und CEA und gegebenenfalls komplexer. Role of focused assessment with sonography for trauma as a The objective of the study was to review the utility of focused assessement with sonography for trauma FAST as a screening tool for blunt abdominal trauma BAT in children involved in high energy trauma HET , and to determine whether a FAST could replace computed tomography CT in clinical Konsensfaehige Vereinbarungen ueber eine standardisierte Untersuchungstechnik und einheitliche Befundung existierten bislang aber nicht.
Von der Arbeitsgemeinschaft ''Diagnostische Radiologie bei arbeits- und umweltbedingten Erkrankungen'' der Deutschen Roentgengesellschaft DRG wurde ein CT -Beurteilungsbogen eingesetzt, der auf Erfahrungen aus gutachtlichen Stellungnahmen, arbeitsmedizinischen nachgehenden Untersuchungen und Fortbildungskursen basiert und im Rahmen einer Multicenterstudie eingesetzt wurde.
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Ein weiter entwickeltes Schema einer internationalen Arbeitsgruppe P. Parker, USA wurde international getestet. Es soll dazu dienen, die computertomographische Befundung der arbeits- und umweltbedingten Lungen- und Pleuraveraenderungen zu standardisieren und international Vergleiche zu ermoeglichen. Das Klassifizierungsschema hat einen rein deskriptiven Charakter, sodass alle Aspekte arbeits- und umweltbedingter Folgeerscheinungen an Parenchym und Pleura erfasst werden koennen.
Obwohl einige der deskriptiven Bezeichnungen mit pneumokoniotischen Befunden verknuepft sind, wie z. Chest sonography is an established procedure in the stepwise imaging diagnosis of pulmonary and pleural disease. It is the method of choice to distinguish between solid and liquid lesions and allows the investigator to make an unequivocal diagnosis without exposing the patient to costly and stressful procedures. This book presents the state of the art in chest investigation by means of ultrasonography.
A number of excellent illustrations and the compact text provide concise and easy-to-assimilate information about the diagnostic procedure. Basic elements such as indications, investigation techniques and image artifacts are detailed in separate chapters. Spiral and multislice CT.
Spiral- und Multislice- CT. Spiral and multidetector techniques have improved the diagnostic possibilities of CT , so that image analysis and interpretation have become increasingly complex. This book represents the current state of the art in CT imaging, including the most recent technical scanner developments. The second edition comprises the current state of knowledge in cT imaging.
There are new chapters on image processing, application of contrasting agents and radiation dose. All organ-specific pathological findings are discussed in full. There is an introduction to cardio- CT , from calcium scoring and CTA of the coronary arteries to judgement of cardiac morphology. There are detailed scan protocols with descriptions of how to go about parameter selection. Practical hints are given for better image quality and lower radiation exposure of patients, guidelines for patient preparation and complication management, and more than images in optimum RRR quality.
Percutaneous CT -guided treatment of osteoidosteomas: The purpose of this study was the clinical evaluation of a percutaneous treatment modality in patients with an osteoidosteoma. The procedure was started under local anaesthesia, but drilling of the nidus was carried out under a short general anaesthesia using ketamine. The intervention was successful in all patients.
No postinterventional infection occurred and no recurrence was observed in any of the patients in a follow-up time between 0. Der Eingriff wurde in Lokalanaesthesie begonnen, die Ausbohrung des Nidus unter einer Ketanestkurznarkose durchgefuehrt. Das Vorgehen war bei allen Patienten erfolgreich. In keinem Fall wurde eine postinterventionelle Infektion beobachtet.
Ueber den Nachbeobachtungszeitraum von 0,5 bis zu 2,5 Jahren trat bei keinem der Patienten ein Rezidiv auf. Diagnostic imaging of complex multiple trauma remains a challenge for any department providing modern emergency radiology ER service. An early and comprehensive approach for ER imaging is crucial for a priority-oriented and timely therapy concept with the aim of identifying potentially life-threatening injuries early and initiating appropriate treatment. The basic diagnostic approach still consists of focused ultrasound using focused assessment with sonography for trauma FAST and conventional radiography CR , usually limited to a single supine chest x-ray for triaging patients undergoing immediate operations.
At the same time, the spatial and temporal resolution of MDCT was improved resulting in considerably shortened examination times but WBCT is still associated with a significant radiation exposure, even in the acute single use setting. The substantial number of images in WBCT is another challenge; images must be processed priority-oriented, read and transferred to the picture archiving and communications system PACS. For rapid diagnosis, volume image reading VIR offers additional options to keep the diagnostic process on time. Eine umfassend angelegte, fruehe und praezise radiologische Diagnostik ist entscheidend fuer eine prioritaetenorientierte und.
C-arm computed tomography for transarterial chemoperfusion and chemo-embolization of thoracic lesions; Transarterielle Chemoperfusion und -embolisation thorakaler Neoplasmen mittels C-Arm CT. From September to March a total of 31 patients 20 males and 11 females, average age: C-arm CT of the latest generation was used to localize the lesion before local chemotherapy Artis Zeego, Siemens, Erlangen.
For TACP a rotation and a volume of ml ratio of 1: For TPCE a volume of 75 ml ratio of 1: C-arm CT provides additional information on the vascular characteristics and perfusion of pulmonary lesions resulting in a change of interventional strategy in a relevant number of patients. Alle Behandlungen erfolgten an einem C. Sonography of acne vulgaris. The purpose of this study was to assess the sonographic morphology of the clinical and subclinical pathology of facial acne vulgaris. We studied patients with facial acne vulgaris diagnosed by certified dermatologists, and using a standardized protocol for sonographic examinations, we sequentially described the sonographic pathomorphologic characteristics.
Lesions of particular interest to the referring clinician were also analyzed separately. Additionally, acne involvement was staged clinically and sonographically SOS-Acne using morphologic definitions of the relevant lesions and predefined scoring systems for gradation of the severity of acne lesions. A total of acne lesions in 20 consecutive patients were studied.
Sonographic abnormalities consisted of pseudocysts, folliculitis, fistulas, and calcinosis. Facial acne vulgaris often involves deeper tissues, beyond the reach of the spatially restricted clinical examination; these subclinical conditions can be detected and defined with sonography. Additionally, acne vulgaris is amenable to sonographic scoring. Evaluation of injuries of the upper cervical spine in a postmortem study with digital radiography, CT and MRI; Evaluation experimentell erzeugter Verletzungen der oberen Halswirbelsaeule mit digitaler Roentgentechnik, Computertomographie und Magnetresonanztomographie.
To compare digital X-ray, CT , and MRI in the evaluation of ligamentous and osseous lesions in upper cervical spine specimens after artificial craniocervical injury with the findings of macroscopic preparation. A rotation trauma of defined severity was applied to 19 human corpses. The findings were correlated with the macroscopic results of preparation.
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MR Magnetom Vision, Siemens imaging was obtained with a 1. Preparation revealed 6 fractures of the vertebral bodies, 5 fractures of the dens axis, 1 fracture of the arcus anterior of the atlas, 4 osseous flakes at the occipital condylus, and 6 lesions of the alar ligaments. Digital radiography showed all fractures and 4 osseous flakes at the occipital condylus. With conventional and helical CT , all fractures and all ruptured alar ligaments could be detected. In post-mortem studies, CT was superior to MRI in the visualization of osseous and ligamentous injuries after trauma of the upper cervical spine.
However, these results are not transferable to patients with rotation injury in general. Vergleich verschiedener Techniken digitale Roentgentechnik, Computertomographie, Magnetresonanztomographie in der Detektion von ligamentaeren und ossaeren Laesionen der oberen Halswirbelsaeule nach definiertem Trauma sowie Korrelation mit den experimentellen Praeparateergebnissen. Visualization of coronary arteries in CT as assessed by a new 16 slice technology and reduced gantry rotation time: First evaluation of image quality of a new slice multidetector-row computed tomography MDCT for the assessment of coronary artery disease and lesion detection of the coronary arteries.
CTA was performed after injecting ml contrast media intravenously. The scan time for calcium score was 12s, for CTA 18s scan range 15 and 12 cm, respectively. Volume score was between 0 and In the CT angiography the entire coronary tree could be visualized in all patients up to the very distal subsegmental branches.
In one of these patients, a large aneurysm of the left anterior ventricular wall was also delineated. Considering our first experiences with the new slice technology, an excellent visualization of the entire coronary tree including the very distal and side branches due to substantially increased spatial resolution seems to be achievable. In these patients the acquired image quality raises the hope for improved, non-invasive cardiac diagnostics. In larger studies, the clinical impact of this new technology needs to be further investigated.
Principles and practice of sonography. This book is a text of sonographic technique, emphasizing clinical and diagnostic procedures. Ultrasound images and explanatory line drawings are placed side-by-side to facilitate interpretation. This book covers instrumentation and scanning principles, obstetric, gynecologic, abdominal, renal and urologic, pediatric, plus superficial structure sonography.
Color coded duplex sonography. Interdisciplinary vascular ultrasonography; Farbkodierte Duplexsonographie. An interdisciplinary team of experts impart the state of the art in color coded duplex sonography applied for examination of all anatomic areas. Detailed information is given for every vascular area, describing the examination procedure, possible origins of mistakes or faults, and means to avoid them. In addition to the classical applications, eg. Fuer jede der Gefaessregionen werden detaillierte Angaben zum Untersuchungsablauf, zu moeglichen Fehlerquellen und zu deren Vermeidung geboten.
Neben den klassischen Anwendungen bei der Untersuchung - der extra- und intrakraniellen Gefaesse, - der Extremitaetengefaesse, - der viszeralen Gefaesse sowie der Gefaesse von Niere und Leber finden Sie Kapitel zu den Themen: Haemodialyseshunt, arteriovenoese Malformationen, Duplexsonographie des Penis und Tumorvaskularisation. Perforated pyloroduodenal peptic ulcer and sonography. The purpose of this article is to illustrate the spectrum of sonographic findings in perforated pyloroduodenal peptic ulcer and discuss the potential role of sonography in the diagnosis.
Although sonography is not the first-line investigation of choice in suspected perforated peptic ulcer, understanding of the characteristic appearances seen during general abdominal sonography may aid the reader in the diagnosis of this important and sometimes overlooked cause of nonspecific abdominal pain. This may shorten time to the diagnosis and ultimate surgical management. Recent studies indicate that transcranial sonography TCS reliably displays the extension of malignant brain tumors.
Noncoplonar conformal treatment plans for both PTVs were compared. A sufficient temporal bone window for TCS was present in 11 of 13 patients. Addition of TCS tumor volume to the contrast-enhancing CT volume in postoperative radiotherapy planning for GBM increases the treated volume by a median factor of 1. Since a high frequency of marginal recurrences is reported from dose-escalation trials of this disease, TCS may complement established methods in PTV definition.
Prenatal diagnosis of the Dandy-Walker syndrome by sonography and computed tomography. A case of Dandy-Walker-syndrome is presented, comparing the value of sonography and CT in intrauterine diagnosis.
Together with a review of the literature of the subject, pathogenesis, morphology and prognosis in regard to the psychomotoric development are discussed. Recurrent pains of the temporomandibular joint represent a frequent symptom with numerous different causes. CT and MRI can reliably show the cause of these disorders and therefore have substituted conventional X-ray imaging. Modern multi-slice- CT MSCT allows for examination of the skull base including the mandible in a very short time with thinnest slice collimation 0.
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With 2D- and 3D- reformations reconstructed out of this volume data set in parasagittal, coronal or any other arbitrary slice orientation excellent imaging of fractures and bony changes of arthrosis as well as benign and malignant tumors of the temporomandibular joint can be performed.
MRI offers very good soft tissue contrast in order to visualize the intra-articular disc, the ligaments and muscles, as well the possibility to acquire cross sectional images in any user-defined orientation. MRI is the method of choice to diagnose 'internal derangement', particularly displacement of the intra-articular disc and inflammatory disease of the temporomandibular joint. The present paper will provide diagnostic strategies for the use of MSCT or MRI imaging concerning the different causes of disorders to the temporomandibular joint. Imaging follow-up after treatment was performed with contrast-enhanced CT at 6 weeks, 3 months and every 6 months after the procedure.
The endpoints of the study were local tumor control and time to progression. The Kaplan-Meier method was used to estimate survival functions and local tumor progression rates. The mean diameter of the tumors was The first contrast-enhanced CT showed that complete ablation was achieved in all lesions.
The mean minimal tumor enclosing dose was Three patients developed a pneumothorax after the procedure. The mean follow-up time was CT -HDRBT ablation is a safe and attractive treatment option for patients with lung malignancies and allows targeted destruction of tumor tissue with simultaneous preservation of important lung structures. Duplex sonography in portal hypertension.
We measure the diameter and blood velocity of the portal vein in 50 patients with cirrhosis of the liver and 40 healthy subjects, and calculated cross sectional area, mean blood flow velocity, blood flow volume and congestion index. In patients with cirrhosis of the liver, the cross sectional area of the portal vein was significantly increased: Duples sonography may play an important role in the diagnosis of portal hypertension.
CT -guided percutaneous gastrostomy: Technischer Erfolg, Frueh- und Spaetkomplikationen. Neumaier und Kollegen Germany. Percutaneous endoscopic gastrostomy PEG and percutaneous radiologic gastrostomy PRG are the standard methods of ensuring long-term enteral food intake in patients with dysphagia caused by neoplasia or neurological disorders. High-grade obstructions of the upper digestive tract or inadequate transillumination can prevent PEG.
CT -guided percutaneous gastrostomy PG represents a special technique for enabling gastrostomy in patients for whom the endoscopic method is impossible. The aim of this study was to evaluate the results and complications of CT -guided percutaneous gastrostomy. CT -guided PG was performed in 83 patients, mostly with malignancy of the upper respiratory or digestive tract. Medical records for these patients were reviewed, and the results and complications of the CT -guided PG were analyzed retrospectively.
Complications were grouped into four categories: Major and minor complications as well as early and late complications. One of these patients experienced two early major complications. Early minor complications, mainly local skin irritations and temporary stomachache, were observed in 31 patients Three days after CT -guided PG, 4 cases of major complications were documented, yielding a total rate of major complications was 8. Hemorrhage requiring blood transfusion or perforation after gastrostomy was not observed.
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Results of the Austrian CT dose study Universitaetsklinik fuer Radiologie und Nuklearmedizin. To determine typical doses from common CT examinations of standard sized adult patients and their variability between CT operators for common CT indications. In a nationwide Austrian CT dose survey doses from approx. Median effective doses to the average patients for standard head and neck scans were 1. Read more Read less. Save Extra with 1 offer. To get the free app, enter mobile phone number. See all free Kindle reading apps. I'd like to read this book on Kindle Don't have a Kindle?
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