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  • Articles: DFG German National Licenses  (22)
  • Electronic Resource  (22)
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  • Articles: DFG German National Licenses  (22)
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  • Electronic Resource  (22)
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  • 1
    ISSN: 1432-2161
    Keywords: Key words Echinococcosis ; Bone ; Soft tissue ; Liver
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. The present study demonstrates the osseous and soft tissue manifestations of alveolar echinococcosis (AE). Patients. We report on eight patients with AE with bone or soft tissue involvement confirmed at biopsy or needle cytology. Results. All eight patients showed hepatic involvement. Four exhibited infiltration of the spine as a result of direct spread of the hepatic primary lesion; distant metastases were observed in only three of these patients. Calcifications, which are typical for hepatic manifestations of the disease, were observed in soft tissue in only two of eight cases (25%); we observed no instances of endovesicular daughter cysts. Conclusion. AE manifests itself in the vertebral column as a form of spondylitis and in soft tissue presents similar to an abscess. Since in most of these cases spread of the disease per continuitatem from the liver is present, the diagnosis is easily made from the characteristic hepatic findings.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 36 (1996), S. 843-844 
    ISSN: 1432-2102
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Spiral-CT ; Virtuelle Endoskopie ; Larynx ; Key words Helical CT ; Virtual endoscopy ; Larynx
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary This pilot study investigated the feasibility and clinical value of high-resolution virtual real-time laryngoscopy based on helical CT data sets. Nine patients with laryngeal pathology (three with tumors of the vocal cords, two laryngeal carcinomas, one with invasion of the larynx by thyroid carcinoma and six subglottic stenoses) underwent examination by helical CT at a collimation of 1 mm. Following acquisition, the images were processed at a workstation with standard visualization software, such that virtual endoscopy (VE) in real time was possible. The images were then compared with the findings of conventional endoscopy. Because of swallowing artifacts, reconstruction failed in 2 of 12 patients. None of the carcinomas of the vocal cords was recognized at VE or in the cross-sectional CT images. VE provided the correct diagnosis in 8 of 12 cases (laryngeal tumors, subglottic stenoses). Virtual laryngoscopy is capable of simulating the visual findings of endoscopy in cases of laryngeal tumors and subglottic stenoses. Small tumors of the vocal cords are not adequately visualized. The major problem affecting results is motion artifacts resulting from involuntary swallowing.
    Notes: Zusammenfassung Im vorliegenden Beitrag wird eine Pilotstudie zur Überprüfung der Machbarkeit und des klinischen Nutzens einer hochauflösenden virtuellen Echtzeitlaryngoskopie aus Spiral-CT-Datensätzen vorgestellt. 12 Patienten mit Erkrankungen im Kehlkopfbereich (3 Stimmlippentumore, 2 Larynxkarzinome, ein in den Larynx eingebrochenes Schilddrüsenkarzinom und 6 subglottische Stenosen) wurden mittels hochauflösender Spiral-CT (Kollimation 1 mm) untersucht. Anschließend wurden die Bilder auf einer Workstation mit einer standardmäßigen Visualisierungssoftware so rekonstruiert, daß eine virtuelle Endoskopie (VE) in Echtzeit möglich wurde, welche der herkömmlichen Fiberendoskopie gegenübergestellt wurde. 2 der 12 Patienten waren bedingt durch Schluckartefakte nicht zu rekonstruieren. Keines der Stimmlippenkarzinome war in der VE oder den Querschnittsbildern zu erkennen. In 8 von 12 Fällen war die VE diagnostisch (Larynxtumore, subglottische Stenosen). Die virtuelle Laryngoskopie in der hier beschriebenen Technik vermag Larynxtumoren und subglottische Stenosen, nicht aber kleine Stimmbandtumoren in einer dem Kliniker vertrauten endoskopischen Sichtweise darzustellen. Hauptproblem sind Bewegungsartefakte durch unwillkürliche Schluckbewegungen.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2102
    Keywords: Schlüsselwörter A. ischiadica ; Aneurysma ; Thrombolyse ; Angiographie ; Keywords Sciatic artery ; Aneurysm ; Thrombolysis ; Angiography ; Stentgraft
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The sciatic artery is a rarely seen variant of the vessels of the lower limb. Anatomically it is the prolongation of the inferior gluteal artery and accompanies the sciatic nerve from the sciatic foramen to the knee. More than other vessels, the sciatic artery shows vasculopathies like diffuse dilatation or aneurysms. This report describes an interesting case of embolic acute ischemia, caused by a persistent sciatic artery with an aneurysm. We treated the ischemia with intraA. l lysis and bridged the aneurysm with an covered stent.
    Notes: Zusammenfassung Die A. ischiadica ist eine selten zu findende anatomische Variante des Gefäßsystems der unteren Extremität. Anatomisch entspricht die A. ischiadica einer Verlängerung der A. glutea inferior und begleitet den N. ischiadicus ab dem Foramen ischiadicum bis zum Knie, wo sie in die Unterschenkelarterien mündet und zu den muskelversorgenden Arterien gehört. Die A. ischiadica neigt aufgrund eines minderwertigen Gefäßaufbaus zu Vaskulopathien. Insbesondere aneurysmale Dilatationen der A. ischiadica sind mit einer hohen Inzidenz beschrieben worden. Der vorliegende Fallbericht beschreibt den interessanten Fall einer akuten Ischämie im Bereich des Unterschenkels, ausgelöst durch Thromben aus einer aneurysmatisch veränderten A. ischiadica. Die akute Ischämie wurde erfolgreich durch eine intraarterielle Lyse behandelt. Das Aneurysma wurde sekundär durch eine beschichtete Stentprothese ausgeschaltet.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1262
    Keywords: Keywords MRI ; Abdomen ; Crohn’s disease ; Inflammatory small bowel disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Conventional enteroclysis remains the method of choice in the diagnosis of inflammatory small bowel disease. The reported sensitivity rates, however, for the diagnosis of extraintestinal processes, such as fistulae and abscesses, are moderate. Computed tomography (CT) is the method of choice for the diagnosis of extraintestinal complications. The anatomical designation of the affected bowel segment may, however, prove difficult due to axial slices, and the applied radiation dose is high. The use of magnetic resonance imaging (MRI) in the diagnosis of inflammatory small bowel disease is a relatively new indication for the method; prerequisites were the development of breathhold sequences and phased array coils. Optimized magnetic resonance tomographic imaging requires a combined method of enteroclysis and MRI, which guarantees an optimal filling and distension of the small bowel. The high filling volume leads to a secondary paralysis of the small bowel and avoids motion artifacts. In a trial of 84 patients with histological and endoscopic correlation the sensitivity in diagnosing inflammatory bowel disease was 85.4% for enteroclysis and 95.2% for MRI, and the specificity was 76.9% for enteroclysis and 92.6% for MRI. As none of the abscesses was diagnosed with enteroclysis, the sensitivity was 0% for enteroclysis, but 77.8% for MRI. The sensitivity in diagnosing fistulae was 17.7% for enteroclysis and 70.6% for MRI. In summary, MRI can detect the most relevant findings in patients with inflammatory small bowel disease with an accuracy superior to that of enteroclysis.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1433-0563
    Keywords: Schlüsselwörter Flächendosisprodukt ; Dosimetrie ; Durchleuchtung ; Radiographie ; Miktionszysturethrographie ; Key words Dose-area product ; Dosimetry ; Fluoroscopy ; Radiography ; Voiding cystourethrography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Objective: Determination of the proportion of the dose-area product caused by fluoroscopy at voiding cystourethrography in children, using digital image intensifier technology. Patients and methods: Using computer-assisted dosimetry, we determined the dose-area product and the respective proportions of the dose-area product caused by fluoroscopy and radiography as well as the number of radiographs taken at a given examination of 40 children (8 children less than 2 years old, 15 children between 2 and 6 years old and 17 children between 6 and 15 years old). Results: The computer software program correctly differentiated between fluoroscopy and radiography in 80 % of cases. Incorrect results were primarily observed in newborns and young children. The total radiation dose ranged in relation to patient age from 22 to 651 cGy × cm2. Fluoroscopy was responsible for an average 78 % of the applied radiation dose. Conclusion: Computer-assisted dosimetry is useful in determining the proportion of the dose-area product caused by fluoroscopy in older children undergoing voiding cystourethrography. When image intensifier technology is used, this accounts for more than 75 % of the total radiation dose. The method is not suitable for use in small children.
    Notes: Zusammenfassung Ziel: Bestimmung des Anteils der Durchleuchtung am Gesamtflächendosisprodukt beim Kindermiktionszysturethrogramm in digitaler Bildverstärkertechnik. Material und Methode: Bei 40 Kindern (8 Kinder 〈 2 Jahre, 15 Kinder zwischen 2 und 6 Jahren und 17 Kinder zwischen 6 und 15 Jahren) wurden PC-gestützt die Anzahl der Zielaufnahmen, deren Anteil am Gesamtflächendosisprodukt sowie der durchleuchtungsbedingte Anteil am Gesamtflächendosisprodukt ermittelt. Ergebnisse: In 80 % der Fälle ermöglichte der Einsatz des Computerprogramms eine korrekte Differenzierung zwischen Fluoroskopie und Radiographie. Falsche Ergebnisse fanden sich hauptsächlich bei Neugeborenen und Kleinkindern. Die Gesamtstrahlenbelastung variierte abhängig vom Patientenalter zwischen 22 und 651 cGy × cm2, durchschnittlich betrug der Anteil der Durchleuchtung 78 %. Schlußfolgerung: PC-gestützt ist es möglich den Anteil der Durchleuchtung am Gesamtflächendosisprodukt bei älteren Kindern, die sich einem Miktionszysturethrogramm unterziehen, zu ermitteln. Dieser beträgt bei Verwendung der digitalen Bildverstärkertechnik mehr als 75 %. Bei Neugeborenen und Kleinkindern versagt die Methode.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 8 (1998), S. 1452-1454 
    ISSN: 1432-1084
    Keywords: Key words: Epidurography ; MRI ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to evaluate and describe MRI epidurography as a new imaging tool. Five volunteers and one patient were investigated with MR epidurography after injection of 20 ml Gd-DPTA solution (1 : 250/1 ml Gd-DPTA/250 ml normal saline). Magnetic resonance epidurography is possible. With fat-suppression techniques, the contrast between Gd-DPTA solution in the epidural space and surrounding soft tissue proved adequate. Using the multiplanar capability of MRI with MR epidurography coronal and sagittal projections similar to conventional epidurography, axial slices comparable to CT epidurography can be obtained. Magnetic resonance epidurography is superior to conventional and CT epidurography. Presently, due to high costs as compared with conventional and CT epidurography, MRI is not suitable for the routine monitoring of peridural catheters, but it may have a place in the future with decreasing costs for MRI and for the evaluation of patients with spine pathology, especially in describing epidural processes.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1084
    Keywords: Key words: Breast ; Parenchymal pattern ; MR imaging ; Contrast enhancement ; MR mammography ; Menstruation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Magnetic resonance mammography (MRM) provides data regarding the nature of tumours based on contrast medium dynamics; fibrocystic changes in the breast, however, may lead to false-positive results. This study investigated whether the contrast medium dynamics of fibrocystic changes are dependent on the menstrual cycle. Twenty-four patients with palpable lumps but normal mammographies and ultrasound studies were examined. The MRM technique was performed during the first and second part of the menstrual cycle using a FLASH 3D sequence, both native and at 1, 2, 3 and 8 min after intravenous application of 0.15 mmol/kg body weight of gadodiamide. The calculated time–intensity curves were evaluated based on the following criteria: early percentage of contrast medium uptake in relation to the native value; formation of a plateau phenomenon after the second minute; the point of maximal contrast medium uptake; and calculation of the contrast enhancing index. During the second half of the menstrual cycle, a generally greater contrast medium uptake was observed. Nevertheless, when further diagnostic criteria, such as continuous contrast medium increase as a function of time, were considered, there was no increased rate of false-positive findings. The phase of the menstrual cycle may affect the specificity of the examination, if only the quantitative contrast medium uptake and the percentage of contrast medium uptake in the first 2 min are considered. A control MRM during the other half of the cycle may then be indicated and additional diagnostic criteria may improve specificity.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1084
    Keywords: Key words: Papilloma ; Breast ; MRM ; Galactography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was evaluation of MRI alone and in combination with mammography and galactography in the diagnosis of intraductal papillomas. From 1994 to 1998, a total of 48 women presenting with pathologic mammary secretion underwent galactography and magnetic resonance mammography (MRM). Thirty-five patients aged 16–71 years (average age 46 years) subsequently underwent surgery or diagnostic puncture and the histologic findings were compared with the results of the radiologic examination. Histology revealed papillomas in 16 cases. In 6 of these patients, there was associated malignant degeneration. Malignancy without associated papilloma was observed in 3 cases. Galactography displayed a sensitivity of 94 % and a specificity of 79 % with five false-positive findings and one false-negative finding in the recognition of intraductal papillomas. Malignant processes were detected by mammography/galactography in only one instance. Magnetic resonance mammography visualized pathologic contrast medium uptake in 8 of 9 cases of malignant disease (sensitivity 89 %). One patient with in situ ductal carcinoma escaped detection with MRM. Papillomas showed no or below-the-threshold-lying contrast uptakes with no specific sign suggestive of papilloma. Galactography in combination with mammography remains the primary diagnostic procedure in cases of pathologic mammary secretion or suspected papilloma. The addition of MRI permits exclusion of malignant disease with a high degree of certainty; thus, expectant management in individual cases with negative findings appears justified.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 10 (2000), S. 802-805 
    ISSN: 1432-1084
    Keywords: Key words: Gastrointestinal bleeding ; Embolization ; Interventional therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18–89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83 %). In one case (3 %) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14 %) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14 %, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications.
    Type of Medium: Electronic Resource
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