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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 36 (1996), S. 709-712 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter MR-Arthrographie ; MR-gezielte Gelenkpunktion ; Real-time-MRT ; Key words MR arthrography ; MR-guided joint puncture ; Real-time MR imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To develop an MR-guided technique for joint puncture in MR arthrography of the shoulder and to confirm the intracapsular position of the needle tip by visualization of the flow of contrast media into the joint. Materials and methods: Three unfixed human shoulder joint specimens were examined on a 1.0 T unit. The optimal point of entrance and depth for joint puncture were estimated by means of MR-compatible markers on the skin. Needle orientation and localization of the needle tip (MR-compatible 22-gauge needle) in the shoulder joint were monitored by rapid localizer gradient-echo sequences in two orthogonal planes. To confirm the intracapsular position of the needle tip, diluted gadolinium-DTPA was administered via a long connecting tube and the flow of contrast media into the joint was viewed directly on an LCD screen using real-time MR imaging (local look technique). Results: The MR-compatible markers on the skin allowed determination of the optimal point of entrance and estimation of the depth for joint puncture. Passive visualization of the MR-compatible needle due to spin dephasing and signal loss provided adequate localization of the intra-articular needle tip position in all specimens, although significant artefacts were present on rapid localizer gradient-echo sequences with an increase in width of the apparent needle shaft. Real-time MR imaging of the flow of contrast media was possible using the local look technique and the LCD screen of the MR unit and allowed confirmation of the intracapsular position. Conclusion: MR-guided joint puncture and real-time MR-assisted contrast media application results in improved MR arthrography and may replace conventional fluoroscopic guidance.
    Notes: Zusammenfassung Für die MR-Arthrographie der Schulter wurde eine MR-gezielte Punktionstechnik entwickelt und an 3 nicht fixierten menschlichen Schulterpräparaten getestet. MR-kompatible Marker an der Hautoberfläche erlaubten eine Bestimmung der Punktionsstelle und Abschätzung der Punktionstiefe. Auf einem 1,0 Tesla geschlossenem MR-System zeigten multiplanare schnelle Gradientechosuchsequenzen trotz Artefakte die Orientierung und Position der Spitze einer MR-kompatiblen Nadel zuverlässig. Für die Kontrolle der intraartikulären Lage der Nadelspitze wurde der Kontrastmitteleinstrom in das Gelenk während Applikation von Gadolinium-DTPA über eine lange Leitung auf einem LCD-Schirm mittels Echtzeit-MRT (Local-look-Technik) direkt kontrolliert. Die MR-gezielte MR-Arthrographie des Schultergelenks ist eine rasch durchzuführende Technik um die Gelenkpunktion und den intraartikulären Kontrastmitteleinstrom direkt in der MR-Einheit zu kontrollieren und kann die Röntgendurchleuchtung ersetzen.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 1-7 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Sprunggelenke ; Anatomie ; Kinematik ; MR-Bildgebung ; Bandstrukturen ; Key words Ankle and intertarsal joints ; Anatomy ; Arthrokinematics ; MR analysis ; Ligaments
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In the ankle (talocrural) joint, the lower end of the tibia and fibula embrace the trochlea tali. Thus, an approximately uniaxial joint is formed which permits dorsiflexion and plantarflexion of the foot against the leg. Due to the geometry of the trochlea tali, conjunct lateral rotation of the fibula against the tibia occurs at the tibiofibular articulations synchronously with active dorsiflexion at the ankle joint. Movements at the talocrural joints are mainly limited by the opposing muscles as well as by strong collateral ligaments. Talus and calcaneus form a functional unit connected by posterior and anterior articulations. The posterior articulation is the subtalar (talocalcaneal) joint; in the anterior articulation, talar facets of the calcaneus together with the posterior surface of the navicular and the superior fibrocartilaginous surface of the plantar calcaneonavicular ligament form a concavity for the talar head. Thus, the talocalcaneonavicular joint is a compound and – like the subtalar joint – a multiaxial articulation. On the weight-bearing foot, the distal tarsus and metatarsus are pronated and supinated against the talus in order to maintain plantigrade contact. When the foot is off the ground, these movements are modified to eversion and inversion, also involving the calcaneocuboid joint. In addition, movements between the calcaneus and cuboid also occur during pronative or supinative changes between the fore- and hindfoot. Limitation of movements is due to leg muscles as well as strong ligaments. Finally, the cuneonavicular, cuboideonavicular, intercuneiform and cuneocuboid joints permit some additional alterations of the loaded foot in contact with the ground.
    Notes: Zusammenfassung Der Komplex der Sprunggelenke stellt die Verbindung von Unterschenkel und Fuß des Menschen her. In der Articulatio talocruralis, dem oberen Sprunggelenk, stehen die distalen Enden von Tibia und Fibula mit der Trochlea tali im Gelenkkontakt. In diesem von starken Kollateralbändern gesicherten Gelenk kann um eine durch die Spitzen der Malleolen laufende Achse dorsal- und plantarflektiert werden. Das zusammengesetzte untere Sprunggelenk besteht aus den Articulationes subtalaris et talocalcaneonavicularis. In diesem multiaxialen Gelenk, das ebenfalls von kräftigen Bändern geführt wird, kann am Standbein der in der Malleolengabel geführte Talus um eine schräge Kompromißachse gegen die angrenzenden Fußwurzelknochen proniert und supiniert werden. Am Spielbein kommt es zusätzlich zur Pronation auch noch zur Abduktion des Fußes, während die Supination von einer Adduktion begleitet wird. Diese kombinierten Bewegungen, zu denen vor allem die Articulatio calcaneocuboidea, aber auch alle anderen Gelenke zwischen den distalen Fußwurzelknochen beitragen, werden als Eversion bzw. Inversion bezeichnet.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2102
    Keywords: Key words Larynx • Anatomy ; normal • Computed tomography (CT) • Magnetic resonance imaging (MRI) • Sonography (US) • Radiography ; Schlüsselwörter Larynx • Anatomie ; normal • Computertomographie (CT) • Magnetresonanztomographie (MRT) • Ultraschall (US)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Primäres Ziel der bildgebenden Diagnostik des Larynx ist die Analyse der submukös gelegenen Strukturen, die der laryngoskopischen Beurteilung nicht zugänglich sind. Demzufolge gilt als allgemeine Regel, die bildgebende Diagnostik des Larynx unter Kenntnis der Befunde der endoskopischen Diagnostik vorzunehmen. Die topographisch-anatomischen Verhältnisse des Skeletts, der Binnenstrukturen und der Umgebung des Larynx werden synoptisch dargestellt werden.
    Notes: Summary The primary goal of diagnostic imaging of the larynx is analysis of submucosal structures that are not visible by clinical or endoscopic means. Therefore, image analysis of the larynx should only be performed under knowledge of the results of clinical diagnosis. The anatomic relationships of the laryngeal skeleton, the intrinsic structures, and the surrounding soft tissue are presented synoptically.
    Type of Medium: Electronic Resource
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