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  • 1
    Electronic Resource
    Electronic Resource
    Imaging of obstructive azoospermia (1997)
    Springer
    European radiology 7 (1997), S. 1079-1085 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Obstructive azoospermia ; Scrotal ultrasonography ; TRUS ; Endorectal MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Obstructive azoospermia represents approximately 10 % of cases of male hypofertility. It is classified according to the volume of ejaculate. When the latter is normal a proximal obstruction is suspected. Scrotal sonography can help to detect dilation of the epididymal head when clinical findings are equivocal. Ejaculatory duct obstruction (EDO) is suspected when the volume of ejaculate is low. The use of transrectal ultrasonography (TRUS) plays a major role in the investigation of these patients, and endorectal MRI is a very useful adjunct in selected cases. The most common cause of EDO is congenital bilateral absence of vas deferens, which is now thought to be a genital form of cystic fibrosis in 80 % of cases. Consequently, a definitive diagnosis must be made before any attempt at in vitro fertilization. TRUS accurately visualizes abnormalities of the caudal junction of the vas deferens and seminal vesicles, yielding a definitive diagnosis without scrototomy. Other causes of EDO are congenital cysts compressing the distal part of the ejaculatory ducts and inflammatory distal stenosis. The former are accurately identified by TRUS, but the latter give more or less marked signs of obstruction which are only of value in azoospermic patients with a low-volume ejaculate. More invasive imaging is required to diagnose partial obstruction of the ED. Surgical vasography is still the reference, but puncture of the seminal vesicles under TRUS guidance is an attractive alternative, as it permits aspiration of seminal fluid (to seek motile sperm) and vasography without scrototomy. Lastly, endorectal MRI well assesses the relationships between the proximal prostatic urethra and the posterior wall of the ejaculatory ducts, which need to be precisely known when endoscopic resection of the ejaculatory ducts is planned.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050258
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Varicocele: strategies in diagnosis and treatment (1999)
    Springer
    European radiology 9 (1999), S. 536-545 
    Details
    ISSN: 1432-1084
    Keywords: Key words: Varicocele ; Continuous Doppler ; Pulsed Doppler ; B mode sonography ; Color Doppler sonography ; Spermatic veins ; embolization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Varicocele can be very easily diagnosed by physical examination and subsequently treated when it is painful or associated with testicular hypotrophy. However, palpability of the spermatic vein and reflux in low grade or even questionable varicoceles can be difficult to assess without imaging modalities. This can be a common problem for all physicians treating hypofertile men to decide whether the varicele needs to be treated or not. However, a gold standard that defines the presence of a subclinical varicocele has not yet been established. The different diagnostic tools based on ultrasonography investigated these past years to define a flow reversal in incontinent spermatic veins are presented in the first part of this review, with emphasis on subclinical varicocele. In the second part, we present our experience, together with a review of the literature concerning embolization of the spermatic veins as an alternative to surgery to treat varicoceles.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050706
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    0.5 T MRI of small renal masses: value of T2-weighted and Gd-DOTA-enhanced images (1993)
    Springer
    European radiology 3 (1993), S. 447-452 
    Details
    ISSN: 1432-1084
    Keywords: Gadolinium ; Kidney, benign tumours ; Kidney, cysts ; Kidney, MRI studies ; Kidney, neoplasms ; MRI, contrast enhancement
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We compared the value of T2-weighted and Gd-DOTA-enhanced T1-weighted images for the detection and characterisation of 33 small renal masses (14 clear cell carcinomas, 6 angiomyolipomas, 3 angiomyomas, 4 adenomas, 3 papillary carcinomas, 3 oncocytomas, 1 haemorrhagic cyst). Dynamic enhanced MRI was performed to study the tumoral vascular supply (19 cases). MRI depicted all the masses more than 1 cm in diameter, but missed all the lesions less than 1 cm (4 false-negative). The results of T2-weighted images and Gd-DOTA-enhanced images were similar as regards detection; however, Gd-DOTA-enhanced images depicted more clearly the tumours smaller than 2 cm (11 cases). MRI enabled the characterisation of only 3 masses (2 angiomyolipomas, 1 haemorrhagic cyst). New MRI features are described for oncocytomas (low signal intensity on T1-weighted images, high signal intensity on T2-weighted images, early and marked enhancement on dynamic enhanced MRI). Dynamic enhanced MRI did not contribute to the differentiation of benign from malignant tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00221422
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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