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  • 1
    Electronic Resource
    Electronic Resource
    Treatment of bile duct stones: value of laser lithotripsy delivered via percutaneous endoscopy (1996)
    Springer
    European radiology 6 (1996), S. 734-740 
    Details
    ISSN: 1432-1084
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Extraction of stones from the bile ducts via standard endoscopic techniques, a percutaneous transhepatic approach, or a T-tube track can be unsuccessful. We report our preliminary experience with a combination of percutaneous cholangioscopy and dye laser lithotripsy. Flash lamp-excited dye laser (504 nm) lithotripsy delivered by percutaneous cholangioscopy (12 F) was evaluated in 13 patients with stones in the bile ducts. Conventional endoscopic treatment had not been attempted in 4 patients after hepaticojejunostomy and had failed in 3 patients after gastric bypass surgery or gastrectomy, and in 6 patients because of technical difficulties, i. e. due mainly to largeness of stones. In 12 patients a percutaneous transhepatic route was used. In 1 patient the T-tube track was used as access to the bile ducts. Laser lithotripsy resulted in successful fragmentation of stones in 12 patients (92%). The bile ducts cleared spontaneously in 2 patients only. Using additional techniques, i. e. sphincterotomy and stent insertion, the overall combined success rate for duct clearance after laser fragmentation was 100%. Four patients had a retrograde endoscopic sphincterotomy after failed attempts for stone removal at endoscopic retrograde cholangioscopy. Two patients had an antegrade fluoroscopically monitored sphincterotomy. Bleeding complications occured in 2 patients. This accounted for a high rate (15%) of severe complications. The intrahepatic bleeding in 1 patient was due to an intrahepatic vessel injury by the 13-F sheath. The periampullary bleeding in the other patient occurred after an antegrade papillotomy. Pulsed dye laser lithotripsy proved to be an effective technique in patients with difficult bile duct stones. The main problem of a percutaneous approach is the complete removal of the fragmented stones, which requires additional procedures in most cases. The percutaneous access is time-consuming and bears a relatively high risk of major bleeding complications. It should therefore be restricted to cases in which conventional endoscopic procedures are impossible or unsuccessful.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187681
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  • 2
    Electronic Resource
    Electronic Resource
    MR mammography: influence of menstrual cycle on the dynamic contrast enhancement of fibrocystic disease (1999)
    Springer
    European radiology 9 (1999), S. 1107-1112 
    Details
    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
    URL: http://dx.doi.org/10.1007/s003300050800
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  • 3
    Electronic Resource
    Electronic Resource
    Quiz case of the month (1997)
    Springer
    European radiology 7 (1997), S. 589-590 
    Details
    ISSN: 1432-1084
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300050212
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  • 4
    Electronic Resource
    Electronic Resource
    Magnetic resonance epidurography with gadolinium-DTPA (1998)
    Springer
    European radiology 8 (1998), S. 1452-1454 
    Details
    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
    URL: http://dx.doi.org/10.1007/s003300050573
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  • 5
    Electronic Resource
    Electronic Resource
    Diagnostic imaging in Crohn’s disease: comparison of magnetic resonance imaging and conventional imaging methods (2000)
    Springer
    International journal of colorectal disease 15 (2000), S. 176-181 
    Details
    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
    URL: http://dx.doi.org/10.1007/s003840000219
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  • 6
    Electronic Resource
    Electronic Resource
    MRI in the diagnosis of small bowel disease: use of positive and negative oral contrast media in combination with enteroclysis (2000)
    Springer
    European radiology 10 (2000), S. 1377-1382 
    Details
    ISSN: 1432-1084
    Keywords: Key words: MR imaging – Gastrointestinal tract – Contrast agent – Inflammatory bowel disease – Crohn's disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of the study was to evaluate the additional findings of MRI following small bowel enteroclysis and to compare the efficacy of negative and positive intraluminal contrast agents. Fifty patients with inflammatory or tumorous small bowel disease were investigated by small bowel enteroclysis and consecutive MRI using breathhold protocol (T1-weighted fast low-angle shot, T2-weighted turbo spin echo). Patients were randomly assigned to either receiving a positive oral (Magnevist, Schering, Berlin, Germany) or a negative oral MR contrast media (Abdoscan, Nycomed, Oslo, Norway). The pattern of contrast distribution, the contrast effect, presence of artifacts, as well as bowel wall and extraluminal changes, were determined and compared between the contrast type using Fischer's exact test. Sensitivity, specificity, and diagnostic accuracy for MRI and enteroclysis were calculated. Twenty-seven patients had clinically proven Crohn's disease and two patients surgically proven small bowel tumours. Magnetic resonance imaging had important additional findings as abscesses and fistulae in 20 patients. Surgically compared sensitivities were 100 and 0 % for MRI and enteroclysis, for the detection of abscesses, and 83.3 and 17 % for the diagnosis of fistulae, respectively. Bowel wall thickening was more reliably detected with use of positive oral contrast media without intravenous enhancement (p 〈 0.001), whereas postcontrast negative oral contrast media allow for a superior detection (p 〈 0.001). T2-weighted sequences were necessary with use of negative oral contrast media, because loop abscesses may be masked. Magnetic resonance imaging should be performed in all patients with suspicion of extraintestinal complications, because the complications are more reliably detected by MRI. Negative oral contrast media show advantages with the use of intravenous contrast but can mask loop abscesses using only T1-weighted imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300000354
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  • 7
    Electronic Resource
    Electronic Resource
    Diagnosis of papillomas of the breast: value of magnetic resonance mammography in comparison with galactography (2000)
    Springer
    European radiology 10 (2000), S. 1733-1736 
    Details
    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.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003300000498
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  • 8
    Electronic Resource
    Electronic Resource
    Faziales und orbitales Weichteilemphysem (1996)
    Springer
    Der Radiologe 36 (1996), S. 843-844 
    Details
    ISSN: 1432-2102
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050148
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  • 9
    Electronic Resource
    Electronic Resource
    Neugeborenes mit zerebraler Symptomatik (1996)
    Springer
    Der Radiologe 36 (1996), S. 591-592 
    Details
    ISSN: 1432-2102
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050115
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  • 10
    Electronic Resource
    Electronic Resource
    Die infektiöse Spondylitis Eine retrospektive Auswertung der MRT-Merkmale (1997)
    Springer
    Der Radiologe 37 (1997), S. 139-144 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Spondylitis ; Spondylodiszitis ; Wirbelkörper ; Bandscheibe ; Kernspintomographie ; Key words Spondylitis ; Spondylodiscitis ; Spine ; Intervertebral disc ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aim and methods: The aim of the present study was to evaluate the MRI criteria of infectious spondylitis (spondylodiscitis). The MR images of 23 patients suffering from spondylodiscitis (78 % unspecific, 22 % specific) were retrospectively analyzed. Results: The height of the intervertebral discs involved was normal in 40 %, reduced in 43 % and increased in 17 % of the cases. The most common findings can be summarized in an MR triad: 1) The vertebral bodies involved are hypointense in T1-weighted images (100 %) with a lack of delineation of the intervertebral discs (53 %). 2) The injection of Gd-DTPA yields an enhancement of the vertebral bodies involved and intervertebral discs (95 % and 74 % respectively). 3) The vertebral bodies and intervertebral discs are hyperintense in T2-weighted sequences (76 % and 90 % respectively). When present, a paravertebral or intraspinal extension of the infection was isointense compared with the adjacent involved vertebral body in the majority of the patients. A differentiation between unspecific and specific etiology based on the MR images was not possible. Conclusions: The vertebral bodies affected were usually hypointense in T1-W with enhancement after the administration of Gd-DTPA and hyperintense in T2-W. The discs involved were usually hyperintense in T2-W and demonstrated an inhomogeneous enhancement.
    Notes: Zusammenfassung Um die kernspintomographischen Merkmale der Spondylitis zu überprüfen, wurden die MRT-Bilder von 23 Patienten mit einer Spondylitis (78 % unspezifisch, 22 % spezifisch) retrospektiv analysiert; 40 % der befallenen Bandscheiben zeigten eine normale Höhe, 43 % waren verschmälert und 17 % zeigten eine Höhenzunahme. Die häufigsten Veränderungen lassen sich in einer MRT-Trias zusammenfassen: 1. In T1-gewichteten Sequenzen sind die befallenen Wirbelkörper hypointens (100 %) und die Bandscheiben nicht abgrenzbar (53 %). 2. Wirbelkörper und Bandscheiben nehmen Kontrastmittel auf (95 bzw. 74 %). 3. Wirbelkörper und Bandscheiben sind in T2-gewichteten Sequenzen hyperintens (76 bzw. 90 %). Dabei stellt sich ein paravertebraler Weichteilbefall in allen Sequenzen isointens zum befallenen Wirbelkörper dar. Eine Differenzierung zwischen unspezifischer und spezifischer Ätiologie war kernspintomographisch nicht möglich.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050186
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