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  • 1
    ISSN: 1432-0509
    Keywords: Key words: Liver—MR imaging—Contrast media.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of this study was to compare the performance of in-phase and out-of-phase gradient recalled echo (GRE) pulse sequences on paramagnetic contrast-enhanced magnetic resonance (MR) imaging of malignant liver lesions. Methods: Fifty patients (27 women, 23 men; mean age = 50 ± 27 years) with known or suspected focal liver lesions, nine of whom had a fatty liver, were examined at 1.5 T before and 60 min after injection of gadobenate dimeglumine at a dose of 0.05 or 0.1 mmol/kg using two GRE techniques: echo time of 2.3 ms (out-of-phase) or 4.6 ms (in-phase). Liver signal-to-noise ratio (SNR) and lesion–liver contrast-to-noise ratio (CNR) were calculated. Results: In patients with a nonfatty liver, liver SNR increased from 26 ± 9 to 41 ± 17 on in-phase images and from 28 ± 8 to 45 ± 14 on out-of-phase images. In patients with a fatty liver, in-phase images provided significantly higher (p 〈 0.01) liver SNR than did out-of-phase images predose (34 ± 8 on in-phase vs. 21 ± 8 on out-of-phase) and postdose (44 ± 13 on in-phase vs. 33 ± 14 on out-of-phase). In patients with a nonfatty liver, lesion–liver CNR was similar on in-phase and out-of-phase images, predose and postdose. In patients with fatty liver, lesion–liver CNR was significantly (p 〈 0.01) lower on out-of-phase images on predose and postdose images. Conclusion: In-phase GRE imaging is recommended for imaging focal liver lesions on paramagnetic contrast-enhanced MR imaging in patients with fatty infiltration of the liver.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0509
    Keywords: Graft-versus-host-disease (GVHD) ; Bonemarrow transplantation, complications ; Esophagus, motility disorders
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Successful allogeneic bone marrow transplantation (BMT) for hematologic disorders may be complicated by graft-versus-host-disease (GVHD). Chronic GVHD is a systemic disease, involving, among other organs, the skin, mouth, liver, and esophagus. Esophageal involvement results in mucosal inflammation, leading to submucosal fibrosis and, occasionally, formation of webs and strictures. We investigated 25 allogeneic BMT recipients (17 with and eight without chronic GVHD). All patients had a videofluoroscopic study of the pharynx and esophagus to determine the radiographic abnormalities characteristic of chronic GVHD. Oropharyngeal abnormalities (poor bolus control, pharyngeal retention, or excessive mucous secretions) were found in five patients with and three patients without GVHD. Only one patient with GVHD had a pharyngo-esophageal stricture. There was no significant difference between the two groups with regard to pharyngo-esophageal radiographic abnormalities and esophageal symptoms. Radiographic evidence of esophageal motility disorder is not specific for GVHD involvement. In the absence of specific radiographic features, endoscopy is the most accurate method for the diagnosis of esophageal involvement by GVHD.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Internet ; World Wide Web ; Computer applications ; Education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Global exchange of information is one of the major sources of scientific progress in medicine. For management of the rapidly growing body of medical information, computers and their applications have become an indispensable scientific tool. Approximately 36 million computer users are part of a worldwide network called the Internet or “information highway” and have created a new infrastructure to promote rapid and efficient access to medical, and thus also to radiological, information. With the establishment of the World Wide Web (WWW) by a consortium of computer users who used a standardized, nonproprietary syntax termed HyperText Markup Language (HTML) for composing documents, it has become possible to provide interactive multimedia presentations to a wide audience. The extensive use of images in radiology makes education, worldwide consultation (review) and scientific presentation via the Internet a major beneficiary of this technical development. This is possible, since both information (text) as well as medical images can be transported via the Internet. Presently, the Internet offers an extensive database for radiologists. Since many radiologists and physicians have to be considered “Internet novices” and, hence, cannot yet avail themselves of the broad spectrum of the Internet, the aim of this article is to present a general introduction to the WWW/Internet and its applications for radiologists. All Internet sites mentioned in this article can be found at the following Internet address: http://www.univie.ac.at/radio/radio.html (Department of Radiology, University of Vienna)
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 9 (1999), S. 724-727 
    ISSN: 1432-1084
    Keywords: Key words: Pneumomediastinum ; Diabetes ; Asthma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In this paper two cases of spontaneous pneumomediastinum, occurring in a patient with diabetic ketoacidosis and in a patient with bronchial asthma, are presented. We describe the radiological findings, the differential diagnosis and the important radiographic considerations in establishing the diagnosis. In addition, we discuss the anatomical pathways and review the pathophysiological mechanisms responsible for the development of respiratory spontaneous pneumomediastinum.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1084
    Keywords: Key words: Pseudoaneurysm ; Internal carotid artery ; CT angiography ; Subtraction technique
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. A case of pseudoaneurysm of the left internal carotid artery (ICA) after shrapnel injury is demonstrated by intra-arterial digital subtraction angiography (DSA) and computed tomography angiography (CTA) with subtraction technique. Although the pseudoaneurysm was well demonstrated by intra-arterial DSA, CTA was the only modality to demonstrate the three-dimensional shape of the perfused part of pseudoaneurysm and the aneurysmal neck, which affected the therapeutic strategy. The CTA technique is useful in the assessment of large pseudoaneurysms and for therapeutic planning.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    European radiology 9 (1999), S. 1745-1754 
    ISSN: 1432-1084
    Keywords: Key words: Magnetic resonance angiography ; Contrast-enhanced time-of-flight MRA ; Pulmonary arteries ; Pulmonary embolism
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. In the past few years magnetic resonance angiography (MRA) of the pulmonary vasculature has advanced from a research tool to a clinically relevant imaging modality. Early 2D phase-contrast and time-of-flight (TOF) sequences without the use of contrast agents were time-consuming and limited by considerable imaging and motion artifacts. Since the introduction of MR scanners with stronger gradients (〉 20 mT/m) and contrast-enhanced techniques, imaging of the pulmonary vasculature with adequate spatial resolution within a single breathhold is now possible. In the detection of pulmonary embolism in the lobar or segmental arteries, contrast-enhanced MRA is now on the verge of being considered an established modality, possibly competing with conventional pulmonary angiography and contrast-enhanced helical CT. In the future, utilization of phased-array torso coils, the application of navigator pulse sequences, and 3D time-resolved ultrafast MRA will overcome the final limitations of current techniques. Blood-pool MR contrast agents may provide a “one-stop-shopping” approach to the investigation of lower extremity veins and pulmonary arteries in venous thromboembolism.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 37 (1997), S. 197-204 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lebertransplantation ; Komplikation ; Radiologische Diagnostik ; Key words Liver transplantation ; Complications ; Radiological diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Introduction: Orthotopic liver transplantation (OLT) has become an accepted treatment for end-stage liver disease. However, postoperative complications result in significant patient morbidity and mortality. Early detection and treatment of these complications is therefore of utmost importance. Materials and methods: We retrospectively reviewed the postoperative complications of the patients who underwent OLT at our institution. Duplex Doppler sonography and cholangiography were the primary imaging modalities in postoperative evaluation of the transplanted liver. Other important techniques were CT, MRI, and angiography, which may contribute to a reliable diagnosis of vascular or biliary complications. Results: Second to primary organ dysfunction, vascular complications are the most frequent cause of graft loss. Thrombosis of the hepatic artery is the most common and most serious vascular complication, with a reported incidence from 4 to 42 %. Bile duct sludge, leaks and strictures are frequent complications after liver transplantation, which can contribute to graft dysfunction. Biliary tract complications usually occur within the first 3 months and require interventional radiological or surgical therapy. Since liver transplant recipients undergo immunosuppressive therapy, they are at increased risk of developing late post-transplant malignancies, which are best depicted by US, CT or MRI. However, radiological diagnosis of lymphoproliferative disorder has to be confirmed by liver biopsy. Conclusion: Cholangiography and Duplex sonography are routinely used in the postoperative evaluation of patients with OLT. CT, MRI, and angiography are problem-solving tools in equivocal cases.
    Notes: Zusammenfassung Einleitung: Die orthotope Lebertransplantation hat sich zu einer etablierten Therapie bei Lebererkrankungen im Endstadium entwickelt. Der frühe Nachweis und die prompte Therapie eventueller Komplikationen sind für das Überleben des Patienten und des Organs entscheidend. Material und Methode: Es wurden im eigenen Krankengut die postoperativen Komplikationen nach OLT retrospektiv ausgewertet. Die Duplexsonographie und die Cholangiographie erwiesen sich als die primären Untersuchungsmethoden der Wahl zum Nachweis vaskulärer oder biliärer Komplikationen. CT, MRI und die Angiographie waren in Problemfällen wertvolle additive bildgebende Verfahren zur Diagnosesicherung. Ergebnisse: Nach der primären Organdysfunktion sind die vaskulären Komplikationen als häufigste Ursache für den Verlust des Spendeorgans anzuführen. Die Thrombose der A. hepatica ist die häufigste vaskuläre Komplikationen mit einer Inzidenz von 4–42 %. Galleleaks, -sludge und -strikturen sind häufige Komplikationen, die letztlich zu einer Dysfunktion des transplantierten Organs führen können. Biliäre Komplikationen treten gehäuft in den ersten 3 Monaten auf und erfordern eine interventionelle oder chirurgische Therapie. Da Patienten nach OLT einer immunsuppressiven Therapie unterliegen, sind sie einem erhöhten Risiko einen lymphoproliferativen Tumor zu entwickeln ausgesetzt. Diese Posttransplant-Tumore können mit US, CT und MRI ausgezeichnet abgegrenzt werden, erfordern jedoch eine Sicherung der Diagnose durch eine Feinnadelpunktion. Schlußfolgerung: Die postoperative Verlaufskontrolle und der Nachweis von Komplikationen nach OLT ist eine Domäne von Cholangiographie und Duplexsonographie. In Problemfällen kommen CT, MRI und Angiographie zum Einsatz.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Pharynx ; Anatomie ; MRT ; CT ; Videokinematographie ; Key words Pharynx ; Anatomy ; MR ; CT ; Videocinematography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background. The pharynx, being part of the digestive as well as the respiratory system, is embedded in the complex spatial anatomy of the neck and, due to its function and location, represents a very sophisticated region. Diagnosis. Cross-sectional imaging with CT and MR imaging plays an indispensable complementary role to clinical work-up, as far as submucosal and deep cervical spaces are concerned. However, as dysphagia is a common symptom in clinical practice, interpretation of double contrast studies and videofluoroscopic investigations are also on frequent demand in the daily routine. Conclusion. Close interdisciplinary co-operation and the radiologist's familiarity with the anatomy of the region are required in order to use the diagnostic tools in an optimal fashion.
    Notes: Zusammenfassung Hintergrund. Der Pharynx repräsentiert, durch seine Funktion als Luft- und Speiseweg einerseits sowie durch seine Topographie in der komplexen Zervikalregion andererseits, ein äußerst differenziertes Organsystem. Bildgebungsverfahren. Neben den, in den letzten Jahren und Jahrzehnten einer rasanten Entwicklung unterworfenen, und in der Kopf-Hals-Radiologie unerlässlichen Schnittbildverfahren, spielen, gerade bei der Bildgebung des Pharynx, konventionelle Röntgenverfahren, welche eine dynamische Beurteilung der Funktion erlauben, weiterhin eine wichtige Rolle in der Diagnostik. Die Methoden der Bildgebung stellen somit heute, ergänzend zur klinischen Untersuchung, unumstritten das 2. Standbein in der Abklärung von Pathologien am Pharynx dar. Resümee. Dieses Zusammenwirken bietet dem Radiologen, entsprechend der Fragestellung nach funktionellen oder strukturellen Pathologien, ein vielfältiges Betätigungsfeld, erfordert gleichzeitig aber das grundlegende Verständnis der normalen Anatomie und Physiologie sowie die Kenntnis der spezifischen Vor- und Nachteile der zur Verfügung stehenden bildgebenden Verfahren.
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Der Radiologe 39 (1999), S. 568-577 
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Leber ; Pankreas ; Hepatozelluläres Karzinom ; Metastase ; Pankreaskarzinom ; Sonographie ; Computertomographie ; Magnetresonanztomographie ; Key words Liver ; Pancreas ; Contrast-enhanced CT ; Contrast-enhanced MRI ; Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Modern therapeutic strategies can improve survival of patients with pancreatic or liver malignancies. A prerequisite is thorough radiologic assessment of these patients. A variety of radiologic techniques are available, such as ultrasound, contrast-enhanced CT, CTAP, contrast-enhanced MRI, and endoscopic ultrasound. In this review the advantages and weaknesses of the different techniques are presented in the staging of patients with HCC, cholangiocarcinoma, suspected liver metastases, and pancreatic carcinoma. In an era of economic restraints, funds are not flowing freely anymore for radiologic studies. We have to consider not doing so many different examinations for each patient. We have to decide in the future which diagnostic test we want to perform for detection and staging of a particular disease. For liver and pancreatic malignancies it is likely to be MRI that will take this role.
    Notes: Zusammenfassung Moderne Therapieverfahren können die Überlebenschance von Patienten mit malignen Tumoren von Leber oder Pankreas deutlich verbessern. Um das Potential dieser Techniken ausnutzen zu können, ist eine genaue prätherapeutische Abklärung nötig. Dafür steht eine Reihe von bildgebenden Verfahren für das Staging von Leber- oder Pankreasmalignomen zur Verfügung, die entsprechend einem diagnostischen Algorithmus eingesetzt werden sollten. Die Vorzüge und Nachteile der jeweiligen bildgebenden Verfahren, wie transabdominelle Sonographie, kontrastverstärkte CT, CTAP, MRT mit organspezifischen Kontrastmitteln und Endosonographie, werden dargestellt und ihre diagnostische Wertigkeit im klinischen Kontext erläutert. In Zeiten zunehmender ökonomischer Restriktionen in der Gesundheitspolitik wird es notwendig, die Zahl der präoperativen Untersuchungen beim Tumorstaging zu limitieren, ohne an diagnostischer Genauigkeit einzubüßen. Der Trend geht deshalb immer mehr zum radiologischen „one stop-shopping”, d.h. der vollständigen diagnostischen Abklärung eines Patienten mit nur einer bildgebenden Methode. Diese Rolle wird in Zukunft die Magnetresonanztomographie mit organspezifischen Kontrastmitteln übernehmen, die eine hohe diagnostische Aussagekraft bei der Detektion und beim Staging von Leber- und Pankreasmalignomen besitzt.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-2102
    Keywords: Key words Laryngeal carcinoma • Laryngectomy • Complication • Videofluoroscopy • Pharynx • Aspiration ; Schlüsselwörter Larynxkarzinom • Laryngektomie • Komplikation • Videocinematographie • Pharynx • Aspiration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Durch die Verbesserung der larynxchirurgischen Techniken sowie auch die Entwicklung der adjuvanten Radiochemotherapie ist es meistens möglich, Larynxkarzinompatienten funktionserhaltenden Larynxteilresektionen zuzuführen und früher als inoperabel betrachtete Tumore durch eine totale Laryngektomie kurativ zu resezieren. Radiologische Untersuchungen, insbesondere Pharyngographie und Videocinematographie, sind die wichtigsten Methoden, um postoperative Komplikationen nachzuweisen. In der vorliegenden Übersicht wird die videocinematographische Untersuchungstechnik bei Verdacht auf postoperative Komplikation nach Larynxresektion erklärt. Weiterhin wird das typische radiologische Erscheinungsbild der Früh- und Spätkomplikationen, wie Fisteln, Hämatome, Aspiration, Strikturen, Hypertrophie des pharyngoösophagealen Sphinkters, Tumorrezidive und metachrone Zweittumore gezeigt. Die Videocinematographie ist die sensitivste Untersuchungsmethode, um gleichzeitig funktionelle Störungen des Schluckaktes und strukturelle Veränderungen nach Larynxresektionen nachweisen zu können.
    Notes: Summary In past decades, the surgical techniques for treating laryngeal carcinoma have been vastly improved. For circumscribed tumors, voice-conserving resections are possible and for extensive neoplasms, radical laryngectomy, sometimes combined with chemoradiation, has been developed. Postoperative complications regarding swallowing function are not uncommon. Radiologic examinations, especially pharyngography and videofluoroscopy, are most often used to evaluate patients with complications after laryngeal surgery. An optimized videofluoroscopic technique for evaluation of complications is described. The radiologic appearance of early and late complications, such as fistulas, hematomas, aspiration, strictures, dysfunction of the pharyngoesophageal sphincter, tumor recurrence, and metachronous tumors is demonstrated.
    Type of Medium: Electronic Resource
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