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  • 2000-2004  (576)
  • 1920-1924
  • Schlüsselwörter  (301)
  • Magnetic resonance imaging  (158)
  • MRI  (121)
  • 1
    Electronic Resource
    Electronic Resource
    Bone marrow response in treated patients with Gaucher disease: evaluation by T1-weighted magnetic resonance images and correlation with reduction in liver and spleen volume (2000)
    Springer
    Skeletal radiology 29 (2000), S. 563-571 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Gaucher disease ; MRI ; Enzyme replacement therapy ; Liver ; Spleen ; Bone marrow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Purpose. To determine whether T1-weighted magnetic resonance (MR) images can demonstrate response in the marrow of patients with type 1 Gaucher disease treated with enzyme replacement therapy (ERT) and to determine whether a relationship exists between liver and spleen volume reductions and visible marrow changes. Patients. Forty-two patients with type 1 Gaucher disease were evaluated on at least two occasions. Thirty-two patients received ERT. Of these patients, 15 had a baseline examination prior to the initiation of ERT. The remaining 10 patients did not receive ERT. Design. T1-weighted and gradient recalled echo (GRE) coronal images of the femurs and hips were obtained. Concurrently, liver and spleen volumes were determined using contiguous breath-hold axial gradient-echo images. T1-weighted images of the hips and femurs were evaluated to determine change or lack of change in the yellow marrow. Results. Of the 32 patients receiving ERT, 14 (44%) demonstrated increased signal on T1-weighted images suggesting an increase in the amount of yellow marrow. If only the 15 patients with a baseline examination were considered, the response rate to ERT was 67%. Using Student’s t-test a highly significant correlation (P〈0.005) was found between marrow response and reduction in liver and spleen volume. Conclusions. Marrow changes in patients receiving ERT can be detected by T1-weighted images. This response correlated with reductions in visceral volumes (P〈0.0005).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000276
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  • 2
    Electronic Resource
    Electronic Resource
    Imaging of plant-thorn synovitis (2000)
    Springer
    Skeletal radiology 29 (2000), S. 605-608 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Plant-thorn synovitis ; Monoarticular arthritis ; Elbow ; Magnetic resonance imaging ; Ultrasound ; Power Doppler
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe a case of plant-thorn synovitis of the elbow resulting from a thorn injury. This caused recurrent pain and swelling of the elbow over a 3-month period. A magnetic resonance imaging examination was initially requested to exclude septic arthritis, and demonstrated a joint effusion, synovitis, and a 2-cm linear opacity embedded in the synovium. Ultrasound was performed prior to surgery to confirm these findings and provide accurate localization of the thorn fragment, later removed at surgery. To our knowledge this is the first example of this condition that has been confirmed by radiological imaging prior to surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000244
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  • 3
    Electronic Resource
    Electronic Resource
    MR arthrography of the shoulder and hip after fluoroscopic landmarking (2000)
    Springer
    Skeletal radiology 29 (2000), S. 81-84 
    Details
    ISSN: 1432-2161
    Keywords: Key words Arthrography ; MRI ; Fluoroscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Purpose. To describe a technique for intra-articular injection in the MR suite after conventional fluoroscopic landmarking in order to streamline MR arthrography. Design and patients. This technique was performed on 33 consecutive patients referred for MR arthrography of the shoulder to evaluate the glenoid labrum and on 15 consecutive patients referred for MR arthrography of the hip to evaluate the acetabular labrum. The patients were landmarked in the fluoroscopy suite, followed by a conventional MR examination. The intra-articular injection was then performed on the MR table and the MR arthrographic sequences obtained. Results. One of the 48 injections was extra-articular, requiring a second injection. The other injections were performed without incident, and the average total procedure time for all injections was 10 min. Conclusions. This technique is a reliable method of streamlining intra-articular injections when performing conventional MR imaging prior to the MR arthrographic portion of the examination. It shortens the total MR examination time by eliminating a visit to the fluoroscopy suite in the middle of the MR study, and its use of a straight anterior approach for both the shoulder and hip joints should be familiar to most people who perform conventional arthrography.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050014
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  • 4
    Electronic Resource
    Electronic Resource
    Are magnetic resonance flexion views useful in evaluating the cervical spine of patients with rheumatoid arthritis? (2000)
    Springer
    Skeletal radiology 29 (2000), S. 85-89 
    Details
    ISSN: 1432-2161
    Keywords: Key words Rheumatoid arthritis ; Cervical spine ; Magnetic resonance imaging ; Dynamic imaging ; Flexion views
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To determine whether MR imaging in flexion adds value relative to imaging in the neutral position with respect to displaying involvement of the subarachnoid space, brainstem and spinal cord. Design and patients. T1-weighted MR images of the cervical spine in 42 rheumatoid arthritis patients with cervical spine involvement were obtained and analyzed prospectively. We assessed changes between images obtained in the neutral position and following active flexion, especially horizontal atlantoaxial and subaxial motion, presence or absence of brainstem compression, subarachnoid space involvement at the atlantoaxial and subaxial level and the cervicomedullary angle. Vertical atlantoaxial subluxation and the amount of pannus were correlated with motion and change in subarachnoid space. Results. The flexion images showed horizontal atlantoaxial motion in 21 patients and subaxial motion in one patient. The flexion view displayed brainstem compression in only one patient. Involvement of the subarachnoid space increased at the atlantoaxial level in eight (19%) patients (P=0.004) and at the level below C2 in five (12%) patients (P=0.03). There were no patients with a normal subarachnoid space in neutral position and compression in the flexed position. The cervicomedullary angle changed significantly with flexion. Vertical atlantoaxial subluxation and the amount of pannus did not show a significant correlation with motion or subarachnoid space involvement. Conclusion. MR imaging in the flexed position shows a statistically significant narrowing of the subarachnoid space at the atlantoaxial level and below C2. Cord compression is only observed on flexion views if the subarachnoid space in neutral position is already decreased. MR imaging in the flexed position might be useful, since subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050015
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  • 5
    Electronic Resource
    Electronic Resource
    Elastofibroma of the neck (2000)
    Springer
    Skeletal radiology 29 (2000), S. 109-111 
    Details
    ISSN: 1432-2161
    Keywords: Key words Fat ; Elastofibroma ; Neck ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Elastofibromas are benign lesions of the chest wall. We describe the first reported case of elastofibroma in the neck. Imaging features as well as location of the lesion were atypical. On computed tomography and magnetic resonance imaging the lesion contained a marked preponderance of fat, because the lesion arose within fat.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050021
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  • 6
    Electronic Resource
    Electronic Resource
    Oncogenic osteomalacia (2000)
    Springer
    Skeletal radiology 29 (2000), S. 117-124 
    Details
    ISSN: 1432-2161
    Keywords: Key words Osteomalacia ; Metabolic disease ; Hemangiopericytoma ; Fibrohistiocytic tumors ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The clinical, imaging, metabolic, histologic and biochemical aspects of oncogenic osteomalacia are reviewed. The bone and soft tissue tumor and tumor-like lesions associated with this paraneoplastic syndrome are discussed. The radiologist’s role in the diagnosis and evaluation of this entity is presented.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050581
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  • 7
    Electronic Resource
    Electronic Resource
    Giant distal humeral geode (2000)
    Springer
    Skeletal radiology 29 (2000), S. 165-167 
    Details
    ISSN: 1432-2161
    Keywords: Key words Rheumatoid arthritis ; Geode ; Pathological fracture ; Humerus ; X-ray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050587
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  • 8
    Electronic Resource
    Electronic Resource
    Retroisthmic cleft: a stress fracture of the lamina (2000)
    Springer
    Skeletal radiology 29 (2000), S. 162-164 
    Details
    ISSN: 1432-2161
    Keywords: Key words Retroisthmic cleft ; Stress fracture ; Laminar fracture ; Xray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The retroisthmic cleft is a rarely diagnosed defect in the lamina of the lumbar spine. It has always been considered a congenital anomaly. This is the first report we are aware of showing radiological changes in a retroisthmic cleft over a period of time. The follow-up of this patient over a period of 6 years, the radiological and scintigraphic appearances and a review of the literature suggests that the retroisthmic cleft is a stress fracture of the lamina.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050586
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  • 9
    Electronic Resource
    Electronic Resource
    Unsuspected metastases presenting as solitary soft tissue lesions: a fourteen-year review (2000)
    Springer
    Skeletal radiology 29 (2000), S. 270-274 
    Details
    ISSN: 1432-2161
    Keywords: Key words Soft tissue neoplasm ; Metastasis ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To describe a series of patients with no known primary malignancy who presented with a solitary unsuspected soft tissue metastasis masquerading as a soft tissue sarcoma, and secondarily to describe the imaging appearance of these lesions. Design. Records of two academic hospitals with active orthopedic oncology services were reviewed for patients meeting the above criteria. Clinical charts were examined, and the imaging appearance of the soft tissue lesions retrospectively reviewed. Patients. Of 1421 patients examined for soft tissue lesions, 11 were found who met the above criteria. Results. Of the 11 patients whose initial presentation was a solitary soft tissue metastasis, eight were found to have a primary lung cancer, two were diagnosed with adenocarcinoma of unknown primary, and adenocarcinoma of the colon was discovered in the remaining patient. Conclusions. The clinical presentation of a solitary soft tissue metastasis without a known primary malignancy is a rare occurrence, with an incidence of approximately 0.8%. Lung cancer is the primary neoplasm in a high percentage of these cases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050606
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  • 10
    Electronic Resource
    Electronic Resource
    MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review (2000)
    Springer
    Skeletal radiology 29 (2000), S. 187-195 
    Details
    ISSN: 1432-2161
    Keywords: Key words Clear cell sarcoma ; Malignant melanoma of soft parts ; MRI ; Magnetic resonance ; Neoplasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To evaluate MR imaging and pathology findings in order to define the characteristic features of clear cell sarcoma of the soft tissues (malignant melanoma of the soft parts). Design and patients. MR examinations of 21 patients with histologically proven clear cell sarcoma of the musculoskeletal system were retrospectively reviewed and assessed for shape, homogeneity, delineation, signal intensities on T1- and T2-weighted images, contrast enhancement, relationship with adjacent fascia or tendon, secondary bone involvement, and intratumoral necrosis. In 19 cases the pathology findings were available for review and for a comparative MR-pathology study. Results. On T1-weighted images, lesions were isointense (n=3), hypointense (n=7) or slightly hyperintense to muscle (n=11). Immunohistochemical examination was performed in 17 patients. All 17 specimens showed positivity for HMB-45 antibody. In nine of 11 lesions with slightly increased signal intensity on T1-weighted images, a correlative MR imaging-pathology study was possible. All nine were positive to HMB-45 antibody. Conclusions. Clear cell sarcoma of the musculoskeletal system often has a benign-looking appearance on MR images. In up to 52% of patients, this lesion with melanocytic differentiation has slightly increased signal intensity on T1-weighted images compared with muscle. As the presence of this relative higher signal intensity on T1-weighted images is rather specific for tumors displaying melanocytic differentiation, radiologists should familiarize themselves with this rare entity and include it in their differential diagnosis when confronted with a well-defined, homogeneous, strongly enhancing mass with slightly higher signal intensity compared with muscle on native T1-weighted images.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050592
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  • 11
    Electronic Resource
    Electronic Resource
    Erdheim-Chester disease with intramuscular lipogranuloma (2000)
    Springer
    Skeletal radiology 29 (2000), S. 227-230 
    Details
    ISSN: 1432-2161
    Keywords: Key words Erdheim-Chester Disease ; Lipogranuloma ; MRI ; Muscle ; Rectus femoris
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a rare manifestation of Erdheim-Chester disease with intramuscular lipogranuloma. The patient was a 66-year-old man who noted a soft tissue mass in the right quadriceps femoris muscle. Radiographs revealed symmetrical osteosclerosis in the diametaphysis of both femora and tibiae. An open biopsy revealed a proliferation of lipid-laden histiocytes in the femoral bone marrow and the quadriceps femoris muscle. To our knowledge, this is the second case of Erdheim-Chester disease involving muscle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050598
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  • 12
    Electronic Resource
    Electronic Resource
    MR appearances in a case of femoral ecchinococcosis (2000)
    Springer
    Skeletal radiology 29 (2000), S. 235-238 
    Details
    ISSN: 1432-2161
    Keywords: Key words Femur echinococcosis ; MRI ; echinococcosis ; Hydatid cyst surgery ; Hydatid cyst ; anticestodal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Magnetic resonance (MR) findings of a rare case of osseous echinococcosis with involvement of the femur are described. Attention is drawn to the typical MR appearances and therapeutic management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050600
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  • 13
    Electronic Resource
    Electronic Resource
    Congenital transverse deficiency of the tibia and fibula: a report of two cases (2000)
    Springer
    Skeletal radiology 29 (2000), S. 243-246 
    Details
    ISSN: 1432-2161
    Keywords: Key words Tibial deficiency ; Fibular deficiency ; Congenital hip dislocation ; Transverse limb deficiency ; X-ray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report two similar, but unrelated, patients with congenital bilateral partial deficiencies of the tibia and fibula associated with intact feet. In both patients, the tibia and fibula were absent on initial radiographs, while the femur and the tarsal bones were well developed and there was bilateral teratologic dislocation of the hips. Ultrasound and magnetic resonance imaging (MRI) studies suggested the presence of cartilaginous remnants of the tibia and fibula. There were multidirectional instabilities in the knees and ankles. The clinical and radiological features of these cases are distinct from those of congenital longitudinal deficiency of the tibia, in which the fibula is always preserved, and from longitudinal deficiency of the fibula, in which the tibia is present and the foot is usually involved. We suggest that the bilateral partial deficiencies of the tibia and fibula associated with the intact foot and teratologic dislocation of the hips is a single-entity disorder, possibly categorized as an intercalary transverse deficiency of the lower limb.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050602
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  • 14
    Electronic Resource
    Electronic Resource
    The magnetic resonance imaging of musculoskeletal hemorrhage (2000)
    Springer
    Skeletal radiology 29 (2000), S. 1-9 
    Details
    ISSN: 1432-2161
    Keywords: Key words Soft tissue masses ; Hemorrhage ; MRI ; Iron ; Contrast enhancement, MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Hematomas in the extremities can present clinically as a soft tissue mass. Hematomas can usually be distinguished from neoplasia on MR by the signal patterns of hemoglobin breakdown products, which are dependent on the chemical bonding and oxidation state of hemoglobin iron. Beginning with a discussion of relevant atomic electronic structure, this review will examine how oxyhemoglobin, deoxyhemoglobin, methemoglobin, and hemosiderin, the principal iron compounds occurring in the various stages of a hematoma, affect its appearance on MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050001
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  • 15
    Electronic Resource
    Electronic Resource
    Indirect wrist MR arthrography: the effects of passive motion versus active exercise (2000)
    Springer
    Skeletal radiology 29 (2000), S. 10-14 
    Details
    ISSN: 1432-2161
    Keywords: Key words Wrist ; MR arthrography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Purpose.In the wrist, to determine whether passive motion or active exercise yields a better indirect MR arthrographic effect following intravenous gadolinium administration. Design and patients. Twenty-six consecutive patients were studied by indirect wrist MR arthrography. In half active exercise and in half passive motion was performed. Four regions of interest were studied including the distal radioulnar joint, the radiocarpal joint, the midcarpal joint, and the triangular fibrocartilage. Ranges and means of signal intensity were calculated. Surgical follow-up was performed in 22 patients. Results. The joint fluid intensity was greatest in the distal radioulnar joint. Fluid signal intensity was greater and more consistent in the passive motion group although the results did not achieve statistical significance. Imaging accuracy appeared similar in the two groups and was excellent for the triangular fibrocartilage (100%) and scapholunate ligaments (96%). Conclusion. Active exercise and passive motion yield similar degrees of wrist arthrographic effect, but the effect of passive motion is somewhat more consistent. Preliminary data show good accuracy for internal derangements.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050002
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  • 16
    Electronic Resource
    Electronic Resource
    Type I Gaucher disease: extraosseous extension of skeletal disease (2000)
    Springer
    Skeletal radiology 29 (2000), S. 15-21 
    Details
    ISSN: 1432-2161
    Keywords: Key words Gaucher disease ; Bone disease ; Extraosseous Gaucher disease ; Bone marrow imaging ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To investigate the frequency and morphology of extraosseous extension in patients with Gaucher disease type I. Design and patients. MRI examinations of the lower extremities were analyzed in 70 patients with Gaucher disease type I. Additionally, the thoracic spine and the midface were investigated on MRI in two patients. Results. Four cases are presented in which patients with Gaucher disease type I and severe skeletal involvement developed destruction or protrusion of the cortex with extraosseous extension into soft tissues. In one patient, Gaucher cell deposits destroyed the cortex of the mandible and extended into the masseter muscle. In the second patient, multiple paravertebral masses with localized destruction of the cortex were apparent in the thoracic spine. In the third and fourth patient, cortical destruction with extraosseous tissue extending into soft tissues was seen in the lower limbs. Conclusions. Extraosseous extension is a rare manifestation of Gaucher bone disease. While an increased risk of cancer, especially hematopoietic in origin, is known in patients with Gaucher disease, these extraosseous benign manifestations that may mimic malignant processes should be considered in the differential diagnosis of extraosseous extension into soft tissues. A narrow neck of tissue was apparent in all cases connecting bone and extraosseous extensions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050003
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  • 17
    Electronic Resource
    Electronic Resource
    Subchondral insufficiency fracture of the femoral head and medial femoral condyle (2000)
    Springer
    Skeletal radiology 29 (2000), S. 40-44 
    Details
    ISSN: 1432-2161
    Keywords: Key words Subchondral insufficiency fracture ; Femoral head ; Medial femoral condyle ; Osteonecrosis ; MRI ; X-ray
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line. There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple occurrence of collapsed subchondral insufficiency fracture.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050007
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  • 18
    Electronic Resource
    Electronic Resource
    Cystic fibrous dysplasia mimicking giant cell tumor: MRI appearance (2000)
    Springer
    Skeletal radiology 29 (2000), S. 45-48 
    Details
    ISSN: 1432-2161
    Keywords: Key words Cystic fibrous dysplasia ; Giant cell tumor ; Femur ; X-ray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report the case of a 43-year-old man who presented with an osteolytic and expansive lesion in the left distal femur mimicking a giant cell tumor. Magnetic resonance imaging (MRI) showed that most of the lesion was cystic, and histological examination revealed fibrous dysplasia with marked cystic degeneration. Radiographic findings of cystic fibrous dysplasia in the end of a long bone may be similar to those of a giant cell tumor, and a biopsy is essential for the final diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050008
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  • 19
    Electronic Resource
    Electronic Resource
    Primary hemangiopericytoma of the tibia: MR and angiographic correlation (2000)
    Springer
    Skeletal radiology 29 (2000), S. 49-53 
    Details
    ISSN: 1432-2161
    Keywords: Key words Hemangiopericytoma ; Tibia ; MRI ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The Magnetic Resonance Imaging (MRI) appearances of primary osseous hemangiopericytoma (HPC) have been rarely described. We report on a 46-year-old Chinese man with primary osseous HPC of the right tibia. The characteristic vascular distribution of this tumor, presenting with a ”spoke-wheel” appearance on MR images and with angiographic correlation, is described. Although not pathognomonic, this MR appearance may be an important finding in suggesting the diagnosis of osseous HPC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050009
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  • 20
    Electronic Resource
    Electronic Resource
    Diffusion-weighted imaging of the musculoskeletal system in humans (2000)
    Springer
    Skeletal radiology 29 (2000), S. 555-562 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Diffusion ; MRI ; Skeletal system ; Spine ; neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  This article reviews the principles of diffusion-weighted imaging (DWI) and recent results in DWI of the musculoskeletal system. The potential of DWI in the diagnosis of pathology of the musculoskeletal system is discussed. DWI is a relatively new MR imaging technique that has already been established in neuroradiology, especially in the early detection of brain ischemia. The random motion of water protons on a molecular basis can be measured with DWI. To date DWI of the abdomen and of the musculoskeletal system has only been employed in scientific studies, but first results indicate that it may also be beneficial in these fields. Different diffusion characteristics have been found in normal tissues such as muscle, fat and bone marrow. Also, pathologic entities such as neoplasms, post-therapeutic soft tissue changes and inflammatory processes can be differentiated. Normal muscle shows significantly higher diffusion values than subcutaneous fat and bone marrow, due to a higher mobility of water protons within muscle. Soft tissue tumors exhibit a significantly lower diffusion value compared with post-therapeutic soft tissue changes and inflammatory processes. Necrotic tumor tissue can be distinguished from viable tumor due to significantly higher diffusion of water protons within necrotic tissue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000243
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  • 21
    Electronic Resource
    Electronic Resource
    Telangiectatic dedifferentiation of a parosteal osteosarcoma (2000)
    Springer
    Skeletal radiology 29 (2000), S. 597-600 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Parosteal osteosarcoma ; Telangiectatic osteosarcoma ; Dedifferentiation ; Femur ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A unique case of parosteal osteosarcoma (POS) of the proximal femur, with areas of telangiectatic dedifferentiation, in a 28-year-old woman is reported. The patient had a 7-week history of pain and swelling in her right thigh. A biopsy diagnosis of POS was established. The patient was treated with two cycles of intra-arterial chemotherapy, followed by limb salvage surgery. Histological examination of the resected specimen showed POS with areas of dedifferentiation composed of high-grade telangiectatic osteosarcoma with associated secondary aneurysmal bone cyst change.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000247
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  • 22
    Electronic Resource
    Electronic Resource
    Malignant round cell tumours of bone: atypical clinical and imaging features (2000)
    Springer
    Skeletal radiology 29 (2000), S. 646-651 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Ewing sarcoma ; Primitive neuroectodermal tumour ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective.To describe the clinical, radiological and MRI features of six atypical cases of histologically proven appendicular Ewing sarcoma/ primitive neuroectodermal tumour (PNET). Design. Retrospective review of case notes and available imaging was carried out. Patients. Six patients (4 male, 2 female; mean age 27years, range 19–44 years), presenting over a 77-month period, were identified from the Bone Tumour Register. All had unusual clinical and imaging features for Ewing sarcoma/PNET. Results and conclusions. Four tumours were centred on the distal femoral metaphysis, one in the proximal tibial metaphysis and one in the distal tibial metaphysis. Plain radiographs were available in four cases and showed minor cortical changes. MRI demonstrated a relatively small, eccentrically located intraosseous component with a large, eccentric extraosseous component. Extension into the epiphysis was seen in three cases and into the adjacent joint in two cases. Intraosseous ”skip” metastases were present in three cases. The clinical and imaging features were atypical for conventional intraosseous Ewing sarcoma/PNET and the exact site of origin (intraosseous, periosteal or soft-tissue) was unclear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000277
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  • 23
    Electronic Resource
    Electronic Resource
    Osteoblastoma-like osteosarcoma (2000)
    Springer
    Skeletal radiology 29 (2000), S. 656-659 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Osteoblastoma-like osteosarcoma ; Osteosarcoma ; Aggressive osteoblastoma ; Fibula ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report an osteoblastoma-like osteosarcoma in the right proximal fibula in a 22-year-old woman. Radiographs showed an irregular osteolytic lesion from the metaphysis to the epiphysis in the proximal fibula with partial destruction of cortical bone. Tissue from a biopsy indicated a typical osteoblastoma. Curettage and bone graft was performed. One year after the surgery, local recurrence occurred, and a wide excision was performed. Histological examination of the en-bloc surgical specimen revealed the tumor had permeated through the host bony trabeculae, although the nuclear atypia was not marked. Immunohistochemical expression of MIB-1 was detected in 9.0% of cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000271
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  • 24
    Electronic Resource
    Electronic Resource
    Tunneling Schmorl’s nodes in an elderly woman treated for acute lymphoblastic leukemia (2000)
    Springer
    Skeletal radiology 29 (2000), S. 660-663 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Acute lymphoblastic leukemia ; Chemotherapy ; Spine ; Tunneling Schmorl’s nodes ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom serial imaging studies showed the development of multiple vertebral collapse, and communicating superior and inferior Schmorl’s nodes creating a longitudinal channel (”tunneling” Schmorl’s nodes) through the anterior aspect of T12 to L3 vertebral bodies of her osteoporotic thoracolumbar spine. This was observed after achieving complete remission of the disease and during maintenance therapy. The finding is felt to be secondary to iatrogenic exacerbation of osteoporosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000272
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  • 25
    Electronic Resource
    Electronic Resource
    Mid-foot reconstruction following involvement of five bones by giant cell tumor (2000)
    Springer
    Skeletal radiology 29 (2000), S. 664-667 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Giant cell tumor ; Multiple mid-foot bones ; Reconstructive surgery ; Radiography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000274
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  • 26
    Electronic Resource
    Electronic Resource
    Intra-articular membranous interposition detected by MRI in developmental dysplasia of the hip (2000)
    Springer
    Skeletal radiology 29 (2000), S. 726-728 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Developmental dysplasia ; Hip ; Membrane ; Interposition ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intra-articular membranous interposition was detected by MRI in the hip joint with residual subluxation of a girl aged 5 years 10 months. This structure, which had low signal intensity on both T1- and T2-weighted images, separated the femoral head from the acetabulum. Histological examination revealed chondrometaplasia, which suggested that this interposition might be transformed to a surface cartilaginous tissue of the secondary acetabulum often observed in residual subluxation of the hip.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000293
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  • 27
    Electronic Resource
    Electronic Resource
    Popliteal amyloidoma presenting with leg ischemia in a chronic dialysis patient (2000)
    Springer
    Skeletal radiology 29 (2000), S. 717-720 
    Details
    ISSN: 1432-2161
    Keywords: Keywords Amyloidoma ; Bilateral ; Knee ; Popliteal fossa ; Claudication ; MRI ; MR angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The authors report a case of bilateral popliteal amyloidoma causing stenosis of the popliteal artery and vein. This patient had been treated with hemodialysis for 26 years. The diagnosis was made with MR angiography. A popliteal tumor of the right knee was resected surgically and the histologic examination showed deposition of amyloid. After resecting the popliteal tumor, the severe leg pain and intermittent claudication improved. This report suggests that popliteal amyloid tumors should be considered in a patient undergoing long-term hemodialysis who complains of leg pain and intermittent claudication.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000282
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  • 28
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    Electronic Resource
    Sarcomatoid chordoma: chordoma with a massive malignant spindle-cell component (2000)
    Springer
    Skeletal radiology 29 (2000), S. 721-725 
    Details
    ISSN: 1432-2161
    Keywords: Key words Chordoma ; Sarcomatoid chordoma ; Transitional feature ; Sacrum ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a case of chordoma containing a spindle cell sarcomatoid component with a gradual transition from conventional chordoma. Immunohistochemically, many tumor cells in both conventional chordoma and sarcomatoid components were positive for cytokeratins (AE1/AE3, CAM5.2) and epithelial membrane antigen as well as vimentin. This report provides a rare example of sarcomatoid chordoma. Familiarity with this type of bone tumor should help to avoid confusion with dedifferentiated chordoma and other spindle cell sarcomas or carcinomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000264
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  • 29
    Electronic Resource
    Electronic Resource
    Intra-articular regional migratory osteoporosis of the knee (2000)
    Springer
    Skeletal radiology 29 (2000), S. 97-100 
    Details
    ISSN: 1432-2161
    Keywords: Key words Transient osteoporosis ; Transient bone marrow edema ; Intra-articular regional migratory osteoporosis ; Knee ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a case of lntra-articular regional migratory osteoporosis of the knee in a 53-year-old man. The case demonstrates an unusual pattern of migration of the marrow edema within the knee joint. This phenomenon has received scant attention in the radiological literature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050018
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  • 30
    Electronic Resource
    Electronic Resource
    Dumb-bell-type teratoma in the lumbar spine (2000)
    Springer
    Skeletal radiology 29 (2000), S. 104-108 
    Details
    ISSN: 1432-2161
    Keywords: Key words Adult teratoma ; Dumb-bell type tumor ; Lumbar spine ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a case of a lumbar teratoma in a 50-year-old woman. The teratoma showed a dumb-bell-type expansion at the level of the left L3/4 foramen with massive erosion of the L3 vertebral body. MRI revealed inhomogeneous signal changes in the tumor, which were histologically compatible with a mixture of bone, muscle, fat, and cyst containing sebaceous material. Complete resection of the tumor and spinal arthrodesis with pedicle screw fixation was necessary to obtain stability of the affected spinal segment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050020
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  • 31
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    Electronic Resource
    Desmoplastic fibroma of bone: MRI features (2000)
    Springer
    Skeletal radiology 29 (2000), S. 171-175 
    Details
    ISSN: 1432-2161
    Keywords: Key words Desmoplastic fibroma ; Bone tumor ; Femur ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Desmoplastic fibroma of bone is a very rare benign tumor, which may be locally aggressive. In contrast to the well-documented radiological appearance, the literature on MR imaging features of this tumor is scarce. The MR imaging characteristics in our case are compared to those previously reported. Although there is a considerable overlap in the MR imaging features with other bone tumors, an interesting MR feature of desmoplastic fibroma is the presence of low to intermediate signal intensity foci on T2-weighted images, which radiographically does not correspond to calcifications. This feature may help narrow the differential diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050589
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  • 32
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    Electronic Resource
    Chondromyxoid fibroma of the acromium with soft tissue extension (2000)
    Springer
    Skeletal radiology 29 (2000), S. 168-170 
    Details
    ISSN: 1432-2161
    Keywords: Key words Chondromyxoid fibroma ; Acromium ; Soft tissue extension ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chondromyxoid fibroma is an unusual, benign tumor of cartilaginous origin and represents less than 1% of all primary bone tumors. It usually involves the long bones around the knee joint or the flat bones of the pelvis or ribs. Soft tissue extension is also thought to be rare in these lesions. They are usually eccentrically located in the metaphyses of the long bones and centrally in the flat bones. The radiographic appearances are characteristically those of a single, lytic lesion with lobulated margins, septations, cortical expansion and a sclerotic rim. Histologically, they display a lobulated pattern with spindle-shaped cells lying within a myxoid matrix with areas of hyaline cartilage. The differential diagnosis includes giant cell tumor, chondroblastoma or enchondroma as well as chondrosarcoma. The rarity of these lesions may render the diagnosis difficult to make, especially when the lesion involves an unusual site such as the acromium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050588
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  • 33
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    Electronic Resource
    Intraosseous schwannoma of the metacarpal (2000)
    Springer
    Skeletal radiology 29 (2000), S. 224-226 
    Details
    ISSN: 1432-2161
    Keywords: Key words Intraosseous neurilemmoma (schwannoma) ; Primary bone neoplasm ; Metacarpal ; X-ray ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Intraosseous schwannoma (neurilemmoma) is an extremely rare, benign neoplasm, constituting less than 0.2% of primary bone tumors. It infrequently involves the bones of the hand. We present a case of intraosseous neurilemmoma of the metacarpal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050597
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  • 34
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    Electronic Resource
    Hemangioma of bone arising in the ulna: imaging findings with emphasis on MR (2000)
    Springer
    Skeletal radiology 29 (2000), S. 231-234 
    Details
    ISSN: 1432-2161
    Keywords: Key words Hemangioma ; Ulna ; CT ; MRI ; X-ray
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  An 18-year-old woman presented with left elbow joint pain. Radiographs and computed tomographic scan showed a well-defined osteolytic lesion of the left ulna associated with a honeycomb appearance on the radiographs. Magnetic resonance images showed intermediate signal intensity on T1-weighted images and mixed intermediate and high signal intensities on T2-weighted images. Only the periphery of the lesion enhanced with intravenously injected gadolinium-diethylenetriamine pentaacetic acid. The lesion was curetted to avoid pathologic fracture, and a histologic diagnosis of cavernous hemangioma of bone was made. Hemangioma involving the ulna is rare, but should be included in the differential diagnosis of a radiographic osteolytic lesion with a honeycomb appearance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050599
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  • 35
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    Electronic Resource
    Effect of low back posture on the morphology of the spinal canal (2000)
    Springer
    Skeletal radiology 29 (2000), S. 217-223 
    Details
    ISSN: 1432-2161
    Keywords: Key words Spinal canal ; Low back posture ; Morphologic change ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To define the possible mechanism of posture-dependent symptoms of spinal stenosis by measuring the effect of low back posture on morphologic changes of the intervertebral discs and spinal canal in healthy young people. Design.Twenty healthy young volunteers underwent magnetic resonance imaging while supine with their spine in neutral, flexed, extended, and right and left rotational positions. The axial MR images at the middle of the intervertebral discs of L3–4 and L4–5 were analyzed to measure the difference in the size and shape of the intervertebral discs and spinal canal in each posture. Results.  Extension or rotation decreased the sagittal diameters and cross-sectional areas of the dural sac and spinal canal and increased the thickness of the ligamentum flavum, whereas flexion had the opposite effects. The gap between the convex posterior disc margin and the anterior margin of the facet joint on each side, represented as the subarticular sagittal diameter, increased with flexion and decreased with extension or rotation. The direction of rotation did not result in asymmetry of the subarticular sagittal diameter, but right rotation caused thickening of the right ligamentum flavum, and vice versa. The shape and dimensions of the disc did not change significantly according to the positions of the low back. Conclusions.With extension or rotation, the thickness of the ligamentum flavum increased and the posterior margin of the intervertebral disc was approximated to the facet joint without any change in shape and size of the disc. These phenomena result in a decrease in the size of the spinal canal and dural sac in extension or rotation postures in young healthy people without disc degeneration, and may explain the posture-dependent symptom of spinal stenosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050596
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  • 36
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    Electronic Resource
    Angiomyolipoma arising in the thigh (2000)
    Springer
    Skeletal radiology 29 (2000), S. 293-297 
    Details
    ISSN: 1432-2161
    Keywords: Key words Angiomyolipoma (AML) ; Soft tissue ; Thigh ; MRI ; CT ; Angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A 41-year-old man presented with an asymptomatic mass in the right medial thigh. Magnetic resonance imaging (MRI) revealed a well-demarcated, 10-cm mass in the right adductor muscles. The margins of the mass exhibited high signal intensity and the rest showed low or iso signal intensity on T1-weighted MR images. However, the high signal intensity was decreased on T2-weighted images with fat suppression. The central part of the tumor was of inhomogeneous high signal intensity on T2-weighted images; after Gd-DTPA injection it enhanced inhomogeneously on T1-weighted images with fat suppression. On dynamic computed tomography (CT) in the arterial phase, there were strongly enhancing spotty areas in the tumor. At surgery, a yellow-whitish tumor was resected and a pathological diagnosis of angiomyolipoma (AML) in the thigh was made.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050612
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  • 37
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    Electronic Resource
    Bilateral metachronous periosteal tibial amyloid tumors (2000)
    Springer
    Skeletal radiology 29 (2000), S. 346-348 
    Details
    ISSN: 1432-2161
    Keywords: Key words Amyloid tumor ; Tibia ; Periosteum ; Bilateral ; MRI ; Bilateral metachronous periosteal tibial amyloid tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Localized primary periosteal amyloid tumors are extremely rare. A case of bilateral tibial amyloid tumor is presented. A 62-year-old woman initially presented with a painful mass in the anterior aspect of the right leg. There was no evidence of underlying systemic disease, including chronic infection or malignancy. Based on the results of resistance with Congo red staining to treatment with potassium permanganate and positivity for kappa light chain, we classified this particular case as AL-type amyloidosis. The patient noticed a swelling in the opposite leg 2 years later. The second tumor was also an AL-type amyloidoma. Amyloid tumors are generally solitary. This is the first case of bilateral periosteal amyloid tumors of the AL-type occurring in the tibiae.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000215
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  • 38
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    Electronic Resource
    Complete rupture of the distal semimembranosus tendon with secondary hamstring muscles atrophy: MR findings in two cases (2000)
    Springer
    Skeletal radiology 29 (2000), S. 362-364 
    Details
    ISSN: 1432-2161
    Keywords: Key words Hamstring muscles ; Semimenbranosus ; Tear ; mass ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Complete rupture of the hamstring muscles is a rare injury. The proximal musculo-tendinous junction is the most frequent site of rupture. We present two cases of complete rupture of the distal semimenbranosus tendon, which clinically presented as soft-tissue masses. MR imaging permitted the correct diagnosis. There has been only one other such case reported.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000216
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  • 39
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    Electronic Resource
    Sonographic evaluation of digital annular pulley tears (2000)
    Springer
    Skeletal radiology 29 (2000), S. 387-391 
    Details
    ISSN: 1432-2161
    Keywords: Key words Trauma ; Hand ; Sonography ; Ultrasound ; Annular pulleys ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To evaluate the sonographic (US) appearance of digital annular pulley (DAP) tears in high-level rock climbers. Design and patients. We performed a retrospective analysis of the US examinations of 16 high-level rock climbers with clinical signs of DAP lesions. MRI and surgical evaluation were performed in five and three patients respectively. The normal US and MRI appearances of DAP were evaluated in 40 and three normal fingers respectively. Results. Nine of 16 patients presented a DAP tear. In eight subjects (seven with complete tears involving the fourth finger and one the fifth finger), US diagnosis was based on the indirect sign of volar bowstringing of the flexor tendons. Injured pulleys were not appreciated by US. Tears concerned the A2 and A3 in six patients and the A3 and A4 in two patients. A2 pulley thickening and hypoechogenicity compatible with a partial tear was demonstrated in one patient. MRI and surgical data correlated well with the US findings. Four patients had tenosynovitis of the flexor tendons but no evidence of pulley disruption. US examinations of three patients were normal. In the healthy subjects US demonstrated DAP in 16 of 40 digits. Conclusion. US can diagnose DAP tears and correlates with the MRI and surgical data. Because of its low cost and non-invasiveness we suggest US as the first imaging modality in the evaluation of injuries of the digital pulley.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000226
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  • 40
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    Electronic Resource
    Chronic post-traumatic osteomyelitis of the lower extremity: comparison of magnetic resonance imaging and combined bone scintigraphy/immunoscintigraphy with radiolabelled monoclonal antigranulocyte antibodies (2000)
    Springer
    Skeletal radiology 29 (2000), S. 378-386 
    Details
    ISSN: 1432-2161
    Keywords: Key words Bones ; infection ; Bones ; radionuclide studies ; MRI ; comparative studies ; Bones ; MRI studies ; MRI ; extremities ; Bones ; immunoscintigraphy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. A retrospective study of the validity of combined bone scintigraphy (BS) and immunoscintigraphy (IS) using 99mTc-labelled murine antigranulocyte antibodies (MAB) and magnetic resonance imaging (MRI) in chronic post- traumatic osteomyelitis. Design and patients. The results of MRI and combined BS/IS of 19 lesions in 18 patients (13 men, 5 women; mean age 45 years, range 27–65 years) were independently evaluated by two radiologists and one nuclear medicine physician with regard to bone infection activity and extent. The patient group was a highly selective collection of clinical cases: the average number of operations conducted because of relapsing infection was eight (range 2–27), the average time interval between the last surgical intervention and the present study was 6.5 years (range 3 months to 39 years), and from the first operation was 14 years (range 1.5–42 years). Interobserver agreement on MRI was measured by kappa statistics. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated for MRI and the nuclear medicine studies. Results. For MRI/nuclear medicine, a sensitivity of 100%/77%, a specificity of 60%/50%, an accuracy of 79%/61%, a PPV of 69%/58% and a NPV of 100%/71% were calculated. Four MR examinations were false positives because of postsurgical granulation tissue. A high degree of interobserver agreement was found on MRI (κ=0.88). A low-grade infection was missed on two scintigrams, while four were false positive because of ectopic haematopoietic bone marrow, and in one examination the anatomical distortion resulted in an inaccurate assignment of the uptake leading to false positive findings. Image analysis was frequently hindered by susceptibility artefacts due to residual abrasions of metallic implants after removal of orthopaedic devices (15/18 patients); this led to limited assessment in 17% (3/18 patients). Conclusion. Acute activity in a chronic osteomyelitis can be excluded with high probability if the MRI findings are negative. In the first postoperative year fibrovascular scar cannot be distinguished accurately from reactivated infection on MRI and scintigraphy may improve the accuracy of diagnosis. MRI is more sensitive in low-grade infection during the later course than combined BS/IS. Scintigraphic errors due to ectopic, peripheral, haematopoietic bone marrow can be corrected by MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000228
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  • 41
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    Tuberculosis of the sternum and clavicle: imaging findings in 15 patients (2000)
    Springer
    Skeletal radiology 29 (2000), S. 447-453 
    Details
    ISSN: 1432-2161
    Keywords: Key words Tuberculosis ; Sternum ; Clavicle ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To describe the imaging findings in sterno-clavicular tubercular involvement. Design and patients. Fifteen patients with pathologically proven tuberculosis of the sternum and clavicle were retrospectively evaluated. Routine radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical information and imaging features were evaluated in each case. Results. Eight patients had sterno-clavicular joint (SCJ) involvement, five had isolated sternal involvement and two had isolated clavicular involvement. Seven patients were evaluated with only CT, six with only MRI and two with both. There were eight male and seven female patients, varying in age between 16 and 78 years. Fever, swelling and pain were common presenting symptoms. Two patients were HIV positive. Radiographs were positive in only eight patients. Destruction and signal intensity (SI) changes of the sternum and clavicle, destruction of the cartilage, soft tissue changes representing granulation tissue/abscess, displacement of the adjacent structures (vessels, trachea, etc.) and inflammatory changes in the adjacent structures in the form of cellulitis and myositis were common imaging features. Conclusions. All imaging methods can provide complementary information regarding sterno-clavicular tubercular involvement that is helpful for determination of the therapy. MRI is useful in determining the extent of the lesion, particularly marrow involvement and soft tissue extent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000207
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  • 42
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    Diabetic muscle infarction: atypical MR appearance (2000)
    Springer
    Skeletal radiology 29 (2000), S. 477-480 
    Details
    ISSN: 1432-2161
    Keywords: Key words Diabetes mellitus ; Muscle, infarction ; Short T1 ; Hemorrhage ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We describe a case of diabetic muscle infarction which had atypical features of hyperintensity of the affected muscle on T1-weighted images. Biopsy was performed which revealed diffuse extensive hemorrhage within the infarcted muscle. We believe increased signal intensity on T1-weighted images should suggest hemorrhage within the infarcted muscle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000246
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  • 43
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    Electronic Resource
    Solid aneurysmal bone cyst in the humerus (2000)
    Springer
    Skeletal radiology 29 (2000), S. 470-473 
    Details
    ISSN: 1432-2161
    Keywords: Key words Aneurysmal bone cyst ; Humerus ; Giant cell reparative granuloma ; Pathological fracture ; Radiography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a 69-year-old woman with a solid variant of aneurysmal bone cyst (solid ABC) in the left humerus with a pathological fracture. Radiographically, the lesion exhibited a relatively well-defined osteolytic lesion in the diaphysis of the left humerus. On magnetic resonance (MR) imaging, the medullary lesion exhibited a homogeneous signal intensity isointense with surrounding normal muscles on the T1-weighted images and a mixture of low and high signal intensity on the T2-weighted images. Contrast-enhanced T1-weighted images revealed diffuse enhancement of the entire lesion. The pathological study showed a proliferation of fibroblasts, histiocytes, chronic inflammatory cells and numerous multinucleated giant cells in a collagenous matrix. Abundant osteoid formation in the matrix was observed, but the cells were devoid of nuclear atypia. Aneurysmal cystic cavities were absent. A review of the English literature found 22 cases of solid ABC of the long bones.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000236
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  • 44
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    Multimodality imaging assessment of meniscal ossicle (2000)
    Springer
    Skeletal radiology 29 (2000), S. 481-484 
    Details
    ISSN: 1432-2161
    Keywords: Key words Meniscal ossicles ; Ultrasound ; CT-arthrography ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of meniscal ossicles occurring in the left knee of a 23-year-old woman is presented. Radiographs showed two calcified lesions at the posteromedial aspect of the knee which were interpreted as loose bodies. Sonography, computed tomography arthrography and magnetic resonance imaging showed the fragments within the posterior horn of the medial meniscus permitting a diagnosis of meniscal ossicles. These techniques can detect meniscal ossicles and exclude intra-articular loose bodies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000235
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    Juxta-articular hemangioma of long bone (2000)
    Springer
    Skeletal radiology 29 (2000), S. 535-537 
    Details
    ISSN: 1432-2161
    Keywords: Key words Computed tomography ; Intraosseous hemangioma ; Magnetic resonance imaging ; Epiphysis equivalent ; Tibia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report on a rare case of an intraosseous hemangioma involving the proximal tibia in a 70-year-old man. Radiographically, the lesion was a well-defined osteolytic lesion with marginal sclerosis. The CT images demonstrated a well-defined osteolytic lesion with partial cortical breakthrough. T1-weighted MR images showed a hypointense lesion, while T2-weighted images revealed hyperintense areas, with internal, hypointense septa. Gadolinium-enhanced T1-weighted images showed lattice-like enhancement of the lesion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000256
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  • 46
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    Metastatic bone tumor mimicking spontaneous osteonecrosis of the medial condyle of the femur: misleading appearance on MR imaging (2000)
    Springer
    Skeletal radiology 29 (2000), S. 286-288 
    Details
    ISSN: 1432-2161
    Keywords: Key words Metastatic bone tumor ; Knee ; Spontaneous osteonecrosis ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We report a case of a metastatic bone tumor that mimicked spontaneous osteonecrosis of the medial condyle of the femur on magnetic resonance imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050610
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  • 47
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    Chronic ulceration of the leg following extensive scarring due to a snake bite complicated by squamous cell carcinoma (2000)
    Springer
    Skeletal radiology 29 (2000), S. 298-301 
    Details
    ISSN: 1432-2161
    Keywords: Key words Chronic leg ulcers ; Squamous cell carcinoma ; Malignancy ; Snake bite ; X-rays ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chronic ulcers of the leg are common in Brazil, perhaps more common than in the developed world. We report a case of a chronic ulcer of the leg following extensive scarring due to a bite by a venomous snake, which eventually led to a squamous cell carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560050613
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  • 48
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    Pectoralis major muscle and tendon tears: diagnosis and grading using magnetic resonance imaging (2000)
    Springer
    Skeletal radiology 29 (2000), S. 305-313 
    Details
    ISSN: 1432-2161
    Keywords: Key words Pectoralis major muscle ; Magnetic resonance imaging ; Tendons ; injuries ; Tendons ; magnetic resonance imaging ; Muscles ; injuries ; Muscles ; magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To assess the accuracy and utility of magnetic resonance (MR) imaging in the detection and grading of pectoralis major muscle and tendon tears. Design and patients. A retrospective review was carried out of 10 patients referred for MR imaging for suspected pectoralis muscle injury and possible operative therapy. The pectoralis muscle and tendon were imaged using thin (3–4 mm) axial sections with a variety of sequences combined for anatomical delineation (T1-weighted SE or PD SE) and fluid detection (T2-weighted SE, T2-weighted FSE with fat suppression, or STIR). Surgical correlation was available in six patients. Clinical follow-up was available in four patients treated by nonoperative therapy. Results. MR imaging identified five complete tears, four partial tears and one normal tendon. One complete and one partial tear were at the myotendinous junction. The remaining seven injuries were at the enthesis. Surgical correlation consisted of five complete tears and one partial tear. One complete and one partial tear were at the myotendinous junction with the remaining four complete tears at the enthesis. The MR interpretation and surgical findings were in agreement in all six cases. All four patients treated with nonoperative therapy demonstrated improvement at a clinical follow-up examination, with restoration of function and strength consistent with a healed prior partial injury. Conclusion. MR imaging is accurate and useful in detecting and grading tears involving the pectoralis major muscle and tendon, facilitating the identification of patients with complete tears who are candidates for operative therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000199
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  • 49
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    Electronic Resource
    Intraosseous microcystic meningioma (2000)
    Springer
    Skeletal radiology 29 (2000), S. 354-357 
    Details
    ISSN: 1432-2161
    Keywords: Key words Intraosseous meningioma ; Microcystic meningioma ; Parietal bone ; X ray ; CT ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Extradural ectopic meningioma is a rare tumor. We report on an example of microcystic meningioma arising in the skull of an elderly woman. Radiological examination revealed a localized osteolytic lesion in the left parietal bone. At surgery, it was discovered that the tumor was located within the skull without any evidence of extraosseous extension. The light microscopic, immunohistochemical and ultrastructural features were consistent with a microcystic variant of meningioma. To our knowledge, this is the first case of an intraosseous microcystic meningioma, and we believe that this type of meningioma should be considered in the differential diagnoses of myxoid bone tumors of the calvarium.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000217
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  • 50
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    Imaging in isolated sacral tuberculosis: a review of 15 cases (2000)
    Springer
    Skeletal radiology 29 (2000), S. 392-396 
    Details
    ISSN: 1432-2161
    Keywords: Key words Sacral ; Tuberculosis ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To review imaging studies of isolated involvement of the sacrum due to tuberculosis and determine the role of imaging in the diagnosis and management of these patients. Design and patients. A retrospective analysis of 15 cases of isolated sacral tuberculosis imaged with MR imaging was performed. The CT images were also reviewed where available, and the various lesion characteristics were identified. We also reviewed the medical records in an attempt to determine the impact of the imaging studies on the management of these patients. Results. Fifteen patients (5 male, 10 female) presented with symptoms of 3–15 months’ duration. Chronic localized backache with muscle spasm was the commonest presenting symptom; discharging sinuses with abscess formation was found in six patients, five of whom were children. MR imaging of the sacrum revealed a hypointense marrow signal on T1-weighted images and hyperintense signal on T2-weighted images in 14 of 15 patients, the S2 vertebra being always involved. CT revealed osteolytic changes in the sacrum in all the five patients in whom CT was performed. All patients showed marked clinical improvement within 1 year of anti-tuberculous chemotherapy. Conclusion. Isolated tuberculosis of the sacrum is uncommon but should be suspected in patients presenting with chronic low backache or children with discharging sinuses/abscesses and showing sacral destruction on CT or MR imaging. MR imaging can identify cases and enables early institution of anti- tuberculous chemotherapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000229
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  • 51
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    Subcutaneous and musculoskeletal sparganosis: imaging characteristics and pathologic correlation (2000)
    Springer
    Skeletal radiology 29 (2000), S. 402-408 
    Details
    ISSN: 1432-2161
    Keywords: Key words Soft tissue ; Magnetic resonance imaging ; Sparganosis ; Sparganosis ; magnetic resonance imaging ; Sparganosis ; ultrasonography ; Parasitic infection ; Sparganum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Objective. To document the imaging characteristics of subcutaneous and musculoskeletal sparganosis. Design and patients. Ten patients with musculoskeletal sparganosis were examined, with a variety of imaging modalities including MRI (n=6), ultrasonography (n=8), plain radiography (n=7) and CT (n=1). Pathologic correlation was carried out in all cases. Results. Nine lesions involved soft tissues, of which seven were in the thigh, two in the trunk and one involved a vertebral body. The majority of the lesions in soft tissue were confined to the subcutaneous layer but two extended deep into underlying muscles. Sonography revealed low-echoic serpiginous tubular tracts (8/8), and an intraluminal echogenic structure (4/8). MRI revealed multiple serpiginous tubular tracts and peripheral rim enhancement. Two patients showed perilesional soft tissue edema. Pathologically, the lesion consisted of a larva surrounded by three layers of inflammation: an inner epithelioid granulomatous cell layer, middle chronic inflammatory cell layers, and an outer fibrous layer. Conclusion. The study suggests that if serpiginous tubular tracts are seen at imaging studies, musculoskeletal sparganosis should be included in the differential diagnosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000206
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  • 52
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    Electronic Resource
    Collagenous fibroma of the arm: a report of two cases (2000)
    Springer
    Skeletal radiology 29 (2000), S. 417-420 
    Details
    ISSN: 1432-2161
    Keywords: Key words Arm ; Collagenous fibroma ; Desmoplastic fibroblastoma ; Short T2 ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A recently proposed addition to fibrous tumors in soft tissue was first described as desmoplastic fibroblastoma and later renamed collagenous fibroma. This tumor is clinically and morphologically distinct and benign. However, only a few series have been reported, and the clinicopathologic features are not widely recognized. We present two cases of collagenous fibroma of the arm. Both patients presented with an enlarging, well-circumscribed and mobile soft tissue mass. Magnetic resonance imaging showed areas of low signal intensity on both T1- and T2-weighted sequences. Needle aspiration cytology revealed nondiagnostic samples because of the low cellularity of the tumors. Each of the resected tumors was composed of low-cellular spindle- to stellate-shaped cells in a fibrous matrix with clear margination. After the marginal excisions, no recurrences were observed. Clinicians should be aware of this entity to prevent overtreatment, because imaging findings and cytologic features are similar to those of desmoid tumor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000223
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  • 53
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    MRI in inflammatory myopathies (2000)
    Springer
    Skeletal radiology 29 (2000), S. 425-438 
    Details
    ISSN: 1432-2161
    Keywords: Key words Muscles ; MRI ; Myositis ; Muscles ; Abscess ; Dermatomyositis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Inflammatory myopathies encompass a group of acquired muscle disorders caused by infectious agents (bacteria, viruses, fungi and parasitic agents) or autoimmune processes (polymyositis, dermatomyositis and other types). In suspected infection sonography, CT and MRI are all able to show edema and fluid collections in soft tissues and muscles; sonography and CT may help guidance of a needle aspiration to establish a correct diagnosis. By offering better tissue differentiation, MRI appears to be more efficient than sonography and CT in diagnosing and managing autoimmune myopathies. MRI is indeed very sensitive to the presence of water and edema, and appears to be a very good indicator for an early diagnosis of diseases. MRI may also help to evaluate the extent and number of lesions, to guide a biopsy in an area of active disease and finally to follow the evolution under therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000238
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  • 54
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    Chondro-osseous differentiation in fat tissue tumors: magnetic resonance imaging with pathological correlation (2000)
    Springer
    Skeletal radiology 29 (2000), S. 459-465 
    Details
    ISSN: 1432-2161
    Keywords: Key words Chondrolipoma ; Liposarcoma ; Mesenchymoma ; Cartilage ; Metaplasia ; MRI
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Chondro-osseous differentiation of three benign or malignant fat tissue tumors – two chondrolipomas and a liposarcoma with cartilaginous metaplasia – was studied with magnetic resonance (MR) imaging and compared with their pathological findings. The results suggest that demarcation of cartilage tisssue can be clearly defined on MR imaging when the size of the cartilaginous area is large. Myxoid matrix, degenerative fat tissue and lipodystrophic change may decrease the delineation of the cartilage tissue.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000241
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  • 55
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    Juxtacortical chondromyxoid fibroma arising in an apophysis (2000)
    Springer
    Skeletal radiology 29 (2000), S. 466-469 
    Details
    ISSN: 1432-2161
    Keywords: Key words Bone neoplasm ; Chondromyxoid fibroma ; Femur ; Apophysis ; Radiography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  We present a rare case of juxtacortical chondromyxoid fibroma arising in the lesser trochanter of the right femur which corresponds to an apophysis. Radiography showed a well-defined expansive lesion with a sclerotic margin measuring 5×3.5 cm in diameter in the lesser trochanter. On spin echo T1-weighted images, the lesion revealed low signal intensity similar to muscle. On spin echo T2-weighted images, the lesion revealed high heterogeneous signal intensity, which after gadolinium injection showed heterogeneous enhancement. The inner margin of the cortex was intact and adjacent bone marrow was of normal signal intensity. The outer margin of the lesion was also clearly defined and extension into adjacent soft tissue beyond the exophytic cortical outgrowth was not evident.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002560000245
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  • 56
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    Sonographie des Gehirns und Rückenmarks bei Früh- und Neugeborenen (2000)
    Springer
    Der Radiologe 40 (2000), S. 35-42 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Neugeborenes ; Frühgeborenes ; Ultraschall ; Gehirn ; Rückenmark ; Key words ; Premature infant ; Newborn ; Sonography ; Brain ; Spinal cord
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Examination of the central nervous system in premature and full-term infants requires a sensible selection of the available diagnostic procedures such as ultrasound, MRI and CT to allow sufficient and accurate diagnosis and management. Ultrasound: Ultrasound, including the various Doppler techniques, is a very reliable, safe, noninvasive diagnostic tool that allows evaluation of even severely ill patients in intensive care units. It is especially well suited for the study of intracranial hemorrhage, hypoxic-ischemic encephalopathy, congenital malformations of the brain and lesions produced by intrauterine and acquired infections. Sonography is also very reliable in examination of spinal dysraphism and spinal cord injuries during birth. The necessity of surgical intervention (i.e. shunt implantation) as well as subsequent postoperative follow-up can be provided. MRI: In contrast to ultrasound, MRI is most useful to demonstrate the age-dependent myelinization pattern and clearly discriminates between the white and gray matter of the central nervous system. We therefore use MRI for the detection of complex malformations of the central nervous system in particular disorders of cell migration and for a final estimation of a perinatal brain injury. Conclusion: A precise ultrasound examination performed by an experienced physician who is familiar with the expected pathology and has access to a well-adjusted ultrasound machine should help to minimize the use of confirming CT and MRI investigations and to optimize their optional use in more complex cases.
    Notes: Zusammenfassung Zur Untersuchung des Gehirns und Rückenmarks von Früh- und Neugeborenen müssen die zur Verfügung stehenden Bildmodalitäten – Ultraschall, MR, CT – gemäß ihrer Aussagekraft in Bezug auf klinische Fragestellung und therapeutische Konsequenz angewendet werden. Ultraschall: Der Ultraschall einschließlich der verschiedenen Dopplertechniken ermöglicht ohne Sedierung die rasche, risikoarme und sehr zuverlässige Untersuchung auch schwerkranker Kinder auf der Intensivstation. Es gilt, die Hirnblutungen, die hypoxisch-ischämischen Hirnschädigungen und ihre Folgen, Hirnmissbildungen, Folgen kongenitaler und postnatal erworbener Infektionen, die Dysrhaphien des Rückenmarks und die geburtstraumatischen Rückenmarkschädigungen nachzuweisen oder auszuschließen, die Indikation zu chirurgischen Interventionen (z.B. Drainage eines Hydrozephalus) zu stellen und deren Erfolg zu beurteilen. Für den frühen Nachweis hypoxisch-ischämischer Schädigungen ist der Ultraschall wenig sensitiv. MRT: Da das MR im Gegensatz zum Ultraschall die altersabhängige Myelinisierung zeigt und die Unterscheidung zwischen grauer und weißer Substanz ermöglicht, nützen wir diese anatomische Auflösung bei der Untersuchung von sowohl sehr komplexen Hirnfehlbildungen als auch solchen, die mit Migrationsstörungen einhergehen, und gelegentlich für die abschließende Beurteilung des Ausmaßes einer perinatalen Hirnschädigung. Schlussfolgerung: Nach einer sorgfältig durchgeführten Ultraschalluntersuchung durch einen mit der zu erwartenden Pathologie vertrauten Untersucher mit einem hochauflösenden Ultraschallgerät sollten CT- und MR-Untersuchungen nur zur Bestätigung des Ultraschallbefunds überflüssig sein, zu deren evtl. notwendiger Ergänzung jedoch optimiert erfolgen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050006
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  • 57
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    Harntransportstörungen bei Neugeborenen (2000)
    Springer
    Der Radiologe 40 (2000), S. 72-77 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Kongenitale Anomalien der Nieren ; Neonatale Hydronephrosen ; Ultraschall in der Neonatalperiode ; Key words ; Congenital anomalies of the kidneys ; Neonatal hydronephrosis ; Neonatal ultrasound
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Malformations of the urinary tract are one of the most common types of anomalies in the neonatal period. Approximately 15–20% of all prenatally detected malformations require acute postnatal imaging. Sonography is the primary imaging modality in the evaluation of nephro-urologic problems in infancy. Hydronephrosis represents the most common pathology, followed by multicystic-dysplastic kidney. Discussion: The result of the sonographic examination directs further imaging. An adequate diagnostic algorithm is decisive for accurate diagnosis, for the appropriate therapeutic regimen and for the prognosis of the patients.
    Notes: Zusammenfassung Fehlbildungen der Nieren und der ableitenden Harnwege zählen zu den häufigsten kongenitalen Anomalien in der Neugeborenenperiode. Etwa 15–20% aller pränatal diagnostizierten Fehlbildungen erfordern eine akute postnatale Diagnostik. Die Sonographie ist das initiale bildgebende Verfahren der Wahl in der Abklärung nephrourologischer Fragestellungen im Kindesalter. Hydronephrosen stellen die häufigsten Pathologien dar, die multizystisch-dysplastische Niere steht an 2. Stelle. Diskussion: Das Ergebnis der Sonographie ist richtungsweisend für die Wahl der weiteren bildgebenden Verfahren. Der adäquate diagnostische Algorithmus ist entscheidend für die richtige Diagnose, das geeignete therapeutische Prozedere und letztendlich für die Prognose der Patienten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050011
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    Magnetresonanztomographie (MRT) des Gelenkknorpels Aktueller Wissensstand und neue Entwicklungen (2000)
    Springer
    Der Radiologe 40 (2000), S. 1141-1148 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Gelenkknorpel ; MRT ; Arthrose ; Keywords Hyaline cartilage ; MRI ; Osteoarthritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract MRI is the most accurate noninvasive technique available for assessment of normal articular cartilage and cartilage lesions. MRI cannot only provide morphologic information about the area of damage, but can also provide unique insight into the biochemical composition of the articular cartilage. New image processing techniques such as three-dimensional mapping of cartilage thickness will help to establish automated analysis of cartilage loss. Theses techniques are ideally suited for monitoring patients who undergo treatment with new chondroregenerative drugs.
    Notes: Zusammenfassung Die MRT ist die beste verfügbare Untersuchungsmethode zur Darstellung des normalen und geschädigten Gelenkknorpels. Sie gibt nicht nur Aufschluss über die Morphologie des geschädigten Areals, sondern auch über die biochemische Zusammensetzung des Gelenkknorpels. Neue Bildverarbeitungstechniken wie die dreidimensionale Erfassung/Darstellung der Knorpeldicke werden bei der Entwicklung einer automatisierten Analyse des Knorpelverlustes helfen. Diese Techniken sind auch ideal zur Verlaufsbeobachtung von Patienten, die sich einer Behandlung mit knorpelregenerierenden Substanzen unterziehen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050898
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  • 59
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    Electronic Resource
    Nutritialgefäßkanäle (2000)
    Springer
    Der Radiologe 40 (2000), S. 469-472 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Nutritialgefäßkanäle ; Os lunatum ; Lunatummalazie ; Ganglion ; Ulnaimpaktionssyndrom ; Key words Nutrient vessel canals ; Lunate bone ; MRI ; Kienböcks disease ; Ulna impaction syndrome ; Carpal ganglia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To find and describe potential MRI criteria of nutrient vessel canals of carpal bones. Methods and Material: 16 wrists of 13 patients with pain and radiographic depiction of cystic changes within the lunate were examined. The MRI protocol included coronal and sagittal T1- and T2-weighted SE sequences (4 mm slices, 120 FOV, 256×256 matrix) as well as coronal STIR images. Final diagnosis was confirmed by surgery (n=5) and follow up. 10 cadaveric ossa lunata were studied to describe size, number, location and shape of nutrient vessel canals. Results: Ganglion cysts (n=6) showed characteristic signs. In ulnar impaction syndrome (n=1) small cystic lesions in the lunate were surrounded by a sclerotic rim and located near the proximal ulnar surface. In Kienböck’s disease (n=3) cystic components were irregular and surrounded by bone marrow edema. Nutrient vessel canals (n=7) imaged as 1 to 3 small cystic lesions within the palmar or dorsal subchondral region. Conclusion: MRI can aid in differential diagnosis of cystic carpal lesions. Nutrient vessel canals may not be mistaken for pathologic cystic lesions. Carpal ganglion cysts show distinct diagnostic pattern.
    Notes: Zusammenfassung Fragestellung: Sind karpale Nutritialgefäßkanäle auf MRI Bildern sichtbar und welche differentialdiagnostischen Kriterien lassen sich finden. Material und Methode: In 16 Fällen lagen bei 13 Patienten röntgenologisch wenige mm bis 2 cm große zystische Läsionen im Os lunatum vor. Das MRT-Protokoll umfaßte koronare und sagittale T1- und T2-gewichtete SE-Sequenzen mit 4 mm Schichtdicke, 120 mm Meßfeld und 2562 Matrix sowie koronare STIR-Sequenzen. Die Diagnosesicherung erfolgte durch Operation in 5 Fällen sowie Verlaufskontrollen. 10 mazerierte Ossa lunata wurden auf Form, Lokalisation, Anzahl und Größe der Nutritialgefäßkanäle untersucht. Ergebnisse: Ganglien (n=6) wiesen typische Zeichen auf. Im Falle eines Ulnaimpaktionssyndroms bei Ulna-Nullvariante wurden mehrere kleine zystische Läsionen im Os lunatum gefunden, umgeben von einem Sklerosesaum. Bei 3 Fällen einer frühen Lunatummalazie waren unregelmäßige zystische Komponenten von einem diffusen Ödem umgeben. In 7 Fällen mit sehr kleinen zystischen Defekten waren diese subchondral, palmar und dorsal gelegen und entsprachen aufgrund des klinischen Verlaufs und der Lokalisation Nutritialgefäßkanälen. Schlußfolgerung: Nutritialgefäßkanäle dürfen nicht mit pathologischen zystischen Prozessen des Os lunatums verwechselt werden. Mittels MRT können zystische Läsionen im und am Os lunatum weiter spezifiziert werden. Handgelenksganglien weisen typische MR-Zeichen auf.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050698
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    Plasmazelluläre Osteomyelitis der Brustwirbelsäule – ein Fallbericht (2000)
    Springer
    Der Radiologe 40 (2000), S. 557-560 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Plasmazell-Osteomyelitis ; Magnetresonanztomografie ; Wirbelsäule ; Key words Plasmacellular osteomyelitis ; MRI ; Spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The authors report the case of a young patient suffering from plasmacellular osteomyelitis of the thoracic spine, a unusual localisation of this type of chronic osteomyelitis. They discuss the role of imaging diagnostic modalities in this disease, focussing on MRI.
    Notes: Zusammenfassung Wir berichten über den Fall einer jungen Patientin mit Plasmazell-Osteomyelitis an der Brustwirbelsäule als ungewöhnliche Lokalisation dieser chronischen Osteomyelitis-Form. Dabei wird die Rolle der bildgebenden Diagnostik, insbesondere der Magnetresonanztomografie diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050753
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    MR-Angiographie der supraaortalen Gefäße (2000)
    Springer
    Der Radiologe 40 (2000), S. 785-791 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Zerebrovaskuläre Erkrankung ; Arteriosklerose ; Magnetresonanztomographie ; Magnetresonanzangiographie ; Digitale Subtraktionsangiographie ; A. carotis ; Keywords Cerebrovascular disease ; Arteriosclerosis ; Magnetic resonance imaging ; Magnetic resonance angiography ; Digital subtraction angiography ; Carotid artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. To compare high resolution contrast-enhanced MR angiography (MRA) and digital subtraction angiography (DSA) in the assessment of supraaortic vessel stenosis. Methods. 14 patients with suspicion of cerebrovascular disease or upper limb ischemia underwent selective DSA and high resolution contrast enhanced MRA employing a new Panoramic-Array coil. Stenosis assessment in comparison to DSA followed NASCET criteria. Additionally signal-/noise ratios (SNR) were evaluated to assess contrast enhancement. Results. Diagnostic image quality was achieved in all patients. Sensitivity and specificity for assessing high-grade stenosis of the supraaortic vessels were 100% and 96% respectively. In the assessment of high-grade common or internal carotid artery stenosis sensitivity and specificity was 100%. Conclusion. High resolution contrast enhanced supraaortic MRA combined with new coil sytems allow for a reliable assessment of stenoses along the whole vessel course including the aortic arch. Previous stent procedures limit its use in post-interventional follow-up.
    Notes: Zusammenfassung Fragestellung. Ziel der Studie war ein Vergleich zwischen hochauflösender kontrastverstärkter MR-Angiographie (MRA) und digitaler Subtraktionsangiographie (DSA) in der Diagnostik von Stenosen der supraaortalen Gefäße. Methoden. 14 Patienten mit Verdacht auf eine zerebrovaskuläre Erkrankung oder Durchblutungsstörung der oberen Extremität wurden mit DSA und hochaufgelöster, kontrastverstärkter MR-Angiographie mit Verwendung einer Panoramic-Array-Spule untersucht. Neben der Beurteilung der Kontrastierung erfolgte die Bestimmung der Stenosegrade im Vergleich zur selektiven DSA nach den NASCET-Kriterien. Ergebnisse. Bei allen Patienten konnte mit der MRA eine diagnostisch ausreichende Bildqualität erzielt werden. In der Diagnostik hochgradiger Stenosen der supraaortalen Gefäße ergab sich eine Sensitivität von 100% und eine Spezifität von 96%. In der Erkennung hochgradiger Stenosen der A. carotis communis oder interna lagen Sensitivität und Spezifität bei 100%. Schlussfolgerung. Die ultraschnelle MRA der supraaortalen Gefäße in Kombination mit einer geeigneten Spulenkombination ermöglicht die zuverlässige Erkennung stenotischer Veränderungen im gesamten Gefäßverlauf einschließlich des Aortenbogens. Stentimplanationen limitieren derzeit den Einsatz in der postinterventionellen Kontrolle.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050824
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    Electronic Resource
    Diffusionsgewichtete Magnetresonanztomographie in der Diagnostik der Encephalitis disseminata (2000)
    Springer
    Der Radiologe 40 (2000), S. 1057-1063 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Diffusion ; Magnetresonanztomographie ; Encephalitis disseminata ; Keywords Diffusion ; Magnetic resonance imaging ; Multiple sclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Magnetic resonance (MR) imaging is one of the best methods in diagnosis of multiple sclerosis, particularly in disclosure of active demyelinating lesions. Aim of this study was to compare diffusion weighted imaging and contrast enhancement in the detection of active lesions. A MR study with a contrast enhanced T1-weighted pulse sequence with magnetization transfer presaturation and a diffusion weighted echoplanar pulse sequence (b=1000 s/mm2) was performed in 17 patients (11 women, 6 men) with multiple sclerosis. 29 of 239 lesions showed an increased signal intensity in diffusion weighted imaging, 24 lesions a contrast enhancement, but only 16 lesions were visible in both pulse sequences. In patients with short clinical symptomatology significant more lesions could be detected with diffusion-weighted pulse sequence in comparison to patients with long standing symptomatology showing more lesions with contrast enhancement. Hence it is likely, that both pulse sequences detect different histopathologic changes. The early detection of demyelinating lesions in diffusion weighted imaging is attributed to the extracellular edema, however the contrast enhancement is caused by a blood brain barrier abnormality. It can be expected that diffusion weighted imaging will have a high impact on imaging of multiple sclerosis not only in therapeutic trials, but also in clinical routine.
    Notes: Zusammenfassung Die Magnetresonanztomograpie ist eine der wichtigsten Untersuchungsmethoden in der Diagnostik der Encephalitis disseminata, insbesondere im Nachweis aktiver Entmarkungsherde. Ziel der Untersuchung war es, diffusionsgewichtete und kontrastverstärkte Untersuchungen bezüglich der Erkennung aktiver Läsionen zu vergleichen. Bei 17 Patienten (11 Frauen, 6 Männer) mit bekannter Encephalitis disseminata wurden sowohl eine kontrastverstärkte T1-gewichtete Sequenz mit Magnetization-Transfer-Sättigung als auch eine diffusionsgewichtete Echoplanar-Sequenz (b=1000 s/mm2) durchgeführt. 29 der 239 Läsionen zeigten eine Signalsteigerung in der diffusionsgewichteten Sequenz, 24 eine Kontrastmittelaufnahme, jedoch waren nur 16 Läsionen in beiden Techniken nachweisbar. Bei Patienten mit kurzzeitig bestehender Symptomatik zeigten sich signifikant mehr Entmarkungsherde mit Signalsteigerung in der Diffusionswichtung im Vergleich zu Patienten mit länger bestehender neurologischer Symptomatik, die mehr kontrastmittelaffine Läsionen aufwiesen. Dies lässt darauf schließen, dass mit beiden Verfahren unterschiedliche histopathologische Veränderungen beobachtet werden. Das sehr frühe Auftreten der Diffusionsänderung in den Entmarkungsherden wird auf das Ödem zurückgeführt, während die Kontrastmittelaufnahme durch eine Blut-Hirnschranken-Störung verursacht wird. Es ist zu erwarten, dass die diffusionsgewichtete Magnetresonanztomographie einen hohen Stellenwert in der Bildgebung der Encephalitis disseminata nicht nur in Therapiestudien, sondern auch in der klinischen Routinediagnostik erlangen wird.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050878
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  • 63
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    Electronic Resource
    Septisch-embolischer und septisch-metastatischer Hirnabszess (2000)
    Springer
    Der Radiologe 40 (2000), S. 1017-1029 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Hirnabszess ; Zerebritis ; Metastatische Herdenzephalitis ; Endokarditis ; MRT ; Gd-DTPA ; Keywords Brain abscess ; Cerebritis ; Metastatic focal encephalitis ; Endocarditis ; MRI ; Gd-DTPA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract The hematogenous spread of bacteria, fungi and protozoa may also reach the brain vessels, which happens mostly through septic emboli. From such an embolus a metastatic focal encephalitis and later a septic-embolic brain abscess may arise. The most frequently underlying infections that may cause septic emboli are bacterial endocarditis as well as bacterial infections of artificial heart valve prostheses. Congenital heart malformations with a right-to-left shunt also play here a certain role. Basically, however, all septic conditions and bacteriemias may cause septic-embolic brain abscesses. They occur frequently as multiple lesions. MRI is superior to CT in depicting the different stages of evolution from focal encephalitis, through the hardly encapsulated early abscess, to the formation of a membrane and later a dense fibrous capsule. The medical treatment of a brain abscess requires properly performed CT or MRI follow-up examinations in order to realize early enough a possible growing of such a lesion.
    Notes: Zusammenfassung Die hämatogene Ausbreitung von Bakterien, Pilzen oder Protozoen bis in die Hirngefäße erfolgt meist durch eine septische Embolie. Es entstehen eine metastatische Herdenzephalitis und im weiteren Verlauf daraus ein septisch-embolischer Hirnabszess. Die häufigste Grunderkrankung die zu septischen Embolien führt ist die bakterielle Endokarditis sowie die bakterielle Infektion von Herzklappenprothesen. Eine besondere Bedeutung kommt hier den angeborenen kardialen Fehlbildungen mit Rechts-Links-Shunt zu. Grundsätzlich können jedoch alle Bakteriämien zu septisch-embolischen Hirnabszessen führen. Septisch-embolische Hirnabszesse treten aufgrund ihres Entstehungsmechanismus häufig multipel auf. Die CT und besser noch die MRT erlauben die Darstellung aller Entwicklungsstadien von der Herdenzephalitis über den kaum abgegrenzten Abszess, die Membranbildung bis zur Entstehung einer dicken, die eitergefüllte Höhle allseits umgebenden Abszesskapsel. Die medikamentöse Therapie von Hirnabszessen erfordert Verlaufsuntersuchungen, um einer eventuellen Größenzunahme der Läsion(en) frühzeitig durch Umstellung der antibiotischen Medikation oder durch operative Abszessentfernung zu begegnen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050874
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  • 64
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    Electronic Resource
    Optimierung der Zeitauflösung in der CT mittels retrospektivem EKG-Gating (2000)
    Springer
    Der Radiologe 40 (2000), S. 123-129 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Spiral-CT ; Herz ; Retrospektives Gating ; Zeitauflösung ; Key words ; Spiral CT ; Heart imaging ; Retrospective gating ; Temporal resolution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Spiral CT of the heart using the established ways of ECG synchronization is hampered by the relatively long acquisition times of 250 to 500 ms. This only allows to acquire diastolic images in patients with moderate heart rates. In this work, algorithms for time-optimized retrospective cardiac gating are presented, and their potential to improve temporal resolution is investigated. Material and methods: These algorithms use data from multiple gantry rotations for image reconstruction, which is possible for multi-scans at fixed slice positions as well as for overlapping spiral scans. Temporal resolution was quantified using computer simulations and compared to experimental data from pigs. Results: Using a conventional sub-second CT scanner, considerably higher temporal resolutions are possible with spiral scanning. A temporal resolution of 170 ms already provides systolic images with little motion artifacts. Higher temporal resolutions of up to 70 ms are demonstrated for multi-scans, which allows to depict ventricle wall movement over the complete cardiac cycle. Discussion: The method of time-optimized retrospective cardiac gating broadens the spectrum of conventional spiral-CT for cardiac imaging. It can be directly transferred to multi-slice scanners. Here it can be used clinically because of reduced scan time. Potential applications are the determination of functional cardiac parameters like ejection fraction and the detection of disorders of ventricle wall movement.
    Notes: Zusammenfassung Zielsetzung: Die Spiral-CT des Herzens ist mit bisherigen Verfahren zur EKG-Synchronisation nur eingeschränkt möglich. Die Aufnahmezeit von ca. 250 bis 500 ms ermöglicht nur diastolische Aufnahmen bei Patienten mit moderater Herzfrequenz. In dieser Arbeit wurden Algorithmen zum zeitoptimierten retrospektiven EKG-Gating entwickelt und untersucht, wie höhere Zeitauflösungen erreicht werden können. Material und Methode: Das Prinzip der Algorithmen ist es, Daten von mehreren Gantry-Umläufen für die Bildrekonstruktion heranzuziehen. Dies ist sowohl in einzelnen Schichten als auch bei Spiralscans mit überlappenden Aufnahmeschichten möglich. Die Zeitauflösung wurde durch Computersimulationen für verschiedene Aufnahmeparameter bestimmt und mit Experimenten an Schweinen verglichen. Ergebnisse: Es zeigt sich, dass mit einem Standard-Subsekunden-CT-Scanner mit überlappenden Spiralen deutlich höhere Zeitauflösungen möglich sind, bereits 170 ms ermöglichen eine Darstellung der Systole mit nur minimalen Bewegungsartefakten. An einzelnen Schichten wurden Zeitauflösungen von bis zu 70 ms demonstriert, womit die Herzwandbewegung über den kompletten Herzzyklus dargestellt werden kann. Diskussion: Die Methode des zeitoptimierten retrospektiven EKG-Gating erweitert die Einsatzmöglichkeiten herkömmlicher Spiral-CTs für die Bildgebung des Herzens. Sie lässt sich direkt auf Multizeilen-CTs übertragen, wo sie wegen der Reduktion der Untersuchungszeit klinisch eingesetzt werden kann. Mögliche Anwendungen sind die Bestimmung von funktionellen Herzparametern wie Ejektionsfraktion und die Detektion von Wandbewegungsstörungen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050020
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    Electronic Resource
    Flussquantifizierung in Koronar- und Bypass- gefäßen mit der MR-Phasenkontrasttechnik (2000)
    Springer
    Der Radiologe 40 (2000), S. 143-149 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Magnetresonanztomographie ; Flussmessung ; Koronararterie ; Koronare Bypassgefäße ; Key words ; MR imaging ; Flow quantification ; Coronary artery ; Coronary bypass grafts
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To evaluate accuracy of velocity encoded cine MR imaging for determination of blood flow in coronary arteries and coronary bypass grafts. Materials and methods: 12 patients with 22 coronary bypass grafts underwent intraoperative flow quantification using the transit time ultrasound method. These values were compared to postoperative MR phase shift measurements. Flow measurements were performed preoperatively in 28 coronary arteries of 20 patients. For flow measurement, we used a velocity-encoded k-space segmented gradient echo sequence with a temporal resolution of 110 or 125 ms, respectively. 6–8 pase shift images could be acquired during one cardiac cycle. Results: There was a significant correlation between intraoperative and flow measurements using velocity-encoded MR imaging (r=0.74, p〈0.0001, t-test). Flow volumes determined by MR imaging were systemati-cally larger than those determined by the transit time ultrasound method. Mean flow in coronary arteries was reduced in severly stenosed vessels (〉70%) compared to normal vessels. Intra- and interobserver vari-ability were 10.5 and 15% (coronary bypass grafts), and 12.3 and 15.8% (coronary ar- teries), respectively. Conclusions: Velocity-encoded MR imaging enables determination of flow in coronary artery bypass grafts and coronary arteries. Future developments should aim at the improvement of spatial and temporal resolution of the method.
    Notes: Zusammenfassung Ziel: Es sollte die Genauigkeit der MR-Phasenkontrastmethode zur Ermittlung des Flusses in Koronararterien und koronaren Bypassgefäßen bestimmt werden. Material und Methode: Die MRT-Flussmessungen von 12 Patienten mit 22 Bypassgefäßen wurden mit intraoperativ mittels Ultraschalldurchflussmethode bestimmten Flüssen verglichen. Präoperativ wurden zusätzlich Flussmessungen in 28 Koronararterien von 20 Patienten durchgeführt. Zur MRT-Flussmessung wurde eine segmentierte 2D-Flash-Sequenz verwendet, die eine zeitliche Auflösung von 110 bzw. 125 ms aufwies. Dies ermöglichte die Akquisition von 6–8 Bildpaaren pro Herzzyklus. Ergebnisse: Es bestand eine signifikante Korrelation zwischen den Ergebnissen der intraoperativen und denen der postoperativen MRT-Flussmessung (r=0,76, p〈0,0001, t-Test). Das mit der MRT gemessene Flussvolumen lag über dem bei der Ultraschallmessung ermittelten. Die Bestimmung des mittleren Flusses in den Koronararterien zeigte deutliche Unterschiede zwischen Gefäßen mit höhergradiger Stenose (〉70%) und Gefäßen ohne Stenose. Die Intra- und Interbeobachtervariabilitäten betrugen 10,5 und 15% (Bypass) bzw. 12,3 und 15,8% (Koronararterien). Schlussfolgerungen: Die Phasenkontrastmethode ermöglicht – in Kenntnis ihrer Limitationen – eine relativ genaue Bestimmung des Blutflusses in Koronararterien und koronaren Bypassgefäßen. Weiterentwicklungen der Methode müssen eine verbesserte räumliche und zeitliche Auflösung zum Ziel haben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050023
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  • 66
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    Electronic Resource
    Brustkrebsfrüherkennung in Deutschland (2000)
    Springer
    Der Radiologe 40 (2000), S. 177-183 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Mammakarzinom ; Früherkennung ; Qualitätssicherung ; Key words ; Breast cancer ; Screening ; Quality assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In Germany there is still an urgent need for action in regard to screening for breast cancer. The announcement of research projects for mammography screening proves this. The following reports the results of the Munich field study. In 2 years, 2489 breast cancer cases were registered (status 6/98). Screening data were available for 1319 patients. The reduction in mortality, found in randomized studies, due to mammography in women over 50 years old was confirmed. A relative reduction of 44.8% in 10-year mortality could be estimated through mammography and 25.1% through palpation, in comparison with ”doing nothing”. We could also estimate the participation of screening and the used methods in the Munich region. If the mammographies carried out today were used at 2-year intervals for women aged between 50 and 70 years, then the mammography screening could be performed with no additional costs for 70% of the women. The known facts regarding the population-based mortality and regarding the acceptance of the palpation screening and frequency of mammography are additional aspects for inclusion in the discussion of what research projects in Germany are and what they should fulfill.
    Notes: Zusammenfassung Hintergrund: Bei der Früherkennung des Mammakarzinoms besteht in Deutschland nach wie vor ein dringender Handlungsbedarf. Die Ausschreibung von Modellprojekten zur Einführung des Mammographiescreenings belegt dies. Im folgenden wird – als Diskussionsgrundlage –über erste Ergebnisse der Feldstudie München berichtet. Ergebnisse: In einem Zeitraum von 2 Jahren wurden 2489 Mammakarzinome registriert (Stand Juni 1998). Zu 1319 Patientinnen sind Angaben zur Früherkennung verfügbar. Die durch randomisierte Studien gesicherte Senkung der Mortalität durch die Mammographie im Alter 〉50 Jahre konnte bestätigt werden. Aufgrund der dokumentierten Stadienverteilung beträgt die Schätzung für die relative Senkung der 10-Jahres-Mortalität durch die Mammographie 44,8% und durch die Palpation 25,1% im Vergleich zum „Nichtstun”. Auch die Inanspruchnahme der Früherkennung und die in der Region München eingesetzten Methoden konnten abgeschätzt werden. Schlussfolgerungen: Würden die heute durchgeführten Mammographien bei Frauen im Alter zwischen 50 und 70 Jahren mit einem Abstand von 2 Jahren eingesetzt, so könnte das Mammographiescreening bei etwa 82% der Frauen kostenneutral durchgeführt werden. Die bekannten Fakten zur Mortalität und zur bundesweiten Inanspruchnahme des heutigen Früherkennungsangebots sind weitere Grundlagen für die Diskussion, was Modellprojekte in Deutschland sein und was sie wann leisten sollten.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050029
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    Electronic Resource
    Akutbehandlung des episodischen kindlichen Spannungskopfschmerzes mit Flupirtin und Paracetamol (2000)
    Springer
    Der Schmerz 14 (2000), S. 1-4 
    Details
    ISSN: 1432-2129
    Keywords: Schlüsselwörter ; Kopfschmerz ; Kinder ; Akuttherapie ; Flupirtin ; Paracetamol ; Keywords ; Children ; Acute treatment ; Tension-type headache ; Flupirtine ; Paracetamol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background: About 10% of all schoolchil- dren are suffering from migraine and 50% from tension-type headache. Headache of acute onset usually will be treated with analgesic substances like paracetamol, acetylsalicylic acid or ibuprofen, the first one being the reference drug for tension-type headache in childhood. In case of lacking improvement or side-effects there is demand for an alternative safe substance for the acute analgesic therapy. Methods: In a double-blind randomised investigation flupirtine and paracetamol were given in two consecutive attacks of episodic tension-type headache. 30 children, 6–12 years old, were included. Dosage was determined according to age and weight. The children documented the acute headache intensity and duration in a special diary. Results: Headache intensity was reduced during 2 h after intake in 89% of the 19 children treated. The reduction was 6,5 to 3,1 for flupirtine and 6,9 to 3,3/10 for paracetamol. There was no statistically significant difference between the two substances. Relevant side-effects could not be observed. Conclusion: Flupirtine has shown a convincing clinical effect treating acute episodic tension-type headache for children. The substance was well tolerated by the patients. In addition, flupirtine provides a high degree of safety.
    Notes: Zusammenfassung Hintergrund: Etwa 10% aller Schulkinder leiden nach neueren deutschen epidemiologischen Untersuchungen zumindest gelegentlich an Migräne und etwa 50% an Kopfschmerzen vom Spannungstyp. Häufig nehmen sie bei Spannungskopfschmerzen analgetische Monosubstanzen wie Paracetamol, Azetylsalizylsäure oder Ibuprofen ein. Bei nicht ausreichender Wirkung bzw. Unverträglichkeit besteht Bedarf nach weiteren Substanzen für die Akutanwendung. Methode: In einer doppelblindrandomisierten und gekreuzten Anordnung wurden Paracetamol bzw. das analgetisch und muskelrelaxierend wirksame Flupirtin 30 6- bis 12jährigen Kindern für 2 episodische Spannungskopfschmerzattacken angeboten. 10 Kinder benötigten nach dem Erstkontakt keine Medikation mehr, 1 Kind lehnte die Einnahme grundsätzlich ab. Ergebnisse: Die Kopfschmerzstärke verringerte sich laut Kopfschmerztagebuch innerhalb von 2 h nach der Einnahme auf einer numerischen Schmerzskala (0–10) von 6,5 auf 3,1 unter Flupirtin und von 6,9 auf 3,3 unter Paracetamol bei 89% der verbliebenen 19 Kinder. Statistisch signifikante Unterschiede zwischen beiden Substanzen bestanden nicht. Als Nebenwirkung trat 1-mal Erbrechen unter Paracetamol auf. Schlussfolgerung: Flupirtin hat sich in der Akutphase von episodischen Spannungskopfschmerzen beim Kind bewährt. Es verfügt über eine gute Verträglichkeit. Im Vergleich zu Paracetamol scheint v.a. bei akzidenteller Überdosierung eine größere Sicherheit zu bestehen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/PL00009797
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  • 68
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    Electronic Resource
    Begutachtung peripherer Nervenschäden (2000)
    Springer
    Der Schmerz 14 (2000), S. 5-9 
    Details
    ISSN: 1432-2129
    Keywords: Schlüsselwörter ; Periphere Nervenläsionen ; Begutachtung ; Neuropathie ; Minderung der Erwerbs- fähigkeit ; Keywords ; Peripheral nerve lesion ; Neuralgia-physiopathology ; Causalgia-physiopathology ; Loss of earning capacity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Introduction: The loss of functional capacity by peripheral nerve lesion is easy to be estimated: A certain neurologic dysfunction results in a characteristic reduction of the former individual capacity. In contrast, the effect of accompanying pain to every-day life and working ability is not known exactly. In this study, we compared the results of judgement in nerve lesions under the circumstances of additional pain syndromes. Methods: From January 1994 until Dezember 1998 we saw 57 patients with peripheral nerve lesions, part of them with an additional pain syndrome. Beside conventional neurological examination a detailed pain analysis has been done. Results: Lesions of the median or ulnar nerves showed regularly disturbences in neurological functions (10/14 for the mediane nerve, 13/16 for the ulnar nerve). Astonishing is the fact, that serious pain after nerve lesion only occurs in cases of partial nerve lesion. We saw neuralgias in 6 patients with ulnar neuropathy, in three cases of median nerve lesions we could see severe neuralgia (causalgia we found in 3 cases of ulnar neuropathy, in 6 cases after Median Nerve lesion). Patients with a lesion of the central plexus brachialis showed in 10 of 11 cases an additional pain syndrome. Other nerves have been affected more rarely. For the judgement of the loss of earning capacity we saw an additional pain related diminuition of at least 10% compared to those patients without pain problems. Conclusions: The common grading scales for peripheral nerve lesions are not suitable in cases accompanied by an additional pain syndrome. Beside a functional deficit the effect of severe pain in these patients has to be estimated. On an average, patients with addtitional pain-problems get a 10% extended loss of earning capacity, even more in particular cases.
    Notes: Zusammenfassung Fragestellung: Anhand retrospektiver Daten sollten geeignete Bewertungsgrundlagen für die Begutachtung peripherer Nervenläsionen erarbeitet werden. Methode: Von Januar 1994 bis Dezember 1998 wurden insgesamt 57 Patienten (36 männlich, 21 weiblich, Durchschnittsalter 33,9 Jahre) mit dieser Fragestellung im Rahmen einer Begutachtung untersucht. Ursächlich lagen traumatische Ereignisse bei 39 (68%), postoperative Störungen bei 14 und andere Schädigungen bei 4 Patienten zugrunde. Ergebnisse: Beim N. medianus und N. ulnaris (beispielhaft) überwogen die Schmerzzustände bei inkompletten Läsionen. Neuralgien fanden sich bei 3 bzw. 6 Patienten mit N.-medianus- bzw. N.-ulnaris-Läsion. Eine Kausalgie fand sich bei 6 bzw. 3 Patienten. Mit Ausnahme von Armplexusläsionen waren andere Nerven seltener betroffen. Diese Situation wurde mit einer durchschnittlich um 10% höher gelegenen Einschätzung der Leistungseinbuße berücksichtigt, wenn gleichzeitig Schmerzen vorlagen. Schlussfolgerungen: Die für die reine Funktionseinbuße gültigen Skalen zur Bemessung peripherer Nervenläsionen können für die Begutachtung von Schmerzsyndromen nur bedingt herangezogen werden. Meist führen Schmerzen zu einer um durchschnittlich 10% höheren Einschränkung der Erwerbsfähigkeit (MdE), allerdings sind in manchen Fällen auch größere Einbußen denkbar.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004820050002
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  • 69
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    Electronic Resource
    Chronifizierungsausmaß von Schmerzerkrankungen (2000)
    Springer
    Der Schmerz 14 (2000), S. 10-17 
    Details
    ISSN: 1432-2129
    Keywords: Schlüsselwörter ; Schmerzerkrankungen ; Krankheitsschwere ; Chronifizierungsstadien ; Mainzer Stadienmodell ; Keywords ; Chronic pain ; Grading procedure ; Mainz Pain Staging System
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Introduction: Chronic pain is an individually variable experience, incorporating physical, psychological and social dimensions. Chronic pain occurs in a broad spectrum of severity; therefore, a grading procedure is of crucial importance in clinical research and in epidemiologic studies. The Mainz Pain Staging System is an interview-administered, multi-dimensional measure of chronic pain severity. The system suggests grading chronic pain in terms of 4 axes: time (persistence), spreading of pain site, medication use, and health care utilization. The whole scale consist of 10 items. The resulting score is used to classify the pain problem in three stages (I, II, III). Analysing the broader validity and parametric properties of the staging system is the purpose of the present study. Methods: The staging system and psychosocial data were administered to 542 consecutive patients of different diagnoses who attended one of six pain clinics in the year 1995/96. In a time period of 3 months since first contact, treatment procedures were registered. Three months after first contact patients rated the effectiveness of treatment concerning reduction of pain intensity. Results: According to the criteria of the staging system 25% of the sample belonged to each stage I and stage III, whereas 50% were classified to stage II. As a measure of validity, chronic pain status demonstrated significant correlation with psychological impairment, disability and time off work, whereas there was no correlation to pain intensity and persistence of pain. Surprisingly we found no difference in amount and quality of treatment between patients who were graded as severe pain patients (stage III) and the other stages. Furthermore, effectiveness of treatment also did not differ between the three stages. We made several proposals for optimizing the staging system. Conclusion: Given the high prevalence of recurrent and chronic pain as well as the broadness of severity, an important issue on further research is identification of factors which influence the chronification process. For this purpose improved measures of graded classification of pain status are needed.
    Notes: Zusammenfassung Hintergrund: Die Beschreibung von Schmerzsyndromen ist durch eine Diagnose allein nicht ausreichend gewährleistet; erst die Angabe der Krankheitsschwere ermöglicht sowohl die Indikation der entsprechenden Behandlung als auch eine Vergleichbarkeit von Fällen. Patienten und Methode: In einer multizentrischen Studie wurde bei 542 Patienten das aus der Mainzer Arbeitsgruppe um Gerbershagen 1986 vorgestellte Stadienmodell der Chronifizierung ermittelt und in Abhängigkeit von Patienten- und Diagnosemerkmalen sowie im Hinblick auf seine parametrischen Eigenschaften analysiert. Ergebnisse und Diskussionen: Die Ergebnisse der Untersuchung bestätigen die gute Validität des Verfahrens im Hinblick auf seine Unabhängigkeit von schmerzspezifischen Parametern. Es besteht theoriegemäß eine gute Übereinstimmung zum Ausmaß der emotionalen Befindlichkeit (Depression), zur subjektiven Beeinträchtigung und zum Ausmaß der Arbeitsunfähigkeit. Die Ergebnisse zeigen auch Ansätze für Verbesserungsmöglichkeiten. Einige der berücksichtigten Kriterien sind vermutlich überflüssig, während der zusätzliche Einbezug des subjektiven Beeinträchtigungserlebens notwendig erscheint. Ob ein übergreifendes Graduierungsmodell für verschiedene Schmerzerkrankungen überhaupt valide sein kann, muss eine weitergehende Analyse zeigen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004820050003
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    Electronic Resource
    Langzeitbehandlung mit Flupirtin (2000)
    Springer
    Der Schmerz 14 (2000), S. 29-32 
    Details
    ISSN: 1432-2129
    Keywords: Schlüsselwörter ; Flupirtin ; Langzeitbehandlung ; Keywords ; Flupirtine ; Long-term treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Case report: The worker O.H., born in 1959, had in 1992 an accident as a car driver. His injuries were a severe acceleration trauma of the cervical spine with rupture of the longitudinal ligament, a concussion of the brain, and an eye injury. Therapy: After the emergency treatment, the multidisciplinary management could not resolve the persistent musculoskeletal cervicocephal and -brachial pain syndrome. The long-term application of 100 mg flupirtine tid improved the chronic pain state for 50–60%. Due to this regimen, the patient could be rehabilitated.
    Notes: Zusammenfassung Fallbericht: Der 1959 geborene Arbeiter (O.H.) erlitt im September 1992 als PKW-Fahrer einen Wegeunfall mit schwerem HWS-Trauma, Commotio cerebri, Oberlidverletzung und Augapfelprellung rechts. Danach persistierten zervikozephale und zervikobrachiale Schmerzen. Behandlung: Nach der Evaluation verschiedener Therapieverfahren erfolgte die Einstellung auf durchschnittlich 3-mal 100 mg Flupirtin täglich mit dem Ergebnis einer durchschnittlich 50- bis 60%igen Linderung starker, belastungsabhängiger Dauerschmerzen. Dank dieser Medikation konnte der Betroffene beruflich integriert werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004820050006
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    MRT bei Neugeborenen mit Verdacht auf zerebrale Störung (2000)
    Springer
    Der Radiologe 40 (2000), S. 18-27 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; MRT ; Neugeborene ; Cerebrum ; Fetus ; Key words ; MRI ; Neonatal ; Brain ; Fetal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Magnetic resonance tomography (MRT) has become the most important method in the workup of infantile cerebral complications after primary sonography. Cerebral MR examination and image interpretation during the infantile period require extensive knowledge of morphological manifestations, their pathophysiological background, and frequency. The choice of imaging parameters and image interpretation is demonstrated in infarctions and hemorrhages of the mature and immature brain. A review of the main differential diagnoses is also given. The relevance of MR spectroscopy and fetal MRI is discussed.
    Notes: Zusammenfassung Zur Abklärung zerebraler Veränderungen bei Neugeborenen hat sich die Magnetresonanztomographie (MRT) als wichtigste weiterführende Methode nach der Sonographie entwickelt. Die Durchführung und Auswertung der MR-Untersuchungen erfordern jedoch eine genaue Kenntnis der morphologischen Manifestationen, des pathophysiologischen Hintergrunds und der Häufigkeit bestimmter zerebraler Komplikationen in diesem Lebensalter. Resümee: Ausgehend von zerebrovaskulären Erkrankungen werden diese Fragen behandelt, wobei sowohl auf die Auswahl der adäquaten Untersuchungsparameter als auch auf die Bildinterpretation und die wichtigsten Differentialdiagnosen eingegangen wird. Die Bedeutung von MR-Spektroskopie und fetaler MRT wird diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050004
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    Thoraxröntgen beim neonatologischen Patienten (2000)
    Springer
    Der Radiologe 40 (2000), S. 43-51 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Thorax ; Neugeborene ; Frühgeborene ; Kongenitale Pathologien ; Erworbene Pathologien ; Key words ; Chest ; Newborn ; Preterm infant ; Congenital pathologies ; Acquired pathologies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In diagnostic imaging of thoracic pathologies in mature and especially immature neonates, chest X-ray has a leading position. Profound knowledge of the normal chest X-ray and the potential physiological perinatal changes is the basic requirement for interpretation of the X-ray of a neonate. Childhood pathologie: Many congenital and acquired diseases that the radiologist is faced with in neonatology are unknown in the imaging of adults. Many of these changes are life-threatening or may have an impact on the patient’s future quality of life. Therefore early diagnosis in close cooperation with the paediatrician is essential. We give here an overview of the most important pathologic changes that the radiologist may be con- fronted with in daily routine.
    Notes: Zusammenfassung In der bildgebenden Diagnostik thorakaler Pathologien bei reifen und insbesondere unreifen Neugeborenen steht das Thoraxröntgenbild an erster Stelle. Profunde Kenntnisse des normalen Thoraxbilds und der möglichen physiologischen peripartalen Veränderungen sind Voraussetzung für die Interpretation der neonatologischen Thoraxaufnahme. Kindliche Pathologien: Eine Vielzahl von kongenitalen und erworbenen Veränderungen, mit denen der Radiologe in der Neonatologie konfrontiert ist, sind in der Radiodiagnostik des erwachsenen Patienten unbekannt. Viele dieser Veränderungen sind für den Patienten lebensbedrohlich oder können die Lebensqualität in seinem weiteren Leben beeinflussen. Eine frühzeitige Diagnostik in enger Zusammenarbeit mit dem Pädiater ist daher essenziell. Hier wird ein Überblick über die wichtigsten Pathologien, mit denen der Radiologe in der täglichen Routine konfrontiert sein kann, gegeben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050007
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    Gastrointestinaler Notfall im Neugeborenenalter (2000)
    Springer
    Der Radiologe 40 (2000), S. 63-71 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Gastrointestinaler Notfall ; Neugeborenenalter ; Bildgebende Diagnostik ; Key words ; Gastrointestinal emergency ; Nenoate ; Diagnostic imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Gastrointestinal emergencies in neonates often demand a quick and efficient diagnos-tic imaging. The procedures have to take the special diseases and conditions in these babies and preterm children into account. Conclusion: This paper summarises the most common causes for gastrointestinal neonatal emergencies and discusses the indication and performance as well as the diagnostic value of the commonly used modalities, giving some suggestions for an efficient imaging algorithm. Most of the time conventional plain abdominal films and sonography can answer the clinically important questions, however, in certain conditions fluoroscopy with contrast administration (enema, etc.) is mandatory. Only rarely is CT, MRI or Angiography indicated.
    Notes: Zusammenfassung Der gastrointestinale Notfall im Neugeborenenalter erfordert oft eine rasche, effiziente, den Bedingungen des Neu- und Frühgeborenenalters angepasste bildgebende Diagnostik. Diese Arbeit beschreibt die in diesem Zusammenhang wichtigsten angeborenen und erworbenen Erkrankungen und diskutiert die Durchführung und Indikation bzw. den Stellenwert der zur Verfügung stehenden bildgebenden Methoden. Schlussfolgerung: Zumeist kann mit dem Abdomenübersichtsröntgen und dem Sonogramm eine ausreichende diagnostische Klärung erzielt werden. Bei bestimmten Fragestellungen ist jedoch eine weitergehende Beurteilung durch ein Kontrastmittelröntgen bzw. eine Durchleuchtungsuntersuchung (wie z.B. Schluckakt- und Magenröntgen oder Irrigoskopie) unabdingbar. CT, MRT oder Angiographie werden nur seltenst benötigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050010
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    Intranetanwendungen in der Radiologie (2000)
    Springer
    Der Radiologe 40 (2000), S. 78-82 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Intranet ; Internet ; PACS ; Radiologie ; Key words ; Intranet ; Internet ; PACS ; Radiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The aim of the paper is to present the conceptual basis and capabilities of intranet applications in radiology. The intranet, which is the local brother of the internet can be readily realized using existing computer components and a network. All current computer operating systems support intranet applications which allow hard and software independent communication of text, images, video and sound with the use of browser software without dedicated programs on the individual personal computers. Radiological applications for text communication e.g. department specific bulletin boards and access to examination protocols; use of image communication for viewing and limited processing and documentation of radiological images can be achieved on decentralized PCs as well as speech communication for dictation, distribution of dictation and speech recognition. Discussion: The intranet helps to optimize the organizational efficiency and cost effectiveness in the daily work of radiological departments in outpatients and hospital settings. The general interest in internet and intranet technology will guarantee its continuous development.
    Notes: Zusammenfassung Ziel dieses Beitrags ist es, konzeptionelle Grundlagen und Möglichkeiten von Intranetanwendungen in der Radiologie aufzuzeigen. Das Intranet, das der lokale Bruder des Internets ist, kann gegenwärtig relativ einfach mit den bestehenden Computerkomponenten und einem Netzwerk realisiert werden. Alle aktuellen Betriebssysteme unterstützen Intranetanwendungen, mit denen sowohl Hardware – als auch Software – unabhängig mit Hilfe von sog. Browsern die Kommunikation von Text, Bild, Video und Ton möglich ist, ohne dass auf den peripheren Rechnern entsprechend spezielle Software vorhanden sein muss. Beispielhafte Anwendungen der Textkommunikation werden vorgestellt, wie z.B. abteilungsspezifische Informationen und Untersuchungsprotokolle, außerdem Anwendungen der Bild- und Tonkommunikation. Diskussion: Das Intranet eröffnet insbesondere im täglichen Einsatz radiologischer Abteilungen im ambulanten und stationärem Bereich neue Möglichkeiten zur organisatorischen Effizienzsteigerung und Kosteneffektivität. Das globale Interesse an der Inter- und Intranettechnologie sichert die kontinuierliche Weiterentwicklung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050012
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    Electronic Resource
    Radiodiagnostik der Lunge (2000)
    Springer
    Der Radiologe 40 (2000), S. 870-877 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lunge ; Perfusion ; Ventilation ; Computertomographie (CT) ; Magnetresonanztomographie (MRT) ; Keywords Lung ; Perfusion ; Ventilation ; Computed tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Radiological cross-sectional imaging modalities, particularly computed tomography (CT) have become the mainstays for diagnosing lung disease in recent years. These enable morphological visualization of pathological processes with the greatest possible spatial resolution. Modern technical developments and complementary strategies have led to new applications and new functional assessments which need to be reviewed together with state-of-the-art techniques in nuclear imaging. The diagnosis of pulmonary embolism using spiral CT angiography and magnetic resonance (MR) angiography certainly belongs in this category. CT has become the an alternative modality of first choice, and it is also challenging pulmonary angiography as the gold standard. Direct visualization of patent pulmonary arteries and thromboembolic material is complemented by that of effects on the pulmonary parenchyma and right heart function; it also provides perfusion studies and MR-based flow measurement to assess hemodynamic compromise. Ventilation studies have long been a domain of nuclear imaging, and new techniques for the direct visualization of ventilation are emerging from recent developments in the field of MR imaging, for example, using hyperpolarized inert gases. New functional parameters of ventilation can be derived from these studies. For the diagnosis of metabolically active disease, such as tumor and pneumonia, CT offers very high sensitivity, for example, in screening for intrapulmonary nodules using low-dose CT and in the early detection of pulmonary infiltrates in high-risk patients. Especially for characterizing pulmonary nodules there is a need to combine nuclear medicine techniques, such as in positron-emission tomography.
    Notes: Zusammenfassung Die radiologischen Schnittbildverfahren, insbesondere die CT, haben sich innerhalb kurzer Zeit einen herausragenden Stellenwert in der Diagnostik von Lungenerkrankungen erworben. Dies umfasst in erster Linie die morphologische Darstellung pathologischer Prozesse mit hoher räumlicher Auflösung. Moderne technische Entwicklungen und kombinierte Untersuchungsstrategien eröffnen neue Einsatzgebiete und auch funktionelle Aussagen, die nach einer aktuellen Standortbestimmung gemeinsam mit den nuklearmedizinischen Verfahren verlangen. Dazu gehört die Diagnostik der Lungenembolie mittels Spiral-CT-Angiographie und MR-Angiographie der Pulmonalarterien. Hier hat sich mittlerweile die CT als alternatives Verfahren der Wahl etabliert und die Rolle der Pulmonalisangiographie als Goldstandard infrage gestellt. Die reine direkte Darstellung der durchströmten Pulmonalarterien und des thromboembolischen Materials wird durch Diagnostik intrapulmonaler und kardialer Veränderungen, Perfusionsuntersuchungen sowie MR-basierte Flussmessungen zur hämodynamischen Beurteilung erweitert. Nachdem Untersuchungen der Ventilation lange Zeit eine Domäne der Nuklearmedizin waren, eröffnen aktuelle Entwicklungen in der MRT neue Verfahren zur direkten Visualisierung der Lungenbelüftung, z. B. mittels polarisierter Edelgase. Aus diesen Verfahren lassen sich auch neue funktionelle Parameter der Ventilation ableiten. In der Diagnostik von Tumoren und Entzündungen überzeugt die CT insbesondere durch ihre hohe Sensitivität, z. B. beim Screening auf intrapulmonale Rundherde mittels Niedrigdosis-CT oder bei der Früherkennung pneumonischer Infiltrate bei Risikopatienten. Insbesondere bei der Charakterisierung intrapulmonaler Rundherde ist eine Kombination mit nuklearmedizinischen Verfahren (PET) grundsätzlich anzustreben.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050846
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    Präoperative Markierung und Biopsie nicht palpabler Mammaläsionen mit einer Zieleinrichtung am Magnetom Open (2000)
    Springer
    Der Radiologe 40 (2000), S. 1098-1105 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Mammatumor ; MRT ; Markierung ; Biopsie ; Keywords Breast lesion ; MRI ; Localization ; Biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. MRI-guided interventional maneuvers in the breast, when closed MRI scanners are employed are relatively complex and time consuming. The purpose of our investigations was to develop a special device for the localization and biopsy of breast lesions using an open low-field MRI Scanner (Magnetom Open, Siemens, Erlangen, Germany) permitting free access to the patient. Materials and Methods. Due to its particular material and construction characteristics, a newly developed device for localization and biopsy of breast lesions is appropriate to remain within the magnetic field during the examination without degrading image quality. We performed 125 tests in a phantom and 31 investigations in patients including 26 wire-localizations and 5 biopsies. Results. The interventional maneuvers in the phantom could be performed very precisely. In all 125 phantom studies, the needle (14G coaxial biopsy cannula, Bard) was positioned close to the simulated lesion. In 25 out of 26 patients the needle was positioned within a distance less than 5 mm from the lesion. When using the 14G coaxial biopsy cannula (Bard, Karlsruhe, Germany) the needle tip was found adjacent next to the lesion in all 12 cases (7 wire-localizations, 5 biopsies). Conclusions. Our results indicate that our device allows very precise preoperative localization of breast lesions within the Magnetom Open. Using MRI-compatible, large-core needles, biopsy under direct MRI control resulted in good results.
    Notes: Zusammenfassung Zielsetzung. Am geschlossenen MRT-Gerät sind Interventionen an der Mamma relativ aufwendig und zeitintensiv. Ziel unserer Untersuchungen war es, eine Lokalisations- und Biopsieeinrichtung für das offene MRT-Gerät (Magnetom Open, Siemens) zu entwickeln und zu erproben, das Patienten und Methode. Es wurde eine Lokalisations- und Biopsieeinrichtung entwickelt, die aufgrund ihrer Bauart während der Intervention im Magnetfeld des MRT-Gerätes verbleiben kann und die Bildgebung nicht nachteilig beeinflusst. Um die Tauglichkeit dieses Gerätes zu überprüfen wurden 125 Untersuchungen am Phantom und 31 Patientenuntersuchungen (26 Drahtlokalisationen, 5 Biopsien) durchgeführt. Ergebnisse. Die Interventionen am Phantom konnten sehr genau gesteuert werden. In allen 125 Fällen lag die Interventionsnadel (14 G-Coaxial-Biopsiekanüle, Bard) direkt der Läsion an. Bei den Patientenuntersuchungen lag die Interventionsnadel in 25 von 26 Fällen weniger als 5 mm von der Läsion entfernt. Bei Verwendung der 14 G-Coaxial-Biopsie-Kannüle (Bard, Karlsruhe, Germany) lag die Interventionsnadel in allen 12 Fällen direkt der Läsion an (7 Drahtlokalisationen, 5 Hochgeschwindigkeitsbiopsien). Schlussfolgerung. Die Untersuchungen zeigen, dass mit der von uns entwickelten Zieleinrichtung sehr genaue präoperative Lokalisationen am Magnetom Open durchführbar sind. Durch die stabile Nadelführung sind bei Verwendung lumenstarker Materialien (14G) zudem exakte MRT-kontrollierte Biopsien möglich.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050882
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    Erste Erfahrungen mit der Mehrzeilendetektorspiral-CT in der Diagnostik der Arteriosklerose der Koronargefäße (2000)
    Springer
    Der Radiologe 40 (2000), S. 118-122 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Mehrzeilen-CT ; Elektronenstrahl-CT ; Koronar-Screening ; CT Angiographie ; Koronarsklerose ; Keywords ; Multidetector CT ; Electron beam CT ; Coronary screening ; CT angiography ; Coronary atherosclerosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: Multirow-detector-spiral-CT (MSCT) allows for 250 ms effective exposure time. The purpose of this study was to demonstrate the possibilities and limitations of this CT technology for non enhanced and contrast enhanced investigation of the coronary arteries. Methods: Investigation of the coronary arteries without contrast medium for quantification of coronary calcifications was performed in an obese patient (140 kg) with MSCT and electron beam CT (EBCT). In 56 patients contrast enhanced CT angiography of the coronary arteries was performed to determine image quality depending on the heart rate. Results: In the obese patient superior image quality could be achieved with MSCT allowing for reliable quantification of coronary calcifications. With MSCT angiography of the coronary arteries good image quality was achieved in patients with a heart rate of 59±8 beats per minute. Conclusion: Even if there are limitations in patients with higher heart rates with an effective exposure time of 250 ms MSCT has clear advantage of image quality in the assessment of non enhanced and contrast enhanced coronary arteries.
    Notes: Zusammenfassung Fragestellung: Mit dem Mehrzeilendetektorspiral-CT (MSCT) sind effektive Aufnahmezeiten von 250 ms möglich. Die Möglichkeiten und Grenzen dieser CT-Technologie zur nativen und kontrastverstärkten Untersuchung der Koronargefäße sollen in dieser Arbeit dargestellt werden. Methode: Die native Untersuchung der Koronargefäße zur Quantifizierung von Koronarkalk wurde bei einem Patienten mit Adipositas (140 kg) mit dem Elektronenstrahl-CT (EBCT) und dem MSCT vorgenommen. Bei 56 Patienten wurde eine kontrastverstärkte MSCT-Angiographie der Koronargefäße vorgenommen und festgestellt, bei welcher Herzfrequenz eine diagnostisch ausreichende Bildqualität zu erreichen ist. Ergebnisse: Bei der Untersuchung des Patienten mit Adipositas konnte mit dem MSCT eine erheblich bessere Bildqualität erreicht werden, die eine Quantifizierung von Koronarkalk erheblich erleichterte. Mit der MSCT-Angiographie der Koronargefäße konnte bei einer Herzfrequenz von 59±8 Schlägen/min eine diagnostisch gute Bildqualität erreicht werden. Schlussfolgerung: Auch wenn mit einer effektiven Aufnahmezeit von 250 ms Limitationen bei höheren Herzfrequenzen zu erwarten sind, können mit dem MSCT entscheidende Vorteile in der Bildqualität in der nativen und kontrastverstärkten Untersuchung der Koronargefäße erreicht werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050019
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    Bestimmung links- und rechtsventrikulärer Volumenejektionsfraktionen (VEF) mittels MRT bei 1,0 T (2000)
    Springer
    Der Radiologe 40 (2000), S. 136-142 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Herz ; Herz-MR ; Volumen ; Cine MR ; Key words ; Heart ; Cardiac MRI ; Volume ; Cine MR
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To evaluate method- and user effects as well as the required time in the determination of left- and right ventricular ejection fractions in comparing manual and semiautomatic border detection of the endocardium. Methods: In 22 patients with varying cardiac diseases endocardial borders were detected either manually or semiautomatically (seeded ROI) and subsequently the right and left ventricular volume ejection fractions were computer-calculated. Two investigators defined the endocardial borders for both ventricles using both methods. For statistical analysis two-factorial analyses of variance were performed for the four variables: VEF right ventricle, VEF left ventricle, required time right ventricle, required time left ventricle (SAS, Anova). Results: There was no user or method effect detectable for both ventricles. The required time for both ventricles also did not reveal a user effect, but there was a dramatic method effect concerning a reduction of the required time for analysis for both ventricles 〉50%. Conclusions: The semiautomatic mode for detecting the endocardial borders in determining right and left ventricular ejection fractions did not demonstrate results differing from the results of the manual method, but is significantly superior concerning the time required for analysing ejection fractions of both ventricles with a reduction of over 50%. This might significantly reduce the expenditure for personnel.
    Notes: Zusammenfassung Fragestellung: Die manuelle und semiautomatische Endokarddetektion zur Bestimmung links- und rechtsventrikulärer Volumenejektionsfraktionen (VEF) werden verglichen. Ziel dieser Arbeit ist die Evaluierung des Methoden- und Anwendereffekts sowie der Bearbeitungszeit beider Verfahren. Methode: An 22 Patienten mit unterschiedlichen kardialen Erkrankungen wurden die Endokardgrenzen manuell und mit einem semiautomatischen Verfahren (Seeded-ROI) ermittelt und anschließend die rechts- und linksventrikulären Volumenejektionsfraktionen automatisch berechnet. In allen Fällen wurden von 2 Untersuchern die Endokardgrenzen des rechten und linken Ventrikels manuell und semiautomatisch bestimmt. Zur statistischen Analyse wurden 2-faktorielle Varianzanalysen (Methoden- und Anwendereffekt einschließlich Wechselwirkungen) für die 4 Variablen durchgeführt: VEF rechtsventrikulär, VEF linksventrikulär, Zeitaufwand rechtsventrikulär, Zeitaufwand linksventrikulär (SAS, Anova). Ergebnisse: Bezüglich der Bestimmungen der rechts- und linksventrikulären VEF war weder ein Methoden- (p=0,9613) noch ein Anwendereffekt (p=0,3095) nachweisbar. Bezogen auf die benötigte Bearbeitungszeit fand sich ebenfalls kein Anwendereffekt, aber ein massiver Methodeneffekt (p〈0,0001) im Sinn einer Reduzierung der Bearbeitungszeit um 〉50% sowohl für den rechten als auch für den linken Ventrikel. Schlussfolgerung: Nach unseren Erfahrungen liefert das semiautomatische Seeding-Verfahren zur Festlegung der Endokardgrenzen bei der Bestimmung der links- und rechtsventrikulären Ejektionsfraktionen keine von der manuellen Methode abweichenden Ergebnisse, ist aber bezüglich der Bearbeitungszeit deutlich überlegen. Die über 50%ige Zeitersparnis reduziert den Personalaufwand.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050022
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    Myokardperfusion in Ruhe und unter Belastung (2000)
    Springer
    Der Radiologe 40 (2000), S. 155-161 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Koronare Herzkrankheit ; Magnetresonanztomographie ; Myokardperfusion ; SPECT ; Key words ; Coronary artery disease ; Magnetic resonance imaging ; Myocardial perfusion ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Aim: Performance of combined rest/stress MR perfusion studies and the analysis of qualitative signal intensity parameters in comparison with 99mTc-SestaMIBI SPECT in patients with known coronary artery disease (CAD). Methods: Sixteen patients with CAD underwent MR myocardial perfusion assessment at rest and after dipyridamole-induced hyperemia. Qualitative parameters (SI increase, SI upslope) of the SI time-curves were evaluated and characteristics of normal, reversible and persistent hypoperfused myocardium as assessed by 99mTc-SestaMIBI SPECT were compared. Results: Compared with the rest values, normal myocardium showed a significant increase of the SI upslope during hyperemia (P〈0.001), whereas persistent (P=0.07) and reversible (P=0.15) hypoperfusions showed only minor changes. SI increase over baseline also showed a significant increase only in normal myocardium (P〈0.001). At rest, reversible ischemic areas showed no significant differences from normal myocardium, whereas during hyperemia SI increase was significantly lower (P=0.02). Conclusions: Qualitative SI parameters of a combined rest/stress MR myocardial perfusion study allow to differentiate normal from reversibly or persistently hypoperfused myocardium.
    Notes: Zusammenfassung Fragestellung: Die kombinierte Ruhe- und Belastungsuntersuchung der myokardialen Durchblutung in der MRT sowie die Analyse qualitativer SI-Parameter der MR-Myokardperfusion bei Patienten mit koronarer Herzkrankheit wurden mit der 99mTc-SestaMIBI SPECT verglichen. Methode: Bei 16 Patienten mit koronarer Herzkrankheit (KHK) wurde in der MRT mit einer Mehrschichtgradientenechotechnik die Myokardperfusion unter Ruhe- und Belastungsbedingungen untersucht. Qualitative Signalintensitätsparameter der Kontrastmittelanflutung wurden berechnet und die Parameter in normalen, reversibel und persistierend minderperfundierten Myokardarealen miteinander verglichen. Ergebnisse: Normales Myokard zeigte im Gegensatz zu reversiblen (P=0,15) und persistierenden (P=0,07) Ischämien eine signifikante Zunahme der SI-Anstiegssteilheit unter Belastung (P〈0,001). Die SI-Zunahme zeigte ebenfalls nur in normal perfundierten Arealen eine signifikante Zunahme (P〈0,001) nach Belastung. Unter Belastung zeigte sich bei reversiblen Ischämien eine signifikant niedrigere SI-Zunahme als in normalem Myokard (P=0,02), während sich in Ruhe kein Unterschied zeigte. Schlussfolgerung: Qualitative SI-Parameter der kombinierten MR-Perfusionsuntersuchung des Myokards in Ruhe und unter Belastung erlauben die Differenzierung zwischen normalem sowie reversibel oder persistierend minderperfundiertem Myokard.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050025
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    Wertigkeit der diffusionsgewichteten MRT in der Beurteilung von Knochenmarkveränderungen bei Wirbelkörpermetastasen (2000)
    Springer
    Der Radiologe 40 (2000), S. 731-736 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Diffusionsgewichtete Kernspintomographie ; Wirbelkörpermetastasen ; Diffusionskoeffizient ; Keywords Diffusion weighted imaging (DWI) ; Magnetic resonance imaging ; Vertebral metastases ; Diffusion coefficient ; ADC
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Aim of the study. The aim of the study was the evaluation of the diffusion coefficient (ADC) of vertebral metastasis and regular vertebral bodies with diffusion weighted MRI (DWI). DWI evaluates the tissue-specific molecular diffusion of protons. In tissues with high cell densities (neoplasm) a decreased ADC can be expected due to restricted diffusion according to an exaggerated amount of intra- and intercellular membranes (i. e. diffusion barriers). Methods. In 5 breast cancer patients the ADC of both known vertebral metastases and of adjacent regular vertebral bodies were measured with DWI (1.0 T; Phased-Array-Body-Coil; b: 880 and 440 s/mm2). Results. The ADC of regular vertebral bodies (1.3±0.23×10–,3s/mm2) was significantly (p≤0.0002) higher than in vertebral metastases (0.39±0.11×10–3s/mm2). Conclusions. These data demonstrate that the ADC can be reliably measured in vertebral bodies. The quantitative evaluation of the ADC in vertebral bodies seems to be an objective and comparable parameter for differentiating malign from benign vertebral tissue.
    Notes: Zusammenfassung Ziel. Ziel der Arbeit war die Messung des Diffusionskoeffizienten (ADC) mittels diffusionsgewichteter (DW) MRT in Wirbelkörpermetastasen und in MR-morphologisch unauffälligen Wirbelkörpern. Die DW-MRT misst den für ein Gewebe spezifischen ADC, welcher der Eigendiffusion von Wasserstoffmolekülen entspricht. In zellreichem Tumorgewebe mit zahlreichen intra- und interzellulären Membranen (d. h. Diffusionsbarrieren) ist ein niedriger, in zellarmen oder nekrotischem Gewebe, ein hoher ADC zu erwarten. Methode. Bei 5 Patientinnen mit Mammakarzinom wurde der ADC von Lendenwirbelkörpermetastasen sowie von angrenzenden, MR-morphologisch unauffälligen Wirbelkörpern ermittelt (1,0 T; Phased-Array-Body-Coil; b: 880 und 440 s/mm2). Ergebnisse. Der ADC in MR-morphologisch unauffälligen Wirbelkörpern (1,3±0,23×10–3s/mm2) war signifikant (p≤0,0002) höher als in Wirbelkörpermetastasen (0,39±0,11×10–3s/mm2). Schlussfolgerung. Anhand dieser Daten konnte gezeigt werden, dass der ADC von Wirbelkörpern verlässlich gemessen werden kann, und dass durch die quantitative Bestimmung des ADC ein objektiv vergleichbarer Parameter zur Verfügung steht, der zur Differenzierung von malignem und benignem Gewebe gut geeignet erscheint.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050803
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  • 81
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    Ossäre Manifestationen beim Non-Hodgkin-Lymphom im Kindes- und Jugendalter (2000)
    Springer
    Der Radiologe 40 (2000), S. 737-744 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Lymphom ; MRI ; Keywords Lymphoma ; Bone neoplasms ; Diffusion coefficient ; ADC
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Purpose. Skeletal manifestation of Non-Hodgkin's lymphoma is rare in pediatric patients. Objective of the study was to determine imaging features, before and after treatment, and to correlate these features with clinical outcome. Methods. A retrospective analysis of 1246 patients from two therapy studies (NHL-BMF-90 and 95) was performed. Imaging studies of 63 patients with bone involvement of lymphoma were reevaluated. Results. Incidence of initial bone involvement in Non-Hodgkin's lymphoma was 6.8%. Distribution was best assessed by bone scan, MRI revealed larger areas of marrow involvement and detected additional lesions. Sites of prediliction were long bones of the lower extremities with epiphyseal involvement in 39%. Residual signal alterations in MRI after succussful therapy remained in 71%. Osteonecrosis after therapy was a common finding. Clinical outcome war not correlated to the presence of bone involvement. Conclusions. Since clinical outcome is not effected by bone involvement in childhood NHL, value of screening may be limited. Knowledge of imaging characteristics is mandatory for inital evaluation of primary osseous lymphomas and symptomatic lesions as well as for therapy controlls.
    Notes: Zusammenfassung Fragestellung. Skelettale Manifestationen des Non-Hodgkin-Lymphoms sind selten. Ziel der Studie waren die Analyse charakteristischer Veränderungen in der Bildgebung vor und nach Therapie sowie die Korrelation mit dem Therapieerfolg. Methode. Die retrospektive Analyse von 2 Therapiestudien (NHL-BMF-90 und 95) schloss 1246 Patienten ein. Die bildgebenden Untersuchungen von 63 Patienten mit skelettalem Lymphombefall wurden reevaluiert. Ergebnisse. Die Inzidenz des initialen Skelettbefalls beim Non-Hodgkin-Lymphom lag bei 6,8%. Die Verteilung der Skelettherde wurde durch die Szintigraphie am sichersten erfasst, die MRT detektierte im Vergleich größere Markraumbeteiligungen sowie zusätzliche Herdbildungen im Skelett. Prädilektionsorte waren die langen Röhrenknochen der unteren Extremitäten mit epiphysärer Beteiligung in 39% der Fälle. Residuale Signalveränderungen im MRT verblieben trotz kompletter Remission in 71% der Fälle. Osteonekrosen nach Chemotherapie waren häufig. Die therapeutische Ergebnisse wurden durch das Vorhandensein eines Skelettbefalls nicht beeinflusst. Schlussfolgerungen. Aufgrund der Beobachtung, dass die Therapieergebnisse vom Nachweis eines Skelettbefalls nicht wesentlich beeinflusst werden, erscheint der Wert der Screeninguntersuchung begrenzt. Die Kenntnis des Erscheinungsbilds vom NHL in der Bildgebung ist aber für die Beurteilung der primär ossären Lymphome und symptomatischer Herdbildungen sowie in der Therapiekontrolle notwendig.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050804
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    Entwicklungen in der Neonatologie (2000)
    Springer
    Der Radiologe 40 (2000), S. 2-7 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Neugeborenes ; Frühgeborenes ; Bildgebung ; Key words ; Newborn ; Premature infant ; Diagnostic imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Modern neonatology comprises care for a growing number of infants with congenital abnormalities and an increasing number of premature born infants. The survival rates of premature infants have increased dramati- cally during the past decade. This increase in survival rates can be attributed to improved prenatal and obstetric management and to advances in neonatal intensive care medicine. Radiological support: Neonatology has become a pediatric subspeciality of its own resulting in the demand for an equally specialised radiological support. Therefore the availability of a children´s radiologist for radiological and sonographic examinations is mandatory (24 hours a day) for optimal patient care on a neonatal intensive care unit. A good cooperation between radiologist and neonatologist in neonatal intensive care medicine is therefore warranted.
    Notes: Zusammenfassung Die moderne Neugeborenenintensivmedizin umfasst neben den typischen neonatalen Krankheitsbildern eine wachsende Zahl kleiner Frühgeborener mit einem Geburtsgewicht 〈1500 g und eine, durch verbesserte pränatale Diagnostik, zunehmend größer werdende Gruppe von Kindern mit komplexen Fehlbildungen. Anforderungen an den Radiologen: Diese Entwicklungen stellen auch an den Radiologen neue Anforderungen; neben der zunehmenden Zahl an Frühgeborenen und ihren speziellen Krankheitsbildern ist auch die Abklärung von speziellen, beim Intensivpatienten auftretenden Problemen erforderlich. Durch die meist gegebene Dringlichkeit der radiologischen Abklärung ist die Verfügbarkeit eines Kinderradiologen rund um die Uhr unabdingbar. Zudem müssen fahrbare Röntgen- und Ultraschallgeräte zur Verfügung stehen, um eine Diagnostik direkt am Krankenbett zu ermöglichen. Diskussion: An einer Neugeborenenintensivstation ist daher eine enge Zusammenarbeit mit dem Kinderradiologen unbedingt notwendig.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050002
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    Bildgebende Diagnostik des Neonatal stroke (2000)
    Springer
    Der Radiologe 40 (2000), S. 28-34 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Zerebralinfarkt ; Krampfanfall ; Neugeborenes ; Dopplersonographie ; Vasospasmus ; Key words ; Cerebral artery infarction ; Seizure ; Newborn ; Doppler sonography ; Vasospasm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclininal, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed.
    Notes: Zusammenfassung Ein Infarkt im Stromgebiet der Zerebralarterien stellt eine wichtige Differentialdiagnose bei neurologischen Auffälligkeiten in der Neonatalperiode dar. Die Inzidenz wird anhand von klinischer Daten auf 1:4000 Lebendgeborene geschätzt. Da der Verlauf oft subklinisch ist, liegt die wahre Inzidenz wahrscheinlich höher. Diagnose: Bei der Diagnosestellung kommen dem Schädelultraschall und der Dopplersonographie als leicht verfügbaren Screening-Methoden eine zentrale Rolle zu. Die definitive Diagnose wird, je nach Verfügbarkeit, mittels Computertomographie oder Kernspintomographie gestellt. Die Behandlung ist neben der symptomatischen (antikonvulsiven) Therapie auf die Vermeidung von ischämischen Sekundärschäden gerichtet. Diskussion: Wir wollen mit der vorliegenden Arbeit anhand von 3 Kindern mit verschiedenen klinischen Verläufen eines sog. Neonatal stroke den Stellenwert der bildgebenden Verfahren bei der Diagnostik und Verlaufskontrolle aufzeigen und die Sensibilität für dieses vermutlich unterdiagnostizierte Krankheitsbild erhöhen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050005
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  • 84
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    Electronic Resource
    „Lines and Tubes” beim neonatologischen Intensivpatienten (2000)
    Springer
    Der Radiologe 40 (2000), S. 52-57 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Zentrale Katheter ; Neonatologie ; Radiologie ; Key words ; Central catheter ; Neonatology ; Radiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background: Central catheters in neonatological intensive care patients are used for the prolonged application of medicataion or parenteral infusions. Dislocations and septic and thromboembolic complications may occur. Control of position: Radiologically, the correct position of the catheter must be proven. Dislocations or complications associated with central catheters must be diagnosed. For catheter monitoring plain film radiographs are the first line of investigation; however, sonography may be of additional assistance. Angiographic techniques should only be performed when conventional noninvasive methods do not supply satisfactory results. Special knowledge is necessary for monitoring catheters that are set via the umbilical artery or vein. The radiological applications for catheter monitoring in the neonate intensive care unit are discussed in this article.
    Notes: Zusammenfassung Hintergrund: Die im neonatologischen Krankengut am häufigsten verwendeten Zugänge sind Katheter, die eine prolongierte Verabreichung von Antibiotika, höher osmolarer Lösungen oder evtl. Chemotherapeutika gewährleisten. Komplikationen ergeben sich durch Fehllagen oder sind septischer und thrombembolischer Genese. Lagekontrolle: Für den Radiologen gilt es, eine adäquate Lagekontrolle des Katheters durchzuführen, um Fehllagen zu vermeiden, jedoch auch Komplikationen zu diagnostizieren. Für dieses Kathetermonitoring steht zur Lagekontrolle das Nativbild im Vordergrund, des Weiteren erweist sich jedoch die Sonographie als wesentlicher Pfeiler in der Katheterdiagnostik, insbesondere im Hinblick auf die katheterassoziierten Komplikationen. Angiographische Techniken sollten erst nach Ausschöpfen sämtlicher nichtinvasiver diagnostischer Möglichkeiten durchgeführt werden. Besondere Anforderungen ergeben sich durch die in der Neonatologie verwendeten Zugänge über den Nabel, wobei sowohl Kenntnis der exakten Topographie der Katheterlage als auch der speziellen potentiellen Komplikationen von großer Bedeutung ist. Im Folgenden sollen die radiologischen Aufgaben und Möglichkeiten beim Kathetermonitoring unter besonderer Berücksichtigung spezieller Anforderungen bei neonatologischen Intensivpatienten vorgestellt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050008
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    Nekrotisierende Enterokolitis (NEC) beim Neugeborenen (2000)
    Springer
    Der Radiologe 40 (2000), S. 58-62 
    Details
    ISSN: 1432-2102
    Keywords: Schlüsselwörter ; Nekrotisierende Enterokolitis ; Pneumatosis intestinalis ; Pneumoportogramm ; Perforation ; Leeraufnahme des Abdomens ; Sonographie ; Key words ; Necrotizing enterocolitis ; Pneumatosis intestine ; Pneumoportogram ; Perforation ; Plain radiography ; Sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Necrotizing enterocolitis (NEC) is a disease of the premature neonate that requires early therapy, sometimes even surgery and therefore early diagnosis. In general, plain radiography of the abdomen and sonography are valuable imaging techniques for diagnosis of NEC. Course of NEC: The disease starts with distension of small bowel loops. Furthermore the children develop pneumatosis in the bowel wall, which is a nonspecific pattern. If the NEC persists, the air passes into the portal vein system, causing a pneumoportogram. Finally, the disease can lead to perforation. In doubtful cases, the plain radiogram must be repeated within a period of 6 h. With sonography distension of the bowel, thickening of and pneumatosis in the bowel wall, the pneumoportogram and free intraperitoneal fluid can be easily depicted. The most common complications of NEC are intestinal stenosis and strictures that can lead to ileus. Differential diagnosis: Focal perforation of ileum, volvulus and Hirschsprung’s disease are some of the differential diagnoses.
    Notes: Zusammenfassung Die nekrotisierende Enterokolitis (NEC) ist eine schwere Erkrankung des Abdomens bei Frühgeborenen, die einer raschen, nötigenfalls chirurgischen Therapie zugeführt werden muss. Dazu bedarf es einer frühen Diagnose, die mit einer Leeraufnahme des Abdomens und Sonographie gestellt werden kann. Verlauf von NEC: Die NEC beginnt mit einer Dilatation des Darms, zumeist des Dünndarms, in 2. Linie des Dickdarms. Des Weiteren entwickeln sich stehende Schlingen und eine Pneumatosis intestinalis, die ein unspezifisches Zeichen ist und bei allen ischämischen Darmerkrankungen auftreten kann. Beim Fortschreiten der Erkrankung kommt es zum Pneumoportogramm und im schlimmsten Fall zur Perforation. Bei unklaren Abdomenleerbefunden ist eine engmaschige radiologische Kontrolle notwendig. Sonographisch können sowohl die Distension des Darms als auch die Pneumatosis intestinalis als auch das Pneumoportogramm als auch freie Flüssigkeit hervorragend erfasst werden. Spätkomplikationen sind Stenosen und Strikturen, die zu Subileus und Ileus führen können. Differentialdiagnosen: Die Differentialdiagnosen reichen von fokaler Ileumperforation bis hin zu Volvulus und Morbus Hirschsprung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001170050009
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    MRI demonstration of intracerebral cryptococcal granuloma (2000)
    Springer
    Neuroradiology 42 (2000), S. 30-33 
    Details
    ISSN: 1432-1920
    Keywords: Key words Granuloma cryptococcal ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report an intracerebral cryptococcal granuloma in a patient who presented with recent memory disturbance and deteriorating mental status followed by temporary loss of consciousness. To our knowledge, this is the first reported case of an intracerebral cryptococcal granuloma examined by a combination of conventional MRI, fluid-attenuated inversion-recovery and diffusion-weighted imaging and in which the surgical specimen was analysed histochemically.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050006
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  • 87
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    MRI of intracranial toxoplasmosis after bone marrow transplantation (2000)
    Springer
    Neuroradiology 42 (2000), S. 14-18 
    Details
    ISSN: 1432-1920
    Keywords: Key words Bone marrow, transplantation ; Toxoplasmosis, cerebral ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Toxoplasma encephalitis was confirmed by biopsy in three patients with bone marrow (BMT) or peripheral blood stem-cell transplantation (PBSCT). All had MRI before antimicrobial therapy. The intensity of contrast enhancement was very variable. One patient had one large, moderately enhancing cerebral lesion and several smaller almost nonenhancing lesions. The second had small nodular and haemorrhagic lesions without any enhancement. The third had late cerebral toxoplasmosis and showed multiple lesions with marked contrast enhancement. The moderate or absent contrast enhancement in the two patients in the early phase of cerebral toxoplasmosis may be related to a poor immunological response, with a low white blood cell count in at least one patient. Both received higher doses of prednisone than the patient with late infection, leading to a reduced inflammatory response. In patients with a low leukocyte count and/or high doses of immunosuppressive therapy, typical contrast enhancement may be absent.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050003
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  • 88
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    Cranial MRI in the Nijmegen breakage syndrome (2000)
    Springer
    Neuroradiology 42 (2000), S. 43-47 
    Details
    ISSN: 1432-1920
    Keywords: Key words Nijmegen breakage syndrome ; Anomalies of brain ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present the results ¶of MRI examinations in ten patients with documented Nijmegen ¶breakage syndrome (NBS), aged 1.75–19 years. T1-, Proton-Density- and T2-weighted spin-echo sequences were performed in three planes. All patients showed microcephaly with decreased size of the frontal lobes and narrow frontal horns. In four patients agenesis of the posterior part of the corpus callosum was found, with colpocephaly and temporal horns dilatation. In one patient callosal hypoplasia was accompanied by abnormal cerebrospinal fluid spaces and wide cerebral cortex, suspicious of pachygyria. Sinusitis was present in all ten patients, as a result of primary immunodeficiency. As in ataxia teleangiectasia and other breakage syndromes, patients with NBS show an inherited susceptibility to malignancy and hypersensitivity to X- and γ-radiation. CT is therefore contraindicated in these patients and MRI should be the method of choice for diagnostic imaging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050011
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    MRI and 18F-fluorodeoxyglucose positron emission tomography in hemimegalencephaly (2000)
    Springer
    Neuroradiology 42 (2000), S. 749-752 
    Details
    ISSN: 1432-1920
    Keywords: Key words Hemimegalencephaly ; Positron emission tomography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report hemimegalencephaly in a 44-year-old woman with mental retardation, epilepsy and a mild hemiparesis. In addition to typical findings on MRI, 2-deoxy-2[18F]fluorodeoxyglucose positron-emission tomography (PET) demonstrated glucose hypometabolism of the affected hemisphere. The results of PET have been coregistered with morphological information from the MRI studies by image fusion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000398
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  • 90
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    Classification of acquired lesions of the corpus callosum with MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 795-802 
    Details
    ISSN: 1432-1920
    Keywords: Key words Corpus callosum ; Ischaemia ; Demyelination ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract MRI has facilitated diagnostic assessment of the corpus callosum. Diagnostic classification of solitary or multiple lesions of the corpus callosum has not attracted much attention, although signal abnormalities are not uncommon. Our aim was to identify characteristic imaging features of lesions frequently encountered in practice. We reviewed the case histories of 59 patients with lesions shown on MRI. The nature of the lesions was based on clinical features and/or long term follow-up (ischaemic 20, Virchow-Robin spaces 3, diffuse axonal injury 7, multiple sclerosis 11, hydrocephalus 5, acute disseminated encephalomyelitis 5, Marchiafava-Bignami disease 4, lymphoma 2, glioblastoma hamartoma each 1). The location in the sagittal plane, the relationship to the borders of the corpus callosum and midline and the size were documented. The 20 ischaemic lesions were asymmetrical but adjacent to the midline; the latter was involved in new or large lesions. Diffuse axonal injury commonly resulted in large lesions, which tended to be asymmetrical; the midline and borders of the corpus callosum were always involved. Lesions in MS were small, at the lower border of the corpus callosum next to the septum pellucidum, and crossed the midline asymmetrically. Acute disseminated encephalomyelitis and the other perivenous inflammatory diseases caused relatively large, asymmetrical lesions. Hydrocephalus resulted in lesions of the upper part of the corpus callosum, and mostly in its posterior two thirds; they were found in the midline. Lesions in Marchiafava-Bignami disease were large, often symmetrically in the midline in the splenium and did not reach the edge of the corpus callosum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000430
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  • 91
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    Invasive aspergillosis presenting as a cavernous sinus mass in immuno competent individuals; report of 3 cases (2000)
    Springer
    Neuroradiology 42 (2000), S. 108-111 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cavernous sinus ; Magnetic resonance imaging ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aspergillosis of the cavernous sinus is rare, especially in immuno competent individuals. We report three such cases secondary to paranasal sinus aspergillosis, with imaging findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050025
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  • 92
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    How often is haemosiderin not visible on routine MRI following traumatic intracerebral haemorrhage? (2000)
    Springer
    Neuroradiology 42 (2000), S. 81-84 
    Details
    ISSN: 1432-1920
    Keywords: Key words Haemorrhage, intracerebral ; Haemosiderin ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Intracerebral haemorrhage may be visible indefinitely on MRI, due to persistence of haemosiderin in macrophages around the lesion, but it is not clear whether all haemorrhages produce haemosiderin or, if not, what proportion cannot be identified as former haemorrhages on routine MRI. We performed routine MRI (spin-echo T2- and proton-density weighted images) in 116 survivors of moderate to severe head injury, 1–5 years after injury. We reviewed the images blindly and correlated them with CT in the acute stage, to determine how many haemorrhages from the acute stage were identifiable by virtue of haemosiderin deposition on late MRI. Of 106 haemorrhages in 78 patients on CT at the time of injury, 96 (90 %) were visible as haemosiderin on late MRI. Of the old haemorrhages without haemosiderin, seven of ten were in patients where another haemorrhage with haemosiderin was still visible elsewhere in the brain. No patient or haemorrhage features explained the formation or absence of haemosiderin. Thus about 10 % of definite haematomas show no trace of haemosiderin on routine spin-echo MRI. Radiologists should be alerted to supplement routine spin-echo with gradient-echo sequences if there is a reason to suspect, or specifically exclude, prior haemorrhage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050019
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  • 93
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    Electronic Resource
    Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding (2000)
    Springer
    Neuroradiology 42 (2000), S. 115-117 
    Details
    ISSN: 1432-1920
    Keywords: Key words Degeneration, subacute combined ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a case of vitamin B12 deficiency and subacute combined degeneration in a patient with a gastrectomy. MRI showed high-signal lesions on T2-weighted images in both the posterior and anterior columns, associated with minor thoracic spinal cord expansion. The patient was treated with B12 supplements and clinical improvement was associated with reduction of the size of the lesions on MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050027
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  • 94
    Electronic Resource
    Electronic Resource
    Radionecrosis of the temporal lobe: dynamic susceptibility contrast MRI (2000)
    Springer
    Neuroradiology 42 (2000), S. 149-152 
    Details
    ISSN: 1432-1920
    Keywords: Key words Carcinoma nasopharyngeal ; Radionecrosis ; Magnetic resonance imaging ; Pulse sequences
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We examined nine patients with histologically proven nasopharyngeal carcinoma (NPC), treated with radiotherapy, using dynamic susceptibility contrast MRI (DSC-MRI). In eight there was clinical evidence of radionecrosis of the temporal lobe, and one was examined for local recurrence in the nasopharynx. All patients had either high-signal finger-like or cystic lesions in the temporal lobes on T2-weighted images. Heterogeneous contrast enhancement occurred in all patients. Relative regional cerebral blood volume (rrCBV) mapping revealed marked hypoperfusion in all patients. One underwent bilateral temporal lobectomy and radionecrosis was confirmed histologically.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050036
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  • 95
    Electronic Resource
    Electronic Resource
    Imaging and radiological-pathological correlation in histologically proven cases of focal cortical dysplasia and other glial and neuronoglial malformative lesions in adults (2000)
    Springer
    Neuroradiology 42 (2000), S. 157-167 
    Details
    ISSN: 1432-1920
    Keywords: Key words Dysplasia, focal cortical ; Hamartomas ; Epilepsy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Focal cortical dysplasia (FCD) is a pathological entity first described in 1971. Other more subtle cortical malformations found in patients with epilepsy include microdysgenesis (MD), and glioneuronal hamartias. Although these glial and neuronoglial malformations have distinct histological features, there is terminological confusion in the radiological literature. Few cases have been reported in adults with both imaging and histology. We address these issues, giving a radiological-pathological correlation of histologically proven cortical malformations in adults. We describe clinical, radiological and histological features of 12 cases (five FCD, five MD with glioneuronal hamartias, and two hamartomas), unassociated with other conditions, and discuss them in the light of the literature. FCD is usually seen on MRI as cortical thickening, with or without signal change, which may extend into the adjacent white matter. On histology, abnormal neurons and/or glial cells, blurring of the grey-white matter interface, myelin pallor, demyelination, and gliosis may be found. Glioneuronal hamartias and hamartomas usually appear as complex masses on MRI. FCD and hamartias may be associated, and a combination of imaging findings may be seen on MRI. Atrophy of the ipsilateral hippocampus may be present on MRI in patients with hamartias, and minor cell loss on histology, but not definitive hippocampal sclerosis. Although the imaging findings of cortical malformations are protean, some characteristic MRI features, with histological correlates, may be found. The relevance of most of these observations remains unclear.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050038
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  • 96
    Electronic Resource
    Electronic Resource
    Hippocampal malrotation with normal corpus callosum: a new entity? (2000)
    Springer
    Neuroradiology 42 (2000), S. 339-345 
    Details
    ISSN: 1432-1920
    Keywords: Key words Brain, development ; Hippocampus ; Magnetic resonance imaging ; Epilepsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Among 527 MRI examinations of patients with a suspicion of epilepsy in 5 years, we found 32 cases of hippocampal malrotation (HIMAL). The characteristic features are: incomplete inversion of the hippocampus with and abnormally round shape; unilateral involvement of the whole hippocampus; normal signal intensity and size; blurred internal structure; an abnormal angle of collateral sulcus; abnormal position and size of the fornix; normal size of the temporal lobe; enlargement and particular configuration of the temporal horn, typical of corpus callosum agenesis; and a normal corpus callosum. In 7 cases (22 %) HIMAL occurred together with developmental disorders. It was predominantly seen in men. The clinical features were varied. Based on some MRI features, the presence of developmental disorders, the male predominance, the frequently positive family history, and a review of the literature, we think HIMAL may be the consequence of a mild hemisphere developmental disorder. It is probably not the basic cause of epilepsy in such varied clinical setting, but may be a sign of a developmental disorder and can help in selecting patients for more meticulous investigation. It also may give some new understanding of brain development.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050895
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  • 97
    Electronic Resource
    Electronic Resource
    Cystic lesions of the pineal region – MRI and pathology (2000)
    Springer
    Neuroradiology 42 (2000), S. 399-402 
    Details
    ISSN: 1432-1920
    Keywords: Key words Pineal region ; Cysts pineal ; Pineocytomas ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Pineal lesions are rare. Tumours in this location comprise 0.4–1 % of intracranial tumours. They grow mainly as solid-mass lesions, and cystic tumours are not common. On MRI, a cystic configuration is associated usually with non-neoplastic pineal lesions rather than with a tumour, but analysis does not allow cystic pineal tumours to be distinguished from glial cysts with certainty. We compared neuroradiological and pathological data from 13 cystic pineal lesions, analysing preoperative MRI. Formalin-fixed, paraffin-embedded surgical specimens were stained routinely and immunocytochemically, using the streptavidin-biotin-complex method. Histology revealed six pineocytomas, four glial cysts, an arachnoid cyst, a low-grade astrocytoma and a teratoma. Signal characteristics of pineocytomas were similar in many respects to those of glial pineal cysts. Histomorphological analysis allowed unambiguous discrimination between pineocytomas and glial pineal cysts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000308
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  • 98
    Electronic Resource
    Electronic Resource
    MRI in decompression illness (2000)
    Springer
    Neuroradiology 42 (2000), S. 368-370 
    Details
    ISSN: 1432-1920
    Keywords: Key words Decompression illness ; Caisson disease ; Spinal cord ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report a case of decompression illness in which the patient developed paraparesis during scuba diving after rapid ascent. MRI of the spine revealed a focal intramedullary lesion consistent with the symptoms. The pathophysiological and radiological aspects of spinal decompression illness are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050901
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  • 99
    Electronic Resource
    Electronic Resource
    Spontaneous regression of a cyst of the cavum septi pellucidi (2000)
    Springer
    Neuroradiology 42 (2000), S. 360-362 
    Details
    ISSN: 1432-1920
    Keywords: Key words Cyst, cavum septi pellucidi ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 20-year-old woman with secondary amenorrhoea and an empty sella turcica was found to have a cyst of the cavum septi pellucidi (CSP) on MRI. The cyst had regressed spontaneously on follow-up MRI.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050899
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  • 100
    Electronic Resource
    Electronic Resource
    White-matter abnormalities in unirradiated patients cured of primary central nervous system lymphoma (2000)
    Springer
    Neuroradiology 42 (2000), S. 406-412 
    Details
    ISSN: 1432-1920
    Keywords: Key words Lymphoma, primary central nervous system ; Chemotherapy ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract On MRI, primary brain tumors are commonly seen as contrast-enhancing masses surrounded by areas of abnormal signal on T2-weighted images. Following successful treatment tumors may no longer show contrast enhancement. The residual abnormalities are assumed to be represent “edema” and infiltrating tumor cells. We report nine patients with primary lymphoma of the central nervous system who had complete responses to intravenous methotrexate, but did not receive intrathecal chemotherapy or cranial irradiation. After complete resolution of contrast-enhancing lesions, persistent abnormalities on T2-weighted images in the region of prior tumor were initially assumed to reflect residual viable tumor. As they remained unchanged for years, however, this may not hold true in the cases in which primary central nervous system lymphoma responds to chemotherapy alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340000301
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