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1

Interventional MR imaging: Clinical results obtained with a 1.5 Tesla system; Interventionelle MR-Tomographie: Klinische Erfahrungen mit einem 1,5 Tesla System  

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The clinical feasibility of using interventional examination techniques was tested with an equipment combining fluoroscopy and MR imaging. This hybrid system showed to be of advantage in a great number of interventional examinations. The 1.5 Tesla magnet proved to be superior to open MR scanning systems in terms of image quality and scanning times. (orig.) [Deutsch] Es wurde die klinische Durchfuehrbarkeit interventioneller Techniken an einem kombinierten Durchleuchtungs- und MR-Arbeitsplatz untersucht. Dieses Hybridsystem erwies sich bei einer Vielzahl interventioneller Eingriffe als vorteilhaft. Der 1,5 Tesla-Magnet ist offenen MR-Systemen hinsichtlich Bildqualitaet und Messzeit ueberlegen. (orig.)

1997-05-01

2

Radiological diagnosis of lesions of intervertebral discs; Radiologische Diagnostik von Bandscheibenlaesionen  

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During their life, intervertebral discs undergo degenerative changes which need not necessarily become lesions. Conventional X-rays do not provide information on the condition of the intervertebral discs, so MRT or CT are recommended as primary techniques as they are non-invasive. Invasive methods like myelography and especially discography should not be used unless a case is highly problematic. In infants with pains in the back, MRT should be carried out as early as possible as there is nearly always an organic cause. (orig.) [German] Die Bandscheibe ist im Laufe des Lebens degenerativen Veraenderungen unterworfen, die klinisch zu Beschwerden fuehren koennen, aber nicht fuehren muessen. Konventionlle Roentgenaufnahmen lassen zwar die Hoehenminderung des Bandscheibenfachs und begleitende knoecherne Veraenderungen erkennen, nicht aber den Zustand der Bandscheibe selbst. Die Beurteilung der Bandscheibe und des Knochens gelingt mit der CT, die parallel zum ...

2003-03-01

3

Early diagnosis of skeletal disorders in childhood and adolescence by MRI; Fruehdiagnose orthopaedischer Erkrankungen des Kindes- und Jugendalters mit der MRT  

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The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)

1998-09-18

4

Die Umsetzung von Studienergebnissen in die klinische Praxis - Beispiel Kardiologie  

British Library Electronic Table of Contents (United Kingdom)

Summary A prospective and randomized trial design is of utmost interest when it comes to evaluating new developments in the management of cardiovascular medicine. By defining the primary end point and a profound related statistic new therapeutic options can be tested with an adequate number of patients. The course of the trial is supervised by a Clinical Events Committee and a Data and Safety Monitoring Board. Registries are promising tools for describing how the results of clinical trials are translated into daily practice. Their drawbacks include lack of control of the clinical endpoints and their uniform definition and lack of a control group. There are numerous examples from cardiology of the limited usefulness of data obtained from registry studies with their often unexpected results ...

2009-01-01

5

New stent developments for peripheral arterial occlusive disease; Neue Stententwicklungen fuer die periphere arterielle Verschlusskrankheit  

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Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' (Stentgrafts) haben eine zunehmende Bedeutung als Zusatztherapie zusammen mit der primaeren Ballonangioplastie gewonnen. In ...

2010-01-15

6

Atlas and toolbook of MR mammography; Lehratlas der MR-Mammographie  

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This richly illustrated toolbook and atlas contains information on all aspects of nmr diagnostic imaging of benign or malignant neoplasms of female and male mammary glands. It offers pinpointed guidance and insight for vocational training and continuing training of radiology assistants, students and medical radiologists. (orig./AJ) [German] Die MRT als hochaufloesendes und schaedigungsfreies Diagnostikum gewinnt gerade in der emotional stark besetzten Mammadiagnostik zunehmend an Bedeutung. Dennoch beherrschen nur wenige Zentren im deutschsprachigen Raum diese Technik, die - eine hohe Reproduzierbarkeit bei fehlender Belastung fuer die Patientin bietet, - invasive Karzinome bereits ab einer Groesse von 5 mm mit hoher Zuverlaessigkeit ausschliessen kann und - gerade bei widerspruechlichen Befunden zwischen klinischer Untersuchung, Roentgenmammographie und perkutaner Biopsie eine wesentliche Entscheidungshilfe bieten kann. Aus einem der fuehrenden Zentren in der ...

2000-07-01

7

New procedures. Comprehensive staging of lung cancer by MRI; Neue Verfahren. Umfassendes Staging des Lungenkarzinoms mit der MRT  

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Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das Staging des ...

2010-08-15

8

Assessment of the value of various tomography modalities for diagnostic evaluation of the female genital system; Stellenwert der Schnittbildverfahren bei der Abklaerung von Erkrankungen des weiblichen Genitaltrakts  

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The comprehensive survey explains the indications and the specific value of the modern tomographic modalities with respect to the various diagnostic issues. Numerous reproductions of CT, MRI, US scans illustrate the aspects discussed. (orig./CB) [German] Bildgebende Verfahren kommen bei der Abklaerung von Erkrankungen des weiblichen Urogenitaltrakts ergaenzend zu der klinischen Untersuchung zur Anwendung. Kongenitale Uterusanomalien werden primaer mit der HSG oder der Laparoskopie diagnostiziert. Zusaetzlich koennen der transvaginale US und in unklaren Faellen die MRT eingesetzt werden. Die Diagnose entzuendlicher Erkrankungen des weiblichen Genitaltrakts erfolgt in der Regel klinisch. Schnittbildverfahren werden bei therapieresistenten, komplizierten Faellen angewendet. Initial werden benigne Neoplasien des Uterus mit dem transvaginalen US abgeklaert. Eine Verdickung des Endometriums ist dabei ein unspezifischer Befund und kann auf eine Hyperplasie, Polypen oder ...

2001-09-01

9

Value of contrast-enhanced MRI of breast after silicone implant; Wertigkeit der Kontrastmittelmagnetresonanztomographie der Mamma bei Wiederaufbau mittels Implantat  

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Early recognition of recurrence and work-up of clinically indeterminate lesions may be impaired after reconstruction with silicone implants due to superimposition of the implant or to scarring. This study was undertaken to evaluate the use of contrast-enhanced MRI in patients with silicone implant after breast cancer. Contrast-enhanded MRI was offered to 169 patients. Comparative two- to three-view mammography was also performed in 169 patients, as well as comparative sonography in 144 patients. Conventional imaging and clinical examination detected only 8/13 recurrences, whereas 12/13 were detected by MRI. One recurrence had been visible as a strongly enhancing 2-mm dot in a previous examination (2 years before), but was not called. It was therefore counted as false negative. In addition, multicentricity was detected by MRI alone in two of three cases. MRI correctly diagnosed scar tissue in all cases with indeterminate findings. However, due to false-positive calls caused by enhancing ...

1997-09-01

10

The value of high-resolution MR-imaging for the staging of malignant lesions of tongue, pharynx and larynx; Klinische Wertigkeit der hochaufloesenden Magnetresonanztomographie beim Staging von Tumoren der Mundhoehle, des Pharynx und des Larynx  

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In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT{sub 2} to pT{sub 4} tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx. (orig.) [Deutsch] In einer prospektiven Studie wurden 102 Patienten mit malignen Tumoren der Mundhoehle, des Oro- und Hypopharynx sowie des Larynx mit der Mgnetresonanztomographie (MRT) untersucht, wobei besonders Wert auf die Bestimmung derjenigen ...

1994-02-01

11

Rational imaging strategies in larynx disease; Rationelle bildgebende Strategien bei Kehlkopferkrankungen  

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Clinical information is indispensable for swift and cost-effective clarification of diseases of the larynx. While quality clarification of neurological changes in the area of the posterior cranial fossa and in the course of the vagus nerve as a cause of glottis malfunction is possible with MRI, localized disease of the larynx can more effectively be assessed with low-artifact CT. In the particularly difficult assessment of the post-operative larynx, a recurrence can be diagnosed only after a baseline study has been carried out after the end of therapy. With knowledge of the pretherapeutic findings, the findings immediately post-therapy, and the operation technique used, the optimal CT examination, which can be carried out quickly, will be able to provide more information about recurrence. (orig.) [Deutsch] Zur schnellen und kostenguenstigen Abklaerung von Erkrankungen des Larynx ist die klinische Information unabdingbar: Wenn neurologische Veraenderungen im Bereich ...

1998-02-01

12

New MR techniques in diagnostic imaging of joints; Neue MRT-Techniken in der Gelenkdiagnostik  

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Already, MR Imaging is superior in diagnostic imaging of joints in many cases; however, there have been recent developments, which are the subjects of this paper. With gradient-echo sequences acquired in 3D technique, it is possible to produce high-resolution images of joints in acceptable scantime, because gradient-echo sequences are less time-consuming than convential SE sequences. With the acquisition of two echoes, phase difference between water and fat protons have to be considered. 3D Imaging is capable of displaying complex pathology in a superior way, which should be useful in preoperative planning. Tissue contrast is altered by fat saturation or magnetization transfer in order to achieve better conspicuity of lesions. Although diagnostic value of some of these options is not yet clear and further clinical studies are needed, they are a promising possibility for improving MR Imaging of the joints. (orig.) [Deutsch] In der Gelenkdiagnostik gibt es einige neuere Entwicklungen in ...

1993-12-31

13

Computed tomography in AIDS-related thoracic diseases; Computertomographie AIDS-assoziierter Thoraxerkrankungen  

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Pulmonary infections and tumors are a major cause of death in patients with AIDS. The combination of clinical, radiological, laboratory, and pathohistological data helps to narrow the spectrum of differential diagnoses or even allows a specific diagnosis in many patients. Nevertheless, an accurate diagnosis should be obtained as soon as possible during the clinical course of the illness to initiate treatment in time. Computed tomography (CT) has proven to provide promising results in the diagnosis of AIDS-related throacic diseases. The aim of this paper was to demonstrate the diagnostic capacities of CT in the context of particular AIDS-related thoracic pathologies. Additional information on the spectrum of pathological agents and on differential diagnostic signs is summarized. (orig.) [Deutsch] Pulmonale Infektionen und Tumore sind eine wesentliche Todesursache bei Patienten, die am erworbenen Immunmangelsyndrom AIDS leiden. In den meisten Faellen gelingt es, durch Zusammenschau ...

1996-07-01

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Local ablading therapy methods in case of liver metastases of colorectal carcinoma; Lokal abladierende Therapieverfahren bei Lebermetastasen kolorektaler Karzinome  

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Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende Verfahren. Klinische Studien belegen die ...

2003-03-01

15

Immunoscintigraphy with anti-225.28S for ocular melanoma - a comparison with histology and immunohistochemistry  

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Aim: The purpose of this prospective study was to evaluate the value of immunoscintigraphy (ISG) with anti-225.28S in clinically suspected ocular melanoma. Methods: For this purpose standardized ISG was performed in 36 patients using both planar acquisition and emission computed tomography (ECT). Ocular melanoma was present in 31 patients. In 21 patients therapy was enucleation of the eye. These specimens were evaluated by histology and immunohistochemistry in 11 of 21 patients. Results: Regarding the clinical diagnosis, ISG was positive only in 15 of 31 patients with ocular melanoma, regarding histology in 11 of 21 and regarding immunohistochemistry in 5 of 6 patients with a positive immunoreaction. 5 patients showed no immunoreactivity, their ISG was negative. Conclusion: Thus a good correlation between ISG and immunohistochemistry was observed. However ISG using the cutaneous melanoma antibody 225.28S cannot be recommended for the diagnostic work-up of an ocular melanoma considering ...

1997-03-01

16

Soft tissue manifestations of early rheumatic disease. Imaging with MRI; Fruehmanifestationen rheumatischer Gelenkerkrankungen an den Weichgewebestrukturen der Hand. Nachweis mit der MRT  

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The aim of this study was to evaluate typical magnetic resonance imaging (MRI) findings in early rheumatic diseases manifesting at the soft tissues of the hand using a retrospective analysis. A total of 186 MRI examinations of patients with clinical suspicion of a rheumatic disease were evaluated in a consensus reading by two experienced radiologists. All imaging patterns were assessed with respect to their type and localization. Under blinded and non-blinded conditions diagnoses were correlated with final clinical diagnosis. The most frequent diagnoses were rheumatoid arthritis (RA, 45.7%) and psoriatic arthritis (PsA, 15.6%). The mean correlation between clinical and MRI diagnosis (r) was 0.75 in blinded and 0.853 in non-blinded reading (p <0.001). The following extra-articular imaging patterns were found: synovitis (59.1%), tendovaginitis (91.4%), dactylitis (14.5%), and bone marrow edema (18.3%). Only dactylitis was specific for a particular rheumatic disease (PsA; r=0.934; ...

2006-08-15

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Magnetic resonance imaging (MRI) of the central nervous system in long-term manganese dioxide (MnO{sub 2}) exposed workers; Magnetresonanztomographie des Gehirns bei Beschaeftigten mit chronischer beruflicher Mangandioxid-Exposition  

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Aim: Changes within the brain detected by MRI after chronic manganese poisoning raised the question whether morphological changes of the basal ganglia, particularly of the globus pallidus, could be detected after chronic occupational exposure to manganese dioxide. Results: No cases of parkinsonism were detected in clinical examinations or by other means. The mean manganese concentration in blood was 12 {mu}g/l (range: 3.9-23.3 {mu}g/l). In comparison to the upper reference value of 10 {mu}g/l, 42 workers (56%) had a higher body burden. A significant positive correlation between manganese levels in blood and the PI (indicated by T{sub 1}-shortening) was observed as well as between the CBI and workplace-specific exposure. Brain atrophy was not detected in any of the observed cases. Conclusions: Long-term exposure to manganese dioxide dust correlates with the Pallidum-Index in MRI scans. Although the MRI findings have no current clinical relevance for individuals, further studies are ...

2000-06-01

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MR-based volumetric analysis of small tumor volumes: accuracy of phantom examinations of simulated eye tumors; Evaluierung der MR-Volumetrie kleiner Volumina am Beispiel von Augentumoren mittels Phantomuntersuchungen  

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Purpose: The determination of tumor volume in ocular tumors is very important for the planning and success of radiation therapy. This study uses an animal model to evaluate the accuracy of MR-based volumetry of ocular tumors. Materials and methods: In a total of 25 porcine eyes obtained from the slaughterhouse, ocular tumors were produced by injecting a mixture of hand creme and Gd-DTPA under ophthalmoscopic guidance. The injected volume varied between 0.05 ml and 2.7 ml. The eyes were examined with a 1.5 Tesla scanner and a 4 cm circular surface coil especially developed for ocular MRI. After data transfer to a separate workstation, volumetric analysis was carried out by three independent radiologists using semiautomated software. The determined volume was compared with the injected volume. Results: Of the 25 prepared porcine eyes, 23 were suitable for volumetric analysis. The injection of the mixture of hand creme and GD-DTPA produced two different types of tumors. ...

2003-07-01

19

HDR and MDR intracavitary treatment for carcinoma of the uterine cervix. A prospective randomized study  

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Aim: Treatment of carcinoma of the uterine cervix by remote afterloading brachytherapy has been accompanied with new isotopes having dose rates different from the classical low-dose rate (LDR) radium source. The dose rate conversion factor from LDR to high-dose rate (HDR) found to be around 0.54 in most studies. As regards medium-dose rate (MDR) brachytherapie, the published data are very few and the experience is still short. In this study the experience of Osaka University Hospital with micro-HDR-Selectron and Selectron-MDR, as a preliminary report of the clinical trial, is presented. Results: The 3-year survival and loco-regional control rates for both modalities were nearly equivalent (62% and 67% for HDR and 68% and 74% for MDR)(totally 45 patients). The cumulative rectal and bladder complication rates were the same in both groups (29% at 3 years), with only 1 patient (MDR-group) developed grade 3 rectal and bladder complication. In this study, point A dose rate correction factor ...

1997-03-01

20

Role of nuclear medicine and magnetic resonance imaging in cardiac diagnostics; Rolle der nuklearmedizinischen Verfahren und der Magnetresonanztomographie in der kardialen Diagnostik  

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Nuclear medicine and magnetic resonance imaging (MRI) are widely used in cardiac diagnostics. Both techniques have been carefully evaluated and are equivalent for the assessment of regional and global wall motion as well as the evaluation of ejection fraction and cardiac volumes, though MRI is herein currently seen as gold standard. For evaluation of myocardial perfusion, extensive data exist for nuclear imaging, that, next to high diagnostic accuracy for evaluation of coronary artery disease, show incremental prognostic information and allow for independent risk stratification. Because of rapid technical advance, myocardial perfusion imaging has also become feasible with cardiac MRI. Results of recent studies are promising, but the data are few compared to perfusion scintigraphy. For viability assessment in patients with ischemic cardiomyopathy, positron emission tomography (PET) with FDG is currently seen as gold standard. However, single photon emission computed tomography (SPECT) ...

2003-12-01

 
 
 
 
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Magnetic resonance imaging. Handbook and atlas; Kernspintomographie. Kompendium und Atlas  

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Magnetic resonance imaging (MRI) as a diagnostic imaging tool relies on the generation of magnetic fields, whereas the computerized tomography (CT) uses X-radiation. The fundamental principle of MRI is the magnetic resonance of paramagnetic atomic nuclei. These nuclei, as e.g. protons (= hydrogen nuclei), are aligned in required orientation by application of a strong magnetic field. Upon simultaneous application of an electromagnetic high-frequency field perpendicular to the axis of the basic magnetic field, and in response to periodical changing of the electromagnetic field at a given frequency, the originally aligned paramagnetic nuclei are forced into a movement similar to that of a ``whipping top``. When the resonance frequency is shut off, the nuclei return to their former, aligned positions, inducing a weak signal in a coil. The series of signals generated by multiple repetition of this process of excitation of nuclei and their return to aligned rest is used as input to a ...

1999-10-01

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Quantitative analysis of spinal CSF dynamics using magnetic resonance imaging: experimental and clinical studies; MR-tomographische Liquorflussmessungen am Spinalkanal mit einem optimierten MRT-Protokoll: experimentelle und klinische Untersuchungen  

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Purpose: Measurement of the oscillating CSF flow in the spinal canal (SC) of healthy volunteers and in patients with post-traumatic syringomyelia (PTS) using an optimized MRI protocol as well as to determine whether stenosis induced velocity changes are detectable using MRI. Methods: In 68 healthy volunteers quantitative studies of CSF flow in the cervical, thoracic, and lumbar regions were performed. First, an optimized sequence was developed and tested in 19 volunteers using four different flow-encoding velocities (4, 8, 12, 16 cm/s). Secondly, the optimized sequence was employed in 49 volunteers to measure the different CSF patterns in the cervical, thoracic, and lumbar spinal canals (CSC, TSC, LSC). Part three of the study, in which patients with PTS are being examined is still underway. We measured the maximum velocity (cm/s), the pixel area (mm{sup 2}), and the stroke volume (ml/s). Using a flow model the velocities prior to and after compression with 5 different power levels ...

2001-04-01