RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. ⋯ Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides.
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The so-called non-occlusive disease (NOD) or non-occlusive mesenteric ischemia (NOMI) is a severe and life-threatening pathology. Even under optimal circumstances and standardised diagnostic and therapeutic procedures maximum survival rates do not exceed 50 %. The NOD is a pathology of the elder patient and its incidence rises with other comorbidities such as reduced cardiac output, diabetes and renal insufficiency. ⋯ The only sufficient method for diagnosis implicating a possible treatment option seems to be an immediate angiographic examination. Because of the disappointing results of a solitary surgical approach transarterial medication via catheter is indicated. Depending of the course of the disease only a combination of local mesenteric infusion of vasodilatory drugs and surgical resection of already necrotic bowel promises a successful therapeutic approach and better survival rates.
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Comparative Study
[Prospective observation of abdominal ultrasound in radiological emergency services: approaches to cost saving].
To analyze prospectively abdominal ultrasound in an emergency department (ED) with special emphasis on different routes of obtaining radiology service, reasons for consultation and ordering diagnosis, and to identify strategies for realizing cost savings. ⋯ In the ED, sonography was performed with significantly lower clinical effectiveness on self-referred than on physician-referred patients. Substantial cost-savings could be achieved by more selective use of abdominal sonography for self-referred patients.
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Comparative Study
[Contrast-enhanced MR angiography of the arterial and portovenous system of the liver with varying concentrations of contrast medium].
To evaluate the diagnostic value of a higher concentrated contrast medium (gadobutrol) for contrast-enhanced MRA of the hepatic arteries and portovenous system. ⋯ For MRA of the hepatic arteries and the portal veins, the higher concentrated Gd-DTPA contrast medium gadobutrol can be used at half the dosage recommended for the standard Gd-DTPA contrast medium.
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To introduce a new interventional method for CT-guided aortic balloon occlusion in patients with life-threatening abdominal or pelvic bleeding. ⋯ CT-guided aortic occlusion provides fast and effective bleeding control immediately after completion of the diagnostic CT. The procedure can be combined with other specific emergency surgical or interventional procedures. Experience with more patients is necessary for further evaluation of this new technique.