RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
-
Neurofibromatosis type 1 (NF1) is a neurogenetic disorder. Individuals with NF1 may develop a variety of benign and malignant tumors of which peripheral nerve sheath tumors represent the most frequent entity. Plexiform neurofibromas may demonstrate a locally destructive growth pattern, may cause severe symptoms and may undergo malignant transformation into malignant peripheral nerve sheath tumors (MPNSTs). Whole-body magnetic resonance imaging (MRI) represents the reference standard for detection of soft tissue tumors in NF1. It allows for identification of individuals with plexiform neurofibromas, for assessment of local tumor extent, and for evaluation of whole-body tumor burden on T2-weighted imaging. Multiparametric MRI may provide a comprehensive characterization of different tissue properties of peripheral nerve sheath tumors, and may identify parameters associated with malignant transformation. Due to the absence of any radiation exposure, whole-body MRI may be used for serial follow-up of individuals with plexiform neurofibromas. (18)F-fluorodeoxyglucose positron-emission-tomography (FDG PET/CT) allows a highly sensitive and specific detection of MPNST, and should be used in case of potential malignant transformation of a peripheral nerve sheath tumor. PET/CT provides a sensitive whole-body tumor staging. The use of contrast-enhanced CT for diagnosis of peripheral nerve sheath tumors is limited to special indications. To obtain the most precise readings, optimized examination protocols and dedicated radiologists and nuclear medicine physicians familiar with the complex and variable morphologies of peripheral nerve sheath tumors are required. ⋯ Individuals with NF1 may develop benign and malignant nerve sheath tumors. Whole-body MRI is the reference standard to identify nerve sheath tumors in NF1. MRI provides a comprehensive characterization of the growth pattern, growth dynamics and extent of nerve sheath tumors. (18)F-FDG PET/CT provides a sensitivity of 100% and a specificity of 77-95% for detection of malignant transformation.
-
To date, no prospective comparative study of the diagnostic value of STIR versus T1-weighted (T1w) sequences at both 1.5 T and 3 T has been performed with special focus on the detectability of bone metastases. ⋯ In a routine MR protocol, T1w imaging is sufficient for the detection of bone metastases. In case of differential diagnostic problems, other appropriate sequences can be added to the protocol. STIR is inferior to T1w in the detection of metastases, especially at 3 T.
-
To evaluate the effect of an age-dependent D-Dimer cut-off in patients who underwent a computed tomography pulmonary angiogram (CTPA) for suspected pulmonary embolism (PE) Material and Methods: Retrospective application of an age-dependent D-dimer cut-off (age/100 in patients aged over 50) in 530 consecutive patients, both in- and outpatients, aged over 18, who underwent CTPA for suspected PE according to the guidelines. ⋯ The application of an age-dependent D-dimer cut-off reduces the number of CTPA as part of the diagnostic algorithm in patients suspected for PENo reduction in diagnostic safety was found. The age adjustement performed equally in outpatients and inpatients
-
Since the Ebola virus was discovered in 1976, the largest outbreak to date is the ongoing epidemic in West Africa based on the number of cases. The number of infected people is high among aid workers, some of whom have been treated at intensive care units in specialized centers in Europe and the USA. A 38-year-old patient who got infected with the Ebola virus was treated in a special isolation ward at the Frankfurt University Hospital from 10/3/14 to 11/19/14. During intensive care of the patient, X-rays were essential for control of the cardiopulmonary system and for follow-up. Special guidelines had to be considered for performing X-rays due to the risk of transmitting the virus. These are presented and discussed in the following. ⋯ Chest radiographs are essential in the intensive care monitoring of Ebola patients. Chest radiographs help to assess the extent of pulmonary edema and capillary leak syndrome. With careful observance of hygiene guidelines, he risk of transmission can be virtually eliminated.