RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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To retrospectively evaluate the performance of breath-hold contrast-enhanced 3D dynamic parallel gradient echo MRI (pMRT) for the characterization of focal liver lesions (standard of reference: histology) and for the analysis of hepatic vasculature (standard of reference: contrast-enhanced 64-detector row computed tomography; MSCT) in a single MRI session. ⋯ Diagnostic image quality remains good or excellent in most cases when the data acquisition time is accelerated by means of parallel imaging in dynamic MRI. It allows reliable detection and characterization of focal liver lesions as well as the depiction of hepatic vascular variants, portal vein thrombosis, and arterial stenosis. Introducing pMRT in routine liver MRI may be another step towards a simplified diagnostic work-up prior to liver surgery.
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Assessment of fat-suppressing diffusion imaging as a tool for tumor search in primary oncological staging and follow-up after treatment. ⋯ Introduction of diffusion-weighted imaging provides a new independent parameter in oncological scanning. DWIBS meets the requirements of a fast, robust technique. Homogeneous fat suppression allows the use of maximum intensity projections which may visualize the spread of the disease at first glance. Most of the tumor entities examined in this study showed a bright signal in DWI. Exceptions were some osteoplastic metastases and hemorrhaged lesions. Although sensitive, visual evaluation of signal intensity alone showed limited specificity. Detection of lesions in physiological hyperintense structures may be difficult. DWIBS imaging seems to be a sensitive tool in the search for lymphomas and gastrointestinal tumors.
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Whole-body CT scans for patients with multiple trauma represent an increasingly accepted first diagnostic tool. The multidetector approach in particular provides appropriate diagnostic algorithms for detecting nearly all relevant traumatic findings in a short time with a high grade of sensitivity and specificity. Non-trauma-associated additional findings are commonly depicted based on these CT examinations. The aim of this study is to evaluate the number and quality of these additional findings in consecutive patients with multiple trauma. ⋯ Whole-body CT scans of patients randomized by a trauma show a considerable number of non-trauma-associated additional findings. In about 30 % of cases, these findings are clinically relevant because further diagnostic workup or treatment in the short or medium-term is needed. The results of these analyses emphasize the diagnostic value of CT examinations with high demands on the examining radiologist.
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The spectrum of pathology affecting the central nervous system (CNS) in patients suffering from acquired immunodeficiency syndrome (AIDS) includes not only the human immunodeficiency virus (HIV) infection itself but also opportunistic infections and tumors secondary to AIDS. Despite progress in antiretroviral therapy and the subsequent decrease in the incidence of associated diseases, opportunistic infections and tumors secondary to the HIV infection continue to be the limiting factor in terms of survival with AIDS. ⋯ Magnetic resonance imaging is often the diagnostic method of choice in suspected CNS pathology of HIV patients. In the following, the typical clinical and radiological features of several AIDS-related pathologies are presented and discussed.