Der Radiologe
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The advent of whole-body MRI (WB-MRI) has introduced a systemic approach to oncologic imaging compared to established sequential, multi-modal diagnostic algorithms. Hardware innovations, such as whole-body scanners at 1.5 Tesla and also recently 3 Tesla, combined with acquisition acceleration techniques, have made WB-MRI clinically feasible. With this method dedicated assessment of individual organs with various soft tissue contrast, high spatial resolution and contrast media dynamics can be combined with whole-body anatomic coverage. ⋯ WB-MRI is also very attractive as a radiation-free alternative for imaging of pediatric tumor patients in whom multiple follow-up examinations may be required. WB-MRI allows for precise assessment of the bone marrow and has been proven to be highly accurate for the staging of hematologic diseases, such as multiple myeloma. In this article recent developments and applications of WB-MRI in oncologic imaging are addressed and compared to the results of PET/CT.
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(18)F-fluorodeoxyglucose positron-emission tomography (FDG-PET) and especially hybrid FDG-PET/CT is becoming more and more accepted for the clinical management of adult and pediatric patients with sarcomas. By integrating the CT component the specificity in particular but also the sensitivity of the modality are improved further. With PET/CT a complete staging including the detection of lung metastases is feasible in a single examination. ⋯ Contrast-enhanced MRI remains a key tool in the diagnosis of recurrent disease, especially in tumors which are not hypermetabolic. Dynamic contrast-enhanced MR sequences can significantly contribute to therapy monitoring. More research is necessary to prospectively compare dynamic contrast-enhanced MRI and FDG-PET/CT for evaluation of local and recurrent diseases.
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Acute abdomen is a serious clinical situation and prompt imaging is mandatory so that appropriate therapeutic measures can be taken. Multiple diseases can present with the clinical signs and symptoms of acute abdomen. Ultrasound is widely available and can be performed expeditiously. ⋯ Contrast-enhanced ultrasound is among these valuable innovations. In this article the application of modern ultrasound techniques for the diagnosis of the most common causes of acute abdomen is outlined, which may be due to diseases of the gastro-intestinal tract, parenchymal organs in the upper abdomen as well as vascular disorders. Moreover, the diagnostic efficacy and the value as compared to other imaging modalities are analyzed.
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Although diseases of the paranasal sinuses have a relatively homogeneous clinical presentation, their causes can vary considerably. Radiological imaging only became relevant in paranasal sinus diagnostics following the introduction of cross-sectional imaging. ⋯ Particularly in acute inflammatory diseases as well as traumatic lesions, imaging is essential in preoperative planning and postoperative control. The article gives a detailed description of options in radiologic imaging of the paranasal sinuses.
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Case Reports
[Acute compartment syndrome of the forearm after paravasation of contrast medium. Case report].
The paravasation of radiographic contrast medium has a wide spectrum of clinical presentations, ranging from local erythema and swelling to extensive damage to the extremity affected. We report the case of a patient who developed an acute compartment syndrome of the forearm after paravenous mechanical injection of 100 ml radiographic contrast medium. After emergency fasciotomy for muscle and nerve decompression the full range of motion and sensitivity could be restored.