Der Radiologe
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Diagnosis of trauma-related injuries is a key task in modern radiology. Early, thorough and accurate detection of potentially life-threatening injuries is crucial for fast and targeted initiation of treatment. Conventional radiography (CR) and ultrasound (US) are well-established and still represent the basic diagnostic tools for trauma imaging. ⋯ Careful optimization of imaging parameters has to be performed to minimize exposure and maximize diagnostic safety. Modern MDCT examinations produce a large number of images, which have to be limited to a reasonable number for interpretation. This review article focuses on optimization of examination protocols and on how to handle the flood of images for viewing and archiving.
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Case Reports
[A 74-year-old female patient with histologically proven carcinoid of the lungs and pulmonary mosaic pattern].
Diffuse idiopathic neuroendocrine cell hyperplasia (DIPNECH) can be idiopathic or reactive to chronic airway disease, then termed pulmonary neuroendocrine cell hyperplasia (PNECH). DIPNECH can be complicated by obliterative bronchiolitis and is presumably often misdiagnosed because the clinical symptoms are unspecific, the entity is relatively unknown and high-resolution computed tomography (HRCT) in inspiration and expiration is necessary for the diagnosis. ⋯ DIPNECH is thought to be a precursor of tumorlets and carcinoids and usually runs a benign course. The diagnosis is confirmed by histology.
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Primary bone tumors and tumorlike lesions are rare. However, they are found on x-ray incidentally or during examination of a painful skeletal region. This article explains how to diagnose such a detected lesion. ⋯ Further steps include analysis of the tumor matrix and the location within the tumor-bearing bone to make a specific diagnosis. Finally, the patient's age is included as a further parameter. With an optimized combination of the different parameters, the expert achieves a correct specific diagnosis in about 80% of cases.
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Neuroendocrine tumors are slowly growing neoplasms and 75% of patients already present with hepatic metastases at the time of diagnosis. Size and growth of liver metastases is of prognostic value. Due to arterial vascularization of metastases, transarterial embolization (TAE) is a suitable procedure, which can also be combined with chemotherapeutic agents. ⋯ Embolization is usually performed in several sessions depending on individual tumor stage and disease progression. Embolization is a cost-effective procedure and is included in the treatment algorithm of international guidelines. Therefore, evaluation of new embolization therapies must be evaluated in randomized controlled studies.