Der Radiologe
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Comparative Study
[Diffusion weighted MRI: ischemic and traumatic injuries of the central nervous system].
Diffusion weighted magnetic resonance imaging (DWI) represents a recent development that extends imaging from the depiction of the neuroanatomy into the field of functional and physiologic processes. DWI measures a fundamentally different physiologic parameter than conventional MRI. Image contrast is related to differences in the microscopic motion (diffusion) of water molecules within brain tissue rather than a change in total tissue water. ⋯ Full tensor DWI allows to calculate a variety of functional maps, the most widely used maps include maps of apparent diffusion coefficients and isotropic diffusion. In addition maps of anisotropic diffusion can be calculated which are believed to give information about the integrity and location of fiber tracts. This functional-anatomical information will most probably play an increasingly important role in the early detection of primary and secondary tissue injury from various reasons and could guide and validate current and future neuroprotective treatments.
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A targeted successful treatment of spinal infectious diseases requires clinical and laboratory data that are completed by the contribution of imaging procedures. Neuroimaging only provides essential informations on the correct topography, localisation, acuity and differential diagnosis of spinal infectious lesions. ⋯ We present pyogenic, granulomatous and postoperative variants of spondylodicitis, spinal epidural abscess, spinal meningitis and spinal cord infections. The importance of intravenous contrastmedia application is pointed out.
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The indication for spinal angiography has to be closely set as in case of inadequate handling this procedure bares the risk of paraplegia. In unclear spinal symptoms lasting over a longer period of time, spinal vascular malformation have to be considered. ⋯ Diagnostic methods have to include spinal angiography if other non-invasive methods do not lead to results. The main point is to consider spinal vascular malformations in unclear cases.
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To evaluate the use of a needle guide for CT guided puncture for the reduction of radiation dose of the interventional radiologist. ⋯ The use of the needle guide is reducing the radiation dose of the interventional radiologist during CT-guided punctures.
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Dissections due to deceleration trauma are rarely limited to the infradiaphragmal aorta (only 2-3%) and are usually lethal. Here we report the unusual course of an abdominal aortic dissection with aneurysmatic enlargement of the false lumen. ⋯ During the intervention sondation of the false lumen revealed that the left renal artery had a reentry. Due to the complexity of the entry-reentry situation of the left renal artery the intervention was not possible, and the patient had to undergo vascular surgery.