0000000000055073
AUTHOR
A. Teifke
Dynamic MR imaging of breast lesions: correlation with microvessel distribution pattern and histologic characteristics of prognosis.
To evaluate the association of dynamic enhancement parameters of benign and malignant breast lesions at magnetic resonance (MR) imaging with microvessel distribution and histologic prognostic tumor characteristics.Regional review board approval and informed consent were obtained. Surgical resection specimens of breast lesions (32 benign, 86 malignant) in 118 patients (age range, 28-86 years; mean, 58 years) who had undergone dynamic T1-weighted MR imaging of both breasts were included in the study. Different MR enhancement parameters and microvessel density (MVD) distribution were determined. In malignant lesions, TNM stage, tumor grade, proliferative activity, and hormone receptor expressi…
Preoperative assessment of breast cancer: sonography versus MR imaging.
The purposes of our study were to compare the diagnostic value of whole-breast sonography and MR imaging as adjunctive techniques to mammography and to determine whether MR imaging should be used routinely in the preoperative assessment of patients with suspected breast cancer.. One hundred four women (age range, 34-84 years; mean age, 60 years) with findings highly suggestive of malignancy in the breast were examined with mammography, sonography, and dynamic MR imaging before undergoing surgery. All visualized suspicious lesions were correlated histologically. The diagnostic relevance of sonographic and MR imaging findings was compared with the diagnostic value of the findings of clinical …
Spiral-Computertomographie der Mamma
Aim To evaluate the use of spiral CT in the diagnosis of breast lesions. Material and methods 93 female patients with suspicious or uncertain mammographic findings were examined by CT before and after contrast enhancement according to the following practical method: table movement, 6 mm/s, slice thickness 6 mm, increment 4 mm, contrast 200 ml, injection rate 3 ml/s, scan start 50 s after the beginning of the injection. Histological confirmation was present in 85 patients. Results All 44 invasive carcinomas were recognised. They were characterised by intensive focal contrast uptake. Only 2 out of 7 intraductal carcinomas were not shown by CT. 36 out of 38 benign lesions were correctly diagno…
Wertigkeit und Leistungsfähigkeit moderner bildgebender Verfahren
Ausgehend von Anamnese und Symptomatik der Patienten ergibt sich eine klinische Fragestellung an die bildgebende Diagnostik, die zur Wahl eines bestimmten Untersuchungsverfahrens fuhrt. Das Untersuchungsergebnis wird mit der Fragestellung korreliert. Als Ergebnis kann dann die Frage definitiv beantwortet werden, mus die Antwort uberpruft werden, wurde die Frage nur inkomplett beantwortet oder hat sich eine neue Frage ergeben. Dies kann zur Wahl eines zweiten Untersuchungsverfahrens fuhren. Der hier skizzierte iterative Problemlosungszyklus der bildgebenden Diagnostik lauft alltaglich in Klinik und Praxis ab und unterstreicht die zentrale Bedeutung der Wahl des geeigneten Verfahrens der bild…
Outcome Analysis and Rational Management of Enhancing Lesions Incidentally Detected on Contrast-Enhanced MRI of the Breast
The purpose of our study was to assess the prevalence, characteristics, and clinical consequence of incidentally detected enhancing lesions on MRI of the breast. SUBJECTS AND METHODS. MRI of the breast (1.0-T scanner, dynamic gadolinium-enhanced T1-weighted three-dimensional gradient-echo sequence, double breast coil) was performed on 1273 women for different indications. Enhancing incidental lesions were defined as enhancing lesions on MRIs that were not expected from findings on the previous conventional imaging. They were classified in five assessment categories using a scoring system based on morphologic and kinetic enhancement characteristics. Detection of enhancing incidental lesions …
Die Skaphoidpseudarthrose: Häufigkeit, Pathogenese und Verlauf
Eight-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixty-seven were present at the first examination and 16 pseudoarthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion.
Das prim�re mediastinale Seminom
Die seltenen primaren extragonadalen Seminome sind mit in die Differentialdiagnose des unklaren Mediastinaltumors einzubeziehen. Die Symptomatik ist uncharakteristisch, die Diagnose wird in den meisten Fallen durch eine Thoracotomie bzw. Sternotomie gestellt. Therapeutisch steht das chirurgische Vorgehen mit kurativer Zielsetzung oder palliativer Tumorverkleinerung im Vordergrund. Bei makroskopisch vollstandig entferntem Tumor ist die Nachbestrahlung des Mediastinums zu diskutieren, bei metastasierendem Tumor sollte postoperativ eine Chemotherapie mit Cisplatin enthaltenden Kombinationen durchgefuhrt werden.
Eine Kombination niedrig und hochauflösender dynamischer T1-gewichteter Sequenzen zur besseren Beurteilung der Morphologie Kontrastmittel aufnehmender Läsionen in der MRT der weiblichen Brust
Purpose: Presentation of a new protocol for simultaneous acquisition of both low and high resolution T 1 -weighted images of breast lesions for dynamic contrast-enhanced MR mammography. Demonstration of possible diagnostic improvement with representative measurements in patients with suspected breast cancer by adding morphologic parameters from high resolution sequences to the analysis of the signal-time curve. Materials and Methods: Dynamic MR imaging was performed with a 1.5 T system (Magnetom SONATA, Siemens Medical Systems, Germany) and the manufacturer's double-breast coil. Coronal T 1 -weighted 3D FLASH sequences (spatial resolution 1.25 ×1.25 mm 2 ; slice thickness 1.7 mm) were acqui…
Selbstorganisierende neuronale Netze zur automatischen Detektion und Klassifikation von Kontrast(mittel)-verstärkten Läsionen in der dynamischen MR-Mammographie
Purpose: Investigation and statistical evaluation of "Self-Organizing Maps," a special type of neural networks in the field of artificial intelligence, classifying contrast enhancing lesions in dynamic MR-mammography. Material and Methods: 176 investigations with proven histology after core biopsy or operation were randomly divided into two groups. Several Self-Organizing Maps were trained by investigations of the first group to detect and classify contrast enhancing lesions in dynamic MR-mammography. Each single pixel's signal/time curve of all patients within the second group was analyzed by the Self-Organizing Maps. The likelihood of malignancy was visualized by color overlays on the MR-…
Undetected Malignancies of the Breast: Dynamic Contrast-enhanced MR Imaging at 1.0 T
To assess the prevalence and characteristics of malignant breast lesions not identified with magnetic resonance (MR) imaging.Breast tissue specimens were obtained in 464 of 967 patients who had undergone dynamic gadolinium-enhanced T1-weighted fast low-angle shot three-dimensional MR imaging of both breasts. A comparison of sensitivity, specificity, and predictive values of the prospectively recorded findings of mammography, ultrasonography (US), and MR imaging with the histopathologic results was performed with receiver operating characteristic (ROC) curve analysis. MR imaging examination findings that caused a false-negative diagnosis were reviewed to identify possible sources of error.Hi…
Der Sicherheitsgurt: Auswirkungen auf das Verletzungsmuster von Autoinsassen
Since 1984 the law concerning safety belts has been implemented; this paper deals with the findings in 386 victims of motor accidents who were x-rayed between 1981 and 1989. Minor injuries have been ignored. The number of passengers wearing belts increased by 30% after 1984. The number of passenger injuries did not decrease. Injuries directly caused by the belts included a small number of fractures of clavicles, the sternum and ribs and one pelvic fracture, one serious abdominal injury with tearing of the mesenteric artery and one ruptured spleen. An indirect result of wearing seat belts was a marked increase in cervical whiplash injuries and some increase in thoracic vertebral fractures. N…
Das Chlorom (Granulozytäres Sarkom, Myeloblastom) - Klinik und radiologische Diagnostik -
Six cases of granulocytic sarcoma are presented. A mediastinal chloroma and a tumor of the submandibular gland were observed with two patients as single sign of acute myeloic leukaemia. In one patient a chloroma appeared as first manifestation of acute myeloic leukaemia. Two patients exhibited the tumor as first symptom of a blastic crisis of chronic myelogenous leukaemia (femoral bone, lumbar spine). The sixth patient with a myelodyplastic syndrom showed a chloroma of the breast. Various radiological procedures were applied including plain radiography, MRT, CT and mammography. The results are compared with literature. Principles of therapy were supplemented.
Die direkte perkutane radiologische Jejunostomie (PRJ) und Duodenostomie: eine retrospektive Auswertung
Purpose: To present our experience with direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) for alimentation. Materials and Methods: A retrospective study identified 24 patients who had undergone percutaneous jejunostomy or duodenostomy guided by CT and fluoroscopy over a period of 9 years. Whenever possible, the jejunum was inflated with a 5 French diagnostic catheter and jejunopexy was performed using Cope anchors (T-fasteners). A 12 to 14 French locking pigtail drain was inserted for alimentation. In 8 patients, percutaneous direct jejunostomy was performed using only fluoroscopy. In 9 patients, both CT and fluoroscopy were used to guide the jejunostomy. In all 7 patients w…
Drei-Phasen-Spiral-CT in der Diagnostik von Lebererkrankungen: Vergleich mit CT-Arteriographie und -Arterioportographie
PURPOSE Assessment of the diagnostic efficacy of triphasic spiral-CT scanning (TPS-CT) for liver disease evaluation. CT arteriography (CTA) and CT arterio-portography (CTAP) were used as reference, methods which together have the highest sensitivity for detecting tumours and the perfusion conditions of the liver. MATERIAL AND METHODS 50 TPS-CT and CTA/CTPA were performed in 49 patients. After an initial examination without enhancement the first scan was initiated 15-25s after the peripheral bolus injection of contrast medium, the second after an interscan delay of 20-25s. By this means the liver was imaged in different phases of perfusion. In the course of the CTA/CTPA-exam the imaging was …
Imaging findings of primary breast sarcoma : results of a first multicenter study
Abstract Purpose To investigate imaging findings in patients with primary breast sarcoma (PBS). Materials and methods A retrospective search in the databases of 10 radiological departments in Germany from 2000 to 2011 was performed. Only histologically proven cases of PBS were included into the study. Mammography was available in 31 patients (33 lesions), ultrasound images in 24 patients (24 lesions), and for 10 patients (14 lesions) magnetic resonance imaging (MRI) of the breast was performed. The breast findings were classified according to the American College of Radiology Breast Imaging Reporting and Data Systems (BI-RADS) 5th edition categories. Collected data were evaluated by means o…
MR-Mammographie zur Responsekontrolle bei primärer Chemobrachytherapie des BET-inoperablen Mammakarzinoms
Ziel: Evaluierung (1) moglicher storender Effekte neoadjuvanter Chemobrachytherapie auf die MR-Mammographie, (2) der Eignung der MRM zur Bestimmung der Resttumorgrose nach Therapie und (3) der Eignung der MRM zur Prognose des Gesamtansprechens nach den ersten Therapiezyklen. Methoden: 14 Patientinnen, die an einer praoperativen Tumorreduktionstherapie (4 Zyklen Chemotherapie kombiniert mit interstitieller Radiotherapie) teilnahmen, wurden mittels dynamischer MR-Mammographie (1 T, zeitliche Auflosung 93 s, raumliche Auflosung 1,9 mm, 0,1 mmol/kg GdDTPA) vor Therapie, nach den ersten beiden Chemotherapiezyklen, nach der Radiotherapie und dem dritten Zyklus sowie nach Therapieabschluss untersu…