0000000000185476
AUTHOR
O. Rieker
CT-Angiographie bei arterieller Verschlußkrankheit: Vergleich von 3 Rekonstruktionsverfahren
Purpose To evaluate different rendering techniques of CT data for the assessment of long vessel segments in peripheral vascular occlusive disease. Material and methods 40 CT angiograms (aortoiliac: n = 20, leg arteries: n = 20) were viewed using three different rendering techniques: 1, maximum intensity projection (MIP); 2, volume rendering (VR); 3, shaded surface display (SSD). CT angiograms were obtained in 6 or 8 projections. Axial cross-section images were analysed using an interactive cine mode. Intraarterial DSA was the standard in all cases. Results The sensitivities for the diagnosis of occlusive disease were 100% (cross-section images), 94% (MIP), 91% (VR) and 93% (SSD). The specif…
Das Popliteaaneurysma: Klinik und Diagnostik
PURPOSE To identify clinical and radiological features allowing an early diagnosis of popliteal aneurysms. MATERIAL AND METHODS History, clinical features and radiological findings of 23 patients with 37 aneurysms were reviewed. RESULTS 14 patients presented with a history of a sudden onset of rest pain localised in the calf or foot. Arteriography found popliteal artery occlusion in 12 of them. Amputation was necessary in one patient in spite of immediate diagnosis and therapy. In two cases embolisation of the tibial vessels caused intermittent claudication. In at least 7 patients the underlying disease was not suspected until arteriography was performed. In 16/23 patients the presence of t…
CT angiography versus intraarterial digital subtraction angiography for assessment of aortoiliac occlusive disease.
The purpose of this study was to evaluate the accuracy of CT angiography (CTA) with a single helical acquisition for assessment of stenoses and occlusions of the iliac arteries.In our prospective study, intraarterial digital subtraction angiography and IV CTA were performed from the suprarenal aorta to below the femoral bifurcation in 30 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were also obtained. The accuracy of CTA with and without analysis of axial images was determined.Sensitivity and specificity of CTA were 100% for iliac artery occlusions with a confidence interval 85-100% and 97-100%, respectively. When axial scans were interpret…
CT-Angiographie versus intraarterielle DSA bei Bauchaortenaneurysmen
PURPOSE To evaluate if CT angiography is able to image all features necessary for the preoperative planning of abdominal aortic aneurysms (accessory renal arteries, stenoses or occlusions of renal and iliac arteries, patency of inferior mesenteric artery). METHODS CT angiography and DSA were performed on 27 patients with abdominal aortic aneurysms. CT angiography was performed using a protocol that covered the abdominal aorta and the pelvic arteries with a single spiral acquisition (contrast dose: 150 ml, collimation: 5 mm, table feed: 7.5 mm/s, increment of reconstruction: 2 mm). Maximum intensity projections (MIP) and axial scans were compared with the results of intraarterial DSA. RESULT…
Radiologic Evaluation of the Transplant Candidate
Before a patient is placed on the waiting list for liver transplantation, a variety of screening procedures are performed, including laboratory tests and radiological procedures. One goal is to search for abnormalities that preclude liver transplantation. Another is to detect abnormalities that in some way will affect the operative procedure. The individual periopera- tive risk is evaluated by searching for pulmonary, cardiac, and renal changes.
Automatische Klassifikation der Lebersegmente nach Couinaud: Entwicklung eines neuen Algorithmus und Evaluierung an Spiral-CT-Datensätzen
Purpose: To develop a software tool that analyzes the anatomy of the portal vein branches and assigns segmental and subsegmental branches according to Couinaud's classification system and to evaluate its accuracy. Materials and Methods: The algorithm was developed in C++ on a PC. The algorithm recognizes the three major branching patterns of the portal vein. Segmental and subsegmental branches are assigned to 8 segments following Couinaud and encoded by 8 colors. The software was evaluated using CT data sets of 39 patients. After the individual segmental anatomy of each patient was determined by an experienced radiologist, automatic classification was performed and the results were compared…
Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings.
Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease. Computed tomography showed a calcified rim of the lesion which may be a useful feature to rule out osteosarcoma in this condition.
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-…
3D-CT von Frakturen: Vergleich von Volumen- und Oberflächen-Rekonstruktionen
Purpose The comparison of volume rendering (VR) and surface rendering (SSD) for demonstrating fractures from spiral-CT data. Materials and methods Standardized VR and SSD projections were produced from 50 spiral CT scans of 50 consecutive patients with fractures. Appropriate multiplanar reformattings (MPR) were used as the standard. Results SSD provided sufficient information in 31/50 cases. Results of VR were not significantly different (33/50). VR was superior in demonstrating 6/7 craniofacial fractures and 3/3 calcaneal fractures. SSD was superior for visualizing 2/3 shoulder fractures and 2/2 elbow fractures. Conclusion VR is a flexible technique for the depiction of fractures and the a…
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 …
MRT des Herzens bei Verdacht auf Myokarditis
Purpose To evaluate the potential of ECG-gated breath-hold MRI in diagnosing acute myocarditis. Material and methods Cardiac MRI was performed on 21 consecutive patients with suspected myocarditis. ECG-gated breath-hold T2-weighted images with fat suppression were acquired in 3 standard views. T1-weighted imaging (FLASH) was performed 10 min after IV administration of Gd-DTPA. Laboratory data included creatine kinase, troponin T and serological tests, ECG findings and echocardiography. Imaging findings were retrospectively compared to the discharge diagnoses. Signal alterations were semiquantitatively classified. Results Acute myocarditis was diagnosed in 9 patients and cardiac sarcoidosis …
Farbkodierte Volumen-Rekonstruktionen zur dreidimensionalen Darstellung von CT-Daten
PURPOSE To evaluate a technique of colored three-dimensional reconstructions without segmentation. MATERIAL AND METHODS Color-coded volume rendered images were reconstructed from the volume data of 25 thoracic, abdominal, musculoskeletal, and vascular helical CT scans using commercial software. The CT volume rendered voxels were encoded with color in the following manner. Opacity, hue, lightness, and chroma were assigned to each of four classes defined by CT number. Color-coded reconstructions were compared to the corresponding grey-scale coded reconstructions. RESULTS Color coded volume rendering enabled realistic visualisation of pathologic findings when there was sufficient difference in…
Segmentanatomie der Leber in der Computertomographie: Lokalisieren wir die Läsionen richtig?*
Purpose: To evaluate if Couinaud's model using the planes of the major veins is an adequate tool for the presurgical localization of focal liver lesions. Methods: Biphasic helical CT scans were performed on patients evaluated for liver resection using an increased IV bolus of contrast medium (180 ml lopamidol) and 2 mm image reconstruction increments. During the first evaluation, all liver lesions were localized in the conventional way using the planes of the 3 major hepatic veins and the portal trunks as segmental boundaries. In a second review, all lesions were attributed to the nearest peripheral portal branches. The path and the segmental attribution of the portal branches were analysed…
Prospective comparison of CT angiography of the legs with intraarterial digital subtraction angiography.
The aim of this study was to determine the accuracy of CT angiography (CTA) with a single spiral acquisition for the diagnosis of arterial stenoses and occlusion in patients with peripheral vascular occlusive disease.In a prospective study, intraarterial digital subtraction angiography and i.v. CTA from the groin to the lower calves were performed on 50 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were produced. The accuracy of CTA with and without analysis of the axial scans was determined with digital subtraction angiography as the standard.The sensitivities of CTA were 100% for the diagnosis of femoral artery occlusion, 100% for the dete…