Die Schnittbilddiagnostik in der Traumatologie und in der prä- und posttherapeutischen Abklärung nach Arthroskopie umfasst Ultraschall (US), Computertomographie (CT) und Magnetresonanztomographie (MRT). In den letzten Jahren kam es zu umfassenden Veränderungen in der Gerätetechnik. Die folgende Übersicht gibt einen Überblick über die relevanten Veränderungen in der muskuloskelettalen Diagnostik.

Poster: ECR 2011 / C-2285 / Monitoring of neoadjuvant chemotherapy by contrast-enhanced ultrasound in patients with breast carcinoma: preliminary results by: Schuster, A. Haid, M. Knauer, A. Lang, M. Cejna; Feldkirch/AT

Die Arthroskopie ist in vielen Bereichen eine Alternative zur offenen Operation geworden, so auch bei Ellenbogen und Handgelenk. Dieser Überblick befasst sich mit der Rolle der Schnittbilddiagnostik vor und nach einer Arthroskopie und gibt einen Überblick über die Rolle der MR- und CT-Arthrographie.

Purpose: Accurate stenosis quantification in the carotid arteries is of great clinical importance. We aimed to compare the diagnostic accuracy of multi-slice computed tomography angiography (CTA) to digital subtraction angiography (DSA) for the detection and grading of atherosclerotic lesions involving the supraaortic arteries.Materials and methods: We retrospectively analyzed 30 patients (10 women; mean age, 67 years). CTA was performed after administration of 100 ml Ultravist 370 (Bayer Schering, Germany), at a flow of 5 ml/s, using a Philips Brilliance 16MDCT scanner (Philips, Best, Netherland) at a collimation of 16 mm x 0.75 mm prior to DSA. The supraaortic arteries were divided into 17 segments, and, within each segment, the presence and severity of stenotic or occlusive lesions was determined, based on a four-point scale (0-49%, 50-69%, 70-99%, occlusion), by four independent readers using the NASCET criteria. Sensitivity and specificity of MDCT was calculated for the detection of moderate (50-69%) versus significant stenoses (70-99%) and occlusion.Results: There were 291 segments assessed with both methods. Thirteen lesions were "not assessable" on CTA. DSA identified 53 significant lesions, and CTA 56 significant lesions. With regard to significant lesions, CTA overrated six lesions and underestimated six lesions, resulting in a sensitivity, specificity, and accuracy of 86.4%, 97.6%, and 95.9%, respectively. For the detection of stenoses greater than 50%, sensitivity, specificity, and accuracy were 90.2%, 95.8%, and 94.8%, respectively.Conclusions: Compared to DSA, CTA shows high accuracy in the detection and grading of lesions involving the supraaortic arteries enabling its use in the detection and treatment planning for stenoses of the supraaortic vessels. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

Purpose: Computed tomography angiography (CTA) is a time and cost saving investigation for postoperative evaluation of clipped cerebral aneurysm patients. A retrospective study was conducted to analyse image quality and artefact generation due to implanted aneurysm clips using a new technology.Methods: MSCTA was performed pre- and postoperatively using a Philips Brilliance 64-detector-row CT scanner. Altogether, 32 clipping sites were analysed in 27 patients (11 female and 16 male, mean ages 52a, from 24 to 72 years). Clip number per aneurysm was 2.3 mean (from 1 to 4), 54 clips were made of titanium alloy and 5 of cobalt alloy.Results: Altogether, image quality was rated 1.8 mean, using a scale from 1 (very good) to 5 (unserviceable) and clip artefacts were rated 2.4 mean, using a 5 point rating scale (1 no artefacts, 5 unserviceable due to artefacts). A significant loss of image quality and rise of artefacts was found when using cobalt alloy clips (1.4 versus 4.2 and 2.1 versus 4.0). In 72% of all investigations, an excellent image quality was found. Excluding the cobalt clip group, 85% of scans showed excellent image quality. Artefacts were absent or minimal (grade 1 or 2) in 69% of all investigations and in 81% in the pure titanium clip group. In 64-row MSCTA of good image quality with low artefacts, it was possible to detect small aneurysm remnants of 2 mm size in individual patients.Conclusion: By using titanium alloy clips, in our study up to 85% of postoperative CTA images were of excellent quality with absent or minimal artefacts in 81% and seem adequate to detect small aneurysm remnants. (C) 2010 Elsevier B.V. All rights reserved.

Clinical & Experimental OphthalmologyVolume 36, Issue 1 p. 94-96 Reversible posterior leukoencephalopathy syndrome and intravenous bevacizumab Silvia Peter MD, Silvia Peter MD Departments of Ophthalmology andSearch for more papers by this authorNorbert Hausmann MD, Norbert Hausmann MD Department of Ophthalmology, Medical University Graz, Graz, AustriaSearch for more papers by this authorAntonius Schuster MD, Antonius Schuster MD Radiology, Academic Teaching Hospital Feldkirch, Feldkirch, andSearch for more papers by this authorHubert Friedrich Boehm MD, Hubert Friedrich Boehm MD Departments of Ophthalmology andSearch for more papers by this author Silvia Peter MD, Silvia Peter MD Departments of Ophthalmology andSearch for more papers by this authorNorbert Hausmann MD, Norbert Hausmann MD Department of Ophthalmology, Medical University Graz, Graz, AustriaSearch for more papers by this authorAntonius Schuster MD, Antonius Schuster MD Radiology, Academic Teaching Hospital Feldkirch, Feldkirch, andSearch for more papers by this authorHubert Friedrich Boehm MD, Hubert Friedrich Boehm MD Departments of Ophthalmology andSearch for more papers by this author First published: 17 February 2008 https://doi.org/10.1111/j.1442-9071.2007.01658.xCitations: 19Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume36, Issue1January/February 2008Pages 94-96 RelatedInformation

PURPOSE To prospectively determine, in a randomized controlled trial, whether cutting balloon angioplasty (CBA) yields superior morphologic and clinical outcomes at 6 months compared with the 6-month outcomes after conventional percutaneous transluminal angioplasty (PTA) in patients with short de novo superficial femoropopliteal artery (SFA) lesions. MATERIALS AND METHODS This study was approved by the ethics committees of the two participating centers, and informed consent was obtained from all patients. The authors randomly assigned 43 patients (26 men, 17 women; median age, 69 years) who had 5 cm or shorter de novo SFA lesions in association with intermittent claudication or chronic limb ischemia to undergo CBA or PTA. The patients were followed up clinically, and restenosis was assessed with duplex ultrasonography (US) at 6 months. chi(2) and Mann-Whitney U tests were used to compare data between the two treatment groups. RESULTS The US-determined 6-month restenosis rate was 32% (seven patients) in the PTA group versus 62% (13 patients) in the CBA group (P = .048). Sixteen (73%) PTA group patients versus eight (38%) CBA group patients were asymptomatic at follow-up (P = .059). There was no significant difference in ankle-brachial index (median, 0.83 vs 0.77 for PTA vs CBA group, respectively; P = .56) or pain-free walking distance (median, >1000 m vs 600 m for PTA vs CBA group, respectively; P = .17) between the two groups. CONCLUSION CBA did not prove to be superior to conventional PTA for treatment of short de novo SFA lesions and yielded increased restenosis rates at 6 months.

Purpose: To compare ventricular volume measurement using a volumetric approach in the three standard cardiac planes and ventricular volume estimation by a geometrical model, the Area-Length method (ALM).Materials and methods: Fifty-six healthy volunteers were examined (27 males, 29 females) on a 1.5 T MR-unit with ECG-triggered steady state free precision (SSFP) Cine-MR sequences and parallel image acquisition. Multiple slices in standardized planes including the short-axis view (sa), 4-chamber view (4ch), left and right 2-chamber views (2ch) were used to cover the whole heart. End-systolic and end-diastolic ventricular volumes (EDV, ESV), stroke volume (SV), and ejection fraction (EF) were calculated with Simpson's rule in all planes and with ALM in the 2ch and 4ch planes. Global function parameters measured in the sa plane were compared with those obtained in the other imaging planes.Results: A very good correlation is observed when comparing functional parameters calculated with Simpson's rule in all imaging planes: for instance, the mean EDV/ESV of the left and right ventricle of the female population group measured in sa, 4ch, and 2ch: left ventricle EDV/ESV 114.3/44.4, 120.9/46.5, and 117.7/45.3 ml; right ventricle EDV/ESV 106.6/46.0, 101.2/41.1, and 103.5/43.0 ml. Functional parameters of the left ventricle calculated with ALM in 2ch and 4ch correlate to parameters obtained in sa with Simpson's rule in the range of 5-10%: for instance, the EDV/ESV of the left ventricle of the male population group measured in the sa, 4ch, and 2ch: 160.3/63.5, 163.1/59.0, and 167.0/65.7 ml. Functional parameters of the right ventricle measured with ALM in 4-ch are 40-50% lower and calculated in 2ch almost double as high as compared with the parameters obtained in sa with Simpson's rule: for instance, male right ventricular EDV/ESV measured in sa, 4ch, and 2ch: 153.4/68.1, 97.5/34.5, and 280.2/123.2 ml. The EF correlates for all imaging planes measured with the Simpson's rule in both ventricles and using ALM in the left ventricle except for males with an overestimation of less than 6%. The EF of the right ventricle is calculated higher using ALM in 4ch and 2ch compared to the EF calculated in sa: female/male EF of the right ventricle measured in the sa, 4ch, and 2ch: 56.8/55.7, 66.0/65.0, and 60.0/57.0%.Conclusion: In the setting of healthy volunteers the ALM method should not be used in 2ch and 4ch planes of the right ventricle because of lacking correlation of global functional parameters compared to those obtained in the sa plane. Using Simpson's rule functional parameters correlate well to each other in the different imaging planes. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

BACKGROUND:Breast cancer is increasingly detected during an early non-palpable stage. Together with pre-operative marking of the mass, intra-operative imaging provides invaluable clues. This study was designed to evaluate the usefulness of intra-operative sonography in the hands of the surgeon.METHODS:Between July 2001 and October 2006, 567 patients underwent treatment for operable breast cancer at the landeskrankenhaus (LHK) Feldkirch. Three hundred and sixty lesions were not palpable. Two hundred and ninety-nine patients with poorly definable or non-definable lesions well seen by ultrasound imaging underwent intra-operative sonography (group 1), while 61 patients with non-palpable lesions only seen on mammography (group 2) were subjected to pre-operative needle localization. The study was non-randomized with prospective data acquisitionRESULTS:All lesions were identified by both sonography and pre-operative needle localization. In the ultrasound group (group 1) 81% of the lesions were successfully removed by primary intention without metachronous secondary surgery versus 62% in group 2 (p < 0.00228). Eighty-eight percent of the lesions in group 1 were eligible for breast-conserving surgery versus 75% in group 2. The mean clear margin in group 1 was substantially smaller (4.8 mm) than in group 2 (7.2 mm) (p < 0.0001).CONCLUSION:Intra-operative sonography proved to be a reliable and helpful tool in the hands of the surgeon, not only for tumor localization, but also for orientation during tumor excision. It simplifies organizational work and spares the patient the discomfort of pre-operative needle localization.

OBJECTIVE:To investigate whether a mechanism of action of alpha-blockers on lower urinary tract symptoms (LUTS) involves improved perfusion of the LUT.PATIENTS, SUBJECTS AND METHODS:The accuracy of perfusion measurements using transrectal colour Doppler ultrasound (TRCDUS) and colour pixel density (CPD) was initially confirmed in a porcine model. Following this confirmation, measurements were taken from four healthy male volunteers and 19 patients with LUTS. The urinary bladder was filled slowly (50 mL/min) with 0.2 m KCl, which resembles the osmolarity of concentrated urine, and evaluated by cystometry. In parallel, TRCDUS and measurement of the CPD of the LUT were performed. The patients with LUTS were then treated with daily alpha-blocker (0.4 mg tamsulosin) for 5 weeks and urodynamic variables as well as perfusion were evaluated again.RESULTS:In the healthy men, perfusion of the LUT increased considerably (157%) during filling of the bladder to a mean (sd) maximum cystometric capacity (C(max)) of 481 (28.9) mL. All the patients with LUTS had a reduced mean C(max) during filling with KCl at 322.4 (58.5) mL. The mean CPD in the urinary bladder and the prostate were only increased by 58.4% during filling with KCl. After alpha-blocker therapy the mean C(max) during filling with KCl rose to 382.5 (42.9) mL; furthermore, perfusion of the LUT measured by CPD was significantly increased (132.8%).CONCLUSIONS:The present data strongly suggest that LUTS are associated with chronic ischaemia of the prostate and urinary bladder. alpha-blockers increase perfusion in the LUT and C(max). These results might explain the therapeutic effects of alpha-blockers on LUTS.

We collected data to provide evidence that orbital cavernous malformations (CMs) are histopathologically, neuroradiologically, and clinically different from cerebral CMs and may represent a distinct entity. In this study, the main clinical, histopathological and radiological characteristics of 19 patients (11 females and eight males, mean age 49.1 years) with orbital CMs out of a series of 376 orbital tumors are analyzed and compared with 107 cases with cerebral CMs treated in the same period. Decrease of visual acuity and painless progressive proptosis were the main clinical signs observed in 17 patients (89%). Complete microsurgical excision of lesions via individualized approaches was obtained in all cases. Follow-up examinations were obtained after a mean of 3.1 years (11 months to 7 years) and yielded complete recovery in 14 patients, while five remained clinically unchanged. Based on clinicopathological and neuroradiological studies of these 19 patients with orbital and 107 patients with cerebral CMs treated in the same period, we found evidence that orbital CMs have specific features to distinguish them from cerebral CMs. Orbital CMs, in contrast to the cerebral CMs, showed non-degenerated well-developed vessel walls and were covered by a hard and compact capsule. Clinical symptoms are characterized by the growth of orbital CMs due to intraluminal thrombosis and subsequent recanalization of cavernous vessels; there were no signs of hemorrhage. We found evidence to suggest that orbital CMs represent a distinct clinicopathologic and neuroradiologic entity.

OBJECTIVE:To determine if there are areas of major and minor perfusion in a single testicle, and if the quality and quantity of sperm are correlated with the level of perfusion, we collected testicular tissue from areas with different levels of perfusion.DESIGN:Controlled clinical study.SETTING:Consecutive patients with azoospermia.PATIENT(S):Patients with azoospermia undergoing testicular sperm extraction (TESE) biopsy for the retrieval of sperm to be used in an assisted reproduction program.INTERVENTION(S):Perfusion mapping was performed with the use of color Doppler ultrasound. Areas with different levels of perfusion were marked with needles. After incision with radiofrequency cutting, the exposed tissue was examined with a laser Doppler flowmeter, and biopsies were taken for TESE and histology. Sperm were analyzed using World Health Organization criteria, and prepared for intracytoplasmic sperm injection (ICSI).MAIN OUTCOME MEASURE(S):Correlation of sperm quality and quantity in testicular-tissue biopsies, with tissue-perfusion units (TPU) measured by laser Doppler flowmeter.RESULT(S):From 40 biopsies taken from 20 testicles of 12 patients, tissue was analyzed for sperm quality and quantity. Sperm quality was highest in areas of high tissue perfusion. In areas of 70 TPU, 72.3% progressive sperm were detected, whereas in areas of 10 TPU, only 13.3% progressive sperm and elevated numbers of precursor cells could be observed. The number of motile sperm isolated from tissue samples correlated well with the intensity of tissue perfusion.CONCLUSION(S):We have shown for the first time that in patients suffering from azoospermia, sperm quality and quantity depend on tissue perfusion within the testicle.

Diverticula of the left ventricle are rare developmental disorders found together with other malformations or incidentally detected by ventriculography. MR diagnosis of such diverticula is discussed with the aid of four case reports. Using a retrospective gated turbo-field-echo single-shot-free-precision Cine-MR technique temporal and spatial resolution is sufficient enough to detect left ventricular diverticula. MRI is valuable for the exact differentiation of muscular contracting diverticula and dyskinetic or non-contracting fibrous diverticula which might be important for the management of such malformations.

This study was designed to evaluate power Doppler imaging for assessment of urinary bladder neck blood flow in comparison with laser Doppler flowmetry (LDF) in an animal model. Transrectal power Doppler ultrasound (US) and LDF of the urinary bladder neck were performed in three anesthetized pigs during comparative cystometry. Normal saline (NaCl) was used for the first run, followed by a second run with 0.2 mol/L potassium chloride (KCl). Standardized sonographic equipment settings (Acuson Sequoia 512); MountainView, CA) were used for power Doppler imaging. Computer-assisted calculation of color pixel density (CPD) of power Doppler images was performed using Scion Image) software image analysis. Tissue perfusion units (TPU) were measured using a BLF21 laser Doppler flowmeter (Transonic Systems Inc., Ithaca, NY, USA). The power Doppler results were compared with the findings obtained by LDF. NaCl filling resulted in a mean CPD increase at the bladder neck from 18.65 (+/- 1.78) at empty bladder to 37.8 (+/- 1.84) at 100 mL and to 88.32 (+/- 1.35) at full bladder capacity (C(max)) of 270 mL, respectively. With KCl filling, a mean CPD increase from 18.65 (+/- 1.78) to 59.63 (+/- 0.5) at 100 mL and 110.82 (+/- 2.98) at full bladder capacity (270 mL) was observed. The CPD increase was significantly higher for KCl than with NaCl (p < 0.001). With NaCl filling, bladder neck blood flow increased from 22 TPU (empty) to 46 TPU (100 mL) and 62.5 TPU at C(max), compared to 22 TPU, 50 TPU and 102.5 TPU with KCl. CPD and TPU measurements showed a strong correlation at p = 0.01. In conclusion, transrectal power Doppler US image quantification is a feasible and accurate method for assessing blood flow changes in the urinary bladder neck.

You have accessJournal of UrologyDiscussed Poster, Tuesday, May 11, 2004, 1:00 - 5:00 pm1 Apr 20041612: Increased Perfusion in the Prostate after Administration of Pde-Inidbitor Sildenafil Germar M. Pinggera, Antonius Schuster, Ferdinand Frauscher, Ralf Herwig, Peter Rehder, Georg Bartsch, and Hannes Strasser Germar M. PinggeraGermar M. Pinggera More articles by this author , Antonius SchusterAntonius Schuster More articles by this author , Ferdinand FrauscherFerdinand Frauscher More articles by this author , Ralf HerwigRalf Herwig More articles by this author , Peter RehderPeter Rehder More articles by this author , Georg BartschGeorg Bartsch More articles by this author , and Hannes StrasserHannes Strasser More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38820-7AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1612: Increased Perfusion in the Prostate after Administration of Pde-Inidbitor Sildenafil." The Journal of Urology, 171(4S), pp. 425–426 © 2016 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByMcVary K, Roehrborn C, Kaminetsky J, Auerbach S, Wachs B, Young J, Esler A, Sides G and Denes B (2018) Tadalafil Relieves Lower Urinary Tract Symptoms Secondary to Benign Prostatic HyperplasiaJournal of Urology, VOL. 177, NO. 4, (1401-1407), Online publication date: 1-Apr-2007. Volume 171Issue 4SApril 2004Page: 425-426 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Germar M. Pinggera More articles by this author Antonius Schuster More articles by this author Ferdinand Frauscher More articles by this author Ralf Herwig More articles by this author Peter Rehder More articles by this author Georg Bartsch More articles by this author Hannes Strasser More articles by this author Expand All Advertisement Loading ...

You have accessJournal of UrologyDiscussed Poster, Tuesday, May 11, 2004, 8:00 am - 12:00 pm1 Apr 20041313: Chronic Ischemia of the Lower Urinary Tract- A Possible cause of Lower Urinary Tract Symptoms Germar M. Pinggera, Antonius Schuster, Leo Pallwein, Ferdinand Frauscher, Wolfgang Horninger, Georg Bartsch, and Hannes Strasser Germar M. PinggeraGermar M. Pinggera More articles by this author , Antonius SchusterAntonius Schuster More articles by this author , Leo PallweinLeo Pallwein More articles by this author , Ferdinand FrauscherFerdinand Frauscher More articles by this author , Wolfgang HorningerWolfgang Horninger More articles by this author , Georg BartschGeorg Bartsch More articles by this author , and Hannes StrasserHannes Strasser More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38538-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1313: Chronic Ischemia of the Lower Urinary Tract- A Possible cause of Lower Urinary Tract Symptoms." The Journal of Urology, 171(4S), p. 346 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 346 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Germar M. Pinggera More articles by this author Antonius Schuster More articles by this author Leo Pallwein More articles by this author Ferdinand Frauscher More articles by this author Wolfgang Horninger More articles by this author Georg Bartsch More articles by this author Hannes Strasser More articles by this author Expand All Advertisement PDF downloadLoading ...