During the last years the indications of Cardiac Magnetic Resonance Imaging (CMRI) have been continuously expanded. However, the acceptance of the method by cardiologists and radiologists does not correlate with respect to the diagnostic potential. Several factors, such as expensive equipment, relatively long examination times, high technical know how and lack of remuneration, limit the application of CMRI in everyday clinical practice. Furthermore, doctors tend to apply more conventional, well established diagnostic procedures, the access to the method is still limited and there exist difficulties in the interdisciplinary collaboration. The interdisciplinary Austrian approach to Cardiac Imaging is aimed to improve the aforementioned problems and to support the implementation of CMRI in the diagnostic tree of cardiac diseases thus enabling a cost efficient management of patients in cardiology.

To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis.

Clinical Relevance and Indications for Cardiac Magnetic Resonance Imaging 2013: An Interdisciplinary Expert Statement. During the last years the indications of Cardiac Magnetic Resonance Imaging (CMRI) have been continuously expanded. However, the acceptance of the method by cardiologists and radiologists does not correlate with respect to the diagnostic potential. Several factors, such as expensive equipment, relatively long examination times, high technical know how and lack of remuneration, limit the application of CMRI in everyday clinical practice. Furthermore, doctors tend to apply more conventional, well established diagnostic procedures, the access to the method is still limited and there exist difficulties in the interdisciplinary collaboration.The interdisciplinary Austrian approach to Cardiac Imaging is aimed to improve the aforementioned problems and to support the implementation of CMRI in the diagnostic tree of cardiac diseases thus enabling a cost efficient management of patients in cardiology.

During the last years the indications of Cardiac Magnetic Resonance Imaging (CMRI) have been continuously expanded. However, the acceptance of the method by cardiologists and radiologists does not correlate with respect to the diagnostic potential. Several factors, such as expensive equipment, relatively long examination times, high technical know how and lack of remuneration, limit the application of CMRI in everyday clinical practice. Furthermore, doctors tend to apply more conventional, well established diagnostic procedures, the access to the method is still limited and there exist difficulties in the interdisciplinary collaboration. The interdisciplinary Austrian approach to Cardiac Imaging is aimed to improve the aforementioned problems and to support the implementation of CMRI in the diagnostic tree of cardiac diseases thus enabling a cost efficient management of patients in cardiology.

Ziele: Die Magnetresonanztomographie (MRT) wird zunehmend zur Eisenbestimmung in parenchymatösen Organen eingesetzt. Ziel war es den Nutzen einer Kombination von T1- und T2*-Maps zur Bestimmung einer pathologischen Eiseneinlagerung bzw. -speicherung (pFe) der Leber bei Patienten mit Verdacht auf Eisenspeicherkrankheit (Hämachromatose=HÄM) zu evaluieren. Methode: Insgesamt wurden 27 Patienten (29–82 Jahre, mittleres Alter 46) mit klinischem Verdacht auf HÄM mittels MRT (1.5T Avanto, Siemens, Erlangen) untersucht. Zur Quantifizierung der T2*-Werte der Leber wurde eine Fett-gesättigte multi-Gradienten-Echo-Sequenz (TR=200ms; TE=0,99ms + n*1.14ms, n=0–11) in axialer Orientierung angefertigt. Die Quantifizierung der T1-Werte erfolgte mittels einer schnellen inversion-recovery snapshot FLASH T1-mapping-Sequenz. Mithilfe von ImageJ wurden in jedem Leberlappen sowohl in den T2*- als auch T1-Maps an identischen Lokalisationen die jeweiligen Werte bestimmt.

Ziele: Ziel ist es die Wertigkeit der Magnetresonanztomographie (MRT) mit T1- und T2*-Maps in der Diagnose einer Lebersteatose (SH) zu evaluieren. Methode: Bei 78 Patienten mit bekannter SH wurde mittels MRT (1.5T Avanto, Siemens, Erlangen) die Leber in axialer Orientierung unter Verwendung folgender Sequenzen untersucht: T1-FLASH in In- und Opposed-Phase (IN/OPP) [OPP: TE 2,37; IN: TE 5,05; TR 103], Fett-gesättigte multi-Gradienten-Echo [TR=200ms; TE=0,99ms + n*1.14ms, n=0–11] zur Quantifizierung der T2*-Werte sowie eine schnelle inversion-recovery snapshot FLASH T1-mapping-Sequenz. Mithilfe von ImageJ wurden in jedem Leberlappen in den T2*- und T1-Maps als auch in der IN/OPP an identischen Lokalisationen die jeweiligen Werte bestimmt. Bei den T1- und T2*-Maps dienen publizierte Normalwerte zur Orientierung (T1 530–610ms und T2* 18–30ms); bei den IN/OPP wurde die jeweilige Differenz zwischen In- und Opposed-Phase berechnet.

Noninvasive imaging of cardiac electrophysiology is still a major goal despite all recent technical innovations. This review gives an overview about the historical background, recent developments and possible future applications of noninvasive imaging of cardiac electrophysiology.

Fragestellung: 15% der Frauen haben zu Beginn der Schwangerschaft einen retroflektierten Uterus. Dieser richtet sich bis zur 15 SSW meist problemlos auf. Die in älteren Lehrbüchern (Bumm, Zweifel) über viele Seiten beschriebene fixierte Retroflexion des Uterus (auch: Uterus incarceratus) ist heute zu einer Rarität geworden. Methodik: Es wird der Schwangerschaftsverlauf einer 33-jährigen Erstgravida mit einer fixierten Retroflexion des Uterus dargestellt. In der 27. SSW einer bis dahin unauffälligen und regelmässig kontrollierten Schwangerschaft bemerkte die sportliche Patientin zunehmend stärker werdende Rückenschmerzen. Die Biometrie war unauffällig, der Ultraschallbefund schien eine Plazenta praevia zu zeigen, allerdings war weder sonografisch noch im Tastbefund eine Zervix darstellbar. Man entschloss sich zu einer Kernspintomografie (MRI), die das Bild einer Retroversio Uteri fixata zeigte. Die vermutete Plazenta praevia wurde nun als Fundusplazenta gedeutet, wobei der Fundus uteri im kleinen Becken festgeklemmt war. Die Zervix war oberhalb der Symphyse zu sehen. Die Patientin wurde stationär aufgenommen, die Lungenreife wurde induziert. In liegender Position war sie weitgehend beschwerdefrei, die Blasenfunktion war problemlos. Ergebnisse: Es gelang die Schwangerschaft bis zur 33. SSW fortzusetzen, dann wurde eine geplante Sectio caesarea gemacht. Es zeigte sich, dass der Uterus nicht nur retrovertiert war, sondern auch zu 90° torquiert: es handeltes sich um einen Uterus bicornis, wobei der Kopf des Kindes im rechten Horn lag, die Beine – eigentlich als Querlage – im linken Horn. Die Uterotomie erfolgte damit in dem Bereich, der sich dann als linke Seitenwand herausstellte. Das Mädchen wog 1620g, und hatte einen NapH von 7,29 sowie einen APGAR von 8/9/9. Schlussfolgerung: Von Versuchen, den Uterus bei bestehender Schwangerschaft aufzurichten, wurde aus Sicherheitserwägungen abgesehen. Wird eine Retroversio Uteri fixata nicht pränatal erkannt, so besteht die Gefahr, dass bei einer Sectio die meist weit nach oben gezogene mütterliche Blase durchtrennt wird. Durch den Sonderfall der 90° Torsion bestand diese Problematik in unserem Fall nicht. Es empfielt sich, wenn einmal ein Verdacht auf eine Retroversio Uteri fixata besteht, großzügig die MRI Bildgebung in Anspruch zu nehmen.

Purpose: To assess with cardiac magnetic resonance imaging (CMR) the relationship between treatment delay and improvement of regional left ventricular function after primary percutaneous transluminal coronary angioplasty (p-PTCA) for acute myocardial infarction (AMI).Materials and Methods: We performed cine- and late-enhancement (LE) CMR in 40 patients with first AMI after restoring TIMI 3 flow with p-PTCA and at a follow-up 4 months later. Infarcted segments were determined from LE images. Regional left ventricular function was quantified from cine-CMR images. Segmentation followed the American Heart Association 17-segments model. Patients were divided into groups with delay <3 hours, 3-6 hours. 6-12 hours, and a delay >12 hours.Results: Segmental wall thickening (SWT) significantly iproved only in segments reperfused within 6 hours (P < 0.001). Follow-up SWT was significantly higher if segments were reperfused early (<3 hours: 74 +/- 4%, 3-6 hours: 57 +/- 4%, 6-12 hours: 48 +/- 7%, <3 to 3-6: P < 0.003, and <3 to 6- 12 hours: P < 0.001). The extent of improvement was greater if delay was <3 hours compared to segments with a delay of >3 hours (<3 hours: +21 +/- 3%, 3-6 hours: +8 +/- 4%, 6-12 hours: +6 +/- 3%; <3 hours to 3-6 hours, and 6- 12 h, P < 0.02).Conclusion: We quantitatively demonstrated that Lime to p-PTCA treatment significantly influences regional functional recovery of infarcted myocardium at a 4-month follow-up.

(2013 in press) The ups and downs of beta oscillations in sensorimotor cortex. Experimental Neurology Context-related frequency modulations of macaque motor cortical LFP beta oscillations. (2010) Evoked potentials in motor cortical LFPs reflect task timing and behavioral performance. Comparison of local measures of spike time irregularity and relating variability to firing rate in motor cortical neurons. Kilavik BE, Silveira LCL, Kremers J (2007) Spatial receptive field properties of lateral geniculate cells in the owl monkey (aotus azarae) at different contrasts: a comparative study. (2007) Neurons in area V4 of the macaque translate attended visual features into behaviorally relevant categories. Kilavik BE, Kremers J, Silveira LCL (2003) Center and surround responses of marmoset lateral geniculate neurons at different temporal frequencies. Influence of contrast on the responses of marmoset lateral geniculate cells to drifting gratings.

Background: This study sought to assess the relationship between treatment delay and improvement of regional left ventricular function after primary angioplasty (p-PTCA) for acute myocardial infarction (AMI) with cardiac magnetic resonance imaging (CMR).Methods: We performed cine-CMR and late-enhancement (LE) sequences in 40 patients with first AMI shortly after restoring TIMI 3 flow with p-PTCA and four months thereafter. Infarcted segments were determined from LE short-axis images. Regional left ventricular function was quantified from short-axis cine-CMR images. Segmentation followed the AHA 17-segments model. Patients were divided into groups with delay < 3 h, 3-6 h, 6-12 h and a group with a delay > 12 hours.Results: Out of 640 evaluated segments 335 (52 %) showed LE (infarcted) and consecutively impaired regional function in terms of systolic wall thickening (SWT, 49 +/- 2 % vs 60 +/- 2 % in uninfarcted segments; p < 0.01). Mean infarct transmurality and baseline SWT were not significantly different between infarcted segments after reperfusion with respect on the duration of ischemia. Paired Wilcoxon rank test revealed significant improvement of SWT only in segments reperfused within 6 h (p < 0.001). Follow-up SWT was significantly higher if segments were reperfused early (< 3 h: 74 +/- 4 %; 3-6 h: 57 +/- 4 %; 6-12 h: 48 +/- 7 %; < 3 to 3-6 h: p < 0.003 and < 3 to 6-12h: p < 0.001). The amount of improvement was higher if delay was < 3 h compared to segments with a delay of > 3 h (< 3 h: + 21 +/- 3 %; 3-6 h: + 8 +/- 4 %; 6-12 h: + 6 +/- 3 %; < 3 h to 3-6 h and 6-12 h; p < 0.02).Conclusion: We could quantitatively demonstrate for the first time that time to p-PTCA treatment significantly influences regional functional recovery of infarcted myocardium after a four-month follow-up.

A 39-year-old man presented with erectile dysfunction that had persisted since its sudden onset 5 years ago. He exhibited none of the classic risk factors, and all attempts at medication had been unsuccessful. An ultrasound examination revealed the presence of an arteriovenous shunt in the corpus spongiosum penis. Selective digital subtraction angiography of the left internal pudendal artery showed an arteriovenous fistula from the arteria bulbi penis to the corpus spongiosum penis. The outflow of venous blood took place via the penile veins into the periprostatic vein plexus. Superselective catheterization of the arteria bulbi penis was performed with a 3 French coaxial catheter (Topaz Micro Coils; Micro Therapeutics, Inc, Irvine, CA) and it was occluded by inserting several platinum coils. 1 week after the procedure, the patient reported normal erectile function, which was subsequently maintained.

Recent studies in mTLE showed by means of EEG, MRI and FDG-PET structural or functional abnormalities outside the seizure onset-zone. Recent voxel-based morphometry (VBM)-studies were able to show hippocampal degeneration in mesial temporal lobe epilepsy (mTLE) patients, however, there was also marked extrahippocampal loss of brain volume. This VBM-study aimed to depict volume loss outside the seizure focus and to correlate neuropsychological deficits.

Summary Objectives: This paper presents an efficient approach for extracting myocardial structures from given atrial and ventricular blood masses to enable non-invasive estimation of electrical excitation in human atria and ventricles. Methods: Based on given segmented atrial and ventricular blood masses, the approach constructs the myocardial structure directly, in the case that the myocardium can be detected in the volume data, or by using mean model information, in the case that the myocardium cannot be seen in the volume data due to image modalities or artefacts. The approach employs mathematical and gray-value morphology operations. Regulated by the spatial visibility of the myocardial structure in the medical image data especially the atrial myocardium needs to be estimated repeatedly using the a-priori knowledge given by the anatomy. Results: The approach was tested using eight patient data sets. The reconstruction process yielded satisfying results with respect to an efficient generation of a volume conductor model which is essential when trying to implement the estimation of electrical excitation in clinical application. Conclusion: The approach yields ventricular and atrial models that qualify for cardiac source imaging in a clinical setting.

Apical ballooning is an increasingly reported transient cardiomyopathy with yet unknown origin. In this study 2 cases of apical ballooning are described in whom we used a combined approach of cardiac magnetic resonance imaging (CMR) and 31-Phosphorous magnetic resonance spectroscopy (31P MRS). Electrocardiogram showed ST abnormalities and cardiac serum markers were mildly elevated, but CAG demonstrated smooth coronary arteries. Cine-CMR revealed severe apical akinesia and significantly decreased ejection fraction. Furthermore we detected reduced myocardial phosphocreatine to beta-ATP (PCr/b-ATP) ratios during the first week of acute disease. After 1 week we observed an improvement of PCr/b-ATP ratios by 68% and 34%, which was associated with an increase in left ventricular function. Our data suggest that 31P MRS might be a valuable tool in the evaluation of apical ballooning, but larger cohorts are needed to improve the understanding of metabolic changes during transient apical ballooning.