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A Bockisch

Publications and source records attributed to A Bockisch.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Diagnostic evaluation of acute scrotum--testicular perfusion scintigraphy].

The method of and the results obtained with testicular scintigraphy in the differential diagnosis of acute scrotal pain are described. Both sensitivity and specificity were found to be high and in excess of 90%. Misinterpretation of findings is rare and is seldom reported except in case reports. Normal findings usually genuinely reflect absence of disease, and only in the case of suboptimal imaging conditions they might correspond to a false-negative finding in the presence of acute torsion. Chronic torsion may be missed on scintigraphy because of intermediate normalization of arterial perfusion at the time of the investigation. Missed torsion presents a characteristic activity pattern. The halo sign is a proven sign of avitality of the testicle. Orchitis and epididymitis are correlated with hyperperfusion and hyperaemia and are reliably diagnosed by scanning. When testicular scintigraphy is needed immediate availability is essential. In a nuclear medicine department with standard equipment, the investigation can be started within 5 min; it takes about 15 min to perform and the findings can be evaluated within another 5 min. Acute testicular torsion that has already been reliably diagnosed by clinical examination is not an indication for testicular perfusion scintigraphy. This diagnostic procedure is, however, valuable if the clinical findings are equivocal and, especially, if a conservative treatment is planned.

Acute Disease↗
PubMed1992

Primary melanoma of urinary bladder.

The fourth case of primary melanoma of the bladder is presented together with a review of the previously reported cases and the relevant literature on malignant melanoma in urology. The criteria for classification of the bladder lesion as the primary site are discussed. The eighty-one-year-old female patient was felt not to be suitable for extensive surgery and was successfully treated with a combination of radiation and immunotherapy with recombinant alpha 2 interferon. After previous monthly recurrences of the tumor the patient is in complete remission fifteen months after initiation of therapy. It appears that this form of treatment might be a valuable alternative to radical surgery in elderly patients.

Aged↗
PubMed1992

[Importance of whole body skeletal scintigraphy within the scope of staging of neoplasms in the ENT area].

Concerning malignant tumours of the oral cavity, pharynx and larynx, bone metastases are in general rarely seen. For the specification to which patients the whole body bone scintigraphy as detection method should be applied, the findings of 370 patients were analysed retrospectively. In respect of primary staging, bone metastases could be found by scintigraphy in only 1.4% of the patients. On the other hand, there was a detection rate of 12% during the further course of the disease, especially in case of clinical symptoms pointing at spreading metastases or in tumour recurrences. Nevertheless, positive scan findings which were not due to metastases could be found in both groups with equal frequency (12 and 13%, respectively). Therefore the routine performance of whole body bone scintigraphy as a screening method does not seem to be useful in the primary staging of cancer of the mouth, pharynx and larynx. Contrary to this, in the follow-up of these tumours bone scanning proves to be a valuable and sensitive method for detecting skeletal metastases.

Bone Neoplasms↗
PubMed1992

[A comparison of the value of magnetic resonance tomography and computed tomography in Nelson syndrome patients].

The hypophyses of 13 patients with Nelson syndrome following bilateral adrenalectomy were examined by MRI and CT. Diffuse enlargement of the hypophysis was demonstrated in 8 patients by CT and in 9 by MRI. Compared with CT, MRI provides better demonstration of tumour development, such as abnormal convexity of the cranial margin of the hypophysis (MRI 4/13, CT 1/13), displacement of the infundibulum (MRI 4/13, CT 0/13) or optic chiasm (MRI 2/13, CT 0/13). MRI also provides diagnostically important differentiation between scar tissue and recurrence of tumour following hypophysectomy (MRI 1/3, CT 0/3) and more accurate demonstration of infiltration of the cavernous sinus (MRI 4/13, CT 2/13). CT is superior only in showing the floor of the sella. MRI is the method of choice for imaging in cases of Nelson syndrome.

Adrenalectomy↗
PubMed1992

[Scintigraphic use of 87Y during 90Y therapy of bone metastases].

Carrier-free 87Y is produced by cyclotron irradiation of Rb. It decays with a half-life of 80.3 h, transforming via 87mSr to stable 87Sr with the emission of gamma lines of 0.48 and 0.39 MeV. Experience in 6 patients shows good scan quality and correspondence between 99mTc-DPD and 87Y images useful in 90Y-citrate therapy for bone metastases. 87Y offers new possibilities of studying biological kinetics in 90Y therapy. To avoid contamination this should only be used in departments with possibilities of radioactive waste storage and controlled disposal.

Aged↗
PubMed1991

[HMPAO-SPECT during carotid artery compression (Matas test) in the evaluation of cervical tumor surgery with potential carotid involvement].

For planning the surgical approach in patients with head and neck tumours and extensive cervical metastasis the evaluation of possible vascular involvement is necessary. If the carotid artery is suspected to be infiltrated by the tumour masses its resection or plastic substitute becomes sometimes inevitable. For evaluation of the collateral brain perfusion before a possibly necessary carotid resection we examined 10 patients with neck tumours performing the Matas-Test combined with HMPAO Single-Photon-Emission-Computed-Tomography. During ultrasound-controlled manual compression of the involved common carotid artery 99mTc-labelled HMPAO was injected. The SPECT demonstrated the brain perfusion during the carotid compression time period. 6 patients showed a decreased perfusion of the affected hemisphere with - as far as obtained - normal baseline SPECT-results and balloon occlusion tests. 2 of these patients underwent a carotid artery resection, one of the common carotid artery and one of the internal carotid artery. One patient had a significant perfusion deficit in the SPECT but no pathologic findings in angiography and balloon occlusion test. He suffered from hemiparesis postoperatively. The other patient showed preoperatively a minor decrease in perfusion and had no neurological defects postoperatively. Our findings show that the Matas-Test combined with HMPAO-SPECT is a valuable tool for the preoperative evaluation of the collateral brain perfusion. This technique is not invasive and can be performed in every nuclear medicine department with an ECT camera. The HMPAO-SPECT during carotid compression can add useful information or even replace angiography and the balloon occlusion test.

Aged↗
PubMed1991

Static and dynamic radionuclide imaging in the diagnosis of the acute scrotum.

In the acute scrotum, diagnosis can be difficult in certain cases. In 107 patients the value of static and dynamic radionuclide imaging was evaluated. Static images provide a sensitivity and reliability of over 90%. Quantitative measurements do not give additional information in the differential diagnosis of these patients. Generally, scintigraphy can only be advocated if available as an emergency procedure. It is not necessary in cases with clinically obvious diagnosis of acute testicular torsion or epididymitis, but can be very helpful and reliable in unclear cases, i.e. for the evaluation of testicular perfusion after scrotal trauma.

Acute Disease↗
PubMed1991

[A comparison of 201Tl and 99mTc-MIBI in the follow-up of differentiated thyroid carcinomas].

12 patients with suspected recurrence of differentiated thyroid carcinoma following thyroidectomy, radioiodine therapy and, in some cases, external radiation therapy had 201Tl and 99mTc-MIBI scintigraphy. Except in one case, the findings concerning tumor localization and extension were identical. In all cases, locoregional lymph node metastases as well as osseous metastases were imaged by 201Tl and 99mTc-MIBI scintigraphy. MRI images obtained in all patients with suspected lymph node metastases revealed inoperable situations in 2 cases, whereas there was no correlation in 1 patient with positive 201Tl and 99mTc-MIBI scintigraphy. In contrast, the sensitivity of the two methods was relatively low in the detection of pulmonary metastases which were imaged in 1 out of 3 patients only. Discrepancies between 201Tl and 99mTc-MIBI were observed in a case of axillary lymph node metastasis. Although tumor-/background ratios were slightly higher for 201Tl, 99mTc-MIBI SPECT showed a higher imaging quality compared to 201Tl SPECT, especially in deeply situated tumor lesions. In conclusion, 99mTc-MIBI seems to be a promising alternative imaging agent in the follow-up of differentiated thyroid carcinomas.

Adenocarcinoma↗
PubMed1991

Technetium-99m-HMPAO brain SPECT in medically intractable temporal lobe epilepsy: a postoperative evaluation.

The aim of the present study was to evaluate the predictive value of interictal single-photon emission computed tomography (SPECT) using technetium-99m-labeled hexamethyl propyleneamine oxime (HMPAO) for the outcome after temporal lobectomy in patients with complex partial seizures. Out of 40 patients, 21 underwent right-sided and 19 left-sided temporal lobectomy. EEG and CT/MRI were primarily used to select the side of surgery. SPECT results correlated with temporal lobectomy in 68% of the patients. After surgical intervention, memory function was tested for both sides. Following left-sided temporal lobectomy, verbal memory was impaired in 8% of the patients, if SPECT agreed with the side selected for surgery, but in 83%, if it diverged from it. In the present study, there was no relationship between SPECT concordance with the side of temporal lobectomy and outcome as to seizure frequency and non-verbal memory. We conclude that preoperative interictal HMPAO/SPECT can contribute to the prediction of postoperative verbal memory function and that this method should be considered for use prior to temporal lobectomy.

Adolescent↗
PubMed1990

Diagnosis of bone and joint infection by leucocyte scintigraphy. A comparative study with 99mTc-HMPAO-labelled leucocytes, 99mTc-labelled antigranulocyte antibodies and 99mTc-labelled nanocolloid.

Fifty-five patients with 60 suspected infections of bones or joints were studied with 99mTc-hexamethylpropyleneaminooxine- (HMPAO-) labelled leucocytes and 99mTc-labelled antigranulocyte antibodies, in part supplemented with 99mTc-labelled nanocolloid. The findings using the different procedures were in good agreement. Apart from in vertebral lesions, a negative scan--even if the radionuclide bone scan is positive--excludes an infection with high probability (sensitivity 94%). The low specificity (57%) is due to positive imaging of various non-infected lesions. Spondylitis usually shows as non-specific cold lesions. A subtraction technique with computer assisted analysis of HMPAO and nanocolloid scans provides a more precise diagnosis of this condition.

Adolescent↗
PubMed1990

[Qualitative and quantitative NMR tomographic findings in focal nodular hyperplasia of the liver].

The qualitative and quantitative MRI findings in 16 patients with focal nodular hyperplasia (FNH) of the liver are described; nine of these were confirmed histologically. A central scar is typical of FNH and provides a reliable diagnosis. This finding was seen in half the cases. If the scar is not demonstrable, the following features suggest the diagnosis: smooth margins, homogeneous signal distribution, increased signal intensity in T2-weighted spin-echo images and reduced signal intensity in inversion-recovery sequences. The T1 and T2 relaxation times in FNH are increased by about 30% compared with normal liver tissue.

Adult↗
PubMed1990

[Early and late HMPAO-SPECT during an epileptic seizure].

For presurgical evaluation of epilepsy a 44-year old patient with complex-partial seizures underwent HMPAO-SPECT. The morphology of the seizures, the MRI-scan, psychometry and ictal as well as interictal EEGs showed a left temporal origin of the seizures. Early images were obtained 20 min and late images 24 h following injection. On both scans a marked hyperperfusion was observed in the left temporal area. A crossed cerebellar diaschisis was also seen on both SPECTs. It could be shown that during ictal examinations there is no bloodflow-dependent wash-out from brain tissue.

Adult↗
PubMed1990

HMPAO-SPECT imaging resembling Alzheimer-type dementia in mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS).

Single-photon emission computed tomography (SPECT) of the brain using hexamethyl propylene amine oxime (HMPAO) was performed in a 37-year-old patient suffering from mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS). Reduced blood flow was observed bilaterally in the parieto-occipital regions (resembling Alzheimer type dementia) and in the right parietal lobe.

Acidosis, Lactic↗
PubMed1989

Immunoscintigraphy using CA 125 antibodies in the management of ovarian cancer.

Radioimmundetection (RID) using anti-CA 125 antibodies proved to be a valuable tool in the follow-up of metastasizing ovarian cancer. Sensitivity, specificity, and accuracy were high. RID had no clinical side effects. But some patients formed antibodies which interfered a) with the evaluation of the scintigram and b) with further measurement of CA 125 levels. We found 2 cm diameter metastases that were not detected by computed tomography. However, the heterogeneity of tumor metastases limits the sensitivity of this method. CA 125 serum levels, immunohistochemistry, and immunoscintigraphy did not always correlate. Monitoring serum levels of CA 125 was most valuable in clinical management of tumor spread and in the optimal use of RID.

Antibodies, Monoclonal↗
PubMed1989

[Bone marrow scintigraphy and magnetic resonance tomography in plasmacytoma].

In 17 patients suffering from plasmocytoma bone marrow scintigraphy (BMS), and magnetic resonance tomography (MRT) was performed. RES expansion in the extremities was found by both methods, MRT also visualized a diffuse infiltration of the marrow. In that location, cold lesions in BMS correspond to yellow marrow. In the pelvis, however, cold lesions are due to tumor involvement. Both methods offer additional diagnostic opportunities and may in the future allow to expand the time intervals between routinely performed iliac crest biopsies.

Aged↗
PubMed1989

Blood flow in the carotid arteries: quantification by using phase-sensitive MR imaging.

The feasibility of MR phase-sensitive imaging for the quantification of blood flow in the carotid arteries was studied in two normal volunteers and six patients with carotid artery and/or cerebrovascular disease. The technique consists of sensitizing the phase of the MR signal to blood flow velocity gated to different times in the cardiac cycle. Flow velocities and volumes were measured by using transverse planes in the common, internal, and external carotid arteries, and flow curves were generated. Measurements made by using flow phantoms correlated well with calculated results. The MR measurements yielded values between 250 and 580 ml/min for the total flow through each of the common carotid arteries in the two normal volunteers. Markedly reduced flow (about 50% below normal) was detected in a patient whose arteriogram showed severe occlusion of the internal carotid artery. In a second patient, who had a large frontal intracranial arteriovenous malformation noted by arteriography, the MR-quantified flow was abnormally high (about 1 liter/min). In the remaining four patients, the findings on phase-sensitive quantification were consistent with those expected from clinical and other laboratory studies (including arteriography and sonography). These preliminary findings suggest that MR phase mapping may be a feasible tool for the noninvasive quantification of carotid blood flow.

Adult↗