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Biomedical subjects

A Hutzelmann

Publications and source records attributed to A Hutzelmann.

32 records · Page 2Linked to original sources
PubMed1997

[CT morphology of fractured thoraco-lumbar vertebrae after transpedicular spongiosaplasty and use of internal fixator].

PURPOSE: An analysis of the CT morphology of fractured thoraco-lumbar vertebrae after treatment with internal fixation and transpedicular spongiosaplasty (SP). MATERIAL AND METHOD: 30 patients were examined following trauma and surgery after about 12 and 30 months by means of CT. The following were evaluated: width of the spinal canal; height of the vertebra and intervertebral space; degree of kyphosis; position, size and appearance of the SP and of the vertebral body. RESULTS: The width of the spinal canal was reconstituted in 91%; in 83% the anterior vertebral margin and in 35% the intervertebral space was reduced. A kyphosis of 8.9 degree was found on the followup examination. The SP showed a reduction in size (18/30) or could no longer be defined (6/30). Hypodense areas (28/30) with cavitation (12/30) were found in the vertebral body and the SP could be identified by a sclerotic margin (22/30). CONCLUSION: Treatment by this form of therapy was successful, reaction of the vertebral body against the spongiosaplasty could be identified.

Adolescent↗
PubMed1997

[Comparison of T2-weighted turbo spin-echo and ultrafast HASTE sequence in the diagnosis of cervical myelopathies and spinal stenoses and static and kinematic MRT of the spine].

PURPOSE: The purpose of this study was to compare HASTE-sequence with T2-weighted TSE-sequence in the detection of cervical myelopathy and cervical spinal stenosis in kinematic MRI. METHODS: 24 patients with degenerative disease of the cervical spine were studied. Images were evaluated according to the following criteria: artifacts, delineation of the vertebra, disks and degenerative changes, grade of spinal stenosis (grade 0-3) and evaluation of the cervical spinal cord. RESULTS: Due to image blurring and artifacts, evaluation and delineation of the cervical spine was possible in all cases in the T2-weighted TSE-sequence, but only in 23 of 24 patients using HASTE-sequence. Differentiation between osteophytes and disks was obtained in most cases (23/24) in the T2-weighted TSE-sequence but none in the HASTE-sequence. Cervical myelopathy was observed in 4 patients in T2-weighted TSE images but only in two cases using HASTE-sequence. Compared to T2-weighted TSE-sequence spinal canal stenosis was underestimated using HASTE-sequence. CONCLUSION: T2-TSE-sequence is superior to HASTE-sequence in the delineation of anatomical structures of the cervical spine, the grading of cervical spinal stenosis and the evaluation of cervical myelopathy.

Adult↗
PubMed1997

[MR myelography in spinal canal stenosis].

PURPOSE: The purpose of this prospective study was to evaluate the clinical value of 3D-MR-myelography (3D-MRM) in comparison to myelography and intra-operative findings. MATERIAL AND METHODS: 25 patients with suspected lumbar spinal canal stenosis were studied via myelography and 3D-MRM (volume-data set, 3D-FISP sequence, TR 73 ms, TE 21 ms, flip angle 7 degrees, sagittal slices) besides the routinely acquired sagittal and axial T1- and T2-weighted images. Diagnoses were made by two radiologists and one neurosurgeon without knowing the clinical history and symptoms, in two separate sessions. Results were compared to intraoperative findings. RESULTS: 3D-MRM has the same diagnostic sensitivity (25/25 = 100%) as conventional X-ray myelography (25/25 = 100%) compared to intraoperative findings, but is not invasive and shows more diagnostic details than myelography. Especially in cases of high-grade spinal canal stenosis there is often a lack of intrathecal contrast medium distally of the stenosis. CONCLUSION: 3D-MRM is as good as conventional myelography in predicting intraoperative findings in patients with lumbar spinal canal stenosis. This new method is non-invasive and can be performed routinely on an outpatient basis.

Adult↗
PubMed1997

MR imaging of the central nervous system in diving-related decompression illness.

PURPOSE: This investigation was conducted to determine whether MR imaging showed cerebral or spinal damage in acute diving-related decompression illness, a term that includes decompression sickness (DCS) and arterial gas embolism (AGE). MATERIAL AND METHODS: A total of 16 divers with dysbaric injuries were examined after the initiation of therapeutic recompression. Their injuries comprised: neurological DCS II n = 8; AGE n = 7; combined cerebral-AGE/spinal-DCS n = 1. T1- and T2-weighted images of the brain were obtained in 2 planes. In addition, the spinal cord was imaged in 7 subjects. The imaging findings were correlated with the neurological symptoms. RESULTS: MR images of the head showed ischemic cerebrovascular lesions in 6/8 patients with AGE but showed focal hyperintensities in only 2/8 divers with DCS. Spinal cord involvement was detected in 1/7 examinations, which was the combined cerebral-AGE/spinal-DCS case. There was agreement between the locations of the documented lesions and the clinical manifestations. CONCLUSION: MR readily detects cerebral damage in AGE but yields low sensitivity in DCS. A negative MR investigation cannot rule out AGE or DCS. However, MR is useful in the examination of patients with decompression illness.

Adult↗
PubMed1997

[Vertebral body metastases: characteristic MRI findings in epidural infiltration].

PURPOSE: In case of lumbar vertebral metastasis associated with anterior epidural carcinomatous infiltration, we have observed that infiltrations tend to respect the midline. This study led to the systematic recognition of these phenomena in vertebral metastases. MATERIALS AND METHODS: 11 patients with 17 vertebral metastases and adjacent anterior epidural infiltration were reviewed retrospectively. All cases were studied by MRI. The routinely used imaging technique included spin echo (SE) T1 and T2 weighted sequences in the sagittal plane native and T1-SE without and with Gd-DTPA in the axial planes. The radiological findings of these phenomena and the anatomy were studied. RESULTS: We observed these phenomena to be uni- or bilateral in 88.3% of all cases with intraspinal anterior epidural carcinomatous infiltration, especially in that part of the vertebral body where the basal vertebral venous plexus was located. CONCLUSION: We conclude that vertebral metastases respect the midline. We interpret this fact as being due the anatomy of the vertebral body and especially its stabilization by the posterior longitudinal ligament. These findings may be helpful in the differential diagnosis of vertebral body metastases with epidural infiltration in contrast to intraspinal processes which proceed with the destruction of the vertebral body.

Aged↗
PubMed1997

[Dura thickening adjacent to intracranial, para-dural space-occupying lesions in MRI. Histologic correlation].

PURPOSE: With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Thers we have attempted to evaluate a tumor infiltration of these enhancement on MRI. MATERIAL AND METHODS: This study included 50 patients, 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patient did not (12 meningiomas and 19 metastases). Studies included plane T2-weighted spin echo (SE) images as well as T1-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater. RESULTS: 7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural thickening at the tumor base also showed tumor invasion into the dura mater. CONCLUSION: MR imaging is still not able to determine whether or not there is a dural infiltration of the tumors base because there was no correlation between MR images and histopathologic results. In conclusion, metastases adjacent to the dura infiltrate the dura mater in a higher percentage than meningiomas.

Aged↗
PubMed1996

[The CT of calcaneal fractures: 3-D reconstructions with electronic disarticulation].

PURPOSE: To evaluate the clinical value of 3-D-reformations with and without electronic disarticulation of calcaneal fractures compared to axial CT and sagittal reformations. MATERIAL AND METHODS: 25 patients with intra-articular calcaneal fractures underwent diagnostic CT-examinations. Axial slices, sagittal and 3-D-reformations with and without electronic disarticulation were performed. The sagittal and both types of 3-D-reformations were compared to the axial slices with regard to the diagnostic criteria: involvement of articular facets, number of fragments, and traumatic changes of the hindfoot. RESULTS: The best proof of involvement of articular facets is found in axial slices and 3-D-reconstructions after disarticulation followed by sagittal reconstructions. Usually on 3-D-reconstructions without disarticulation articular facets cannot be identified because of overlapping bones. The number of fragments is clearly demonstrated by axial slices and sagittal reconstructions followed by 3-D-reconstructions after disarticulation. Traumatic changes of the hindfoot can be diagnosed in all four forms of visualisation. CONCLUSION: The decisive diagnosis for treatment planning is made based on the axial slices supported by sagittal reformations. In unclarified cases 3-D-reformations after electronic disarticulation may provide further information. 3-D-reformations without disarticulation are useless.

Adult↗
PubMed1996

[The meningeal sign: a new appraisal].

PURPOSE: To evaluate the occurrence of the meningeal sign in meningiomas and metastases. MATERIAL AND METHODS: We studied 20 patients with meningiomas and 17 patients with cerebral metastases adjacent to the dura. MRI studies (Siemens, Magnetom 1,5) included axial T1-weighted and T2-weighted unenhanced as well as gadolinium-DTPA enhanced T1-weighted (axial, coronal, sagittal) SE imaging. In all patients the tumours were resected with the attached dura mater. Histopathological examinations were done, which corresponded to the area of marked enhancement by gadolinium-DTPA. There was no correlation between the occurrence of the meningeal sign and the histopathological examinations. RESULTS: In 20 patients with meningiomas adjacent to the dura we found the meningeal sign in 11 cases. Histologically we observed an increase of collagen fibres and fibrocytes. In 5 of 17 cases with superficial cerebral metastases the meningeal sign was seen, histologically as dura infiltrations and microbleedings. CONCLUSION: The meningeal sign is not specific for meningiomas and can be observed in a wide variety of pathological entities.

Brain Neoplasms↗
PubMed1996

[Spiral computed tomography for treatment planning and quality assurance in radiotherapy].

BACKGROUND: The possibilities of spiral CT for radiotherapeutic treatment planning and quality assurance have been systematically investigated. PATIENTS AND METHODS: The influence of parameters such as slice thickness, table speed and increment on geometric accuracy was studied. Ring-, spheric-, PMMA- and humanoid Alderson phantoms were used. Furthermore, patients with infradiaphragmatic irradiation of Hodgkin's disease or with mediastinal irradiation were studied using CT-angiography. Patients with carcinomas of the head and neck before HDR- and PDR-brachytherapy were examined as well. RESULTS: Spiral CT offers 3D volume data information with excellent reduction of breath and motion artefacts for virtual simulation. 2D multiplanar reconstructions with excellent local resolution may be obtained. 3D MIP (Maximum Intensity Projection), based on CT-angiographic imaging, is a good tool for infradiaphragmatic treatment planning of Hodgkin's disease, if small numbers for slice thickness, table speed and increment are used. SSD (Surface Shaded Display) offers good 3D visualization and good geometric control of intracavitary and interstitial brachytherapy applicators. High qualitative multiplanar reconstructions are useful for CT-based brachytherapy planning. CONCLUSIONS: Spiral CT is a precious tool for 3D treatment planning and virtual simulation in radiotherapy and superior to conventional CT data acquisition. Quality assurance is improved for dose-volume-histograms and for brachytherapy.

Angiography↗
PubMed1995

[Double spiral CT angiography].

AIM: To evaluate the clinical value of CT angiography using double-spiral CT technique. METHOD: 7 patients with peripheral occlusive disease were examined after stent placement into iliac arteries (5/7) or prior surgery under the clinical suspicion of an occluded vascular graft (2/2). After a delay of 25 sec two spiral CT-scans, each of 32 sec duration, were started. The average interscan delay was between 12-15 sec. The total examination time was about 100 sec and the total range 36 cm using a slice thickness of 3 mm and a table feed of 6 mm/sec. 150 ml of contrast material were injected continuously with 3 ml/sec. RESULTS: All stents were exactly located and diagnosed as patent (6/6) in comparison to intraarterial angiography. Two occluded vascular grafts were diagnosed, confirmed by surgical findings (2/2). Density measurements showed enough of contrast material in the vessels to perform CT-angiography even in the second part of the examination. CONCLUSION: Double-spiral CT angiography is a clinical applicable and helpful method to examine patients with peripheral occlusive disease. It allows to double the examination range without losing the advantages of small slice thickness.

Aged↗
PubMed1995

Evaluation of the ventricular system in adults by transcranial duplex sonography.

Transcranial duplex color-flow sonography provides visualization of intracranial structures, and measures angle-corrected blood flow velocity in the basal cerebral arteries of adults. In 44 patients with central nervous system disease, the oblique diameters of the third and the middle part of the lateral ventricle were measured by transcranial duplex color-flow sonography using a system with a 2.5-MHz transducer, and compared to computed tomography measurements. The correlation coefficients for the third and lateral ventricle measurements were r = 0.83 (p < 0.0001, N = 38) and 0.73 (p < 0.0001, N = 78), respectively. A second investigation was performed by transcranial duplex to evaluate intraobserver and interobserver reproducibility. The correlation coefficient representing interobserver reproducibility in 27 patients was r = 0.87 (p < 0.0001, N = 47) for the lateral ventricle and r = 0.9 (p < 0.0001, N = 49) for the third ventricle. The intraobserver reproducibility correlation coefficient was r = 0.93 (p < 0.0001, N = 22) for the lateral ventricle in 12 patients. In 49 healthy volunteers the oblique diameters of the lateral and third ventricles were age dependent, measuring 16.7 +/- 2.3 mm and 4.8 +/- 1.9 mm, respectively, in those younger than 59 years, compared to 19.0 +/- 2.9 mm and 7.6 +/- 2.1 mm in those 60 years or older. Therefore, transcranial duplex color-flow sonography measures noninvasively the third and the lateral ventricle in adults.

Adult↗
PubMedDate not supplied

[Morphometric dual-energy roentgen absorptiometry in follow-up of scoliosis].

PURPOSE: Taking pictures of the spine with Morphometric X-ray Absorptiometry (DXA) leads to a radiation dose of just 1% of conventional X-ray. Purpose of this study was to evaluate if DXA is a suitable method for sufficient measuring of the scoliosis angle. METHOD: We examined 20 patients with scolioses I. Control-pictures were made with conventional X-rays and compared to those made by DXA, measuring of scoliosis angle was performed by the method of Lippmann/Cobb. RESULTS: The difference between both methods was -10.5% DXA to conventional X-ray-each angle examined on DXA was smaller. CONCLUSION: It is possible to measure scolioses I on DXA.

Absorptiometry, Photon↗
PubMedDate not supplied

Spiral CT angiography for preoperative planning in patients with epigastric tumors: comparison with arteriography.

PURPOSE: Spiral CT angiography (CTA) was performed on 22 patients for the preoperative assessment of epigastric tumors in comparison with intraarterial angiography. METHODS: One hundred fifty milliliters of contrast material was administered with a flow of 4 ml/s. After a delay of 30 s, a spiral CT examination of the epigastrium was performed (slice thickness 3 mm, table feed 6 mm/s). Axial images were reconstructed at 2 mm increments. Postprocessing was performed with a maximum intensity projection and shaded surface display imaging program. Plain film arteriography was performed via a catheter inserted transfemorally and placed into the epigastric arteries. The following parameters were evaluated: visualization of the arteries and the portal vein and involvement of these vessels by disease. RESULTS: The vessels (22/22 = 100%) and variations (1/22 = 4.5%) were clearly identified with both techniques. Involvement was diagnosed by angiography 15 times compared with 22 findings by CTA. CONCLUSION: Concerning vessel anatomy, the correlation between both techniques was excellent and vessel involvement showed good correlation, especially when using the axial slices additionally. CTA has the potential to become a minimally invasive diagnostic tool for preoperative planning in epigastric tumors.

Abdomen↗