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Biomedical subjects

A Lienemann

Publications and source records attributed to A Lienemann.

At least 37 records · Page 2Linked to original sources

Malignant hemangiopericytoma of the bone.

Hemangiopericytoma is a rare vascular tumor of pericyte origin with variable malignant potential. Very rarely, this tumor occurs as a primary bone lesion. We present a case of a highly malignant hemangiopericytoma of the proximal tibia. Current therapy consists of radical resection of the tumor with postoperative radiation therapy being recommended. Chemotherapy seems to be useful in disseminated disease. The prognosis correlates to the histological grading of the tumor. Early or late recurrence and distant metastases with fatal outcome, as shown in our case study, are not uncommon.

Amputation, Surgical↗

Detection and mapping of intraabdominal adhesions by using functional cine MR imaging: preliminary results.

PURPOSE: To identify and map intraabdominal adhesions by using functional cine magnetic resonance (MR) Imaging. MATERIALS AND METHODS: Twenty-seven patients suspected of having intraabdominal adhesions were examined. Section-by-section dynamic depiction of induced visceral slide throughout the whole abdomen was achieved by using a transverse or sagittal true fast imaging with steady-state precession sequence. Location and type of diagnosed adhesions were documented by using the nine segments of the abdominal map. These criteria and intraoperative results were compared in 13 patients. RESULTS: MR images depicted a total of 42 intraabdominal adhesions; 21 (50%) were in the lower abdomen. The most common types of adhesions were located between the ventral abdominal wall and small-bowel loops (n = 10 [24%]) and between adjacent small-bowel loops (n = 9 [21%]). Comparison with the intraoperative results showed a sensitivity of 87.5% and a specificity of 92.5%. MR imaging was most accurate in depicting adhesions to the abdominal wall (15 [94%] of 16) and subperitoneal space (eight [100%] of eight). The presence of adhesions between bowel loops was overestimated. CONCLUSION: Detection of visceral slide at functional cine MR imaging is easy to perform and represents a well-tolerated and accurate procedure for use in the identification of intraabdominal adhesions in patients with chronic pain and equivocal clinical findings.

Abdomen↗

Speech processing in radiology.

The goal of this study was to evaluate the recognition rate, learning potential and amount of time needed to complete a report with the Philips speech recognition system SP 6000 (Philips, Best, The Netherlands). Four radiologists dictated reports of interventional radiology, MRI examinations of the musculoskeletal system and CT examinations of the thorax and abdomen with the Philips system using the German language. The recognition rate of each report and improvement rate after each learning phase of the Philips system was assessed. The time needed to complete a report using the Philips system was then compared with the time needed to complete a report using the tape-based system via a time analysis. The average recognition rate for the four radiologists using the Philips system was 79.6 %, which improved to 92.5 % after the third adaptation. Initially, the average time demand to dictate and correct one report was approximately 16.8 min, but this time decreased to 8.1 min after the third adaptation. In contrast, only 3. 6 min were needed to dictate and correct one report using the tape-based system. However, with the speech recognition system, dictation, correction and transcription of the report can be completed within 15 min, whereas with the tape-based system, it takes nearly 1 day. With the Philips system, speech recognition can reach as high as 95 % since each adaptation of the system improves the recognition rate by approximately 5 %. While the Philips system is associated with longer dictation times than the tape-based system, turn-around time for a complete report is substantially shorter with the Philips system than the tape-based system.

Computer Communication Networks↗

Fibromatosis of the plantar fascia: diagnosis and indications for surgical treatment.

Plantar fibromatosis is a rare, benign lesion involving the plantar aponeurosis. Eleven patients (13 feet) underwent 24 operations, including local excision, wide excision, or complete plantar fasciectomy. Clinical results were evaluated retrospectively. There were no differences among the subgroups in postoperative complications. Two primary fasciectomies did not recur. Three of six revised fasciectomies, seven of nine wide excisions, and six of seven local excisions recurred. Our results indicate that recurrence of plantar fibromatosis after surgical resection can be reduced by aggressive initial surgical resection.

Adult↗

[Radiologic diagnosis of chronic constipation and outlet obstruction].

The aim of this review article is to present the role and extent of gastrointestinal radiology in adults with chronic obstipation and stool outlet obstruction. The radiological investigations are well established second-line diagnostic procedures. Special attention is given to the indications as well as to the imaging techniques which include barium enema, measurement of colon transit time and dynamic colpocystorectoviscerography. New emerging modalities such as functional MR Imaging provide an objective, unifying diagnostic approach to the pelvic floor and the colon. This will contribute to an improved perception of the composite entity of the pelvic floor and of the interactions of its adjacent structures. Consequently the longstanding "compartmentalization" practiced by the different medical specialties might be avoided in the future.

Adult↗

[The demonstration of blood flow in focal breast lesions by power-Doppler sonography. A new approach to assessment?].

PURPOSE: Power-Doppler sonography is regarded as a very sensitive method for detecting low-velocity and low-volume blood flows. The purpose of our study was to investigate whether increased vascularity in breast carcinoma can be visualized by power-Doppler sonography and whether new criteria for differentiating benign and malign lesions can be found. METHOD: 315 patients were examined with a 13-MHz high-resolution linear transducer. If a suspicious lesion was found, it was evaluated further by power-Doppler sonography. Compared to normal breast parenchyma (reference structure), a focal increase in blood flow signals was registered using a 3-step grading system with a 4th step for no flow increase. RESULTS: In 97 cases the sonographic findings were correlated with histology (n = 95) or cytology (n = 2). There were 50 benign lesions, 42 cases of invasive and 5 cases of in-situ carcinoma. 73.5% benign lesions showed no or just minimal increases in flow signal. 81% of invasive cancer presented middle- or high-flow increases compared to normal breast parenchyma. The extend of flow increase was linked to tumor size in invasive cancer. In stage T1b to T4, 94.3% of invasive carcinoma presented middle or high flow increases. CONCLUSION: Power-Doppler sonography is able to visualize vascularization in breast tumors. According to first clinical results PD sonography is a promising additional diagnostic tool which seems to offer new criteria for differential diagnosis in breast tumors.

Adult↗

Acute calcific tendinitis of the pectoralis major insertion associated with cortical bone erosion.

A case of calcific tendinitis of the pectoralis major insertion with cortical bone erosion is presented. Clinical and laboratory findings showed a significant inflammatory reaction. Both CT and MR images demonstrated the extent of the lesion providing additional information on the dimensions of inflammatory soft tissue and bone marrow reaction. Biopsy was performed and histology revealed the typical features of calcification, inflammation and giant cell reaction.

Adult↗

MRI of posttraumatic cyst-like lesions of bone after a greenstick fracture.

Posttraumatic bone-cyst formation is a known but rare process. Typical location is the distal radius, usually as a result of a greenstick fracture. The pathogenesis is unknown; however, subperiosteal migration of fat or hemorrhage with later absorption may cause cyst formation. We present the first reported case of MR imaging of this lesion. At MRI subperiosteal hemorrhage was found to be the cause of cyst formation.

Bone Cysts↗

Dynamic MR colpocystorectography assessing pelvic-floor descent.

Magnetic resonance colpocystorectography (MR-CCRG) is presented in the evaluation of patients with pelvic-floor disorders. Five healthy volunteers and 44 female patients with isolated or combined visceral descent underwent dynamic MRI and dynamic fluoroscopy (DF). MR-CCRG was performed with the patient in a supine position using a True FISP sequence (1 image/1.2 s; in-plane resolution 1.02 mm) during pelvic floor contraction, relaxation, and straining maneuvers. Relevant organs, such as urethra, bladder, vagina, and rectum, were opacified by using a saline solution, Magnevist (Schering AG, Berlin, Germany), and sonography gel, respectively. The clinical evaluation and the intraoperative results (30 cases) were used as reference. MR-CCRG and DF were non-diagnostic in 3 cases each. Most patients had a combined type of visceral prolapse, the most frequent combination being a vaginal vault prolapse and a cystocele. The points of reference were sufficiently outlined by DF and MR-CCRG. In comparison with the clinical and intraoperative results, MR-CCRG proved to be especially beneficial in the diagnosis of different types of enteroceles including a uterovaginal prolapse. MR-CCRG showed an equal or higher sensitivity and specificity for all individual sites when compared with DF. Also, predominant herniation obscuring other concomitant prolapse could be verified in 8 cases. MR-CCRG is superior to DF and accurately depicts pelvic-floor descent and prolapse in women. The possibility of dynamic presentation (see enclosed CD-ROM) allows for a better understanding of the organ movements within a given topographic reference setting.

Contrast Media↗

[Dynamic MR colpocystorectography. A new methods for evaluating pelvic floor descent and genital prolapse].

AIM: Introduction of a new method for the dynamic evaluation of genital prolapse by using fast magnetic resonance imaging. METHODS: Dynamic fast magnetic resonance imaging with pelvic floor contraction, relaxation and straining manoeuvres were performed with volunteers and patients presenting with pelvic descent. The urethra, bladder, vagina and rectum were opacified by using a water or Magnevist enteral solution. RESULTS: Delineation and movement of the urethra, bladder, uterus, vagina, rectum and small bowel can be shown in a reliable manner. In comparison to dynamic fluoroscopy an equal or superior diagnosis has been achieved in all cases. CONCLUSION: In comparison to dynamic fluoroscopy MR-Colpocystorectography is a promising new method in assessing pelvic floor descent and prolapse in women. Further studies will have to focus on standardisation and clinical implication.

Aged↗

[Transbrachial arterial catheter angiography. Technique, indications, complications].

In a large group of patients, most of whom were attending a department of vascular surgery, who underwent arterial digital subtraction angiography (DSA), a transfemoral approach was not possible in 9%. Therefore in 142 cases transbrachial arterial angiography was electively performed with 4-F or 5-F catheters. This method proved to be a safe and reliable alternative, though the examination technique was more demanding and the complication rate somewhat higher. It offers clear advantages over a transaxillary or translumbar approach. Special attention is paid to the role of transbrachial arterial DSA in evaluating the descending aorta and the peripheral outflow in the legs and to its usefulness in certain angioplasty manoeuvres.

Adult↗

[Magnetic resonance tomography of scaphoid pseudarthrosis: clinical and x-ray aspects].

37 patients with non-unions of fractures of the carpal scaphoid were examined with MRI and the results compared with conventional radiographs. Advantages of MRI are the documentation of concomitant soft tissue changes in the region of the pseudarthrosis, and the early detection of osteonecrosis of one of the fragments. Advantages of conventional radiographs are the exact documentation of cancellous bone morphology and the position of the fragments.

Adolescent↗

[Intraneuronal ganglia: value of diagnostic radiologic possibilities].

This report describes two cases of intraneuronal ganglia cysts with degeneration of the peroneal and suprascapular nerve. In addition to standard radiographs other diagnostic studies such as CT and MRI may be required to ascertain the extent of the lesion. Histopathologic information is derived from biopsy.

Adolescent↗

[Value of high-resolution CT and nuclear magnetic resonance tomography compared to the standard procedures in the diagnosis of meniscal lesions].

The knees of 20 patients with evidence of meniscal tears were examined via high-resolution computed tomography (HRCT); 10 of these were studied by MRI. The HRCT study was performed directly after double-contrast arthrography (AG). For comparison with HRCT, slice orientation for MRI examination was in transverse view; gradient echo sequences using the FISP technique were applied instead of spin echo sequences. All results were correlated to the arthroscopy (AS) findings. In 95% of the cases AG and AS results agreed, HRCT/AS in 85% and MRI/AS in 70%. In certain cases HRCT provided additional information which influenced appropriate surgical treatment. MRI is a noninvasive nonionising method but gives a less exact documentation of the lesion than AG and HRCT. The gradient echo mode is superior to the SE mode in respect of outlining meniscal structures, at least in transverse view.

Adult↗

[Imaging of the Achilles tendon using magnetic resonance tomography].

The Achilles tendon and pre-achillean space of 30 patients was studied by MRI. A surface coil (Helmholtz' principle) was applied and all patients were examined with a superconducting magnet operating at 1.0 Tesla field strength. The purpose of the study was to illustrate pathological changes of the tendon and the surrounding soft tissue. In 3 cases MRI diagnosed a total rupture of the Achilles tendon. Furthermore, the strain of the tendon and side effects of an inflammatory process could be demonstrated. The use of a surface coil yields a high resolution of the normal anatomy of the region and of the pathological changes of the tendon and the surrounding soft tissue structures. The advantages of MRI for Achilles tendon diagnostics against competitive modalities are excellent soft tissue contrast, multiplanar imaging, as well as exact delineation and visualisation of the lesion.

Achilles Tendon↗

[Primary manifestation of hepatocellular carcinoma as osteolytic hand metastasis--a case report].

Osseous metastases to the hand are very rare. Only a single case of osseous metastasis of hepatocellular carcinoma to the hand has been reported in the literature to date. We report a case of osteolytic metastasis of the right first metacarpal as first manifestation of unresectable, alpha-fetoprotein-negative hepatocellular carcinoma (pT3, Nx, M1, UICC stage IVB, Okuda's stage I). The therapy consisted of R0-resection and hormonal therapy with tamoxifen 2 x 10 mg/d orally. Generally patients with metastatic cancer to the bones of the hand have a very poor prognosis.

Bone Neoplasms↗