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Biomedical subjects

A Rieber

Publications and source records attributed to A Rieber.

At least 109 records · Page 6Linked to original sources
PubMed1991

[Intra-arterial angio-CT as a perfusion control before intra-arterial chemotherapy in bronchial, breast and liver tumors].

Intra-arterial angio-CT is used increasingly in the diagnosis of liver metastases since the sensitivity of this method is greater than that of IV-contrast CTs. We carried out this procedure in eight patients with inoperable carcinomas of the bronchus, eight patients with carcinoma of the breast, one patient with an hepatocellular carcinoma and one patient with carcinoma metastases, before starting intra-arterial chemotherapy or tumour embolisation. The procedure permitted optimal placing of the catheter to ensure complete perfusion of the tumour. Perfusion of normal tissue can be reduced to a minimum. Failure of contrast filling on the angio-CT indicates the presence of a second vessel supplying the tumour.

Angiography, Digital Subtraction↗
PubMed1991

[Combined intra-arterial chemotherapy and radiotherapy in inoperable non-small cell bronchial carcinoma].

The five years survival rates of patients with non-operable non-small cell lung carcinoma are between 6% and 9%. Multiple attempts have been made to improve the response rate and the survival of these patients with different chemo- and radiotherapy schemes. The systemic chemotherapy with cisplatin-vindesine is until now one of the most active treatments with a response rate of 40%, but it is limited because of its side effects and toxicity. Eleven patients are treated one to four times with an intraarterial infusion of 3 mg/m2 vindesine and 20 mg/m2 cisplatin into the tumor-feeding bronchial artery combined with a simultaneous radiotherapy (60 Gy). Until now no major side effects occurred and the systemic toxicity was insignificant. An objective tumor response was encountered in 7/11 patients. The intraarterial chemotherapy combined with radiotherapy is strictly local and therefore effective especially in patients with limited or locally advanced disease.

Adenocarcinoma↗
PubMed1990

[Therapy of bile duct occlusion. Transhepatic/endoscopic "Rendezvous procedure" and percutaneous transhepatic stent placement].

Conversion of a percutaneous transhepatic drainage (PTD) into internal drainage by transhepatic/endoscopic implantation of an endoprosthesis or percutaneous transhepatic implantation of a stent is a relatively simple technique associated with few complications. The advantage of both methods is that they can be performed if endoscopic placement of an endoprosthesis fails, as is often the case in patients with a prior Billroth II procedure or hepaticojejunostomy. Indications, methodology and experience with 29 patients treated with these procedures are described.

Biliary Tract Neoplasms↗
PubMed1989

[Arterial angio-CT and magnetic resonance tomography of Klatskin tumors].

The knowledge of the exact spreading and location of a malignant bile duct tumor and the exclusion of differential diagnoses are the prior conditions for the development of an optimal therapy concept. All usual methods such as ERCP, PTC, ultrasound, CT and angiography have weak points in the diagnosis of Klatskin tumors. A new aspect for the solution of this problem is the ability to visualize these tumors by arterial angio-CT and MR.

Adenocarcinoma↗
PubMed1989

[The radiologic diagnosis of inflammatory aneurysms].

An inflammatory aneurysm is defined as a nonbacterial special type of atherosclerotic aneurysm. The macroscopic characteristics are: a porcelaneous appearance, excessive thickening of the aortic wall, and perianeurysmal adhesions. Chronic inflammatory infiltrations, which are localized in the adventitia, can be found via microscopy. Six of forty-three patients with abdominal aortic aneurysms were found to have an inflammatory aneurysm at operation. In a retrospective study, we examined the sonographic, computed tomographic and angiographic appearance of inflammatory aneurysms. Only with computed tomography can thickening of the aneurysmal wall be demonstrated; angiography does not have this capacity and can only find an inflammatory aneurysm in particular cases.

Angiography, Digital Subtraction↗
PubMedDate not supplied

The radiological management of biliary complications following liver transplantation.

PURPOSE: Biliary complications contribute significantly to morbidity and mortality in the liver transplant recipient. Surgery has been the mainstay of therapy, but interventional radiological techniques have made significant progress. METHODS: Diagnostic percutaneous transhepatic cholangiography (PTC) was performed in 12 patients; percutaneous transhepatic drainage (PTD) was performed in 10 patients. Additional interventional procedures included laser lithotripsy, biopsy, dilatation, and stent implantation. RESULTS: In 6 patients PTC revealed anastomotic, and in 6 patients nonanastomotic biliary strictures. Four patients had intrahepatic stones. Biliary strictures were treated by implantation of Palmaz stents in 5 of 6 patients with anastomotic strictures, and in 3 of 6 patients with nonanastomotic strictures. The intrahepatic stones were fragmented with dye laser lithotripsy under cholangioscopic control in 3 of 4 patients. One spontaneous stent migration after 24 months and one stent occlusion were observed; the remaining stents are still patent. Patients with anastomotic strictures had a more favorable outcome: 5 of 6 of these patients are still alive and symptom-free after an average of 27.4 months, but only 3 of 6 patients with nonanastomotic strictures are alive after an average of 9.8 months. CONCLUSION: The different outcomes in patients with anastomotic versus nonanastomotic strictures may be explained by the different causes of these types of stricture.

Adult↗
PubMedDate not supplied

MRI of the abdomen with positive oral contrast agents for the diagnosis of inflammatory small bowel disease.

Magnetic resonance imaging (MRI) is being used more often in the evaluation of inflammatory bowel diseases. A prerequisite for adequate image quality is the oral application of contrast medium, which can be administered with different modalities. Positive and negative oral contrast media can be used; in terms of diagnostic efficacy, there appears to be no relevant differences between them. Sequences usually are acquired using breath-hold or respiration-triggered protocols. The underlying principle is visualization of circumscribed thickening of the intestinal wall, which shows a pathologic pattern of contrast medium uptake. The available data suggest that MRI is equally as effective as enteroclysis in the primary diagnosis of Crohn's disease and actually more sensitive in the detection of extraintestinal manifestations such as fistulae or abscesses. Supporters of the method predict that MRI will replace enteroclysis in the long term.

Abdomen↗
PubMedDate not supplied

Metallic stents in malignant biliary obstruction.

PURPOSE: Retrospective analysis of our results with metallic stent placement for malignant biliary strictures. We sought to determine parameters that influence stent patency. METHODS: A total of 95 Wallstents were implanted in 65 patients (38 men, 27 women; mean age, 65.1 years) with malignant biliary obstruction. Serum bilirubin levels were assessed in 48 patients; the mean value prior to intervention was 15.0 mg/dl. RESULTS: In 12 patients (21%) complications occurred as a result of percutaneous transhepatic drainage. Stent implantation was complicated in 13 patients, but was possible in all patients. A significant decrease in bilirubin level was seen in 83.3% of patients following stent implantation. Approximately 30% of patients developed recurrent jaundice after a mean 97.1 days. In 9 patients (15%) the recurrent jaundice was caused by stent occlusion due to tumor growth. The mean follow-up was 141.8 days, the mean survival 118.7 days. Patients with cholangiocarcinomas and gallbladder carcinomas had the best results. Worse results were seen in patients with pancreatic tumors and with lymph node metastases of colon and gastric cancers. CONCLUSIONS: The main predictive factors for occlusion rate and survival are the type of primary tumor, tumor stage, the decrease in bilirubin level, and the general condition of the patient.

Aged↗
PubMedDate not supplied

Alveolar liver echinococcosis: a comparative study of three imaging techniques.

BACKGROUND: We compared the imaging findings in patients with alveolar liver echinococcosis using ultrasound (US), computerized tomography (CT) and magnetic resonance imaging (MRI) in a prospective study. PATIENTS AND METHODS: 30 patients with alveolar echinococcosis (AE) were examined with the above imaging techniques. RESULTS: 30 lesions were detected with all three methods and most lesions (n = 55) were detected with CT. Calcifications were seen in 15 lesions with US, in 21 with CT and in 16 with MRI. MRI best detected necrotic areas and multivesicuLar structures. CONCLUSION: US is the screening method of choice and should primarily be complemented by CT due to its ability to detect the greatest number of lesions and clear demarcation of the characteristic calcifications. MRI may facilitate the diagnosis in uncertain cases with noncalcified or partially calcified lesions by showing the characteristic multivesicular structure, necrotic areas and proximity to vascular structures.

Adult↗
PubMedDate not supplied

MRI of the breast in the differential diagnosis of mastitis versus inflammatory carcinoma and follow-up.

PURPOSE: Our goal was to evaluate the potential of dynamic MRI in differentiating mastitis and inflammatory breast carcinoma. Furthermore, we evaluated the potential of breast MRI to follow up mastitis patients under antibiotic treatment. METHOD: Twenty-one cases of dynamic breast MR (11 mastitis, 10 inflammatory carcinomas) were reviewed. All patients had a history consistent with either mastitis or inflammatory breast carcinoma. The final diagnosis was histologically confirmed. RESULTS: Ninety percent of the inflammatory carcinomas were found to enhance > 100% in the first minute compared with 55% for mastitis. There is no significant difference between mastitis and inflammatory carcinoma. CONCLUSION: While breast MR cannot currently be used definitively to distinguish inflammatory carcinoma from mastitis, the differences in dynamic enhancement may prove to be useful in follow-up of presumed mastitis in problematic cases. If after biopsy the diagnosis remains unclear, breast MR may help to (a) demonstrate the success of the antibiotic treatment and (b) diagnose coexisting or confounding inflammatory carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

MRI of histologically confirmed mammary carcinoma: clinical relevance of diagnostic procedures for detection of multifocal or contralateral secondary carcinoma.

PURPOSE: MR mammography (MRM) is a sensitive diagnostic method for the detection of mammary carcinomas. The present study evaluates whether MRM can yield additional relevant data in cases of histologically confirmed mammary carcinoma. METHOD: Thirty-four patients with histologically confirmed mammary carcinoma were examined at MRM using a T1-weighted GE sequence and a T2-weighted SE sequence. Morphologic criteria and the dynamic contrast medium behavior of the tumors were evaluated. RESULTS: MRM showed a 100% sensitivity and diagnostic accuracy in the detection of mammary carcinomas. Additionally, three unexpected contralateral carcinomas were discovered. In 26 patients, there was a multifocal or multicentric tumor process. In 24 patients, peritumoral edema was visualized, which corresponded histologically in 21 patients with lymphangiosis and in 3 with an inflammatory peritumoral reaction. CONCLUSION: Because of its high sensitivity in the diagnosis of multifocal disease and of contralateral carcinomas, MRM would seem to represent a useful addition to preoperative diagnostic procedures. The potential benefit to the patient and its cost efficiency, however, remain to be clarified.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

Value of MR mammography in the detection and exclusion of recurrent breast carcinoma.

PURPOSE: This is a study of 140 patients undergoing MR mammography (MRM) for evaluation of possible local recurrent disease following breast-conserving surgical treatment of mammary carcinoma. MRI was performed 1-228 months (mean 28.3 months) postoperatively. METHOD: MRM and interpretation of the dynamic measurements were performed in a standardized manner after positioning the patient in a double breast coil. A GRE sequence (Flash 3D, TE 5 ms, TR 12 ms, FA 25 degrees) was acquired before and 1, 2, 3, and 8 min after intravenous injection of Gd-DTPA in a dose of 0.15 mmol/kg body wt. RESULTS: Recurrent disease was excluded in 82.8% of cases with MRM. In another 13.6% of patients, MRM was able to reliably detect recurrence of malignancy. In five cases (3.6%), MRM returned false-positive results. CONCLUSION: MRM is a sensitive method for detecting or excluding recurrence of malignant disease. It remains to be determined whether early detection of recurrent disease can contribute significantly to improving the prognosis in these patients.

Adult↗