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E Knöpfle

Publications and source records attributed to E Knöpfle.

8 recordsLinked to original sources
PubMed2003

[CT in ureterolithiasis with a radiation dose equal to intravenous urography: results in 209 patients].

PURPOSE: To evaluate a low-dose, nonenhanced helical CT protocol for the diagnosis of renal colic using an effective dose equivalent of radiation not higher than that of intravenous urography. MATERIALS AND METHODS: A new low-dose helical-CT protocol (120 kV; 70 mA; rotation time 0.75 s; collimation 5 mm, pitch = 2) was used to examine 209 consecutive patients with symptoms of renal colic. The initial CT reports were compared with retrograde ureterography, ureteral endoscopy, stone retrieval, surgical or clinical findings. The effective radiation dose was calculated by the method published by Nagel. The prevalence of ureterolithiasis was 70 %. RESULTS: Sensitivity and specificity of the low-dose-helical CT in detecting ureteral calculi were 97.7 % and 96.8 %, respectively. The positive predictive value was 99.3 % and negative predictive value 92.4 %. The mean effective radiation dose equivalent was 0.97 mSv in male and 1.35 mSv in female patients. CONCLUSIONS: The diagnostic value of the reported CT protocol does no differ from previously published protocols. However, the effective radiation dose equivalent is at least 50 % lower than stated in the published protocols. We recommend the low-dose helical CT protocol as the method of choice.

Adult↗
PubMed2001

[Ileus in colorectal carcinoma. Preoperative implantation of self-expanding metal stents and early elective surgery as an alternative to emergency surgery].

INTRODUCTION: The objective of this study was to evaluate preoperative decompression with self-expanding metallic stents in patients with acute bowel obstruction due to colorectal carcinoma. METHODS: In 28 patients, admitted to our clinic between January 1996 and May 1999 with suspicion of acute colonic obstruction caused by a colorectal carcinoma, we attempted to insert under fluoroscopic control a self-expanding metallic stent in the stenosis. After successful relief of obstruction, an elective one-stage surgical procedure followed. RESULTS: The stent application was technically successful in 21 patients. In 19 patients symptom relief was reached within 2 days. One of these patients died perioperatively and two patients developed an anastomotic leakage. In eight of the other nine patients, in whom decompression was not possible, an emergency surgical procedure was performed; four of these patients died perioperatively. In only one of the five patients who survived, could a surgical procedure without an enterostoma be performed. CONCLUSION: In cases of acute malignant colorectal obstruction, preoperative stent application under fluoroscopic control is a reliable method to allow single-stage surgical resection without requiring a protective enterostoma.

Adult↗
PubMed2001

[Unenhanced spiral computerized tomography in acute diagnosis of flank pain. Examination in contraindications for contrast medium administration].

The diagnostic value of unenhanced helical computed tomography was investigated in a prospective study. In 53 patients (aged 35 to 82 years) with acute flank pain tomography was performed in addition to abdominal plain film and ultrasound examination. All 53 patients had a contraindication for intravenous administration of contrast medium. Ureteral calculi were either confirmed or excluded by retrograde ureteropyelography in 44 cases, in 9 patients by asservation of calculi and clinical follow-up. Helical computed tomography was able to precisely identify all of the 34 ureteral calculi, whereas abdominal plain films led to 6 false positive and 17 false negative findings. In 1 patient with retroperitoneal lymphoma (diagnosed by CT) false positive findings occurred. Unenhanced helical computed tomography reaches a distinctively increased diagnostic value (sensitivity 100%, specificity 95%, accuracy 97%) in the evaluation of acute flank pain as compared to conventional radiologic imaging and ultrasound. This non-invasive procedure is to be considered method of choice for patients with contraindications for the application of radiopaque material.

Acute Disease↗
PubMed2001

Unenhanced helical computed tomography in the evaluation of acute flank pain.

OBJECTIVE: The diagnostic value of unenhanced helical computed tomography (CT) for the evaluation of acute flank pain is investigated in a prospective study. PATIENTS AND METHODS: In 125 patients aged 18-86 years, we performed unenhanced helical CT in addition to abdominal plain film, abdominal ultrasound and urinalysis as a diagnostic measure for acute flank pain. Ureteral calculi were confirmed or, respectively, excluded by retrograde ureteropyelography in 80 cases. In the other cases, diagnosis was verified by clinical course and/or stone asservation. RESULTS: In 91 of 125 patients the flank pain was caused by a ureteral calculus. In 67 of 91 patients with urolithiasis, stones could be collected for analysis. Helical CT was able to precisely identify 90 ureteral calculi. Abdominal plain films led to 8 false-positive and 48 false-negative findings. Thus, sensitivity of plain radiography, ultrasound and urinalysis was 47, 11 and 84% with a specificity 76, 97 and 32%, respectively. CONCLUSIONS: Unenhanced helical CT reaches a distinctively increased diagnostic value (sensitivity 99%, specificity 97%) in the evaluation of acute flank pain as compared to plain radiography, ultrasound and urinalysis.

Acute Disease↗
PubMed1998

[Emergency decompression of a mechanical colonic ileus before elective surgery: first clinical results of fluoroscopic stent placement].

PURPOSE: Evaluation of fluoroscopic stent placement as an emergency therapeutical approach for treatment of acute large bowel obstruction due to colorectal neoplasm. METHODS AND MATERIAL: From January to December 1996 in 11 patients suffering from colorectal stenosis due to known or supposed malignancy the indication for the fluoroscopic placement of self-expanding metal stents was established. All patients showed clinical and radiological signs of an acute mechanical large bowel obstruction. Elective single-stage surgery was planned if the decompression had been carried out successfully. RESULTS: Stent placement was successful in 8 cases. Functional success in respect of resolving the acute large bowel obstruction was seen in 7 out of 11 patients. Elective surgery was possible in all 7 cases creating a primary end-to-end anastomosis without major complications during the perioperative period. CONCLUSION: Fluoroscopic placement of self-expanding metal stents in malignant colorectal stenosis is a promising method to avoid emergency surgery.

Aged↗
PubMed1997

[Does the core biopsy of solid liver lesions permit an exact histological classification? Results of a prospective study under routine clinical conditions].

PURPOSE: The aim of this prospective study was to answer the question to what extent percutaneous core-cut biopsy of solid lesions of the liver can permit (sub-)classification under routine conditions. MATERIAL AND METHODS: Subject of this study were 80 percutaneous core-cut biopsies of solid liver lesions in 75 patients. The biopsies were done consecutively under routine conditions by 10 different radiologists with Tru-Cut-needles and a biopsy gun with sonographic (n = 73) or CT (n = 7) guidance. After receiving the histological analysis, the radiologists then prospectively divided the biopsies into "valid" und "unclear" using clinical and radiologic data of the respective patient. The results were verified by a second biopsy, follow-up or surgery. RESULTS: 80% of all histological analyses were rated as "valid", 20% as "unclear". The accuracy of the "valid" reports in respect of ranking was 95% and 90% for the accurate tumour classification. These values were reduced to 81.3% and 74%, respectively, with regard to the total number of cases. The negative predictive value was reduced from 78% to 51.7%. CONCLUSION: Core-cut biopsy of solid liver lesions guided by imaging yields good results even under routine conditions as long as all histological reports have been correlated with imaging and clinical informations.

Biopsy, Needle↗
PubMed1979

Shock kidney.

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Acute Kidney Injury↗