[An unclear circulatory disorder].
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Biomedical subjects
Publications and source records attributed to G Reuther.
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Special X-ray tubes with electromagnetic focusing provide a spatial resolution of up to 50 lp/mm at a focal spot size of about 10 microns. Radiographs of whole female breast specimens as well as paraffin blocks were taken at magnifications up to x 10. The initial results revealed numerous microcalcifications smaller than < 100 microns that had not been detected by conventional grid mammography. The combination of a microfocal spot with digital radiography results in as yet unmatched resolution of microcalcifications and makes the advantages of image post-processing available to mammography. However, specific types of calcification could not be established in malignant or benign histological findings.
Opinions about the relation between the dimensions of the syrinx and the severity and distribution of symptoms in patients with syringomyelia are controversial. Therefore, this study investigates the relation of clinical symptoms, a disability score, quantified (1- and 2-dimensional) radiological findings (magnetic resonance imaging, MRI) and electrophysiological data (somatosensory and motor evoked potentials) in 22 patients with syringomyelia. There was a close relation between clinical symptoms and electrophysiological data. By both electrophysiological methods subclinical deficits could be detected. Furthermore, the results disclosed that the clinical symptoms, the degree of disability and the duration of the disease are not related to the dimensions of the syrinx or the electrophysiological results obtained by investigating the long ascending and descending spinal tracts of the lower limbs. Our findings suggest that, besides the syrinx, other factors not directly visible in the MRI are responsible for the development and progress of clinical symptoms.
The diagnostic ranking of trabecular morphology for the evaluation of osteoporosis in quantitative CT (QCT) is presented. 5 patterns of cancellous bone correlating with trabecular density may be discerned. However, these patterns may indicate osteoporotic changes in particular cases only, by confluent rarefactions if the density is still within the normal range. There is neither a predictive value for the degree of spontaneous or therapy-induced bone loss, nor for therapy response. The trabecular appearances remain unchanged in short term even under strong quantitative changes and are therefore of no value for follow-up.
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In a prospective study 43 patients with shoulder pain were examined by sonography and MRI. The findings were controlled by plain radiography, arthrography, and CT arthrography. Joint effusions and humeral head defects were equally identified by MR and sonography. In the diagnosis of labrum lesions, rotator cuff lesions, subacromial spurs, and synovial inflammatory disease sonography was not as accurate as MR. A special MR scoring system improved the diagnosis of an impingement syndrome.
The potential of digital luminescence radiography in replacing conventional myelography was analyzed using ROC methodology. 95 conventional (CR), digital (DR) and edge enhanced digital (EDR) myelograms (49 disk herniations, 46 normal) were read independently by 5 radiologists; and a ROC analysis was performed. Higher confidence levels were used in making both correct and incorrect diagnoses with DR and EDR than with CR. However, no statistically significant differences between AUC (area under the curve) values obtained with the different techniques, were noted. The separate analysis of cervical and lumbar myelograms showed no significant differences between the different techniques. With DR and EDR, the sensitivity of 4 of 5 readers was somewhat higher in the lumbar but lower in the cervical region than with CR. Replacement of conventional by digital luminescence myelography seems possible; however, some decrease of sensitivity in the cervical region must be accepted.
Diagnostic efficacy of T1-weighted 3D gradient-echo and 2D spin-echo pulse sequences in the detection of adenomas were evaluated in a ROC study of 50 patients. Sensitivity, specificity and accuracy did not differ significantly, but in direct comparison gradient-echo received a clear lower rating due to susceptibility artifacts, lower signal-to-noise ratio, and inferior periglandular contrasts. Additional lesions could not be reliably detected in gradient-echo imaging at 1 mm slice thickness. A substitution of 2D spin-echo imaging by gradient-echo sequences cannot be recommended at present.
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The usefulness of direct radiological magnification is inversely related to the resolution of film-screen systems when very small focal spots are used. Thus, spatial resolution of digital luminescence radiography (DLR) may closely approximate that of high-detail screens at the expense of a more restricted field of view. Apart from the major drawback of limited spatial resolution, DLR makes it possible to take full advantage of image-processing techniques and an unmatched dynamic range.
A 2 1/2-year prospective study of surgically treated malignant mesenchymal neoplasms showed magnetic resonance imaging (MRI) to be superior to computed tomography (CT) in sensitivity for local recurrent disease measuring less than 15 cm3. Larger masses were detected with similar sensitivity; specificity and predictive values did not differ. The presence of areas of high signal intensity on T2-weighted images proved to be a reliable criterion except in fibrous neoplasms. However, differentiation between non-hemorrhagic fluid collections, cross-sectioned veins or bowel contents and small tumor nodules cannot be made simply by signal intensity, but has to be based upon the evaluation of gross morphologic criteria.
Twelve patients with central neurofibromatosis underwent MR examination of the head. Among these, chiasma glioma was the most common CNS tumour (6/12). Seven patients had multifocal areas of increased T2-signal without mass effect predominantly involving the region of the basal ganglia. No corresponding CT abnormalities were present. These lesions may represent multifocal dysplasia and seem to be characteristic of central neurofibromatosis.
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The normal ligamentous anatomy and an efficient examination technique for the wrist are demonstrated with reference to examinations conducted in healthy volunteers. Only the ulnar complex, the radial collateral ligament, the distal intercarpal ligaments and the radial parts of the palmar and dorsal V-ligaments are adequately visualized. Thus, limited specificity means that static high-resolution MRI of the wrist cannot at present be considered an adequate examination method for the evaluation of unexplained wrist pain and instability. So far MRI can only play a key role in the diagnosis of lesions of the ulnar complex.
The incidence of pathologic duodenal abnormalities in patients suffering from chronic recurrent pancreatitis is derived from a retrospective analysis of 128 hypotonic duodenographies. The value of established diagnostic criteria and the present indication for a hypotonic duodenography in chronic pancreatitis are determined.
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A retrospective study of 50 exostotic chondrosarcomas of the trunk reveals statistically significant correlations of histological grading and growth pattern as well as bone destruction pattern as general hallmarks of the degree of malignancy. No correlation between presence and type of matrix mineralisations was found. A radiomorphological classification derived from the CT appearance of mineralisations allows a distinction of 5 types that are important for diagnostic specificity and recurrence detection. MRI provides sensitive detection of early local recurrences due to high-contrast display of chondroid tissue irrespective of mineralisations. However, the specificity is low.