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Gerd Bodner

Publications and source records attributed to Gerd Bodner.

At least 19 recordsLinked to original sources
PubMed2006

Pathologic-sonographic correlation in temporomandibular joint pathology.

The accuracy of high-resolution ultrasonography (HR-US) in detecting disk displacement and condylar erosion of the temporomandibular joint (TMJ) was evaluated, using corresponding cryosections as a "gold standard". HR-US of the TMJ was performed with a high frequency 12 MHz transducer on 30 preserved autopsy specimens. Succeeding sonography, the autopsy specimens were deep-frozen and cut in paracoronal planes corresponding to the sonographic images. HR-US diagnoses were compared with cryosectional findings in a blinded fashion. HR-US detected 19 (95%) of 20 instances of condylar erosion and 16 (73%) of 22 instances of disk displacement. There were one false-positive finding for condylar erosion and two false-positive findings for disk displacement. The accuracy of HR-US evaluating condylar erosion and disk displacement rated 93% and 73%, respectively. In conclusion, condylar erosion was reliably assessed by HR-US, but the evaluation of disk position was less accurate.

Aged↗
PubMed2006

Intrarater reliability in the ultrasound diagnosis of medial and lateral orbital wall fractures with a curved array transducer.

PURPOSE: The aims of the study were to document the effectiveness of ultrasound (US) in diagnosing orbital wall fractures when compared with computed tomography (CT) and to measure the intraobserver reliability of US using a curved array transducer. MATERIALS AND METHODS: From December 2003 to March 2004, 13 patients with the clinical diagnosis of an orbital trauma were investigated prospectively by CT (reference) and 2 US investigators. Both orbits were investigated. Sensitivity, specificity, accuracy, and positive and negative predictive value were calculated. The statistical difference between the 2 US investigators was calculated by a chi-square test. The interrater reliability was calculated using the lambda coefficient. Values below 0.4 represent poor reliability, between 0.4 and 0.75 represent fair to good reliability, and a score > 0.75 is graded as excellent reliability. RESULTS: The comparison of the results of the 2 US investigators by the chi-square test showed P values of .385 for the medial orbital wall and .638 for the lateral orbital wall, which shows no significant difference. The lambda-value for the investigation of the medial orbital wall reached 0.429, 0.714, and 0.750. The lambda-value for the investigation of the lateral orbital wall yielded 0.647, 0.750, and 0.882. These values show a good and excellent inter-rater reliability. CONCLUSION: The US investigation does not yet reach the diagnostic quality of CT. US could be a helpful diagnostic imaging tool in cases with clear clinical symptoms. The results of the current study and the previously published results imply that US has the potential to reach the same diagnostic quality as CT in the future, but further studies must be performed to improve the diagnostic quality of the method.

Adolescent↗
PubMed2006

Predictors of carpal tunnel syndrome: accuracy of gray-scale and color Doppler sonography.

OBJECTIVE: The purpose of this study was to retrospectively assess the accuracy of gray-scale and color Doppler sonography in the diagnosis of carpal tunnel syndrome. MATERIALS AND METHODS: A total of 206 wrists in 151 patients with a clinical suspicion of carpal tunnel syndrome were examined with high-resolution sonography using a 7-15-MHz linear array transducer. The presence of median nerve swelling, edema, and flattening and increased bowing of the flexor retinaculum was evaluated with gray-scale sonography, and the presence of nerve hypervascularization was evaluated with color Doppler sonography. Sensitivity and specificity were calculated for each sonographic feature in comparison with nerve conduction studies as the standard of reference. Multivariate logistic regression analysis was used to determine variables predictive of carpal tunnel syndrome. RESULTS: Carpal tunnel syndrome was confirmed in 172 wrists at nerve conduction studies. A median nerve cross-sectional area of at least 0.11 cm2 was calculated as a definition of median nerve swelling. In comparison with nerve conduction studies, nerve swelling showed the highest accuracy (91%) among gray-scale sonography criteria, and the presence of intraneural hypervascularization showed the highest accuracy (95%) among all sonography criteria. Logistic regression analysis showed that nerve hypervascularization was the only variable that independently predicted median nerve entrapment (odds ratio, 16.4; 95% confidence interval, 8.7-31.1; p <0.001). CONCLUSION: Color Doppler sonography is more accurate than gray-scale sonography for characterizing median nerve involvement in patients with suspected carpal tunnel syndrome.

Adolescent↗
PubMed2005

Primary angiosarcoma of the breast associated Kasabach-Merritt syndrome during pregnancy.

Primary angiosarcoma of the breast is a rare aggressive tumour of unknown etiology. A frequent clinical presentation is a painful palpable smooth mass or diffuse enlargement of the breast without a palpable mass but with purple discolouration of the overlying skin with apparent bruising. An uncommon clinical presentation of an angiosarcoma is spontaneous bleeding due to disseminated intravascular coagulation (DIC) by consumption coagulopathy, known as the Kasabach-Merritt syndrome. Imaging characteristics of a breast angiosarcoma are limited to a few radiological reports. We report a case of a young pregnant woman with a bleeding angiosarcoma of the breast and associated Kasabach-Merritt syndrome and describe the sonographic and MRI findings.

Adult↗
PubMed2005

Interrater reliability of sonographic examinations of orbital fractures.

OBJECTIVE: The purpose of this study is to determine whether there are statistically significant variations among different observers when examining fractures of the orbital walls. MATERIAL AND METHODS: From December 2003 to April 2004, 28 patients with clinically suspected orbital fractures were examined by ultrasound prospectively. The US images of the infra-orbital margins, the orbital floors, the medial and lateral orbital walls of each patient were reexamined by two independent investigators. RESULTS: Computed tomography revealed fractures of the orbital floor in 28 out of 31 patients (90.3%). The infra-orbital margins showed fractures of 14 of 31 patients (45.2%). The ultrasound examinations of the orbits by the three examiners presented satisfactory correlation regarding sensitivity and specificity. There were no significant differences between investigators. There was good agreement among the ultrasound examiners regarding the infra-orbital margins. This was not the case for the orbital floors. CONCLUSIONS: If there are clear cut clinical findings ultrasound examination could represent an alternative to computed tomography. If the clinical findings were indeterminate, computed tomography was essential as implicated by this study. Accordingly, further evaluation of ultrasound examinations of fractures of the orbital margins and floors are necessary.

Adolescent↗
PubMed2005

Ultrasound guidance for facet joint injections in the lumbar spine: a computed tomography-controlled feasibility study.

UNLABELLED: We conducted this study to develop an ultrasound-guided approach for facet joint injections of the lumbar spine. Five zygapophyseal joints (L1-S1) on each side of 5 embalmed cadavers were examined by ultrasound for a total of 50 examinations. The joint space was demonstrated under ultrasound guidance. The midpoint of the joint space, defined as the middle of its cranio-caudal extension on its dorsal surface, was taken as a reference point, and its position was computed from its depth and lateral distance from the spinous process. Forty-two of 50 approaches could be clearly visualized. Subsequently, these distances were compared to those obtained by computed tomography (CT). To assess the efficacy of ultrasound in the needle placement, all lumbar facet joints were approached in one embalmed cadaver. The exact placement of the needle tips was again evaluated by CT. Ultrasound and CT measurements showed the same mean depth and lateral distance to the reference point, 3.15 +/- 0.5 cm and 1.9 +/- 0.6 cm, respectively. Pearson's coefficient of correlation was 0.86 (P < 0.0001) between ultrasound and CT. All 10 needle tips were within the joint space during simulated facet joint injections. We conclude that ultrasound guidance might be a useful adjunct for facet joint injections in the lumbar spine. IMPLICATIONS: This study was designed to develop an ultrasound-guided approach to the facet joints of the lumbar spine and to assess its feasibility and accuracy by means of a comparison to computed tomography images. The imaging study demonstrated a significant correlation between ultrasound and computed tomography measurements. During simulated facet injection, ultrasound guidance consistently resulted in accurate needle placement.

Cadaver↗
PubMed2005

Peroneal nerve palsy associated with knee luxation: evaluation by sonography--initial experiences.

OBJECTIVE: Traumatic knee dislocation needs immediate surgical repair to restore joint function. A concomitant traction injury of the peroneal nerve is reported to exist in up to 25% of cases and is often overlooked initially. In patients with major nerve lesions, immediate surgical nerve repair might be necessary to avoid irreversible loss of neural function. In the present study, we tried to evaluate whether sonography is a valuable tool for identification of nerve pathology that warrants surgical intervention. SUBJECTS AND METHODS: In this prospective study, both peroneal nerves in nine patients with one-sided peroneal nerve palsy after closed knee luxation and the peroneal nerves of 11 healthy volunteers were investigated with sonography. Using statistical analysis, we tried to define the comparability and significance of the findings. RESULTS: The mean cross-sectional area of healthy peroneal nerves in the genicular region was 0.18 cm2 (SD, 0.07 cm2). Impaired nerves were significantly discerned because of their increased cross-sectional area at the level of the injury (mean cross-sectional area, 0.7 cm2; SD, 0.46 cm2; p < 0.05). Identification of caliber changes and depiction of at least one nerve stump were found to be the most specific criteria for the definition of a major neural lesion. The ability of sonography to provide additional information about surrounding soft-tissue impairment (scar tissue and hematoma formation) proved helpful. CONCLUSION: Sonography allows radiologists to visualize neural and extraneural pathology and to define the exact level and extent of lesions. Thus, it may be a valuable adjunct in the decision of whether surgical intervention is necessary.

Adolescent↗
PubMed2005

Sonographic diagnosis of plantar vein thrombosis: report of 3 cases.

OBJECTIVE: The purpose of this series is to describe sonographic findings in 3 patients with plantar vein thrombosis. METHODS: Three patients had sudden pain and swelling at the plantar side of the affected foot. Sonography of the plantar foot was performed with a broadband linear array working at 5 to 12 MHz. Gadolinium-enhanced magnetic resonance imaging was performed in 1 patient. RESULTS: Sonography showed enlarged incompressible plantar veins in all 3 cases. Magnetic resonance imaging confirmed venous thrombosis in 1 case. CONCLUSIONS: Pain and swelling at the plantar side of the foot can be caused by plantar vein thrombosis. This type of rare thrombosis can be diagnosed with sonography.

Adult↗
PubMed2005

Real-time sonographic imaging for periradicular injections in the lumbar spine: a sonographic anatomic study of a new technique.

OBJECTIVE: We conducted this study to develop a sonographically guided approach to the spinal nerve of the lumbar spine and to assess its feasibility and accuracy by means of computed tomography (CT). METHODS: Fifty sonographically guided approaches at 5 levels (L1-S1) were performed on 5 embalmed cadavers, which were positioned prone. The spinal nerves of the lumbar spine were shown under sonographic guidance. In 1 cadaver, the most lateral aspect of the roof of the intervertebral foramen was defined as a reference point. Its position was computed as a distance from the tip of the spinal process (A), the midline (B), and the intervertebral disk (C). Subsequently, axial transverse CT scans were made to verify these distances. In a second part of the experiment, a spinal needle was advanced under sonographic guidance to the spinal nerves for each lumbar spinal level on 1 embalmed cadaver. The exact placement of the needle tips was checked with the help of CT. RESULTS: This technique for a sonographically guided approach to the periradicular area proved to be feasible and accurate. Sonography and CT provided the same mean measurements of 4.0, 2.5, and 1.4 cm for distances A, B, and C, respectively. The Pearson correlation coefficient was 0.99 (P < .001) between sonography and CT. In the experimental study, all 10 needle tips were placed periradicular to the spinal nerves. CONCLUSIONS: Sonographic guidance is a useful adjunct to increase the safety and efficacy of periradicular injections in the lumbar spine.

Humans↗
PubMed2004

Sternal osteomyelitis complicating percutaneous coronary artery stenting.

Hematogenous sternal osteomyelitis is a rare infection that has been associated with i.v drug abuse and blunt thoracic trauma, but iatrogenic infections have also been described following resuscitation and in conjunction with hemodialysis catheters. Staphylococcus aureus is the most common causative organism. Stenting is the preferred treatment for isolated stenosis of the coronary artery and is associated with a low complication rate and high patency rate. Such intravascular procedures are rarely complicated by infections. A 72-year-old man developed hematogenous sternal osteomyelitis following coronary artery stenting. Radiological diagnosis was made using CT scan and MRI, and blood cultures and aspiration fluid from the infected soft tissue were positive for S. aureus. Initial therapy consisted of i.v. second-generation cephalosporin followed by oral cephalexin and later linezolid. Prolonged antibiotic therapy without surgical intervention was successful in controlling this rare complication. The patient was well at the one-year follow up, with patent stent and no signs for recurrent osteomyelitis. Although transcutaneous stenting is a widely accepted strategy for treating stenosed arteries, this case highlights the possibility of hazardous infectious complications associated with such procedures.

Aged↗
PubMed2004

The superior rectal artery and its branching pattern with regard to its clinical influence on ligation techniques for internal hemorrhoids.

BACKGROUND: The hemorrhoidal artery ligation has been used for submucosal ligation of hemorrhoidal arteries by means of an ultrasonographic transducer since 1995. The success of this technique depends on the submucosal course of these arteries. Our investigation deals with branches of the superior rectal artery which pierce the rectal wall where they cannot be reached by this method. METHODS: The branching patterns were investigated by means of 5 macroscopic preparations of adult pelves, histological section series of 35 fetal and 3 adult pelves impregnated in epoxy-resin, and transperineal color Doppler ultrasound of 7 proctologic patients and 28 volunteers. RESULTS: Additional branches of the superior rectal artery coursing in outer layers of the rectal wall were shown entering the rectal wall just above the levator ani muscle to supply the internal hemorrhoidal plexus (corpus cavernosum recti). CONCLUSIONS: The terminal course of the branches of the superior rectal artery is not only applied to the rectal submucosa. We have shown that additional branches may be detected by ultrasonography and should be taken into account by the operating surgeon.

Adult↗
PubMed2004

Why CT-guided?

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Anesthetics, Local↗
PubMed2004

Detection and characterization of perianal inflammatory disease: accuracy of transperineal combined gray scale and color Doppler sonography.

OBJECTIVE: To evaluate the accuracy of transperineal gray scale and color Doppler sonography for the detection and characterization of perianal inflammatory disease with surgical correlation. METHODS: Eighty-seven patients with suspected perianal inflammatory disorders underwent transperineal gray scale and color Doppler sonography with a linear 4- to 7-MHz transducer that was used to scan the entire perianal region for the detection of suspected inflammatory disorders. Each detected inflammatory disorder was evaluated to determine its morphologic characteristics and extent. Color Doppler sonography was applied to assess the presence of increased vascularity in the perianal region. In comparison with surgical findings, the diagnostic performance of transperineal sonography was assessed by means of receiver operating characteristic analysis for lesion detection and the Spearman rho test for lesion characterization. Logistic regression analysis was used to assess whether increased perineal vascularity was a predictive factor of perianal inflammatory disease. RESULTS: Seventy-seven perianal inflammatory disorders were confirmed in 62 patients. Gray scale sonography achieved a significantly good performance in the detection (area under the curve = 0.86; P < .001) and characterization (r = 0.65; P < .001) of perianal inflammatory disease. For the detection of perianal fistulas and abscesses, sensitivity was 100% for both, and specificity was 100% and 94%, respectively. With the use of color Doppler sonography, the diagnostic confidence increased slightly (area under the curve = 0.89) but significantly (P = .002). Logistic regression analysis identified hypervascularity at the periphery of a perianal lesion as a significant independent predictor of an inflammatory disease. CONCLUSIONS: Combined gray scale and color Doppler sonography enables a high detectability rate and comprehensive characterization of perianal abscesses and fistulas.

Adolescent↗
PubMed2003

Condylar erosion and disc displacement: detection with high-resolution ultrasonography.

PURPOSE: Our goal was to determine the feasibility of high-resolution sonography for the detection of condylar erosion and associated disc displacement at the temporomandibular joint (TMJ) condyle. MATERIALS AND METHODS: Forty-eight consecutive patients (96 joints) with TMJ disorders were investigated prospectively using a 12.5-MHz array transducer. Images were assessed for condylar erosion and disc displacements. Sonographic findings were correlated with those of magnetic resonance imaging (MRI). RESULTS: At MRI, 18 osseous changes were diagnosed with condylar erosion. Sonographically, 15 of the 18 condylar erosions were diagnosed correctly. Sensitivity, specificity, and accuracy of sonography in the depiction of condylar erosion were 83%, 63%, and 67%, respectively. The positive predictive value was 34%, and the negative predictive value was 94%. Disc displacement without reduction (43 of 96) and disc displacement without reduction concomitant with condylar erosion (16 of 96) were detected with an accuracy of 93% and 80%. CONCLUSION: Sonography is an insufficient imaging technique for the detection of condylar erosion. Assessment of disc displacement without reduction may be reliably made with sonography.

Adolescent↗
PubMed2003

Hyperperfusion syndrome of the deltoid muscle after subclavian artery angioplasty and stenting.

PURPOSE: To report a case of hyperperfusion syndrome of the deltoid muscle after percutaneous transluminal angioplasty of a symptomatic high-grade subclavian artery stenosis. CASE REPORT: Immediately after balloon dilation of a left-sided subclavian artery stenosis, a 53-year-old man developed severe ipsilateral shoulder pain and swelling. Computed tomographic angiography revealed no extravasation or hematoma. Sonography showed massive edema and increased anteroposterior diameter of the left deltoid muscle (3.5 cm compared to 2.0 cm on the right). Hyperperfusion syndrome was suspected, and decompression by anterolateral fasciotomy was performed. Subsequently, both pain and swelling decreased. At day 3, the skin incision, which was temporarily covered with a synthetic skin substitute, was sutured; the wound healed uneventfully. Two weeks after surgery, both muscle strength and shoulder movements showed no restrictions. CONCLUSIONS: Hyperperfusion syndrome after endovascular treatment of subclavian artery stenosis should be considered in the differential diagnosis of atypical muscle pain in the upper extremity. It may present as a compartment syndrome requiring surgical decompression.

Angioplasty, Balloon↗