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H J Brambs

Publications and source records attributed to H J Brambs.

At least 91 records · Page 5Linked to original sources
PubMed1997

Sensitivity of computed tomography in detecting local recurrence of prostatic carcinoma following radical prostatectomy.

The aim of this study was to evaluate CT imaging in the post-operative follow-up and in the detection of recurrence after radical prostatectomy in cases of prostatic carcinoma. In over 500 patients undergoing radical prostatectomy for prostatic carcinoma, 22 cases with local recurrence were found. CT examinations of the pelvis were retrospectively evaluated in these patients. Local recurrence was detected by PSA uptake and confirmed by transrectal ultrasound (TRUS) in combination with guided biopsy. In 22 cases of confirmed local recurrence, positive results on CT were found in eight patients (36%) and negative results in nine patients (41%). In the remaining five cases (23%), no distinction could be made between scar and local recurrence. All cases definitively classified as recurrent tumour disease showed a soft tissue mass of 2 cm or more. CT sensitivity in local recurrence of prostatic carcinoma after surgery is low. Even in a very careful follow-up, the understaging would be up to 41%. In comparison, PSA, TRUS and needle biopsy are the methods of choice and are superior to CT imaging. Based on these results, there would be no reason for including pelvic CT examinations in the follow-up of prostatic carcinoma after radical prostatectomy.

Follow-Up Studies↗
PubMed1997

MR imaging measurement of the femoral antetorsional angle as a new technique: comparison with CT in children and adults.

OBJECTIVE: Our objective was to determine the accuracy, precision, and reliability of MR imaging as a technique for measurement of the femoral antetorsional angle. SUBJECTS AND METHODS: We used MR imaging to measure anteversion of the femoral neck in 44 patients: 19 children (range, 3-17 years old; mean, 11 years old) and 25 adults (range, 18-83 years old; mean, 29 years old). RESULTS: We found a high correlation between MR imaging and CT measurements (r = 77). On CT, the mean angle for children was 34 degrees and for adults it was 22.2 degrees. On MR imaging, the mean angle for children was 23.22 degrees and for adults it was 15.71 degrees. The mean anteversion angles obtained by CT exceeded those obtained by MR imaging. Mean interobserver and intraobserver agreements were high for MR imaging (r = .97 and r = .97, respectively) and for CT (r = .99 and r = .96, respectively). CONCLUSION: Compared with CT as the gold standard, MR imaging measurement of femoral anteversion allows precise anatomic measurements and produces reliable, reproducible results. MR imaging is recommended for preoperative planning in pediatric patients with femoral rotation osteotomies.

Adult↗
PubMed1997

Musculoskeletal involvement in cystic echinococcosis: report of eight cases and review of the literature.

OBJECTIVE: Our purpose was to describe the morphologic appearance of musculoskeletal lesions in patients with cystic echinococcosis shown by CT and MR imaging. CONCLUSION: Patients with musculoskeletal lesions of cystic echinococcosis typically have cystic structures in adjacent soft tissues. These cysts morphologically resemble abscesses, with peripheral uptake of contrast medium and variable signal intensities on T1-weighted MR images. The absence of calcifications or endovesicular daughter cysts does not exclude the diagnosis of cystic echinococcosis.

Adult↗
PubMed1997

Displaced metallic biliary stents: technique and rationale for interventional radiologic retrieval.

OBJECTIVE: We investigated the spontaneous course and the possibility of transhepatic removal of displaced biliary stents. MATERIALS AND METHODS: Displaced biliary stents were observed in 11 patients (13-75 years old) between October 1988 and August 1996. Stent types included the Palmaz stent (n = 3), Wallstent (n = 3), and the Strecker stent (n = 5). Reasons for stent displacement included primary misplacement (n = 4), dislocation due to transhepatic endoscopy with biopsy (n = 2), dislocation resulting from a recanalization maneuver in stent occlusion (n = 3), and unknown causes (n = 2). In three cases, the stent was displaced into the proximal bile duct system. Seven patients had primary malignancy. RESULTS: Eight of 11 displaced biliary stents were removed transhepatically. Extraction was performed using either a wire loop (n = 4) or forceps (n = 4). No complications occurred. In the remaining three patients, whose stents were displaced into the intestine, no invasive action was taken. In one of these patients, a Palmaz stent was passed spontaneously after 1 week. In the second of these patients, a 6 cm Wallstent remained innocuously at a position in the right lower abdomen, and the patient died as a result of malignancy. In the third patient, who had a 10-cm Wallstent, an abscess developed in the stent region 4 months after displacement and resulted in formation of an ileocutaneous fistula. CONCLUSION: Transhepatic extraction of displaced biliary stents is technically possible, even in the case of rigid stents such as the Palmaz stent. Because of the risk of intestinal perforation, displaced stents should be removed.

Adolescent↗
PubMed1997

[Abdominal arteriovenous and arterio-portal fistulas: etiology, diagnosis, therapeutic possibilities].

PURPOSE: Arterioportal and arteriovenous fistulas (APF, AVF) are rare vascular disorders occurring as a result of congenital vascular malformation, trauma, iatrogenic causes or neoplasms. The clinical spectrum of presentation ranges from symptom-free individuals to patients with severe portal hypertension or congestive heart failure. While the majority of patients have been treated surgically in the past, interventional radiological procedures are being performed with increasing frequency. To prove this trend we reviewed the international literature. REVIEW: We reviewed the clinical presentation and management of 79 cases reported between 1980 and 1996 in the literature and six own patients. RESULTS: Review of the literature and our own six cases show that these fistulas can be divided in intrahepatic (n = 49, 75%) and extrahepatic fistulas (n = 20, 25%). The most important causes are trauma (n = 29, 37%), iatrogenic induced by procedures (n = 21, 27%) and congenital vascular malformations (n = 10, 13%). APFs and AVFs can be diagnosed by ultrasound, computed tomography and magnetic resonance imaging. Angiography confirms the diagnosis and in many cases allows definitive interventional radiologic treatment. CONCLUSION: Management of AVFs and APFs remains a challenge. However, interventional radiologic procedures provide a safe, low-cost, and effective method for treatment. Due to these facts in the last three years we notice an increasing part of interventional procedures for treatment.

Arteriovenous Fistula↗
PubMed1996

[Space-occupying lesions in the liver--rational step-wise diagnosis].

For high diagnostic quality, it is crucial that the examiner has an exact knowledge of the liver tumor pathology in order to search for characteristic criteria. On the other hand knowledge of the overall spectrum of all diagnostic possibilities would also be necessary, for isolated cases, i.e. to be able to select in an individual clinical situation the critical investigation or the efficient sequence of investigations, in order to produce a swift and reliable diagnosis. With it, however, comes the aggravation of perpetual technical improvements in the tomographic imaging technique, and a wide variety of contrast mediums are constantly being developed and introduced, causing continuous problems in taking the right decision.

Carcinoma, Hepatocellular↗