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S Trattnig

Publications and source records attributed to S Trattnig.

At least 109 records · Page 6Linked to original sources
PubMed1996

[Current aspects in diagnosis and therapy of carotid artery kinking].

Elongation, coiling and/or kinking of the interal carotid artery occur in 10-25% of the population. While coiling of the internal carotid artery is ascribed to embryological causes, elongation and kinking are due to atherosclerosis or fibromuscular dysplasia. Seventy-seven patients with carotid kinking were examined using different diagnostic imaging methods. Of these, 64 underwent surgery because of cerebrovascular symptoms that ranged from local disturbances, vertigo, diplopia and cerebrovascular insufficiency producing ischemic attacks or infarction. The treatment of choice was surgical correction of the carotid kinking in symptomatic cases and, if indicated, endarterectomy of atherosclerotic lesions of the internal carotid artery to prevent ischemic stroke. Because of the anatomical position of the interal carotid artery kink there is a potential risk of complications in head and neck surgery. For this reason, the presence of carotid kinking should be excluded preoperatively by means of non-invasive diagnostic imaging, such as afforded by ultrasonic testing. The merits of the different diagnostic imaging methods to diagnose internal carotid artery disease were compared and discussed.

Brain Ischemia↗
PubMed1996

[The shoulder joint--diagnostic imaging].

In the assessment of shoulder joint abnormalities plain films must still be used today as primary imaging modality. For soft tissue, cartilage, tendon and ligament lesions, CT with arthrography and particularly MRI with arthrography is available today. Especially latter method leads to a significantly extended diagnosis, which in many cases implies a major therapeutical significance.

Arthritis↗
PubMed1995

The role of stereotactic biopsy in radiosurgery.

Radiosurgery offers a very powerful, minimally invasive therapeutic tool in the modern treatment of intracranial lesions. A direct contact with the lesion, as always takes place, e.g. in a stereotactic biopsy or microsurgical operation, is no longer an absolute prerequisite. Treatment planning is done using modern imaging techniques like computer assisted tomography (CT) or magnetic resonance imaging (MRI). Both provide high resolution and contrast images. The lesions can be displayed with high accuracy. The specificity of these techniques is adequate enough to provide neuropathological data which are a prerequisite for treatment? In 1991 we published a retrospective study in which the diagnosis based on CT was compared with the histological diagnosis following stereotactic biopsy on a series of 181 patients with intracranial processes. We could show clearly that CT alone does not offer a reliable basis for therapy planning. Overall CT-scan was inaccurate in 22% of the cases. Now in an additional series of 195 patients with intracranial processes, we have compared the MRI diagnosis with the neuropathological diagnosis. MRI results and the neuropathological diagnosis based on microsurgical operation were compared and evaluated according to the following criteria: 1. Absolute agreement between MRI and histological diagnosis. 2. No agreement between MRI and histological diagnosis. 3. Conditional agreement: the MRI result offered several differential diagnoses one of which was accurate.

Biopsy, Needle↗
PubMed1995

[Systemic diseases and blastomas of the foot].

Analysis of roentgenograms by location, pattern of destruction, classification of tumor matrix and periosteal new bone formation, together with clinical data, preserves valuable information for discrimination of neoplasms in the foot. Furthermore, specific information on tumor histology and tumor extension in the bone marrow and soft tissues can be obtained by CT and MRI. Preoperative staging, guided biopsy of tumor tissue, monitoring of chemotherapeutic response and postoperative observation are further indications for MRT and other modern imaging modalities.

Bone Marrow↗
PubMed1995

[Trauma of the ligaments and tendons. Examination technique and detection in MRI].

For stress radiography, the inversion stress test can be performed during radiographic examination and widening of the lateral joint space can be measured quite accurately. However, there is no general agreement on the meaning of various degrees of talar tilt. Today MRI allows evaluation of the integrity of injured ankle ligaments. The major difficulty in MRI is inconsistency in visualization by inadequate appreciation of the three-dimensional orientation of each ankle ligament. The appropriate combination of foot position and imaging plane is very important to achieve the best visualization of each ligament. Using this technique, 52 patients with sprained ankles underwent MRI. The integrity of rupture of the collateral lateral ligaments was obtained in all 52 ankles. Full-length visualization is essential for evaluation of the ankle ligaments with MRI. In these 52 patients the ankle of tilt on the stress X-ray was compared with the rate of MRI findings showing an injury affecting two ligaments We found that none of the patients in whom the angle of lateral tilt was less than 5 degrees had rupture of two lateral ligaments, while 32% of patients with angles of tilt of 6-14 degrees and 42% of those with angles of tilt over 15 degrees on stress X-ray had two ruptured lateral ligaments. When a stress X-ray with a 6-14 degrees angle of tilt suggests only slight ligamentous injury, MRI could be indicated in specific cases to allow identification of the 32% with rupture of two ligaments. The only practical means of imaging tendons is high-frequency ultrasound and MRI.(ABSTRACT TRUNCATED AT 250 WORDS)

Achilles Tendon↗
PubMed1995

[Sinus tarsi syndrome. MRI diagnosis].

Sinus tarsi syndrome is a well-defined clinical pathological entity. The sinus tarsi is an anatomic space between the inferior aspect of the talus and the superior aspect of the calcaneus, anterior to the posterior subtalar joint. The entire space is filled with fat, five ligaments and vessels. MRI demonstrates characteristic findings with obliteration of normal fat and lack of visualization of the ligaments. This syndrome is relatively frequent and is related to trauma in about 70% in association with the lateral collateral ligament and tibialis posterior tendon injuries. In the remaining 30% the reason is an inflammatory condition.

Calcaneus↗
PubMed1995

[Tarsal tunnel syndrome. MRI diagnosis].

Clinical findings and symptoms of tarsal tunnel are commonly vague and diffuse and electrodiagnostic studies do not provide definitive diagnosis. MR imaging with its excellent soft tissue contrast can demonstrate clearly the anatomy of the tarsal tunnel and its contents. MRI is able to demonstrate a space-occupying lesion and its relationship to the posterior tibial nerve and its branches. This information aids in surgical planning by determining the extent of the decompression required. MR imaging may also be used to follow up non-surgical causes of tarsal tunnel syndrome such as tenosynovitis.

Diagnosis, Differential↗
PubMed1995

[Ultra-short turbo-spin echo in comparison with turbo-spin echo. Possible applications in the musculoskeletal system].

Ultrashort turbo spin-echo sequence (TSE) has the advantage of shorter scan times, minimizing motion artifacts, but has the disadvantage of a lower signal-to-noise ratio and suffers from different artifacts. T2-weighted ultrashort TSE (echo train 24) and TSE (echo train 11) were compared in degenerative lesions of the spine (n = 9) and ligamentous lesions associated with sprained ankle injuries (n = 5). The imaging quality of ultrashort TSE was very similar to TSE. There was no difference in diagnostic reliability with ultrashort TSE compared to TSE in the spine or ankle. With regard to contrast properties a higher signal intensity of fatty bone marrow was obtained with ultrashort TSE, with consecutive lower contrast between fluid and edema on the one hand and fatty tissue on the other.

Ankle Injuries↗
PubMed1995

Oculomotor abnormalities in Dyssynergia cerebellaris myoclonica.

In 1921 Ramsay-Hunt first described the syndrome of dyssynergia cerebellaris myoclonica (DCM), characterized by the clinical triad of action myoclonus, progressive ataxia and epilepsy with cognitive impairment, subsequently also referred to as the "Ramsay-Hunt syndrome". The cause of the symptoms of this rare degenerative syndrome (incidence: 500,000) is the impairment of a regulatory mechanism between nucleus dentatus, nucleus ruber and the bulbar olive. We present two sisters, aged 29 and 30 years, who were investigated for oculomotor abnormalities. The patients were diagnosed as having DCM according to clinical symptomatology, which was confirmed by neurophysiological and radiological findings. In both cases saccadic velocity was markedly reduced, whereas saccadic latency showed a significant increase. In addition, smooth pursuit eye-movements were abnormal and presented reduced gain. These findings suggest that pontine areas and the vestibulocerebellum also seem to be affected in DCM.

Adult↗
PubMed1994

Magnetic resonance angiography and selective angiography following extra-intracranial bypass operations.

Magnetic resonance angiography (MRA) was compared with conventional angiography in 14 patients following extra-intracranial arterial anastomosis. In 13 patients the bypass was shown by MRA and confirmed by conventional angiography. In five of these, the anastomosed vessels, in particular the superficial temporal artery, was of the same calibre or smaller than the same vessels on the contralateral, healthy side. In one patient no anastomosis could be shown by MRA, and occlusion of the bypass was confirmed by conventional angiography. Absence of dilatation of the anastomotic vessels may indicate insufficient bypass function due to stenosis or an incorrect indication for surgery.

Adult↗
PubMed1994

[Recurrent renal vein thrombosis in a premature infant. Doppler ultrasound diagnosis and follow-up].

Renal vein thrombosis (RVT) is a rare disorder in neonates. Early diagnosis is mandatory since immediate thrombolytic therapy favours prognosis. Our case report describes RVT demonstrated by Duplex Doppler Ultrasound. A possibly characteristic sequence of changes in the echogenicity of the renal parenchyma and in the Duplex Doppler flow pattern of the renal arteries could be found.

Blood Flow Velocity↗
PubMed1994

[Ultrasound monitoring of the umbilical artery catheter. A case of a newborn infant with recurrent hypoglycemia].

Hypoglycaemia in neonates can be caused by malposition of the umbilical artery catheter (UAC). If the tip of the umbilical arterial catheter is located next to the origin of the great abdominal vessels glucose infusion is mainly directed into the coeliac trunk and superior mesenteric artery. Direct stimulation of the pancreatic gland might then result in hyperinsulinaemic hypoglycaemia. Generally, UAC position is controlled by x-ray. When using ultrasound for location of the UAC the exact topography and especially the relation of the tip of the UAC to the great vessel lumina can be documented precisely.

Blood Glucose↗
PubMed1994

[Color Doppler ultrasound of kidney transplants. Does the resistance index facilitate diagnosis of chronic kidney failure?].

The retrospective study under report assessed the diagnostic capability of colour Doppler sonography (CDS) with measurement of the resistive index (RI) in the long-term follow-up of patients with renal allografts. 210 CDS examinations were performed in 115 patients. The time since transplantation ranged from 6 months to 22 years. The RI was correlated to laboratory parameters of renal allograft function (serum creatinine, urinary protein levels and serum-cyclosporine). In 97 of 210 examinations, serum creatinine was elevated (> 1.5 mg% or an increase of more then 0.3 mg% within the last 6 months). In 35 out of these examinations RI was > 70%, in 62 RI was < or = 70%. Thus, with a threshold RI of 70%, sensitivity of the RI in the diagnosis of renal allograft dysfunction is 36% and specificity 62%, respectively. There was no significant difference in the RI between examinations of allografts with normal function (68.2% +/- 7.5%) and those with dysfunction (68.5% +/- 8.5%). Furthermore, there was no significant correlation between the RI and any of the laboratory parameters. CDS with calculation of the RI cannot differentiate in the long-term follow-up between allografts with normal function and those with dysfunction.

Adolescent↗
PubMed1994

[The traumatized and surgically treated spine. Current diagnostic imaging].

In trauma patients X-ray and CT are the important imaging modalities for detecting instability of the spine and determining the cause of a spinal cord lesion. MRI should be done to demonstrate the spinal cord lesion itself. Operations on spinal injuries are based on X-ray films and CT. Polydirectional tomography is valuable in the assessment of bone healing, determining osteomyelitis with fistulae, pseudarthrosis and imaging of bone graft fusion in the presence of metallic fixation devices. MRI is indicated for diagnosis and ascertaing the prognosis of spinal cord lesions. In the long-term follow-up syrinx, myelomalacia and atrophy can be differentiated. MRI can also be done for osteomyelitis and complications of bone graft fusion.

Diagnostic Imaging↗
PubMed1994

[Basics of MRI technique and MRI image interpretation].

Today magnetic resonance imaging (MRI) is an important routine diagnostic tool in orthopaedics. It is based on the nuclear magnetic resonance phenomenon: "free" hydrogen atoms (mainly from water) become field-parallel in a strong outer magnetic field. They reach a higher energy level by application of an additional electromagnetic field. After shutdown of this outer field the atoms send out electromagnetic waves (radiowaves), representing the MR signal. Different amounts of "free" water result in various image characteristics. Typically, a higher tissue water content is represented by high MR signals, e.g. in blastomas, inflammations and degenerative changes. Waterless structures such as calcified or fibrous tissues, tendons and ligaments show low MR signals. Fatty structures have high signals; proteins dissolved in "free" water change the water signal dramatically. Besides these basic parameters, para-, ferro- and super-paramagnetic materials--ether naturally present in the human body, such as methemoglobin, or artificially introduced, such as MR contrast media--and flow are responsible for different grey shades in MRI. MRI is not associated with ionizing radiation and allows imaging in all planes without changing the patient's position. Disadvantages of MRI are high costs and low availability. Future technical developments will result in shorter imaging times and broadening of the application spectrum, leading towards "MR fluoroscopy" and MR interventions.

Adolescent↗
PubMed1994

[Bone inflammation (including spondylitis)].

MRI diagnosis of bony inflammations has sensitivity of up to 96%, but specificity of only 70-87%. The most common reasons for false-positive results are fractures, infarctions, neoplasms, septic arthritis and aggressive metastasis. Early MRI diagnosis is based on bone marrow oedema, which is hypointense on T1-weighted images, hyperintense on T2-weighted images. Reactive fibrovascular tissue and hyperaemia lead to contrast enhancement. Necrosis, calcification and sequestra show low signal intensities. Increasing calcifications and restructuring of spongiosa are not well visualized in MRI. In spondylitis, fat conversion is a good marker for healing. Complications of osteomyelitis (e.g. soft tissue abscesses) can be diagnosed by MRI with high sensitivity. In the primary diagnosis and follow-up of osteomyelitis (spondylitis), standard X-ray exams should be performed first. In the initial studies MRI can replace bone scintigraphy, which has poor morphological resolution. Semiquantitative follow-up studies can be done by MRI or scintigraphy.

Adolescent↗
PubMed1993

Colour Doppler imaging of partial subclavian steal syndrome.

The case of a 67-year-old woman with symptoms related to the vertebro-basilar system and blood pressure difference of the upper extremities is presented. Colour-Doppler imaging (CDI) with additional spectral tracing revealed partial subclavian steal syndrome with retrograde flow in the left vertebral artery during systole, which could be significantly enhanced by reactive hyperemia after left arm exercise. Angiography confirmed a high-grade stenosis of the proximal subclavian artery and balloon angioplasty was performed. Noninvasive follow-up by CDI demonstrated regular antegrade vertebral artery flow at rest, but minimal retrograde systolic flow after left arm exercise.

Aged↗