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Biomedical subjects

S Trattnig

Publications and source records attributed to S Trattnig.

At least 127 records · Page 7Linked to original sources
PubMed1993

Difficulties in examination of the origin of the vertebral artery by duplex and colour-coded Doppler sonography: anatomical considerations.

Despite progress in ultrasonographic techniques visualisation of the origin of the vertebral arteries, particularly the left, by duplex and colour Doppler imaging, still poses a problem in a significant number of patients. In anatomical and radiological studies we demonstrated an anomalous origin in 6%, the left vertebral artery originating directly from the aorta in most cases. The origin from the subclavian artery was found to be posterior in 44% and inferior in 6%. The V1 segment of the vertebral artery (from its origin to the entry into the foramen transversarium) was tortuous in 47% of cases. These anatomical variants and variations in the course of the vessel contribute to the nonvisualisation of the origin of the vertebral artery by duplex and colour Doppler imaging. With respect to tortuosities technical modifications for better visualisation are suggested and possible implications for surgery are discussed.

Aged↗
PubMed1993

[Acute renal vein thrombosis in children. Early detection with duplex and color-coded Doppler ultrasound].

Two children with clinically suspected renal vein thrombosis were evaluated by duplex Doppler sonography and colour flow imaging. Both cases presented unspecific findings with an enlarged kidney and loss of cortico-medullary delineation on gray-scale ultrasound, but an unusual flow pattern with retrograde plateau-like frequency shifts during diastole. No venous signal could be obtained. By colour flow imaging only the main renal artery and its proximal branches could be visualised with a reverberating oscillation of blood flow. In addition, partial thrombosis of inferior vena cava in one patient and iliac vein thrombosis in the other could be demonstrated. Clinical improvement during fibrinolytic therapy in one case and nephrectomy in the other case confirmed the diagnosis.

Aortic Coarctation↗
PubMed1993

[Dynamic 3D imaging of peripheral vessels using color-coded Doppler ultrasound].

3-D reconstructions are established as post-processive methods in CT and MRI. However, these methods permit assessment of morphological findings only. To uncover functional relations on the basis of ultrasound would also be of paramount interest. For this purpose a specific method was developed for the acquisition and time-coded 3-D reconstruction in the diagnosis of peripheral vessels, in particular of the extracranial carotid artery. An imaging device (Acuson 128 XP) with a 7.5 MHz probe, a PC-controlled stepping motor and an imaging system (Kontron Mipron) was used. Data acquisition was performed scan-by-scan in a transverse plane with a slice thickness of 1 mm along the vessel. In every slice position multiple ECG-trigger delays during the cardiac cycle were used. Data were transferred to the imaging system via videosignal. In preliminary clinical application this dynamic 3-D reconstruction method yielded good spatial resolution of the complex physiological flow phenomena in the carotid bifurcation.

Blood Flow Velocity↗
PubMed1993

[Diagnostic imaging following surgery of spinal disk herniation].

The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computed tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis.

Humans↗
PubMed1993

Ultrasonography of the Achilles tendon in hypercholesterolemia.

The ultrasonographic (US) appearance of Achilles tendon was examined in 34 patients with hypercholesterolemia (10 with familial (FH), and 24 with secondary hypercholesterolemia (SH)), and in 22 patients with normal tendons. US findings were compared with clinical, laboratory, and radiologic results. In patients with FH, typical xanthomas in the form of hyperechoic tendinal tumors were found in only 15% while various forms of inhomogeneity of tendon structure without xanthoma formation were found in 75%. The high rate of tendon inhomogeneity may be due to the concomitant occurrence of both xanthomas and degeneration of tendon fibers. Physical examination revealed abnormalities in 60% of these patients. At CT of the tendons, abnormalities were found in 65% of the FH patients and in 40%, abnormalities were shown by plain radiography. In SH, the results did not differ significantly from normal controls. In our opinion US should be used to prove or rule out Achilles tendon abnormalities in patients with FH for prophylaxis and treatment of tendinitis and tendon rupture.

Achilles Tendon↗
PubMed1993

[Systematic strength training in the postmenopause: accompanying densitometric control with DXA].

Of all the forms of osteoporosis, the postmenopausal type is the most important in social medicine due to the potentially high fracture risk in aging. The positive effects of physical activity on bone density have been emphasized in several studies. In this study on 31 female volunteers (minimum age 50 years), who had been postmenopausal for at least 2 years, 16 underwent systematic strength building (training group). They were compared with a control group consisting of 15 female volunteers. The parameters of success were physical strength and bone mineral density (BMD) before and after training. BMD was measured by dual-energy X-ray absorptiometry. The subjects in the control group showed significant decrease in bone density after 6 months: between 6.7 and 22.3% of the values measured at the beginning. The loss was more evident in the proximal femur than in the lumbar spine. In contrast, the subjects in the training group only showed a marginal decrease in bone density in the proximal femur: 0.8 to 3.8% of the earlier values. In the lumbar spine there was even a slight increase (+0.3%) in bone density.

Absorptiometry, Photon↗
PubMed1992

[Sonographic structural analysis of the Achilles tendon and biomechanical implications].

Ruptures of the Achilles tendon mainly occur on the ground of predisposing destruction of tendon structure. The aim of this retrospective US study was to evaluate the location and extent of tendon abnormalities. 62 patients (49 male, 13 female; 19 to 57 years, mean 38) with achillodynia of short duration and/or clinically suspected tendon abnormalities were evaluated sonographically. Together with a review of the literature, US findings (location, extent, and echo pattern) were compared with clinical findings. With US, abnormalities could be detected with a sensitivity of 0,76 and a specificity of 0.9. Pathologic lesions could be grouped as follows: (1) pain without any clinical signs or US findings (tenalgia); (2) nodular tendinitis which in 52% appeared in the form of a tiny hypoechoic lesion in the ventromedial part of the tendon 2-3 cm proximal to the os calcis; (3) peritendinal oedema; (4) circumscribed tendon swelling, (5) extensive inhomogeneities of tendon structure. With US, abnormalities of the Achilles tendon may be detected at an early stage of the disease and hence the risk of tendon rupture may be predicted to better advantage.

Achilles Tendon↗
PubMed1992

[Saphenous vein bypass stenoses, early diagnosis with color coded Doppler sonography].

In a prospective study 54 patients with 62 saphenous vein arterial bypass grafts were examined by colour-coded Doppler sonography and angiography. Five cases of graft occlusion were diagnosed by colour-coded Doppler sonography and confirmed by angiography. In comparison with angiography, colour-coded Doppler sonography showed a sensitivity of 92% and a specificity of 100% in the detection of focal graft stenosis. Only two stenoses in the region of the distal anastomosis could not be detected by colour-coded Doppler sonography. In 28 cases a marked dilatation of the proximal anastomosis was found corresponding to the surgically used patch angioplasty. Within this dilated bypass segment, turbulence and flow reversal zones were demonstrated, which might be predisposing factors for graft stenosis. Colour-coded Doppler sonography can accurately detect saphenous vein arterial bypass graft stenoses and should be routinely used in postoperative screening.

Adult↗
PubMed1992

[Noninvasive follow-up by color-coded Doppler sonography after surgical interventions on the extracranial cerebral arteries].

By means of colour-coded Doppler sonography we studied retrospectively the incidence of postoperative changes in 54 patients following 58 carotid endarterectomies. The interval between operation and ultrasound varied from one to 41 months. The overall incidence of recurrent carotid disease was 50% with a 31% (18 of 58) of hemodynamically insignificant restenoses, a 13.8% (8 of 58) incidence of haemodynamically significant restenoses, and a 5.2% (3 of 58) of occlusions. The segment that had been endarterectomized showed a bulbous dilatation in 24.1% (14 of 58). In all of these cases extensive flow reversal zones could be demonstrated, the possible importance of which is discussed. Examinations in 9 patients with reimplantation of subclavian artery to the common carotid artery and grafting technique between these arteries and in 11 patients with reimplantation of vertebral artery to the common carotid artery demonstrated one occlusion of the ipsilateral vertebral artery.

Carotid Artery Thrombosis↗
PubMed1992

[The screening of renal artery stenoses. The initial results with the value of color Doppler sonography].

The value of colour Doppler sonography in the diagnosis of renal artery stenosis has been studied retrospectively. 17 patients were examined (34 main renal arteries and 7 accessory renal arteries; ages 37 to 84 years; 7 males and 10 females). We studied 1) ability to study the main renal arteries, 2) visibility of accessory renal arteries and 3) the sensitivity and specificity of colour Doppler sonography for the diagnosis of renal artery stenosis. The results were compared with intraarterial angiography. Demonstration of the main renal arteries with colour Doppler sonography was possible in 23 of the 34 vessels. Not a single of the 7 accessory renal arteries was demonstrated by colour Doppler sonography. Of 8 angiographically demonstrated stenoses (more than 50% narrowing) 2 were missed by colour Doppler sonography. One stenosis was correctly diagnosed and 5 were incorrectly evaluated by sonography. 16 out of 18 angiographically normal main renal arteries were correctly evaluated by colour Doppler sonography but 2 showed a false positive finding. This results in a sensitivity of 17% and a specificity of 89% per kidney. Colour Doppler sonography cannot be recommended as a screening method for renal artery stenosis in view of its limited accuracy.

Adult↗
PubMed1992

[Pseudo-stenosis of the renal artery: a possible defect of color Doppler sonography].

The diagnostic value of pulsed Doppler sonography for the detection of renal artery stenosis was questioned by recent studies. Until now, the diagnostic value of colour-coded Doppler sonography of the renal arteries is not clearly defined in relation to pulsed Doppler. This study deals with specific problems of colour-coded Doppler sonography in the examination of the renal arteries. Because of basic technical principles of colour-coded Doppler sonography a stenosis can be imitated especially at the origin of the right renal artery by using a ventral approach to the vessel. This pseudo-stenosis is due to a change of colour similar to an aliasing-phenomenon in a curved vessel. In order to avoid false positive results, a laterodorsal approach to the vessel should be applied additionally. A spectral waveform should be also registered routinely.

Adult↗
PubMed1992

Color Doppler imaging of inferior vena cava: identification of tumor thrombus.

Color-coded Doppler sonography (CCDS) was used for the examination of tumor thrombus (n = 7) and benign thrombosis (n = 6) of the inferior vena cava. Tumor thrombus was due to hepatocellular carcinoma in two cases and to renal cell carcinoma in five cases. Whereas no specific information about the nature of thrombus formation could be gained by gray scale sonography, a typical patchy vascularization pattern was noted within tumor thrombi in six of seven cases using CCDS. This ws due to marked neovascularization within the tumor thrombi, confirmed by histologic examination in all cases. In one patient no vascularization within the tumor thrombus could be observed by CCDS because the thrombus was relatively small. In patients with bland thrombosis, either no vascularization of the thrombus was seen (n = 5) or linear recanalization of the thrombus occurred (n = 1). Therefore, it might be possible to differentiate tumor from nontumor thrombus in the inferior vena cava by using CCDS. Further studies are needed to confirm this preliminary hypothesis.

Adult↗
PubMed1991

[Imaging of peripheral arteriovenous malformations using color-coded Doppler sonography].

By using colour coded Doppler sonography and duplex Doppler sonography, the presence of AV-shunts could be demonstrated correctly in 15 patients with arteriovenous malformations (angiographic correlation was obtained in 10 cases). The feeding vessels could not be identified exactly in all cases by using duplex Doppler sonography; correct identification of the feeding vessels was possible in only 2 patients by using colour coded Doppler sonography. In one patient, a soft tissue tumour could be diagnosed sonographically (histology: malignant synovialoma). Therefore, colour coded Doppler sonography serves as an important supplement to angiography in the diagnostic evaluation of arteriovenous malformations, but cannot replace it.

Adolescent↗
PubMed1991

[Vascular space-occupying lesions of the carotid artery--detection with color-coded Doppler sonography. Comparison with duplex sonography and angiography].

Nine patients with a cervical tumour, diagnosed by duplex Doppler sonography were additionally evaluated by colour-coded Doppler sonography (CCDS). The duplex Doppler diagnosis of three internal carotid artery aneurysm was confirmed by CCDS in only one patient. In the remaining two cases CCDS identified a marked coiling of the internal carotid artery. Three low echogenic lesions, interpreted as cervical lymphomas by conventional Doppler sonography were identified as two internal carotid aneurysm with partial thrombosis and a carotid body tumour in the third patient by CCDS. Duplex-Doppler sonography and CCDS agreed in the diagnosis of two AV-malformations and one carotid body tumour. Angiography confirmed the CCDS-diagnosis in 7 patients. In the two patients with coiling of the ICA angiographic evaluation was not performed. Thus, CCDS was superior to duplex Doppler sonography in the evaluation of vascular lesions of the extracranial section of the carotid artery and provided additional diagnostic information.

Aneurysm↗
PubMed1991

[The patency of the external and internal carotid arteries in patients with occlusion of the common carotid: detection using color-coded Doppler sonography].

Common carotid artery occlusion is not necessarily associated with thrombosis of the ipsilateral internal carotid artery. Noninvasive imaging of the carotid bifurcation with colour-coded Doppler sonography demonstrated patency of the external and internal carotid arteries distal to a common carotid occlusion in 4 patients which could be proven surgically. Identification of internal carotid artery patency could be demonstrated by angiography in two of the patients while in the other two cases angiography was inconclusive. Thus, CCDS provided a correct diagnosis of the internal carotid patency in these patients with common carotid occlusion.

Adult↗
PubMed1991

[Varicosis orbitalis. Its demonstration by color-coded Doppler sonography and computed tomography].

Three patients with intermittent exophthalmos were studied by computed tomography (CT) and colour-coded Doppler sonography (CCDS). By CT the possible diagnosis of an orbital varix was established. CCDS, however, with the dynamic evaluation and realtime direct imaging of flow and the possibility of examination in different positions facilitated the diagnosis of this orbital vascular disorder without the need for any contrast material. This technique may prove to be a useful adjunct to computed tomography for the evaluation of suspected vascular lesions of the orbit. Surgery confirmed the diagnosis in all patients.

Color↗
PubMed1991

Color-coded Doppler sonography of vertebral arteries.

Color-coded Doppler sonography of the vertebral arteries was performed in 86 patients who had a history of vertebrobasilar disease. The origin of the artery was visualized in 87.2% on the right and 70.9% on the left side. The inter-transverse portion of the vertebral artery was visualized in 95% on the right and 97% on the left side. The atlas loop could be visualized in 88.4% on the right and 84.9% on the left side. Pathologic findings were hypoplasia (n = 4), stenosis (n = 19), dissection (n = 2), occlusion (n = 7), kinking (n = 12), cervical tumors (n = 3), and subclavian steal syndrome (n = 3). Nine postoperative patients had subclavian and vertebral artery reimplantation to the common carotid artery. The characteristic color-coded Doppler sonographic features of these findings are presented and discussed.

Angiography↗