Normales Knochenmark und seine Variationen in der MRT

Physiology and age-dependent changes of human bone marrow are described. The resulting normal distribution patterns of active and inactive bone marrow including the various contrasts on different MR sequences are discussed.     

Radiologische Diagnostik der Leber

Highly specific methods are required for the diagnostic workup of focal hepatic lesions, since benign circumscribed liver changes are very common. Although cross-sectional imaging techniques have a high diagnostic accuracy, radionuclide imaging techniques such as colloid, red blood cell, or hepatobiliary scan are commonly performed when a benign lesion is assumed since these permit a definite diagnosis with high specificity. The diagnosis of a primary or secondary malignant liver tumor, however, usually relies on radiological imaging techniques alone, supported by needle biopsy. Whether positron emission tomography as a primary or supplementary diagnostic tool will have a role in the routine staging of malignant tumors remains to be determined.     

肝脏介入操作所致患者辐射剂量的初步研究

目的 测量在肝脏介入操作过程中患者所受到的X射线的辐射剂量。方法 应用热释光测量法、非均匀组织等效拟人体模型实验数据结合实际操作条件等方法，对85例行肝脏介入操作的患者进行辐射剂量测量。结果 肝脏介入操作所致患者最高皮肤剂量范围为179．95～1759．00mGy，有效剂量为29．22mSv(男)和29．27msv(女)。结论 肝脏介入治疗患者所受到的X线辐射剂量很大，应该采取有效的防护措施来降低患者所受到的X线辐射剂量。     

1779例医院感染病例调查分析

目的了解医院感染的发病情况,加强对重点科室医院感染动态监测,控制医院感染发生.方法对苏大附一院2004年全年收住入院的患者33308人次,所发生的医院感染1779例进行调查分析.结果 2004年医院感染率为5.30%,高危科室为:病房ICU、急诊ICU、血液科一、老年科、血液科二,感染高发部位为呼吸道,真菌已成为医院感染的主要致病菌,基础病严重、免疫力低下、侵入性技术操作、抗生素使用不合理等是造成医院感染的主要原因.结论提高患者免疫功能,严格执行无菌技术,减少不必要的侵入性操作,合理使用抗生素,及时、准确地进行病原菌监测,是降低医院感染的有效措施.     

Funktioelle Magnetresonanztomographie in Diagnostik und Therapiemonitoring beim Multiplen Myelom

Aim of the study. Investigation of the quantitative microcirculation parameters amplitude A and exchange rate constant k ₂₁ determined by contrast-enhanced dynamic magnetic resonance imaging (d-MRI) in multiple myeloma (MM). Methods. d-MRT of lumbar spine and right spina iliaca superior posterior of 16 controls (ctr) and 35 patients with active MM. Generation of colour-coded images of microcirculation parameters superimposed onto static MRI images. Results. Amplitude A and k ₂₁ parameters were significantly increased in patients with MM and down modulated by therapy in 7 of 8 MM cases in a follow-up investigation [p<0.01; median A _ctr =0.2 (0.09–0.4); median A _MM =0.93 (0.2–1.52); median k _21ctr =0.09 min^–1 (0.03–0.9); median k _21MM =4.57 min^–1 (0.21–23.8)]. Thirteen patients revealed a “diffuse” and 22 a “focal” pattern of distribution of microcirculation parameters. Bone marrow biopsies in 8 cases revealed an correlation between bone marrow plasma cell infiltration and increased microcirculation parameters. Conclusion. Identification of microcirculation changes by d-MRI is a novel imaging technique for the detection and monitoring of MM bone lesions.     

Morphologische und funktionelle Beckenbodenstörungen aus gynäkologischer Sicht

Purpose. The following article is designed to describe the diagnostics and therapy of morphological and functional defects in the female pelvic floor from a gynaecological point of view. Assessment of the relevance of imaging techniques is of particular importance. Material and methods. The main diagnoses are: in the anterior compartment of the pelvic floor, urethro- cystocele; in the middle compartment, uterine descent/prolapse or enterocele; and in the posterior compartment, rectocele. They are clinically examined by means of a standardised gynaecological examination and classified according to recommendations from the International Continence Society ( ICS) in order to obtain internationally comparable results. Comparison with the usual imaging procedures (introitus- and perineal sonography, colpocystorectography/defaecography and functional MRI of the pelvic floor) are described and critically discussed. The most important functions affected are storage and evacuation of the bladder and rectum. They are clinically examined by means of stress test and pad-weigh test and technically examined using urodynamics, sphincter-rectum manometry and EMG. Imaging procedures play a very important role here also. Results. Comparison of clinical and imaging procedures shows that the two methods are at present limited in comparability, mainly because different points of reference are used to quantify results. The line of the hymen is a good point of reference in grading descent and prolapse. During the gynaecological examination, the three compartments can readily be assessed separately by use of split gynaecological specula. This is presently practically impossible using imaging procedures. The pubococcygeal line is generally used to describe findings. Discussion. Scientific progress can only be expected if and when these problems are studied as a whole. Imaging procedures have securely established themselves in the diagnostic repertoire, but do not as yet influence therapy decisions. The indication and choice of operation depend on the severity of the patient's symptoms the clinical findings and the results of urodynamic investigations. Dynamic CTG is presently the most reliable method of showing all three compartments at rest and during function. It has largely replaced colpocystorectography. Sonography is found to be varied in ist results at the moment.     

Karotisstenose: Technik der PTA und Stentimplantation

Percutaneous transluminal angioplasty and stenting of carotid artery stenosis represents an innovative experimental modality which has been increasingly employed in high-risk patients. Currently, results from prospective randomized trials are not available; thus, guidelines with regard to indications and technique are preliminary. Numerous technical innovations to avoid associated complications have evolved in neurointerventional procedures. Dedicated guiding catheters and stents using a transfemoral approach have been introduced for treatment of carotid artery disease. Low-profile stent delivery systems may decrease risk of releasing embolic load when crossing high-grade stenosis or kinking of the vessel. The introduction of a cerebral protection with the use of temporary occlusion balloons or filter systems has resulted in a reduction of procedure-related neurological complications, and is strongly recommended by leading experts in the field.     

Neuropathologische und neuroradiologische Aspekte akuter disseminierter Enzephalomyelitiden (ADEM)

Among non-neoplastic lesions of the central nervous system, demyelinating pseudotumors of the group of acute disseminated encephalomyelitis (ADEM) most frequently occasion neurosurgical intervention for purposes of definitive diagnosis and thus enter the domain of the surgical pathologist. Typically, ADEM presents with multifocal, bilateral lesions in an asymmetrical distribution. Especially monolocular manifestations may be diagnostically challenging. Due to the acuteness of clinical symptoms and the expansive, space-occupying character of the lesions a diffuse glioma, a metastatic disease, a primary cerebral Non-Hodgkin's lymphoma, brain abscess, a parasitosis or an ischemic brain tissue necrosis may be suspected. This impression is supported by uptake of contrast-medium most pronounced at the periphery of the lesion and the subcortical location. The histomorphologic feature of relative axonal preservation in areas with acute myelin breakdown and lymphocytic infiltrates make the diagnosis of an acute primary demyelinating disease probable. A diagnosis of glioma may be prompted by the florid, cytologically atypical astrogliosis especially in intraoperative request. Based on a series of 14 cases of radiologically and bioptically documented cases of ADEM typical examples will be demonstrated and discussed.     

Pilzpneumonie

Concomitant with advances in medicine, involving the development and use of antibiotics, immunosuppressive drugs, organ/stem cell transplantation and pre-existing illnesses such as AIDS, the frequency of fungal infection has increased dramatically. These factors determine the susceptibility of the lung for an acute or chronic course of disease. Early detection, characterisation and follow-up of the pulmonary infiltrates is the major task of the radiologist. The correct timing to perform an investigation and adequate technique are an additional essential factor in this setting. Furthermore, radiological procedures support the clinicians in identifying the underlying micro-organism. The radiologist can suggest which micro-organism might cause the infiltrate. Certain findings and patterns can point to a specific causative agent, but experience, local epidemiology and clinical information are necessary for the differential diagnosis of infiltrates in long-term immunocompromised hosts. In addition, radiological techniques are useful in guiding interventions for identification of the underlying micro-organism or for therapeutical procedures. This review summarises useful radiological information of appearance and complications of fungal pneumonia.     

ErbB2在MCF-7细胞中的过度表达意义

目的 研究ErbB2的过度表达是否能促进MCF-7细胞株的生长和侵袭。方法通过逆转病毒，将ErbB2转入MCF-7细胞内，并证实ErbB2被表达并具有生物活性。检验实验组和对照组(AP2)的侵袭力和浸润力。结果ErbB2、MCF细胞中被过度表达并产生效果。在体外，相对于对照组，ErbB2组表现了更强的浸润率和侵袭力。但可以被ErbB2的抵制剂赫塞汀所抵制。结论ErbB2过度表达可以促进细胞的浸润和侵袭。抵制实验则提供了一种新的癌症治疗手术方法。