Akute,nicht traumabedingte Veränderungen des unteren Respirationstraktes des Kindes im Thoraxröntgen Erkennen und Verstehen radiologischer Veränderungen

The diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies.     

Toxische Veränderungen des zentralen Nervensystems

Clinical issues

Various toxic agents can cause changes to the white matter of the brain leading to leukoencephalopathies. These changes often lead to signal alterations of the white matter with or without a diffusion restriction signal. White matter lesions can be reversible or irreversible. There are many differential diagnoses of toxic leukoencephalopathies.

Practical recommendations

For the radiologist it is necessary to be familiar with the causes, the clinical and the imaging presentation of toxic leukoencephalopathies because early treatment often leads to improved prognosis.

     

Metabolisch verursachte Veränderungen des Zentralnervensystems

Clinical issue

The diagnosis of metabolic disorders of the central nervous system (CNS) can be very challenging for radiologists because of the nonspecific white matter lesions of the brain, the rarity of these diseases, and the variety of possible differential diagnoses.

Radiological standard methods

Standard for the evaluation of the metabolic disorders is cranial MRI. The MRI spectroscopy can additionally help to reduce the possible differential diagnoses.

     

Hirnnerven – Spektrum entzündlicher und tumoröser Veränderungen

Inflammatory processes as well as primary and secondary tumorous changes may involve cranial nerves causing neurological deficits. In addition to neurologists, ENT physicians, ophthalmologists and maxillofacial surgeons, radiologists play an important role in the investigation of patients with cranial nerve symptoms. Multidetector computed tomography (MDCT) and particularly magnetic resonance imaging (MRI) allow the depiction of the cranial nerve anatomy and pathological neural changes. This article briefly describes the imaging techniques in MDCT and MRI and is dedicated to the radiological presentation of inflammatory and tumorous cranial nerve pathologies.     

Histologische Veränderungen des Zentralnervensystems bei experimentellen Ammoniakvergiftungen

Ohne Zusammenfassung     

Veränderungen am Papillarmuskel des Herzens nach Leuchtgasvergiftung

Ohne Zusammenfassung     

Degenerative und altersbedingte Veränderungen an der Wirbelsäule

Degenerative alterations of the spine occur in an individual-specific manner with increasing age. This is not only dependent on external factors, such as hard physical labor over many years but can also be genetically influenced as demonstrated in recent studies. The spinal cord is well-protected within the spinal canal but can be impaired by degenerative alterations of the intervertebral discs and functional spinal segments. Depositions or narrowing of nerve structures can cause lasting pain or focal neurological deficits, such as paralysis or sensitivity disorders. These complaints can slowly develop over years, e.g. by a gradually increasing bony narrowing of the spinal canal (spinal canal stenosis) or can occur suddenly, e.g. an acute herniated disc. However, low back pain is much more common and occurs in approximately 80?% of people sometime during their lifetime. It is necessary to recognize the normal age-related anatomical alterations in magnetic resonance imaging (MRI), particularly for intervertebral discs in order to interpret these correctly. Knowledge of the spectrum of the various age-related degenerative processes which can occur in intervertebral discs and vertebral bodies is necessary to be able to differentiate them from pathological alterations. This is important because therapy decisions are often made as a direct result of MRI.     

Stoffwechselstörungen mit typischen Veränderungen im MRT

The classification of metabolic disorders according to the etiology is not practical for neuroradiological purposes because the underlying defect does not uniformly transform into morphological characteristics. Therefore typical MR and clinical features of some easily identifiable metabolic disorders are presented. Canavan disease, Pelizaeus-Merzbacher disease, Alexander disease, X-chromosomal adrenoleukodystrophy and adrenomyeloneuropathy, mitochondrial disorders, such as MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes) and Leigh syndrome as well as L-2-hydroxyglutaric aciduria are presented.     

MVZ-Trägergesellschaften – Veränderungen auf Gesellschafter- und Trägerebene

Ohne Zusammenfassung     

Pathologische Veränderungen des Hypopharynx im Brennpunkt der Bildgebung

The spectrum of pathological changes in anatomical sections of the hypopharynx ranges from benign pathologies to hypopharyngeal carcinoma. Beside the clinical status and the endoscopic evaluation performed by ear, nose and throat specialists, imaging techniques play an important role in pre-therapeutic and post-therapeutic diagnostics and in the follow-up of pharyngeal disease patterns, especially for malignant lesions. A conventional x-ray swallow examination, contrast-enhanced multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), as well as positron emission tomography (PET) and positron emission tomography computed tomography (PET-CT) are applied depending on the medical question and disease. Especially in radiological oncology, it is extremely important in regions which are clinically difficult to assess to determine the exact localization and extent of hypopharyngeal pathologies to plan the optimal therapy for the patient. This article demonstrates the radiological appearance of pathological changes of the hypopharynx and discusses in particular the hypopharynx carcinoma in the focus of pre-therapeutic and post-therapeutic imaging.     

Die Veränderungen des Acetaldehydspiegels im Blute nach Alkoholaufnahme

Ohne Zusammenfassung     

Veränderungen in den Haarwurzeln faulender und exhumierter Leichen

Ohne Zusammenfassung     

Zur bedeutung bronchiolitischer und peribronchiolitischer Veränderungen beim plötzlichen Tode im Säuglingsalter

Zusammenfassung An Hand eines größeren Obduktions- und histologischen Materials von Feten, Neugeborenen und Säuglingen wurden die postmortalen von vital-entzündlichen Veränderungen am Bronchiolensystem abgegrenzt. Eine eigentliche Bronchiolitis ist keine Ursache plötzlichen Todes im Säuglingsalter. Dagegen finden sich in vielen Fällen bei anscheinend primär extrapulmonal erkrankten und dann plötzlich verstorbenen Säuglingen sowohl perivasculäre Infiltrate der Bronchiolenwand, als auch (meist gleichzeitig) multifokal angeordnete, vermutlich durch diabronchiolären Reiz entstandene, parabronchioläre Infiltrate im Parenchym bei intaktem Bronchiolus, die vielleicht Ausgangsstadien nicht mehr zu voller Entwicklung gelangter bronchopneumonischer Herde darstellen. Die Gesamtheit dieser Veränderungen wird zwar in dem vorliegenden Material als höchstens sekundär todesursächlich oder überhaupt agonal aufgefaßt, bietet aber eine Stütze der Annahme einer hämatogenen Genese der Säuglingspneumonie über die Bronchiolargefäße bzw. die endobronchiale Infektion des Lungengewebes ohne Bronchiolitis. Für die forensische Praxis ist der sekundäre Charakter aller dieser Befunde zu beachten.     

Sonographie synovialer und erosiver entzündlicher Veränderungen

High-frequency sonography enables excellent detection of early erosions and synovial proliferations. Power Doppler sonography (PDUS) allows for an improved characterization of articular and peritendinous augmented volume, because detection of hypervascularity correlates with inflammatory activity and further is helpful in differentiation from effusion and inactive pannus. The use of contrast media improves the sensitivity of vascularity detection, because they allow for a delineation of vessels at the microvascular level. This is of increased interest, as the development of new therapeutic options targeting the microvascular level calls for earlier diagnosis and optimal assessment of disease activity. Because of good availability, cost effectiveness, and patient acceptance, sonography facilitates early diagnosis of synovial proliferations and erosions as well as therapy follow-up.     

Dental-CT bei pathologischen Veränderungen im Bereich des Kiefers

CT with multiplanar reconstruction of the jaws (DentaScan) is the method of choice for the radiographic assessment of the mandible and maxilla. It is instrumental in delineating the relationship between bony lesions and the adjacent anatomy. Therefore, this technique allows precise evaluation of the intricate details of the oral cavity. Using it, distinct characterization of pathology including infectious, metabolic, congenital and neoplastic lesions can be obtained.