Anatomie des Kleinhirnbrückenwinkels

The cerebellopontine angle (CPA) is an anatomically complex region of the brain. In this article we describe the anatomy of the CPA cisterns, of the internal auditory canal, the topography of the cerebellum and brainstem, and the neurovascular structures of this area.     

Entzündliche Erkrankungen des Pharynx Bildgebende Befunde und diagnostische Strategie

PURPOSE: To demonstrate imaging findings in inflammatory diseases of the pharynx and possible complications. MATERIAL AND METHODS: Radiologic imaging of the pharynx is based on the use of conventional X-ray films, computed tomography and magnetic resonance imaging, plain and contrast enhanced. RESULTS: The advantages of cross sectional imaging techniques like CT and MRT lie in the possibility to diagnose submucosal disease and localized as well as general complications. Most frequently abscesses and phlegmonous diseases have to be diagnosed. CT proves advantageous due to its fast imaging protocol and the widely availability. MRI is superior due to its superior soft tissue contrast and the multiplanar imaging. CONCLUSION: Spiral-CT and MRI mean valuable diagnostic tools for the evaluation of inflammatory diseases of the pharynx and possible complications.     

Entzündliche Erkrankungen des Felsenbeins

Clinical/methodical issue

Inflammatory lesions of the petrous portion of the temporal bone are very common and can be followed by cerebral complications.

Practical recommendations

Thin layer computed tomography (CT) is useful for detecting bony changes of the temporal bone and contrast-enhanced magnetic resonance imaging (CE MRI) is a sensitive method for detecting cerebral complications.     

Akute Entzündung des intestinalen Systems

Acute intestinal inflammation is common. In most cases the medical history, clinical investigations and laboratory parameters alone are not sufficient for a conclusive diagnosis because of the wide variety of differential diagnoses and the striking similarity of symptoms. Modern imaging methods can help to clarify the diagnosis and multi-slice CT (MSCT) is highly useful in this diagnostic dilemma. It is widely available, employs standardized protocols, is cost-effective and can be performed within an acceptable examination time. MSCT enables the location and extension of the underlying pathology to be assessed and detection of complications which require immediate therapeutic intervention.     

Benigne und maligne Veränderungen der Innenohr- und Kleinhirnbrückenwinkelregion

Tumorous lesions in the region of the inner ear and cerebellopontine angle are very rare and can be classified into benign and malignant disease forms. This contribution presents and explains the CT and MRI characteristics of these tumors.High-resolution computed tomography (HRCT) in the axial projection is applied for evaluation in the high-resolution bone window. The coronary slices can be reconstructed from the axial datasets or in individual cases examined in the coronary plane.HRCT excellently demonstrates osseous lesions and in individual cases - e.g., exostoses - it can simply suffice to perform HRCT of the temporal bone, while HRCT is also excellent for detecting osseous lesions to determine whether the tumor is benign or malignant.MRI, on the other hand, excellently shows the extent of tumor spread because of its superb soft tissue contrast. Consequently, HRCT and MRI images of the inner ear and cerebellopontine angle provide meaningful information for visualization and classification of tumorous lesions. The two methods should not be considered as competing but rather as complementary and among other aspects exert considerable influence on the therapeutic approach.     

Entz��ndliche Erkrankungen der Wirbels?ule und des Myelons

Inflammatory diseases of the spine and the spinal cord (myelon) can be caused by a wide range of pathological conditions. Except for degenerative inflammatory diseases of the spine, infectious and autoimmune disorders are relatively rare. The latter can also be a significant source of pain and disability, especially if these hard to diagnose conditions go untreated. In cases of advanced disease some entities, such as spondylodiscitis or rheumatoid arthritis can cause severe neurological impairment especially by progressive intraspinal spread. Inflammation of the myelon cannot be depicted with conventional radiographs in general and by computed tomography only occasionally. In these cases magnetic resonance imaging is the method of choice to detect early abnormalities of the myelon and to provide detailed information for the differential diagnosis.     

Sonographie des Gehirns und Rückenmarks bei Früh- und Neugeborenen

Examination of the central nervous system in premature and full-term infants requires a sensible selection of the available diagnostic procedures such as ultrasound, MRI and CT to allow sufficient and accurate diagnosis and management. ULTRASOUND: Ultrasound, including the various Doppler techniques, is a very reliable, safe, noninvasive diagnostic tool that allows evaluation of even severely ill patients in intensive care units. It is especially well suited for the study of intracranial hemorrhage, hypoxic-ischemic encephalopathy, congenital malformations of the brain and lesions produced by intrauterine and acquired infections. Sonography is also very reliable in examination of spinal dysraphism and spinal cord injuries during birth. The necessity of surgical intervention (i.e. shunt implantation) as well as subsequent postoperative follow-up can be provided. MRI: In contrast to ultrasound, MRI is most useful to demonstrate the age-dependent myelinization pattern and clearly discriminates between the white and gray matter of the central nervous system. We therefore use MRI for the detection of complex malformations of the central nervous system in particular disorders of cell migration and for a final estimation of a perinatal brain injury.Conclusion: A precise ultrasound examination performed by an experienced physician who is familiar with the expected pathology and has access to a well-adjusted ultrasound machine should help to minimize the use of confirming CT and MRI investigations and to optimize their optional use in more complex cases.     

Entzündliche Skelettveränderungen der oberen Thoraxapertur und der Mandibula

33j?hrige Patientin, 1987 Extraktion eines Weisheitszahns rechts. Im Anschlu? daran Schmerzen und Schwellungen im Unterkiefer. Keine Besserung durch Antibiotika und orale Steroidbehandlungen. 6 Jahre sp?ter unter der Verdachtsdiagnose einer chronischen Osteomyelitits mehrfache Dekortikationen und 1997 prim?re prothetische Rekonstruktion des Unterkiefers. Histologischer Befund einer chronischen, eitrig-abszedierenden Osteomyelitis mit herdf?rmiger Sequestrierung. Mikrobiologisch kein Erregernachweis. Jahrelange Beschwerden in beiden Schultergelenken, ab 1998 Schwellungen der Sternoklavikulargelenke. Seit 1 Jahr rezidivierende Diarrh?en ohne Blut- und Schleimbeimengungen. Hautsymptome: Keratosis pilarsi und Akne comedonica an Dekolleté und Rücken sowie Pityriasis simplex der Kopfhaut. Diagnostische Ma?nahmen: 3-Phasen-Skelettszintigraphie mit 99mTc-HDP (früh- und sp?tstatische Aufnahmen) (Abb. 1), CT (Abb. 2) und Kernspintomo-?graphie (Abb. 3).     

Entzündliche Wirbelsäulenerkrankungen

Regardless of the compartment involved, imaging of spinal infections and other spinal inflammatory diseases must be performed by magnetic resonance imaging (MRI). This allows early detection of changes in disk space or vertebral bodies. Associated paraspinal and epidural masses are depicted. However, in spinal cord inflammation MRI has a very limited specificity and cannot usually differentiate between the wide array of possible causes of intramedullary lesions. This article covers a spectrum of inflammatory lesions of the spinal cord.     

Zur versicherungsrechtlichen Beurteilung des traumatischen Volvulus der Flexura sigmoidea und des Dünndarmes

Ohne Zusammenfassung     

Zur versicherungsrechtlichen Beurteilung des traumatischen Volvulus der Flexura sigmoidea und des Dünndarms

Ohne Zusammenfassung     

Entzündliche Wirbelsäulenerkrankungen: Spondylarthritis

Die Radiologie - Die Projektionsradiographie des Beckens und der Lendenwirbelsäule ist die Methode der ersten Wahl in der primären Abklärung der Spondylarthritis (SpA). Die...     

Entzündliche Wirbelsäulenerkrankungen als Ursache für Rückenschmerzen

PURPOSE: The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. MATERIAL AND METHODS: A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. RESULTS: The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-alpha antagonists. DISCUSSION: Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-alpha antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI is useful for assessment of the effectiveness of anti-inflammatory therapy.