Imaging, arthroscopy, and markers in osteoarthritis.

Osteoarthritis is the most common form of arthritis occurring in humans, but its diagnosis in early stages continues to be elusive. Early diagnosis is of great potential importance because it would allow identification of individuals at risk for progressive disease and permit early intervention. At present, perhaps even more important, the ability to recognize patients with early, often asymptomatic, disease and the ability to monitor disease progression over time would be most useful for the evaluation of new forms of therapy to prevent, halt, or even reverse osteoarthritis. Thus, 1991 has witnessed the continued search for the ideal indicator of early osteoarthritis.     

Renal Artery Stenosis: Imaging Options,Pitfalls, and Concerns

Renal artery stenosis can be diagnosed with multiple imaging modalities, each one having different risk vs accuracy tradeoffs. Catheter angiography with pressure gradient measurements is the definitive gold standard but also the most invasive and thus reserved primarily for imaging at the time of renal revascularization. Ultrasonography is the safest and least expensive but also the least accurate and most operator-dependent. Contrast-enhanced computed tomographic angiography and magnetic resonance angiography are intermediate (between ultrasound and catheter angiography) with respect to accuracy and expense. Exciting new advances in magnetic resonance that include new contrast agents, which eliminate nephrogenic systemic fibrosis risk, and techniques to characterize the hemodynamic significance of renal artery stenoses are now becoming available. In addition, magnetic resonance angiography without any contrast has become more accurate and rivals contrast-enhanced techniques in some patients. This review explores these techniques for renal artery stenosis imaging.     

Imaging the airways. Hemoptysis, bronchiectasis, and small airways disease

Advances in technology have increased the contribution of radiology in understanding and evaluating diseases of the airways. In patients with hemoptysis, CT is now established as a complementary technique to bronchoscopy, or as an alternative to bronchoscopy in selected cases. The introduction of high-resolution CT has improved the detection and assessment of bronchiectasis and small airways disease, allowed better correlation between pathologic changes and radiologic appearances, and provided new insights into possible links between small airways disease and bronchial disease.     

Tissue Harmonic Imaging und Contrast Harmonic Imaging

Zum Thema Mit konventioneller Ultraschalltechnik k?nnen manche Raumforderungen der Leber, besonders kleine, überhaupt nicht dargestellt werden; und wenn man sie erfassen kann, lassen sich oft aus den Befunden keine ausreichenden Rückschlüsse zur Dignit?t ziehen. Dies ist, vereinfacht gesagt, ein vielen Untersuchern bekanntes Problem. Anzustreben sind also erh?hter Kontrast und bessere Bildqualit?t, die durch die hier erl?uterten weiterentwickelten Techniken des sogenannten Tissue Harmonic Imaging und Contrast Harmonic Imaging erm?glicht werden. Da? die neuen Ultraschallmethoden, in der vorliegenden Arbeit im Bereich der dafür sicher besonders geeigneten Leber dargestellt, künftig auch in anderen Organen zur Anwendung kommen wird, liegt auf der Hand. Die Weiterentwicklung der die Patienten nicht belastenden, beliebig wiederholbaren, nichtinvasiven und universell verfügbaren Ultraschalltechnik stellt sicher einen gro?en Fortschritt für die Diagnostik dar. Nicht verschwiegen werden sollte das ungekl?rte Problem, wie die Kosten für verbesserte und natürlich verteuerte Technik, Kontrastmittel und erh?hten Zeitaufwand vergütet werden.