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Die Anaesthesiologie - 相似文献
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Ghanem N Altehoefer C Högerle S Nitzsche E Lohrmann C Schäfer O Kotter E Langer M 《European journal of radiology》2005,54(2):264-270
PURPOSE: We evaluated the diagnostic accuracy of magnetic resonance imaging (MRI) and positron emission tomography (PET) for detection of liver metastases in malignant melanoma. MATERIAL AND METHODS: Thirty-five patients with 39 combined unenhanced MRI and fluorine-18 deoxyglucose (F-18 FDG) PET scans were prospectively studied. In discordant imaging findings final diagnosis was proven by clinical follow-up >6 months and demonstration of progressive liver metastases by at least one imaging method. Sensitivities and specificities were compared and the influence of lesion size and melanin content on diagnostic accuracy was determined. RESULTS: MRI and PET were concordantly negative for presence and number of liver metastases in 28 patients and positive in four patients. PET and MRI were false positive in one patient each. In one patient MRI showed a single metastases not seen by PET and in one patient MRI demonstrated more metastases at the first examination. In follow-up investigations MRI revealed more metastases than PET in both patients. The sensitivities for lesion detection were 47% (16/34) for PET and 100% for MRI. Lesion detectability by PET was related to lesion size (P < 0.0001) but not to melanin content. CONCLUSION: MRI is more sensitive in the detection of liver metastases in patients with malignant melanoma. Small lesions are easily missed by PET, while melanin content does not influence detectability by PET. 相似文献
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Lohrmann C Uhl M Warnatz K Ghanem N Kotter E Schaefer O Langer M 《European journal of radiology》2004,52(2):137-143
PURPOSE: To assess pulmonary abnormalities in patients with primary Sjogren's syndrome (PSS) using high-resolution computed tomography (HRCT). MATERIAL AND METHODS: The HRCT scans of 24 patients with the diagnosis PSS were retrospectively reviewed regarding the presence, extension and distribution of 16 pathological findings. RESULTS: Nineteen patients (79.2%) showed pathological findings and in five patients (21.8%) the HRCT scan was judged to be normal. A predominance of abnormalities in the lower lobes and subpleural areas was detected. The following pathologies were found: bronchiectasis, thin-walled cysts and small pulmonary nodules (46.2%), ground-glass attenuation and emphysema (37.8%), interlobular-septal thickening (29.4%), honeycombing (25.2%), bronchial wall thickening, tree-in-bud pattern (21.0%), mosaic perfusion (16.8%), architectural distortion (12.6%). Airspace consolidation, air trapping, large nodules (10-30mm) and masses (>30mm), mediastinal lymph node enlargement (>15mm) and free pleural fluid were seen each in 4.2%. In 7 of the 11 patients with thin-walled cysts areas of ground-glass attenuation were detected. CONCLUSION: HRCT seems is contributive to the characterization of the wide variety of lung abnormalities in PSS. Airway disease alone or in association with the presence of varying degrees of interstitial disease represents the main findings in accordance with earlier reports. Unexpectedly, almost half of the patients had thin-walled cysts on the HRCT scans, which etiology is unclear but could be associated with areas of ground-glass attenuation indicating LIP. 相似文献
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Bley TA Kotter E Saueressig U Springer OS Fisch D Ghanem NA Langer M 《AJR. American journal of roentgenology》2003,181(6):1487-1490
OBJECTIVE: The aim of this study was to compare the diagnostic quality of paper prints with film copies in a sample of observers who were trying to detect small coin lesions on radiographs of a phantom. MATERIALS AND METHODS: The phantom consisted of 60 high-contrast and 60 low-contrast test objects, half of which had holes in them. Diameter and depth of the holes varied from 0.5 mm to 2 mm. Fifteen radiographs were obtained from different areas of the test objects. Film copies and paper prints were made using high-quality printers. Five observers independently evaluated 1,800 high-contrast and 1,800 low-contrast images. Data were evaluated using the well-established receiver operating characteristic methodology. RESULTS: The mean area under the curve rated 0.863 for paper prints (0.859 for high contrast and 0.860 for low contrast) and 0.926 for laser films (0.937 for high contrast and 0.913 for low contrast). The difference between the two imaging techniques was statistically significant for both high- and low-contrast lesions (p < 0.05). CONCLUSION: Detection of small coin lesions on radiographs of a phantom was significantly less sensitive on paper prints than on film. We found paper prints less acceptable for the diagnosis of small-sized lesions. 相似文献
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I. Kotter A. Eckstein N. Stubiger M. Zierhut 《The British journal of ophthalmology》1998,82(5):488-494
AIM—To study long term effects of interferon α2a (IFNα2a) on panuveitis in seven patients with Behçet's disease in a prospective, open clinical trial.
METHODS—Seven patients were treated with IFNα2a for a mean of 23.6 months (14-37 months). They received an initial dose of IFNα2a of 6×106 IU/day, followed by 3×106 IU/day after 1 month and 3×106 IU every other day after 3 months. Two patients received low dose prednisolone (between 0.2 and 0.4 mg/kg/body weight) additionally at the beginning of the therapy. Complete cessation of IFNα2a was possible in three patients (observation period 22, 6, and 4 months).
RESULTS—Marked improvement occurred in six patients who had ocular manifestations of Behçet's disease for the first time or with minor damage during their course of chronic relapsing panuveitis. In one patient with advanced ocular Behçet's disease, new relapses were prevented. Retinal infiltrates resolved within 2 weeks; vasculitis, macular oedema, infiltration of the anterior chamber and vitreous resolved within 4 weeks. Mean posterior uveitis score before treatment (nine affected eyes) was 6.6, 4 weeks after IFN it was reduced to 0.4. The mean observation period is 27.6 months, ranging from 14 to 42 months.
CONCLUSION—Treatment of ocular symptoms of Behçet's disease with IFNα2a alone or in combination with low dose steroids led to complete remission of ocular vasculitis in all patients treated in this open, uncontrolled trial. Treatment with IFNα2a may prevent permanent retinal or optic nerve damage due to vascular occlusion. No severe side effects occurred. Controlled randomised studies are warranted in order to prove the efficacy of IFNα2a in ocular Behçet's disease and to compare it with other, established treatments such as azathioprine or cyclosporin A.
Keywords: Behçet's disease; uveitis; interferon α2a 相似文献
METHODS—Seven patients were treated with IFNα2a for a mean of 23.6 months (14-37 months). They received an initial dose of IFNα2a of 6×106 IU/day, followed by 3×106 IU/day after 1 month and 3×106 IU every other day after 3 months. Two patients received low dose prednisolone (between 0.2 and 0.4 mg/kg/body weight) additionally at the beginning of the therapy. Complete cessation of IFNα2a was possible in three patients (observation period 22, 6, and 4 months).
RESULTS—Marked improvement occurred in six patients who had ocular manifestations of Behçet's disease for the first time or with minor damage during their course of chronic relapsing panuveitis. In one patient with advanced ocular Behçet's disease, new relapses were prevented. Retinal infiltrates resolved within 2 weeks; vasculitis, macular oedema, infiltration of the anterior chamber and vitreous resolved within 4 weeks. Mean posterior uveitis score before treatment (nine affected eyes) was 6.6, 4 weeks after IFN it was reduced to 0.4. The mean observation period is 27.6 months, ranging from 14 to 42 months.
CONCLUSION—Treatment of ocular symptoms of Behçet's disease with IFNα2a alone or in combination with low dose steroids led to complete remission of ocular vasculitis in all patients treated in this open, uncontrolled trial. Treatment with IFNα2a may prevent permanent retinal or optic nerve damage due to vascular occlusion. No severe side effects occurred. Controlled randomised studies are warranted in order to prove the efficacy of IFNα2a in ocular Behçet's disease and to compare it with other, established treatments such as azathioprine or cyclosporin A.
Keywords: Behçet's disease; uveitis; interferon α2a 相似文献
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Ghanem N Uhl M Müller C Elgeti F Pache G Kotter E Markmiller M Langer M 《European radiology》2006,16(11):2533-2541
In this study we evaluated magnetic resonance imaging (MRI) in trauma patients for assessing traumatised adjacent discs of
fractured vertebrae before dorsoventral stabilisation. In a prospective study, MRI of 54 discs was performed with a 1.5-T
MRI unit. The preoperative MRI with sagittal T1-W-SE and T2-W-TSE was compared to intraoperative discography, which was carried
out on both intervertebral discs adjacent to the fractured vertebrae. Signal alterations, morphological changes in the adjacent
discs, fractured vertebrae and associated ligament injuries were evaluated. In 47/54 (87%) of the intervertebral discs, the
results of both imaging findings were concordant. The discs adjoining vertebral fractures were normal in 18 cases. Regarding
the positive concordant imaging findings, MRI and discography revealed traumatised adjacent cranial and caudal discs in 22
discs. In 7 cases, only the cranial adjacent disc was affected. Moreover, 17 cases of intradiscal bleeding, 13 intraosseous
herniations into the fractured vertebrae and 20 anuluar tears were visualised in MRI. Associated ligament injuries were detected
in 18 cases. Findings were discordant in eight discs. In six discs, MRI was abnormal, demonstrating signal alterations suggestive
of positive imaging findings, whereas discography demonstrated no disc injury. MRI failed to detect disc injury in two discs,
whereas discography was positive, showing an irregular intradiscal contrast media distribution. MRI, as a non-invasive method
for assessing fractures of the thoraco-lumbar spine, may detect traumatised adjacent intervertebral discs. MRI is superior
to intraoperative discography. The performance of MRI of the thoraco-lumbar spine is recommended before dorsoventral stabilisation
in trauma patients, as it can reveal additional preoperative information such as fractures, disc and associated ligament injuries. 相似文献
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This case report describes focal myositis, a rare inflammatory pseudotumorous disease previously not mentioned in the surgical literature. Most often a single muscle of the upper or lower extremity is affected. Usually the diagnostic process and treatment require a long time. We present a useful diagnostic cascade and a surgical therapy, which allows the histological differentiation between malignant and inflammatory disease. Even after partial resection of the tumor, the prognosis of focal myositis is excellent. 相似文献