Der Bundeswehreinsatz im Inneren: Eine verfassungsrechtliche Bestandsaufnahme (German Edition)

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Computed tomography is used to exclude osteoarthritis of the zygapophyseal joints, Baastrup's disease kissing spines and other sources of low back pain. Magnetic resonance imaging is useful to exclude substantial disc protrusions; it allows for the detection of disc dehydration and bone marrow edema in the case of activated spondylochondrosis. If osteoporosis is suspected, an osteodensitometry of the lumbar spine should be performed.

Postoperative plain X-rays should include antero-posterior and lateral views as well as flexion - extension views in the later postoperative course. Measurements should determine the disc space height in the lateral view, the segmental and total lumbar lordosis as well as the segmental mobility in the flexion - extension views. The ideal position of a TDR is exactly central in the ap-view and close to the dorsal border of the vertebral endplates in the lateral view. Malpositioning may cause segmental hyperlordosis and unbalanced loading of the endplates with the risk of implant subsidence and migration.

Radiological assessment of loss of disc height during acute and chronic degenerative lumbar disc alterations; Radiologische Beurteilung der segmentalen Hoehenabnahme bei akuten und chronisch degenerativen lumbalen Bandscheibenveraenderungen. Aim of the study: A loss of disc height with increasing segmental mobility is an important reason for low back pain. The measurement of hyaluronic acid content of the nucleus pulposus prolaps shows a difference between acute group 1 and chronic group 2 disc degeneration.

The purpose of the present investigation was to determine the decreasing of disc height between these two groups and the no-symptomatic segments of these patients. The used method is not suitable to answer the present question conclusively. Die segmentale Hoehenabnahme der Bandscheibe mit nachfolgender Instabilitaet im Rahmen von degenerativen lumbalen Bandscheibenerkrankungen hat eine wesentliche klinische Bedeutung.

In einer vorgeschalteten Untersuchung konnte ueber die Bestimmung des Hyaluronsaeuregehaltes von Nucleus pulposus-Material der Grad der Bandscheibendegeneration beurteilt werden.

Die Frage ist, ob hier ein praeoperativ radiologisch nachweisbarer Hoehenunterschied zwischen den akuten Gruppe 1 und den chronischen Gruppe 2 Bandscheibenvorfaellen im Vergleich zu den klinisch nicht betroffenen Bandscheibensegmenten der Patienten besteht? Es wurden 20 konsekutive praeoperative seitliche Roentgenaufnahmen der Lendenwirbelsaeule nach der Methode von Frobin et al.

Diese bestanden aus einer ersten Gruppe 7 Patienten mit einem durchschnittlichen Alter von 41 Jahren und einer zweiten Gruppe 13 Patienten mit einem durchschnittlichen Alter von 44 Jahren. Die Ergebnisse der Untersuchung zeigten lediglich in der 2. Gruppe mit einer chronischen Bandscheibendegeneration eine Tendenz zur Abhaengigkeit p. Onkologische Diagnostik und Therapie.

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 along, 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. Hierfuer sind radiologische Schnittbildtechniken grundsaetzlich gut geeignet. Wenn aufgrund der sonographischen, computertomographischen oder magnetresonanztomographischen Befunde eine gutartige Laesion anzunehmen ist, werden jedoch haeufig ergaenzend die Kolloiderythrozyten- oder hepatobiliaere Szintigraphie - ggf.

Bei malignen primaeren oder sekundaeren Lebertumoren hingegen werden nuklearmedizinische Zusatzuntersuchungen seltener angefordert, da der radiologische Befund, ggf. Inwieweit sich der primaere oder ergaenzende Einsatz der Positronenemissionstomographie im Vergleich zu radiologischen Schnittbildtechniken beim Staging boesartiger Tumoren bewaehrt, ist noch nicht abschliessend geklaert.

Clinical and imaging features of intracranial arterial aneurysms in the pediatric population; Klinische und radiologische Merkmale des intrakraniellen arteriellen Aneurysmas bei Kindern und Jugendlichen. Intracranial arterial aneurysms IAAs are rare in children. Traditional vascular risk factors, which are common in the adult population, are generally absent in the pediatric population, engendering distinct modes of IAA pathogenesis. Classification of pediatric IAAs according to the pathogenetic mechanism shows eight distinct categories: Pathogenetic mechanism is the best predictor of the clinical course of the disease, response to treatment, and long-term prognosis.

The pathogenetic subtypes of pediatric IAA show characteristic and variably overlapping features. In most cases, IAAs manifesting during the first two decades of life are idiopathic. Most of the remaining pediatric IAAs are the result of congenital cerebral aneurysmal arteriopathies or infection. Multiple IAAs are unusual in young children except in those with acquired secondary to immune deficiency states or congenital cerebral aneurysmal arteriopathies or infectious IAAs. Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax.

Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome. Diagnostische und Interventionelle Radiologie. The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: Whole body staging stands at the beginning of the diagnostic algorithm in CUP syndrome to localize a potential primary tumor.

In der Ganzkoerperbildgebung hat die CT eine hohe Sensitivitaet fuer Tumoren, die haeufig als metastasierte Tumorerkrankung auftreten. Ontwikkeling van een bepalingsmethode en enige klinische toepassingen. In dit proefschrift wordt een kolomchromatografische bepalingsmethode van het HbA1c beschreven. Radiological evaluation of esophageal motility and gastroesophageal reflux disease; Funktionsstoerungen des Oesophagus. Radiological evaluation of esophageal motility and the lower esophageal sphincter has gained increased attention in recent years.

Videofluoroscopic investigation of esophageal motor function is superior to static film radiography, as repeated analysis of the videotaped recordings is possible. With emphasis on radiological techniques, normal esophagel physiology and motility and a variety of esophageal motor disorders are discussed in this review paper. Radiological evaluation of gastroesophageal reflux and reflux esophagitis is described. Clinical and radiological findings in esophageal motility disorders and gastroesophageal reflux disease and the radiological efficacy compared to that of manometry and pH-metry are discussed.

Die Videokinematographie ist hierbei der konventionellen Roentgenuntersuchung aufgrund der Moeglichkeit der wiederholten Analyse ueberlegen. Ziel der vorliegenden Uebersicht ist es, prinzipiell das radiologische Erscheinungsbild der normalen Funktion sowie diagnostische Kriterien fuer verschiedene Motilitaetsstoerungen zu demonstrieren. Weiterhin werden auch die verschiedenen Moeglichkeiten der radiologischen Refluxpruefung zur Untersuchung der Funktion des gastrooesophagealen Sphinkters verglichen und deren Wert diskutiert. Die Pruefung der Funktion von Oesophagus und gastrooesophagealem Sphinkter als ein integraler Bestandteil der Roentgenuntersuchung der Speiseroehre verbessert deren Treffsicherheit, wodurch die radiologische Untersuchung die primaere diagnostische Methode bei Patienten mit Schluckstoerungen darstellt.

Structured diagnostic imaging in patients with multiple trauma; Strukturierte radiologische Diagnostik beim Polytrauma. Development of a concept for structured diagnostic imaging in patients with multiple trauma. Evaluation of data from a prospective trial with over documented patients with multiple trauma.

All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented. Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a h-coverage with constant quality. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines.

Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. Entwicklung eines strukturierten Konzeptes zur radiologischen Diagnostik polytraumatisierter Patienten.

Die Datenevaluation erfolgte auf Basis einer prospektiven interdisziplinaere Polytraumastudie mit ueber Patienten. Alle diagnostischen und therapeutischen Schritte werden jeweils unter Angabe von Zeitpunkt und auftretenden Komplikationen erfasst, ein primaeres oder sekundaeres Versterben und die Tage-Letalitaet werden dokumentiert.

Die strukturierte radiologische Diagnostik von Mehrfachverletzen verlangt die Integration eines erfahrenen Radiologen in. To demonstrate and document 10 years of clinical experience gathered by us with TIPSS and to discuss achievements, problems and outlook. Variceal filling was widely reduced by TIPSS, and significantly reduced portal liver perfusion as assessed morphologically and rheologically. However, there was an immediate onset of compensated liver perfusion by increased arterial inflow. Total liver perfusion did not change significantly.

In TIPSS portal decompression was readily achieved, the portosystemic gradient dropping from an average of 24 mm Hg to In our series we could not demonstrate an increased incidence of hepatic encephalopathy during the day post-TIPSS period. Beyond a follow-up time span of months the necessity for re-intervention dropped significantly: Less than one-third of our patients required some sort of re-intervention.

Die Gesamtleberperfusion aendert sich nicht signifikant. Die portale Drucksenkung erfolgt von einem portosystemischen Mitteldruck von 24 mmHg auf 10,5 mmHg im Durchschnitt. Insbesondere die Standardisierung von Indikationen und Kontraindikationen, des Punktionsbesteckes, der. Clinically relevant incidental cardiovascular findings in CT examinations; Klinisch relevante kardiovaskulaere Zufallsbefunde bei CT-Untersuchungen. Incidental cardiovascular findings are a frequent phenomenon in computed tomography CT examinations.

As the result of a dedicated PubMed search this article gives a systemic overview of the current literature on the most important incidental cardiovascular findings, their prevalence and clinical relevance. The majority of incidental cardiovascular findings are of only low clinical relevance; however, highly relevant incidental findings, such as aortic aneurysms, thromboses and thromboembolic events can also occasionally be found, especially in oncology patients.

The scans from every CT examination should also be investigated for incidental findings as they can be of decisive importance for the further clinical management of patients, depending on their clinical relevance. Mit dieser Arbeit soll nach gezielter PubMed-Recherche ein systematischer Literaturueberblick ueber die wichtigsten kardiovaskulaeren Zufallsbefunde sowie deren Haeufigkeit und klinische Relevanz gegeben werden. Die Mehrzahl der inzidentellen kardiovaskulaeren Befunde sind klinisch nur von untergeordneter Bedeutung, allerdings werden immer wieder auch hochgradig relevante Zufallsbefunde wie beispielsweise Aortenaneurysmata oder - gerade bei onkologischen Patienten - Thrombosen und thrombembolische Ereignisse detektiert.

Jede CT-Untersuchung sollte gezielt nach inzidentellen Befunden durchsucht werden, da diese je nach klinischer Relevanz von entscheidender Bedeutung fuer das weitere klinische Management des Patienten sein koennen. Natural and anthropogenic environmental hazards. Research results of the Department of Applied Geology; Natuerliche und anthropogene Umweltgefaehrdungen.

Forschungsergebnisse aus dem Lehrstuhl fuer Angewandte Geologie. Applied geology is employed in mining geology, raw materials geology, engineering geology, and hydrogeology, of which the two last-mentioned are the most important for the Department of Applied Geology. This series of publications arose from the need of making research findings, dissertations, theses and conference papers accessible to the public faster and more comprehensively than in national and international journals.

Der engere Aufgabenbereich der Institute fuer Angewandte Geologie konzentriert sich der heutigen Fragestellung entsprechend meist auf die Ingenieurgeologie und Hydrogeologie. Die vorliegende Schriftenreihe ist aus der Notwendigkeit entstanden, Forschungsergebnisse, Dissertationen und ausgewaehlte Diplomarbeiten sowie Beitraege einschlaegiger Tagungen in Karlsruhe rascher und u. Patients with Klatskin's tumour present clinically unspecific symptoms such as painless jaundice and cholangitic discomfort.

The only curative treatment is R0 resection of the tumour. To allow stage-specific therapy, accurate tumour staging is indispensable, the first step of which is abdominal sonography. Biopsy using ERC is required before starting any specific treatment. If therapeutically relevant peritoneal carcinosis is clinically suspected although not radiologically confirmed, PET should also be performed. For optimal treatment, close cooperation between clinicians and radiologists is necessary. Eine R0-Resektion ist der einzige kurative Therapieansatz.

Um eine stadiengerechte Therapie zu ermoeglichen, muss ein moeglichst exaktes Tumorstaging erfolgen. Primaer kommt die abdominelle Sonographie zum Einsatz. Wird klinisch trotz negativem Nachweis einer Peritonealkarzinose eine solche suspiziert, sollte bei Therapierelevanz z. Directory of Open Access Journals Sweden. Full Text Available Die radikale Prostatektomie scheint die zur Zeit effektivste Therapie des klinisch lokalisierten Prostatakarzinoms zu sein. Schwerpunkt bildete hierbei die Einbeziehung der Ergebnisse der systematischen Sextanten-Biopsie der Prostata.

The clinical use of mammography in the male; Klinische Relevanz der Mammographie beim Mann. Merkle, E [Ulm Univ. Radiologie; Mueller, M [Ulm Univ. Radiologie; Vogel, J [Ulm Univ. Radiologie; Klatt, S [Ulm Univ. During a period of four years mammograms were performed in 89 men. Mastectomies were carried out on 23 men group 1. In group 1 there were 5 patients with bilateral gynaecomastia, 9 with unilateral gynaecomastia and two with pseudogynaecomastia and there were 7 patients with malignancies.

In group 2 there were 46 patients with bilateral gynaecomastia and 10 patients with unilateral gynaecomastia. Pseudogynaecomastia was found in 25 patients.

There were 7 malignancies, of which 5 had been suspected clinically and one had been diagnosed as gynaecomastia by mammography. Two carcinomas in situ were missed clinically and also by mammography. When malignancy is not suspected on clinical grounds the first examination should be sonography. Where, however, malignancy is suspected, and for follow-up, mammography retains its primary position. Alle Mammogramme wurden in Unkenntnis des klinischen Befundes retrospektiv ausgewertet und, wenn moeglich, dem histologischen Ergebnis gegenuebergestellt. Von 7 Malignomen waren 5 klinisch suspekt, wobei eines mammographisch als Gynaekomastie imponierte.

Zwei In-situ-Karzinome waren sowohl mammographisch als auch klinisch okkult. Klinisch nicht malignomsuspekte Befunde sollten primaer der Mammasonographie zugefuehrt werden. Spondarthritis hyperostotica pustulo-psoriatica - Review and a clinical-radiological study with special emphasis on SAPHO syndrome; Die Spondarthritis hyperostotica pustulo-psoriatica: Spondarthritis hyperostotica pustulo-psoriatica Spond. Thus, the pustulo-psoriatic terrain seems to have a decisive influence on osseous pathology. A total of 38 cases from a study during the years to is analysed with regard to morphological characteristics.

Rare cases with diaphyseal and pelvic hyperostotic lesions subsequent to bland sclerosing osteomyelitis constitute an overlapping region to chronic recurrent multifocal osteomyelitis CRMO and illustrate the relationship between hyperostotic spondarthritis and CRMO. Although hyperostosis is a guidepost for the radiologist and SAPHO symptoms are one for the clinician, the syndrome does not represent a diagnosis by itself and requires further differentiation.

Nosometamorphotische Verwandtschaft besteht mit der rekurrierenden chronischen multifokalen Osteomyelitis. Die symptomatologische Struktur der Spond. Fakultativ gehoeren zum Krankheitsbild Spondylodiszitis, sklerosierender Iliosakralumbau und trockene periphere Arthritiden. Radiological differential diagnosis of rheumatoid arthritis; Radiologische Differenzialdiagnose der rheumatoiden Arthritis. Establishing an early and reliable diagnosis of rheumatoid arthritis RA is of major importance but can be a great clinical challenge leading to direct therapeutic consequences. No single epidemiological, genetic, clinical, serological or radiological test exists which can exclusively diagnose RA.

In general diagnosis of RA includes a case history, clinical signs, laboratory abnormalities and radiological examinations, viz. This review summarizes the most important radiological features of RA and the radiological findings of its closest differential diagnoses. Es gibt keinen epidemiologischen, genetischen, klinischen, serologischen oder radiologischen Test, mit dessen alleiniger Anwendung die Diagnose der RA definitiv gestellt werden kann.

Die Diagnose der RA erfolgt durch die Kombination von Patientenanamnese, klinischen Zeichen und serologischen Biomarkern in Zusammenschau mit der radiologischen Diagnostik, allen voran der Anwendung konventioneller Roentgenbilder der Haende und Fuesse. In diesem Uebersichtsartikel werden die wichtigsten radiologischen Merkmale zur Diagnose der RA und der diagnostisch haeufigsten Differenzialerkrankungen dargestellt. Study design in clinical radiology; Studiendesign in der klinisch radiologischen Forschung.

Forschungsschwerpunkt Radiologische Diagnostik und Therapie. To review important aspects of study design in clinical radiology and to introduce the reader to the requirements of Good Clinical Practice GCP. Guideline such as GCP do not limit scientific freedom in research but define high standards for the well-being of patients and volunteers as well as guaranteeing scientific honesty.

The benefits of defined data monitoring and the necessity of a prospective statistical concept are frequently underestimated. Correct study design has to be expected in radiology too. High standards guarantee accuracy and honesty of scientific studies. Only this can warrant the value for the patient of radiological diagnostics and therapy. Richtlinien wie GCP und andere stellen keine Einschraenkung der wissenschaftlichen Freiheit dar, sondern definieren hohe Standards zum Schutz der Patienten und Probanden sowie zur Sicherstellung der wissenschaftlichen Wahrheit.

Positive Auswirkungen eines definierten Datenmonitorings sowie die Notwendigkeit einer prospektiven statistischen Konzeption werden haeufig unterschaetzt. Regelrechtes Studiendesign ist auch in der Radiologie zu fordern. Hohe Standards garantieren die Aussagekraft und Wahrheit wissenschaftlicher Untersuchungen. Nur so kann die Wertigkeit radiologischer Diagnostik und Therapie fuer den Patienten sichergestellt werden. Functional magnetic resonance imaging fMRI is frequently used in the presurgical diagnostic procedure of epilepsy patients, in particular for lateralization of speech and memory and for localization of the primary motor cortex to delineate the epileptogenic lesion from eloquent brain areas.

Collaborative Research Center (SFB) 700 "Governance in Areas of Limited Statehood"

This diagnostic sequence leads either to the decision for or against elective epilepsy surgery or to the decision to proceed with invasive diagnostic techniques Wada test, intra-operative or extra-operative cortical stimulation. It is difficult to evaluate the contribution of the fMRI test in isolation to the validity of the entire diagnostic sequence. Complications such as memory loss and aphasia in temporal lobe resections or paresis after frontal lobe resections are rare and rarely of disastrous extent.

This further complicates the evaluation of the clinical relevance of fMRI as a predictive tool.

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In this article studies which investigated the concordance between fMRI and other diagnostic gold standards will be presented as well as the association between presurgical fMRI and postsurgical morbidity. Das Ergebnis dieser Sequenz ist die Entscheidung fuer oder gegen einen. Case Study Radiologische Netzwerk Rheinland. Full Text Available Healthcare organizations in Germany exploit the benefits of the ISO family of international standards as it became compulsory to implement a quality management system in accordance with ISO requirements.

Until the innovative ISO So far, only few bodies ensured interconnections between different systems of management or associated the quality management system with the strategic planning process. However, healthcare encapsulates supplementary requirements which affect a number of different systems. Additionally, the financial crisis has encouraged the trend to operate integrated reporting beyond financial aspects. This paper aims at presenting the experience on the development of integrated management and reporting system integrated in an organization belonging to the health sector.

Using the case study method, the paper's purpose is to highlight approaches and results of the company that could support practitioners from medical area and bezound. The literature review clarified theoretical concepts while the case study allowed converging comprehensive information and knowledge accumulated by RNR AG, thus helping to bridge the gap between literature on total integrated management reporting and reporting system in healthcare. Pre- and postoperative radioligical evaluation of knee joint endoprothesis. Orthopedist's view; Die prae- und postoperative radiologische Evaluation der Kniegelenkendoprothese.

Aus der Sicht des Orthopaeden. Institut fuer klinische Radiologie. The implantation of a knee arthroplasty is still a demanding operation. There is still no ''golden standard'' available, although a lot of guidelines have been declared. Because of this fact this article should provide the radiologist with an overview of and some background knowledge for the radiological evaluation of knee arthroplasty.

Einen ''Goldstandard'' gibt es bis heute nicht, obwohl vielfach Richtlinien der Knieendoprothetik aufgestellt werden. Deshalb soll dieser Artikel dem Radiologen einen Ueberblick und Hintergrundinformation ueber die radiologische Evaluation der Knieendoprothetik geben. Multiparametric MRI of the prostate. Wichtige radiologische Befunde fuer den Urologen. High prevalence of prostate cancer with multifocality and biological heterogeneity. Insufficient conventional urological diagnostics.

Discrimination between significant and insignificant cancer needed. Prostate cancer is characterized by low signal intensity on T2w MRI, restricted water diffusion and pronounced and early uptake of contrast enhancement. Sensitivity and specificity according to the current literature are ca. Unzureichende konventionelle urologische Diagnostik. Unterscheidung klinisch signifikanter von klinisch nicht signifikanten Karzinomen erforderlich.

Prostatakarzinome sind typischerweise T2-hypointens mit eingeschraenkter Diffusion und zeigen eine rasche Kontrastmittelanflutung. Fuer die Abklaerung bei Verdacht auf. Intracerebral hemorrhage is a common cause of acute neurological deterioration and a frequent indication for emergency neuroimaging. It is often not possible to differentiate intracerebral hemorrhage from cerebral ischemia by clinical examination.

The therapeutic decision between thrombolysis or conservative therapy is comprised by the etiology. To exclude intracerebral hemorrhage as the cause of clinical symptoms, a CT is usually performed. Localisation and extension of the acute intracerebral hemorrhage are easy to detect. Subacute and chronic intracerebral hemorrhage are better delineated with magnetic resonance imaging. The different signal of the hemorrhage can be used for the age of the intracerebral hemorrhage.

Uncommon causes of hemorrhage are head trauma, blood dyscrasia, tumor or venous thrombosis. Non-traumatic intracerebral hemorrhage are most common in patients between 50 and 70 years. In younger patients a malformation should be excluded with a cerebral angiography. Intracerebral hemorrhages are usually conservatively treated, in some cases an operative decompression is performed. Intrazerebrale Blutungen sind klinisch oft nicht von ischaemischen Infarkten zu unterscheiden.

Eine Computertomographie ist zur Zeit fuer die Diagnosesicherung - und damit auch zur weiterfuehrenden Therapie - unerlaesslich. Ausdehnung und Lokalisation der akuten intrazerebralen Blutung koennen damit schnell und sicher erfasst werden. Subakute und chronische Blutungen sind dagegen. Verbesserung von Leistungserfassung, Wirtschaftlichkeit und Qualitaetssicherung? By means of complete service control and standardized accounting processes, radiological information systems clearly contribute to improved results.

They provide the prerequisites for the establishment of expanded networks and allow comprisons with comparable institutions. The quality of patient care can be improved since, for example, the production time from referral to finished result becomes shorter. Direct access to patient and findings data from several positions is possible.

Preliminary results can be viewed immediately. The exact reproducibility and assignment of services leads to more clarity. By means of the information available form RIS, rapid adaptive processes can be undertaken. The system assists the to fulfill the requirements of health regulations. The above-mentioned relationships demonstrate that the EDP systems are well accepted by physicians, medical assistants, and administrators and represent an indispensable aid for solving problems.

Sie stellen die Voraussetzungen fuer den Aufbau erweiterter Netzstrukturen dar und erlauben Quervergleiche mit aehnlichen Institutionen. Die Qualitaet der Patientenversorgung laesst sich verbessern, da z. Der Zugriff zu Patienten- und Befunddaten ist unmittelbar von mehreren Stellen aus moeglich.

Vorbefunde sind sofort einsehbar. Die Patientenhistorie ist jederzeit fuer autorisierte Anwender verfuegbar. Die exakte Reproduzierbarkeit und Zuordnung der Leistungen fuehrt zu einer hohen Transparenz. Durch die Informationen, die ueber das RIS zu erhalten sind, koennen rasche Anpassungsprozesse vorgenommen werden. Adverse effects of immunotherapy.

Clinical aspects, radiological and nuclear medicine results; Unerwuenschte Wirkungen der Immuntherapie. Klinik, radiologische und nuklearmedizinische Befunde. The increasing use of immunotherapy in oncology increases the need for radiologic evaluation of frequent and severe immune-related adverse events. Determination of the incidence and manifestation of radiologic and nuclear medicine findings of immune-related adverse events.

Literature review of clinical and imaging findings of immune-related adverse events induced by the immune checkpoint inhibitors ipilimumab, nivolumab and pembrolizumab. Findings are illustrated with pictorial examples and contrasted to other relevant differential diagnoses. The most frequent imaging manifestations are colitis, hepatitis, pancreatitis, hypophysitis, pneumonitis, arthritis and sarcoid-like lymphadenopathy. Severe to life-threatening complications may result from colitis, pneumonitis and hypophysitis.

A clear differentiation from other autoimmune diseases and discrimination of immune-related and infectious pulmonary findings can be very difficult and need close multidisciplinary collaboration. Knowledge of clinical and imaging findings of adverse events induced by immunotherapy is essential for timely and adequate therapeutic decisions.

In addition to staging and follow-up imaging, identification and monitoring of immune-related adverse events adds to the radiologic responsibility in oncologic care. Inzidenz und Manifestation radiologischer und nuklearmedizinischer Befunde der immunbedingten Nebenwirkungen. Literaturuebersicht zu Klinik und bildgebenden Befunden immunbedingter Nebenwirkungen der Immuncheckpointinhibitoren Ipilimumab, Nivolumab und Pembrolizumab. Veranschaulichung mit Bildbeispielen und Gegenuebergestellung mit anderen relevanten Differenzialdiagnosen.

Clinical applications of proton magnetic resonance spectroscopy of the brain; Klinische Anwendungen der Protonen-Magnetresonanzspektroskopie des Gehirns. In spite of all the scientific advances of the past few years, proton magnetic resonance spectroscopy of the brain has not attained the status of a routine examination technique with clinically accepted indications. The method should be considered as an additional option to MR imaging for inherited and acquired encephalopathic changes as well as, in future, for localization diagnosis of epilepsies.

A proton magnetic resonance spectroscopic investigation without a prior intensive clinical and imaging investigation is not useful. Above all, factors influencing metabolite distribution such as for example, serum osmolability must be known. Methodological prerequisites for the clinical application of proton resonance spectroscopy are, first of all, a high stability of the chosen technique as well as a sufficiently certain quantification of metabolites and the availability of a reference group. The use of short echo times is necessary for the quantification of glutamine and the osmolyte myo-inositol.

Die Untersuchung muss bei angeborenen und erworbenen enzephalopathischen Veraenderungen sowie in Zukunft in der Lokalisationsdiagnostik von Epilepsien als Zusatzoption zur MR-Bildgebung erachtet werden. Eine protonenspektroskopische Untersuchung ohne ausgiebige klinische und bildgebende Basisuntersuchung ist nicht sinnvoll. Insbesondere muessen Einflussfaktoren, wie z. Radiologic assessment of the outcome of Keller and Brandes arthroplasty for hallux rigidus; Hallux rigidus operiert nach Keller und Brandes: Radiologische Erfolgs- und Prognoseparameter.

The aim of this study was to evaluate the pre- and postoperative radiographic findings of hallux rigidus treated with Keller and Brandes arthroplasty to determine the radiographic outcome and to identify a prognostic marker. A comparison of the pre- and postoperative radiographs, the clinical and subjective findings was predicated on a five point scale: No other evaluated radiological parameter proved to be of significance.

The most important radiological parameter in the evaluation of the outcome of Keller and Brandes arthroplasty as the percentage of the proximal phalanx which had ben excised. Laengenverhaeltnis von erstem und zweitem Metartasalknochen, 4. Hallux-valgus-Winkel und mit den klinischen Ergebnissen. Radiological imaging of the upper gastrointestinal tract.

The esophagus; Radiologische Bildgebung des oberen Gastrointestinaltrakts. Die Sooroesophagitis imponiert im Breischluck mit charakteristischen Ulzerationen. Oesophagogastrale Hernien werden mit Breischluck genauer dargestellt als endoskopisch. Ein gastrooesophagealer Reflux kann radiologisch diagnostiziert werden, diskrete Entzuendungen und Epitheldysplasien sind wesentlich besser mit endoskopischen Techniken zu untersuchen. Bei Oesophagustumoren ergaenzt die Radiologie die endoskopisch-endosonographischen Befunde. The child with an acute limp; Das hinkende Kind. Radiologische Differenzialdiagnostik der akuten Gangstoerung des Kinder- und Jugendalters.

Limping is a common and often challenging problem in children and adolescents. A limp is defined as asymetric deviation from a normal gait pattern. A systematic approach is necessary to determine the cause of the limp, so the radiologist should combine a thorough history, clinical information and pertinent radiologic testing. The possible differential diagnosis is extensive and includes many pathologies of the lower extremity and spine like trauma, infection, neoplasia, furthermore inflammatory, developmental and congenital disorders.

In cases with knee or tight pain, an underlying hip condition should be considered. The childs age can narrow the possible differential diagnoses, because certain entities are age-related. Despite this wide bandwidth of entities, potential catastrophic causes like septic arthritis and malignant disease should be excluded first.

Plain radiographs are often diagnostic. The choice of further imaging modalities like ultrasonography, magnetic resonance imaging, computed tomography and bone scan should be guided by the history and clinical findings. Hinken ist definiert als eine asymmetrische Abweichung vom normalen Gangmuster. Um die Ursache des Hinkens suffizient abklaeren zu koennen, ist ein systematisches Vorgehen mit sorgfaeltiger Anamneseerhebung, orientierender klinischer Untersuchung, sowie eine adaequate Wahl der radiologischen Modalitaet durch den Radiologen notwendig.

Das weite Spektrum der moeglichen Differenzialdiagnosen umfasst viele Pathologien der unteren Extremitaet wie Trauma, infektioese, neoplastische und entzuendliche Erkrankungen sowie erworbene und angeborene Stoerungen. In Faellen, in denen das Kind Knie- oder Oberschenkelbeschwerden angibt, muss zusaetzlich an eine Erkrankung der Huefte gedacht werden. Da viele Erkrankungen eine bestimmte Altersgruppe bevorzugen, kann.

Triage and first care of casualties after radiological incidents; Triage en eerste opvang van slachtoffers na radiologische incidenten. Hierbij is onderscheid gemaakt tussen verschillende groepen slachtoffers, waarvoor specifieke maatregelen nodig zijn om gezondheidsrisico's te beperken. Vervolgens zijn de beoordeling, selectie en eerste opvang van deze slachtoffers met bijbehorende maatregelen in stroomschema's uiteengezet.

De stroomschema's geven aan welke personen direct naar het ziekenhuis moeten worden vervoerd en welke na controle en zo nodig verwijdering van radioactief materiaal, bijvoorbeeld besmette kleding, decontaminatie naar huis kunnen. Daarnaast is er aandacht voor de mensen die niet blootgesteld zijn, maar zich wel zorgen maken. De stroomschema's kunnen tijdens een incident worden verfijnd, naargelang de aard en omvang van het incident.

In het rapport worden de gevolgen van incidenten met een 'vuile bom' en met een verborgen radioactieve bron beschreven. Een vuile bom is een conventioneel explosief dat bij ontploffing radioactief materiaal verspreidt. Mensen in de directe omgeving kunnen door de explosie levensbedreigend gewond raken.

Ook kunnen ze worden besmet door rondvliegende scherven en radioactief materiaal. Bij een incident met een verborgen intacte bron wordt het radioactieve materiaal niet verspreid, omdat het op een vaste plaats aanwezig is. In zulke gevallen moeten mensen die in de omgeving van de bron zijn geweest, worden opgespoord. Ook hiervoor geeft het rapport een stroomschema. Het rapport verschaft informatie om de schema's te onderbouwen. In de bijlagen is achtergrondinformatie opgenomen over radioactiviteit en ioniserende straling en de gevolgen daarvan voor de gezondheid.

Daarnaast wordt verwezen naar relevante nationale en internationale richtlijnen en handboeken. Clinical nuclear medicine in radiation therapy - state and perspectives; Klinische Nuklearmedizin in der Strahlentherapie - Stand und Perspektiven. Clinical nuclear medicine has severely changed due to the technical and pharmacological developments within the last 15 years.

An evaluation of the importance of nuclear medicine for treatment planning purposes in radiation therapy revealed in That nevertheless the demand for nuclearmedical examinations is decreasing might be a result of an increasing alienation between nuclear medicine and referring physicians of other specialities. Therefore a reapproach of nuclear medicine with her main clinical partners is desireable which could be achieved e. Dass die Nachfrage nach nuklearmedizinischen Untersuchungen in diesem Bereich trotzdem ruecklaeufig ist, duerfte Ergebnis einer zunehmenden Entfremdung der Zuweiser aus den verwandten Faechern von der Nuklearmedizin sein.

Es ist deshalb eine Wiederannaeherung der Nuklearmedizin an ihre klinischen Hauptpartner wuenschenswert, die durch Austausch von Rotationsassistenten, die Beteiligung an Tumorkonferenzen und die konsiliarische Stellungnahme zu Untersuchungsindikationen erreicht werden koennte. Cerebral activation studies by PET and fMRT will gain increasing clinical relevance for functional neuroanatomy reading, speaking , localisation of largely unknown cortical functions vestibular cortex , imaging of subjective complaints of functional impairments pain, smell, memory , and documentation of neurological rehabilitation at neuronal level regeneration, compensation, substitution, learning.

Radiological evaluation of the skeleton: Traumatologie des distalen Unterarmes, der Handgelenke und der Hand. Zentralinstitut fuer Roentgendiagnostik; Langer, R. Plain X-ray films including some special radiographic views are still the basis of the radiological evaluation of injuries of the distal forearm, the wrist, and the hand. Especially, in the diagnosis of fractures of the distal radius the exact positioning of the arm and hand is essential.

For the description of fractures of the distal forearm the AO classification of fractures should be used, which is comprehensive and universally applicable. Conventional tomography and computed tomography CT of the radio-ulnar joint and the wrist are used in patients with persisting complaints or equivocal findings on plain radiographs, and difficult anatomical situations. Suspected ligamentous injuries of the wrist including tears of the triangular fibrocartilage complex TFCC are evaluated by wrist arthrography or magnetic resonance imaging MRI , the latter requiring a highly skilled imaging and interpretation technique.

MRI is the method of choice for the detection of osteonecrosis. Ultrasound examinations are of minor importance in the work up of wrist and hand injuries. Bei der Beschreibung insbesondere der distalen Radiusfrakturen sollten die historische Benennung oder aeltere Einteilungen zugunsten der allgemeingueltigen und umfassenderen AO-Klassifikation verlassen werden. Die Computertomographie und Magnetresonanztomographie kommen in der Frakturdiagnostik bei unklaren anatomischen Verhaeltnissen oder konventionell nicht zufriedenstellend erklaerbaren Beschwerden zur Anwendung.

Vermutete ligamentaere Verletzungen der Handwurzel lassen sich arthrographisch oder magnetresonanztomographisch abklaeren. MRI of the hyaline knee joint cartilage. Animal experimental and clinical studies; MRT des hyalinen Kniegelenkknorpels. Tierexperimentelle und klinische Untersuchungen. Klinik fuer Radiologische Diagnostik; Prescher, A. Klinik fuer Radiologische Diagnostik; Buehne, M. Klinik fuer Radiologische Diagnostik; Scherer, K. Klinik fuer Radiologische Diagnostik. The value of MR imaging for the detection of hyaline cartilage lesions using 2-D spin-echo and 3-D gradient-echo imaging was evaluated in an animal experiment in 10 dogs and in a clinical study in 30 patients.

MR imaging findings were compared with histopathological and arthroscopy findings, respectively. Radiological diagnosis and staging; Die nichttraumatische Hueftkopfnekrose des Erwachsenen.

radiology der akute: Topics by www.farmersmarketmusic.com

Radiologische Diagnostik und Stadieneinteilung. MR-Institut, Abteilung fuer Osteologie. In recent years diagnosis, and in particular early diagnosis, of osteonecrosis of the hip has been much improved by modern imaging modalities. Magnetic resonance imaging is widely accepted as the primary imaging modality for the early detection of this disorder and can help to facilitate the therapeutic management in later stages. However, plain radiographs, bone scans and computed tomography are still important techniques, which cannot be avoided in most cases.

This paper describes the relative values of the different modalities. The staging system used is the international ARCO system. Die Magnetresonanztomographie hat sich mittlerweile zur Methode der Wahl entwickelt und wird sowohl zur Fruehdiagnostik als auch in spaeteren Stadien zur Therapieplanung eingesetzt. Trotzdem kann auf die anderen Methoden wie Nativroentgen, Szintigraphie und Computertomographie vielfach nicht verzichtet werden.

The stepchild of intestinal diagnostics. Evaluation of radiological methods to diagnose leiomyomas of the small bowel; Das Stiefkind der Darmdiagnostik. Wertigkeit radiologischer Diagnosemoeglichkeiten von Leiomyomen im Duenndarm. Postoperativ wurden diese Diagnosen histologisch bestaetigt. Eine sichere Dignitaetsbestimmung glatter Muskelzelltumoren ist radiologisch nicht moeglich. Daher muss der Befund operativ geklaert werden. Die histopathologische Zuordnung, bedingt durch die Mitoserate kann allerdings schwierig sein.

Eine gewissenhafte Nachsorge muss daher erfolgen. Approval procedures for clinical trials in the field of radiation oncology; Genehmigungsverfahren klinischer Studien im Bereich der Radioonkologie. An important aim for promoting clinical research and patient care in radiation oncology is to further professionalize planning and implementation of clinical trials in this field.

Correct assessment, at an early stage, whether a trial needs to be approved by the BfS may reduce unneccesary costs and reduce the time needed for the approval procedure for those trials which need to be assessed by the BfS. Bei der Abgrenzung zwischen ''Heilkunde'' und ''medizinischer Forschung'' kommt es bei radioonkologischen Studien immer wieder zu widerspruechlichen Einschaetzungen. Ziel ist es, eine Handreichung fuer Antragsteller, im Beantragungsprozess involvierte Personen und Institutionen sowie Ethikkommissionen zu liefern. Die Abgrenzung zwischen Heilkunde und medizinischer Forschung erfolgt anhand der Frage, ob es sich bei der therapeutischen Anwendung um ein nach Art und Umfang klinisch anerkanntes Strahlentherapieverfahren handelt oder nicht.

Zur Einordnung werden die bestmoegliche Evidenz aus klinischen Studien sowie Stellungnahmen wissenschaftlicher Fachgesellschaften herangezogen. Peripheral neuropathies are common and diagnostically often challenging disorders. Difficulties particularly exist in lesion localization and recognition of complex spatial lesion patterns.

Medical history taking, neurological examination, neurophysiological tests and nerve ultrasonography represent the gold standard in the diagnosis of peripheral nerve lesions but have known methodical limitations. The use of 3 Tesla magnetic resonance neurography MRN is an additional diagnostic imaging tool recently developed for the high-resolution visualization of long segments of peripheral nerves.

Reasonable clinical indications for MRN are exemplarily presented. Using MRN a direct visualization and thus precise localization of focal and non-focal peripheral nerve lesions of various origins can be achieved with high spatial resolution down to the anatomical level of nerve fascicles. Using MRN large anatomical areas of the peripheral nervous system PNS can be covered in a single examination session, spatial nerve lesion patterns can be evaluated and the underlying causes can often be detected.

The MRN is a valuable supplement to the diagnostic work-up of the PNS, especially in cases that cannot be clarified with standard diagnostic methods. Evaluation of the spatial nerve lesion pattern gives additional information on the origin of the underlying disease. Reasonable indications for MRN are the assessment of proximal nerve structures including the brachial and lumbosacral nerve plexi, the clarification of inconclusive diagnostic results, preoperative, postoperative and posttraumatic assessments, the identification of fascicular nerve lesions and the differential diagnosis of an alleged somatoform disorder.

Anamnese, klinisch -neurologische Untersuchung. Haemophilic arthropathy of the knee. Clinical and radiological correlation; Haemophile Arthropathie des Kniegelenkes. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process.

Die Kontrastmittelgabe steigerte die Abgrenzbarkeit des Pannus von Gelenkerguss und den Gelenkbinnenstrukturen. Begleitend durchgefuehrte klinische und roentgenologische Bewertungen des Schweregrades der Arthropathie korrelierten nicht mit dem Signalintensitaetsverhalten des Pannus nach Kontrastmittelgabe. In 21 horses with the anamnesis backproblems there had been a clinical, scan- and X-ray-examination of the thoracal and lumbar vertebra in special consideration of the spinosus process and the dorsal intervertebral joint.

But there was not always a relation between the clinical signs and X-rays or scan results. Not all positive X-rays found their corresponding scan activity and not all scan activities took place in X-rays. In many cases there was pathological change of the spinosus process and arthropathy of the dorsal intervertebral joint at the same time. Benign chordoma of the sacral bone. Radiologic appearance and differential dignosis; Benignes Chordom des Os Sacrum. Radiologische Morphologie und differential-diagnostische Aspekte. Berlin Germany ; Vogl, T.

Berlin Germany ; Rausch, M. Berlin Germany ; Klein, U. Berlin Germany ; Balzer, J. Berlin Germany ; Hammerstingl, R. Berlin Germany ; Mack, M. Berlin Germany ; Felix, R. They can occur anywhere along the skull base and spine, where the notochord extends. Chordomas usually occur after the second decade with the highest incidence between the fifth and seventh decade. There is a male predominance, with roughly a 2 to 1 male-to-female ratio. Children are rarely affected [5, 25, 34]. In this article a case of a patient with a Chordoma of the sacrum is presented.

After a fall on the coccyx the patient complained of recurrent and altogether increasing pain for some years. The clinical diagnosis was fracture of the coccyx with consecutive formation of callus. With the help of MRI guided biopsy the diagnosis of a benign highly differentiated chordoma could be confirmed. Sie koennen ueberall dort auftreten, wo embryonale Reste des Chordagewebes vorhanden sind: Chordome werden in der Regel nach der zweiten Lebensdekade beobachtet und erreichen ihre hoechste Inzidenz zwischen der fuenften und der siebten Lebensdekade.

Sie zeigen eine Praeferenz fuer das maennliche Geschlecht mit eine Relation von ungefaehr 2: Kinder sind seltener betroffen [5, 25, 34]. Im folgenden soll ein Patient mit einem Chordom des Os Sacrum vorgestellt werden. Nach Sturz auf das Steissbein klagte der Patient jahrelang ueber rezidivierende und insgesamt zunehmende Schmerzsymptomatik. Die klinische Diagnose lautete Zustand nach Steissbeinfraktur mit Kallusbildung. Die schliesslich durchgefuehrte MRT zeigte eine charakteristische erhoehte. Klinik fuer Strahlentherapie und Nuklearmedizin.

Since tumors exhibit an increased metabolic activity when compared to normal tissue, this imaging modality has a particularly high importance. FDG-PET is not only useful for localizing and staging of malignant tumors, but also to evaluate therapy response. In this context, PET is superior to morphologically orientated modalities, because therapeutically induced changes in glucose metabolism precede morphologic alterations. Numerous studies indicate, that PET will play an important role in radiooncology concerning therapy planning and monitoring the effects of therapy during and after treatment.

Coincidence gamma cameras with adequate imaging characteristics will gain enhanced importance to meet these increasing demands. Da Tumorgewebe im Vergleich zu normalem Gewebe einen erhoehten Stoffwechsel aufweist, hat dieses Untersuchungsverfahren in der Onkologie einen besonders hohen Stellenwert. Die PET ist hierin den anderen morphologischen Verfahren ueberlegen, da die Veraenderungen des Glukosemetabolismus durch therapeutische Massnahmen morphologischen Veraenderungen vorausgehen.

Zahlreiche Untersuchungen lassen erkennen, dass die PET fuer die Radioonkologie einen wichtigen Stellenwert einnehmen wird. Dies betrifft die Bestrahlungsplanung und das Therapiemonitoring waehrend und nach einer Behandlung. Den Koinzidenz-Gammakameras mit adaequaten Bildgebungseigenschaften kommt eine zunehmende Bedeutung zu, um. The dictionary of radiology is based on practical experience in diagnostic radiology. Following a brief clinical introduction, radiological methods including nuclear medicine and the increasingly important field of sonography are presented in alphabetic order, each term with a short definition.

The most favourable order of application is determined by the diagnostic value, technical requirements and discomfort of the various methods. Preparative measures, the duration of the examinations, and problems of radiation hygiene are discussed. Illustrative drawings supplement the text. The fields of application given for the various methods are based on the latest state of knowledge. Seltener finden sich pathologische Veraenderungen an kartilaginaeren Gelenken und an Enthesen. Die Gelenkveraenderungen an Haenden und Fuessen sind oft symmetrisch verteilt und durch folgende Veraenderungen gepraegt: Einer partikulaeren, spindelfoermigen weichteildichten Verschattung, hervorgerufen durch eine entsuendliche Hypertrophie der Synovia, einen Gelenkerguss und einer oedematoesen Durchtraenkung des perartikulaeren Gewebes.

Einer gelenknahen Osteoporose, deren Ursache die benachbarte Synovialitis mit Hyperaemie sein duerfte. Einer diffusen Gelenkspaltverschmaelerung des Gelenkknorpels durch den Pannus, einem fibrovaskulaeren Resorptivgewebe. Durch zentrale und marginale Erosionen, die als Folge einer Zerstoerung des Knochens durch den Pannus hervorgerufen werden. Shortly after the discovery of X-rays, their damaging effect on biological tissues was observed.

The determination of radiation exposure in diagnostic and interventional radiology is usually based on physical measurements or mathematical algorithms with standardized dose simulations. The detectable amount of these DNA damages correlates well with the dose received. However, the biological radiation damage depends not only on dose but also on other individual factors like radiation sensitivity and DNA repair capacity. Iodinated contrast agents can enhance the x-ray induced DNA damage level. After their induction DSB are quickly repaired. A protective effect of antioxidants has been postulated in experimental studies.

Radiological and surgical management of nonpalpable breast leasions; Radiologisches und chirurgisches Management der nichtpalpablen Mammalaesion. Chirurgische Klinik; Schneider, J. In this retrospective study the results of surgical biopsy of suspected breast cancer in outpatients are reported. In cases Concerning the nonpalpable lesions, mammography was performed in 98 patients Prior to operation, Intra-operative specimen mammography was carried out in every case detected by mammography.

Consequently, for improving prognosis and, at the same time, for reducing the rate of breast amputations as a means of curative therapy of breast cancer, regular screening in defined risk groups is necessary. Surgical treatment of patients with small and nonpalpable findings should be reserved for departments with marking and quick-freezing facilities.

Vorgestellt wird eine retrospektive Studie an Patientinnen, die wegen einer karzinomverdaechtigen Mammalaesion in 3 Jahren an unserer Klinik ambulant operiert wurden. Important findings in radiology ; Kindesmisshandlung. Wichtige Befunde der bildgebenden Diagnostik. Important clinical signs are hematoma at different ages and in uncommon locations.

The principle imaging signs are subdural hematoma, brain contusion and multiple skeletal injuries sometimes at different ages. The parents or the persons responsible for care often neglect mentioning an injury. The principle signs are shown and a diagnostic flow chart is presented. Die Skelettverletzungen haben eine unterschiedlich hohe diagnostische Wertigkeit. Insbesondere die metaphysaere Kantenabsprengung ist von hoher Spezifitaet, wenn die Knochenstruktur normal ist und ein Trauma von den Pflegepersonen nicht angegeben wird.

Die wesentlichen Befunde und ein diagnostisches Flussschema werden vorgestellt. Diagnostics of vascular diseases as a cause for acute abdomen; Diagnostik vaskulaerer Erkrankungen als Ursache fuer das akute Abdomen. Vascular pathologies are rare causes of an acute abdomen. If the cause is a vascular disease a rapid diagnosis is desired as vascular pathologies are associated with high mortality. A differentiation must be made between arterial and venous diseases.

An occlusion of the superior mesenteric artery is the most common reason for acute mesenteric ischemia but intra-abdominal arterial bleeding is also of great importance. Venous pathologies include thrombotic occlusion of the portal vein, the mesenteric vein and the vena cava. Multi-detector computed tomography MDCT is predestined for the diagnostics of vascular diseases of the abdomen. Using multiphasic contrast protocols enables reliable imaging of the arterial and venous vessel tree and detection of disorders with high sensitivity and specificity.

Although conventional angiography has been almost completely replaced by MDCT as a diagnostic tool, it is still of high importance for minimally invasive interventions, for example in the management of gastrointestinal bleeding. Liegt eine vaskulaere Erkrankung vor, ist jedoch aufgrund der hohen Mortalitaet eine zuegige Diagnostik von grosser Wichtigkeit.

Bei den Erkrankungen der abdominellen Gefaesse sind arterielle von venoesen Ursachen zu unterscheiden. Ein Verschluss der A. Venoese Pathologien betreffen thrombotische Verschluesse der Pfortader, der V. Mit mehrphasigen Untersuchungsprotokollen gelingt es, den arteriellen und venoesen Gefaessbaum zuverlaessig darzustellen und Erkrankungen mit hoher Sensitivitaet und Spezifitaet zu. Diagnostic radiology for functional analysis of the cervical vertebral column.

The book is averaged in 17 chapters. The first three, introductory chapters dealing with the significance of radiology for the functional diagnosis of the cervical spine are followed by three chapters discussing the movements of the atlantoaxial joints, the statics of the cervical spine, and the sagittal flexural movements in the C2-C7 segments. Subsequent chapters discuss the radiodiagnostical method according to Arlen, the innervation of the cervical spine segments of movement, disturbances of movement including restriction of movement, degenerative processes of the invertebral disks, and hypermobile disturbance of movement.

The final chapters deal with compensational and dissociation phenomena, subluxations, defective or compulsive positions, etc. In this text-book basic knowledge about radiology , biomedical diagnostic methods radiography, computer tomography , nuclear medicine and safety and radiation protection of personnel on the radiodiagnostic place of work are presented. The stepchild of intestinal diagnostics. Evaluation of radiological methods to diagnose leiomyomas of the small bowel; Das Stiefkind der Darmdiagnostik. Wertigkeit radiologischer Diagnosemoeglichkeiten von Leiomyomen im Duenndarm.

Various radiological methods to diagnose small bowel neoplasmas and problems of differential diagnosis specially considerating leiomyomas are discussed. Two patients with leiomyoma of the ileum underwent enteroclysis, computed tomography of the abdomen, intra-arterial DSA and colour Doppler sonography. Another patient with leiomyosarcoma just underwent CT of the abdomen with CT-guided biopsy. Due to the homogenous density and the smooth surface of the tumors in computed tomography and respectively enteroclysis and the presentation of the tumor vascularisation in the angiography and Colour Doppler sonography in both patients a leiomyoma of the small bowel was diagnosed.

Postoperatively this diagnosis was histologically confirmed. The CT-findings of the patient with leiomyosarcoma were not suspicious of a malignant tumor.

Radiologically it is not possible to determine the dignity of smooth muscle cell tumors safely. That is the reason why the diagnosis has to be achieved operatively. But the histopathological diagnosis based on the mitotic rate may be difficult. Therefore the after care has to be carried out thoroughly. Es werden Diagnosemoeglichkeiten von Duenndarmtumoren und differentialdiagnostische Problemstellungen unter besonderer Beruecksichtigung des Leiomyoms diskutiert. Radiology in managed care environment: Klinik fuer Radiologische Diagnostik; Moeller, J.

Fakultaet fuer Gesundheitswissenschaften; Levin-Scherz, J. Klinik fuer Radiologische Diagnostik. Durch umfassende Datenanalysen, Ueberpruefungen der Kodierlogik, Interviews mit Angestellten sowie kritische Beleuchtung der Vertragsbeziehungen zu Leistungserbringern konnte das Einsparpotenzial beziffert werden. Hauptursache war eine verstaerkte Verordnung von Radiologieleistungen pro versichertem Patienten, wobei die Kosten pro Untersuchung annaehernd gleich blieben.

Ein wesentlicher Kostenhebel lag in der Verbesserung des elektronischen Abrechnungssystems, welches fuer eine Ueberbezahlung von Leistungen verantwortlich war. Die Gestaltung der vertraglichen Risikovereinbarungen zwischen Versicherer und Leistungserbringer sowie die Qualitaet der Managementstrukturen innerhalb der radiologischen Einrichtungen hatten einen signifikanten Einfluss auf deren Wirtschaftlichkeit.

Ferner konnte nachgewiesen werden, dass Aerzte mit eigenen Roentgenanlagen bis zu mal mehr Untersuchungen veranlassen als Aerzte ohne eigene Roentgenausstattung und so einen erheblichen Kostentreiber darstellen. This paper reports on disease processes originating within the alimentary tract, may extend through the extraperitoneal spaces, and abnormalities primarily arising within other extraperitoneal sites may significantly affect the bowel.

Symptoms and signs may be obscure, delayed, or nonspecific, and the area is generally not accessible to auscultation, palpation, or percussion. Radiologic evaluation thus plays a critical role. Diagnostic radiology is still the foremost of all innovative medical disciplines. This has many advantages but also some handicaps, e.

This applies in particular to nuclear spin tomography, where the Laender governments and the Scientific Council seen to agree that all universities should have the appropriate equipment as soon as possible in order to intensify interdisciplinary research. Formerly, in the case of computerized tomography, there was less readiness.

As a result, the siting of CT equipment is less organically structured. A special handicap of innovative fields is the problem of training and advanced training. The Chamber of Medicine and the Association of Doctors Participating in the Health Insurance Plan have issued regulations aimed at a better standardisation in this field. Radiation protection during decommissioning of the salt cavern Asse II.

The recommendations by the German Commission on radiological protection concerning radiation protection during decommissioning of the salt cavern Asse II include the following issues: Radiation protection in the diagnostic radiology. General viewpoint including CT; Strahlenschutz in der diagnostischen Radiologie. Allgemeine Sichtweise einschliesslich CT. Kroepil, Patric [Universitaetsklinikum Duesseldorf Germany. Radiation protection in radiology has received public attention due to reports in the media on radiation hazards due to CT.

The contribution covers the issues radiation protection in radiology , including the documentation of dose information, the responsibility of radiologists for their patients, new developments with respect to dose intensive CT and the changes due to the new radiation protection law. Retention of contrast media in the history of radiology. Sequelae of the former use of thorotrast and new challenges; Kontrastmittelretention in der Geschichte der Radiologie. Folgen der frueheren Thorotrastanwendungen und neue Herausforderungen. Detection of gadolinium deposits in patients who have repeatedly been administered intravenous gadolinium chelates have given rise to concern regarding the long-term safety of magnetic resonance imaging MRI contrast media.

Nevertheless, negative long-term clinical effects have not yet been observed. In some publications parallels have been drawn to the sequelae of thorotrast that was formerly used for arterial angiography. In this article the history of thorotrast use is briefly described and in particular why, despite warnings, this substance was used frequently and worldwide.

A brief summary of the results of the German Thorotrast Study revealed that high excess rates were only observed for primary malignant liver tumors after a year or longer latency period and to a lesser degree of leukemias, as well as for severe local complications due to paravascular injections, particularly in the neck region. Based on this historical review, we will venture to take stock of the outcome from the ''success story'' of this contrast agent.

Gleichwohl gibt es bislang keine Hinweise auf resultierende klinische Spaetfolgen. In verschiedenen Veroeffentlichungen wird auf moegliche Parallelen zu den Folgen der Anwendung des frueheren Roentgenkontrastmittels Thorotrast hingewiesen. In diesem Beitrag wird die Geschichte der Thorotrastanwendung dargelegt, insbesondere weshalb es trotz der Warnungen zur haeufigen, weltweiten Anwendung des Praeparats kam.

Aus einer kurzen Zusammenfassung der Ergebnisse der Deutschen Thorotraststudie wird deutlich, dass erst nach einer ueber jaehrigen Latenzzeit hohe Exzessraten an primaeren Lebertumoren und in geringerem Masse auch an Leukaemien auftraten und schwerwiegende Folgen paravasaler Injektionen v. To demonstrate the usefulness of Dental-MRT for imaging of anatomic and pathologic conditions of the mandible and maxilla.

Seven healthy volunteers, 5 patients with pulpitis, 9 patients with dentigerous cysts, 5 patients after tooth transplantation and 12 patients with atrophic mandibles were evaluated. Studies of the jaws using axial T1- and T2-weighted gradient echo and spin echo sequences in 2D and 3D technique have been to performed. The acquired images were reconstructed with a standard dental software package on a workstation as panoramic and cross sectional views of the mandible or maxilla. The entire maxilla and mandibula, teeth, dental pulp and the content of the mandibular canal were well depicted.

Patients with inflammatory disease of the pulp chamber demonstrate bone marrow edema in the periapical region. Dentigerous cysts and their relation to the surrounding structures are clearly shown. After contrast media application marked enhancement of the dental pulp can be found. Dental-MRT provides a valuable tool for visualization and detection of dental diseases. Sieben gesunde Probanden, 5 Patienten mit Pulpitis, 9 Patienten mit dentogenen Zysten, 5 Patienten nach Zahntransplantationen und 12 Patienten mit atrophem Unterkiefer wurden untersucht.

Nach der Untersuchung wurden zusaetzliche Panoramaschnitte und orhoradiale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebraeuchlichen Dental-Software, angefertigt. Patienten mit einer Entzuendung der. Cross-disciplinary management of polytrauma patients: Chirurgie, Allgemeinchirurgische Klinik, Abt. Traumatologie Switzerland ; Loew, R. The comprehensive survey addresses the various modalities available today for trauma screening and presents a comparative assessment of their value in respect of type of trauma and evidence provided. Neben einer schnellen und schonenden Durchfuehrung der notwendigen Diagnostik darf keine potenziell lebensbedrohende Verletzung uebersehen werden.

Es gilt, die sog. Die Primaere und Sekundaere Radiologische Diagnostik ist abhaengig von der Ausstattung der Klinik und besteht aus einer abdominellen Sonographie, Thorax ap, Beckenuebersicht ap, Halswirbelsaeule seitlich sowie falls vorhanden aus CT und Angiographie.

Ein definitiver Schritt zur Verkuerzung der Zeit bis zur Behandlung waeren sterile OP-Einheiten mit integrierter Roentgendiagnostik moeglichst nativ und CT , die ein staendiges Umlagern und Transportieren des Patienten verhindern koennten. Diagnostic radiology of the osteo-articular system. Bohndorf, Klaus [Medizinische Univ. Exzellenzzentrum Hochfeld-Magnetresonanz; Woertler, Klaus ed. Muenchen Klinikum rechts der Isar Germany. The book on diagnostic radiology of the osteo-articular system includes the following chapters: Current role of MDCT in the diagnosis of coronary artery disease Universitaetsklinik fuer Radiodiagnostik] and others.

The clinical guideline of the Austrian Societies for Cardiology and Radiology on the actual role of MDCT in the diagnosis of coronary artery diseases includes the following issues: CT calcium scoring; CT angiography CTA of the coronaries; actually recommended application of MDCR; generally inappropriate use of the technique for specific patients; radiation exposure; structural and organizational framework. Compression of digital images in radiology. Results of a consensus conference; Kompression digitaler Bilddaten in der Radiologie. Recommendations for lossy compression of digital radiological DICOM images in Germany by means of a consensus conference.

The compression of digital radiological images was evaluated in many studies. Even though the results demonstrate full diagnostic image quality of modality-dependent compression between 1: A consensus conference with approx. For individual modalities the following compression factors were recommended: The results may be understood as recommendations and indicate limits of compression factors with no expected reduction of diagnostic image quality. They are similar to the current national recommendations for Canada and England. Multiparametric MRI of the prostate.

Wichtige radiologische Befunde fuer den Urologen. High prevalence of prostate cancer with multifocality and biological heterogeneity. Insufficient conventional urological diagnostics. Discrimination between significant and insignificant cancer needed. Prostate cancer is characterized by low signal intensity on T2w MRI, restricted water diffusion and pronounced and early uptake of contrast enhancement.

Sensitivity and specificity according to the current literature are ca. Unzureichende konventionelle urologische Diagnostik. Unterscheidung klinisch signifikanter von klinisch nicht signifikanten Karzinomen erforderlich. Prostatakarzinome sind typischerweise T2-hypointens mit eingeschraenkter Diffusion und zeigen eine rasche Kontrastmittelanflutung.

Fuer die Abklaerung bei Verdacht auf. Dose monitoring in radiology departments. Status quo and future perspectives; Dosismonitoring in der Radiologie. Status quo und Zukunftsperspektiven. The number of computed tomography examinations has continuously increased over the last decades and accounts for a major part of the collective radiation dose from medical investigations. For purposes of quality assurance in modern radiology a systematic monitoring and analysis of dose related data from radiological examinations is mandatory.

This standard simplifies the process of data collection and enables comprehensive dose monitoring. Various commercial dose monitoring software devices with varying characteristics are available today. Radiological risk assessment of isotope laboratories according to the requirements of the radiation protection ordinance and the protective labour legislation; Beurteilung des radiologischen Risikos von Isotopenlaboratorien nach den Vorgaben der Strahlenschutzverordnung und den Richtlinien fuer Arbeitssicherheit.

According to the Swiss Radiation Safety Ordinance the supervising authority may require a safety report from the operator of a radioactive laboratory Art. Isotope laboratories of the chemical industry are supervised by Swiss accident insurance agency SUVA. In that respect SUVA safeguards both radiation protection issues and general protection of the workers and established guide lines in order to assess conventional risks in industrial premises.

In these conventional analysis the working process is analysed according to its possible detriment death, severe invalidity, slight invalidity, injury with absence, injury without absence and the probability of occurrence frequent, seldom, rare, improbable, virtually impossible. According to this the risks are categorised in a matrix as 'high', 'medium' and 'low'. SUVA requested such a risk analysis for two isotope laboratories of B type in Basel in which on the one hand the hazard to the workers on the other hand to the public should be analysed and radiologically assessed.

It was proposed to use a methodology established in workers safety and the insurance section. This required a comparison of risks of radiation doses in mSv to the consequences of conventional working accidents death, invalidity and the risk perception of the public and politicians. In this paper this risk matrix derived in discussions among the supervising body, the company management, the laboratory head and workers is described.

In the opinion of the authors such a comparison between radiological and conventional risks has not been performed up to now and the results obtained here are open to discussion. Full Text Available [english] Purpose: This article presents partial results of an evaluation study which compared a three-year blended learning scenario with traditional face-to-face training for medical technical assistants specialising in radiology. The blended learning approach investigated here is based on an individual tutoring approach, i.

Following the theory of constructivism, the tutor should see him- or herself as a coach supporting the learner working on the individual training units. As the Saarland University Hospital offers both face-to-face training and the blended learning course, it was possible to perform direct comparative tests.

On the basis of the final state examination results, it could be shown that the participants of the blended learning course achieved equivalent or slightly better exam results. The positive results of the blended learning participants gain increased significance against the backdrop of the demographic data of both groups of participants: That shows that the blended learning method is a good method to be used by people working in radiology.

Der hier untersuchte Blended Learning-Ansatz beruht auf einem individuellen Betreuungsansatz, d. Feasibility study to combine the evaluation of radiological and chemical-toxicological effects of old contaminated sites; Machbarkeitsstudie zur Verknuepfung der Bewertung radiologischer und chemisch-toxischer Wirkungen von Altlasten. The uranium mining regions of the German Federal States Saxony, Thuringia and Saxony-Anhalt are contaminated by radionuclides and by chemical substances.

For both, ionizing radiations and chemicals, concepts and models exists to assess possible health effects for the population living in such areas. However, these assessment models were developed independently for both kinds of contaminants. This feasibility study describes the state of the art of the concepts and models used for the evaluation of radiological and chemical contaminants.

The similarities and differences of these evaluation methods are identified and discussed. Suggestions are made for an integrated assessment to standardize the evaluation of sites contaminated by radionuclides or chemicals. Fuer ionisierende Strahlung und fuer chemische Noxen existieren unabhaengig voneinander entwickelte Bewertungssysteme zum Schutz vor Gesundheitsgefahren und Empfehlungen zum Umgang mit kontaminierten Standorten. Vor diesem Hintergrund forderte die 9. Umweltministerkonferenz - Ost am Ob diese Verknuepfung moeglich ist und in welcher Weise diese vorgenommen werden kann, ist bisher nicht untersucht worden.

Diese Machbarkeitsstudie unternimmt eine Bestandsaufnahme von Uebereinstimmungen und Unterschieden der beiden bestehenden Bewertungssysteme fuer Kontaminationen mit Radionukliden und mit chemisch-toxischen Stoffen und zeigt einen Weg auf zur Verinheitlichung der. Acute injury of the ankle joint; Akutes Trauma des Sprunggelenks.

Klinik fuer Radiodiagnostik, Abt. The diagnosis of lateral collateral ankle ligament trauma is based on patient history, clinical examination, and clinical stress tests. If the clinical stress test is positive, stress radiography could be performed. There is no consensus about the usefulness of stress radiography in acute ankle sprain, particularly about the cut-off talar tilt angle beyond which a two-ligament rupture would be certain, ranging from 5 to Today MRI is not used for this indication, although it allows, with controlled positioning of the foot and with defined sections, visualization of injured lateral collateral ankle ligaments.

In ankle injuries, plain radiographs form the established basis of diagnostic imaging and can provide definitive answers in most cases. CT is used in complex fractures for complete visualization. MRI is the method of choice for several diagnostic problem cases, including occult fractures and post-traumatic avascular necrosis. In tendon injuries, MRI is important if ultrasound is not diagnostic. Generally, for the evaluation of acute ankle injuries, MRI is the most important second-step procedure when radiographs are nondiagnostic.

Bei positiven klinischen Stresstests kann eine Stressradiographie durchgefuehrt werden. Es gibt keine Uebereinstimmung fuer den Wert der Stressradiographie beim frischen Supinationstrauma des Sprunggelenks, insbesonders fuer den Winkel der Aufklappbarkeit bei einer Zweibandverletzung, der von 5 reicht. Die MRT wird zur Zeit bei dieser Indikation nur in Einzelfaellen benutzt, obwohl sie mit definierter Fusspositionierung und Ausrichtung der Untersuchungsebene eine ausgezeichnete Beurteilung der Sprunggelenksbaende erlaubt.

Bei knoecherner Sprunggelenksverletzungen ist die Verwendung des konventionellen Roentgen die etablierte Methode und meist. Radiological imaging in early diagnosis of rheumatoid arthritis. The role of ultrasound and magnetic resonance imaging; Radiologische Fruehdiagnostik der rheumatoiden Arthritis. Stellenwert von Ultraschall und Magnetresonanztomographie.

For optimal therapy management of patients with rheumatoid arthritis RA specific and sensitive diagnostic methods are essential for assessment of disease activity. In addition to projection radiography, imaging techniques, in particular magnetic resonance imaging MRI and ultrasound US are becoming increasingly more important for the early diagnosis of RA. Measurement of inflammation activity represents the basis of therapeutic decision-making and can be quantitatively and qualitatively determined with MRI and US.

Synovitis and bone marrow edema are predictors of erosion. Die Messung der Entzuendungsaktivitaet stellt die Basis fuer die Therapieentscheidung dar. Synovialitis und Knochenmarkoedem sind Praediktoren fuer Erosionen. Radiological assessment of loss of disc height during acute and chronic degenerative lumbar disc alterations; Radiologische Beurteilung der segmentalen Hoehenabnahme bei akuten und chronisch degenerativen lumbalen Bandscheibenveraenderungen. Aim of the study: A loss of disc height with increasing segmental mobility is an important reason for low back pain.

The measurement of hyaluronic acid content of the nucleus pulposus prolaps shows a difference between acute group 1 and chronic group 2 disc degeneration. The purpose of the present investigation was to determine the decreasing of disc height between these two groups and the no-symptomatic segments of these patients. The used method is not suitable to answer the present question conclusively.

Die segmentale Hoehenabnahme der Bandscheibe mit nachfolgender Instabilitaet im Rahmen von degenerativen lumbalen Bandscheibenerkrankungen hat eine wesentliche klinische Bedeutung. In einer vorgeschalteten Untersuchung konnte ueber die Bestimmung des Hyaluronsaeuregehaltes von Nucleus pulposus-Material der Grad der Bandscheibendegeneration beurteilt werden. Die Frage ist, ob hier ein praeoperativ radiologisch nachweisbarer Hoehenunterschied zwischen den akuten Gruppe 1 und den chronischen Gruppe 2 Bandscheibenvorfaellen im Vergleich zu den klinisch nicht betroffenen Bandscheibensegmenten der Patienten besteht?

Es wurden 20 konsekutive praeoperative seitliche Roentgenaufnahmen der Lendenwirbelsaeule nach der Methode von Frobin et al. Diese bestanden aus einer ersten Gruppe 7 Patienten mit einem durchschnittlichen Alter von 41 Jahren und einer zweiten Gruppe 13 Patienten mit einem durchschnittlichen Alter von 44 Jahren. Die Ergebnisse der Untersuchung zeigten lediglich in der 2. Gruppe mit einer chronischen Bandscheibendegeneration eine Tendenz zur Abhaengigkeit p. Arthroplasty of the rheumatoid hand. Pre- and postoperative imaging with special consideration of biomechanical and pathobiomechanical aspects and its radiological evaluation; Arthroplastik der rheumatischen Hand.

Prae- und postoperative Bildgebung mit besonderer Beruecksichtigung der Biomechanik und Pathobiomechanik und ihrer Evaluation am Roentgenbild. Radiology plays a key role when the indications for arthroplasties of the hand and finger joints are determined and for the postoperative follow-up. On the one hand, the degree of inflammatory changes in all affected compartments is to be evaluated and graded; on the other hand, conventional radiograms allow for a first assessment of possible joint instability and impaired biomechanics.

Both aspects influence the choice of the proper surgical therapeutic strategy. Osteolysis, deformity, fracture, prosthesis loosening or failure, heterotopic ossification, and foreign body-associated formation of granulation tissue are complications which can be detected on follow-up radiographs early on. Einerseits ist das Ausmass der entzuendlichen Veraenderungen in allen Kompartimenten umfassend zu beurteilen und graduieren, andererseits lassen sich bereits im konventionellen Roentgenbild Rueckschluesse auf etwaige Instabilitaet oder gestoerte Biomechanik ziehen.

Beide Aussagen wirken sich auf die operative Therapieentscheidung massgeblich aus. Osteolyse, Deformitaet, Fraktur, Implantatlockerung oder -versagen, heterotope Knochenneubildung und fremdkoerperassoziierte Granulationsgewebebildung sind Komplikationen, die in den postoperativen Verlaufskontrollen fruehzeitig erfasst werden koennen.

Lehrbuch fuer den 2. Abschnitt der Aerztlichen Pruefung, das praktische Jahr und die fachaerztliche Weiterbildung. The present volume 2 of the radiology compendium discusses clinical radiology with the list of subjects to be studied in the 2nd section of clinical training.

It is dealing with the following themes: Internal medicine, paediatrics, urology, general surgery, radiological methods in gynaecology and obstetrics, orthopaedics, neurology, ophthalmology, otolaryngology, dentistry and orthodontology, radiotherapy in dermatology. Diagnostic and therapy of acute thoracic aortic diseases; Diagnostik und Therapie akuter Erkrankungen der thorakalen Aorta. Schotten, Sebastian; Pitton, Michael B. Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie.

Acute diseases of the thoracic aorta represent a relatively rare but life threatening spectrum of pathologies. The non-traumatic diseases are usually summarized by the term ''acute aortic syndrome''. A timely diagnosis and initiation of therapy are cornerstones for the patient outcome. CT has become the standard imaging procedure due do its widespread availability and excellent sensitivity. Furthermore, CT is able to discriminate the variants of acute aortic diseases and to detect the wide spectrum of complications. The volumetric CT dataset is also the basis for planning of interventional procedures.

Open surgical repair still represents the standard of care for acute pathologies of the ascending aorta while endovascular therapy, due to minimally invasive character and good outcome, has replaced open surgery in most cases of complicated lesions of the descending aorta. Combined use of contrast media containing iodine and gadolinium for imaging and intervention.

A hitherto widely ignored topic in radiological practice; Kombinierter zeitnaher Einsatz jod- und gadoliniumhaltiger Kontrastmittel in der diagnostischen und interventionellen Radiologie. Ein bisher vernachlaessigtes Kapitel der radiologischen Praxis. Mangels verlaesslicher Daten aus experimentellen und klinischen Studien ist der Radiologe auf Falldarstellungen, Informationen der Hersteller, persoenliche Mitteilungen, die meist spaerlichen eigenen Erfahrungen und ein geschicktes Zeitmanagement angewiesen, um die Situation zu meistern.

Die zeitnahe intravaskulaere Injektion jod- und gadoliniumhaltiger Kontrastmittel verlangt dagegen besondere Aufmerksamkeit. Je schwerer die Erkrankung des Patienten, desto vorsichtiger wird man handeln, desto dringlicher kann allerdings auch die Entscheidung fuer oder gegen die kombinierte Kontrastmittelgabe sein. Die folgende Uebersicht beschreibt die Eigenschaften der jod- und gadoliniumhaltigen Kontrastmittel, soweit sie fuer Interaktionen bei simultaner bzw.

Anschliessend werden die fuer die Praxis bedeutsamen klinischen Situationen und Konstellationen dargestellt und analysiert sowie Entscheidungshilfen gegeben. Efficiency of cineradiography in the diagnosis of dysphagia; Effizienz der Hochfrequenzkinematographie in der Diagnostik der Dysphagie.

Muenster Germany ; Mai, R. Muenster Germany ; Mueller-Miny, H. Bonn Germany ; Peters, P. Dysphagia is a common symptom in clinical practice. Due to the broad spectrum of underlying diseases many disciplines are involved in the therapy and diagnosis of dysphagia, where radiology plays a central role. The radiologist is confronted with different diagnostic problems and has to choose the most appropriate type of investigation. In many cases no organic disorder can be demonstrated by clinical examination, endoscopy or conventional radiological techniques.

In this setting cineradiography is an outstanding tool for finding functional or structural changes in the swallowing chain. This study underlines the efficiency of cineradiography in the diagnosis of dysphagia. Aufgrund des weiten Spektrums zugrundeliegender Erkrankungen sind zahlreiche Fachdisziplinen mit der Diagnostik und Therapie der Dysphagie befasst, wobei der Roentgendiagnostik eine zentrale Rolle zukommt. Der Radiologe wird mit unterschiedlichen Fragestellungen konfrontiert und muss die geeignete Untersuchungsstrategie festlegen.

Haeufig ist durch klinische Untersuchung, Endoskopie und konventionelle Roentgenuntersuchung keine organische Erkrankung nachweisbar. Mit der Hochfrequenzkinematographie steht dann ein Verfahren zur Verfuegung, welches in hervorragender Weise funktionelle und strukturelle Veraenderungen der am Schluckakt beteiligten Organe aufzeigen kann. Die hohe Effizienz der Methode wird in dieser Studie belegt. A plant for the separation of aerosols, krypton and tritium AKUT used for purifying the head end of the reprocessing of thorium-containing fuel elements from combustion waste gases is described.

Data are to be collected to enable a process engineer to plan and construct a large-scale plant, and the correctness and practicability of the concept adopted is to be proved in conjunction with the JUPITER plant. It is true that the tests on the AKUT I plant confirmed that the flow scheme was basically correct, but the actual experimental operation was considerably limited by a fixed and rigid coupling to the combustion furnace.

Some operational conditions were encountered which did not meet the design values. Part of the plant krypton separation is being tested in the USA. The German concept was taken over in the early stages of tests and adapted to existing apparatuses, the result inevitably being different experimental conditions.

The AKUT II plant can now be used for consideration of the economic and safety conditions, and comparisons can be made. Der Fachbereich Fertigungstechnik der Zukunft. Im vorliegenden Papier wird ein internes Entwicklungsprojekt, genannt " Der Fachberich der Zukunft", beschrieben. Conformal radiation therapy of localized prostate cancer: Akute Toleranz und fruehe Wirksamkeit. In a prospective trial early effectiveness and acute toxicity of conformal 3D-planned radiotherapy for localized prostate cancer was quantified using dose-volume-histogramms and evaluated with respect of treatment technique.

Acute complications leading to treatment interruption did not occur. In 16 patients symptoms disappeared within 6 weeks after radiotherapy. Only 2 men had symptoms which lasted longer than 3 months and were endoscopically examined. Up to now no late complications were detected. Incidence and severity of toxicity was significantly p Akute toxicity was found to depend statistically significant p der fruehen Wirksamkeit und akuten Toxizitaet der 3D-geplanten und konformierenden Strahlentherapie des lokalisierten Prostatakarzinoms mittels Dosis-Volumen-Histogramm sowie Untersuchung der Abhaengigkeit von der Bestrahlungstechnik in einer prospektiven Studie.

Bei keinem Patienten musste die. Der Sinn der Lehre. A review of scientific topics and literature in abdominal radiology in Germany. Gastrointestinal tract; Aktuelle Schwerpunkte und Literatur der Abdominalradiologie im deutschsprachigen Raum. Clinic for Radiology; Kinner, S. The working group for abdominal and gastrointestinal diagnosis is a group of the German Radiological Society DRG focusing clinically and scientifically on the diagnosis and treatment of the gastrointestinal tract with all parenchymatous abdominal organs.

In addition to the clinical and scientific further development of abdominal radiology , the education of radiologists within this core discipline of radiology is one of the major aims.

In this article we give an up-to-date literature review of scientific radiological topics especially covered by German radiologists. This manuscript focuses on the most recent literature on the diagnosis of the stomach, small bowel, colon and rectum. The review with a focus on the most recent studies published by German radiologists concludes with a synopsis of mesenterial bleeding and ischemia followed by a critical appraisal of the current literature on conventional abdominal radiography.

Diagnostic radiology of thoracic diseases. The book on diagnostic radiology of thoracic diseases covers the following topics: However, doctors must consider central neurological reasons to vertigo. If it is determined that a patient has oto-neurological vertigo, the next task is to determine whether This review highlights the oto-neurological approach to the dizzy patient with particular focus on the patient's history Radiological framework for the disposal of materials from geothermal energy facilities in repositories; Radiologische Rahmenbedingungen fuer eine Entsorgung von Materialien der Geothermie auf Deponien.

During utilization of deep geothermal energy sources NORM waste accumulate with radiological properties similar to the residues from crude oil or natural gas production or water treatment plants. The estimated total annual amount of radiological relevant materials scales, combustible materials, scrap metals is about 5 to 6 tons with a total activity of about 0. The established disposal paths for metal waste exist. Measurable changes in academic quality indicators? Messbare Veraenderungen der universitaeren Kennzahlen nach der Zertifizierung? Lorenzen, Joern; Habermann, C. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up.

In the field of research an increase in scientific output was achieved based on the number of an internal publication score Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve.

Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. Fractures of the atlantoaxial complex in the elderly: For each subject, trauma mechanism and clinical and neurological status were recorded at admission. Initial imaging studies of the cervical spine were reviewed. Preexistent degenerative changes were assessed and the atlantoaxial fractures classified.

Data were evaluated for the frequency of different types of fractures of C1 and C2 and for accompanying fractures of cervical vertebrae or the occipital condyles, respectively. Materials management system in interventional radiology - initial experience with a computer-supported program; Materialverwaltung in der interventionellen Radiologie - erste Erfahrungen mit einem computergestuetzten Programm. Institut fuer klinische Radiologie; Jung, E.

To perform a cost analysis for assessing options of reorganizing material supplies and reducing costs of the radiology division through the introduction of a materials management system. A materials management system Piranha, Boston Scientific was installed on an existing computer system. All consumables were inventoried and entered into the system. An ABC analysis determined further action. On the basis of order frequencies and availability requirements for emergencies, safety levels were agreed with physicians and other medical staff. Inventory costs were computed using these data.

The inventory showed that the capital tied up in stocks was Euro , and and Euro , in A change in supply strategy reduced inventory cost in and Annual interest expense was lowered by Euro 18, Another saving of Euro 2, was achieved by a reduction in storage cost. Annual inventory turnover totaled Euro , Flexible supply strategies and the introduction of a materials management program can help to reduce inventory costs in interventional radiology divisions without any impact on service levels.

Pada beberapa dekade terakhir, telah terjadi pergeseran paradigma dalam penanganan balita malnutrisi, yang sebelumnya berbasis pendekatan fasilitas kesehatan bergeser menjadi pendekatan berbasis komunitas. Tujuan penelitian ini adalah untuk menganalisis pengaruh program home care terhadap peningkatan status gizi balita malnutrisi pada anak usia bulan. Penelitian menggunakan desain kuasi eksperimen dengan pretest dan posttest control group melalui tiga tahap pendampingan yaitu intensif, mandiri, dan penguatan dengan pendekatan asuhan keperawatan.

Sampel adalah 56 balita malnutrisi akut di dua wilayah, yaitu 33 balita di Kota Yogyakarta eksperimen dan 23 balita di Kabupaten Sleman kontrol dengan teknik pengambilan sampel yaitu purposive sampling. Intervensi home care diberikan selama tiga 3 bulan Januari sampai Maret Klinik fuer Diagnostische und Interventionelle Radiologie. To investigate two event-oriented methods for evaluating patient satisfaction with radiological services like outpatient computed tomography CT examinations. Subsequently a flow chart containing all single steps of the examination procedure was shown to all patients.

The CIT-based part of the questionnaire yielded comments positive and negative , which were assigned to one of four categories: Significantly more detailed comments regarding individual aspects of the CT examination were elicited in the second part of the survey, which was based on the SIT. Positive comments confirm the adequacy of the existing procedures, while negative comments provide direct information about how service quality can be improved.

Full Text Available Einleitung: Vielerorts werden bereits bei der Erstbiopsie 12 Stanzen entnommen. Es wurden nur Proben aus der peripheren Zone der Prostata unter transrektaler Ultraschallkontrolle entnommen. Von den Patienten des Untersuchers R. Increased awareness of high personal dose exposure of medical staff in interventional radiology IR demands an assessment of radiation protection procedures. Mandatory dose monitoring systems do not allow to relate dose to specific actions of the staff as they just accumulate a total dose per month. Doses of head and limbs are expected to be high as those body parts which are not protected by the lead apron.

We decided to use a measuring system by Unfors, RaySafe i2 which is built for real- time- dosimetry of scattered radiation in pulsed X-ray fields. An increased dose of the body side closer to the X-ray source left body side was detected. This is due to the position and the posture of the radiologist during intervention. Separating the phases of digital subtraction angiography DSA from those of fluoroscopy allowed not only to list the separate accumulated doses, but showed as well a big difference in dose rate.

The measurements revealed the need of an improvement of common radiation protection, especially while DSA. Ek olarak porfirine spesifik testler pozitif bulundu. Neurogenic myopathies and imaging of muscle denervation; Neurogene Myopathien und Bildgebung der Muskeldenervation. Neurogenic myopathies are primary diseases of the nervous system, which secondarily result in denervation of the target musculature. The spectrum of potential causes is manifold ranging from acute traumatic injuries and chronic compression to neurodegenerative, inflammatory, metabolic and neoplastic processes.

The medical history, clinical neurological examination, and electrophysiological tests including electromyography and nerve conduction studies are crucial in diagnosing neuropathic myopathies. Electromyography is the gold standard for diagnosing muscle denervation. Additional imaging methods and magnetic resonance imaging MRI in particular, are capable of contributing valuable information.

The MRI examination of denervated musculature shows edema, an increase in the apparent diffusion coefficient ADC and hyperperfusion. Chronic denervation results in fatty degeneration and atrophy of affected muscles, which are also detectable by MRI. Although the MRI findings in muscle denervation are relatively unspecific, they show a high sensitivity, comparable to electromyography.

Dedicated MR neurography may often visualize the underlying lesion s of the innervating nerve s. Besides high sensitivity, comparable to electromyography, MRI is capable of evaluating muscles which are inaccessible for needle electromyography. Due to its non-invasive character, MRI is ideal for follow-up examinations. The use of MRI is often a meaningful addition to the diagnostics of neurogenic myopathies.

The extent and distribution pattern of muscular alterations often provide information on the localization of the causative nerve damage. A correct diagnosis or at least a narrowing down of possible differential diagnoses can often be achieved using MRI. Das Spektrum potenzieller Ursachen ist vielfaeltig und umfasst akute traumatische Verletzungen. The German Radiological Society and the protagonists of radiology during the time of National Socialism.

State of research, explanation attempts, desiderata and research prospects; Die Deutsche Roentgengesellschaft und die Protagonisten der Radiologie in der Zeit des Nationalsozialismus. Forschungsstand, Erklaerungsansaetze, Desiderate und Perspektiven. The intention of the authors is the recognition and critical analysis of efforts to study the history of the German Radiological Society during the time of National Socialism from to with the goal of determining existing desiderata and identifying the resulting research prospects.

There is a need to study concrete individual biographies of radiologists members of the German Radiological Society, perpetrators, and victims and their careers before and after as well as the importance of the interdisciplinarity of the discipline and the lack of institutional involvement during the ''Third Reich''. Moreover, the comparatively difficult starting situation of the study of the history of the German Radiological Society is discussed. Magnetic resonance imaging in acute intractional tuberculosis; Magnetresonanztomographie bei akuter intrakranieller Tuberkulose.

Berlin Germany ; Sander, B. Berlin Germany ; Benndorf, G. Berlin Germany ; Terstegge, K. Berlin Germany ; Podrabsky, P. Berlin Germany ; Cordes, M. Berlin Germany ; Felix, R. We reported three cases of acute intracranial tuberculosis including miliary tuberculosis, basal meningitis, tuberculomas and neuritis of cranial nerves. MRI revealed more granulomas and a better imaging contrast in the detection of basal meningitis. Neuritis was diagnosed only with the MRI. MRI scans should be prefered as the imaging procedure in clinically presumed intracranial tuberculosis.

Ebenso wurde ein hoeherer Bildkontrast bei der Darstellung der Meningitis beobachtet. Die kontrastmittelunterstuetzte MRT sollte in der bildgebenden Diagnostik einer intrakraniellen Turberkulose primaer zum Einsatz gelangen. The radioactive contamination of the earth. Die radioaktive Verseuchung der Erde. The book is intended as a global analysis of the nuclear era. The author is convinced that the damage due to low radiation doses is cumulative, and that the harm so done will become plain only very late, either in a single person, or in his children, or in posterity.

Already now the radioactive wastes produced by industry and the armament industry are irreparably damaging our environment and our genes, and the fear of the author is that it will not take long until the pollution of our planet with highly poisonous radionuclides has reached the point of no return for life. Analysis of patients' X-ray exposure in percutaneous radiologic gastrostomies; Analyse der Strahlenexposition fuer Patienten bei perkutanen radiologischen Gastrostomien. Analysis of patient's X-ray exposure during percutaneous radiologic gastrostomies PRG in a larger population.

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