Der Radiologe
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Computed tomography (CT) accounts for a significant proportion of radiation exposure patients are exposed to during diagnosis, which means that particularly strict indications need to be observed especially where children are concerned. Numerous factors influence the level of radiation exposure, only a few of which can be changed by the radiologist and radiographer. Sound knowledge of the links between technical implementation and the resultant image quality needed for the diagnosis can dramatically reduce the radiation patients are exposed to, which in turn has an influence on the indications. In the present paper the radiologist is given tools for optimisation of CT examinations in children and accepted indications for CT of all body regions are presented.
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Whole body magnetic resonance imaging (MRI) opens new opportunities in diagnostic radiology as systemic disease entities can be examined with high sensitivity. This can lead to a change of paradigm, so that not only organ-related but rather disease-specific MRI examination protocols can be applied which focus on the underlying pathophysiology of the disease. ⋯ Compared to computed tomography, MRI does not use radiation. Although whole body MRI is still in an early stage, the enormous medical and economical potential can be envisioned.
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Recent technical developments have substantially improved the potential of MRI for the diagnosis of pulmonary embolism. On the MR scanner side this includes the development of short magnets and dedicated whole-body MRI systems, which allow a comprehensive evaluation of pulmonary embolism and deep venous thrombosis in a single exam. ⋯ By combining time-resolved pulmonary perfusion MRI with high-resolution pulmonary MRA a sensitivity and specificity of over 90% is achievable, which is comparable to the accuracy of CTA. Thus, for certain patient groups, such as patients with contraindications to iodinated contrast media and young women with a low clinical probability for pulmonary embolism, MRI can be considered as a first-line imaging tool for the assessment of pulmonary embolism.
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CT and MRI are the radiological methods of choice in the diagnostics of diseases of the paranasal sinuses. Detailed anatomical knowledge is mandatory for correct image interpretation. Before endonasal surgery the individually variable anatomic situation has to be known. This article describes radiologically relevant anatomical structures and summarizes normal variations.
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Tumors and tumor-like lesions are rare diseases in the paranasal sinuses. There is a great variety of histological types, but only a small number of morphological patterns on imaging. Histology is an important point in therapeutic planning. ⋯ The main task of imaging is an exact estimation of the extent and spread of a lesion. This article discusses the possibilities and limitations of CT and MRI in the assessment of the dignity and spread of paranasal tumors and tumor-like lesions in consideration of necessary therapeutic information. Additionally, an overview of features on imaging of different paranasal tumors and tumor-like lesions is given.