Der Radiologe
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Point-of-care ultrasound (POCUS) of the lung in patients with COVID-19 plays a key role in the emergency room and intensive care unit. Lung ultrasound is able to depict typical pulmonary findings of COVID-19 and is therefore suitable for diagnosis and follow-up of these patients. ⋯ Lung ultrasound in patients with COVID-19 offers similar performance as CT and is superior when compared to X‑ray in evaluating pneumonia and acute respiratory distress syndrome (ARDS). Lung ultrasound plays an important role in the emergency room and intensive care unit. POCUS reduces exposure to radiation, therapy delays, and minimizes transport of high-risk patients. Differential diagnoses can also be clarified.
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Review
[Fracture classification-part 1 : Modern low-dose radiation imaging in pediatric traumatology].
Fractures in children are significantly more common than bone fractures in adults. Overall, they have a good prognosis regarding spontaneous correction and a restitutio ad integrum. The aim of this study is to provide an overview of established modern (low-dose radiation) imaging techniques in pediatric fractures. ⋯ In addition to conventional x‑rays, fracture sonography is becoming increasingly important for the detection of fractures in children. In the upper extremity, a sensitivity of 96% and specificity of 97% can be achieved for some fracture entities, e.g., at the distal forearm. Computed tomography is used restrictively but plays an important role in a few special indications for polytraumatized children and preoperative assessment, e.g., in the case of transitional fractures.
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The treatment of intracranial wide-necked bifurcation aneurysms-which account for approximately 26-36% of all brain aneurysms-can be challenging both endovascularly and surgically, as a complete cut-off of the blood flow into the aneurysm should be achieved without disruption of the flow into the bifurcation vessels. Intrasacular flow disruption with the Woven-EndoBridge (WEB) is an innovative technique for the treatment of such aneurysms. This review article discusses various aspects of the treatment of intracranial aneurysms with the WEB device, including indications, aneurysm/device selecting strategies, antiplatelet therapy requirements, procedural technique and potential complications. ⋯ Intrasacular flow disruption with the WEB device is a safe and effective treatment method for intracranial wide-necked bifurcation aneurysms, especially for patients with ruptured aneurysms, in patients with contraindications for antiplatelet therapy, and for patients in whom clipping is associated with high risks.
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Traumatic fractures of the pelvic ring are relatively rare, but are associated with increased risk of mortality. Depending on injury mechanism and main vector of energy impact, a distinction is made between anteroposterior compression, lateral compression, and vertical shear (Young and Burgess classification), while the stability-related classification according to Tile distinguishes between type A (stable), type B (rotationally unstable) and type C (completely unstable). A comprehensive modern classification is given by the AO/OTA. ⋯ Knowledge of basic pelvic trauma mechanisms is important to understand the potential severity of traumatic pelvic fractures and to classify them correctly in terms of stability. Being familiar with typical concomitant injuries in pelvic ring fractures allows reliable diagnosis and their communication with the clinician. CT remains the "diagnostic workhorse". In fragile pelvic fractures, the often prolonged course with fracture progression must be taken into account, which is why MRI is of particular importance herein.