Der Radiologe
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Despite highly sensitive imaging techniques, the diagnosis and treatment of spondylodiscitis are often delayed due to a lack of specific symptoms with back pain as the presenting complaint. Late diagnosis and neurological involvement at the time of diagnosis are risk factors for long-term neurological deficits. Unremitting back pain with signs of inflammation should give reason to suspect spondylodiscitis and to rule it out by imaging, especially if risk factors such as diabetes mellitus, malignant neoplasms or immunosuppression are present. Magnetic resonance imaging (MRI) is the imaging procedure of choice with high sensitivity and specificity and typically shows hypointense adjacent vertebrae on T1-weighted images with hyperintense signal on short tau inversion recovery (STIR) sequences and hyperintense disc spaces on T2-weighted images.
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Obesity is an increasing problem faced by the healthcare system. In managing obesity, bariatric surgery is becoming more important with evidence showing a reduction in long-term morbidity and mortality. There are special challenges faced by the radiology department in providing an imaging service for this population of patients, from technical requirements through to the interpretation of post-surgical images. This article provides an overview of the most frequently performed procedures, normal postoperative imaging findings and the appearance of common complications.
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Review Comparative Study
[Whole-body diffusion-weighted imaging in oncology: technical aspects and practical relevance].
This review illustrates the relevance of whole-body diffusion-weighted imaging (WB-DWI) in the field of oncological imaging. WB-DWI is an alternative method to positron-emission tomography/computed tomography (PET/CT) due to the lack of radiation and lower examination costs. Technical aspects of WB-DWI and the current role of the method in cancer imaging regarding practical requirements in oncology are presented.
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In order to secure and continually improve radiation protection standards in the field of medical X-ray imaging, the German X-Ray Ordinance requires that each individual examination be properly justified and that any procedure undertaken be optimized. Diagnostic reference levels have been introduced in Germany as a measure of optimization for common and/or high-dose X-ray procedures, and are regularly checked for compliance by the competent Medical Experts Office. ⋯ The aim of this paper is to describe the essential dosimetric concepts and methods used for the assessment of radiographic, fluoroscopic, and CT procedures. In addition, practical measures for reducing the radiation exposure of patients and personnel will be discussed.
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Endobronchial ultrasound (EBUS), one of the most important advances in pneumology in recent years, provides visualization of bronchial walls and parabronchial structures, extending the diagnostic spectrum of bronchoscopic techniques. Two different techniques are available: radial endobronchial ultrasound and the technique of ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). ⋯ EBUS-TBNA is particularly useful for the evaluation of hilar and mediastinal lymph nodes in cases of lung neoplasms with a sensitivity of 88% and specificity of 100%. EBUS therefore plays an important role in the new interdisciplinary guidelines on "prevention, diagnostics, therapy and aftercare of lung cancer".