Bildgebung = Imaging
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Imaging procedures are important for diagnosis and surveillance of patients in intensive care units. Radiologic examination, ultrasound and echocardiography are of paramount importance because they can be done bedside. ⋯ Ultrasound can show many pathologic changes important for the management of intensive care patients concerning liver, gallbladder, bile duct, pancreas, kidney, spleen, pleural space and vessels. Other imaging procedures such as CT, methods of nuclear medicine, MRT, angiography etc. are done outside the intensive care unit and therefore need a more restricted indication.
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Bildgebung = Imaging · Jun 1995
Postoperative liver allograft dysfunction: the use of quantitative duplex Doppler signal analysis in adult liver transplant patients.
40 patients after orthotopic liver transplantation were prospectively analysed by serial quantitative duplex Doppler signal analysis (DDSA) to quantify the abnormalities of Doppler waveform of the hepatic artery (HA), the portal vein (PV) and the hepatic vein (HV) under various conditions of graft dysfunction. Quantitative analysis of the HA, PV and HV was obtained before, during and after allograft dysfunction by different Doppler angle independent parameters. The results obtained later on were correlated with clinical and laboratory data, cytological and histological findings of liver core biopsy and quantitative DDSA data of healthy transplanted volunteers. ⋯ Different patterns of damping quantified by the damping index (DI = minimum velocity shift/maximum velocity shift) for the portal vein (PV-DI) and the hepatic vein (HV-DI) Doppler signal were observed under various conditions of allograft dysfunction. Acute rejection was identified by premature decrease of PV-DI and increase of HV-DI (p < 0.01) with a sensitivity of 75%, a specificity of 91%, a positive predictive value (ppv) of 75% and a negative predictive value (npv) of 91%. Chronic allograft rejection was not associated with an increase of HV-DI but only with a significant decrease of PV-DI (p < 0.01), with a sensitivity of 80%, a specificity of 95%, ppv of 95%, npv of 98%.(ABSTRACT TRUNCATED AT 250 WORDS)
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Bildgebung = Imaging · Jun 1995
Endosonographically guided transduodenal and transgastral fine-needle aspiration puncture of focal pancreatic lesions.
Mass lesions of the pancreas can be clearly visualized by endoscopic ultrasonography. For the differentiation of benign from malignant mass lesions, however, cytological examination is still recommended. As transcutaneous fine-needle biopsies have a limited diagnostic value, we have evaluated the efficiency of transmural (trangastral, transduodenal) endosonographically guided fine-needle aspiration (EUS-guided FNA) puncture for cytological confirmation of such pancreatic mass lesions. ⋯ It is concluded that transmural EUS-guided FNA puncture-with the application of a curved-array EUS transducer scanning parallel to the axis of the endoscope-is a new approach to the cytological diagnosis of pancreatic mass lesions. However, the of flexible puncture needles with a short needle tip-destined for multiple use-results in a considerable amount of false-negative diagnoses, as the needle tip frequently can only be advanced into the margin of the lesion. New prototypes of aspiration needles with an extending steel are presently under study for improved transmural EUS-guided FNA puncture.
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Bildgebung = Imaging · Mar 1995
[Possibilities and limits of a new color technique: ultrasound angiography--results of the "Heidelberg Round Table Discussion"].
Sonographic diagnostics has been essentially enlarged by blood flow measurements with the color Doppler technique. Nevertheless, the method has certain limitations, especially when employed to visualize extremely slow blood flow velocities, which occur e.g. in malignant tumors due to neovascularization. Recently, a new technique, the so-called angio-color procedure, has been presented, which is supposed to overcome the above-mentioned limitations. ⋯ In summary, ultrasound angiography can provide additional information in the color representation of vessels with slow flow velocities. However, an obvious problem is the unability to quantify detected low blood flow. The new procedure will not replace but usefully complete the established sonographic techniques.
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Bildgebung = Imaging · Sep 1994
Comparative Study[MR tomography of acute pancreatitis: initial results].
Magnetic resonance imaging (MRI) was evaluated for its potential in assessment of acute pancreatitis compared to computed tomography (CT). 15 patients with acute pancreatitis were examined using a routine protocol including T1- and T2-weighted sequences and a fat-suppressed T1-weighted spin-echo sequence. Gadopentant-Dimeglumin (Gd-DTPA) was given. ⋯ MRI failed to detect concrements. These first results show that, considering the latest development in technology, MRI is not inferior to CT in diagnostic imaging of acute pancreatitis.