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Biomedical subjects

B Marincek

Publications and source records attributed to B Marincek.

At least 19 recordsLinked to original sources
PubMed1992

[Magnetic resonance tomography in malignant genital tumors].

Magnetic resonance imaging (MRI) is a valuable noninvasive method for evaluating the female and male pelvis. The advantages of MRI include direct multiplanar imaging and excellent contrast resolution. The superb soft-tissue contrast provides unique depiction of the characteristic zonal architecture of the uterus, vagina and the prostate. The role of MRI in the pre- and posttherapeutic evaluation of carcinoma of the endometrium, cervix, ovaries, vagina and prostate is described. Our own experience with patients with a suspected tumor recurrence shows that MRI is able to distinguish tumor recurrence from posttherapy fibrosis if the interval between therapy and MRI is more than one year. MRI seems not to be useful in differentiating these entities at an early stage after treatment.

Diagnosis, Differential↗
PubMed1992

Pancreatic and hepatic abscesses: a late complication in 10 patients with chronic pancreatitis.

In this prospective long-term study of chronic pancreatitis (n = 336) over the last 3 decades, 10 patients with advanced calcific pancreatitis developed a sepsis associated with intra-abdominal abscesses (6 pancreatic, 4 hepatic). None of the known precipitating factors were present (e.g., no pancreatic necrosis or recent surgical/endoscopic interventions, no evidence of cholangitis). Nine of 10 patients had alcoholic chronic pancreatitis. Interestingly a pancreatojejunostomy in 9 of 10 patients had been performed up to 12 years previously. Cultures from abscess aspirates and/or blood were polymicrobial, mainly a mixed enteric flora in 8 patients. All patients recovered after an appropriate antibiotic therapy with or without drainage procedures. The pathogenesis of "spontaneous" abscess formation in advanced chronic pancreatitis and its relationship to pancreatojejunostomy remain to be established.

Abscess↗
PubMed1992

[The importance of magnetic resonance tomography in the diagnosis and staging of renal cell carcinoma].

The use of magnetic resonance imaging (MRI) for diagnosis and preoperative staging of renal cell carcinoma was evaluated in 79 patients with 88 tumors. Gradient-echo and spin-echo images before and after intravenous administration of Gadolinium-DTPA were compared with the results of computed tomography (CT) and histologic staging. The two imaging techniques had comparable results: T-stage was predicted correctly with CT in 78.4% and with MRI in 84.0% of the cases, while the N-stage was accurately assessed in 81.8% and 79.5%, respectively. MRI had some advantages in diagnosing perirenal tumor spread and in excluding an infiltration beyond Gerota's fascia. Therefore, MRI is a true alternative to CT for staging large renal cell carcinomas and especially for patients with contraindications for iodinated contrast agents.

Adult↗
PubMed1991

[Cervical carcinoma staging with magnetic resonance tomography: the use of gadolinium-DOTA with 31 patients].

Thirty-one patients with histologically proven carcinoma of the cervix were studied by contrast-enhanced MRI. T2-weighted sequences in a spin-echo mode and T1-weighted sequences were carried out before and after the application of Gd-DOTA. This resulted in improved staging. Contrast-enhanced MRI provided valuable additional information concerning tumour extension into the parametrium. In the presence of motion artifacts and ill-defined infiltration into the parametrium on the T2 sequences, the use of contrast-enhanced T1 images provided a valuable addition to the investigation of carcinoma of the cervix.

Adult↗
PubMed1991

Failure of MR imaging to detect reflex sympathetic dystrophy of the extremities.

Reflex sympathetic dystrophy of the extremities is a disease with a wide spectrum of clinical manifestations. It is characterized by pain, hyperthermia, and cutaneous changes and has been linked to an abnormality of regional blood flow. The disease is associated with previous injury or trauma including surgery, but also has been found in association with myocardial infarctions and tumors. The final diagnosis can be made only on the basis of the clinical course, which is characterized either by regression without sequel or the appearance of aponeurotic and tendinous retractions including bony sclerosis in the affected region occurring over many months to years. The literature and our own results show that MR imaging has high sensitivity for diagnosing transient osteoporosis of the hip, which is generally thought to be a form of reflex sympathetic dystrophy. Therefore we investigated the usefulness of MR imaging for diagnosing sympathetic dystrophy of the extremities. Twenty-five patients underwent T1- and T2-weighted MR imaging of the affected body region. They were selected on the basis of the initial clinical findings and positive findings on scintigraphy, which is known to be a sensitive, but not very specific, imaging method for sympathetic dystrophy. The final diagnosis was established on the basis of the clinical course in 17 of the 25 patients. In 10 of these, findings on MR images were completely normal, in six the MR images showed only nonspecific soft-tissue changes or bone marrow sclerosis, and in one patient they showed changes in bone marrow signal. Of the remaining eight patients without a final diagnosis of sympathetic dystrophy, MR showed soft-tissue or bone marrow alterations in six. MR imaging appears to be of little value in establishing the diagnosis of sympathetic dystrophy, but it may improve diagnostic specificity when used in conjunction with scintigraphy.

Adult↗
PubMed1990

[MRI indications in the diagnosis of joint diseases].

Magnetic resonance imaging (MRI) is the method of choice in depicting avascular bone necrosis, occult fractures, and internal lesions of the knee. MRI is a complementary examination in other pathologies of the joints such as rotator cuff tears, limbus lesions, carpal tunnel syndrome, and traumatic or inflammatory lesions of hand and foot ligaments.

Adult↗
PubMed1990

[Skin spots, skin nodules, gangrene of the toes].

A 42-year-old man with multiple cutaneous neurofibromacules, café-au-lait and gangrene of toes was diagnosed having neurofibromatosis in 1976. An aortography performed because of severe hypertension had shown a coarctation and bilateral renal artery stenosis in 1982. Conservative antihypertensive therapy with an ACE-inhibitor, a vasodilatating agent and a diuretic resulted in gradual normalisation of blood pressure values. A recent follow-up revealed minimal progression of neurofibromatosis and hypertensive lesions documenting a benign course for over 13 years.

Adult↗
PubMed1990

[Gd-DOTA in musculoskeletal diseases].

T1-weighted images after the injection of Gd-DOTA, a new paramagnetic contrast medium, were compared with non-enhanced T2-weighted images in 42 consecutive cases of musculoskeletal pathology. In addition we evaluated the incidence of side effects. Enhanced T1-weighted images were superior in depicting the various parts of a lesion and the borders between the lesion and normal tissue or perifocal reaction. On the other hand the non-enhanced T2-weighted images better depicted the border between the perifocal reaction and normal tissue. In aggressive lesions, especially in malignant tumours, the two sequences are complementary. Enhanced T1-weighted images did not contribute significantly to assessing benign lesions. The incidence of side effects was acceptable and no severe reactions occurred.

Adolescent↗
PubMed1990

[MR pelvimetric reference values].

Complete pelvimetry can be easily performed via MR. As shown by comparing the measurements of 4 observers its reproducibility is acceptable. The reference diameters obtained on 53 patients by MR are in 7 out of 9 dimensions larger than those of anatomical and obstetrical textbooks, which have not changed in the last 100 years. Hence, with the general increase in population size an increase in pelvic diameters has taken place.

Adolescent↗
PubMed1990

[MRT and CT in alveolar echinococcosis of the liver].

To compare the value of MRI and CT in evaluating hepatic alveolar echinococcosis a study was conducted on 30 patients. The liver was initially affected in all patients. At the time of examination, 15 patients had undergone partial liver resection. MRI showed no advantage over CT in demonstrating an echinococcal mass lesion. MRI was superior in identifying concomitant pathological changes of the intrahepatic and extrahepatic venous system due to the intrinsic contrast of vascular structures. However, CT was superior in identifying calcifications, an important attribute of the disease. MRI should only be used in imaging alveolar echinococcosis of the liver if diagnostic questions remain open after CT, in particular questions concerning venous pathology. MRI may also be used to replace CT in patients with a contraindication to urographic contrast material.

Adult↗
PubMed1989

The impact of computed tomography in the diagnosis and postoperative follow-up of ureteric obstruction in aorto-iliac aneurysmal disease.

Between 1979, the advent of computed tomography in our institution, and 1987 we have treated 520 aorto iliac aneurysms surgically, almost 2/3 on an elective basis, the others (183 = 35.2%) being ruptured. Among non-ruptured aneurysms 220 were symptomatic and 19 of 20 cases with ureteric entrapment occurred in these patients corresponding to 8.6% of this subgroup and verified at surgery. In all of these cases the association between ureteric obstruction and the underlying aneurysmal disease was clearly documented by computed tomography. In 8 patients ureteric entrapment was caused by an inflammatory aneurysm, in 12 cases by an arteriosclerotic aneurysm which in one case was a largely expanded internal iliac aneurysm left behind during previous surgery for a ruptured aorta aneurysm. Postoperative follow-up studies of the 8 patients with an inflammatory aneurysm revealed a time-dependent regression heading towards complete disappearance of perivascular fibrosis. Because of potential difficulties associated with the surgical treatment of inflammatory aneurysms it is important to identify perivascular fibrosis and its extent and localization pre-operatively, which can only be achieved by a CT scan. Simultaneously, CT offers information concerning the presence and degree of pyelectasis and calyceal dilatation, identifies the localisation of ureteric entrapment, defines the extent of aneurysmal disease of the iliac arteries, is best-suited for postoperative follow-up in all of the cases and has the most to offer if contrast medium investigations are contra-indicated in the presence of renal insufficiency. Probably the main reason, if not the only one for preoperative angiography, is to demonstrate associated anomalies of the visceral arteries the state of which however, can be just as well assessed by duplex sonography. Thus, computed tomography is the single most important diagnostic tool in the assessment of aorto-iliac aneurysmal disease especially when associated with ureteric entrapment.

Aged↗
PubMed1989

[Pelvimetry with magnetic resonance tomography].

Magnetic resonance imaging (MRI) in the mediosagittal and transverse planes was used to measure the antero-posterior and transverse diameters of the minor pelvic cavity. The measurements for the diameters were larger than those usually found in the literature. The antero-posterior pelvic inlet diameter, the most important measurement for obstetrics, was on average 11.9 cm in contrast to the generally accepted length of 11.0 cm.

Adolescent↗
PubMed1989

Magnetic resonance imaging and computed tomography in long-term-functioning duct-occluded pancreas allotransplants.

Duct-occluded segmental-pancreas transplants develop progressive fibrotic atrophy, even though endocrine function seems to be unaffected. To determine end-stage size of the graft and to evaluate magnetic resonance imaging (MRI) and computed tomography (CT), these imaging techniques were applied in eight patients with well-functioning intraperitoneal prolamine-injected segmental-pancreas transplants for 79, 48, 35, 20, 19, 19, 18, and 10 mo. MRI was performed on a 1.5 Tesla system (Philips Gyroscan S15). T1- and T2-weighted images were acquired. CT (Siemens Somatom 2) was done before and after intravenous contrast agent. The graft was visualized in seven of eight patients with both techniques. Visualization with MRI (vs. CT) was considered excellent in 2 (vs. 1), good in 3 (vs. 6), and poor in 2 (vs. 0). The three grafts with function longer than 2 yr measured 3-4 cm in length; the remaining grafts measured 3-6 cm. Because of a marked decrease in size the transplants were no longer localized in Douglas' pouch but adjacent to or on top of the uterus or bladder, the position depending on the volume of these organs. The allografts exhibited an inhomogeneous structure with casual cystic degeneration visible with MRI due to a high signal intensity on T2-weighted images. This study suggests that shrinkage of the duct-occluded pancreatic segment due to exocrine atrophy may be terminated after approximately 2 yr. It is concluded that thereafter an overshooting fibrosis causing late endocrine graft failure may not be anticipated.

Adult↗