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C Gückel

Publications and source records attributed to C Gückel.

32 records · Page 2Linked to original sources
PubMed1994

[The findings and value of computed tomography in pleural empyema].

Chest radiographs and CT images of 25 patients with pleural empyemas were compared retrospectively with those of 20 patients with pleural exudates and transudates in order to determine criteria for differential diagnosis and to define the place of CT in the diagnosis of pleural empyemas. The sign which was most suggestive of an empyema on a chest radiograph was an encapsulated effusion in an atypical position (18/25); this was found in only 4 out of 20 exudates and in none of the transudates. On CT, changes in the pleura, the subcostal tissues and the configuration and position of the fluid were suggestive of an empyema. In nearly all patients with a pleural empyema there was thickening and increased contrast uptake of the parietal pleura (22/25) and thickening and increased density oft the subcostal tissues (23/25). Usually, empyemas were encapsulated and biconvex (20/25). None of the patients with pleural transudates showed any of these changes. In the presence of some pleural exudates, pleural (14/20) or thoracic (11/20) changes were noted. In part, these changes were due to previous treatment (sclerotherapy) or tumour infiltration (7/20). An attempt to correlate the CT findings with changes in the pleura and subcostal tissues with the clinical empyema stages I-III, according to Light, showed that CT was unable to distinguish between early and late empyemas. Consequently, diagnostic aspiration remains necessary for correct treatment.

Adult↗
PubMed1993

[Magnetic resonance tomographic diagnosis of periarticular cystic space-occupying lesions in the knee joint].

The MR images of the knee joint of 100 successively examined patients were evaluated in retrospect with regard to periarticular cystic lesions. There were 18 popliteal cysts, 8 meniscal cysts and 4 ganglion cysts. Localisation and internal structure of the lesions were of main importance in respect of differential diagnosis. All meniscal cysts were associated with horizontal meniscal tears. Spin-echo and 3D gradient-echo images did not enable differentiation because of signal intensity values. A spin-echo sequence with long repetition time in double-echo technique was best suited to assess the periarticular cystic lesions as well as the intraarticular pathological changes which were often concomitant.

Adult↗
PubMed1992

[NMR tomography in plasmacytoma].

In 20 patients with multiple myeloma, the results of MR, x-ray, bone scintigraphy, bone marrow scintigraphy and bone marrow biopsy were compared. MR proved the most sensitive imaging method for the detection of bone marrow infiltration followed by x-ray examinations. Bone marrow scintigraphy and especially bone scintigraphy revealed false-negative results more often. These findings were more impressive by the direct comparison of several investigated regions showing different findings of each imaging method. False-positive results were not found. In 4 patients false-negative results of bone marrow biopsy had to be assumed because of definitely pathological findings by x-ray and MRI.

Aged↗
PubMed1990

MRI of the knee region in leukemic children. Part II. Follow up: responder, non-responder, relapse.

Part II demonstrates the results of MRI follow up studies of 23 children with leukemia. Differentiation between leukemic cells and normal hematopoiesis by MRI is impossible. The state of disease can only be determined together with bone marrow biopsy. Clinical remission precedes the normalization of bone marrow signal by weeks. In non-responders, however, cytological findings and MRI findings seem to correlate at the same time. During therapy, areas of osteonecrosis may develop. They do not necessarily contradict continuing complete remission. But this does not affect the prognosis and complete remission is still a possibility. Diagnosis of relapse by MRI is only possible in correlation with studies during the different states of disease especially at clinical remission.

Adolescent↗
PubMed1990

[Nuclear magnetic resonance tomographic diagnosis of brain tumors in children and adolescents. A comparison with computed tomography].

Thirty-one pediatric patients with brain tumors--25 primarily diagnosed, 6 recurrences--underwent MR and CT examinations before and after application of contrast media. Tumor detection, delineation of the tumor extent and definition of the tumor type were compared. Gd-DTPA-enhanced MR was superior in delineating the extent of primarily diagnosed tumors, which showed enhancement (n = 22). The tumor detection (1/6) and the identification of the tumor margins (5/6) were improved by Gd-DTPA in the 6 recurrences. Tumors without enhancement (n = 3) were judged by T2-weighted images better than by CT. The results suggest that Gd-DTPA is indicated for the evaluation of brain tumors in pediatric patients as well, especially since it offers advantages distinguishing between tumor types. Only the detection of tumor calcifications, which is rarely specific, is not possible by MR.

Adolescent↗
PubMed1989

Mycoplasmal pneumonias in childhood. Roentgen features, differential diagnosis and review of literature.

The chest radiographs of 23 children, aged between 4.2 to 15.4 years with serologically proven mycoplasmal pneumonia were reviewed and correlated with the findings in literature. Three different patterns of infiltration were seen in equal frequency: 1) peribronchial and perivascular interstitial infiltrates, 2) patchy consolidations and 3) homogeneous acinar consolidations like groundglass. The lower fields of the lungs were mostly affected. Pattern 1 was always observed bilaterally. Enlargement of the hilar glands was a common finding. Pleural effusion was rare. Numerous differential diagnoses, especially viral pneumonias, feature the heterogeneity of the infiltration patterns. As no pattern is pathognomonic for mycoplasmal pneumonia clinical symptoms and signs, the epidemiological situation and laboratory data may confirm the diagnosis.

Adolescent↗
PubMed1989

[Nephrocalcinosis in childhood. Sonographic findings and differential diagnosis].

Ultrasonography is the method of choice for the detection of medullary or cortical nephrocalcinosis in infancy and childhood. Compared with abdominal radiographs and computed tomography even smallest calcifications are detected more accurately. Using furosemide, ACTH, steroids or high doses of vitamin D, early forms of medullary nephrocalcinosis associated with a faint hyperechogenic rim at the margins of the renal pyramids can be diagnosed by ultrasound. Idiopathic hypercalciuria, Bartter's syndrome and renal tubular acidosis cause medullary nephrocalcinosis, whereas cortical nephrocalcinosis is the result of renal vein thrombosis; primary hyperoxaluria is associated with cortico-medullary calcifications. Due to the localisation of the nephrocalcinosis and the age distribution of the diseases, sonography merely enables us to narrow down differential diagnosis.

Aging↗
PubMed1989

[Duplex sonography and magnetic resonance tomography in the clarification of nephrologic complications following kidney transplantation].

A prospective study compared duplex sonography and magnetic resonance imaging in evaluating renal transplants. One hundred and two duplex sonographic and 24 MR examinations were performed and correlated with clinical course or biopsy. All normal renal allografts, 6 transplants with acute tubular necrosis and 2 cases of cyclosporin toxicity had normal Doppler waveforms, whereas 9 renal transplants with evidence of interstitial rejection by biopsy showed an obliteration or reversal of diastolic flow. MR imaging was less specific in identifying allograft rejection. There were false positive results in normal renal transplants, allografts with acute tubular necrosis and after rejection therapy. With regard to cost, accessibility and specificity, duplex sonography is the method of choice for the evaluation of renal allografts.

Adult↗
PubMed1988

[Duplex sonographic findings following kidney transplantation-- possible value in the diagnosis of graft rejection].

59 prospective duplex ultrasound studies have been performed on 30 patients after renal transplant to assess the feasibility of detection of acute rejection. The results were compared with clinical, biochemical and histopathologic findings. Real time ultrasound was not a reliable method in predicting acute rejection. Doppler sonography, however, characteristically showed a diminished diastolic blood flow in all cases of acute rejection. Acute tubular necrosis and cyclosporine toxicity were not provable, neither by real time ultrasound nor by doppler sonography. Duplex ultrasound combines the advantages of both methods in detecting perirenal fluid collections, hydronephrosis and acute transplant rejection.

Adult↗
PubMed1988

[Possible computed tomographic and magnetic resonance tomographic detection of wood foreign bodies following perforating eye injuries].

After perforating eye injury the retention of a foreign body in the orbits has to be excluded. Wooden foreign bodies mostly have negative density on CT, which increases later as a result of granulomatous changes. On MRI, pieces of wood appear with low signal intensity, and only in some cases is a collar-shaped structure recognizable, allowing differentiation from gas. Soon after orbital trauma with splinters of wood, therefore CT allows better differentiation of pieces of wood from intraorbital gas by measurement of their density, whereas MRI, makes it possible to demonstrate wooden foreign bodies in older injuries in spite of granulomatous changes.

Eye Foreign Bodies↗
PubMed1987

[Sonographic findings in complications of cystic echinococcosis].

Apart from the difficult differential diagnosis of hydatid liver disease, diagnostic problems may increase in chronic disease because of complications. Compression or infiltration of bile ducts is the most common complication occurring in 16%. Other complications are infiltration of adjacent organs and structures, for instance the right kidney and the diaphragm, or the (often iatrogenic) rupture of hydatid cysts with intraperitoneal spread. Preoperative sonographic diagnosis is important in influencing the surgical procedure.

Adult↗
PubMedDate not supplied

A comparison of methods for enhancing the detection of areas of decreased attenuation on CT caused by airways disease.

PURPOSE: The purpose of this work was to investigate thin section CT image enhancement of subtle areas of decreased attenuation of the lung parenchyma in suspected airways disease. METHOD: Forty-seven consecutive patients with chronic sputum production underwent pulmonary function tests and high resolution CT (HRCT). Single section inspiratory (INSP), expiratory (EXP), and minimum intensity projection (MINIP) images through the lower lobes were acquired. A histogram stretch was applied to the INSP and MINIP images, generating two further image formats. The five image types were compared for the extent of decreased attenuation, observer confidence, and correlations with pulmonary function tests. RESULTS: Interobserver variation was lowest with MINIP images (mean weighted K: MINIP 0.70, INSP sections 0.65, other image formats < or =0.48). Observers were most confident with EXP and MINIP images. EXP sections identified more disease than MINIP images (p<0.001). Correlations with pulmonary function tests were similar for each image format. CONCLUSION: The HRCT changes of small airways disease are enhanced with image postprocessing. MINIP images are associated with increased observer confidence and agreement as compared with HRCT alone.

Adult↗