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C Wagner-Manslau

Publications and source records attributed to C Wagner-Manslau.

18 recordsLinked to original sources

[Intractable and atypical benign paroxysmal vertigo. Pathological results of high-resolution three-dimensional MR-tomography of the vestibular organ].

Benign paroxysmal positional vertigo (BPPV) is the most frequent vestibular disorder and a most common cause of dizziness and vertigo. The modern canalolithiasis theory postulates the existence of free-floating dense otolithic particles in the endolymph of the posterior semicircular canal. The symptoms were exactly described by Dix and Hallpike; BPPV is normally a self-limited disease with spontaneous recovery. There is however a small number of patients who do not respond to any treatment or who present with otolithic vertigo which does not fit all Dix-Hallpike criteria (atypical BPPV). While BPPV in its typical appearance cannot be diagnosed with radiologic imaging, the authors succeeded in identifying structural changes in the vestibular organs of patients suffering from intractable or atypical BPPV using three-dimensional magnetic resonance imaging.

Aged↗

Comparison of fluorine-18-fluorodeoxyglucose PET, MRI and endoscopy for staging head and neck squamous-cell carcinomas.

UNLABELLED: Accurate, preoperative assessment of tumor extent and lymph node involvement is mandatory for individualized therapy in patients with squamous-cell carcinomas (SCCs) of the head and neck region. Metabolic imaging, [18F]fluorodeoxyglucose (FDG) PET and MRI were compared with postoperative, histologic tissue characterization. METHODS: Dynamic and static PET with 370 MBq [18F]FDG up to 60 min postinjection and MRI were compared prospectively in 22 patients with head and neck SCCs. PET results with and without attenuation correction were compared with postoperative T and N stages based on pathologic findings. RESULTS: Kinetic characteristics and tracer uptake intensity were similar in primary tumors and lymph node metastases. In both, FDG uptake did not reach a plateau phase 60 min postinjection. There was no statistically significant correlation of FDG uptake with plasma glucose level or histologic grading. All primary tumors were clearly demonstrated by PET, which tended to overestimate tumor size. The sensitivity and specificity for detecting individual lymph node involvement were 90% and 96%, respectively, for PET and, thus, significantly higher for MRI (78% and 71%, respectively; p < 0.05). N stages were correctly identified by MRI in only 4 patients; PET correctly staged lymph nodes in 15 of 17 patients. Based on "neck sides", the sensitivity and specificity were higher for PET, 89% and 100%, respectively, compared with MRI values of 72% and 56%, respectively. CONCLUSION: FDG-PET may be helpful in detecting occult primary tumors with positive lymph nodes.

Adult↗

[Detection of somatostatin receptors in tumors in the area of the head and neck and their clinical importance].

The development of a radiolabelled somatostatin analogue Indium-111-Pentetreotide makes the detection of somatostatin receptor-bearing tumours by scintigraphic techniques possible. The existence of high-affinity binding sites for somatostatin has been described previously for most endocrine active tumours of the gastroenteropancreatic system (GEP), malignant lymphomas, small cell lung carcinomas, a subgroup of breast tumours and several types of neuroendocrine related human tumours. Using this new diagnostic tool we investigated some head and neck tumours of neuroendocrine origin (carcinoid of larynx, Merkel cell carcinoma, paragangliomas) with the newly developed radiolabelled somatostatin analogue Indium-111-Pentetreotide whether in vivo visualisation of somatostatin receptors might be possible. In cases not accessible for surgery but with a positive receptor status we started a specific therapy with the somatostatin analogue octreotide. The preliminary results suggest that this new isotopic scanning technique in a diagnostic tool and a predictive method for an effective therapy of those head and neck tumours which revealed highly specifically a positive receptor status. The therapeutical results using the somatostatin analogue octreotide indicate that this new concept is an ideal therapeutic strategy for those neuroendocrine head and neck tumours which cannot be controlled by surgical procedures.

Adult↗

[The weighting of SE, IE and GE sequences in tumors of the head and neck].

In a review of 82 patients having different benign and malignant head and neck tumours we studied the value of spin echo (SE), inversion echo (IE) and gradient echo (GE) sequences. The strong T1 weighted IE mode is highly sensitive to demonstrate pathological tissue. Tumour diagnosis was in 20% and lymph node diagnosis in 29% better than T2 weighted SE sequences. According to this experience we choose the IE mode as the first one for all patients examined for tumour staging. All other sequences and orientations are planned on this tomograms knowing the location of the tumour and lymph nodes. T1 weighted SE mode is indispensable and should be recorded in transversal orientation, covering the whole head and neck region. This mode has the best imaging of anatomical structures as the known fatty limitations. The best differentiation of the tumour is usually obtained after contrast enhancement by i.v. Gd-DTPA. The highest contrast enhancement is seen on T1 weighted GE tomograms, which we prefer. T2 weighted SE sequences are less sensitive than IE sequences and T1 weighted tomograms after Gd-DTPA to show the tumour. The T2 weighted SE mode cannot be replaced by the T2 weighted GE mode having a better signal to noise ratio. To minimise the scan-time of T2 weighted SE mode, only one measurement is performed; the quality of the tomograms is satisfactory.

Adult↗

[Computed tomography of the menisci].

Thirty patients were examined with CT of the menisci. All findings were confirmed by arthroscopy. One false positive diagnosis of a torn meniscus was made, caused by partial volume effect. In seven patients with irregular degenerative changes of the menisci, the abnormality could be clearly demonstrated. One meniscus ganglion was shown. Seven meniscus lesions, which were not shown by arthrography or arthroscopy, were clearly demonstrated by CT. The computer tomographic demonstration of menisci can replace knee arthrography as the examination of choice and should be performed before carrying out arthroscopy.

Adult↗

[Computed tomographic findings in amebiasis].

With an increase of travel to foreign countries with endemic amoebiasis we will find this disease also in western countries. The typical pathologic changes can be identified in CT, as we report in a case with proved amoebiasis which showed an abscess in the bowel-wall and another in the neighbouring liver.

Adult↗

High-resolution three-dimensional magnetic resonance imaging of the vestibular labyrinth in patients with atypical and intractable benign positional vertigo.

Benign paroxysmal positional vertigo (BPPV) is a most common cause of dizziness and usually a self-limited disease, although a small percentage of patients suffer from a permanent form and do not respond to any treatment. This persistent form of BPPV is thought to have a different underlying pathophysiology than the generally accepted canalolithiasis theory. We investigated 5 patients who did not respond to physical treatment, presented with an atypical concomitant nystagmus or both with high-resolution three-dimensional magnetic resonance imaging of the inner ear. This method provides an excellent imaging of the inner ear fluid spaces. In all 5 patients, we found structural changes such as fractures or filling defects in the semicircular canals which we did not find in control groups. One patient clinically presented with the symptoms of a 'heavy cupula'. Whereas crosssections through the ampullary region and the adjoining utricle showed no abnormalities, there were significant structural changes in the semicircular canals, which are able to provide an explanation for the symptoms of a heavy cupula.

Adult↗