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Biomedical subjects

E Grabbe

Publications and source records attributed to E Grabbe.

211 records · Page 12Linked to original sources
PubMed1979

[Radiologic investigations following abdomino-perineal resection of the rectum (author's transl)].

After abdominoperineal resection of the rectum specific alterations due to operation and disease can be distinguished. In over eighty percent the ureters and the urinary bladder are concerned. The topography of the small-intestine in the sacral cavity reveals alterations of the pelvic floor which generally are local recurrences of carcinoma. In both examinations special importance has to be laid on a lateral view of the pelvis. Indications and results of supplementary examinations are discussed. Computed tomography will deliver additional informations for the diagnosis of recurrent carcinoma; the value of CT is checked at the moment. Considering the amount and importance of treatable illness following resection of the rectum a standardized program for examination seems inevitable. Our experience with over 400 cases is, that this program can reveal important informations for postoperative care which up to now has often been underestimated, even from a radiologic point of view.

Colectomy↗
PubMed1979

[Computer tomographic findings after resection of the rectum (author's transl)].

Computed tomography findings in the pelvis after resection of the rectum, obtained from 48 patients primarily suspected of recurrent carcinoma, are represented. Compared with conventional radiographic methods CT demonstrates directly in most cases the presence of a pelvic mass, its extension and relationship to adjacent soft tissue. In some cases this is advantageous for further diagnostic procedures, but also for treatment and further check-up. False conclusions are discussed. The distinction between recurrent carcinoma and retroperitoneal fibrosis in the pelvis, frequently enhanced by retarded healing of the sacral cavity, remains a problem. Progress in the early diagnosis of recurrence of pelvic mass could be made by regular CT check-up during the first two years after resection of the rectum, to increase the value of palliative radiotherapy treatment indicated in any case. As CT, however, is expensive and not always available, this demand cannot be met and the value of conventional radiographic methods remains at present unquestioned.

Colectomy↗
PubMed1979

[Computed tomography of soft tissue sarcomas (author's transl)].

CT findings in 50 patients with histologically verified soft tissue sarcomas are presented. In nearly all the cases the cross-sectional view and the higher resolution of density make it possible to determine exactly location of the tumors, their size and relationship to adjacent structures. Thus CT opens a new dimension, which is of great value for staging and therapy treatment planning. The high rank of CT in the follow-up after therapy and the detection of recurrent tumor is demonstrated. The contribution of CT, however, to the anatomic characteristics and its prospective value with the regard to soft tissue tumor is less important. Further limits of the method are discussed.

Humans↗
PubMed1979

[Method and value of the opacified intestine in the computed tomography of abdomen (author's transl)].

In the examination of the intestine CT can deliver further information about diseases transgressing the intestinal wall or bordering on it. Sometimes, however, bowel loops filled with liquid can scarcely be distinguished from abdominal abnormalities. In these cases contrast material given orally or as an enema can facilitate the distinction and the identification of pathological patterns. The method of opacifying bowel loops is presented and demonstrated by several examples. Its value as well as its limits are discussed.

Adult↗
PubMed1979

[The unilateral pulmonary oedema (author's transl)].

6 cases of unilateral pulmonary oedema give rise to discuss the causes of the atypical distribution of pulmonary oedema by means of the literature on hand as well as to consider differential diagnosis in view of pulmonary infiltrates of other origin. Knowledge of the possible unilateral manifestation of pulmonary oedema is necessary to introduce early effective therapy.

Accidents, Traffic↗
PubMed1979

[Roentgenmorphology of the upper stomach after prophylactic reflux surgery (author's transl)].

The combination of vagotomy, of proximal and of total gastrectomy with antireflux-surgery can lead to a characteristic roentgenmorphology of the lower esophagus and the upper stomach. The fundoplication or hemifundoplication may have a tumorlike shape, may open up or may slide down. The knowledge of the preceding operation and of the symptoms allows a correct interpretation of the x-ray findings in most cases.

Deglutition Disorders↗
PubMedDate not supplied

MRI in the evaluation of müllerian duct anomalies.

OBJECTIVE: Müllerian duct anomalies (MDAs) result from nondevelopment or nonfusion of the müllerian ducts and occur in 1-5% of women. Accurate diagnosis of the various subtypes is of great importance as MDAs are frequently associated with a broad variety of clinical symptoms. Recently, evidence arose that MRI might play a major role in diagnosis of MDAs. We present four cases of diverse subtypes of MDAs and the corresponding MRI findings. MATERIALS AND METHODS: Patients (n = 4) with clinical suspicion of MDAs were examined with MRI. Coronal and transaxial T1- and T2-weighted images were acquired. Diagnosis was made and patients were grouped according to the American Fertility Society's classification. Patients underwent laparoscopy or laparotomy in order to confirm the diagnosis. RESULTS: MRI revealed MDAs in all patients. In detail, one patient was diagnosed with hypoplastic uterus, one with unicornuate uterus with a noncommunicating rudimentary horn, one with bicornuate uterus bicollis with a double vagina and one with septate uterus. MRI diagnosis was correct in all cases, as confirmed by subsequent surgical intervention. CONCLUSION: MRI is a valuable tool in diagnosis of MDA subtypes. Its use will help to spare patients mutilating surgery and to prevent pregnancy-associated complications.

Adult↗
PubMedDate not supplied

Detection of renal ischemic lesions using Gd-DTPA enhanced turbo FLASH MRI: experimental and clinical results.

PURPOSE: Our goal was to investigate the role of Gd-DTPA-enhanced dynamic MRI in the evaluation of renal ischemic lesions. METHOD: With a turbo FLASH sequence before and after injection of Gd-DTPA, nine foxhound dogs after 60-120 min of renal ischemia underwent MR examination. In addition, five patients with a tumor in a solitary kidney were examined before and after nephron-sparing renal surgery to evaluate renal perfusion and function. The experimental and clinical findings were correlated with conventional measurements of kidney function and with histological findings. RESULTS: Complete renal ischemia leads to a poor corticomedullary differentiation in Gd-DTPA-enhanced turbo FLASH MRI. The signal-intensity-versus-time plots of kidneys with significant postischemic changes show a less steep increase of signal intensity in the cortex and a steeper increase of signal intensity in the medulla than those of normal kidneys. CONCLUSION: Dynamic MRI demonstrate renal morphology and reflect the functional status of renal vasculature.

Aged↗
PubMedDate not supplied

CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation.

PURPOSE: Our goal was to demonstrate possible pitfalls in the CT diagnosis of retained surgical sponges (textilomas) and to evaluate the impact of gas bubbles inside a textiloma. METHOD: Thirteen patients with textilomas were investigated with CT 3 weeks to 8 years after surgery. Twelve of the 13 textilomas were removed within 3 weeks after the first CT examination. Eight samples of surgical sponges were placed in a water bath for 6 months. Serial CT was performed to document the presence and persistence of gas bubbles. RESULTS: The radiopaque marker inside the textiloma was seen in nine patients but did not lead to the diagnosis in all patients. In seven patients gas bubbles were found inside the textiloma with a typical pattern. None of these patients had an abscess formation. In vitro studies demonstrated gas bubbles in all surgical sponges scanned 1 h afterward. The number of gas bubbles was not significantly reduced after 6 months. CONCLUSION: The variable appearance of retained surgical sponges can lead to diagnostic misinterpretations. If present, typical spongiform pattern with gas bubbles is the most specific sign for the detection of textilomas but does not indicate an abscess formation.

Adolescent↗
PubMedDate not supplied

3D virtual endoscopy of the upper airway: optimization of the scan parameters in a cadaver phantom and clinical assessment.

Our goal was to evaluate the influence of the scan parameters on the 3D virtual endoscopy of the larynx and trachea and the clinical assessment. Helical CT (HiSpeed Advantage; GE, Milwaukee, WI, U.S.A.) of a cadaver phantom was performed with increased collimation (1-10 mm) and pitch (0.5-3). Seventy-two patients with complaints of the upper airways were investigated by virtual endoscopy and their results were compared with the findings of regular endoscopy. Best correlation between virtual endoscopy and anatomical findings, diagnostic quality of the axial slices, and useful longitudinal coverage of the examination were obtained with a collimation of 3 mm and a pitch of 1.5. Space-occupying tumors and stenosis were detected correctly, but the mucous membrane could not be visualized. 3D virtual endoscopy proved to be a valuable method for displaying anatomical structures. For an optimal protocol, a collimation of 3 mm with a pitch of 1.5 is recommended.

Endoscopy↗
PubMedDate not supplied

Diagnostic potential of ultrafast contrast-enhanced MRI of the breast in hypervascularized lesions: are there advantages in comparison with standard dynamic MRI?

PURPOSE: Our goal was to evaluate possible diagnostic advantages of ultrafast MRI of the breast in comparison with dynamic MRI. METHOD: Thirty patients with 35 hypervascularized lesions were selected prospectively after undergoing standard dynamic MRI (temporal resolution 87 s). Patients underwent additional ultrafast imaging (temporal resolution 2 s). Onset, rate, and pattern of enhancement were analyzed. RESULTS: Histopathology revealed 15 malignant and 20 benign lesions (3-40 mm). Enhancement pattern was centripetal in 2 benign and 4 malignant lesions, centrifugal in 5 and 3, and homogeneous in 13 and 8. The onset of lesion enhancement ranged from 3 to 13 s (parenchymal enhancement 4-14 s) and the rate of enhancement from 3 to 70%/s, both without any correlation to the histologic diagnosis. There was no significant difference between ultrafast and standard dynamic MRI. CONCLUSION: Ultrafast MRI does not provide additional information in comparison with standard dynamic MRI.

Adolescent↗
PubMedDate not supplied

Helical CT of the liver: evaluation of injection flow rate, mode, and scan delay with a reduced-volume contrast medium bolus.

OBJECTIVE: The impact of injection flow rates, mono- or biphasic injection mode, and scan delay on liver and portal vein enhancement with helical CT was evaluated. MATERIALS AND METHODS: The liver of 75 consecutive patients was examined with helical CT before and after injection of 100 ml iopromide (30 g of iodine). Patients were randomly assigned to three protocols: (1) injection flow: 2 ml/s; (2) injection flow; 4 ml/s (60 ml) + 2 ml/s (40 ml); and (3) injection flow: 4 ml/s. Scanning started 40 s after the beginning of contrast material injection. A second scan was performed 70 s after contrast agent injection in Protocol 1. RESULTS: Mean parenchymal contrast enhancement was highest with Protocol 3 (48.5 HU) followed by Protocols 2 (38.9 HU) and 1 (early: 21 HU; late: 30.7 HU), with all differences being significant (p < 0.01). Enhancement of the portal vein was significantly higher with Protocols 3 and 2 (121 and 118 HU) than with Protocol 1 (early: 64 HU; late: 75 HU). CONCLUSION: Good enhancement of the liver parenchyma and the portal vessels can be obtained with 30 g of iodine if a monophasic injection with a flow rate of 4 ml/s is used.

Adult↗