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Biomedical subjects

F Fobbe

Publications and source records attributed to F Fobbe.

At least 37 records · Page 2Linked to original sources

Liver tumors: follow-up with P-31 MR spectroscopy after local chemotherapy and chemoembolization.

The authors examined and quantified the changes observed in the phosphorus-31 magnetic resonance (MR) spectra of liver tumors after chemotherapy and chemoembolization to investigate the suitability of P-31 MR spectroscopy for follow-up. A 1.5-T unit was used before and at specific times during therapy to obtain spectra of liver tumors in 10 patients with liver metastases from colorectal carcinoma and two patients with hepatocellular carcinoma. A marked increase in inorganic phosphate and a decrease in the alpha- and beta-nucleotide phosphate portions of the spectra were observed during the first few hours after local chemotherapy or chemoembolization. Later, the phosphomonoester signals increased markedly and the phosphodiester signals decreased slightly. The effects of successful chemoembolization or local chemotherapy become apparent in the P-31 MR spectrum during the first few hours after the start of therapy. The results demonstrate that P-31 MR spectroscopy is a suitable method for follow-up. However, long-term studies are needed to determine whether it also yields prognostic information.

Carcinoma, Hepatocellular↗

[Color-coded duplex sonography of liver tumors. Does the blood supply permit a conclusion on staging?].

Real-time ultrasonography is a sensitive screening method in patients with suspected liver tumors. However, sonomorphology does not differentiate between benign and malignant tumors. In a prospective study we examined patients with liver tumors with color-coded duplex ultrasonography to find out whether the perfusion status of the liver tumor permits a differential diagnosis. A total of 108 patients with liver tumors were included, and the results of color-coded duplex sonography were compared with histology, MRI and CT. No correlation was seen between the final diagnosis and the perfusion pattern. The vascular status visualized by color-coded duplex ultrasonography does not permit differentiation between benign and malignant liver tumors.

Adolescent↗

[Color-coded duplex sonography and ultrasound contrast media--detection of renal perfusion defects in experimental animals].

The diagnostic use of microbubble consisting transpulmonary ultrasound contrast media in combination with color-coded duplex sonography (CCDS) has not been evaluated. Perfusion of the orthotopic kidney was therefore examined in an animal experiment with CCDS and transpulmonary echocontrast agent. The contrast agent consists of tiny stabilized air bubbles which survive the lung passage after peripheral venous injection and cause echo-enhancement of the arterial blood. The combination of CCDS and this contrast agent permits demonstration of the renal perfusion including the peripheral parenchyma. Even small experimental perfusion defects can be identified by this method. The use of this contrast agent in combination with CCDS might contribute significantly to the diagnostic potential of ultrasound.

Animals↗

[The demonstration of the patency of the uterine tubes with color-coded duplex sonography in combination with ultrasonic contrast media].

Tubal patency was studied in 17 sterile women by means of colour-coded duplex sonography (CCDS) with local injection of an ultrasonic contrast medium. The results were compared with a conventional hysterosalpingogram. CCDS demonstrated all the soft tissues and their mobility. The ultrasonic contrast medium was SH U 454 (Schering). The colour signals generated by the air bubbles makes it possible to demonstrate tubal patency on both sides. The combination of an ultrasonic contrast medium and CCDS provides a simple, rapid, accurate and safe method for demonstrating tubal patency. Tubal patency can be demonstrated in the presence of anatomical complications and requires only a small amount of contrast medium.

Adult↗

[Age determination of venous thrombi by ultrasound].

In addition to diagnosing deep-vein thrombosis of the lower limb and pelvis, determination of the age of the thrombus is of considerable importance in guiding treatment. The present study was done to find out whether thrombus age can be determined by ultrasound morphology. 138 examinations were carried out on 76 lower limbs with phlebographically demonstrated thrombosed veins. Diameter of the thrombosed vein, echogenicity of the thrombus and demarcation of the venous wall from its surroundings were determined by colour-coded duplex sonography. The results were compared with histological evidence or with the age of the thrombus as determined by history and clinical course. The diameter of the thrombosed vein in conjunction with the history and clinical data makes it possible to determine the age of a thrombus. Echogenicity of the thrombus and demarcation of the venous wall do not provide any reliable information on thrombus age.

Adult↗

[Diagnosis of deep leg vein thrombosis with color-coded duplex sonography and sonographic determination of the duration of the thrombosis].

In a prospective study, 188 patients with suspected deep venous thrombosis were examined by color-coded duplex sonography. In 114 patients the diagnosis of deep venous thrombosis was based on the criteria of 1) compressibility, 2) blood flow changes during compression, and 3) pelvic level during Valsalva maneuver. In all patients the results were compared with data from contrast venography. Venography was performed by an investigator, who was blinded to the prior findings. Sensitivity and specificity of the color-coded duplex sonography in diagnosing deep vein thrombosis were 96% and 97%, respectively. In the other 74 patients, in which the diagnosis of deep vein thrombosis was made by phlebography and/or ultrasound, a follow-up by color-coded duplex sonography was performed to determine the age of thrombosis. Criteria considered to determine the thrombus age included 1) margin of the vessel, 2) echogenicity; and 3) venous diameter. In 20 patients the results were compared to the age of thrombus that had been determined by histologic criteria (group I). In 54 patients the results were compared with the age that had been determined by patient history and symptoms (group II). A significant correlation was found between the age of thrombosis and the venous diameter (p less than 0.001). When thrombosis was less than 10 days old, the venous diameter was at least twice that of the diameter of the accompanying artery. The two other criteria, echogenicity and margin of the venous wall, however, did not prove to be accurate criteria to determine the age of deep venous thrombosis.

Adolescent↗

[Diagnosis of deep pelvic and leg vein thromboses by imaging procedures].

The gold standard for the diagnosis of deep venous thrombosis (pelvis and lower limb) is still phlebography--sometimes supplemented by DSA to clarify findings in the pelvic region. The indication for phlebography can, however, be markedly reduced by noninvasive procedures and restricted to the clarification of uncertain findings or the confirmation of the diagnosis for subsequent invasive therapy. Ultrasound techniques, particularly color-coded duplex sonography, presently appear to take priority among the noninvasive procedures.

Diagnostic Imaging↗

[Follow-up monitoring of kidney transplants with color-coded duplex sonography].

Fifty patients were examined immediately after renal transplantation by colour-coded duplex sonography. This procedure is a further development of conventional duplex sonography and permits demonstration of soft tissues in real time, as well as simultaneous imaging of blood flow over the whole imaging area. Perfusion of the transplant could be demonstrated in all patients by this method. Colour-coded duplex sonography can replace scintigraphy and angiography for the demonstration of perfusion of renal transplants. It is, however, not possible to distinguish with certainty between acute tubular necrosis and acute rejection by performing spectrum analysis of blood flow in the renal arteries.

Adolescent↗

[Improvement in the diagnosis of scrotal diseases using color-coded duplex sonography].

Two hundred and twenty-two patients with abnormalities of their scrotal contents were examined with colour-coded duplex sonography. The aim of this prospective study was to evaluate this new procedure for the investigation of the scrotal organs. Differentiation between testicular torsion and inflammation by colour-coded duplex sonography achieved 95% accuracy. The diagnosis of varicoceles was simplified and expedited (accuracy = 99%). In other abnormalities of the scrotum, particularly testicular tumours, a knowledge of the blood flow did not provide any important additional diagnostic information compared with conventional sonography.

Acute Disease↗

[Diagnosis of deep venous thrombosis of the leg using color-coded duplex sonography].

One hundred and twenty-nine lower limbs in 103 patients with suspected deep leg vein or pelvic vein thrombosis were examined by colour-coded duplex sonography and the results compared with phlebography. The deep veins could be demonstrated from the popliteal to the distal external iliac vein and internal structure and blood-flow could be evaluated. The procedure can diagnose not only occluding thrombus, but also thrombus with surrounding blood flow and post-thrombotic changes. Fresh venous thromboses can be recognised with a sensitivity of 96% and a specificity of 97%. Colour-coded duplex sonography is a simple, rapid and reliable method in all patients with suspected deep vein thrombosis. Our experience suggests that it can replace phlebography for the above-mentioned venous territories and problems.

Adult↗

Appearance of thyroid diseases using colour-coded duplex sonography.

One hundred and seventeen patients with various thyroid diseases were examined with colour-coded duplex ultrasonography permitting simultaneous real-time display of soft tissue and blood flow. Twenty-four out of 25 patients with an autonomous adenoma, all six patients with thyroid carcinoma and five out of 61 patients with simple nodular goitre showed increased vascularity. Absence of increased vascularity would seem an important parameter for the exclusion of autonomous adenoma and thyroid carcinoma in patients with nodular goitre.

Adolescent↗

[Initial clinical experiences with angiodynography].

Angiodynography is a further development of duplex sonography. In addition to high-resolution realtime visualisation of tissue this technique permits the simultaneous demonstration of the blood flow over the entire image. The flow information is added in color to the grey scale display. This procedure can replace more complex and/or invasive investigations in the monitoring of kidney grafts, differentiation of goitres, and in diagnosing the patency of deep veins of the legs, the inferior vena cava and the portal vein. The examination facilitates the diagnostics of the limb arteries, extracranial brain vessels and varicoceles.

Adenoma↗

[Tele-thermography in the diagnosis of deep leg and pelvic venous thrombosis].

The results of thermography were compared with those of phlebography in 235 patients with suspected deep venous thrombosis in the legs. Any thermal difference between the two sides was regarded as abnormal. On this basis, thermography had a sensitivity of 97%. Thermography is therefore a reliable, simple, non-invasive and repeatable examination for the exclusion of leg vein thrombosis.

Adult↗

Testicular cysts: differentiation with US and clinical findings.

In 34 of 847 patients (4%), testicular cysts were discovered with high-resolution ultrasound (US). Sixteen had a cystic testicular tumor, and US images showed multiple cysts and solid tumor portions in 12 of these 16 (75%). Eighteen patients had nonneoplastic cysts: Five had cysts of the tunica albuginea, and 13 had intratesticular cysts. All tunica albuginea cysts were palpable as small masses, and only US images showed that the masses were cystic. None of the 13 intratesticular cysts was palpable; all were accidentally discovered with US, which showed that 12 were single cysts with a marginal location (92%). On histologic studies, the nonneoplastic cysts were related to the spermatic ducts (rete testis, efferent ductules) and frequently appeared as postinflammatory alterations. Only five patients with intratesticular cysts were followed up with US, and no changes occurred. The combination of clinical and US findings facilitated the differentiation between nonneoplastic and neoplastic testicular cysts.

Adolescent↗

Günther vena caval filter: results of long-term follow-up.

A Günther vena caval filter was implanted in the inferior vena cava in 59 patients to prevent pulmonary embolism. This newly available device, which can be inserted percutaneously via a 10-French introduction system, has three filtering planes. No complications occurred at the puncture site. Follow-up included clinical examinations (54 patients), plain radiographs (50 patients), and CT scans (41 patients); these examinations were performed up to 21 months after implantation. Caudal migration of the filter occurred in 35 (70%) of the 50 patients who had radiographs, but no cranial or oblique movement occurred. Occlusion of the filter was noted in three (7%) of 41 patients who had CT examinations. Thromboemboli were seen inside the filter in 16 (39%) of the 41 patients who had CT scans. Recurrent pulmonary embolism was not observed after filter implantation. The Günther vena caval filter seems to be a satisfactory device for preventing pulmonary embolism.

Adult↗