PubMed Health⌕ Search

Biomedical subjects

G Mostbeck

Publications and source records attributed to G Mostbeck.

At least 19 recordsLinked to original sources
PubMed2007

[Radiologic diagnosis of lung tuberculosis].

The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease.

Adult↗
PubMed2005

Case report: Gluteal injection site granulomas: false positive finding on FDG-PET in patients with non-small cell lung cancer.

Positron-emission-tomography (PET) with fludeoxyglucose F-18 ([(18)F] fluoro-2-deoxy-D-glucose, FDG) has become an established imaging modality in patients with lung cancer for mediastinal lymph node staging and the detection of extrathoracic metastases. However, tracer accumulations are not limited to malignant tissue but are also found in muscles and benign inflammatory processes. We report on two patients with lung cancer in whom FDG-PET revealed suspicious tracer accumulations in the buttock. Ultrasound (US) revealed a hyperechogenic nodule with poorly defined margins in both patients. On specific inquiry both patients reported on repeated "intramuscular" gluteal injections. Histology after US guided biopsy showed an accumulation of macrophages within fibrous tissue, compatible with injection site granulomas. The reported cases underline that (18)F-FDG may accumulate in benign, ancillary processes that have to be distinguished from distant metastases. Tracer accumulation in the buttocks may be highly suggestive of injection site granulomas, especially if the patient reports on "intramuscular" injections. In this setting, US is a widely available modality to distinguish metastasis from adipose tissue necrosis.

Adipose Tissue↗
PubMed2004

[Evaluation of a portable ultrasound device immediately after spiral computed tomography].

AIM: Portable ultrasound devices are an established diagnostic tool. They are frequently used in trauma and emergency wards. Multidetector computed tomography (MD-CT) represents the standard imaging method for many diagnostic questions. In some patients, however, there are findings on CT which remain unspecific. In these cases, a complementary ultrasound (US) examination may help to obtain a specific diagnosis. Aim of this study is the evaluation of a portable US device immediately after MD-CT for further work-up of unclear lesions. METHODS: 257 MD-CT examinations were performed during a 3-week period. A portable US device (LogiqBook, GE Medical Systems, Solingen, Deutschland) was used when a lesion found at MD-CT remained unclear. Time intervals between CT and US as well as US examination times were registered. RESULTS: US was used in 23 of 257 CT examinations (8.9 %), but 3 of these examinations had to be terminated due to unfavourable US conditions. Thus, there remained 19 questions regarding parenchymal lesions in the liver (n = 13), kidney (n = 1) or suprarenal gland (n = 2). Pleural empyema was suspected in the 4 remaining patients. In all of the 20 patients, US helped to narrow down the differential diagnosis of MD-CT results. The mean time span between CT and US was 2.5 min, and the mean US examination time was 6.5 min. CONCLUSION: Portable US immediately after MD-CT helps to narrow down the differential diagnosis of hepatic and pleural lesions with minimal additional effort in time and organization.

Adrenal Gland Diseases↗
PubMed2003

["Disappearance" of retroperitoneal vessels - a case report].

We report the ultrasound findings in a case of pneumo-retroperitoneum. The 74-year-old patient was admitted because of severe dyspnoea. Chest X-ray revealed a left-sided pleural effusion, and a drainage was performed. Later on the patient for the first time complained about severe pain in the lower abdomen. Ultrasound of the abdomen was performed. Sonographically, it was remarkably difficult to obtain images of the right kidney and the retroperitoneal vessels, as massive reverberation artifacts in the retroperitoneum were present. Plain radiography of the abdomen revealed free retroperitoneal and intraabdominal gas. At laparotomy a perforated diverticulitis of the sigma was discovered. Postoperative follow-up was uneventful, but the recurrent pleural effusion was later confirmed to be due to a malignant mesothelioma. This article discusses the characteristic sonomorphologic features of pneumo-retroperitoneum and its differential diagnosis. Although free retroperitoneal air is a rare condition, it is crucial for the examiner to be aware of the characteristic sonographic findings in order to initiate appropriate therapy.

Aged↗
PubMed2001

Treatment of a malignant stenosis of the corpus of the stomach with a self-expanding stent.

In a 50-year-old man, a self-expandable stent was implanted under fluoroscopic guidance to treat symptoms of an inoperable carcinoma of the corpus of the stomach. Foreshortening of the stent necessitated implantation of a proximal extension stent 5 weeks later. Secondary symptoms of advanced stage of the disease negatively influenced clinical success of the procedure, although free passage through the stents was achieved. We conclude that stent implantation for palliation of a carcinoma of the corpus of the stomach seems to be a viable method. The operator has to be aware of the special limitations and problems associated with the procedure.

Esophageal Stenosis↗
PubMed2001

Inferior mesenteric artery as outflow vessel in endoleaks after abdominal aortic stent-graft implantation: 36-month follow-up CT study.

The aim of this study was to determine the role of the inferior mesenteric artery (IMA) as an outflow vessel in endoleaks after abdominal aortic stent-graft implantation. Forty consecutive patients in whom abdominal aortic aneurysms (AAA) had been treated with stent-graft implantation were evaluated retrospectively. Spiral-CT examinations and angiographies up to 36 months after implantation were analyzed. In 29 (73%) of the 40 patients the IMA was perfused prior to implantation. In 5 (17%) of these 29 cases, the artery remained perfused after stent-graft insertion. In all 5 cases, endoleaks were detected; however, in none of these cases was the IMA the sole cause. In 3 of these 5 cases, angiography showed antegrade flow in the IMA. Implantation of extension stent grafts caused thrombosis of the aneurysmal sac and the IMA. There were no secondary endoleaks caused by the IMA at the 36-month follow-up examinations. The majority of IMAs which are patent prior to intervention occlude after successful stent-graft insertion. In cases with leaks and angiographically proven antegrade flow in the IMA, implantation of extension stent grafts is a therapeutic alternative to embolization. In this study, the IMA was not responsible for secondary endoleaks.

Aged↗
PubMed2000

[Spontaneous healing of retroperitonea fibroasis after successful therapy of sigmoid carcinoma].

In a 64 year old man sigma cancer was diagnosed unexpectedly during an operation for retroperitoneal fibrosis (histologically benign fibrosis), that had caused unilateral hydronephrosis. In the following hemicolectomy this tumor of the colon turned out to be a medium high grade adenocarcinoma (tumor staging pT2, pN1, DUKES C). Chemotherapy with 450 mg/m2 5-FU once a week and a concomitant therapy with laevamisol was added for 6 months. Computer-tomography revealed a significant reduction of the retroperitoneal masses already before induction of chemotherapy. One year after termination of chemotherapy retroperitoneal fibrosis was no longer detectable. The course of events makes us assume that the retroperitoneal fibrosis of our patient was paraneoplastic and therefore completely reversible by successful removal of the underlying tumor.

Adenocarcinoma↗
PubMed1999

Amplitude-coded color doppler: clinical applications.

Amplitude-coded color Doppler sonography (ACD) has become an useful adjunct to gray-scale US and conventional color Doppler sonography (CD) for the assessment of vascular diseases and pathologic conditions that might affect or alter tissue vascularization or perfusion. Basically, all US units that generate conventional color Doppler information through autocorrelation technique are capable of displaying ACD. This technique is also referred to as power Doppler, amplitude-mode color Doppler US, color Doppler energy (CDE), or US angiography. Amplitude-coded color Doppler sonography has already emerged as a valuable adjunct to conventional CD, particularly for evaluating flow in parts of the body where CD signal is weak because of slow flow, small blood vessels, or both.

Blood Flow Velocity↗
PubMed1998

[Radiologic evaluation of Crohn disease].

PURPOSE: This paper discusses the role of different imaging modalities in the diagnostic work-up of Crohn's disease (CD). METHODS: We present a concept, which emphasizes different diagnostic aspects with regard to primary diagnosis, follow-up and assessment of complications of CD. The most effective imaging approach to various diagnostic problems of CD is discussed in detail. DISCUSSION: With regard to the primary diagnosis barium studies should contribute to differentiate between CD and ulcerative colitis. Beyond that, these studies should evaluate location and extent of disease. During the follow-up bowel sonography provides staging of disease and enables the detection of complications at an early stage. CT is a valuable tool in the preoperative assessment of complications, such as fistulae and abscesses.

Barium Sulfate↗
PubMed1998

Amplitude-coded colour Doppler sonography: physical principles and technique.

The purpose of this review is to help in understanding the principles of a new ultrasound Doppler technique called amplitude-coded colour Doppler (power) mode. All pertinent information available in the literature on the physical principles of this technique has been revised in order to give a detailed survey. The main components and the key characteristics of this mode are discussed together with illustrative examples. In addition, work-in-progress developments and other future aspects of US imaging in combination with this technique are discussed.

Algorithms↗
PubMed1998

Differentiation of benign and malignant tumors of the parotid gland: value of pulsed Doppler and color Doppler sonography.

To establish criteria for the differentiation of benign and malignant tumors of the parotid gland using color Doppler sonography (CDS) and pulsed Doppler sonography (PDS) we examined 37 patients with parotid tumors by gray-scale ultrasound, CDS, and PDS. Tumor vascularization displayed by CDS was graded subjectively on a 4-point scale (0 = no vascularization, 3 = high vascularization). From the Doppler spectrum, the highest systolic peak flow velocity, the resistive index (RI), and the pulsatility index (PI) were calculated. There were 11 malignant and 26 benign tumors. Tumor vascularization by CDS was grade 0 or 1 in 88.5% of benign lesions, whereas it was grade 2 or 3 in 82% of malignant lesions (P < 0.0001). The highest systolic peak flow velocity was statistically significantly higher in malignant lesions than in benign lesions. Using a threshold systolic peak flow velocity of 25 cm/s, sensitivity was 72% and specificity was 88% for the detection of a malignant tumor. Evaluation of tumor vascularization by CDS and PDS cannot differentiate between benign and malignant parotid tumors with certainty. However, high vascularization and high systolic peak flow velocity in tumor vessels should raise the suspicion of malignancy, even if tumor morphology on gray-scale sonography indicates a benign lesion.

Adenolymphoma↗
PubMed1998

Conflicting results of ileoscopy and small bowel double-contrast barium examination in patients with Crohn's disease.

BACKGROUND AND STUDY AIMS: Ileoscopy has become a routine procedure for the diagnosis of Crohn's disease of the terminal ileum. The aim of this study was to compare the diagnostic accuracy of small bowel barium examination with that of ileoscopy. PATIENTS AND METHODS: In a retrospective study the two methods were compared in 55 patients with Crohn's disease. First, routine radiology reports and second, reevaluation of the small bowel barium study by gastrointestinal radiologists with scoring of examination quality were compared with the results of ileoscopy. RESULTS: Using routine radiology reports, 66% sensitivity and 82% specificity were reached for inflammatory changes of the terminal ileum by small bowel barium study. Sensitivity and specificity increased to 68% and 91% with double reading by experienced radiologists. Disagreement between endoscopic and radiologic results changed from 31% to 27% and were mainly because of false-negative barium studies. Sensitivity and specificity of barium studies were influenced by the quality of the examination with a sensitivity of 91% and specificity of 100% when the quality was good. CONCLUSIONS: In patients in whom the terminal ileum is successfully intubated, ileoscopy is superior to barium examination in the evaluation of Crohn's disease of the terminal ileum. Results of the barium study were strongly influenced by the quality of the examination.

Adolescent↗
PubMed1997

[Diagnostic imaging after liver transplantation].

INTRODUCTION: Orthotopic liver transplantation (OLT) has become an accepted treatment for end-stage liver disease. However, postoperative complications result in significant patient morbidity and mortality. Early detection and treatment of these complications is therefore of utmost importance. MATERIALS AND METHODS: We retrospectively reviewed the postoperative complications of the patients who underwent OLT at our institution. Duplex Doppler sonography and cholangiography were the primary imaging modalities in postoperative evaluation of the transplanted liver. Other important techniques were CT, MRI and angiography, which may contribute to a reliable diagnosis of vascular or biliary complications. RESULTS: Second to primary organ dysfunction, vascular complications are the most frequent cause of graft loss. Thrombosis of the hepatic artery is the most common and most serious vascular complication, with a reported incidence from 4 to 42%. Bile duct sludge, leaks and strictures are frequent complications after liver transplantation, which can contribute to graft dysfunction. Biliary tract complications usually occur within the first 3 months and require interventional radiological or surgical therapy. Since liver transplant recipients undergo immunosuppressive therapy, they are at increased risk of developing late post-transplant malignancies, which are best depicted by US, CT or MRI. However, radiological diagnosis of lympho-proliferative disorder has to be confirmed by liver biopsy. CONCLUSION: Cholangiography and Duplex sonography are routinely used in the postoperative evaluation of patients with OLT. CT, MRI, and angiography are problem-solving tools in equivocal cases.

Diagnostic Imaging↗
PubMed1997

Spiral CT evaluation of deep venous thrombosis.

Spiral CT venography is a technical innovation in vascular imaging that can optimize vessel contrast in the deep venous system and, therefore, is an accurate diagnostic tool to detect deep venous thrombosis. Compared with conventional venography, the amount of contrast material can be reduced by 80%. While using spiral CT as the primary imaging technique for the detection of pulmonary embolism, the cause of embolism can be evaluated within a short period of additional imaging time without further patient mobilization. This review outlines fundamental techniques in spiral CT venography and summarizes our clinical experience at Vienna University Medical Center.

Adult↗
PubMed1997

[Present views on indications and techniques in kidney biopsy].

In the current situation there are available many data on renal biopsies. Nevertheless a lot of questions remain unanswered the effectivity and safety of the technique of renal biopsy. We demonstrate the current insight on indications, contraindications and the technique of renal biopsy. A number of studies in recent years have found the biopsy to be of major value in patients with high levels of proteinuria, those with signs of systemic disease, and certain patients with acute renal failure. We demonstrate our technique of localization of the kidney, with marking of location and depth. Continuous ultrasonic guidance is used as the needle is inserted into the kidney. Biopsy of kidney is performed by an automated technique with Biopty instrument for its safety and better effectivity. (Tab. 1, Fig. 6, Ref. 13.)

Biopsy, Needle↗