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Biomedical subjects

G Sigmund

Publications and source records attributed to G Sigmund.

52 records · Page 3Linked to original sources
PubMed1988

[Pulmonary reaction to radiation following mantle-field irradiation. Comparison of follow-up by conventional x-ray and by computed tomography].

A group of 36 patients who received mantle field irradiation for Hodgkin's disease (35 pts) or non-Hodgkin lymphoma (1 pt) were prospectively examined by plain film radiography and computed tomography (CT) for evaluation of the pulmonary reaction at the beginning and the end of the course of irradiation, and at 12 weeks, 17 weeks, and 37 weeks after the start of the mantle field irradiation. A total of 173 plain chest radiographs (p.a. and lateral view), and 167 CTs were reviewed. As in chest radiography, the pulmonary reaction to radiation seen in CT took a characteristic course with different distinguishable stages. The radiation-induced changes typically seen on on CT were reducible to three basic patterns of opacification, which sometimes appeared in combination, and had a characteristic spatial distribution. Comparison of the two imaging modalities suggest that CT should be used in special cases, while conventional plain film radiography of the chest, with the possibility of short-term controls, is still the mainstay of follow-up for patients with Hodgkin's disease.

Adolescent↗
PubMed1987

Stop-type and shunt-type varicoceles: venographic findings.

Forty-four patients with a left-sided idiopathic varicocele were examined with bidirectional Doppler ultrasound (US), physical examination, and percutaneous retrograde venography. On the basis of the Doppler findings, the varicoceles were classified as either stop type or shunt type. On venography, the stop-type varicoceles showed only retrograde blood flow (reflux) in the testicular (internal spermatic) vein, whereas each shunt-type varicocele showed both retrograde and orthograde (i.e., physiologic) venous blood flow: First, reflux appeared in the testicular vein, then orthograde flow occurred in the deferential vein, cremasteric vein, or both. The shunt-type varicocele therefore represented a kind of venous bypass. Thus, the existence of two hemodynamically different types of varicocele as suggested initially by Doppler US is confirmed by percutaneous retrograde venography. The shunting of venous blood appears to be a precondition for medium and large varicoceles and might have some prognostic significance for subfertility associated with varicoceles.

Humans↗
PubMed1987

Idiopathic varicoceles: feasibility of percutaneous sclerotherapy.

Percutaneous retrograde venography was performed in 717 patients with a left-sided idiopathic varicocele. In 674 (94.0%), testicular (internal spermatic) vein insufficiency was proved by contrast medium reflux from the left renal vein into the testicular vein, down to the pampiniform plexus. The different venographic patterns of the testicular veins were classified into seven basic types. Five of these, comprising 624 patients, had incompetent or missing valves all along the trunk of the testicular vein. In 554 of the 624 (88.8%), sclerotherapy was performed, but such treatment was possible in only three of 50 patients with a competent orifice valve bypassed by an insufficient collateral (type IVb). In 43 of the 717 patients (6.0%), no insufficient vein could be found at all (type 0). The mean fluoroscopy time was 4.4 minutes. There were no serious complications associated with venography or sclerotherapy, and the initial recurrence rate was 9.8%. Percutaneous sclerotherapy is therefore a simple, safe, and effective treatment of testicular vein insufficiency and is suitable for almost 80% of patients with varicoceles.

Adolescent↗
PubMed1987

[Radiation planning in breast cancer. What is the depth of the internal mammary lymph nodes?].

For irradiation of the parasternal lymph nodes by high-energy electrons the target volume depth, i.e. the depth of the parasternal nodes below the skin surface, was determined by CT in 25 consecutive female patients with a sternal irradiation field. On measurement at the cranial end of the sternum, at a middle level, and at the caudal part of the sternal field, intraindividual differences were low, whereas interindividual findings differed markedly--depending on thickness of subcutaneous fatty tissue. For individual treatment planning, we recommend measuring target volume depth by CT.

Breast Neoplasms↗
PubMed1986

[Percutaneous sclerotherapy as primary treatment of testicular insufficiency in idiopathic varicocele].

Among 1217 percutaneous retrograde phlebographies of the left renal/testicular vein 1069 were performed for primary treatment of left-sided idiopathic varicocele. In 989 of these patients (92.5%) an insufficient testicular (internal spermatic) vein with reflux to the pampiniform plexus could be shown phlebographically, in 802 cases percutaneous sclerotherapy could be performed. This amounts 75.0% of patients with varicocele or 81.1% of the cases with a phlebographically proven testicular vein insufficiency. In this group percutaneous sclerotherapy has proven to be a safe and effective treatment of idiopathic varicocele on an outpatient basis and has replaced surgical ligation as method of choice. However, with anatomical and technical obstacles to sclerotherapy, especially in patients with varicocele but without phlebographic evidence of an insufficient testicular vein, surgery remains an essential means of therapy.

Adolescent↗
PubMed1986

[Epidural empyema and orbital phlegmon. Computerized tomographic diagnosis of rare complications of sinusitis].

Among 4019 computed tomograms of the head performed in 2 years we found 2 epidural empyemas combined with an ipsilateral orbital phlegmon and one periorbital abscess with an incipient orbital phlegmon. In all 3 patients they turned out to be intracranial or orbital complications of an adjacent paranasal sinusitis. The CT diagnosis was a guideline for further therapy and was verified by immediate surgery. The reliable diagnosis of orbital and intracranial space-occupying lesions makes CT the radiological method of choice in case of suspicion of a complicated sinusitis.

Adolescent↗
PubMed1986

[Doppler sonography and phlebography in the detection of hemodynamically different varicocele types].

Using the bidirectional doppler sonography to evaluate patients with varicocele two haemodynamically different types of varicoceles, pressure-type and shunt-type, can be determined. By means of retrograde phlebography of the internal spermatic vein (testicular vein) in 44 patients with varicocele the pathophysiologic-anatomic equivalent of these two types could be demonstrated. Shunting veins are the cremasteric vein and deferential vein. The two types of varicoceles have a different effect on male fertility.

Hemodynamics↗
PubMed1986

[Percutaneous sclerotherapy of testicular vein insufficiency in persistent and recurrent varicocele].

Among 1217 retrograde phlebographies of left-sided idiopathic varicoceles 66 patients presented because of persistence or recurrence of varicocele, 34 of them after operation and 32 after sclerotherapy. After operation without success there was always - except for one case - a reflux passing the site of ligature. If persistence or recurrence of varicocele occurred after sclerotherapy, the testicular (internal spermatic) vein was most often found to be obliterated at the junction with the renal vein and the sonographically proven reflux went via collaterals or unidentified veins which prevented a repeat sclerotherapy. In 12 out of 32 patients after sclerotherapy a persistent main stem of the testicular vein allowed a second attempt of sclerotherapy. If sclerotherapy in patients after operation or previous sclerotherapy could be performed, it was an effective, low risk procedure on an outpatient basis just as in primary sclerotherapy of testicular vein insufficiency causing varicocele.

Humans↗
PubMed1985

[Value of computerized tomography in the diagnosis of recurrence in malignant head and neck tumors].

Among 441 CT scans of 303 patients with a malignant tumor of the head or neck 138 scans of 83 patients were performed for evaluation of recurrent tumor. In diagnosing nodal recurrence computed tomography (CT) had a sensitivity of 92% (52 out of 56) and a specificity of 96% (55 out of 57). In diagnosing recurrence at the primary site sensitivity of 72% (56 out of 77) and specificity of 60% (30 out of 50) was lower and clearly inferior to physical examination with 92 and 88% respectively. CT was very useful in delineating advanced recurrencies, especially in regions that were not readily accessible by physical examination or were indurated by flat scarring. In addition to the complete staging of nodal involvement this makes CT the radiologic method of choice in follow-up of patients with malignant tumors of the head and neck. A post-therapeutic baseline scan obtained 6-8 weeks after surgery resp. radiotherapy is expected to further improve results, especially in differentiating scar from recurrent tumor.

Adult↗
PubMed1982

[Value of computer tomography in comparison to mediastinoscopy and test thoracotomy in intrathoracic space-occupying lesions with mediastinal involvement].

The preoperative CT findings in 50 patients out of a total of 144 examined patients with suspected intrathoracal malignant processes with mediastinal involvement were compared to the results obtained by mediastinoscopy and thoracotomy. There was a high diagnostical reliability (95%, n = 40) in assessing lesions in the area, which can be reached by mediastinoscopy. This leads to the conclusion that mediastinoscopy is necessary only in such cases with histologically proven malignant intrathoracal masses, which show lymph nodes of a size from 1 to 2 cm. The evidence of invasive extension into adjacent mediastinal structures as well as the distance from tumour to carina could be assessed well by CT. For follow-up examinations after resection, radiation therapy or chemotherapy, computed tomography is of particular value to detect early mediastinal recurrence.

Adenocarcinoma↗
PubMedDate not supplied

MR imaging of the pericardial cyst.

Findings obtained with magnetic resonance (MR) imaging in four patients with pericardial cyst are reported. MR imaging allowed not only localization and diagnosis in all four cases but characterization of cystic content. MR imaging, including RARE (rapid acquisition with relaxation enhancement) MR hydrography, which shows only liquids with T2s greater than 500 msec, proved to be useful in characterizing the fluid content of a mediastinal lesion and monitoring follow-up. In one case, MR imaging allowed differentiation of a pericardial cyst from a suspected necrotic lymph node in a patient with colic carcinoma, with subsequent correction of staging and therapy. The authors conclude that MR imaging is the method of choice for diagnosis (especially in unusual locations) and monitoring of pericardial cysts and for differential diagnosis of malignant mediastinal cystic tumors that show a solid part.

Diagnosis, Differential↗
PubMedDate not supplied

CT and MRI of Gorham syndrome.

Gorham syndrome, also known as massive osteolysis or vanishing bone, is a rare disorder (135 cases reported) leading to extensive loss of bony matrix, replaced by proliferating thin-walled vascular channels. Three histologically proven cases of the disease are reported, including the clinical presentation and modern imaging features with CT (with 3D reconstruction) as well as T1- and T2-weighted MRI. Two cases in young women were located in the pelvis with extensive osteolysis reaching to the acetabulum. The third case in a 2-month-old boy is the youngest case ever reported and involved the humerus. The radiological appearance of the disease is discussed and the importance of the modern imaging methods debated.

Acetabulum↗
PubMedDate not supplied

Inflammatory and traumatic lesions of the knee and ankle: comparison of 0.23 T and 2 T MRI.

Fifty-six patients with traumatic and 117 patients with inflammatory lesions of the knee and ankle were examined with a 2 T (69 examinations) or 0.23 T (104 examinations) MR system. The quality of all images was assessed by the consensus of three radiologists on a scale of diagnostic (3+, 2+) and nondiagnostic (1+) image quality. More than 90% of images from both systems were diagnostic. However, the proportion of 3+ quality images was significantly higher (p less than 0.001) at the magnetic field strength of 2 T (81% = 56/69 versus 49% = 51/104 at 0.23 T). Motion artifacts were the main cause of reduced image quality independent of field strength. In patients with traumatic and inflammatory diseases of the knee and ankle, high field imaging at 2 T provided better image quality than low field imaging at 0.23 T.

Adolescent↗