PubMed Health⌕ Search

Biomedical subjects

K F Kreitner

Publications and source records attributed to K F Kreitner.

At least 91 records · Page 5Linked to original sources

[Rupture of lateral ligaments of the ankle joint: MR imaging before and after functional therapy].

PURPOSE: Documentation via MRI of the healing of ruptured lateral collateral ankle ligaments after functional therapy. PATIENTS AND METHODS: 35 patients with ankle sprain were examined by MRI and stress radiographs, 13 were operated afterwards, 22 patients underwent a functional conservative therapy and were examined by MRI and stress radiographs and second time after three months. RESULTS: MRI reports were correct in 12 of 13 operated cases. After conservative therapy we did not find any disrupted ankle ligament. MRI showed intact ligaments thickened by scar. CONCLUSION: MRI is able to show injuries of the lateral collateral ankle ligaments and demonstrates the healing by scar after conservative therapy.

Adolescent↗

[Isolated dislocation of the os triquetrum--a rare wrist injury].

The isolated traumatic dislocation of the triquetrum is an extremely rare injury. The clinical signs are unspecific. Roentgenograms of the wrist in posteroanterior and lateral views, possibly complemented by oblique views, will help to provide the diagnosis. The best therapy appears to be the open reduction and fixation with Kirschner wires. With the presented case report, the difficulties in using the classification carpal injuries are discussed. Finally, corresponding to the carpus ring theory, the plausibility of additional injuries to carpal ligaments in such trauma is pointed out.

Adult↗

[Is there a connection between intramedullary pressure increase, bone marrow intravasation and deep venous thrombosis of the leg in endoprosthetics?].

Deep vein thrombosis still is a severe problem in hip replacement. Based on pathophysiological considerations, it is postulated that there is a connection between intramedullary pressure peaks, resulting intravasation of bone marrow, and the induction of deep vein thrombosis. The content of the bone marrow cavity can be considered active where coagulation is concerned. Intravasation may contribute to the development of deep vein thrombosis. In addition to medicamentous prophylaxis and early mobilization, a surgical technique also helps in the prophylaxis thrombosis. In this technique, intramedullary pressure increases are avoided as far as possible, which consequently minimizes intravasation of the content of the bone marrow cavity.

Aged↗

[Osseous manifestations of Bourneville-Pringle disease].

Tuberous sclerosis (Bourneville-Osseous Manifestations of Bourneville-Pringle's Disease) is a rare disease characterised by the clinical traid of epilepsy, mental retardation and adenoma sebaceum. In addition of this triad a number of patients shows other visceral, neurocutaneus or osseous manifestations. We describe the radiological findings of two patients with typical skeletal changes.

Adult↗

[Application possibilities of MR arthrography in diseases of the shoulder joint].

In a prospective study possible indications for MR arthrography of the shoulder were evaluated. 37 patients were examined before and after intraarticular administration of a 2-mmolar solution of Gd-DTPA. MR arthrography was performed if there was no joint effusion and/or an uncertain finding concerning the rotator cuff or the capsulolabral complex on plain MR images. MR arthrography leads to a better demonstration of labrum pathology in 11/22 patients and to a superior delineation of the capsuloligamentous apparatus in 20/22 cases. In 9/15 patients with impingement lesions MR arthrography allowed a differentiation of severe tendinitis from partial and small full-thickness tears of the rotator cuff. MR arthrography of the shoulder joint enhances the accuracy of MR in case of an uncertain finding on plain MR images.

Adolescent↗

[THe differentiation between benign and malignant liver lesions by unenhanced MRI].

UNLABELLED: The aim of the study was to establish qualitative criteria for differentiating between malignant and benign focal lesions of the liver using unenhanced MRT at 0.5 Tesla. PATIENTS AND METHOD: 72 patients with 103 focal liver lesions were examined with T1 and T2 weighted SE sequences. The images were examined by three radiologists according to qualitative criteria (homogeneity, form and signal of the lesions compared with liver, spleen and muscle). RESULTS: The most specific sign applying to 90% of malignant lesions were diffuse or irregular contours on T2 weighted sequences; this had a sensitivity of 43%. For all other features, specificity for malignancy was less than 67%. CONCLUSION: Using these sequences and criteria it is not possible to distinguish between malignant and benign lesions of the liver with sufficient accuracy.

Diagnosis, Differential↗

[Isolated fracture of the trochlea humeri following direct elbow trauma].

Isolated fractures of the Trochlea humeri are only rarely seen because in case of indirect trauma this portion of the elbow is only partially exposed to transmitted forces and in case of direct injury adjacent elements are also involved. On the lateral films a half-moon shaped fragment in front of the Humerus together with joint effusion are indicative of this type of fracture. Depending on the grade of dislocation of the fragment, which has to be shown radiologically, conservative or operative management are chosen.

Athletic Injuries↗

[Magnetic resonance tomography of chronic aortic dissection].

17 patients with chronic aortic dissection were examined by MRI. In 12 patients, comparison between gradient echo sequences and SE sequences was possible. Gradient echo sequences, unlike SE sequences, permitted evaluation of flow in the true and false lumen, reliable differentiation between thrombus and flowing blood and clear delineation of the intimal flap. An additional comparison between transoesophageal ultrasound and MRT in 15 patients showed significant advantages in favour of MRI. In three patients MRI was able to detect more proximal origins of the dissection. Moreover, MRI allowed evaluation of the major aortic branches and their relation to the dissection; this was not possible with ultrasound. MRI plays an important role in the follow-up of chronic aortic dissections.

Adult↗

[MR tomographic functional analysis of the left ventricle].

The following contribution presents a continuous MRT analysis of the contraction and relaxation processes of healthy left ventricles giving reference values for contraction and relaxation velocities. For the total ventricle we have Vsyst. r. total = 342 +/- 47% LVEDV/sec and Vdiast. r. total = 303 +/- 59% LVEDV/sec. In relation to the end-diastolic (tomographic) volume (EDSV) significantly greater changes in volume per unit of time were measured apically compared to basal (systolic: 411 +/- 89% EDSV/sec apical vs 261 +/- 35% EDSV/sec basal; diastolic: 810 +/- 145% EDSV/sec apical vs 245 +/- 70% EDSV/sec basal). Occurrence of the end-systolic minimal volumes of apical tomographic layers was delayed against the total ventricle by 22.4 +/- 7.9% t syst. Within the ventricle there was systolically a redistribution of the proportions of volume from apical to basal.

Adult↗

[MRT for surgical planning in anal atresia].

We evaluated in this study the value of preoperative examinations of anal atresia with an optimised MRI strategy. 13 patients with anorectal anomalies, most of them younger than one year, underwent an MRI examination of the pelvis. 10 of these patients were operated afterwards. Compared with the situs shown by the operation the results of the MRI examination were very exact in all cases in respect of the level of atresia and the development of the striated muscle complex. Fistulas could be completely described in most cases. MRI demonstrated additional lesions in some patients which were of great importance for planning the further treatment of the patients. As a consequence MRI can give valid information on anal atresia for planning the operative treatment.

Anal Canal↗

Pneumatoceles and pneumothoraces complicating staphylococcal pneumonia: treatment by synchronous independent lung ventilation.

A 54 year old man with a staphylococcal sepsis developed staphylococcal pneumonia complicated by multiple pneumatoceles and bilateral tension pneumothoraces caused by bronchopleural fistulae. Excessive enlargement of the right sided pneumatoceles and a tension pneumothorax not improved by drainage led to mediastinal shift and compression of the right lung. Reversal of the mediastinal shift and closure of the bronchopleural fistulae was achieved by assisted independent lung ventilation.

Bronchial Fistula↗

[The value of the radiologic Lachman test in anterior cruciate ligament ruptures].

A radiologic Lachman test of both knees was performed in 35 patients with surgically verified tears of the anterior cruciate ligament (ACL). We found a mean anterior drawer of 3.2 mm for uninjured joints, 4.5 mm for isolated ACL-tears and 10.8 mm for complex ACL-injuries. Sensitivity of the radiological Lachman test was 95% for complex ACL-injuries as only 23% in case of isolated ACL-ruptures. Failure of diagnosis due to clinical investigation in case of ACL-ruptures could not be proved by means of radiological Lachman-test. Technical requirements and radiation exposure are further disadvantages. Clinically doubtful cases of acute knee injuries should therefore be investigated with other diagnostic procedures.

Adolescent↗

[Nuclear magnetic tomography in shoulder dislocation].

Sixty-two patients with anterior shoulder dislocations were examined by magnetic resonance imaging (MRI). After a primary dislocation, 30 patients showed 23 (77%) tears of the glenoid labrum, 13 (45%) anterior-inferior separation of the capsula, 24 (83%) Hill-Sachs lesions, 6 fractures of the greater tuberosity and 4 glenoid rim fractures. Thirty-two patients with recurrent shoulder dislocation had 14 (44%) tears and 15 (47%) defects of the glenoid labrum, 16 (50%) anterior-inferior separation of the capsula, 28 (88%) Hill-Sachs lesions and 3 glenoid rim fractures. MRI permits complete non-invasive documentation of glenohumeral instability if joint effusion is present. In the absence of joint effusion, diagnostic accuracy can be improved by application of a contrast medium.

Adolescent↗

[CT arthrography of the shoulder joint].

Double-contrast CT arthrography of the shoulder is an imaging modality of great diagnostic accuracy with regard to glenohumeral instabilities. The purpose of this study is to describe the technique of the method and to demonstrate normal and pathological conditions in detail. Finally, its diagnostic value compared to other imaging modalities is outlined.

Arthrography↗

[MR tomography in testicular processes. The significance of Gd-DTPA enhanced sequences in comparison with plain T2-weighted sequences].

The value of T1-weighted sequences after intravenous administration of Gd-DTPA and of T2-weighted sequences was compared in 43 patients suspected of having scrotal abnormalities. T2-weighted sequences gave better demonstration of the tunica albuginea and better contrast between tumor and parenchyma. The two techniques were equally sensitive for demonstrating testicular tumors but orchitis was better demonstrated on the contrast enhanced sequences. Motion artifacts were less marked in the T1-weighted sequences with contrast enhancement. In selected cases, contrast enhancement may be a valuable addition to native protocols. Our experience has indicated that MRI provides specific findings in cases of orchitis which are clinically atypical; this facilitates the decision to conservative treatment and prevents unnecessary exploration of the testes.

Adolescent↗

[MR tomography of injuries of the medial collateral ligaments of the knee joint].

Frequency and characteristics of lesions of the medial collateral ligaments (MCL) were studied by MRI in 155 patients with trauma to the knee. There were abnormalities of the MCL in 38% of cases with ligamentous injuries and in 27% these were combined with meniscal tears. 11% of these patients showed isolated rupture of MCL and as a result of the MRI findings were treated conservatively. By means of T2*-weighted images the individual lesions could be accurately localised. Characteristic findings have been defined.

Humans↗