PubMed Health⌕ Search

Biomedical subjects

M Funke

Publications and source records attributed to M Funke.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Impalement injury of the colon, iliac vein and sacrum--a rare combination in penetrating abdominal trauma. A case report].

We report on the treatment of a patient who sustained a penetrating abdominal wound with injury of the left common iliac vein, the sigmoid colon and the sacrum in a motorbike accident. The left iliac vein injury was treated using a Gore-Tex vein patch and an A-V fistula. The colon was restored after an intraoperative washout. The punched fragment of the sacrum was removed. An additional fracture of the proximal left humerus was managed with an osteosynthesis in a second operation. The principles of management of combined colon and vascular injuries are discussed and a short review of the literature is given.

Abdominal Injuries↗
PubMed1996

[Diagnostic imaging of instability of the shoulder joint].

The diagnosis of glenohumeral instability is based on the patient's history and physical examination. The main objective in using imaging techniques is to define the type and extent of the underlying pathology for therapeutic planning. Plain radiography is the initial step in the diagnostic procedure but can miss typical lesions of the glenohumeral joint structures. CT arthrography and MR imaging offer great sensitivity and accuracy for the detection of traumatic abnormalities of the labral-capsular complex, fractures of the glenoid rim and Hill-Sachs lesions. The advantages and pitfalls of both imaging techniques are discussed.

Chronic Disease↗
PubMed1996

[2-D-time-of-flight MR angiography of the peripheral blood vessels. Experimental and clinical studies on value of this method in arterial occlusive diseases].

PURPOSE: A retrospective study was performed in 70 patients with peripheral vascular disease who underwent MR angiography of the lower extremity. MATERIAL AND METHODS: MR angiography was performed with a 2-D-TOF sequence including a travelling presaturation to suppress the venous signal. Postprocessing images were obtained with the MIP algorithm. The MRA results were compared with conventional or digital angiography in all patients. RESULTS: Only 19 stenoses out of 31 which showed a degree of stenosis between 30 and 99% could be visualised by MR angiography. 9 stenoses were correctly classified by MRA. In 9 cases the degree of stenosis was overestimated, in one case it was underestimated. All 56 occlusions were correctly detected. 12 severe stenoses diagnosed with conventional angiography were graded as occlusions with MR angiography. CONCLUSIONS: MR angiography cannot be accepted in preoperative staging of patients with peripheral vascular disease. The postoperative examination seems to be a practical noninvasive alternative.

Algorithms↗
PubMed1996

[Spiral CT with reduced radiation dosage].

PURPOSE: To examine the clinical use of a reduced dose in high-resolution spiral-CT (HR-SCT) in combination with a multiplanar volume reconstruction technique (MPVR) to decrease image noise. MATERIAL AND METHODS: Facial bones, skull and extremities of 33 patients with different pathological findings were examined with spiral-CT using a slice thickness of 1 mm (pitch 1.7-2.0), a tube amperage of 40 mA and tube voltages of 80 or 120 kV. Additionally, 2-D, 3-D, and MPVR images reconstructions were performed. MPVR takes advantage of displaying planar volumes of variable thickness. RESULTS: Increased image noise was negligible if high contrast structures like bones were examined. However, very small bony structures like the stapes of the middle ear were not seen. Soft tissues could also be imaged by using the MPVR-technique. This technique did reduce image noise while at the same time partial volume averaging was increased. The skin entrance dose per investigation did not exceed 3 mGy, which is based on twelve dose measurements in two patients. CONCLUSION: It is feasible to perform HR-SCT with secondary reconstructions of facial bones, skull and extremities using reduced skin entrance doses by 10 to 20 fold to below 3 mGy. With the exception of imaging very small structures, sufficient image quality can be accomplished in routine examinations without relevant diagnostic compromise.

Arthrography↗
PubMed1996

MR arthrography in the diagnosis of rotator cuff tears. Standard spin-echo alone or with fat suppression?

PURPOSE: To examine the value of fat-suppressed images in MR arthrography of the shoulder in patients with rotator cuff tears. MATERIAL AND METHODS: MR arthrography was performed in 25 patients (9 women, 16 men) ranging from 19 to 64 years. Standard T1-weighted spin-echo images (sSE) and fat-suppressed images (FS) were obtained after intraarticular injection of contrast material. The MR studies were analyzed according to contrast, image quality and conspicuity of pathology. A diagnosis was established without knowledge of the conventional arthrographic findings on the basis of sSE versus FS techniques. RESULTS: The contrast between the intraarticular fluid and the adjacent structures in FS images was increased compared to sSE images in all patients. The conspicuity of anatomical structures was improved in 8 patients. Without fat suppression, 2 false-negative and one false-positive full-thickness tears were diagnosed. With the FS technique, 14 full-thickness tears and 4 partial-thickness tears of the cuff were correctly classified. CONCLUSION: The results suggest that, if MR arthrography is chosen for a diagnosis of rotator cuff disorders, a fat suppression sequence should be included.

Adult↗
PubMed1996

[MR-mammography: current status and perspectives].

Dynamic MR imaging of the breast is viewed as an examination technique which is supplementary to mammography and sonography and which can provide important additional diagnostic information. Proven indications for MR mammography include examinations of patients who have undergone lumpectomy and patients with prosthetic breast implants. The method also appears to be useful to differentiate between postoperative scarring and carcinoma as well as to exclude a multicentric breast carcinoma prior to lumpectomy. The sensitivity of MR mammography, however, is limited in cases of DCIS. Hypervascular benign lesions can be difficult to distinguish from malignant lesions.

Breast↗
PubMed1995

[An anatomically adapted variation of the tube current in CT. Studies on radiation dosage reduction and image quality].

PURPOSE: To assess the impact of a method for anatomically adapted tube current variation. The resulting CT image quality was evaluated quantitatively and qualitatively. METHODS: CT scans of 100 patients were performed with a constant tube current (Group 1) and another 100 patients with an anatomically adapted tube current (Group 2). The CT tube current was varied during a 360 degrees tube rotation reflecting the measured density values extracted from two perpendicular scout views. The standard deviation of densities of defined regions was measured. The image quality was ranked (1 = non-diagnostic-5 = excellent) by three radiologists. RESULTS: The effective tube current could be reduced by an average of 8.9% (0-20.4%). The mean tube current reduction depended on the body region: pelvis (13.2%), abdomen (8.4%) and thorax (3.3%). The image quality was not significantly reduced in Group 2. CONCLUSION: The method for anatomically adapted tube current variation leads especially in the pelvis to a significant mAs reduction without considerable loss of image quality.

Aged↗
PubMed1995

[A bimetal anode with tungsten or rhodium? Comparative studies on image quality and dosage requirement in mammography].

PURPOSE: The impact of different anode materials (tungsten and rhodium) on spatial resolution, image contrast and radiation exposure was studied. MATERIALS AND METHODS: Two mammographic systems providing bimetal x-ray tubes (Mo/W and Mo/Rh) were compared by imaging a breast radiography phantom with additional acrylic plates from 3 to 8 cm thickness. Spatial resolution was evaluated using a line bar pattern. Image contrast was assessed by measuring the ratio of optical densities in a acrylic step-wedge. The entrance dose was measured with a low energy ionisation chamber. RESULTS: The spatial resolution was about 13 lp/mm regardless of the beam quality. The image contrast depended substantially on the thickness. A similar image contrast was found with Mo/Mo, Mo/Rh and Rh/Rh for simulated breast thicknesses of 4 to 6 cm and with Rh/Rh and W/Rh for 7 cm. In comparison to Mo/Mo the dose reduction was significant for Mo/Rh (35%), Rh/Rh (50%) and W/Rh (60%). CONCLUSIONS: Bimetal x-ray tubes provide optimal conditions for screen film mammography of both normal and dense breasts, allowing good contrast and dose reduction by using the adequate anode/filter-combination.

Electrodes↗
PubMed1995

Broadband ultrasound attenuation in the diagnosis of osteoporosis: correlation with osteodensitometry and fracture.

PURPOSE: To evaluate the usefulness of broadband ultrasound attenuation in the prediction of osteoporosis. MATERIALS AND METHODS: Broadband ultrasound attenuation measurements of the calcaneus and dual x-ray absorptiometry (DXA) measurements of the lumbar spine and the femoral neck were obtained in 400 patients (295 female and 105 male), 135 of whom were classified as having osteoporosis. Correlation coefficients between broadband ultrasound attenuation and DXA were calculated. RESULTS: Patients with osteoporosis showed a statistically significant decrease in broadband ultrasound attenuation compared with healthy patients (59.7 dB/MHz +/- 1.3 [standard deviation] vs 75.1 dB/MHz +/- 0.8). Broadband ultrasound attenuation correlated statistically significantly with vertebral bone density (r = .49) and femoral neck density (r = .52). At a broadband ultrasound attenuation index of 64 dB/MHz, the sensitivity and specificity were both 85% for patients with osteoporotic fractures. CONCLUSION: Broadband ultrasound attenuation can be used to help differentiate between patients with osteoporosis and healthy patients and seems to be useful in the prediction of fracture risk.

Absorptiometry, Photon↗
PubMed1995

Parenchymal liver enhancement with bolus-triggered helical CT: preliminary clinical results.

A software-driven device for bolus-triggered start of helical computed tomography (CT) was evaluated in liver studies of 30 patients with suspected metastatic liver disease. Compared with results in a control group of 30 patients who underwent conventional contrast material-enhanced helical CT, the study group had significantly higher and more constant parenchymal enhancement (P < .05, Mann-Whitney U test). This technique helps optimize findings at contrast-enhanced helical CT.

Contrast Media↗
PubMed1995

[Ruptured intracranial dermoid as an incidental finding].

This report presents a case of a ruptured intracranial dermoid accidentally found in a 51-year old patient. The tumour appears as a large lesion located in the posterior fossa. The CT and MRI studies identify fatty material into the CSF spaces providing intraventricular fat-fluid levels. These characteristic findings are indicative of the diagnosis.

Cerebellar Neoplasms↗
PubMed1995

Value of magnetic resonance imaging in patients with penile induration (Peyronie's disease).

Magnetic resonance imaging (MRI) is a noninvasive procedure that enables exact imaging of penile anatomy. A total of 34 patients with clinical Peyronie's disease underwent palpation, ultrasound and MRI after intracavernous injection of 10 micrograms. prostaglandin E1. MRI images were obtained before and after intravenous application of gadolinium-diethylenetriaminepentaacetic acid. In 34 patients 45 plaques were palpable. Ultrasound revealed evidence of lesions in 66.6% of the cases. On MRI 36 of 45 palpable plaques (80%) were detected. Not palpable or sonographically revealed indurations could be shown in 4 cases. After intravenous application of gadolinium-diethylenetriaminepentaacetic acid 4 plaques demonstrated contrast enhancement, thus indicating local inflammatory activity. The combination of clinical examination and sonography remains the method of choice for diagnosis and observation of patients with Peyronie's disease. MRI enables exact imaging of penile structures but it does not provide a significant advantage over standard investigative procedures.

Adult↗
PubMed1994

[Signal characteristics of x-ray contrast media and their interaction with gadolinium-DTPA in MRT].

T1 and T2 weighted signals derived from various radiological contrast media were studied during MRT spin-echo sequences. In addition, the interaction between radiological contrast media and Gadolinium-DTPA concerning T1 signals was evaluated. Ionic (ioxitalaminic acid) and non-ionic radiological contrast media (Iopromid, Iotrolan) were used in diagnostic concentrations. Measurements were carried out with a superconductive magnet of 1.5 Tesla. Radiological contrast media produced significantly higher signals than a physiological sodium chloride solution in T1-weighted spin-echo sequences. Even small amounts (15% of total volume) of radiological contrast media during T1-weighted spin-echo sequences led to a significant reduction (about 25%) of the signal intensity of a 2 mM Gadolinium-DTPA solution. This may lead to diagnostic problems, as was shown in a series of 25 MR arthrograms of the shoulder. It is recommended than an interval of at least 6 hours should elapse between the use of a radiological contrast medium and an MRT examination.

Contrast Media↗
PubMed1994

[The determination of the T2* relaxation time for characterizing trabecular bone].

Spongy bone produces local magnetic field inhomogeneities and leads to shortening of the transverse relaxation time from bone marrow. This increased signal decay affects the T2 relaxation time. Measurements of the T2* time from the 4th lumbar vertebra were carried out in 48 normals and 20 patients with osteoporosis. A special multigradient echo technique was used, the echo times selected in relation to phase coherence of the water and fat signals. T2* times showed slight increase in relation to age. Patients with osteoporosis showed significantly increased T2* times (19.9 +/- 3.8 ms) compared to the normal control group (13.4 +/- 1.9 ms). From these findings it is possible to judge the quality of the trabecular structure.

Adult↗
PubMed1994

MR arthrography of the shoulder with gadopentetate dimeglumine: influence of concentration, iodinated contrast material, and time on signal intensity.

OBJECTIVE: MR arthrography of the shoulder with gadopentetate dimeglumine has been proved to be valuable in the diagnosis of injuries of the rotator cuff and glenoid labrum. To date, no standard protocol for the concentration of gadopentetate dimeglumine and the volume of iodinated contrast material used for intraarticular injection exists. This study compared the intraarticular signal intensities achieved with three different MR arthrography protocols with respect to the volume of iodinated contrast material, the concentration of gadopentetate dimeglumine, and the interval between injection of contrast material and the MR study. SUBJECTS AND METHODS: MR arthrography was performed with three different protocols in 38 patients (26 men, 12 women). Patients examined with protocol 1 received an intraarticular injection of 5 ml of iotrolan and 5 ml of a 5 mmol/l solution of gadopentetate dimeglumine, resulting in a gadopentetate dimeglumine concentration of 2.5 mmol/l. Patients in protocol 2 received only 0.5 ml of iotrolan plus 12 ml of a 10 mmol/l solution of gadopentetate dimeglumine, leading to a 10 mmol/l concentration. The interval between injection and MR imaging for patients in protocols 1 and 2 was 30-45 min. Patients in protocol 3 received an intraarticular injection of 10 ml iotrolan and 1 ml of a 500 mmol/l solution of gadopentetate dimeglumine, resulting in an intraarticular concentration of gadopentetate dimeglumine of 45 mmol/l. MR examinations were performed between 20 and 360 min after administration of contrast material. Patients in protocol 3 had additional conventional and CT arthrography within 30 min after injection. The contrast-to-noise ratio of the intraarticular signal intensity was calculated for all protocols. RESULTS: The contrast-to-noise ratio (mean +/- SD) was 22.7 +/- 7.4 for the 2.5 mmol/l solution (protocol 1), 47.5 +/- 11.9 for the 10 mmol/l solution (protocol 2), and 9.9 +/- 3.1 for the 45 mmol/l solution (protocol 3) within 1 hr after injection. For protocol 3, an increase in contrast-to-noise ratio was observed after 90-180 min (53.5 +/- 12.7), followed by a decrease in contrast-to-noise ratio after 180 min (17.1 +/- 8.2). The image quality of conventional, CT, and MR arthrography (90-180 min after injection) was good in all cases of protocol 3. CONCLUSION: For MR arthrography performed within 1 hr after injection, protocol 2 is sufficient. The optimal time frame for protocol 3 is between 1.5 and 3 hr after joint puncture. Protocol 3 allows the prior performance of conventional and CT arthrography. Therefore, the addition of 1 ml of a 500 mmol/l solution of gadopentetate dimeglumine to 10 ml of iodinated contrast material is advisable if a subsequent MR study is anticipated.

Adult↗