Biomedical subjects
Publications and source records attributed to M Nägele.
Conventional radiographs do not always make it possible to confirm a diagnosis of ischemic necrosis of the lunate in the early stages of disease. For these doubtful cases MRI is justifiable in addition, to diagnose or to rule out ischemic necrosis of the lunate.
Magnetic resonance imagine of the carpus is helpful in diagnosing or ruling out even early stages of lunatomalacia. MRI is capable of providing information on the vitality of the lunate and is thus helpful in developing a proper therapy plan.
MRI with imaging in the frontal and axial planes can replace, in most cases, CT as well as angiography. By limiting oneself to these planes, the examination can be carried out on patients with acute symptoms. If the findings on MRI are indefinite due to movement or flow artifacts, angiography can be carried out immediately. This may not be possible after CT, due to limitation of contrast volumes. With the exception of patients being ventilated after multiple trauma, MRI should nowadays be the primary form of examination, particularly in high risk patients.
Conventional radiographs are not always able to exclude ischemic necrosis of the lunate in the early stages of the disease. Tomograms on two planes have a higher sensitivity than radiographs in two planes. Sensitivity during middle and late stages of ischemic necrosis of the lunate is approximately the same as that of magnetic resonance imaging. MRI is indicated if conventional techniques are negative or doubtful and where there are clinical signs of malacia (Decoulx stages 0 to 1). For these indications MRI is a justifiable additional method for diagnosing ischemic necrosis of the lunate.
The optimal technique for examining mediastinal masses is the use of T1 weighted spin-echo sequences (TR 500 msec/TE 17 msec) in transverse and coronal slice orientation pre and post contrast application. This setup provides an excellent morphological depiction of anatomy and pathology as well as T2 comparable information about tumor structure without the disadvantage of a reduction of the signal-to-noise ratio.
This report describes two cases of intraneuronal ganglia cysts with degeneration of the peroneal and suprascapular nerve. In addition to standard radiographs other diagnostic studies such as CT and MRI may be required to ascertain the extent of the lesion. Histopathologic information is derived from biopsy.
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The Achilles tendon and pre-achillean space of 30 patients was studied by MRI. A surface coil (Helmholtz' principle) was applied and all patients were examined with a superconducting magnet operating at 1.0 Tesla field strength. The purpose of the study was to illustrate pathological changes of the tendon and the surrounding soft tissue. In 3 cases MRI diagnosed a total rupture of the Achilles tendon. Furthermore, the strain of the tendon and side effects of an inflammatory process could be demonstrated. The use of a surface coil yields a high resolution of the normal anatomy of the region and of the pathological changes of the tendon and the surrounding soft tissue structures. The advantages of MRI for Achilles tendon diagnostics against competitive modalities are excellent soft tissue contrast, multiplanar imaging, as well as exact delineation and visualisation of the lesion.
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Muscular imaging (sonography, computed tomography, magnetic resonance imaging) has proved to be worthwhile for myologic diagnostic purposes during the past few years. In 319 patients suffering from generalized neuromuscular diseases, muscle atrophies or hypertrophies and the degree and distribution of mesenchymal alterations in skeletal muscles were documented. The various imaging techniques were of assistance defining the optimal biopsy site, and the preparation of electro-myographic examinations. Real time sonography proved to be the method of choice for screening purposes and for documentation of fasciculations. Because of higher sensitivity and superior depiction of soft tissue pathology, magnetic resonance imaging supported the further diagnostic work-up in certain cases. Because of irradiating side effects, computed tomography was applied just for evaluation of muscle involvement in advanced stages of neuromuscular diseases in adults.