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N Gritzmann

Publications and source records attributed to N Gritzmann.

At least 37 records · Page 2Linked to original sources
PubMed2000

Presence or absence of gas in the appendix: additional criteria to rule out or confirm acute appendicitis--evaluation with US.

PURPOSE: To investigate whether the presence or absence of gas in the appendix may be considered as additional ultrasonographic (US) criteria to rule out or confirm acute appendicitis. MATERIALS AND METHODS: The appendices in 239 control subjects, 138 patients with lower right quadrant pain without acute appendicitis, and 80 patients with acute appendicitis were prospectively evaluated for intraluminal gas with US. RESULTS: The appendices in 206 (86%) control subjects showed gas at US, and those in 33 (14%) did not. The appendices in 109 (79%) symptomatic patients without acute appendicitis showed gas, and those in 29 (21%) did not. The appendices in 12 (15%) patients with acutely inflamed appendices showed gas, and those in 68 (85%) did not. The absence of gas as a criterion for acute appendicitis had a sensitivity of 85%; specificity, 79%; positive and negative predictive values, 57% and 94%, respectively; and accuracy, 81%. Gas was useful to exclude acute appendicitis in 64 (46%) symptomatic patients because the established criteria were misleading. In 19 (24%) patients, the absence of gas was useful for diagnosis of acute appendicitis because the other criteria were not convincing. CONCLUSION: US-based detection of gas in the appendiceal lumen helps to rule out acute appendicitis, whereas the absence of gas further confirms its presence, especially in cases where established US criteria are either insufficiently present or misleading.

Acute Disease↗
PubMed2000

Sigmoid diverticulitis: value of transrectal sonography in addition to transabdominal sonography.

OBJECTIVE: Overlying intestinal gas often impairs transabdominal sonographic assessment of the lower sigmoid colon. The aim of this study was to investigate the usefulness of transrectal sonography in addition to transabdominal sonography for the evaluation of sigmoid diverticulitis. SUBJECTS AND METHODS: Eighty-six consecutive patients with clinically suspected acute sigmoid diverticulitis were referred for transabdominal sonography as the initial imaging method. In 46 patients, transrectal sonography was performed in addition to transabdominal sonography if pain was localized to the mid lower abdomen and if a disease process could not be visualized or could be only partially visualized on transabdominal examination. An end-firing 5-9-MHz endocavitary probe was used for transrectal sonography. RESULTS: Thirty-four of 50 patients with a final diagnosis of sigmoid diverticulitis underwent both transabdominal and transrectal sonography. In 20 patients, transrectal sonography showed relevant additional information: six diagnoses of diverticulitis were established on transrectal sonography alone. Transrectal sonography revealed one perforation, five abscesses, and three fistulous complications that were not shown on transabdominal sonography. In the remaining five patients, correct diagnoses were supported on transabdominal examinations, but only transrectal sonography could show an inflamed diverticulum. In 10 patients, transrectal sonography revealed signs of diverticulitis but no relevant information in addition to the results from transabdominal sonography. Four false-negative and two false-positive results were revealed with transrectal sonography. CONCLUSION: Transrectal sonography is accurate for confirming clinically suspected acute colonic diverticulitis when the lower sigmoid colon is affected. It helps avoid false-negative results and defines the severity of disease in the lower sigmoid colon better than transabdominal sonography alone. Transrectal sonography can increase the sensitivity of sonography for diagnosing sigmoid diverticulitis.

Abdomen↗
PubMed1999

[Diverticulitis of the appendix vermiformis: ultrasonographic appearance].

AIM: To describe the sonographic findings in acute diverticulitis of the vermiform appendix. A case report and a review of literature are used to present the sonographic appearance, special clinical aspects and the pathogenesis of this rare entity. CONCLUSION: Acute diverticulitis of the vermiform appendix presents certain sonographic features, which allow preoperative diagnosis and differentiation from acute appendicitis and right colonic diverticulitis.

Acute Disease↗
PubMed1999

Adult celiac disease: US signs.

PURPOSE: To examine whether distinct ultrasonographic (US) signs exist in patients with adult celiac disease. MATERIALS AND METHODS: In a partly retrospective study, abdominal sonograms were obtained in 11 patients with adult celiac disease. Fifty matched control subjects also were examined. After the patients had fasted overnight, they were examined with 2-4-MHz abdominal and high-frequency 5-10-MHz linear-array US transducers. RESULTS: The authors found several US pathologic signs in patients with untreated disease, including abnormal fluid-filled small intestine in all 11 patients, flaccid and moderately dilated small-bowel loops (2.5-3.5 cm) in eight, slight diffuse thickening of the small-bowel wall (3-5 mm) in seven, increased peristalsis of the small intestine in eight, enlarged mesenteric lymph nodes (anteroposterior diameter 5-10 mm) in nine, dilated caliber of the superior mesenteric artery or portal vein in seven, free fluid in the abdominal cavity in five, and increased echogenicity of the liver in six. None of these signs was present in the control group. CONCLUSION: There are several US signs associated with adult celiac disease. None of the signs identified is specific, but a combination of signs is characteristic and indicates suspicion of this disease in a high percentage of cases. US could help to avoid diagnostic delay, especially in patients who have atypical clinical presentations.

Adult↗
PubMed1998

Color Doppler sonography of normal breasts: detectability of arterial blood vessels and typical flow patterns.

In a prospective study, 200 healthy female breasts were examined using color Doppler sonography to study the detectability and the resistive indices (RIs) of arterial vessels. In each breast, we attempted to detect two to three vessels and recorded the frequency spectrum with RI of each vessel. Blood vessels (n = 522) could be demonstrated in 196 (98%) breasts. Continuous diastolic flow (RI < 1) was found in 520 (99.6%) vessels. The mean RI of premenopausal women was 0.64; that of postmenopausal women was 0.70. This difference is highly statistically significant (p < 0.0001), but there is a marked overlap between the RIs of both groups. The variation in RI values of all women (up to 0.45), as well as in the breasts of the same woman (up to 0.31), was considerable. We conclude that modern color Doppler devices permit the detection of blood flow in the breast with regularity. Continuous diastolic flow (RI < 1) is a typical flow pattern. The variations of RI between women, and even for the same woman, are remarkable. The mean RI of premenopausal women is lower than the value for postmenopausal women.

Arteries↗
PubMed1997

New signs of breast cancer: high resistance flow and variations in resistive indices evaluation by color Doppler sonography.

In a prospective study, color Doppler sonograms (CDS) were performed in 142 patients with solid breast lesions (64 carcinomas, 53 fibroadenomas, 25 miscellaneous breast diseases). Exclusively intratumoral RI were determined, with only the highest and lowest value in the various vessels of a tumor being considered. We found that an RI < 0.80 is typical for benign breast conditions, but also frequently occurs in malignant lesions. A significant difference was seen for higher RIs. An RI > or = 0.80 was seen to be an indicator of malignancy with high specificity (96%) and a sensitivity of 55%. Moreover, RI differences in malignant lesions were markedly greater than in benign lesions. An RI difference > or = 0.20 among vessels of one tumor was a malignancy indicator with very high specificity (97%) but relatively low sensitivity (39%). An RI > or = 0.80 and RI differences > or = 0.20 are specific Doppler ultrasound (US) malignancy indicators.

Adult↗
PubMed1997

[Ultrasonography of the normal vermiform appendix].

AIM: To study the detectability and the appearance of the vermiform appendix with ultrasound in asymptomatic adults. METHODS: A prospective study was performed on 300 patients, selected without regard to age, sex and weight. We tried to visualize the appendix with a 3.5 MHz annular array and a 5 MHz linear array transducer. RESULTS: In 63% of the patients the appendix was clearly visualised. The main reasons for non-visualisation were obesity with insufficient ultrasound penetration (38%) and the caecum laying in pelvic or atypical position (24%). In 31%, no cause was apparent but we assume that the appendix often lies behind the caecum. The sonographic image showed an aperistaltic target originating at the caecum, and ending blindly. In 42% of cases the appendix was ovoid in transverse section; in 32%, round; and in 26% both forms were found within one appendix. Intraluminal gas was visible in 86%. The mean transverse diameter was 5.2 mm (min. 3 mm, max. 13 mm) and in 76% the transverse diameter was lower than 6 mm. CONCLUSION: The sonographic detectability, the appearance and the size of the normal appendix show considerable variations.

Adult↗
PubMed1996

[High resolution small parts sonography (7.5 MHz) of the head and neck region].

Frequently, sonography of the head and neck serves only for assessment of the thyroid and arteriosclerotic lesions of the extracranial vessels. This article gives a review of ultrasound of the remaining cervical structures, particularly spaceoccupying lesions. The differentiation between malignant and benign lymphadenopathy or between intraglandular and extraglandular abnormalities of the salivary glands is possible with an accuracy between 90 and 95 %. Limitations of the method lie in the difficult access to the skull basis as well as the retropharyngeal and retrotracheal space.

Diagnosis, Differential↗
PubMed1996

[Spontaneous fatty tissue necrosis of the omentum majus and epiploic appendices: clinical, ultrasonic and CT findings].

UNLABELLED: To describe US and CT findings of primary epiploic appendicitis and segmental infarction of the omentum. MATERIAL AND METHODS: From 1986 through 1996 thirteen patients presented with these pathological findings at our institution (6 patients with greater omental infarction and 7 patients with epiploic appendicitis). US (n = 13) and CT findings (n = 7) were retrospectively reviewed. RESULTS: US revealed moderately hyperechoic, ovoid lesions adherent to the peritoneum. On CT scans the masses appeared as areas of fat with slightly increased attenuation and sometimes with hyperattenuating peripheral rims. Secondary omental or appendiceal involvement caused by inflammation of adjacent organs has to be excluded. CONCLUSION: Segmental infarction of the omentum and primary epiploic appendicitis have characteristic US and CT features that enable the correct diagnosis.

Adipose Tissue↗
PubMed1996

[Ultrasound of stress cholecystitis--diagnosis and differential diagnosis].

A review of the current literature was performed. Many sonomorphologic features are described in literature, but none of these is pathognomonic for AAC. They also can be found in various nonbiliary disorders. For the diagnosis of the acute acalculous cholecystitis it is recommended to combine the findings wall-thickening, hydrops and sludge. The different sonographic features of the wall-thickening as well as anamnestic and clinical datas should be regarded. Computed tomography with i.v. contrast medium offers the highest sensitivity and specificity, but these datas should be proofed by further studies.

Acute Disease↗
PubMed1995

[Diagnostic imaging in arthrosis deformans of the peripheral joints].

Conventional radiology is the most important diagnostic imaging method for the arthrosis deformans of the little peripheral joints, sometimes radionuclide bone imaging is used as a supplement. We deal with the classification and the radiological signs of the arthrosis deformans in general and of the peripheral joints in particular. Great importance is attached to typical findings and finding constellations in text and pictures. We try to explain the complex differential diagnosis and the implication with other disorders of the joints in a brief and poignant way.

Cartilage, Articular↗
PubMed1994

[Color-coded duplex sonography of the parotid gland in Sjögren's syndrome].

27 patients with confirmed Sjögren's syndrome were examined prospectively by means of colour coded duplex sonography and pulsed Doppler sonography in order to determine blood flow in the parotid gland in this condition. Organ perfusion was divided semi-quantitatively into 4 groups: grade 0 (no intraglandular perfusion recognised) to grade 3 (numerous intra-glandular flow signals). Low perfusion values (grade 0 or grade 1) were found in normals and this was also observed in 13 patients (48%). 6 patients (22%) showed moderate increase (grade 2), and 8 patients (30%) showed gross increase (grade 3) in glandular perfusion. The increase in perfusion correlated with the severity of the sono-morphological glandular changes, such as reduced echogenicity, increased size and heterogeneous structure. Increased perfusion was associated with intra-glandular flow velocity as measured by Doppler sonography; maximal systolic flow velocity was significantly higher in patients with markedly increased perfusion than in normals.

Adult↗
PubMed1993

[The sonography of laryngeal cysts].

To evaluate the sonographic appearance of laryngeal cysts, ultrasound examinations of 7 patients were evaluated retrospectively. The ultrasound studies were correlated with endoscopic findings. In two cases, the diagnosis was confirmed histologically, and in 4 patients, a CT examination was additionally performed. The endolaryngeal space could be well seen if the thyroid cartilage was not calcified (n = 6), whereas in one patient, the endolaryngeal part of the cyst could not be seen because of complete calcification of the thyroid cartilage. The laryngeal cysts presented as unechoic (n = 4) or hypoechoic (n = 3) masses, which demonstrated smooth margins in all cases and ranged in size from 6 to 38 mm. In three cases, the cyst was located in the endolaryngeal space, and in 4 cases, it extended cranial of the thyroid cartilage into the pre-epiglottic space. All cysts were closely related to the inner surface of the thyroid cartilage, from which they were delineated by a thin hyperechoic band in all cases.

Adult↗
PubMed1993

[Ultrasound diagnosis of the thyroid gland and adjacent soft tissue of the neck].

The significance of sonography in diffuse and focal thyroid pathologies is summarized. The sonomorphology and the vascularization in pathologies of the thyroid gland are discussed. Supplementary applications of scintigraphy and fine needle aspiration are pointed out. In hyperparathyroidism, the role of sonography to localize parathyroid adenoma is presented. The typical sonomorphology of benign cervical pathologies as cervical cysts, angiomas, lipomas and carotid body tumors is explained. Sonography is the primary imaging method for the assessment of the thyroid gland and the surrounding cervical soft tissue.

Biopsy, Needle↗
PubMed1993

Ultrasound of the neck.

In many institutions sonography still is used for evaluation of the thyroid gland and for assessment of sclerotic lesions of the carotid arteries only. The aim of this article is to summarize the potentials and limitations of sonography in the investigation of the extrathyroidal cervical soft tissues. The knowledge of the anatomy of this complex region is mandatory for the investigation of cervical soft tissue lesions.

Cysts↗
PubMed1992

[The technic of adrenal biopsy. Ultrasound versus CT as the guidance method].

Forty-seven needle biopsies of the adrenal glands have been performed under ultrasound or CT guidance. The aim was to clarify the best guidance method, the best approach, the choice of biopsy needle and possible complications. Analysis of the results provided the following answers: 1. A mass in the right adrenal can be biopsied under ultrasound control by a transhepatic approach. Small lesions of the left adrenal are best approached under CT guidance. In these cases a subcostal angled approach is advised. 2. Cutting biopsy needles provide better results than aspiration biopsy needles. 3. The complication rate of adrenal biopsies is very low if thin cutting needles are used.

Adrenal Glands↗