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Biomedical subjects

P Hübsch

Publications and source records attributed to P Hübsch.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Varicosis orbitalis. Its demonstration by color-coded Doppler sonography and computed tomography].

Three patients with intermittent exophthalmos were studied by computed tomography (CT) and colour-coded Doppler sonography (CCDS). By CT the possible diagnosis of an orbital varix was established. CCDS, however, with the dynamic evaluation and realtime direct imaging of flow and the possibility of examination in different positions facilitated the diagnosis of this orbital vascular disorder without the need for any contrast material. This technique may prove to be a useful adjunct to computed tomography for the evaluation of suspected vascular lesions of the orbit. Surgery confirmed the diagnosis in all patients.

Color↗
PubMed1991

Renal allograft arteriovenous fistula due to needle biopsy with late onset of symptoms--diagnosis and treatment.

A post-biopsy arteriovenous (AV) fistula in a renal allograft was diagnosed using color-coded Doppler sonography. Because the patient was asymptomatic, no specific treatment was initiated. 15 months after the diagnosis was established, severe hematuria with obstruction of the bladder occurred. Angiography revealed a connection of the fistula to the renal pelvis. The patient was treated successfully by transarterial embolization of the fistula. As a conclusion, we suggest periodical follow-up examinations of asymptomatic AV fistulas in renal allografts using color-coded Doppler sonography during 3-6 months. When no spontaneous regression of the fistula can be observed, embolization therapy should be performed even when the fistula is asymptomatic, in order to prevent late onset of complications.

Adult↗
PubMed1991

Color-coded Doppler sonography of vertebral arteries.

Color-coded Doppler sonography of the vertebral arteries was performed in 86 patients who had a history of vertebrobasilar disease. The origin of the artery was visualized in 87.2% on the right and 70.9% on the left side. The inter-transverse portion of the vertebral artery was visualized in 95% on the right and 97% on the left side. The atlas loop could be visualized in 88.4% on the right and 84.9% on the left side. Pathologic findings were hypoplasia (n = 4), stenosis (n = 19), dissection (n = 2), occlusion (n = 7), kinking (n = 12), cervical tumors (n = 3), and subclavian steal syndrome (n = 3). Nine postoperative patients had subclavian and vertebral artery reimplantation to the common carotid artery. The characteristic color-coded Doppler sonographic features of these findings are presented and discussed.

Angiography↗
PubMed1991

[DEXA (dual-energy x-ray absorptiometry) and DPA (dual photon absorptiometry) in densitometry of the femoral neck: correlation of the measurements of three commercially available instruments].

The bone mineral density measurements of three different instruments at the femoral head were compared using 12 cadaver specimens. Two of these instruments were operated by x-rays (dual energy x-ray absorptiometry = DEXA), whereas one system was based on a gadolinium source (dual photon absorptiometry = DPA). Although excellent correlation between the measurements was obtained (r greater than 0,9), the measurements of one of the DEXA-instruments were significantly higher than the measurements of the two other systems. We conclude that a comparison of bone mineral density measurements obtained on different densitometry instruments may pose problems. Follow-up examinations should be done on one single densitometry unit.

Absorptiometry, Photon↗
PubMed1990

[Velocity variance function: additional information in color-coded Doppler sonography of the carotids].

A new software, called the velocity variance programme, by which flow disturbances are additionally colour-coded, was systematically applied with colour Doppler sonography in 59 patients with stenotic atheromatous lesions of different grades in the carotid bifurcation. A direct comparison with and without using this programme was made. In group 1 (n = 23) with stenosis of the internal carotid artery of more than 50% it could be demonstrated that flow disturbances were maximally in the region immediately downstream of the stenosis and complete dissipation of these effects occurred within 8-10 vessel diameters downstream. Moreover, a direct correlation between the size of the region of disturbed flow and the irregularity of the stenotic plaque surface within the stenosis could be demonstrated. Distal to the stenosis there was an inverse relationship between the extension of disturbed flow and the length of the stenosis and a direct relationship to the grade of the stenosis and the irregularity of the plaque surface. In patient group 2 (n = 36) with less than 50% diameter reduction, a local flow disturbance near the atheromatous plaque was shown in 27 patients. In eighteen of these patients the region of disturbed flow could be revealed only by using the velocity variance programme. The importance of this non-invasive in-vivo visualisation of flow disturbances in the carotid bifurcation is discussed.

Arteriosclerosis↗
PubMed1990

[Radiologic therapy of symptomatic lymphoceles following kidney transplantation].

During a four and a half year period ending in November 1988, we performed 13 percutaneous needle aspirations and 35 percutaneous drainages on 32 patients suffering from symptomatic lymphoceles (LC) following renal transplantation. Of 13 needle aspirations, 4 were therapeutic (31%); in 9 cases recurrent lymphoceles were observed within 3 days. 35 percutaneous catheter drainages were carried out on 29 patients. 16 of these (55%) did not require any additional therapy. In 8 cases recurrent lymphoceles were treated surgically by marsupialization, another 5 underwent repeated percutaneous drainage. One patient needed 3 percutaneous interventions until his symptoms ceased. In 8 patients 5 ml. of fibrinous glue was administered before the catheter was removed; nevertheless, 3 of them developed recurrent LC. In the group of patients without any symptoms after percutaneous drainage, 5 LC were infected, in the group of repeatedly drained LC, 2 had superinfection which was treated with antibiotics. All of the infected LC could be managed successfully by percutaneous drainage. The overall rate of success was 72%.

Adult↗
PubMed1990

Color-coded Doppler imaging of normal vertebral arteries.

Using color-coded Doppler sonography, we studied the vertebral arteries of 42 persons without history or physical signs of vertebrobasilar disease. The intertransverse portion of the vertebral artery was visualized in all persons on both sides. Its origin was visualized in 37 persons (88.1%) on the right side and in 28 (66.7%) on the left; the atlas loop was visualized in 32 persons (76.2%) on the right side and in 36 (85.7%) on the left. Four vertebral arteries were hypoplastic. Peak systolic blood velocity ranged from 19 to 98 (mean 56) cm/sec and peak diastolic blood velocity ranged from 6 to 30 (mean 17) cm/sec. Resistive indices ranged from 0.62 to 0.75 (mean 0.69). Thus, color-coded Doppler sonography seems to be a promising noninvasive method for the evaluation of hemodynamics in the extracranial portion of the vertebral arteries.

Blood Flow Velocity↗
PubMed1990

[Sonographic localization of the kidneys for the purpose of radiation treatment of the abdomen: how accurate is this method?].

In 31 patients, the kidneys were located with ultrasonography before urography was carried out. The projection of the medial, lateral, cranial and caudal margins of the kidney were marked on the patient's back with a pellet. On X-ray film, the mean distance between the pellet and margin of the kidney varied from 0.12 to 1.13 cm; nevertheless the standard deviations were high (up to 2.63 cm). In 11 patients, more than one-third of the kidney was located outside the sonographically determined borders; on the left side this happened in 10 patients. We conclude that sonographical localization of the kidneys for protection during irradiation of the abdomen should only be used when other localization procedures cannot be carried out.

Abdomen↗
PubMed1990

Renal osteodystrophy. Radiological diagnosis compared with a new radioimmunoassay method of parathyroid hormone.

The parathyroid hormone concentration in the blood measured by the 'two-site radioimmunoassay', which is specific for the biologically active parathyroid molecule (parathyrine), was compared with the radiological manifestations of secondary hyperparathyroidism (HPT) on magnification radiographs of the phalanges in patients undergoing maintenance hemodialysis and in patients with renal allografts. Sensitivity of radiology for the diagnosis of HPT proved to be high (88%), whereas specificity was low (30%). Statistical analysis showed that there was a good correlation between the parathyrine levels and the intensity of radiological changes in the phalanges in patients with renal allografts (coefficient of Krueger-Spearman = 0.65). In patients undergoing hemodialysis the correlation between laboratory parameters and radiological changes was poor.

Adult↗
PubMed1990

[Flow reversal in the carotid bifurcation. Detection using color-coded Doppler sonography].

Pulsatile blood flow within the normal carotid sinus involves at least two distinct components. Beside the laminar antegrade flow, there is a boundary layer separation zone in the posterolateral aspect with transient flow reversal. This flow reversal is well known from in vitro studies. It is now possible to document these flow velocity components using color-coded Doppler sonography. It is hypothesized that if flow separation is detected, this is indicative of a normal condition of the carotid bifurcation. When atherosclerosis develops, it involves preferentially the posterolateral bulb region, obliterating the normal configuration of the sinus with consequent loss of the flow separation. Therefore, loss of flow reversal should be indicative of atherosclerosis. We have studied this flow pattern retrospectively in 156 patients (312 arteries). In 4 patients no flow reversal could be detected although no atheromatous lesions could be found at the bifurcation, but in these cases there was no bulb formation in the common carotid artery or in the internal carotid artery. On the other hand, flow reversal was demonstrable in several pathological conditions within the carotid bifurcation. These included plaque formation after the bifurcation in 7 patients, internal carotid artery occlusion at the origin in 12, common carotid artery occlusion despite a patent bifurcation in 4, and marked dilatation of the lumen forming a pseudobulb following disocclusion of the carotid artery in 11 patients.

Blood Flow Velocity↗
PubMed1990

[The diagnostic value of scintigraphy and x-rays in unclear arthralgias of the hands].

33 patients presenting with arthralgia of wrists and finger joints were examined by radionuclide imaging and radiography. In 22 patients clinical symptoms turned out to be caused by inflammation, 11 patients suffered from degenerative joint disorder. Radionuclide imaging proved once more to be nonspecific albeit very sensitive; plain film radiography exhibited good specificity. The combination of both methods resulted in an increase in accuracy as compared to scintiphotography alone (0.88 vs. 0.79). Radionuclide imaging and radiography should therefore always be done and interpreted simultaneously. Radionuclide imaging is mandatory to confirm or to rule out inflammatory joint disorder in case of an inconclusive x-ray (absence of erosions or degenerative changes). A negative radionuclide study rules out inflammation, even when juxta-articular demineralisation is suspected on the x-ray.

Adult↗
PubMed1989

[B-mode and color-coded Doppler sonography in irradiation planning in klippel-Trenaunay syndrome with Kasabach-Merritt symptoms].

A patient with intravascular coagulation caused by the Klippel-Trenaunay syndrome is presented; this is a rare phenomenon. The patient was treated with fast electrons. Sonography is a suitable method for determining the extension of the haemangiomas occurring in Klippel-Trenaunay's syndrome. This is important for therapy planning. With colour-coded Doppler sonography, arteriovenous fistulas can be ruled out, this allowing to distinguish the Klippel-Trenaunay syndrome from the Parkes-Weber syndrome.

Adult↗
PubMed1989

[Lung changes in amiodarone therapy].

We describe a 59-year-old patient who was treated with amiodarone for severe ventricular arrhythmia. After a two-year period of medication the therapy had to be abandoned because of pulmonary changes on the chest X-ray that mimicked lung oedema; no other cause for the pulmonary opacities than an adverse effect of amiodarone was to be found. The radiological changes in the lungs regressed within one year with no specific therapy being administered.

Amiodarone↗