PubMed Health⌕ Search

Biomedical subjects

R Erlemann

Publications and source records attributed to R Erlemann.

At least 73 records · Page 4Linked to original sources
PubMed1989

Musculoskeletal neoplasms: static and dynamic Gd-DTPA--enhanced MR imaging.

Static and dynamic magnetic resonance imaging studies were performed in 69 patients with bone and soft-tissue tumors. T1-weighted spin-echo (SE) imaging after intravenous administration of gadolinium diethylenetriaminepentaacetic acid (DTPA) improved the differentiation of necrotic from viable areas; the contrast-to-noise ratio (C/N) between tumor and muscle was an average of 44% lower compared with that in T2-weighted SE imaging. The C/N between tumor and bone marrow or fatty tissue was 43% and 37% lower, respectively, compared with that in nonenhanced T1-weighted SE imaging. Dynamic changes of signal intensity (SI) after Gd-DTPA enhancement were assessed with fast low-angle shot imaging. Of malignant tumors, 84.1% exhibited slopes higher than 30% per minute; 72% of benign tumors showed slopes lower than 30% per minute. The dynamic technique enabled assessment of the malignant potential of a tumor with some overlap (accuracy, 79.7%). Necrotic areas and peritumorous edema showed significantly lower and more gradual increases in SI than adjacent neoplastic tissue.

Adipose Tissue↗
PubMed1989

[New aspects of preoperative imaging diagnosis in aggressive fibromatosis].

Aggressive fibromatosis is a surgical problem due to its tendency to recur following excision. The imaging methods available are presented and their diagnostic value discussed. A combination of different investigative procedures allows preoperative assessment of tumor type and extent and accurate planning of surgical procedure.

Angiography↗
PubMed1989

[The value of nuclear magnetic resonance tomography in staging of bone and soft tissue sarcomas].

The prognosis of survival in bone and soft-tissue sarcomas is definitely correlated with compartmental tumor extension at the time of surgery and with the surgical margins achieved by resection. Preoperative planning and selection of an adequate surgical treatment procedure require a maximum of information on the tumor size, compartmental extension, proximity to the physis, skin layers, and the vessels and nerves. This information is indispensable and can only be obtained by a combination of several diagnostic investigations, MRI being of utmost importance. Whereas CT is superior in illustrating the bone structure, MRI outclasses CT in outlining the intraosseous tumor extension and the extraosseous tumor components. The latter aspects are especially important in planning and performing tumor resection. With the combined use of gradient echo sequences and Gadolinium DTPA with MRI, appreciation of the tumor margin and response to polychemotherapy may be possible in the future.

Bone Neoplasms↗
PubMed1989

[The use of gadolinium-DTPA in inflammatory bone diseases].

In bacterial osteomyelitis and arthritis para-osseous spreading is sensitively detected by Gadolinium-DTPA. Abscessed cavities and membranes are better imaged than with T1- and T2-weighted MRT-sequences without contrast medium. In chronic osteomyelitis it is of advantage, that also florid inflammatory process can be detected. Gadolinium-DTPA selectively induces a signal increase in the synovial pannus, that allows the differentiation from articular effusion. In inflamed para-articular soft tissue only a retarded signal increase is detectable.

Arthritis↗
PubMed1988

Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging.

Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human cadaveric patellae were performed in order to determine optimal imaging parameters. FLASH (TR = 40 ms, TE = 10 ms, flip angle = 30 degrees) and FISP (TR = 40 ms, TE = 10 ms, flip angle = 40 degrees) were used in clinical studies. Advanced stages of chrondromalacia could be visualized with high sensitivity. In less advanced disease, overstaging was observed. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30 degrees FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia.

Arthroscopy↗
PubMed1988

Surgical strategies for combined intraorbital and intracranial tumors.

Three unusual cases of combined intraorbital-intracranial tumors of various types which were chosen from cases treated in the Clinic and Polyclinic of Neurosurgery of the University of Münster, to demonstrate the problems of surgical therapy. A list of indications for the various accesses to the orbita is worked out. Close co-operation among the neurosurgeon, the ophtalmologist, the oto-rhino-laryngologist and the maxillofacial surgeon is necessary. All facets of the patient's condition and situation must be taken into consideration when planning therapy.

Adenoma↗
PubMed1988

[Efficient use of flash sequences in the staging of bone and soft tissue tumors].

Delineation of neoplasms from normal tissue is possible using Flash sequences. These sequences prove useful in preoperative staging of bone tumours and soft tissue tumours. However, contrast between neoplastic and surrounding normal tissue is lower than in optimal selected spin-echo sequences. Flash-90 sequence is superior to Flash-10 sequence in the demonstration of intraosseous extension of predominantly sclerotic, calcified and purely fibrous tumours. In contrast, Flash-10 sequence proves superior for the demarcation of osteolytic tumours with minimal fibrous tissue content. Delineation of extraosseous tumour masses against muscle can best be achieved using Flash-90 sequence after intravenous administration of Gadolinium-DTPA. Flash-90 sequence enables sharp demarcation of extraosseous masses of bone tumours against surrounding fat, whereas Flash-10 sequence proves useful in the delineation of non-lipomatous soft tissue tumours against normal fat.

Bone Neoplasms↗
PubMed1988

[Computerized tomography and magnetic resonance tomography in soft tissue tumors].

The modern cross-sectional imaging techniques, e.g. CT and MR, have brought about a significant improvement in the diagnosis of soft tissue tumors. CT allows these neoplasms to be detected with relatively high sensitivity and their extension to be assessed. MR has proved to be superior to CT owing to the high soft tissue contrast it provides and its multi-planar imaging capabilities. Gadolinium-DTPA, a paramagnetic agent, can be utilized to good advantage as contrast material in MR; it yields further information as to the malignancy or otherwise of particular tumors. In addition, differentiation of tumor recurrences from other postoperative alterations seems to be feasible.

Humans↗
PubMed1988

[Possibilities of magnetic resonance tomography in diagnostic imaging of the shoulder joint].

By virtue of its multiplanar representation, magnetic resonance imaging (MRI) allows clear visualization of the complex anatomical relationships of the shoulder joint. In addition to axial planes, slices perpendicular and parallel to the glenoid cavity are used to good advantage. In tears of the rotator cuff an increase in signal intensity within the cuff is recognized in T2- and proton-density-weighted images. Lesions of the glenoid labrum following luxations of the glenohumeral joint can be detected and classified using MRI. The diagnostic value of MRI as compared with other imaging modalities will have to be evaluated in larger series with operative verification.

Arthrography↗
PubMed1988

[Tumorous space occupying lesions of the scapula. An analysis of preoperative assessment of invasion].

The radiographic and histological morphology of 38 tumors lesions of the scapula are analyzed. Osteochondromas (n = 12), chondrosarcomas (n = 7), plasmacytomas (n = 4) and Ewing's sarcomas (n = 3) were the most frequent neoplasms. The radiographically determined growth rates allowed an estimate of the dignity in all cases. Benign lesions were only observed in the first five decades of life, and were mostly located in the scapular blade. Most tumors found in the acromion and in the glenoid region and all lesions diagnosed in the 6th to the 8th decades of life were malignant. In 63.2% of cases correct diagnosis of the type of lesion present was possible on radiographic examination.

Adolescent↗
PubMed1988

[Time-dependent changes in signal intensity in neoplastic and inflammatory lesions of the musculoskeletal system following intravenous administration of Gd-DTPA].

In 48 patients with primary and secondary bone and soft tissue tumors and in 6 patients with inflammatory diseases of bone, the increase in signal intensity after i.v. administration of Gd-DTPA (0.1 mmol/kg body wt) was assessed in pathologic and normal tissues of the musculoskeletal system by means of a FLASH sequence (TR = 40 ms, TE = 10 ms, tip angle 90 degrees). In normal tissues the increase of signal intensity was slower and less pronounced than in lesions. Malignant tumors showed a more pronounced and rapid increase in signal intensity than benign tumors and inflammatory tissue. It was possible to differentiate necrotic areas and peritumorous edema from tumorous and inflammatory tissue. The increase in signal intensity was perceptibly slower and less pronounced in malignant tumors exposed to cytostatic therapy than in malignant tumors without therapy.

Bone Neoplasms↗
PubMed1987

[Imaging of femur head necrosis using MR tomography].

Magnetic resonance tomography (MR) was used to examine the femoral heads of 20 normals and of 56 patients with diseases of the femoral head, including Perthe's disease (four cases), adult necrosis of the femoral head (39 cases) and pain of unknown cause (13 cases). Femoral head necrosis and Perthe's disease regularly produce reduced signal intensity. The localisation of the areas of necrosis can be determined accurately in the coronary and sagittal plane. In 11 femoral heads, necrosis could be demonstrated unequivocally by MR in the presence of normal radiographic findings. Follow-up of nine patients with negative MR findings and indefinite symptoms confirmed the absence of necrosis.

Adult↗
PubMed1987

[Space-occupying tumor lesions of the spinal column. An analysis of the material submitted to the Westphalia Bone Tumor Register].

308 tumorous lesions of the spine were identified in the material submitted to the bone tumour register in Münster for recording. Histological examination revealed metastases in 38.6% primary bone tumours in 33.1%, tumour-like lesions in 10% and haematological and lymphatic disease in 13%. 5.3% of all lesions could not be classified in these groups. Primary bone tumours were seen more often than metastases in the cervical spine, the sacrum and the coccyx. 54.9% of the primary bone tumours of the spine were benign. However, only 31.2% of all the tumorous lesions of the spine, metastases included, were benign. The portion of malignant disorders increased with increasing age. The risk of having a malignant spine tumour was 5.9% in patients under 10 years of age but 92.3% in patients in the seventh decade.

Age Factors↗
PubMed1987

[Neurofibromatosis and multiple nonossifying bone fibromas].

Three patients with a combination of neurofibromatosis and multiple non-ossifying fibromas are presented. All patients possessed multiple osteolytic lesions with sclerotic margins, resembling non-ossifying fibromas. Two patients showed similar lesions in additional localizations. In two patients, non-ossifying fibroma was histologically verified. The simultaneous occurrence of neurofibromatosis and multiple non-ossifying fibromas can possibly be put down to a generalized mesodermal dysplasia. However, the definite explanation is unknown.

Adolescent↗
PubMed1987

[Primary bone tumors and tumor-like lesions of the spine. The accuracy of radiological assessment criteria].

In 79 primary bone tumors and tumorlike lesions of the spine radiological criteria are analyzed, which allow to assess the biological nature. Criteria associated with benign lesions, are: regular, trabecular matrix, osteoplastic matrix, exostotic growth, location in the posterior elements, absent soft tissue mass, and bulging of the vertebra. Criteria suggestive of malignancy are: Soft tissue mass, location inside the vertebral body, no alteration of the vertebral shape, compression fracture, and osteolysis. Benign lesions can be diagnosed with a higher degree of reliability than malignant tumors. Diagnostic accuracy increases in lesions exhibiting more than one criterion of the same group.

Chondroma↗
PubMed1987

[Computed tomography changes in children with shunted hydrocephalus and intermittent cranial pressure crises].

Seven children with drained hydrocephalus are described who showed increasingly severe and frequent episodes of intermittently raised intracranial pressure. CT examinations during symptom-free intervals, or after conservative treatment, showed collapsed slit-like ventricles. Examination during attacks of raised pressure showed relative dilatation of the ventricles as compared with earlier examinations. Children with ventricular shunts of long duration may develop a shunt-dependent syndrome; CT may show normal or narrow ventricles and this does not exclude the possibility of a rise of intracranial pressure. These findings may help in making the diagnosis by means of CT without any further invasive procedures.

Adolescent↗