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R Rienmüller

Publications and source records attributed to R Rienmüller.

53 records · Page 3Linked to original sources
PubMed1984

[Digital radiography. Equipment technology and initial clinical results of digital angiography with an electronic universal work station].

Using a prototype of an electronic, universal examination unit equipped with a special x-ray TV installation, spotfilm exposures and digital angiographies with high spatial resolution and wide-range contrast could be made in the clinic for the first time. With transvenous contrast medium injection, the clinical results of digital angiography show excellent image quality in the region of the carotids and renal arteries as well as the arteries of the extremities. The electronic series exposures have an image quality almost comparable to the quality obtained with cutfilm changers in conventional angiography. There are certain limitations due to the input field of the 25 cm x-ray image intensifier used. In respect of the digital angiography imaging technique, the electronic universal unit is fully suitable for clinical application.

Angiography↗
PubMed1984

Primary malignant fibrous histiocytoma of the left atrium. Surgical and chemotherapeutic management.

A primary malignant fibrous histiocytoma of the left atrium was diagnosed in a 27 year old woman. After surgical excision the tumour recurred together with enlargement of the right hilar lymph nodes. The patient was then treated with nine courses of chemotherapy using a combined drug regimen. During the first course the tumour regressed, and after nine courses almost complete remission was achieved. Subsequently, the residual tumour was removed by resection of the right lung, the right hilar, paratracheal, and paraeosophageal lymph nodes and by cardiotomy with partial resection of the right and left atria and atrial septum followed by a reconstruction of the atrias. To date, more than two years after initial presentation, the patient is alive and well.

Adult↗
PubMed1983

[Infarct-induced changes in the left ventricular myocardium detected by cardiac computed tomography].

The aim of the present study was to compare left ventricular myocardial changes due to infarcts, as seen by computed tomography (CT), with the clinically well recognised methods, such as electrocardiography and angiocardiography. Our first group consisted of 57 patients with a clinical diagnosis of coronary heart disease, the second group comprised 19 patients with various cardiac abnormalities. The two groups were included in 530 CT examinations of the heart. The sensitivity of CT, compared with the other methods, was 77-100%, its specificity 50-100% in the first group, which had an infarct frequency of 71-82%. In this group a positive predictive value was found in 80-100%. The second group of patients had an infarct prevalence of 13-18% and a positive predictive value of 50-100%. Sensitivity in this group rose to 100% and specificity to 86-100%.

Adult↗
PubMed1983

[A pulsating tumor in the chest wall].

A pericardial constriction with calcification and a pulsating cyst is an unusual outcome after a pericardial windowing. The application of cardiac computed tomography evaluating the morphological parameters of the heart chambers and the adjacent vessels is an appropriate noninvasive method in the diagnostics of pericardial constriction.

Abscess↗
PubMed1983

[Non-invasive determination of the enddiastolic volume of the left ventricle. A comparative angiocardiographic, two-dimensional echocardiographic, computer tomographic and radionuclide ventriculographic study].

60 patients underwent left ventricular angiography (CV) and/or two-dimensional echocardiography (2DE) and/or multiple-gated equilibrium angiography (MUGA) and/or computer-tomography (CT) for determination of the left ventricular end-diastolic volume. Estimation of the enddiastolic volume from the various measurements showed significant correlations: CV/2DE: y equal 0.839 x +6.10, r equal 0.93, SEE equal 34.2 ml; CV/CT: y equal 0.762 x +30.30, r equal 0.82, SEE equal 20.8 ml; CV/MUGA: y equal 0.992 x +20.53, r equal 0.97, SEE equal 31.4 ml; 2DE/CT: y equal 1.167 x +19.58, r equal 0.93, SEE equal 38.4 ml; 2DE/MUGA: y equal 1.068 x +37,79, r equal 0.90, SEE equal 52.1 ml. Our study demonstrates that noninvasive techniques for measurement of the enddiastolic volume give results comparable to those obtained by cardiac catheterization. In addition, it is of interest that the noninvasive techniques examined show good agreement with each other.

Angiocardiography↗
PubMed1982

[Video-densitometric demonstration of abnormal movement of the left ventricle compared with results of levocardiography (author's transl)].

Video-densitograms of the heart of 46 patients were obtained in three projections; these patients had clinically and angiocardiographically confirmed coronary disease of varying severity, or suffered from cardiomyopathy or were normal. The results were compared with levocardiography. The purpose of the investigation was to determine to what extent abnormalities of movement, seen on levocardiography, can also be demonstrated by video-densitometry. Our results show that video-densitometry, compared with levocardiography, has a sensitivity of 97%, a specificity of 44% and an accuracy of 86%. Video-densitometry provides definite proof of abnormal cardiac movement. The differentiation of hypokinesia from akinesia by the two methods is discussed.

Absorptiometry, Photon↗
PubMed1981

[The diagnostic value of computerized tomography in mediastinal diseases depending on their localization].

The diagnostic ranking and importance of computerised tomography was examined in 116 patients with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive x-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnished by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum. -- clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; -- staging of an already identified primary mediastinal tumor of malignant lymphoma; -- in case of suspected changes in the large mediastinal vessels before employing angiography; -- on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands.

Aortic Dissection↗
PubMed1981

[End-diastolic volumes of the left ventricle in computer tomography in comparison to heart catheter ventriculography].

In 47 patients the authors calculated the volume at the end of a diastole according to both the cardiac catheter ventriculogram and the CT ventriculogram, comparing the results obtained with each of these methods. A linear regression was found. The correlation coefficient was approximately r = 0,96; n = 47. Cardiological examination revealed that of the examined patients (including the cardiac catheter finding) 18 patients had coronary heart disease, whereas 9 had cardiomyopathy, 6 arterial hypertension, 9 had various cardiac abnormalities and 5 did not show any organically manifest heart disease. The article discusses CT determination of the volume at the end of the ventricular diastole, and discusses the results.

Cardiac Catheterization↗
PubMed1981

[Optimized calculation of left ventricular enddiastolic volume by equilibrium radionuclide ventriculography (MUGA)--the influence of background correction and absorption (author's transl)].

Left ventricular (LV) enddiastolic volume (EDV) was calculated in 23 patients from background-corrected enddiastolic count rates (ROI technique). The calculation in volume units (ml) was based on the measurement of a well-defined amount of patients' venous blood (50 ml in a syringe) counted by the gamma camera. Decrease in count rate due to tissue attenuation was corrected for by calculation of soft-tissue absorption in the thoracic and LV wall as well as the blood self-absorption within the LV, applying a rotational ellipsoid with an assumed LV depth of 1.5 times that of the LV width within the LV ROI. Furthermore, the influence of various models of LV background superimposition (homogeneous, parabolic and no background) were tested correlatively for calculations of volume. Best correlation with cineventriculographically measured volumes (r = 0.92) was found with a parabolically weighed background correction, determining an individual value of background superimposition for each LV pixel. This approach was chosen because a homogeneous superimposition is an inadequate model to correct for background due to the geometric extension of the LV. Volumes, parabolically corrected were found to correlate most closely to cineventriculography (CVG) (VMUGA = 0.997 X VCVG - 12.6 ml).

Cardiac Volume↗
PubMed1980

[Value of angiotensin I-converting enzyme in the diagnosis of sarcoidosis (author's transl)].

Serum ACE activity measured fluorimetrically was found to be 2.95 +/- (SD) 1.76 mu mol/ml x h in 31 untreated patients with sarcoidosis. It was significantly elevated (p less than 0.001) in comparison to 38 healthy controls 0.97 +/- (SD) 0.30 mu mol/ml x h), 81 subjects with miscellaneous lung diseases, 20 corticosteroid treated patients with sarcoidosis and 15 subjects with resolved sarcoidosis. Resolution of sarcoidosis spontaneously or induced by corticosteroids was accompanied in all 17 cases by a decrease of serum ACE activity, in most cases, to normal values. On the other hand 7 out of 9 untreated patients with a chronic course of sarcoidosis did not show a comparable change of ACE. Our results reveal a close relationship between the activity of the disease and the level of ACE in the serum. The determination of the serum activity of ACE and its variations with time is quite useful in the diagnosis and follow-up of sarcoidosis and contributes to a further restriction of necessary operative procedures in the diagnosis of sarcoidosis.

Adrenal Cortex Hormones↗
PubMed1980

[The significance of demonstrating areae gastricae at hypotonic double contrast examination of the stomach (author's transl)].

150 patients were examined by the double contrast-technique in drug-induced hypotonia of the stomach. They were examined gastroscopically and at the same time biopsies were taken. Comparison of histological and radiological results was performed. There was found an agreement of 82% in the performance of areae gastricae and the histological diagnosis of chronic gastritis.

Biopsy↗
PubMedDate not supplied

MR imaging of pediatric cardiac tumors previously diagnosed by echocardiography.

Ten children, ranging in age from 3 weeks to 11 years, with a history of primary cardiac tumors were studied by two-dimensional echocardiography and by ECG triggered magnetic resonance (MR) imaging (six of them had rhabdomyomas). Eighteen of 31 tumors with intracavitary extension diagnosed by echocardiography were detected by MR. In addition, three intracavitary tumors were found by MR but not by echocardiography. Only 2 of 15 intramural tumors detected by echocardiography were identified by MR. Magnetic resonance imaging is inferior to echocardiography in the detection of intramural rhabdomyomas, but superior in delineation of the intra- and extracardiac extension of nonrhabdomyomal tumors.

Child↗
PubMedDate not supplied

Spirometrically controlled quantitative CT for assessing diffuse parenchymal lung disease.

OBJECTIVE: Assessment of lung attenuation by CT reflects changes in the air-to-tissue ratio of the lung. We have analyzed the interdependence of intrathoracic gas volume, lung morphology, and functional disorder by high resolution CT (HRCT) to assess quantitative disease threshold in obstructive and restrictive diffuse lung disease. MATERIALS AND METHODS: Pulmonary HRCT was performed on 24 healthy volunteers, 11 patients with chronic obstructive pulmonary disease (COPD), and 16 patients with idiopathic lung fibrosis (IPF). HRCT measurement was standardized by taking three scans at the carina +/- 5 cm and by defining inspiration levels by percent vital capacity (VC) via spirometrically gating to the scanner. RESULTS: The mean lung density at 50% VC (DL50) for healthy subjects was -819 +/- 3.8 (mean +/- SEM) HU. In contrast, COPD DL50 was lower, averaging -861 +/- 6.4 HU, and the IPF DL50 was considerably higher (-731 +/- 17.7 HU), both significantly different (p < 0.001) compared with the control group. The accuracy of quantitative HRCT at different inspiration levels was evaluated by scanning the basal layer at 20, 50, and 80% VC. The control values were -747 +/- 5.6, -816 +/- 3.6, and -855 +/- 3.0 HU, respectively, which were significantly higher (p < 0.001) than those seen in COPD patients at 20 and 50% VC. Again, the IPF patients exhibited increased lung density (p < 0.001) at all inspiratory levels. Discrimination power was best among all cohorts at 20 and 50% VC. Position-dependent artifacts on lung density were quantified by the anteroposterior density gradient (APG). Irrespective of the underlying disease, APG at 50 and 80% VC was similar, but was up to twofold higher at 20% VC, indicating that quantitative estimates near RV may misrepresent mean lung density. CONCLUSION: Our data indicate that quantitative HRCT measurements should be performed not near full inspiration or expiration, but at an intermediate degree of lung inflation, e.g., 50% VC, for reasons of accuracy, intra- and intersubjective comparability, and feasibility. We conclude quantitative HRCT to be a sensitive tool for the evaluation of diffuse parenchymal lung disease.

Adult↗