Biomedical subjects

S Feuerbach

Publications and source records attributed to S Feuerbach.

166 records · Page 10Linked to original sources

PubMedDate not supplied

Diffusion-weighted imaging with calculated apparent diffusion coefficient in intracranial hemorrhagic lesions.

In the literature published so far, measurement of values of the apparent diffusion coefficient (ADC) using an echo-planar imaging (EPI) technique in intracranial hemorrhagic lesions show no uniform results. Furthermore, no data exist for bleedings into intracranial lesions. We investigated the ADCs of 18 intracranial hemorrhagic lesions of different stages using echo-planar diffusion-weighted imaging (DWI). The ADC values measured in the hemorrhagic lesions ranged from 1.42 x 10(-3) to 0.22 x 10(-3) mm(2)/s. There were no significant differences between the ADC values in the hemorrhagic lesions and the contralateral white matter (P=.39). A differentiation between the lesions only with the ADC value was not possible as well. Using EPI DWI in intracranial hemorrhagic lesions of different stages, no reliable ADC values were found and a dependable differentiation between the lesions is not possible.

Adult↗

PubMedDate not supplied

Endoscopic ultrasound in pancreatic tumor diagnosis.

In a prospective study from 1988 to 1990, 132 patients with suspected pancreatic tumor were examined with endoscopic ultrasound (EUS), transabdominal ultrasound (US), computed tomography (CT), and ERCP. The final diagnosis of 102 pancreatic tumors of different origin (76 malignant and 26 inflammatory tumors) and the exclusion of a pancreatic tumor in 30 patients was made by operation (N = 47), puncture (N = 36), autopsy (N = 3), or follow-up of a mean of 51 weeks (N = 46). Sensitivity and specificity in pancreatic tumor diagnosis were significantly higher for EUS (99% and 100%) than for US (67%/40%) and CT (77%/53%) and equal to ERCP (sensitivity 90%). This was even more obvious in small pancreatic tumors of 3 cm and less. However, as with the other imaging procedures, EUS was not able to differentiate reliably malignant from inflammatory pancreatic masses (accuracy 76% for malignancy and 46% for focal inflammation). From analysis of the endosonographic pattern of pancreatic tumors, no consistent morphologic features were identified which could have been specifically attributed to malignant or inflammatory masses. Our results show that EUS is superior to US and CT and equal to ERCP in pancreatic tumor diagnosis. In contrast to the indirect evidence obtained by ERCP, EUS provides direct visualization of tumor size and shape in almost all patients examined. Thus, EUS should be considered early in the evaluation of patients with suspected pancreatic tumors.

Adult↗

PubMedDate not supplied

Long-term follow-up of patients with necrotizing pancreatitis treated by percutaneous necrosectomy.

BACKGROUND/AIMS: The objective of this follow-up study was to assess the long-term outcome of patients with infected necrotizing pancreatitis treated with percutaneous catheter drainage and necrosectomy. METHODOLOGY: Nine patients (median age 44 years, range 19-69) with infected pancreatic necrosis and catheter drainage for initial treatment were evaluated after a median follow-up of 30 months (range 15-52) with respect to quality of life (pain, diarrhea, fat intolerance), morphology and endocrine and exocrine pancreatic function. RESULTS: At follow-up all 9 patients (100%) were in good general condition with respect to quality of life. Only 2/9 (22%) patients had moderate to marked changes in computed tomography. There was mild to moderate exocrine dysfunction in 5/8 (63%) patients, 2/8 (25%) patients had a severe restriction of the exocrine pancreatic function; in one patient the serum pancreoaryl test was normal. An oral glucose tolerance test was performed in 6/9 patients, with a normal result in 3/6 (50%) patients. 2/6 (33%) patients had an impaired oral glucose tolerance test with metabolic pathogenesis. One patient with diabetes in the oral glucose tolerance test had a preexisting type II diabetes requiring insulin therapy since the onset of acute pancreatitis. In 3/9 (33%) patients an oral glucose tolerance test was not performed due to known preexisting diabetes. CONCLUSIONS: Percutaneous drainage of infected necrotizing pancreatitis has given good long-term results with regard to quality of life, endocrine and exocrine pancreatic function and may be an alternative to surgical treatment.

Adult↗

PubMedDate not supplied

Spiral-CT in diagnosis of vascular involvement in pancreatic cancer.

BACKGROUND/AIMS: The purpose of this prospective study was to evaluate the efficacy of spiral-CT for the identification of portal venous, superior mesenteric artery and celiac trunk infiltration in the staging of pancreatic (n = 29) and periampullary (n = 6) cancers. MATERIALS AND METHODS: All patients were examined by contrast enhanced spiral-CT using a total volume of 240 ml contrast medium i.v. With a slice thickness of 5 mm and a table increment of 7 mm/sec a overlapping data set, representing a total volume of 21 cm, was covered. The images were reconstructed in 4 mm intervals. In 28 patients the spiral CT results were correlated with surgical findings. RESULTS: Regarding portal venous infiltration spiral-CT had a sensitivity of 91% (10/11), a specificity of 9.4% (16/17), a positive predictive value of 91% (10/11), a negative predictive value of 94% (16/17) and, an overall accuracy of 92.8% (26/28). Spiral CT correctly identified arterial involvement in 5 patients, and no false negative result compared to surgical findings was observed. CONCLUSIONS: These results indicate that spiral-CT reliably verifies occlusion, stenosis and encasement of the major peripancreactic vessels caused by pancreatic cancer.

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