Biomedical subjects

S Müller-Hülsbeck

Publications and source records attributed to S Müller-Hülsbeck.

At least 19 recordsLinked to original sources

PubMed2006

Balloon angioplasty of arteries of the upper extremities in patients with extracranial giant-cell arteritis.

OBJECTIVES: To evaluate the outcome of balloon angioplasty in the arteries of the upper extremities in patients with giant-cell arteritis (GCA) and stenosing extracranial involvement. METHODS: Percutaneous transluminal angioplasty (PTA) for symptomatic upper limb artery stenoses (n = 29) and occlusions (n = 1) resistant to medical treatment was carried out in 10 patients (all women, mean age 65 years) with GCA. Vascular lesions were located in the subclavian (n = 4), axillary (n = 10) and brachial (n = 16) arteries. Interventional treatment was accompanied by immunosuppressive drugs in all patients. Follow-up included clinical and serological examination, magnetic resonance angiography and colour duplex ultrasound. RESULTS: Initial technical success of angioplasty was achieved in the case of all vascular lesions. In five patients, marked recurrent stenoses (vascular territories; n = 10/30) were found during follow-up (mean 24 months). The cumulative primary patency rate was 65.2%. All recurrent lesions developed in the territories of the initial long-segment stenoses. Repeated PTA (vascular territories, n = 8; patients, n = 5) provided a cumulative secondary patency rate of 82.6% and a cumulative tertiary patency rate of 89.7%. CONCLUSIONS: Despite a tendency to restenoses, balloon angioplasty of the upper-extremity artery, in combination with immunosuppressive treatment, is an efficient method for the treatment of extracranial GCA.

Aged↗

PubMed2006

[Rational minimally invasive treatment of pAOD: when should a conservative approach, PTA, or stent be chosen?].

In order to obtain optimal results and satisfied patients, rational therapy of pAOD should strictly follow national and international society guidelines. In particular cases an individual therapeutic concept seems justified beyond these guidelines. Based on clinical data and driven by costs, aortic and iliac lesions may be treated by PTA or selective stent placement with equal results; however, long-term data justify also primary, direct stenting. For treatment of infrainguinal and popliteal stenotic lesions primary stenting should be restricted to PTA failure (dissection, recoil, occlusion); except for treatment of extended lesions, primary stenting compared to PTA alone seems beneficial in terms of midterm patency. Endovascular procedures below the knee and at the toe should be limited to existing limb-threatening ischemia in order to save the extremity; whether PTA or stenting is advantageous has not yet determined.

Angioplasty, Balloon↗

PubMed2006

[Does interventional therapy prolong the patency of hemodialysis fistulas and grafts?].

PURPOSE: To retrospectively evaluate procedural success and patency after endovascular treatment of acute dysfunctional hemodialysis fistulas and grafts in a non-preselected patient cohort. MATERIALS AND METHODS: 185 angiographies of hemodialysis fistulas and grafts on the upper extremities were analyzed for 120 patients (53 male, 67 female; mean-age 63.1 +/- 11.4, range 24 - 91). 70 % (n = 130) were native arteriovenous fistulas, 17 % (n = 31) were prosthetic grafts, and 13 % (n = 24) were non-specific. In total, 278 lesions requiring endovascular treatment were detected. 13 % (n = 35) of the lesions were located in the arterial inflow, 18 % (n = 49) in native arteriovenous anastomoses, 7 % (n = 19) in prosthetic grafts and 62 % (n = 171) in the venous outflow. The primary, secondary and cumulative patency after endovascular treatment was calculated. RESULTS: In 51 % (n = 94) of the cases endovascular treatment could be performed, in 8 % (n = 14) no lesion requiring treatment was detected, and in 42 % (n = 77) intervention was not considered possible. In 45 % (n = 124) of the detected lesions endovascular treatment was successful, in 18 % (n = 51) the intervention failed, and in 37 % (n = 103) intervention was not considered possible. The complication rate was 5 % (n = 10). The primary, secondary, and cumulative patency rates for 50 % of the hemodialysis fistulas and grafts after endovascular treatment were 65, 191, and 370 days, respectively. The results differed significantly from each other with p < 0.05 in the log rank test and log rank trend test. CONCLUSION: Endovascular treatment of acute dysfunctional hemodialysis fistulas and grafts is effective in restoring the patency for hemodialysis.

Acute Disease↗

PubMed2005

A multicentre evaluation of the Medtronic AVE Flexible Iliac Bridge Stent in the iliac arteries (the first study).

PURPOSE: To investigate the short term and 6 month outcomes of a recently introduced iliac stent (the Medtronic AVE Flexible Iliac Bridge Stent). METHOD: One hundred and sixteen patients, 122 limbs from 6 European sites with atherosclerotic occlusive disease were included if they either had a full occlusion or there was a residual gradient >10 mmHg following PTA. Clinical, haemodynamic and Duplex outcomes were recorded to 6 months. RESULTS: After stent placement there was no residual stenosis >30 and 8.1% of segments had a residual resting gradient of >10 mmHg. There were three local complications and three deaths at 30 days. Primary patency at 30 days and 6 months was 94.1 and 82.7%. Marked clinical improvement occurred in 87.6 and 86.2% at 30 days and 6 months. CONCLUSION: The Medtronic AVE iliac stent has good 30 day and 6 months outcomes supporting the effective use of this device in occlusive disease.

Adult↗

PubMed2004

[PTA versus Palmaz stent placement in femoropopliteal artery stenoses: results of a multicenter prospective randomized study (REFSA)].

PURPOSE: To evaluate whether stent placement is superior to percutaneous transluminal angioplasty (PTA) in the treatment of chronic symptoms in short femoropopliteal arterial stenoses. MATERIALS AND METHODS: One hundred twenty-four limbs in 116 patients, who ranged in age from 39 to 87 years (mean age, 67 years), were randomized to PTA (n = 53) versus PTA followed by implantation of long-medium Palmaz-Stents (n = 71). Inclusion criteria were intermittent claudication or chronic critical limb ischemia, short stenosis or occlusion (lesion length < or = 5 cm), and at least one patent run-off vessel at angiography. The follow-up included clinical assessment, measurement of ankle/brachial index (ABI), color duplex ultrasound, and/or angiography at 6, 12 and 24 months. Angiographic follow-up between 12 and 36 months was available in 54 limbs (45 %). RESULTS: Initial technical success was achieved in 50 of 53 limbs (94.4 %) in the PTA group versus 70 of 71 limbs (98.6 %) in the stent group. Overall, major complications occurred in 9.5 % (n = 11), with n = 4 in the PTA group compared to n = 7 in the stent group. No difference was found between the groups of treatment: clinical success at 1 and 2 years was 80.5 and 77.1 % in the PTA group versus 78.1 and 71.0 % in the stent group. The cumulative 1-year and 2-year angiographic primary patency rates were 66.1 and 49.1 % in the stent group versus 76.1 and 66.1 % in the PTA group. The secondary 1-year and 2-year angiographic patency rates were 88.5 and 53.3 % in the stent group versus 82.7 % and 76.2 % in the PTA group. CONCLUSION: The primary success rate was slightly higher after stent placement than after PTA. However, the angiographic, clinical and hemodynamic success after 1 and 2 years tends to be slightly better for PTA.

Adult↗

PubMed2004

Ex-vivo injection technique for implanting solid pulmonary nodules into porcine lungs for multi-slice CT.

PURPOSE: To develop a method for generating realistic pulmonary nodules that equal small pulmonary metastases and granulomas. MATERIALS AND METHODS: A total of 70 artificial lesions were introduced into 5 inflated porcine lungs inside a dedicated chest phantom by high pressure injection of a fat-wax-Lipiodol mixture and scanned with 16-slice computed tomography (CT). Image evaluation by two experienced radiologists included analysis of morphology, nodule size and density. RESULTS: The median nodule density was 78.8 Hounsfield units (HU), with 54 of 70 nodules (77.14 %) judged typical of small lung metastases. CONCLUSION: Without inducing visible damage of lung parenchyma, the injection technique produces highly realistic pulmonary nodules for morphometry or nodule detection with CT.

Animals↗

PubMed2004

[Inflammatory aortic arch syndrome: contrast-enhanced, three-dimensional MR angiography in stenotic lesions].

PURPOSE: To determine the value of contrast-enhanced, three-dimensional MR angiography for the evaluation of stenotic and occlusive vascular lesions in inflammatory aortic arch syndrome. MATERIALS AND METHODS: 14 patients with inflammatory aortic arch syndrome (giant cell arteritis: n = 8, Takayasu arteritis: n = 4, ankylosing spondylitis: n = 1 sarcoidosis: n = 1) underwent MR angiography of the aortic arch and the supra-aortic vessels (n = 15, 2 patients were examined twice) and of the abdominal aorta (n = 2). MRA was performed using a 3D-FLASH sequence (TR/TE 4.6/1.8 ms, flip angle 30 (3)) on a 1.5T system. MRA imaging was compared with the findings of DSA, which served as gold standard. RESULTS: In a total of 467 examined vascular territories, DSA revealed 50 stenoses and 35 occlusions. All lesions were detected by MRA. In 23 segments, the degree of stenosis was overestimated by MRA. Sensitivity and specificity of MRA were 100 % and 94.3 %, positive and negative predictive values were 73.6 and 100 %, and the accuracy was 95.1 %. CONCLUSIONS: Despite a tendency to overestimate stenoses, contrast-enhanced three-dimensional MR angiography is a valid, non-invasive technique in the assessment of inflammatory aortic arch syndrome.

Adult↗

PubMed2003

[In-vitro comparison of the effectiveness of different high-speed rotatory catheters].

OBJECTIVE: To determine the in vitro effectiveness of the Amplatz and Rotarex catheters for thrombus fragmentation and combined thrombus fragmentation and aspiration. MATERIALS AND METHODS: Clots (n = 100) from 5-day-old porcine blood (8.5 g) were fragmented with the 8F Rotarex trade mark catheter (RR; 40.000 rpm), which was directed with or without a coaxial guide wire (GW 0.020 inch [8 F RR(GW)], GW 0.014 inch [6 F RR(GW)]), and with the 7 F Amplatz catheter (ATD; 150.000 rpm), in an artery flow model (pulsed flow of 700 ml/min) simulating the superficial femoral artery. To increase the wall adherence of the thrombus, an additional equal number of silicon tubes (with an inner diameter of 7 mm) were fitted inside with a metallic mesh (wall-adherent thrombus [WAT]; 6 F RR(WAT), 8 F RR(WAT), 6 F R(WAT-GW), 8 F RR(WAT-GW), ATD(WAT) ). The effluent was passed through a three-step filter system (10 to 1000 micro m; pressure gradient 35 mmHg). RESULTS: Highest effectiveness was found for 8 F RR (no remaining thrombus detectable) compared to 6 F RR (0.08 g) and ATD (0.07 g), with a p < 0.001 for both methods. The aspirated volume was significantly lower when 6 F and 8 F RR were used with a coaxial guide wire (p < 0.001). The total emboli rate for 8 F RR was significantly lower compared to ATD (p < 0.001). Even when working without a guide wire, 8 F RR caused the lowest proportion of emboli (depending on the modification 0.12 % to 1.76 %; compared to all p < 0.05). Emboli rates reached 7.99 % for 6 F RR (compared to all p < 0.001) and were maximal 5.61 % for ATD. CONCLUSIONS: The tested mechanical thrombectomy catheters have a high potential for in vitro thrombectomy with moderate performance differences. In contrast to the guidewire-directed Rotarex fragmentation-aspiration device, the ATD trade mark fragmentation catheter and prototype Rotarex 6 F catheter have a considerable peripheral embolization rate of particles larger than 1000 micro m, probably requiring additional measures for in vivo thrombectomy.

Animals↗

PubMed2003

A new concept for covered stent protected carotid angioplasty: an ex vivo study.

OBJECTIVE: To determine the efficacy of a covered stent prototype designed for protected carotid angioplasty to reduce cerebral embolization. MATERIAL AND METHOD: The covered stent tested is made of nitinol, coated with a polyurethane membrane (MembraX trade mark; porous size 80 micro m). In a bench-top model (flow-rate 650 ml/min, pulsatile flow [dicrote] 123 Pulses/min, pressure 100/60 mm Hg [mean pressure 80 mmHg]) with inserted human carotid (n = 6) stent implantation was performed (8/32 mm). Passed particles (mg) were determined in the effluent of a 100 micro m filter prior to intervention, after stent deployment and after final dilation (5 mm). RESULTS: When stenting carotid arteries obtained from human cadavers, the highest rate of particle embolization was measured while crossing the lesion with the delivery device (6,8 mg; for all p < 0,05), embolization after additional balloon angioplasty and particle rates measured in the effluent filter prior covered stent placement were significantly lower (3,8 mg; p < 0,05). Branches of the external carotid artery remained patent in all cases. CONCLUSIONS: The introduced concept of covered stent protected carotid angioplasty with the MembraX trade mark prototype has proven promising results for low cerebral embolization rates ex vivo. Further evaluations using an animal model and a miniaturization of the delivery device are warranted prior to human use.

Adult↗

PubMed2002

Endovascular treatment of peripheral artery disease with expanded PTFE-covered nitinol stents: interim analysis from a prospective controlled study.

PURPOSE: Current covered peripheral stent designs have significant drawbacks in terms of stent delivery characteristics and flexibility. The aim of this study was to analyze the technical performance, safety and initial clinical efficacy of expanded polytetrafluoroethylene (PTFE)-covered nitinol stents for arteriosclerotic peripheral artery disease. METHODS: Eighty-two patients underwent implantation of PTFE-covered nitinol stents for iliac and/or femoral obstructions. The study was conducted prospectively in seven European centers and one Canadian center. Patients were controlled clinically and by duplex ultrasound follow-up. Data up to discharge were collected in 79 patients. Seventy-four patients have thus far received 1 month follow-up and 32 patients, 6 month follow-up examinations. RESULTS: The average lesion length measured 47 mm for the common and external iliac arteries and 50 mm for the femoral arteries. The mean severity of the stenoses was reduced from 94% to 4% in the iliac arteries and from 98% to 7% in the femoral arteries after stent placement and dilatation. One device deviation (inadvertent stent misplacement) and one puncture-related severe adverse event with formation of a pseudoaneurysm occurred. There were occlusions of the stent in five patients. No infections were noticed. CONCLUSION: The interim analysis of this trial using PTFE-covered nitinol stents indicates that a strategy using primary implantation of this stent type is technically feasible, has an acceptable safety profile and is effective from a short-term perspective.

Alloys↗

PubMed2002

[Early results with a monorail-stent-balloon device for endovascular treatment of renal artery stenosis].

OBJECTIVE: To evaluate the technical feasibility of a new monorail-stent-balloon device for treatment of renal artery stenosis (RAS). PATIENTS AND METHODS: During a study period of 18 months, 38 patients with proven RAS in 41 cases (hypertension n = 36, renal insufficiency n = 13) and indication for stenting (calicified ostial lesions n = 35, insufficient PTA n = 4, dissection n = 2) were enrolled into this prospective evaluation. Pre-mounted stents (Rx-Herculink(TM) 5 mm = 13, 6 mm = 34, 7 mm = 1) were implanted a transfemoral (n = 35) or transbrachial approach (n = 6). Mean grade and lengths of stenosis measured were 88 % plus minus 10 and 9 mm plus minus 5. RESULTS: Renal stent implantation was technically successful in all cases (100 %). In 7 cases a second stent had to be implanted to cover the entire lesion. The transstenotic pressure drop decreased from 88 mmHg plus minus 10 before to 1 mmHg plus minus 1.8 after the procedure. Remaining stenosis measured 0.7 % plus minus 4.2. Serum creatine levels decreased from 1.9 mm/dl to 1.5 mg/dl (n. s.), blood pressure decreased from 178/94 mmHg to 148/79 mmHg (p < 0.0001) after the intervention. Primary and secondary patency rates at 6 months were 72 % (Standard Error 9.8 %) and 77 (% (Standard Error 9.2 %), respectively. CONCLUSION: With the used monorail-stend-balloon device a technically easy, secure and exact renal stent placement is guaranteed, patency rates are similar to those described in the current literature.

Adult↗

PubMed2002

[Cerebral protection devices for treatment of carotid stenoses: Where do we stand today?].

The carotid bifurcation is currently a subject of controversial discussion within the vascular territory. These controversies are obvious for diagnostic imaging but the more so for therapy. Performing stenting as a treatment tool, controversies exist also as to whether angioplasty is performed without or obligatory with cerebral protection. Théron and colleagues first described the concept of cerebral protection during carotid angioplasty and stent placement. Currently, there are three temporary cerebral protection systems, i. e. balloon occlusion, filtration baskets, and systems for flow reversal in the internal carotid artery. While these systems provide a considerable degree of protection, as has been shown in in vitro and preliminary clinical studies, embolization might still occur, even under protection. In addition, it is still not clear what the minimum size of emboli is that need to be stopped to prevent a stroke, and what the relevance of cerebral microemboli is. Clinical evidence suggests that the usage of protection systems favours a good outcome of the intervention; however, whether or not such systems should be used routinely remains a matter of discussion and should thus be verified in further clinical studies.

Angioplasty, Balloon↗

PubMed2001

Flow patterns from metallic vascular endoprostheses: in vitro results.

The aim of this study was to determine flow characteristics and pressure gradients of different balloon- and self-expandable stents in an in vitro flow-model. Seven vascular stents (Bridge, Cragg, Memotherm, Palmaz PS 784, Sinus, Symphony, Wallstent), equal in length (60 mm) and diameter (10 mm), were deployed in a closed flow model. The inner diameter of the tube measured 9 mm. Flow at 1.5 and 6 l/min was applied. Flow patterns were visualized by anionic particles illuminated with two helium-neon lasers. Late laminary flow characteristics and pre-/post-stent pressure gradients were determined in either expanded stent, 25 and 50% tube stenosis. Stent implantation induced a decrease of laminary flow when compared with an unstented tube with and without concentric 25% stenosis (p < 0.01) at all flow rates and an increase of pressure gradients when compared with an unstented tube for a flow rate of 6 l/min and all stenoses (p < 0.01). At 1.5 l/min most stents revealed no significant change of pressure gradient, the highest gradient measured 4.0 mmHg. Sinus permitted maximum (expanded: 82.1% and 76.9% at 25% stenosis at 1.5 l/min; p < 0.01) and Palmaz minimum of laminary flow at all flow rates and stenoses (70.2 and 52.4% at 25% stenosis at 1.5 l/min; p < 0.01). At 6 l/min, when completely expanded, Sinus is equal to Bridge and Memotherm; in 25% stenosis Sinus is equal to Bridge, Memotherm, and additionally to Cragg and Wall. None of the endoprostheses revealed laminary flow at 50% stenosis. Inadequate stent deployment bears the risk of creating less laminary flow and pressure gradients. Since flow disturbances and pressure gradients may influence neointimal hyperplasia, stent design and completeness of stent expansion are important factors regarding the appearance of thrombus formation and postinterventional restenosis.

Arteries↗

PubMed2001

[Vasculitis--interdisciplinary diagnosis: radiology].

Determination of disease extension and disease activity are in the foreground of diagnostic imaging in vasculitides. There are several radiologic modalities available each having specific indications. Magnetic resonance imaging (MRI) readily depicts granulomas and mucosal inflammations in the paranasal sinuses, nasal cavity and orbits. Computed tomography detects osseous lesions of the skull. Due to its superb sensitivity MRI is an established screening modality for CNS vasculitides, although there are limitations with regard to specificity. In spite of its limited accuracy in most institutions angiography is still required for radiological confirmation of CNS vasculitis. Perfusion and diffusion MR-imaging may combine the advantages of 'conventional' MRI and angiography. By now the method is not fully validated for vasculitides, however. Vascular disease in Takayasu's arteritis and in giant cell arteritis involving predominantly large and medium sized vessels is readily diagnosed by non invasive magnetic resonance angiography. Percutaneous transluminal angioplasty has proven to be an effective and save therapeutic modality for the cure of vascular stenoses and occlusions. Plain film radiography in two planes is the established modality for pulmonary imaging. In pulmonary vasculitides a more thorough analysis of lung disease is provided by high resolution computed tomography. Diagnostic imaging does substantially assist in the interdisciplinary management of patients suffering from vasculitides.

Angioplasty↗

PubMed2001

Randomized study to compare PTA alone versus PTA with Palmaz stent placement for femoropopliteal lesions.

PURPOSE: The purpose of this study was to evaluate whether percutaneous transluminal angioplasty (PTA) combined with Palmaz stent placement provides long-term advantages compared to PTA alone after 34 months of follow-up in the femoropopliteal region. MATERIALS AND METHODS: Thirty patients randomized to undergo PTA in combination with stent placement and 23 patients randomized to undergo PTA alone were evaluated. RESULTS: Mean follow-up (+/-SD) for the PTA group was 33.8 months (+/- 8.7) and for the Palmaz group 29.1 months (+/- 6.2), with a maximum follow-up period of 39 months for both groups. No significant differences in primary or secondary patency rates could be observed at 12 or 39 months. After 39 months, the primary patency rate for PTA alone was 68.4% and the secondary patency rate was 89.5%; the primary patency rate for PTA with stent placement was 62% and the secondary patency rate was 90%. CONCLUSIONS: The results of this study show that even after a long-term follow up of more than 3 years, PTA with stent placement in the femoropopliteal artery does not produce better results than PTA alone, although it does provide better initial luminal gain after the procedure.

Aged↗

PubMed2001

Comparison of in vitro effectiveness of mechanical thrombectomy devices.

PURPOSE: To determine the in vitro efficacy of clot removal of the following hydrodynamic thrombectomy devices: the AngioJet (AJ), Hydrolyser (HL), Oasis (OS), and Amplatz Thrombectomy Device (ATD). All devices have 6-F catheters. MATERIALS AND METHODS: Thrombectomy of 5-day-old porcine clots (n = 68; 8.5 g) was performed with the AJ without a guide wire [AJ(gw0)], with a coaxial 0.016-inch guide wire [AJ(gw.016)], and with a 0.035-inch guide wire [AJ(gw.035)]), and with the HL, OS, and ATD in an artery flow model (pulsed flow: 700 L/min) simulating the superficial femoral artery (7-mm inner tube diameter). The effluent was passed through a three-step filter system (10-1,000 microm; pressure drop: 35 mm Hg). RESULTS: Mean thrombectomy time ranged from 49 seconds (AJ(gw0)) to 88 seconds (OS; P < .001). The fluid balance with use of the AJ(gw.035) was 0.89, whereas the mean ratio of applied saline solution to aspirated fluid for the other devices was not isovolumetric (AJ(gw0), 0.8; AJ(gw.016), 0.78; HL, 0.73; OS, 0.62; P < .05). Remaining thrombus ranged in size from 8.2 mg (AJ(gw0)) to 27.3 mg (AJ(gw.035); P = .079). Hydrodynamic devices (0.6% [OS] to 0.98% [AJ(gw.016)]) caused low amounts of added emboli greater 10 microm, 100 microm, and 1,000 microm. The ATD (5.19%) caused the most extensive embolization (P < .001). CONCLUSIONS: The tested mechanical thrombectomy devices have the power for sufficient thrombectomy in vitro; however, they showed moderate differences in performance. In contrast to hydrodynamic devices, the ATD fragmentation device showed a higher peripheral embolization rate of particles larger than 1,000 microm; adjunctive in vivo treatment would probably be required.

Animals↗

PubMed2001

Treatment of infrapopliteal occlusive disease by high-speed rotational atherectomy: initial and mid-term results.

PURPOSE: To assess the effectiveness and patency rates of high-speed rotational atherectomy (HSRA) for the treatment of infrapopliteal arterial occlusive disease. MATERIAL AND METHODS: During an 18-month period, a total of 19 infrapopliteal lesions in 15 consecutive patients were treated primarily by HSRA with use of the Rotablator device. Patients were followed up with documentation of clinical symptoms, standardized treadmill exercise, and Doppler sonography at 1, 3, and 6 months. Control angiography was performed 6 months after primary treatment. RESULTS: HSRA was initially successful in 14 of 15 patients, yielding an initial technical success rate of 94%. Percutaneous treatment induced an improvement of the ankle-brachial index (ABI) from 0.6 +/- 0.09 to 0.86 +/- 0.2 after intervention (P < .0001). Doppler analysis showed a mean ABI of 0.85 +/- 0.2 (P < .001) at 1 month, 0.72 +/- 0.2 (P = .012) at 3 months, and 0.7 +/- 0.2 (P = .08) at 6 months after initial therapy. Although six patients were lost to follow-up at various times, control angiography at 6 months was carried out in nine of 15 patients, allowing direct assessment of 12 of 19 treated lesions. Among six high-grade restenoses and five total occlusions in the treated vascular segments, only one arterial lumen (of 12) remained patent without presenting a hemodynamically relevant restenosis. These results led to termination of the study. CONCLUSION: Although HSRA for the treatment of infrapopliteal occlusive disease yields a very high initial technical success rate, mid-term results are extremely poor. Therefore, HSRA cannot be recommended for primary treatment of this type of lesion.

Aged↗

PubMed2001

[Comparison of biphasic spiral CT and MnDPDP-enhanced MRI in the detection and characterization of liver lesions].

INTRODUCTION: To evaluate the efficacy of biphasic spiral CT and MnDPDP (Teslascan, Nycomed Amersham) enhanced MR imaging to detect and classify liver lesions. MATERIALS AND METHODS: 39 patients with known or suspected liver lesions were included into this study and examined with biphasic spiral CT and MnDPDP-enhanced MRI. 25 histological reports and 1 extreme increased serum AFP value could be obtained from 22 patients, therefore only these 26 proven lesions were included into this analysis. RESULTS: From 39 patients CT revealed in 54% (14 lesions) and MRI in 54% correct (i.e., corresponding to the histology) diagnosis. Correct CT/wrong MRT diagnosis and vice versa was present in only 2 lesions each. Differentiating into benign versus malignant lesion was successful in 73% for MRI and 77% for CT. In 81% MRI revealed the correct type of lesion (hepatocellular or non-hepatocellular) vs. 77% with CT. Sensitivity/specificity for differentiation into benign/malignant lesions was 86%/70% (MRI) and 87%/77% (CT) and for differentiation of the lesions origin 100%/80% (MRI) and 80%/75% (CT), these differences were not significant. MnDPDP-enhanced MRI showed significantly more lesions than non-enhanced MRI. CONCLUSION: MnDPDP-enhanced MRI is better than CT in differentiating hepatocellular liver lesions from non-hepatocellular lesions. After contrast enhancement with MnDPDP significantly more lesions could be evaluated in MRI. MnDPDP improves, in combination with biphasic helical CT, the diagnosis of liver lesions.

Adenoma↗