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T Vestring

Publications and source records attributed to T Vestring.

54 records · Page 3Linked to original sources

[The MR tomography of hemophilic osteoarthropathy with special reference to the synovial and chondrogenic changes].

52 knee and ankle joints of hemophiliacs were examined by MRI using FLASH and FISP-3-D sequences; and the degree of synovial hypertrophy and of cartilage destruction were assessed. Findings of synovial hypertrophy varied between thin membranes and tumorous tissue destroying the joint cartilage. Degree of cartilage destruction varied between focal signal decrease and total loss. In spite of recurrent joint bleedings no synovial or cartilaginous changes were seen in 31% and 29% of joints, respectively. Changes were more frequently seen and degree was more marked in the ankle than in the knee joints. With the exception of cysts, osseous destruction was more obvious with radiographs. MRI is suitable for the investigation of joints of hemophiliacs showing no osseous destruction.

Adolescent↗

[Cortical necrosis of the transplanted kidney. MR tomographic confirmation of the diagnosis?].

Cortical necrosis is a rare complication of renal transplants, which requires urgent diagnosis and management to avoid unnecessary immunosuppression. Seven renal transplants with suspected cortical necrosis were evaluated by Doppler-US, 99mTc-DTPA-perfusion study and Gd-DTPA-enhanced dynamic MRI. In four transplants, cortical necrosis was confirmed by angiography and histology. In diagnosing cortical necrosis with preserved medullary perfusion (n = 2) dynamic MRI was superior to the other modalities. Totally necrotic renal transplants (n = 2) were reliably diagnosed by all imaging methods.

Adult↗

[Non-Hodgkin's lymphoma with primary osseous manifestation, from the files of the Bone Tumor Registry of Westphalia].

30 cases of non-Hodgkin-lymphoma with primary bone manifestation were selected from the files of the Bone Tumor Registry of Westfalia from 1975 until 1992. Clinical data and radiologic aspects were evaluated. 60% of the lesions were localized within the long bones (femur 10, humerus 6, tibia 2). The lymphomas were classified based on paraffin-embedded material in combination with immunohistochemical findings according to the updated Kiel-classification. 29 B-cell lymphomas and one T-cell lymphoma of medium-sized pleomorphic type were found. 5 B-cell lymphomas were of low and 23 of high malignancy. Almost 50% of the tumors were of centroblastic type. The Kiel-classification was not applicable for one lymphoma, 3 others could not be subclassified because of shrinking artefacts. Prognosis in patients with localized disease (9 cases) was favorable, whereas only 25% of patients with generalized disease (12/cases) survived for 3 years or longer.

Bone Neoplasms↗

[Magnetic resonance tomography of soft tissue tumors].

Soft tissue tumors are relatively often seen on MR tomography, although they make up a fairly small proportion of malignant lesions. To date, most soft tissue tumors have been investigated by MRI because of its unique soft tissue contrasts and its flexibility in slice orientation. But is MRI really adequate for staging and defining soft tissue tumors, or what role does it have pre-therapeutic work-up? Most malignant soft tissue tumors give rise to somewhat similar MRI findings and may not be sufficiently well characterized. On the other hand, some benign lesions can be clearly identified and staged. The goal of this paper is a critical discussion of the ability of MRI to define a lesion's degree of malignancy, to evaluate diagnostic criteria, and to describe requirements in the set-up of the investigation.

Humans↗

[The place of magnetic resonance tomography in the diagnosis of diseases of the shoulder joint].

In a prospective study 43 patients with shoulder pain were examined by sonography and MRI. The findings were controlled by plain radiography, arthrography, and CT arthrography. Joint effusions and humeral head defects were equally identified by MR and sonography. In the diagnosis of labrum lesions, rotator cuff lesions, subacromial spurs, and synovial inflammatory disease sonography was not as accurate as MR. A special MR scoring system improved the diagnosis of an impingement syndrome.

Adult↗

[A comparison between digital luminescence radiography and conventional myelography].

The potential of digital luminescence radiography in replacing conventional myelography was analyzed using ROC methodology. 95 conventional (CR), digital (DR) and edge enhanced digital (EDR) myelograms (49 disk herniations, 46 normal) were read independently by 5 radiologists; and a ROC analysis was performed. Higher confidence levels were used in making both correct and incorrect diagnoses with DR and EDR than with CR. However, no statistically significant differences between AUC (area under the curve) values obtained with the different techniques, were noted. The separate analysis of cervical and lumbar myelograms showed no significant differences between the different techniques. With DR and EDR, the sensitivity of 4 of 5 readers was somewhat higher in the lumbar but lower in the cervical region than with CR. Replacement of conventional by digital luminescence myelography seems possible; however, some decrease of sensitivity in the cervical region must be accepted.

Humans↗

[The diagnostic reliability of the occipitomental radiograph of the paranasal sinuses. Correlation with magnetic resonance tomography].

100 conventional occipitomental radiographs of the paranasal sinuses were studied independently by five radiologists. Predictive values were determined, based on MRI as the gold standard. Sensitivity and specificity for detection of mucosal thickening in the sinuses were: maxillary sinus: 0.73/0.76, frontal sinus: 0.20/0.85, ethmoid sinus: 0.38/0.87, sphenoid sinus: 0.14/0.96. In the maxillary sinus polypoid thickening was demonstrated with a significantly higher sensitivity than that of diffuse mucosal thickening (0.82 versus 0.65, Chi-square-test, p less than 0.01). Because of the low predictive values the occipitomental view is insufficient to assessing mucosal thickening in the paranasal sinuses, with the exception of polypoid mucosal thickening in the maxillary sinus.

Adult↗

[Magnetic resonance tomography of the ankle joint].

To define the clinical role of MRI of the ankle joint, a total of 88 patients was investigated. In the evaluation of ligamentous injury, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary.

Ankle Injuries↗

[The place of diagnostic imaging in xanthogranulomatous pyelonephritis].

The urographic, angiographic, sonographic and computed tomographic findings in 4 cases of xanthogranulomatous pyelonephritis are presented along with correlation with the pathological specimens. The parenchyma of the kidney was replaced by multiple, rounded, low-density respectively hypoechogenic areas on CT and sonography that corresponded to dilated calices and/or inflammatory tissue. For diagnosing the characteristic extrarenal extension of the disease sonography was not as accurate as CT.

Adult↗

[The use of rapid sequences in craniocerebral MR diagnosis].

MRI of the head is routinely performed with spin-echo sequences whereas gradient-echo sequences are still uncommon. Certain features of fast imaging sequences make them a promising tool for clinical investigations. The relative high signal-to-noise ratio/unit time demonstrates the usefulness of GE imaging as localising images. The extremely high contrast-flexibility is sometimes superior to SE imaging and may help to characterise structures and lesions. Flow dynamics are more clearly depicted than with SE sequences and lead to the dynamic evaluation of intracranial motion (CSF flow, blood flow). This information may be used in a special mode to achieve MR angiograms. Due to the very short repetition times, GE sequences are excellently suited to 3D application. This enables to reduce slice thickness to less than 1 mm with optional reconstructions in any virtual direction. In view of present developments in MR, GE imaging will be accepted in clinical diagnostic imaging in the near future.

Brain↗

[The MR tomographic findings in cranial manifestations of neurofibromatosis].

Twelve patients with central neurofibromatosis underwent MR examination of the head. Among these, chiasma glioma was the most common CNS tumour (6/12). Seven patients had multifocal areas of increased T2-signal without mass effect predominantly involving the region of the basal ganglia. No corresponding CT abnormalities were present. These lesions may represent multifocal dysplasia and seem to be characteristic of central neurofibromatosis.

Adolescent↗

[Mediastinal staging of non-small cell bronchial carcinoma. The place of computed tomography and mediastinoscopy].

Sixty patients with a potentially resectable non-oat-cell lung carcinoma were examined by computed tomography and cervical mediastinoscopy. The sensitivity of computed tomography as opposed to mediastinoscopy was 74% versus 58% and the specificity in 85% versus 100%. Considering the limitations of both methods and the varying prevalence of mediastinal lymph-node metastases associated with peripheral and central lesions, three different situations can be distinguished: 1. with peripheral lesions and a normal mediastinal CT, preoperative mediastinoscopy is unnecessary. 2. With an abnormal mediastinal CT, mediastinoscopy is always indicated irrespective of the location of the tumor. 3. With large central lesions, mediastinoscopy is necessary even when the CT is normal. Using these rules, 37 of 60 mediastinoscopies in our patient group could have been avoided without influencing the resection rate (98%).

Adult↗

[A lung tumor?].

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Adult↗

Recurrent TIPS failure associated with biliary fistulae: treatment with PTFE-covered stents.

PURPOSE: To evaluate the efficacy of covered stents for the treatment of transjugular intrahepatic portosystemic shunt (TIPS) obstruction in human subjects with identified or suspected biliary fistulae. METHODS: Five patients were treated for early failure of TIPS revisions. All had mid-shunt thrombus, and four of these had demonstrable biliary fistulae. Three patients also propagated thrombus into the native portal venous system and required thrombolysis. TIPS were revised in four patients using a custom-made polytetrafluoroethylene (PTFE)-covered Wallstent, and in one patient using a custom-made PTFE-covered Gianturco Z-stent. RESULTS: All identified biliary fistulae were successfully sealed. All five patients maintained patency and function of the TIPS during follow-up ranging from 2 days to 21 months (mean 8.4 months). No patient has required additional revision. Thrombosis of the native portal venous system was treated with partial success by mechanical thrombolysis. CONCLUSION: Early and recurrent failure of TIPS with mid-shunt thrombosis, which may be associated with biliary fistulae, can be successfully treated using covered stents. Stent-graft revision appears to be safe, effective, and potentially durable.

Biliary Fistula↗

Kinetics of metabolism in human kidney transplants measured by dynamic 31P NMR spectroscopy.

The technique of ex vivo 31P NMR spectroscopy has been used for the investigation of metabolic turnover in 15 cadaveric human kidneys obtained from brain-dead donors for transplantation. Measurements were carried out at 1.5 T time-dependently during regular hypothermic storage in histidine-tryptophan-alpha-ketoglutarate solution. The minimum delay between explanation and spectroscopy was 2 h 41 min. In one case of a discarded organ the measurements could be extended over a period of 161 h 35 min. A detailed kinetic model describing monoexponential ischemic phosphate turnover, which accounts for various interrelations of the NMR visible metabolites, has been derived. Averaged velocity constants of the decays of nucleotides and phosphomono- and -diesters ranged from 0.0047 to 0.294h-1 at approximately 4 degrees C. Intracellular pH decreased monoexponentially with an averaged velocity constant of 0.31 h-1.

Brain Death↗