[Diagnostic biopsy of diffuse splenic infiltration in a patient with non-Hodgkin lymphoma].
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Aged↗
Biomedical subjects
U Teichgräber
Publications and source records attributed to U Teichgräber.
Excimer laser-assisted recanalisation of femoral arterial stenosis or occlusion caused by the use of Angio-Seal.
The aim of this study was to demonstrate the effect of excimer laser and balloon angioplasty of femoral artery stenosis and occlusion after use of a haemostatic puncture closure device. A haemostatic puncture closure device (Angio-Seal) was used in 6000 patients after diagnostic or therapeutic artery catheterisation. In 34 of those patients symptoms of peripheral artery disease occurred. Sixteen of those 34 cases were transferred to our clinic for excimer laser angioplasty. All 16 patients presented with symptoms of acute peripheral artery disease within 1-14 days: superficial femoral artery (SFA) occlusions (4 cases); superficial femoral artery stenosis (3 cases); high-grade stenosis of the common femoral artery (CFA; 3 cases); high-grade stenosis of CFA; SFA and profund femoral artery (PFA; 3 cases); and occlusions of CFA, SFA and PFA (3 cases). Before any procedure was performed, informed consent was given by the patient, which included the use of the Angio-Seal closure device. Every patient who had to undergo recanalisation procedures gave additional informed consent which especially included the usage of the excimer laser for recanalisation. A measurement of the walking distance, ankle-brachial systolic pressure index (ABI) and diagnostic angiography was performed in 13 cases before and immediate after as well as 3 and 6 months after therapeutic percutaneous transluminal laser angioplasty followed by balloon angioplasty (PTLA/PTA). In 3 patients the risks of PTLA/PTA was considered too high; those patients underwent surgical repair. Angiographic and clinical improvement was achieved in 13 of 13 patients. The mean walking distance increased from 81 to > 400 m. The average ankle-brachial systolic pressure index (ABI) increased from 0.47 to 0.84. One patient developed a dissection of the SFA, and in 1 case a peripheral embolisation was seen. The PTLA/PTA technique is a successful therapeutic option for patients with femoral artery occlusion or high-grade stenosis after Angio-Seal application.
Angioplasty, Balloon, Laser-Assisted↗
Quantification of morphologic and hemodynamic severity of coarctation of the aorta by magnetic resonance imaging.
OBJECTIVE: As the morpholgic severity of coarctation of the aorta is difficult to assess, especially after previous repair, the value of the technique of multiplanar reconstruction of magnetic resonance imaging data to achieve a 3-dimensional reconstruction of the aortic arch was evaluated and compared to hemodynamic measurements. METHODS AND RESULTS: We performed 30 examinations in 27 patients aged from 6 to 54 years, with a mean of 21 years, by magnetic resonance imaging using a 1.5Tesla scanner with a standard body coil. Measurements of flow across the coarctation were performed using phase shift velocity mapping, and peak velocity was calculated at the site of stenosis. Aortic cross-sectional area before, at, and beyond the stenosis was reconstructed 3-dimensionally to calculate a percentage degree of stenosis. Morphologic severity of stenosis was correlated to invasively assessed hemodynamic gradients and morphologic data from biplane angiography in 23 patients. Among the 30 examinations, 24 patients had been previously treated by either surgery, in 17 patients, or balloon dilation, while 6 had native coarctation. 3-dimensional reconstruction was possible in all and better delineated the anatomy concerning the hemodynamic relevance of stenoses even as compared with biplane angiography. The correlation between severity of narrowing assessed by diameter measurements in the biplane angiography and 2-dimensional magnetic resonance imaging was r = 0.94, and multiplanar reformation with 2-dimensional magnetic resonance imaging was r = 0.87 with a tendency of higher grading with the 3-dimensional technique (p = 0.0001). The correlation of 2-dimensional magnetic resonance imaging with invasively measured hemodynamic gradients was r = 0.67 versus r = 0.74 for the areas assessed by multiplanar reformation, indicating that the hemodynamic relevance of a morphological approach to evaluate the degree of a stenosis should better be assessed 3-dimensionally. CONCLUSIONS: The 3-dimensional reconstruction of the morphologic severity of coarctation offers additional information over conventional imaging especially in patients with kinking, complex geometry, or collaterals, in whom hemodynamic measurements can become unreliable.
Adolescent↗
Survey of conventional and spiral ct doses.
PURPOSE: To investigate the radiation dose for conventional computed tomography (CT) and spiral CT during different CT examinations at various hospitals and practices. MATERIALS AND METHODS: CT dose index with an active length of 15 cm was measured in 16 different types of CT scanners by using ionization chamber dosimetry. Twenty-six holders (one who has legal responsibility under national law for a radiologic installation) operating a total of seven conventional and 20 spiral CT scanners were asked for their standard parameters for various CT examinations. Weighted CT dose index and dose-length product were determined for each examination. RESULTS: For most examinations, the tube current time product was significantly higher for conventional CT than for spiral CT (.002 </= P </=.05). The ratio of section distance to section thickness for conventional CT was significantly lower than the pitch for spiral CT (.001 </= P </=.05). The weighted CT dose index and dose-length product for spiral CT were about half of those for conventional CT. The third quartiles for weighted CT dose index and dose-length product for spiral CT were much lower than those recommended as reference doses. CONCLUSION: CT examinations with conventional CT scanners are often performed with unnecessarily high radiation dose. For the establishment of reference doses, the radiation dose with spiral CT scanners should be taken into account.
Humans↗
A windows based viewing application for image postprocessing in DICOM format.
OBJECTIVE: To design, implement and evaluate a PC-based medical viewing application including image postprocessing for DICOM images for use within an existing hospital infrastructure. MATERIAL AND METHODS: A user-friendly DICOM compliant viewing application including image postprocessing (spatial frequency and contrast enhancement) and HL7 communication ability was designed and implemented on PC basis to run under Windows OS. To assess its quality compared to high-end workstations, an ROC analysis was performed. RESULTS: The use of image postprocessing on a PC significantly improved the perception of low-contrast details in computed radiographs. Review at a radiological workstation was superior to review at a PC with image postprocessing.
Computer Communication Networks↗