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W Bücklein

Publications and source records attributed to W Bücklein.

8 recordsLinked to original sources

[Influence of clinical information on the diagnostic validity of MRI in the detection of abacterial sacroiliitis].

PURPOSE: To evaluate the influence of clinical information on the diagnostic validity of MRI in the detection of abacterial sacroiliitis. Evaluation of sensitivities, specificities, negative (NPV) and positive predictive values (PPV) for MRI with and without clinical information in comparison to a prior defined standard. MATERIALS AND METHODS: The results of routine MRI reports of 65 patients with the clinical suspicion of abacterial sacroiliitis referred by rheumatologists for MR assessment of the sacroiliac joints were retrospectively reviewed. These results were compared to the results of a blinded reading of the same examinations performed without any clinical information. The MRI protocol included T1-SE, STIR and T1-SE contrast-enhanced sequences with fat saturation. All patients were followed for at least four years. The standard of reference was defined by an experienced rheumatologist and included baseline and follow-up data (clinical, laboratory and imaging). Abacterial sacroiliitis was diagnosed in 19 patients. RESULTS: Under routine clinical conditions, MRI revealed a sensitivity of 94.7 % and specificity of 97.8 %. A PPV of 94.7 % and a NPV of 97.8 % were achieved. Without clinical information, MRI revealed a sensitivity and specificity of 64 and 80 %, and a PPV of 49 % and a NPV of 86 %, respectively. CONCLUSION: The additional knowledge of clinical information for the MR diagnosis of abacterial sacroiliitis increases its diagnostic value for the assessment of abacterial sacroiliitis.

Adolescent↗

Power Doppler sonography with and without echo-enhancing contrast agent and contrast-enhanced MRI for the evaluation of rheumatoid arthritis of the shoulder joint: differentiation between synovitis and joint effusion.

OBJECTIVE: To evaluate patients with clinically active rheumatoid arthritis (RA) of the shoulder for joint effusion and synovitis using conventional sonography, power Doppler (PD) sonography with and without echo-enhancing contrast agent, and contrast-enhanced MRI. DESIGN AND PATIENTS: Twenty-four patients (mean age 64 years) with known RA had one symptomatic shoulder evaluated by conventional gray-scale sonography and PD sonography before and after intravenous administration of the echo-enhancing contrast agent Levovist (300 mg/ml, 2.5 g). The degree and extent of the altered echo pattern in the subacromial bursa, axillary recess and glenohumeral joint seen by conventional gray-scale sonography and the intensity of vascular signals of PD sonography were compared with the findings of MRI obtained with T2-weighted turbo spin-echo sequences and contrast-enhanced T1-weighted fat-saturated spin-echo sequences. MRI was evaluated by two readers in consensus without knowledge of the sonographic findings. RESULTS: MRI, which was used as the reference examination, detected joint effusion in 71% (17/24) and synovitis in 92% (22/24) of the patients. Conventional sonography revealed an abnormal articular echo pattern in 96% (23/24) of the patients, especially in the axillary recess and subacromial bursa, but failed to attribute the altered echo pattern to either fluid or specific synovitis. PD sonography allowed a specific diagnosis of synovitis in 33% (8 patients), which increased to 50% (12 patients) after administration of an echo-enhancing contrast agent. In 42% (10/24) of the patients, the findings of synovitis demonstrated by MRI corresponded to an altered echo pattern by conventional sonography, but vascular signals were absent by PD sonography with or without echo-enhancing contrast agent. CONCLUSIONS: Using MRI as the "gold standard," PD sonography with and without echo-enhancing contrast agent cannot reliably identify synovitis or distinguish synovial inflammation from effusion in the shoulder joint.

Adult↗

Ultrasonography of acute musculoskeletal disease.

With technical improvements (higher frequency and extended field-of-view sonography) the ability of ultrasound to detect pathology in the musculoskeletal system has been greatly increased. As in MRI, and unlike conventional radiography, soft tissue lesions in muscles, tendons and occasionally in joints can be shown directly. An advantage is real-time imaging of joints during stress. A disadvantage is limited demonstration of internal structures within joints. This paper provides an overview of various pathologies with emphasis on acute disorders.

Acute Disease↗

[Mucocele of the appendix. Sonographic, computed tomographic and radiologic characteristics].

The knowledge of the diagnostic imaging methods features of the mucocele of the appendix is important for a correct preoperative diagnosis, especially to avoid the formation of pseudomyxoma peritonei. A case of a mucocele of the appendix with a special sonographic appearance by a patient with an additional carcinoma of the left kidney is reported. The computer-tomographic and radiological features of the mucocele (plain abdominal film, i.v. urography, barium enema) are presented and discussed with a review of the literature. A sonographically-guided fine-needle puncture of the mucocele was performed. Its importance for the diagnosis is discussed.

Aged↗