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Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Radiologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report a rarely occurring hematologic neoplasm in a young adult. Hematologic neoplasms were first described in 2008 and are now included in both accepted tumor classification systems, i.e., International Consensus Classification and World Health Organization. This hematologic neoplasm shows a characteristic ALK positivity in immunohistochemical examination and correspondingly, ALK fusion genes in the molecular analysis. Pathologists should be aware of this entity, particularly as it is challenging to differentiate from other more frequent neoplasms of the same disease group or mesenchymal neoplasm with ALK aberration., (© 2024. The Author(s).)

Projective methods have lost significance in child and adolescent psychiatric diagnostics. These methods allow access to important emotional and conflictual topics that can only be determined to a limited extent via diagnostic discussions and questionnaires. The Thematic Apperception Test (TAT-A) has been updated for use in adolescents. For this purpose, special image templates with new motifs were developed, which were redrawn photorealistically in color to increase ambiguity and stimulate imagination. To check the thematic valences, the panels were presented to 184 schoolgirls in Seoul, South Korea, for assessment. The practical suitability and acceptance of the image templates were evaluated on a small clinical German sample (N = 13), and the valences in terms of content were determined by two raters. The results clarify that photorealistic color representation is an appropriate method for this new concept of TAT. In particular, "empty" panels with landscape views initiate meaningful narratives, thereby enabling access to personal topics.

Background: A fundamental argument against minimally invasive oncological chest surgery is the risk of overlooking pulmonary nodules due to a lack of intraoperative palpation. In the literature this risk in the treatment of primary lung cancer is given as up to 8.4 % and as more than 15 % in the surgical treatment of pulmonary metastases., Objective: The aim of this study was to evaluate if modern computed tomography (CT) is sensitive enough to replace intraoperative palpation and justify a minimally invasive approach., Patients and Methods: The medical records from 92 patients who underwent 95 open lung resections due to pulmonary malignancies from April 2010 through September 2011 at the Medical School Hannover were retrospectively analysed. A comparison was carried out between the lesions detected preoperatively by CT and those removed during surgery and histologically confirmed as being malignant. Patients with more than five nodules suspected of being malignant in the preoperative CT scan were excluded., Results: According to the final histopathological examination 125 malignant nodules were resected and 2 of these were not detected in the preoperative CT scan, which were performed in external hospitals with a slice thickness of 5 mm and 8 mm, respectively. This represents a sensitivity of 98 % for all CT scans in terms of detection of pulmonary nodules. With thin slice CT (slice thickness up to 1.5 mm) a sensitivity of 100 % was even achieved., Conclusion: The results demonstrate that a high sensitivity of thin slice CT for detection of lung nodules can be achieved. Based on these results the categorical reservation with respect to thoracoscopic resection of pulmonary metastases should be reconsidered in suitable patients where a minimally invasive resection is possible. The extent of lymph node dissection is not influenced by these data. Further studies with larger sample sizes are warranted to confirm these results.

Diseases of the airways are common symptomatic patterns with a steadily increasing prevalence. Bronchial pathologies are often encountered in the daily routine and also often as secondary findings, e.g. in cancerous diseases in the form of (chronic) bronchitis, emphysema and bronchiolitis. Characteristic methodological techniques in imaging of the airways are computed tomography (CT) acquisition in expiration for occlusive diseases of the airways and the possibility of quantitative CT image analysis by measuring the thickness of the parenchyma and the bronchial wall. In general a differentiation is made between diseases of the large and small airways. In diseases of the large airways, which include bronchitis, pulmonary cystic fibrosis and allergic bronchopulmonary aspergillosis, the predominant pattern is the occurrence of bronchial wall thickening, bronchiectasis and mucus impaction. Examples of diseases of the small airways are emphysema, bronchial asthma, exogenous allergic alveolitis and the various forms of bronchiolitis. The predominant morphological patterns are the tree-in-bud pattern and air trapping. Even though the morphological pattern of findings is unspecific, together with the distribution and clinical findings it can often be decisive for the diagnostics.

Background: In patients with unilateral femoroacetabular impingement (FAI), bony characteristics predisposing to FAI (e.g., acetabular retroversion) are also commonly observed in the contralateral asymptomatic hip. This study investigated the prevalence of these characteristics in an asymptomatic population and the influence of pelvic inclination and tilt on acetabular anteversion., Patients and Methods: In this study, patients with unspecific abdominal pain in whom CT including the hip was performed to aid diagnosis were included. Exclusion criteria were previous fractures of the acetabulum or the femur and surgical pretreatment of the hip. AV, CE angle, CCD angle and the distance between the anterior and posterior acetabular rims were determined., Results: 11.5 % of the 400 included hip joints had a central AV of < 15°. A central retroversion was not found. Female patients had a significantly higher AV compared to males (p < 0.05). Pelvic tilt and inclination had a significant influence on the AV., Conclusion: Correct assessment of AV is dependent on a correct pelvic radiograph. 16.5 % of the hips of asymptomatic patients had at least one bony characteristic predisposing to FAI., (Georg Thieme Verlag KG Stuttgart · New York.)

Purpose: Exact preoperative determination of the liver volume is of great importance prior to hepatobiliary surgery, especially in living donated liver transplantation (LDLT). In the current literature, a strong correlation between preoperatively calculated and intraoperatively measured liver volumes has been described. Such accuracy seems questionable, primarily due to a difference in the perfusion state of the liver in situ versus after explantation. Purpose of the study was to asses the influence of the perfusion state on liver volume and the validity of the preoperative liver volumetry prior to LDLT., Methods: In an experimental study, 20 porcine livers were examined. The livers were weighted and their volumes were determined by water displacement prior and after fluid infusion to achieve a pressure physiologically found in the liver veins. The liver volumes in the different perfusion states were calculated based on CT-data. The calculated values were compared with the volume measured by water displacement and the weight of the livers., Results: Assessment of calculated CT volumes and water displacements at identical perfusion states showed a tight correlation and differed on average by 4 +/- 5 %. However, livers before and after fluid infusion showed a 33 +/- 8 % (350 +/- 150 ml) difference in volume., Conclusion: CT-volumetry acquires highly accurate data as confirmed by water displacement studies. However, the perfusion state has major impact on liver volume, which has to be accounted for in clinical use.

The advantages of interactive Volume Rendering Technique (VRT) for routine diagnostics of CT and particularly Multislice CT data are unquestionable. However, with apart from Virtual Endoscopy, where besides Shaded Surface Display, perspective Volume Rendering is used in some cases, VRT at present is only playing a minor role in routine diagnostics. One reason is time consuming calculation, so far requiring powerful computers. Due to the variety of possible parameter settings and the poorly predictable outcome of the resulting images, there also exists a certain discomfort in using the technique. In this paper the underlying principles of VRT are illustrated. Different parameter settings and their impact on the final images are explained. Possible pitfalls in VRT and also suitable parameter settings and indications for VRT are shown.

Background: In an interdisciplinary approach, HepaVision (MEVIS, Bremen), a software tool specifically developed for 3D visualization of the liver, was employed for individual planning of extensive liver resections and evaluation of living-relative donations. So far there is experience with more than 50 biphasic spiral CT examinations., Results: The spatial relationship of large tumors to crucial hepatic structures, the demonstration and evaluation of anatomic variants regarding vascular supply and the risk stratification of liver failure by volumetric analysis on the basis of portal venous drainage supported precise indication for surgery. Surgical safety is increased by preoperative planning and simulation of necessary vessel reconstructions. By hiding selective areas of portal venous drainage or applying freely selectable clip planes, segmental as well as non-anatomical resections can be simulated and their effects analyzed. The virtual preoperative situs was confirmed intraoperatively in all 17 patients of our study population who underwent segmental liver resection for either a tumor or living-relative donation.

Creating models for virtual reality subdivides into several steps. The aim of the data acquisition is the extraction of nearly isotropic (same solution in all three axes) data sets with low noise content. An approximate isotropy can be achieved by suitable choice of scan parameters. For raw data reconstruction, the application of high-resolution reconstruction algorithms is prohibited due to increased noise. A missing isotropy can computationally be approximated by interpolation. Further noise suppression is achieved by applying filters. Additionally, the contrast of the object for segmentation can be increased by image processing operators. The correct choice of the segmentation method and the editing tools is essential for a precise segmentation with minimal user interaction. Prior to visualization, smoothing the shape of the segmented model (shape-based or morphological interpolation, polygon reduction of wire frame model) further improves the visual appearance of the 3D model.