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64. Improvements of diagnostic accuracy and visualization of vertebral metastasis using multi-level virtual non-calcium reconstructions from dual-layer spectral detector computed tomography

Author

Jasmin A Holz, Simon Lennartz, D Maintz, J Borggrefe, Barbara Krug, Nuran Abdullayev, N Große Hokamp, Z Romman, Gregor Pahn, and V Neuhaus

Subjects
Adult, Male, medicine.medical_specialty, chemistry.chemical_element, Lumbar vertebrae, Calcium, Thoracic Vertebrae, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Bone Marrow, medicine, Humans, Radiology, Nuclear Medicine and imaging, Bone Marrow Diseases, Neuroradiology, Lumbar Vertebrae, Spinal Neoplasms, medicine.diagnostic_test, business.industry, Ultrasound, Soft tissue, Bone metastasis, Magnetic resonance imaging, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Vertebra, medicine.anatomical_structure, chemistry, 030220 oncology & carcinogenesis, Female, Radiology, business, Epidemiologic Methods, Tomography, X-Ray Computed, Algorithms
Abstract

To evaluate feasibility and diagnostic performance of multi-level calcium suppression in spectral detector computed tomography (SDCT) for assessment of bone metastasis. Retrospective IRB-approved study on 21 patients who underwent SDCT (120 kV, reference mAs 116) and MRI. Thoracic and lumbar vertebrae (n = 357) were included and categorized as normal (n = 133) or metastatic (n = 203) based on MRI (STIR, T1w, ±contrast). The multi-level virtual non-calcium (VNCa) algorithm computes dynamic soft tissue/calcium pairs allowing for computation of different suppression index levels to address inter-individual variance of prevalent calcium composition weights. We computed images with low, medium, and high calcium suppression indices and compared them with conventional images (VNCa_low/med/high and conventional images (CI)). For quantitative image analysis, regions of interest were placed in normal and metastatic bone. Two readers reviewed the datasets independently in multiple sessions. They determined the presence of vertebral metastases on a per vertebra basis using a binary scale. Statistic assessment was performed using ANOVA with Tukey HSD, Student’s T test, and ROC analysis. Attenuation of both normal and metastatic bone was lower in VNCa images than that in conventional images (e.g., CI/VNCa_low, − 46.3 to 238.8 HU/343.3–60.2 HU; p ≤ 0.05). VNCa_low+med improved separation of normal and metastatic bone in ROC analysis (AUC, CI/VNCa_low/VNCa_med = 0.74/0.95/0.98; p ≤ 0.05). In subjective analysis, both sensitivity and specificity were clearly improved in VNCa_low as compared with CI (0.85/0.84 versus 0.78/0.82). Readers showed a good inter-rater reliability (kappa = 0.65). Multi-level VNCa reconstructed from SDCT improve quantitative separation of normal and metastatic bone and subjective determination of bone metastases when using low to intermediate calcium suppression indices. • Spectral detector CT allows for multi-level calcium suppression in CT images and low and medium calcium suppression indices improved separation of normal and metastatic bone. • Thus, multi-level calcium suppression allows to optimize image contrast in regard to dedicated pathologies. • Low-level virtual non-calcium images (index 25–50) improved diagnostic performance regarding detection of metastasis.

Published
2019

75. Differenzierung von Nierensteinen in niedrig- und normal-Dosis-Protokollen in der Spektral-Detektor CT

Author

Jasmin A Holz, Johannes Salem, N Große Hokamp, Stefan Haneder, G Dervishi, Axel Heidenreich, D Maintz, and M Ritter

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Zielsetzung: Die Genauigkeit der Zusammensetzungsanalyse von Nierensteinen sollte für die Spektral-Detektor CT (SDCT) unter Verwendung von niedrig- und normal-Dosis Protokollen untersucht werden. Methodik: 180 Steine mit bekannter, durch Infrarot-Spektrometrie bestimmter Zusammensetzung wurden[zum vollständigen Text gelangen Sie über die oben angegebene URL], 63. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie

Published
2018

77. Non-invasive Evaluation of Soft-Plaque-Restenosis in Coronary Artery Stents: Initial In-vitro Comparison of a Spectral Photon Counting CT and a Spectral Dual Layer CT System

Author

T, Hickethier, D, Bar-Ness, AC, Bunck, D, Maintz, G, Pahn, P, Coulon, Salim, Si-Mohamed, Philippe, Douek, Sigovan, Monica, Imagerie et modélisation Vasculaires, Thoraciques et Cérébrales (MOTIVATE), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2017

78. Radiation Dose Reduction in Computed Tomography-Guided Lung Interventions using an Iterative Reconstruction Technique

Author

Jan Borggrefe, De-Hua Chang, M. Hackenbroch, Alexander C. Bunck, S. Hiss, D. Mueller, Martin Hellmich, and D Maintz

Subjects
Adult, Image-Guided Biopsy, Lung Diseases, Male, medicine.medical_specialty, Lung Neoplasms, Image quality, Noise reduction, Iterative reconstruction, Radiology, Interventional, Radiation Dosage, Reduction (complexity), Fiducial Markers, Image Processing, Computer-Assisted, medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Aged, 80 and over, Radon transform, business.industry, Radiation dose, Middle Aged, Feasibility Studies, Female, Radiology, Artifacts, Tomography, X-Ray Computed, Fiducial marker, business, Nuclear medicine, Radiotherapy, Image-Guided
Abstract

Purpose: To compare the radiation doses and image qualities of computed tomography (CT)-guided interventions using a standard-dose CT (SDCT) protocol with filtered back projection and a low-dose CT (LDCT) protocol with both filtered back projection and iterative reconstruction. Materials and Methods: Image quality and radiation doses (dose-length product and CT dose index) were retrospectively reviewed for 130 patients who underwent CT-guided lung interventions. SDCT at 120 kVp and automatic mA modulation and LDCT at 100 kVp and a fixed exposure were each performed for 65 patients. Image quality was objectively evaluated as the contrast-to-noise ratio and subjectively by two radiologists for noise impression, sharpness, artifacts and diagnostic acceptability on a four-point scale. Results: The groups did not significantly differ in terms of diagnostic acceptability and complication rate. LDCT yielded a median 68.6 % reduction in the radiation dose relative to SDCT. In the LDCT group, iterative reconstruction was superior to filtered back projection in terms of noise reduction and subjective image quality. The groups did not differ in terms of beam hardening artifacts. Conclusion: LDCT was feasible for all procedures and yielded a more than two-thirds reduction in radiation exposure while maintaining overall diagnostic acceptability, safety and precision. The iterative reconstruction algorithm is preferable according to the objective and subjective image quality analyses. Key Points: • Implementation of a low-dose computed tomography (LDCT) protocol for lung interventions is feasible and safe. • LDCT protocols yield a significant reduction (more than 2/3) in radiation exposure. • Iterative reconstruction algorithms considerably improve the image quality in LDCT protocols. Citation Format: • Chang DH, Hiss S, Mueller D et al. Radiation Dose Reduction in Computed Tomography-Guided Lung Interventions using an Iterative Reconstruction Technique. Fortschr Rontgenstr 2015; 187: 906 – 914

Published
2015

79. [Thoracic and abdominal imaging in immunocompromised patients]

Author

J R, Kroeger, D, Maintz, and D-H, Chang

Subjects
Abdomen, Acute, Lung Diseases, Immunocompromised Host, Abdomen, Humans, Abdominal Injuries, Tomography, X-Ray Computed
Abstract

The number of patients with immunosuppression is rising worldwide. The spectrum of diseases and pathogens in these patients differs widely from that of immunocompetent patients due to frequent opportunistic infections. Symptoms are sometimes unspecific, and imaging plays a key role in the management of these patients. The lungs are a frequent site of infection in immunosuppressed patients. Chest X‑ray is the starting point for radiological diagnostics, but shows only limited sensitivity and specificity for infections with atypical pathogens. Thus, computed tomography (CT) is of great importance and allows a better distinction between viral, bacterial, or fungal infections, as well as other noninfectious diseases. Even with CT, however, is exact specification of the pathogen unfortunately not possible. CT is also the main diagnostic tool for assessment of the abdomen, particularly in patients presenting with acute abdomen or when sonographic findings are inconclusive. Moreover, CT allows diagnostic and therapeutic interventions such as percutaneous biopsies, or abscess and fluid drainage.

Published
2017

80. [Hemichorea with Contralateral High Signal Intensity Putaminal Lesion on T1-Weighted Images in Non-Ketotic Hyperglycemia]

Author

E I S, Achilles, V, Maus, G R, Fink, D, Maintz, T, van Eimeren, and A, Mpotsaris

Subjects
Glycated Hemoglobin, Aspartic Acid, Magnetic Resonance Spectroscopy, Hyperglycinemia, Nonketotic, Putamen, Middle Aged, Creatine, Choline, Diabetes Complications, Diffusion Magnetic Resonance Imaging, Diabetes Mellitus, Type 2, Chorea, Humans, Female, Dominance, Cerebral
Abstract

A 64-year-old diabetic female patient presented with involuntary unilateral hyperkinetic movements of the left limbs. Cranial MRI showed a contralateral high signal intensity putaminal lesion on T1-weighted images without any signal changes in the T2-weighted images. This finding is characteristic for hemichorea-hemiballism associated with insufficiently treated diabetes mellitus. Additionally, proton MR spectroscopy was performed and revealed a decreased N-acetylaspartate/creatine and N-acetylaspartate/choline ratio, indicating neuronal damage of the contralateral putamen.

Published
2016

83. Konsensusempfehlungen der DRG/DGK/DGPK zum Einsatz der Herzbildgebung mit Computertomographie und Magnetresonanztomographie

Author

S. Achenbach, J. Barkhausen, M. Beer, P. Beerbaum, T. Dill, J. Eichhorn, S. Fratz, M. Gutberlet, M. Hoffmann, A. Huber, P. Hunold, C. Klein, G. Krombach, K.-F. Kreitner, T. Kühne, J. Lotz, D. Maintz, H. Marholdt, N. Merkle, D. Messroghli, S. Miller, I. Paetsch, P. Radke, H. Steen, H. Thiele, S. Sarikouch, and R. Fischbach

Subjects
Cardiology and Cardiovascular Medicine
Published
2012

84. [Modern magnetic resonance imaging of the liver]

Author

D M, Hedderich, K, Weiss, D, Maintz, and T, Persigehl

Subjects
Liver, Liver Diseases, Image Interpretation, Computer-Assisted, Humans, Reproducibility of Results, Signal Processing, Computer-Assisted, Image Enhancement, Magnetic Resonance Imaging, Sensitivity and Specificity, Algorithms
Abstract

Magnetic resonance imaging (MRI) of the liver has become an essential tool in the radiological diagnostics of both focal and diffuse diseases of the liver and is subject to constant change due to technological progress. Recently, important improvements could be achieved by innovations regarding MR hardware, sequences and postprocessing methods. The diagnostic spectrum of MRI could be broadened particularly due to new examination sequences, while at the same time scanning time could be shortened and image quality has been improved. The aim of this article is to explain both the technological background and the clinical application of recent MR sequence developments and to present the scope of a modern MRI protocol for the liver.

Published
2015

85. Abstracts

Author

V. Dunet, A. Dabiri, G. Allenbach, A. Goyeneche Achigar, B. Waeber, F. Feihl, R. Heinzer, J. O. Prior, J. E. Van Velzen, J. D. Schuijf, F. R. De Graaf, M. A. De Graaf, M. J. Schalij, L. J. Kroft, A. De Roos, J. W. Jukema, E. E. Van Der Wall, J. J. Bax, E. Lankinen, A. Saraste, T. Noponen, R. Klen, M. Teras, T. Kokki, S. Kajander, M. Pietila, H. Ukkonen, J. Knuuti, A. P. Pazhenkottil, R. N. Nkoulou, J. R. Ghadri, B. A. Herzog, R. R. Buechel, S. M. Kuest, M. Wolfrum, O. Gaemperli, L. Husmann, P. A. Kaufmann, D. Andreini, G. Pontone, S. Mushtaq, L. Antonioli, E. Bertella, A. Formenti, S. Cortinovis, G. Ballerini, C. Fiorentini, M. Pepi, A. S. Koh, J. S. Flores, F. Y. J. Keng, R. S. Tan, T. S. J. Chua, A. D. Annoni, G. Tamborini, M. Fusari, A. L. Bartorelli, S. H. Ewe, A. C. T. Ng, V. Delgado, J. Schuijf, F. Van Der Kley, A. Colli, A. De Weger, N. A. Marsan, K. H. Yiu, A. C. Ng, S. A. J. Timmer, P. Knaapen, T. Germans, P. A. Dijkmans, M. Lubberink, J. M. Ten Berg, F. J. Ten Cate, I. K. Russel, A. A. Lammertsma, A. C. Van Rossum, Y. Y. Wong, G. Ruiter, P. Raijmakers, W. J. Van Der Laarse, N. Westerhof, A. Vonk-Noordegraaf, G. Youssef, E. Leung, G. Wisenberg, C. Marriot, K. Williams, J. Etele, R. A. Dekemp, J. Dasilva, D. Birnie, R. S. B. Beanlands, R. C. Thompson, A. H. Allam, L. S. Wann, A. H. Nureldin, G. Adelmaksoub, I. Badr, M. L. Sutherland, J. D. Sutherland, M. I. Miyamoto, G. S. Thomas, H. J. Harms, S. De Haan, M. C. Huisman, R. C. Schuit, A. D. Windhorst, C. Allaart, A. J. Einstein, T. Khawaja, C. Greer, A. Chokshi, M. Jones, K. Schaefle, K. Bhatia, D. Shimbo, P. C. Schulze, A. Srivastava, R. Chettiar, J. Moody, C. Weyman, D. Natale, W. Bruni, Y. Liu, E. Ficaro, A. J. Sinusas, A. Peix, E. Batista, L. O. Cabrera, K. Padron, L. Rodriguez, B. Sainz, V. Mendoza, R. Carrillo, Y. Fernandez, E. Mena, A. Naum, T. Bach-Gansmo, N. Kleven-Madsen, M. Biermann, B. Johnsen, J. Aase Husby, S. Rotevatn, J. E. Nordrehaug, J. Schaap, R. M. Kauling, M. C. Post, B. J. W. M. Rensing, J. F. Verzijlbergen, J. Sanchez, G. Giamouzis, N. Tziolas, P. Georgoulias, G. Karayannis, A. Chamaidi, N. Zavos, K. Koutrakis, G. Sitafidis, J. Skoularigis, F. Triposkiadis, S. Radovanovic, A. Djokovic, D. V. Simic, M. Krotin, A. Savic-Radojevic, M. Pljesa-Ercegovac, M. Zdravkovic, J. Saponjski, S. Jelic, T. Simic, R. Eckardt, B. J. Kjeldsen, L. I. Andersen, T. Haghfelt, P. Grupe, A. Johansen, B. Hesse, H. Pena, G. Cantinho, M. Wilk, Y. Srour, F. Godinho, N. Zafrir, A. Gutstein, I. Mats, A. Battler, A. Solodky, E. Sari, N. Singh, A. Vara, A. M. Peters, A. De Belder, S. Nair, N. Ryan, R. James, S. Dizdarevic, G. Depuey, M. Friedman, R. Wray, R. Old, H. Babla, B. Chuanyong, J. Maddahi, E. Tragardh Johansson, K. Sjostrand, L. Edenbrandt, S. Aguade-Bruix, G. Cuberas-Borros, M. N. Pizzi, M. Sabate-Fernandez, G. De Leon, D. Garcia-Dorado, J. Castell-Conesa, J. Candell-Riera, D. Casset-Senon, M. Edjlali-Goujon, D. Alison, A. Delhommais, P. Cosnay, C. S. Low, A. Notghi, J. O'brien, A. C. Tweddel, N. Bingham, P. O Neil, M. Harbinson, O. Lindner, W. Burchert, M. Schaefers, C. Marcassa, R. Campini, P. Calza, O. Zoccarato, A. Kisko, J. Kmec, M. Babcak, M. Vereb, M. Vytykacova, J. Cencarik, P. Gazdic, J. Stasko, A. Abreu, E. Pereira, L. Oliveira, P. Colarinha, V. Veloso, I. Enriksson, G. Proenca, P. Delgado, L. Rosario, J. Sequeira, I. Kosa, I. Vassanyi, C. S. Egyed, G. Y. Kozmann, S. Morita, M. Nanasato, I. Nanbu, Y. Yoshida, H. Hirayama, A. Allam, A. Sharef, I. Shawky, M. Farid, M. Mouden, J. P. Ottervanger, J. R. Timmer, M. J. De Boer, S. Reiffers, P. L. Jager, S. Knollema, G. M. Nasr, M. Mohy Eldin, M. Ragheb, I. Casans-Tormo, R. Diaz-Exposito, F. J. Hurtado-Mauricio, R. Ruano, M. Diego, F. Gomez-Caminero, C. Albarran, A. Martin De Arriba, A. Rosero, R. Lopez, C. Martin Luengo, J. R. Garcia-Talavera, I. E. K. Laitinen, M. Rudelius, E. Weidl, G. Henriksen, H. J. Wester, M. Schwaiger, X. B. Pan, T. Schindler, A. Quercioli, H. Zaidi, O. Ratib, J. M. Declerck, E. Alexanderson Rosas, R. Jacome, M. Jimenez-Santos, E. Romero, M. A. Pena-Cabral, A. Meave, J. Gonzalez, F. Rouzet, L. Bachelet, J. M. Alsac, M. Suzuki, L. Louedec, A. Petiet, F. Chaubet, D. Letourneur, J. B. Michel, D. Le Guludec, A. Aktas, A. Cinar, G. Yaman, T. Bahceci, K. Kavak, A. Gencoglu, A. Jimenez-Heffernan, E. Sanchez De Mora, J. Lopez-Martin, R. Lopez-Aguilar, C. Ramos, C. Salgado, A. Ortega, C. Sanchez-Gonzalez, J. Roa, A. Tobaruela, S. V. Nesterov, O. Turta, M. Maki, C. Han, D. Daou, M. Tawileh, S. O. Chamouine, C. Coaguila, E. Mariscal-Labrador, N. Kisiel-Gonzalez, P. De Araujo Goncalves, P. J. Sousa, H. Marques, J. O'neill, J. Pisco, R. Cale, J. Brito, A. Gaspar, F. P. Machado, J. Roquette, M. Martinez, G. Melendez, E. Kimura, J. M. Ochoa, A. M. Alessio, A. Patel, R. Lautamaki, F. M. Bengel, J. B. Bassingthwaighte, J. H. Caldwell, K. Rahbar, H. Seifarth, M. Schafers, L. Stegger, T. Spieker, A. Hoffmeier, D. Maintz, H. Scheld, O. Schober, M. Weckesser, H. Aoki, I. Matsunari, K. Kajinami, M. Martin Fernandez, M. Barreiro Perez, O. V. Fernandez Cimadevilla, D. Leon Duran, E. Velasco Alonso, J. P. Florez Munoz, L. H. Luyando, C. Templin, C. E. Veltman, J. H. C. Reiber, S. Venuraju, A. Yerramasu, S. Atwal, A. Lahiri, T. Kunimasa, M. Shiba, K. Ishii, J. Aikawa, E. S. J. Kroner, K. T. Ho, Q. W. Yong, K. C. Chua, C. Panknin, C. J. Roos, J. M. Van Werkhoven, A. J. Witkowska-Grzeslo, M. J. Boogers, D. V. Anand, D. Dey, D. Berman, F. Mut, R. Giubbini, L. Lusa, T. Massardo, A. Iskandrian, M. Dondi, A. Sato, Y. Kakefuda, E. Ojima, T. Adachi, A. Atsumi, T. Ishizu, Y. Seo, M. Hiroe, K. Aonuma, M. Kruk, R. Pracon, C. Kepka, J. Pregowski, A. Kowalewska, M. Pilka, M. Opolski, I. Michalowska, Z. Dzielinska, M. Demkow, V. Stoll, N. Sabharwal, A. Chakera, O. Ormerod, H. Fernandes, M. Bernardes, E. Martins, P. Oliveira, T. Vieira, G. Terroso, A. Oliveira, T. Faria, F. Ventura, J. Pereira, S. Fukuzawa, M. Inagaki, J. Sugioka, A. Ikeda, S. Okino, J. Maekawa, T. Uchiyama, N. Kamioka, S. Ichikawa, M. Afshar, R. Alvi, N. Aguilar, R. Ippili, H. Shaqra, J. Bella, N. Bhalodkar, A. Dos Santos, M. Daicz, L. O. Cendoya, H. G. Marrero, J. Casuscelli, M. Embon, G. Vera Janavel, E. Duronto, E. P. Gurfinkel, C. M. Cortes, Y. Takeishi, K. Nakajima, Y. Yamasaki, T. Nishimura, K. Hayes Brown, F. Collado, M. Alhaji, J. Green, S. Alexander, R. Vashistha, S. Jain, F. Aldaas, J. Shanes, R. Doukky, K. Ashikaga, Y. J. Akashi, M. Uemarsu, R. Kamijima, K. Yoneyama, K. Omiya, Y. Miyake, Y. Brodov, U. Raval, A. Berezin, V. Seden, E. Koretskaya, T. A. Panasenko, S. Matsuo, S. Kinuya, J. Chen, R. J. Van Bommel, B. Van Der Hiel, P. Dibbets-Schneider, E. V. Garcia, I. Rutten-Vermeltfoort, M. M. J. Gevers, B. Verhoeven, A. B. Dijk Van, E. Raaijmakers, P. G. H. M. Raijmakers, J. E. Engvall, M. Gjerde, J. De Geer, E. Olsson, P. Quick, A. Persson, M. Mazzanti, M. Marini, L. Pimpini, G. P. Perna, C. Marciano, P. Gargiulo, M. Galderisi, C. D'amore, G. Savarese, L. Casaretti, S. Paolillo, A. Cuocolo, P. Perrone Filardi, M. Al-Amoodi, E. C. Thompson, K. Kennedy, K. A. Bybee, A. I. Mcghie, J. H. O'keefe, T. M. Bateman, R. L. F. Van Der Palen, A. M. Mavinkurve-Groothuis, B. Bulten, L. Bellersen, H. W. M. Van Laarhoven, L. Kapusta, L. F. De Geus-Oei, P. P. Pollice, M. B. Bonifazi, F. P. Pollice, I. P. Clements, D. O. Hodge, C. G. Scott, M. De Ville De Goyet, B. Brichard, T. Pirotte, S. Moniotte, R. A. Tio, A. Elvan, R. A. I. O. Dierckx, R. H. J. A. Slart, T. Furuhashi, M. Moroi, H. Hase, N. Joki, H. Masai, R. Nakazato, H. Fukuda, K. Sugi, K. Kryczka, E. Kaczmarska, J. Petryka, L. Mazurkiewicz, W. Ruzyllo, P. Smanio, E. Vieira Segundo, M. Siqueira, J. Kelendjian, J. Ribeiro, J. Alaca, M. Oliveira, F. Alves, I. Peovska, J. Maksimovic, M. Vavlukis, N. Kostova, D. Pop Gorceva, V. Majstorov, M. Zdraveska, S. Hussain, M. Djearaman, E. Hoey, L. Morus, O. Erinfolami, A. Macnamara, M. P. Opolski, A. Witkowski, V. Berti, F. Ricci, R. Gallicchio, W. Acampa, G. Cerisano, C. Vigorito, R. Sciagra', A. Pupi, H. Sliem, F. M. Collado, S. Schmidt, A. Maheshwari, R. Kiriakos, V. Mwansa, S. Ljubojevic, S. Sedej, M. Holzer, G. Marsche, V. Marijanski, J. Kockskaemper, B. Pieske, A. Ricalde, G. Alexanderson, A. Mohani, P. Khanna, A. Sinusas, F. Lee, V. A. Pinas, B. L. F. Van Eck-Smit, H. J. Verberne, C. M. De Bruin, G. Guilhermina, L. Jimenez-Angeles, O. Ruiz De Jesus, O. Yanez-Suarez, E. Vallejo, E. Reyes, M. Chan, M. L. Hossen, S. R. Underwood, A. Karu, S. Bokhari, V. Pineda, L. M. Gracia-Sanchez, A. Garcia-Burillo, K. Zavadovskiy, Y. U. Lishmanov, W. Saushkin, I. Kovalev, A. Chernishov, A. Annoni, M. Tarkia, T. Saanijoki, V. Oikonen, T. Savunen, M. A. Green, M. Strandberg, A. Roivainen, M. C. Gaeta, C. Artigas, J. Deportos, L. Geraldo, A. Flotats, V. La Delfa, I. Carrio, W. J. Laarse, M. M. Izquierdo Gomez, J. Lacalzada Almeida, A. Barragan Acea, A. De La Rosa Hernandez, R. Juarez Prera, G. Blanco Palacios, J. A. Bonilla Arjona, J. J. Jimenez Rivera, J. L. Iribarren Sarrias, I. Laynez Cerdena, A. Dedic, A. Rossi, G. J. R. Ten Kate, A. Dharampal, A. Moelker, T. W. Galema, N. Mollet, P. J. De Feyter, K. Nieman, D. Trabattoni, A. Broersen, M. Frenay, M. M. Boogers, P. H. Kitslaar, J. Dijkstra, D. A. Annoni, M. Muratori, N. Johki, M. Tokue, A. S. Dharampal, A. C. Weustink, L. A. E. Neefjes, S. L. Papadopoulou, C. Chen, N. R. A. Mollet, E. H. Boersma, G. P. Krestin, J. A. Purvis, D. Sharma, S. M. Hughes, D. S. Berman, R. Taillefer, J. Udelson, M. Devine, J. Lazewatsky, G. Bhat, D. Washburn, D. Patel, T. Mazurek, S. Tandon, S. Bansal, S. Inzucchi, L. Staib, J. Davey, D. Chyun, L. Young, F. Wackers, M. T. Harbinson, G. Wells, J. Dougan, S. Borges-Neto, H. Phillips, A. Farzaneh-Far, Z. Starr, L. K. Shaw, M. Fiuzat, C. O'connor, M. Henzlova, W. L. Duvall, A. Levine, U. Baber, L. Croft, S. Sahni, S. Sethi, L. Hermann, A. Nureldin, A. Gomaa, M. A. T. Soliman, H. A. R. Hany, F. De Graaf, A. Pazhenkottil, H. M. J. Siebelink, J. H. Reiber, M. Ayub, T. Naveed, M. Azhar, A. Van Tosh, T. L. Faber, J. R. Votaw, N. Reichek, B. Pulipati, C. Palestro, K. J. Nichols, K. Okuda, Y. Kirihara, T. Ishikawa, J. Taki, M. Yoshita, M. Yamada, A. Salacata, S. Keavey, V. Chavarri, J. Mills, H. Nagaraj, P. Bhambhani, D. E. Kliner, P. Soman, J. Heo, A. E. Iskandrian, M. Jain, B. Lin, A. Walker, C. Nkonde, S. Bond, A. Baskin, J. Declerck, M. E. Soto, G. Mendoza, M. Aguilar, S. P. Williams, G. Colice, J. R. Mcardle, A. Lankford, D. K. Kajdasz, C. R. Reed, L. Angelini, F. Angelozzi, G. Ascoli, A. Jacobson, H. J. Lessig, M. C. Gerson, M. D. Cerqueira, J. Narula, M. Uematsu, K. Kida, K. Suzuki, P. E. Bravo, K. Fukushima, M. Chaudhry, J. Merrill, A. Alonso Tello, J. F. Rodriguez Palomares, G. Marti Aguasca, S. Aguade Bruix, V. Aliaga, P. Mahia, T. Gonzalez-Alujas, J. Candell, A. Evangelista, R. Mlynarski, A. Mlynarska, M. Sosnowski, B. Zerahn, P. Hasbak, C. E. Mortensen, H. F. Mathiesen, M. Andersson, D. Nielsen, L. Ferreira Santos, M. J. Ferreira, D. Ramos, D. Moreira, M. J. Cunha, A. Albuquerque, A. Moreira, J. Oliveira Santos, G. Costa, L. A. Providencia, Y. Arita, S. Kihara, N. Mitsusada, M. Miyawaki, H. Ueda, H. Hiraoka, Y. Matsuzawa, J. Askew, M. O'connor, L. Jordan, R. Ruter, R. Gibbons, T. Miller, L. Emmett, A. Ng, N. Sorensen, R. Mansberg, L. Kritharides, T. Gonzalez, H. Majmundar, N. P. Coats, S. Vernotico, J. H. Doan, T. M. Hernandez, M. Evini, A. D. Hepner, T. K. Ip, W. A. Chalela, A. M. Falcao, L. O. Azouri, J. A. F. Ramires, J. C. Meneghetti, F. Manganelli, M. Spadafora, P. Varrella, G. Peluso, R. Sauro, E. Di Lorenzo, F. Rotondi, S. Daniele, P. Miletto, A. J. M. Rijnders, B. W. Hendrickx, W. Van Der Bruggen, Y. G. C. J. America, P. J. Thorley, F. U. Chowdhury, C. J. Dickinson, S. I. Sazonova, I. Y. U. Proskokova, A. M. Gusakova, S. M. Minin, Y. U. B. Lishmanov, V. V. Saushkin, G. Rodriguez, F. Roffe, H. Ilarraza, D. Bialostozky, A. N. Kitsiou, P. Arsenos, I. Tsiantis, S. Charizopoulos, S. Karas, R. C. Vidal Perez, M. Garrido, V. Pubul, S. Argibay, C. Pena, M. Pombo, A. B. Ciobotaru, A. Sanchez-Salmon, A. Ruibal Morell, J. R. Gonzalez-Juanatey, E. Rodriguez-Gomez, B. Martinez, D. Pontillo, F. Benvissuto, F. Fiore Melacrinis, S. Maccafeo, E. V. Scabbia, R. Schiavo, Y. Golzar, C. Gidea, J. Golzar, D. Pop-Gorceva, M. Zdravkovska, S. Stojanovski, L. J. Georgievska-Ismail, T. Katsikis, A. Theodorakos, A. Kouzoumi, M. Koutelou, Y. Yoshimura, T. Toyama, H. Hoshizaki, S. Ohshima, M. Inoue, T. Suzuki, A. Uitterdijk, M. Dijkshoorn, M. Van Straten, W. J. Van Der Giessen, D. J. Duncker, D. Merkus, G. Platsch, J. Sunderland, C. Tonge, P. Arumugam, T. Dey, H. Wieczorek, R. Bippus, R. L. Romijn, B. E. Backus, T. Aach, M. Lomsky, L. Johansson, J. Marving, S. Svensson, J. L. Pou, F. P. Esteves, P. Raggi, R. Folks, Z. Keidar, J. W. Askew, L. Verdes, L. Campos, V. Gulyaev, A. Pankova, J. Santos, S. Carmona, I. Henriksson, A. Prata, M. Carrageta, A. I. Santos, K. Yoshinaga, M. Naya, C. Katoh, O. Manabe, S. Yamada, H. Iwano, S. Chiba, H. Tsutsui, N. Tamaki, I. Vassiliadis, E. Despotopoulos, O. Kaitozis, E. Hatzistamatiou, R. Thompson, J. Hatch, M. Zink, B. S. Gu, G. D. Bae, C. M. Dae, G. H. Min, E. J. Chun, S. I. Choi, M. Al-Mallah, K. Kassem, O. Khawaja, D. Goodman, D. Lipkin, L. Christiaens, B. Bonnet, J. Mergy, D. Coisne, J. Allal, N. Dias Ferreira, D. Leite, J. Rocha, M. Carvalho, D. Caeiro, N. Bettencourt, P. Braga, V. Gama Ribeiro, U. S. Kristoffersen, A. M. Lebech, H. Gutte, R. S. Ripa, N. Wiinberg, C. L. Petersen, G. Jensen, A. Kjaer, C. Bai, R. Conwell, R. D. Folks, L. Verdes-Moreiras, D. Manatunga, A. F. Jacobson, D. Belzer, Y. Hasid, M. Rehling, R. H. Poulsen, L. Falborg, J. T. Rasmussen, L. N. Waehrens, C. W. Heegaard, J. M. U. Silvola, S. Forsback, J. O. Laine, S. Heinonen, S. Ylaherttuala, A. Broisat, M. Ruiz, N. C. Goodman, J. Dimastromatteo, D. K. Glover, F. Hyafil, F. Blackwell, G. Pavon-Djavid, L. Sarda-Mantel, L. J. Feldman, A. Meddahi-Pelle, V. Tsatkin, Y.- H. Liu, R. De Kemp, P. J. Slomka, R. Klein, G. Germano, R. S. Beanlands, A. Rohani, V. Akbari, J. G. J. Groothuis, M. Fransen, A. M. Beek, S. L. Brinckman, M. R. Meijerink, M. B. M. Hofman, C. Van Kuijk, S. Kogure, E. Yamashita, J. Murakami, R. Kawaguchi, H. Adachi, S. Oshima, S. Minin, S. Popov, Y. U. Saushkina, G. Savenkova, D. Lebedev, E. Alexandridis, D. Rovithis, C. Parisis, I. Sazonova, V. Saushkin, V. Chernov, L. Zaabar, H. Bahri, S. Hadj Ali, A. Sellem, I. Slim, N. El Kadri, H. Slimen, H. Hammami, S. Lucic, A. Peter, S. Tadic, K. Nikoletic, R. Jung, M. Lucic, K. Tagil, D. Jakobsson, S.- E. Svensson, P. Wollmer, L. Leccisotti, L. Indovina, L. Paraggio, M. L. Calcagni, A. Giordano, M. Kapitan, A. Paolino, M. Nunez, J. Sweeny, N. Kulkarni, K. Guma, Y. Akashi, M. Takano, M. Takai, S. Koh, F. Miyake, N. Torun, G. Durmus Altun, A. Altun, E. Kaya, H. Saglam, D. T. Matsuoka, A. Sanchez, C. Bartolozzi, D. Padua, G. Ponta, A. Ponte, A. Carneiro, A. Thom, R. Ashrafi, P. Garg, G. Davis, A. Falcao, M. Costa, F. Bussolini, J. A. C. Meneghetti, M. Tobisaka, E. Correia, J. W. Jansen, P. A. Van Der Vleuten, T. P. Willems, F. Zijlstra, M. Sato, K. Taniguchi, M. Kurabayashi, D. Pop Gjorcheva, M. Zdraveska-Kochovska, K. Moriwaki, A. Kawamura, K. Watanabe, T. Omura, S. Sakabe, T. Seko, A. Kasai, M. Ito, M. Obana, T. Akasaka, C. Hruska, D. Truong, C. Pletta, D. Collins, C. Tortorelli, D. Rhodes, M. El-Prince, A. Martinez-Moeller, M. Marinelli, S. Weismueller, C. Hillerer, B. Jensen, S. G. Nekolla, H. Wakabayashi, K. Tsukamoto, S. M. E. A. Baker, K. M. H. S. Sirajul Haque, A. Siddique, S. Krishna Banarjee, A. Ahsan, F. Rahman, M. Mukhlesur Rahman, T. Parveen, M. Lutfinnessa, F. Nasreen, H. Sano, S. Naito, M. L. De Rimini, G. Borrelli, F. Baldascino, P. Calabro, C. Maiello, A. Russo, C. Amarelli, P. Muto, I. Danad, P. G. Raijmakers, Y. E. Appelman, O. S. Hoekstra, J. T. Marcus, A. Boonstra, D. V. Ryzhkova, T. V. Kuzmina, O. S. Borodina, M. A. Trukshina, I. S. Kostina, H. Hommel, G. Feuchtner, O. Pachinger, G. Friedrich, A. M. Stel, J. W. Deckers, V. Gama, A. Ciarka, L. A. Neefjes, N. R. Mollet, E. J. Sijbrands, J. Wilczek, C. Llibre Pallares, O. Abdul-Jawad Altisent, H. Cuellar Calabria, P. Mahia Casado, M. T. Gonzalez-Alujas, A. Evangelista Masip, D. Garcia-Dorado Garcia, Y. Tekabe, X. Shen, Q. Li, J. Luma, D. Weisenberger, A. M. Schmidt, R. Haubner, L. Johnson, L. Sleiman, S. Thorn, M. Hasu, M. Thabet, J. N. Dasilva, S. C. Whitman, D. Genovesi, A. Giorgetti, A. Gimelli, G. Cannizzaro, F. Bertagna, G. Fagioli, M. Rossi, R. Bonini, P. Marzullo, C. A. Paterson, S. A. Smith, A. D. Small, N. E. R. Goodfield, W. Martin, S. Nekolla, H. Sherif, S. Reder, M. Yu, A. Kusch, D. Li, J. Zou, M. S. Lloyd, K. Cao, D. W. Motherwell, A. Rice, G. M. Mccurrach, S. M. Cobbe, M. C. Petrie, I. Al Younis, E. Van Der Wall, T. Mirza, M. Raza, H. Hashemizadeh, L. Santos, B. A. Krishna, F. Perna, M. Lago, M. Leo, G. Pelargonio, G. Bencardino, M. L. Narducci, M. Casella, F. Bellocci, S. Kirac, O. Yaylali, M. Serteser, T. Yaylali, A. Okizaki, Y. Urano, M. Nakayama, S. Ishitoya, J. Sato, Y. Ishikawa, M. Sakaguchi, N. Nakagami, T. Aburano, S. V. Solav, R. Bhandari, S. Burrell, S. Dorbala, I. Bruno, C. Caldarella, A. Collarino, M. V. Mattoli, A. Stefanelli, A. Cannarile, F. Maggi, V. Soukhov, S. Bondarev, A. Yalfimov, M. Khan, P. P. Priyadharshan, G. Chandok, T. Aziz, M. Avison, R. A. Smith, D. S. Bulugahapitya, T. Vakhtangadze, F. Todua, M. Baramia, G. Antelava, N.- C. Roche, P. Paule, S. Kerebel, J.- M. Gil, L. Fourcade, A. Tzonevska, K. Tzvetkov, M. Atanasova, V. Parvanova, A. Chakarova, E. Piperkova, B. Kocabas, H. Muderrisoglu, C. P. Allaart, E. Entok, S. Simsek, B. Akcay, I. Ak, E. Vardareli, M. Stachura, P. J. Kwasiborski, G. J. Horszczaruk, E. Komar, A. Cwetsch, B. Zraik, R. Morales Demori, A. D. J. Almeida, M. E. Siqueira, E. Vieira, I. Balogh, G. Kerecsen, E. Marosi, Z. S. Szelid, A. Sattar, T. Swadia, J. Chattahi, W. Qureshi, F. Khalid, A. Gonzalez, S. Hechavarria, K. Takamura, S. Fujimoto, R. Nakanishi, S. Yamashina, A. Namiki, J. Yamazaki, K. Koshino, Y. Hashikawa, N. Teramoto, M. Hikake, S. Ishikane, T. Ikeda, H. Iida, Y. Takahashi, N. Oriuchi, H. Higashino, K. Endo, T. Mochizuki, K. Murase, A. Baali, R. Moreno, M. Chau, H. Rousseau, F. Nicoud, P. Dolliner, L. Brammen, G. Steurer, T. Traub-Weidinger, P. Ubl, P. Schaffarich, G. Dobrozemsky, A. Staudenherz, M. Ozgen Kiratli, B. Temelli, N. B. Kanat, T. Aksoy, G. A. Slavich, G. Piccoli, M. Puppato, S. Grillone, D. Gasparini, S. Perruchoud, C. Poitry-Yamate, M. Lepore, R. Gruetter, T. Pedrazzini, D. Anselm, A. Anselm, H. Atkins, J. Renaud, R. Dekemp, I. Burwash, A. Guo, R. Beanlands, C. Glover, I. Vilardi, B. Zangheri, L. Calabrese, P. Romano, A. Bruno, O. C. Fernandez Cimadevilla, V. A. Uusitalo, M. Luotolahti, M. Wendelin-Saarenhovi, J. Sundell, O. Raitakari, S. Huidu, R. Gadiraju, M. Ghesani, Q. Uddin, B. Wosnitzer, N. Takahashi, E. Alhaj, A. Legasto, B. Abiri, K. Elsaban, T. El Khouly, T. El Kammash, A. Al Ghamdi, B. Kyung Deok, K. Bon Seung, Y. Sang Geun, D. Chang Min, and M. Gwan Hong

Subjects
Cardiology and Cardiovascular Medicine
Published
2011

87. Polyarterial clustered recurrence of cervical artery dissection seems to be the rule

Author

Darius G. Nabavi, Rainald Bachmann, D. Maintz, I. Nassenstein, Erich Bernd Ringelstein, Ralf Dittrich, Walter Heindel, and Gregor Kuhlenbäumer

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Cervical Artery, Carotid Artery, Internal, Dissection, Asymptomatic, Magnetic resonance angiography, Predictive Value of Tests, Secondary Prevention, medicine, Humans, Prospective Studies, Prospective cohort study, Vertebral Artery, Vertebral Artery Dissection, medicine.diagnostic_test, business.industry, Vascular disease, Anticoagulants, Middle Aged, Prognosis, medicine.disease, Surgery, Dissection, Space-Time Clustering, Predictive value of tests, Disease Progression, Female, Neurology (clinical), medicine.symptom, business, Scad, Carotid Artery, Internal, Magnetic Resonance Angiography
Abstract

Background: Spontaneous cervical artery dissection (sCAD) in multiple neck arteries (polyarterial sCAD) is traditionally thought to represent a monophasic disorder suggesting nearly simultaneous occurrence of the various intramural hematomas. Its incidence ranges from 10 to 28%. The recurrence rate of sCAD in general over up to 8.6 years has been recorded to be 0 to 8%. Objective: To analyze more precisely the temporal and spatial neuroangiologic course of sCAD with particular focus on polyarterial manifestation. Methods: We prospectively investigated 36 consecutive patients with sCAD unexceptionally proven by MR imaging at 1.5 T. We reinvestigated these patients by two follow-up MR examinations. The first follow-up MR examination was performed after a mean of 16 ± 13 days, and the last MR study after a mean of 7 ± 2 months after the initial diagnosis. Results: Systematic data evaluation of the 36 patients revealed the following phenomena of sCAD: 1) seemingly simultaneous polyarterial sCAD on the initial MRI scan (n = 2; 6%); 2) recurrent sCAD in one or several initially uninvolved cervical arteries during follow-up (n = 9; 25%). These latter sCAD occurred as an early polyarterial recurrent event within 1 to 4 weeks in 7 patients (19%), and as a delayed polyarterial recurrent event within 5 to 7 months in 2 patients (6%). Under a spatial perspective, sCAD recurrence took place in one additional cervical artery in 5 patients (14%), or in more than one previously uninvolved cervical artery in 4 patients (11%). All patients except one with sCAD recurrence remained asymptomatic or had local symptoms only. One patient experienced a significant clinical deterioration due to ischemic stroke with acute impairment of cerebral hemodynamics. During follow-up, patients received transient oral anticoagulation for at least 6 months with subsequent acetylsalicylic acid (ASA). Conclusion: More often than previously thought, the recurrence of spontaneous cervical artery dissection (sCAD) involves multiple cervical arteries in sequence. sCAD recurrence frequently appears to cluster within the first 2 months after the index event, rather than occurring steadily over time. The prognosis of recurring sCAD appears benign, particularly in patients already receiving antithrombotic therapy.

Published
2007

88. Association between Single Nucleotide Polymorphisms in the Lysyl Oxidase-Like 1 Gene and Spontaneous Cervical Artery Dissection

Author

Gregor Kuhlenbäumer, I. Nassenstein, Ralf Dittrich, B. Kis, D. Maintz, F. Friedrichs, B. Ringelstein, Darius G. Nabavi, Peter Berlit, and M. Stoll

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Cervical Artery, DNA Mutational Analysis, Connective tissue, Single-nucleotide polymorphism, Dissection (medical), Polymorphism, Single Nucleotide, Risk Assessment, Linkage Disequilibrium, Exon, Aneurysm, Gene Frequency, Risk Factors, Polymorphism (computer science), Odds Ratio, Humans, Medicine, Genetic Predisposition to Disease, Stroke, Retrospective Studies, Models, Genetic, integumentary system, business.industry, Exons, Middle Aged, medicine.disease, Introns, Aortic Dissection, medicine.anatomical_structure, Neurology, Cervical Vertebrae, Female, Amino Acid Oxidoreductases, Neurology (clinical), Cardiology and Cardiovascular Medicine, business
Abstract

Background: Spontaneous cervical artery dissection (sCAD) is a common cause of stroke in patients below 55 years. Dermal connective tissue abnormalities have been observed in up to 60% of patients. A chromosomal locus for connective tissue abnormalities associated with sCAD has been mapped to chromosome 15q24 to a candidate region containing the lysyl oxidase-like 1 gene (LOXL1). LOXL1 an excellent candidate susceptibility gene for non-familial sCAD was investigated by mutation analysis and a genetic association study. Methods: We sequenced the whole coding region of the LOXL1 gene in 15 sCAD patients and performed a genetic association study in 157 sCAD patients using 12 single nucleotide polymorphisms (SNP). Results: The SNP rs3825942 (Gly153Asp) showed marginal association with sCAD on an allele basis and in the dominant genetic model, and intronic SNP rs893817 under a recessive model only. None of the SNP haplotypes was associated with sCAD. Conclusions: Genetic variation in LOXL1 might play a role as a risk factor for sCAD.

Published
2007

89. MRT-gesteuerte Vakuumbiopsien (VAB) der Mamma an einem 1.0 T Tomographen: Einfluss klinischer, sowie Läsionscharakteristika auf den Interventionsprozess und das klinische Outcome

Author

Peter Mallmann, KB Krug, D Maintz, A Ulhaas, Wolfram Malter, and Stefan Kramer

Subjects
Maternity and Midwifery, Obstetrics and Gynecology
Abstract

Die kontrastmittelgestutzte MR-Tomografie der Mamma bietet die Moglichkeit klinisch okkulte sowie Rontgen-mammographisch und sonographisch nicht zu detektierende Befunde nachzuweisen. Bei fehlender Reproduzierbarkeit einer MR-tomographisch nachgewiesenen Lasion der MRT-BI-RADS Kategorie 4 oder 5 ohne Korrelat in der Rontgen-Mammografie und der Sonografie ist die Indikation zu einer MRT-gestutzten perkutanen Intervention gegeben. Die Studie hatte das Ziel den Einfluss klinischer, sowie Lasionscharakteristika auf den Interventionsprozess sowie das klinische Outcome an einem 1.0 T Tomographen zu beurteilen. Klinische, bildmorphologische sowie histopathologische Befunde aller 132 Patientinnen, welche eine Erstintervention per VAB zwischen 07/2005 und 03/2012 im Institut fur Diagnostische und Interventionelle Radiologie der Universitatsklinik Koln erhielten und wurden aus den handischen und elektronischen Krankenakten extrahiert. Die Daten wurden anhand eines strukturierten, elektronischen Fragebogens erfasst und in Form einer elektronischen Datenbank angelegt. Der weitere klinische Verlauf aller Patientinnen mit benignen Befunden wurde anhand der Datenerfassung durch die behandelnden, niedergelassenen Gynakologen beurteilt. Sowohl Lage als auch Grose der untersuchten Ziellasionen aller 103 verfugbarer Datensatze wurden im Sinne einer Doppelbefundung von 2 radiologischen Oberarzten befundet. Einfluss der Lokalisation und der Bildmorphologie auf die technischen und klinischen Kenndaten, insbesondere der Lage der Ziellasion, Grose und der Sichtbarkeit der Ziellasion vor und nach Kontrastmittelgabe auf das interventionelle und klinische Outcome wurden in Subgruppenanalysen uberpruft. 131 von 132 MR-gesteuerten Brustbiopsien (99,2%) waren technisch erfolgreich. Die mediane Interventionszeit betrug 30 Minuten (25% Perzentile 25 Minuten, 75% Perzentile 35 Minuten, max. 75 Minuten.) Minor Komplikationen traten in 13 Fallen auf (3, 3%). Die histopathologische Befundung zeigte benigne Befunde in 95 der 132 Interventionen (72%), B3-Lasionen, also Lasionen mit unklarem biologischem Potential fanden sich in 6 Biopsien (4,5%) und maligne Befunde in insgesamt 30 Biopsien (23,5%). Weder das Alter der Patientinnen, noch die bisherige klinisch-onkologische Anamnese hatten Einfluss auf den technischen Erfolg, die Komplikationsraten oder die Interventionszeit. Die maximale Lasionsgrose lag zwischen 1 und 5 mm in 16 Fallen (15,5%), 6 bis 10 mm in 41 Fallen (39,8%) und 11 bis 15 mm in 29 Fallen (28,2%) in den 108 vorhandenen retrospektiv ausgewerteten Daten. Insgesamt ergaben sich 2 falsch negative histopathologische Befunde (2,4%) der 70 Patienten mit benignen Befunden. MRT-gesteuerte Vakuumbiopsien suspekter Lasionen der Brust an einem offenen 1.0 T Tomographen sind eine klinisch sichere und praktikable Methode besonders fur kleine und anatomisch diffizil gelegene Befunde.

Published
2015

94. Our 2015 approach to invasive pulmonary aspergillosis

Author

Christopher Bangard, Guido Michels, Axel Hamprecht, Konrad Frank, Jorg-Janne Vehreschild, Birgid Markiefka, H. Wisplinghoff, Sabine Grönke, D. Maintz, Maria J G T Vehreschild, K. Hekmat, Blasius Liss, and Oliver A. Cornely

Subjects
medicine.medical_specialty, Posaconazole, Antifungal Agents, Dermatology, Microbial Sensitivity Tests, Aspergillosis, Chemoprevention, Fever of Unknown Origin, Hospitals, University, Mannans, chemistry.chemical_compound, Internal medicine, Biopsy, medicine, Humans, skin and connective tissue diseases, Voriconazole, Invasive Pulmonary Aspergillosis, Lung, medicine.diagnostic_test, business.industry, Mucormycosis, Galactose, General Medicine, Triazoles, bacterial infections and mycoses, medicine.disease, respiratory tract diseases, Surgery, Infectious Diseases, Bronchoalveolar lavage, medicine.anatomical_structure, Aspergillus, chemistry, Radiography, Thoracic, France, Caspofungin, business, Tomography, X-Ray Computed, Bronchoalveolar Lavage Fluid, medicine.drug
Abstract

Summary At the University Hospital of Cologne, in general two patient groups at high risk for invasive aspergillosis receive posaconazole prophylaxis: Acute myelogenous leukaemia patients during remission induction chemotherapy and allogeneic haematopoietic stem cell transplant recipients. Other patients at risk undergo serum galactomannan testing three times weekly. At 72–96 h of persisting fever despite broad-spectrum antibiotics, or at onset of lower respiratory tract symptoms a thoracic computed tomography (CT) scan is performed. Without lung infiltrates on CT, IPA is ruled out. In lung infiltrates not suggestive for IPA mycological confirmation is pursued. In patients without posaconazole prophylaxis empiric caspofungin will be considered. CT findings typical for IPA prompt targeted treatment, and mycological confirmation. Bronchoalveolar lavage (BAL) is most important for cultural identification and susceptibility testing, and facilitates diagnosing other pathogens. BAL performance is virtually independent of platelet counts. If despite suggestive infiltrates BAL does not yield the diagnosis, CT-guided biopsy follows as soon as platelet counts allow. Surgery can also be beneficial in diagnosis and treatment of IPA. If the diagnosis of IPA is not established, mucormycosis is a valid concern. In patients with breakthrough IPA during posaconazole prophylaxis liposomal amphotericin B is the drug of choice. If no posaconazole prophylaxis was given, voriconazole is the treatment of choice for IPA.

Published
2015

95. [Response criteria for malignant melanoma: RECIST and irRC]

Author

J, Spiro, D, Maintz, and T, Persigehl

Subjects
Diagnostic Imaging, Treatment Outcome, Humans, Antineoplastic Agents, Immunotherapy, Drug Monitoring, Melanoma, Response Evaluation Criteria in Solid Tumors
Abstract

In the field of oncology the response evaluation criteria in solid tumors (RECIST) currently represent the most commonly used and validated radiological response criteria for objective treatment monitoring of conventional chemotherapy. For therapy monitoring of classical cytostatic and cytotoxic tumor therapies RECIST has been tested and successfully validated in many clinical studies. However, with the introduction of novel molecular drugs limitations of these size-based criteria became obvious due to response patterns which are not reflected by RECIST. Thus, for a comprehensive evaluation of modern immunotherapeutic agents new immune-related response criteria (irRC) were developed.This review gives a brief overview of the most important radiological response criteria RECIST 1.0 and 1.1 as well as irRC for malignant melanoma.

Published
2015

96. Whole-Heart-MR-Koronarangiographie - erste Ergebnisse

Author

M. Quante, René M. Botnar, D Maintz, Andreas Hoffmeier, Walter Heindel, Murat Ozgun, and Roman Fischbach

Subjects
Coronary angiography, medicine.medical_specialty, business.industry, Image quality, Mr angiography, Steady-state free precession imaging, medicine.disease, eye diseases, Data set, Stenosis, medicine.anatomical_structure, cardiovascular system, medicine, Radiology, Nuclear Medicine and imaging, In patient, cardiovascular diseases, Radiology, Nuclear medicine, business, circulatory and respiratory physiology, Artery
Abstract

PURPOSE: To evaluate a new coronary MR angiography technique covering the whole coronary artery tree in one data set acquisition. MATERIALS AND METHODS: Six healthy volunteers and 15 patients with known CAD were examined with a navigator gated and corrected (NAV) free-breathing 3D steady-state free precession sequence covering the whole heart (WH-MRA) (TR = 5.4, TE = 2.7, SENSE factor = 2, 160 slices, 0.75 mm reconstructed slice thickness, in-plane resolution = 0.99 x 0.99 mm(2), scan time 14 min [50 % NAV efficiency]) and a vessel targeted 3D SSFP MRA sequence (t-MRA) (TR = 5.6 ms, TE = 2.8 ms, 20 slices of 1.5 mm reconstructed slice thickness, in-plane resolution = 0.99 x 0.99 mm(2), scan time = 7 min [50 % NAV efficiency]). Subjective image quality (4-point scale) and objective image quality parameters including vessel sharpness, vessel diameter and CNR were calculated for WH-MRA and t-MRA. In patients, the accuracy for detection of stenosis larger than 50 % was compared to the accuracy of X-ray coronary angiography (XA), which was considered the standard. RESULTS: WH-MRA demonstrated good vessel visibility in healthy subjects (100 %) whereas vessel visibility in patients was limited (78 % in an 8 segment evaluation). Vessel sharpness was inferior to that of t-MRA in patients (37 vs. 42 %) but equal in healthy subjects (42 %). Vessel diameter did not differ significantly between WH-MRA and t-MRA. CNR was significantly reduced for WH-MRA (CNR 7.4 vs. 11.5). The diagnostic accuracy for the detection of CAD was comparable for both MRA approaches (85.5 vs. 86.2 %). CONCLUSION: WH-MRA allows good coronary artery visualization in healthy subjects and patients and provides a simplified scanning procedure and advantages in 3D post-processing. Regarding image parameters and the detection of CAD, the results are comparable to those acquired with t-MRA. The major disadvantage remains the high number of diagnostically insufficient images.

Published
2006

97. Hochfeld-Magnetresonanztomographie: Magnetische Anziehungs- und Rotationskräfte auf metallische Implantate bei 3,0 T

Author

C Pavlidis, A Schmiedel, Frank Träber, M Hackenbroch, Horst Urbach, Torsten Sommer, D Maintz, U. Hofer, M Höher, and H. H. Schild

Subjects
Physics, Iliac artery, medicine.diagnostic_test, Aneurysm clips, medicine.medical_treatment, Stent, Magnetic resonance imaging, Magnetostatics, Magnetic field, Nuclear magnetic resonance, Magnet, medicine, Radiology, Nuclear Medicine and imaging, Implant
Abstract

Ziel: Die In-vitro-Evaluierung verschiedener biomedizinischer Implantate hinsichtlich der auf sie wirkenden magnetischen Anziehungs- und Rotationskrafte an einem 3,0-Tesla-MRT-System. Methode: Es wurden 53 metallische Implantate (14 intrakranielle Aneurysmaclips, 19 Koronararterien- sowie 20 Iliakalarterienstents) an einem 3,0-Tesla-MRT-System (Gyroscan Intera 3.0 T, Philips) untersucht. Die Bestimmung der auf die Implantate im statischen Magnetfeld wirkenden Translationskrafte Fz erfolgte mithilfe des Fadentests uber die Messung der Deflektionswinkels β. Die Evaluierung der Rotationskraft Frot erfolgte qualitativ mit einer 5-Punkte-Graduierung (Grad 0: keine Rotationskraft, Grad 4: starke Rotationskraft). Ergebnisse: Bei 52 von 53 getesteten Implantaten blieb die Translationskraft Fz unterhalb der auf das jeweilige Implantat wirkenden Gravitationskraft (β: 0 - 21°, Fz: 0 - 3,8 mN). Bei keinem dieser 52 Implantate wurde eine Rotation relativ zum Magnetfeld B0 (Rotationskraft Grad 0/4) beobachtet. Bei einem Implantat, einem Iliakalarterienstent aus Edelstahl (Zenith, Fa. Cook), wurde ein Deflektionswinkel β von 88° gemessen, entsprechend einer Translationskraft Fz von 299 mN, die dem 29fachen der auf das Implantat wirkenden Gravitationskraft entspricht. Hierzu konkordant zeigten sich in der qualitativen Evaluierung deutliche auf diesen Stent wirkende Rotationskrafte Grad 4/4. Schlussfolgerungen: 52 von 53 getesteten Implantaten konnen bezuglich der auf sie wirkenden magnetischen Anziehungs- und Rotationskrafte nach ASTM-Kriterien als „sicher” bei der Verwendung in einem MRT-System mit der Feldstarke 3,0 Tesla klassifiziert werden. Purpose: To evaluate magnetic field interactions of commonly used biomedical implants at 3.0 Tesla. Materials and Methods: Fourteen aneurysm clips designed for permanent placement in intracranial aneurysms, 19 coronary artery stents and 20 iliac artery stents were evaluated in an actively shielded compact 3.0 T MR system (Intera, Philips Medical Systems, Best, The Netherlands, length of magnet 1.57 m). The magnetic deflection forces (translational movement) were evaluated as follows: The implants were suspended by a fine string and placed in the magnet bore at the location of the maximum magnetic field gradient. The translational forces Fz were calculated from the measured angle of deflection from the vertical axis. The magnetic field-induced torque (rotational forces) was evaluated as follows: Each implant was placed in the center of the magnetic bore parallel to the static magnetic field B0 (position 0°). Any possible displacement of the implant was noted on a millimeter scale and any torque qualitatively evaluated using a 5 point grading scale (0: no torque; + 4: very strong torque). The implant was turned in steps of 45°, and the procedure was repeated to encompass a full 360° rotation. Results: In 52 of the 53 devices tested, the deflection force (deflection angle: range 0-21°, translational force: range 0-3.8 mN) was less than the gravitational force (i.e., the implant’s weight). These devices (n = 52/53) did not show any alignment to or rotation in the magnetic field at any of the various 45°-increment positions corresponding to a qualitative torque evaluation of grade 0/4. One device (n = 1/53), an iliac artery stent made of stainless steel (Zenith, Cook, Monchengladbach, BRD), was found to have deflection forces (deflection angle 88° translational force 299 mN) greatly exceeding the gravitational force as well as a pronounced torque (grade 4/4). Conclusion: Out of 53 biomedical implants evaluated for magnetic field interactions at 3.0 T, one iliac artery stent made of stainless steel was found to be potentially unsafe based on ASTM criteria. MR imaging at 3.0 Tesla may be performed safely in patients with any of the other 52 different implants evaluated in this study with respect to magnetic field translational attraction and torque.

Published
2004

98. Coronary MR Angiography: Comparison of Quantitative and Qualitative Data from Four Techniques

Author

Walter Heindel, Kraig V. Kissinger, Warren J. Manning, Franz C. Aepfelbacher, D Maintz, Matthias Stuber, René M. Botnar, and Peter G. Danias

Subjects
Male, medicine.medical_specialty, Radiography, Coronary Artery Disease, Coronary Angiography, Imaging, Three-Dimensional, Humans, Medicine, False Positive Reactions, Radiology, Nuclear Medicine and imaging, Prospective Studies, False Negative Reactions, Spiral, Aged, medicine.diagnostic_test, business.industry, Mr angiography, Reproducibility of Results, Signal Processing, Computer-Assisted, General Medicine, Coronary arteriography, Middle Aged, Coronary heart disease, Radiographic Image Enhancement, Vessel diameter, Angiography, Female, Radiology, Nuclear medicine, business, Magnetic Resonance Angiography
Abstract

The optimal coronary MR angiography sequence has yet to be determined. We sought to quantitatively and qualitatively compare four coronary MR angiography sequences. SUBJECTS AND METHODS. Free-breathing coronary MR angiography was performed in 12 patients using four imaging sequences (turbo field-echo, fast spin-echo, balanced fast field-echo, and spiral turbo field-echo). Quantitative comparisons, including signal-to-noise ratio, contrast-to-noise ratio, vessel diameter, and vessel sharpness, were performed using a semiautomated analysis tool. Accuracy for detection of hemodynamically significant disease (50%) was assessed in comparison with radiographic coronary angiography.Signal-to-noise and contrast-to-noise ratios were markedly increased using the spiral (25.7 +/- 5.7 and 15.2 +/- 3.9) and balanced fast field-echo (23.5 +/- 11.7 and 14.4 +/- 8.1) sequences compared with the turbo field-echo (12.5 +/- 2.7 and 8.3 +/- 2.6) sequence (p0.05). Vessel diameter was smaller with the spiral sequence (2.6 +/- 0.5 mm) than with the other techniques (turbo field-echo, 3.0 +/- 0.5 mm, p = 0.6; balanced fast field-echo, 3.1 +/- 0.5 mm, p0.01; fast spin-echo, 3.1 +/- 0.5 mm, p0.01). Vessel sharpness was highest with the balanced fast field-echo sequence (61.6% +/- 8.5% compared with turbo field-echo, 44.0% +/- 6.6%; spiral, 44.7% +/- 6.5%; fast spin-echo, 18.4% +/- 6.7%; p0.001). The overall accuracies of the sequences were similar (range, 74% for turbo field-echo, 79% for spiral). Scanning time for the fast spin-echo sequences was longest (10.5 +/- 0.6 min), and for the spiral acquisitions was shortest (5.2 +/- 0.3 min).Advantages in signal-to-noise and contrast-to-noise ratios, vessel sharpness, and the qualitative results appear to favor spiral and balanced fast field-echo coronary MR angiography sequences, although subjective accuracy for the detection of coronary artery disease was similar to that of other sequences.

Published
2004

99. Erratum zu: Konsensusempfehlungen der DRG/DGK/DGPK zum Einsatz der Herzbildgebung mit Computertomographie und Magnetresonanztomographie

Author

Holger Thiele, Meinrad Beer, H. Marholdt, Matthias Gutberlet, T. Dill, P. Hunold, Stephan Miller, Henning Steen, T. Kühne, R. Fischbach, Joachim Eichhorn, D. Messroghli, K.-F. Kreitner, M. Hoffmann, I. Paetsch, Stephan Achenbach, D. Maintz, G. Krombach, Joerg Barkhausen, Jeffrey C. Lotz, Christoph Klein, A. Huber, N. Merkle, PW Radke, Philipp Beerbaum, Samir Sarikouch, and Sohrab Fratz

Subjects
Gynecology, medicine.medical_specialty, business.industry, Medicine, Cardiology and Cardiovascular Medicine, business, Clinical routine
Abstract

Die kardiale Schnittbilddiagnostik mit der Magnetresonanztomographie (MRT) und Computertomographie (CT) hat sich in der letzten Dekade technisch rasant weiterentwickelt. Diese Verbesserungen und die breite Verfugbarkeit moderner CT- und MRT-Systeme haben dazu gefuhrt, dass beide Verfahren regelmasig in der klinischen Routine eingesetzt werden. Dieses deutsche Konsensuspapier wurde daher gemeinsam von der Deutschen Gesellschaft fur Kardiologie – Herz- und Kreislaufforschung (DGK), der Deutschen Rontgengesellschaft (DRG) und der Deutschen Gesellschaft fur Padiatrische Kardiologie (DGPK) erarbeitet und orientiert sich nicht an Modalitaten und Methoden, sondern gliedert sich nach grosen Krankheitsgruppen. Behandelt werden die koronare Herzerkrankung, Kardiomyopathien, Herzrhythmusstorungen, Klappenvitien, Perikarderkrankungen, erworbene und strukturellen Veranderungen sowie angeborene Herzfehler. Fur unterschiedliche klinische Szenarien werden die beiden Schnittbildmodalitaten CT und MRT vergleichend gegenubergestellt und in einem kurzen Textfeld bewertet.

Published
2012

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