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Karpitschka M, Augart D, Becker C, Reiser MF, Graser A. Dosisreduktion bei onkologischen CT-Staginguntersuchungen durch iterative Bilddatenrekonstruktion. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Staehler M, Nuhn P, Haseke N, Tüllmann C, Bader M, Graser A, Stief CG. [Clinical approach to renal trauma]. Urologe A 2010; 49:837-41. [PMID: 20625874 DOI: 10.1007/s00120-010-2319-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Management of kidney injuries is an uncommon challenge to urologists. Therapy has evolved in recent years from mainly surgical to predominantly conservative treatment. Immediate surgical intervention for renal trauma is now only necessary in rare instances. This overview is based on the guidelines of the European Association of Urology and the Societé International d'Urologie as well as clinical experience and is intended to provide practical advice for treatment of renal trauma.
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Graser A, Becker CR, Nikolaou K, Mang T. 3D CT-Kolonographie (CTK): Vergleich von diagnostischer Genauigkeit und Befundungszeit zwischen Standard-3D-Software und virtueller Dissektionstechnik. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Graser A, Schoepf UJ, Huda W, Reiser M, Becker CR. Strahlenexposition und Organdosen bei CT-Kolonographie in Niedrigdosistechnik. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Sommer W, Schenzle JC, Becker CR, Neumaier K, Nikolaou K, Graser A, Reiser M, Johnson TR. Dosiseinsparung bei Triple-Rule-Out Protokollen durch hohe Pitch-Faktoren. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Graser A, Mang T, Becker CR, Reiser MF. [Indications for and results of CT colonography: from screening to the symptomatic patient]. Radiologe 2009; 48:118-25. [PMID: 18231767 DOI: 10.1007/s00117-007-1611-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CT colonography (CTC) is also referred to as virtual colonoscopy and is being used with increasing frequency in radiological practice. While there are still no generally accepted, clear-cut indications for its use in mass colorectal cancer screening, there is evidence that this investigation is useful in patients in whom colonoscopy has not been successful or who have known stenotic lesions in the colon. Recent results of significant comparative studies of CTC and conventional colonoscopy will have some influence on the future place of CTC in screening for cancer of the bowel; they show the great potential of CT-aided bowel examination.
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Johnson TR, Morhard D, Fink C, Graser A, Reiser MF, Becker CR. Knochenentfernung aus CT-Angiographien mittels Dual Energy CT. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Graser A, Kolligs FT, Schäfer C, Reiser MF, Becker CR, Mang T. Vergleich der diagnostischen Genauigkeit verschiedener 3D-Visualisierungen in der CT-Kolonographie. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Graser A, Staehler M, Nikolaou K, Reiser MF, Becker CR, Johnson TR. Dual Energy CT bei Patienten mit Nierentumoren: Histopathologische Korrelation, diagnostische Genauigkeit und Strahlenexposition. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Graser A, Stieber P, Nagel D, Schäfer C, Horst D, Becker CR, Nikolaou K, Lottes A, Geisbüsch S, Kramer H, Wagner AC, Diepolder H, Schirra J, Roth HJ, Seidel D, Göke B, Reiser MF, Kolligs FT. Comparison of CT colonography, colonoscopy, sigmoidoscopy and faecal occult blood tests for the detection of advanced adenoma in an average risk population. Gut 2009; 58:241-8. [PMID: 18852257 DOI: 10.1136/gut.2008.156448] [Citation(s) in RCA: 290] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS This prospective trial was designed to compare the performance characteristics of five different screening tests in parallel for the detection of advanced colonic neoplasia: CT colonography (CTC), colonoscopy (OC), flexible sigmoidoscopy (FS), faecal immunochemical stool testing (FIT) and faecal occult blood testing (FOBT). METHODS Average risk adults provided stool specimens for FOBT and FIT, and underwent same-day low-dose 64-multidetector row CTC and OC using segmentally unblinded OC as the standard of reference. Sensitivities and specificities were calculated for each single test, and for combinations of FS and stool tests. CTC radiation exposure was measured, and patient comfort levels and preferences were assessed by questionnaire. RESULTS 221 adenomas were detected in 307 subjects who completed CTC (mean radiation dose, 4.5 mSv) and OC; 269 patients provided stool samples for both FOBT and FIT. Sensitivities of OC, CTC, FS, FIT and FOBT for advanced colonic neoplasia were 100% (95% CI 88.4% to 100%), 96.7% (82.8% to 99.9%), 83.3% (95% CI 65.3% to 94.4%), 32% (95% CI 14.9% to 53.5) and 20% (95% CI 6.8% to 40.7%), respectively. Combination of FS with FOBT or FIT led to no relevant increase in sensitivity. 12 of 45 advanced adenomas were smaller than 10 mm. 46% of patients preferred CTC and 37% preferred OC (p<0.001). CONCLUSIONS High-resolution and low-dose CTC is feasible for colorectal cancer screening and reaches sensitivities comparable with OC for polyps >5 mm. For patients who refuse full bowel preparation and OC or CTC, FS should be preferred over stool tests. However, in cases where stool tests are performed, FIT should be recommended rather than FOBT.
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Schäfer C, Graser A, Wagner A. Unusual cause for dysphagia: perforation of the proximal esophagus by a toothpick. Endoscopy 2008; 40 Suppl 2:E217-8. [PMID: 18819064 DOI: 10.1055/s-2008-1077421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Mang T, Graser A, Imhof H, Reiser M. Moderne Kolondiagnostik. Radiologe 2008; 48:117. [DOI: 10.1007/s00117-007-1613-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Clevert DA, Graser A, Jung E, Stickel M, Reiser M. Value of ultrasound in the diagnosis of aneurysms of the extracranial internal carotid arteries. Clin Hemorheol Microcirc 2008. [DOI: 10.3233/ch-2008-1076] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Graser A, Johnson TR, Staehler M, Reiser M, Stief C, Becker CR. Kann die Nativphase bei der Untersuchung von Patienten mit Nierentumoren durch die virtuellen Nativbilder eines Dual Energy-Scans ersetzt warden? ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Johnson TR, Graser A, Bader M, Stähler M, Haseke N, Stief CG, Reiser M, Becker CR. Dual Energy CT Typisierung von Nierensteinen in vitro und in vivo. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Graser A, Stieber P, Becker CR, Geisbüsch S, Schäfer C, Reiser M, Göke B, Kolligs FT. Prospektiver Vergleich von Koloskopie, CT-Kolonographie, Sigmoidoskopie und Tests auf okkultes Blut im Stuhl in der Detektion von Kolonadenomen bei asymptomatischen Personen. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Clevert DA, Graser A, Jung EM, Stickel M, Reiser M. Value of ultrasound in the diagnosis of aneurysms of the extracranial internal carotid arteries. Clin Hemorheol Microcirc 2008; 39:133-146. [PMID: 18503119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Aneurysms of the extracranial carotid arteries are a rare abnormalitiy and may represent a diagnostic challenge in examination of the patients. B-flow is a new digital vascular ultrasound technique and is an especially reliable method in the diagnosis of the extracranial portion of the internal carotid arteries as it shows less flow artifacts than color-coded Doppler sonography (CCDS) and power Doppler (PD). This review compares color-coded Doppler sonography, power Doppler and B-flow findings in extracranial ICA and CA aneurysm to emphasize the usefulness of B-flow in this clinical condition.
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Wiedemann K, Graser A, Lang RA, Rader T, Suckfuell M. [Persistent pharyngeocutaneous fistula after transcervical resection of a diverticulum of the hypopharynx]. HNO 2007; 57:1275-9. [PMID: 17882393 DOI: 10.1007/s00106-007-1613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CASE A 26-year-old white male patient had undergone resection of a diverticulum of the hypopharynx and myotomy of the cricopharyngeal muscle elsewhere. A transcervical approach had been chosen owing to the presence of an arteria lusoria and the associated risk of vessel injury. The patient had subsequently had recurrent fistulas through the skin incision, which had not resolved despite four further operations. He presented in our department with significant weight loss and persistent retrosternal pain. Esophageal manometry revealed that resting muscle tone in the upper esophageal sphincter was still significantly elevated. Assuming that the earlier myotomy had not been completely successful, we decided to complete this operation as revision surgery. The pharynx was closed with a running suture using the Conley technique. The fistula healed, and there were no further recurrences. CONCLUSION Complete and careful dissection of all muscle fibers back to the mucosa is essential, as well as complete removal of the diverticulum if this operation is to be successful when performed by the transcutaneous approach. Recurrent diverticula are not the only possible complication; persistent pharyngeocutaneous fistulas can also arise.
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Trottmann M, Tritschler S, Graser A, Strittmatter F, Becker A, Haseke N, Stief CG. Verletzungen des Nierenbeckens und des Ureters. Urologe A 2007; 46:927-34; quiz 935-6. [PMID: 17628782 DOI: 10.1007/s00120-007-1373-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
About 5% of injuries of the urinary tract affect the renal pelvis and ureter and constitute a severe complication. Around 75% of these injuries are iatrogenic and only about 25% are caused by blunt abdominal trauma or perforation. To avoid complications and improve prognosis, immediate diagnosis and therapy are essential. The diagnostic accuracy of preoperative studies is low, therefore frequently injuries are detected during explorative laparotomy. The management of upper urinary tract lesions depends on severity and localization, whereas the ultimate ambition should always be the preservation of the kidney. As a basic rule, ureteral stenting is mostly sufficient for small lesions, and only larger injuries require open reconstructive techniques. Longitudinal studies document a high degree of functional reconstitution if adequate and immediate treatment is carried out.
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Graser A, Kolligs FT, Mang T, Schaefer C, Geisbüsch S, Reiser MF, Becker CR. Computer-aided detection in CT colonography: initial clinical experience using a prototype system. Eur Radiol 2007; 17:2608-15. [PMID: 17429646 DOI: 10.1007/s00330-007-0579-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2006] [Revised: 12/11/2006] [Accepted: 01/08/2007] [Indexed: 01/08/2023]
Abstract
Computer-aided detection (CAD) algorithms help to detect colonic polyps at CT colonography (CTC). The purpose of this study was to evaluate the accuracy of CAD versus an expert reader in CTC. One hundred forty individuals (67 men, 73 women; mean age, 59 years) underwent screening 64-MDCT colonography after full cathartic bowel cleansing without fecal tagging. One expert reader interpreted supine and prone scans using a 3D workstation with integrated CAD used as "second reader." The system's sensitivity for the detection of polyps, the number of false-positive findings, and its running time were evaluated. Polyps were classified as small (< or =5 mm), medium (6-9 mm), and large (> or =10 mm). A total of 118 polyps (small, 85; medium, 19; large, 14) were found in 56 patients. CAD detected 72 polyps (61%) with an average of 2.2 false-positives. Sensitivity was 51% (43/85) for small, 90% (17/19) for medium, and 86% (12/14) for large polyps. For all polyps, per-patient sensitivity was 89% (50/56) for the radiologist and 73% (41/56) for CAD. For large and medium polyps, per-patient sensitivity was 100% for the radiologist, and 96% for CAD. In conclusion, CAD shows high sensitivity in the detection of clinically significant polyps with acceptable false-positive rates.
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Graser A, Schaefer C, Geisbüsch S, Becker CR, Kramer H, Reiser MF, Kolligs FT. Vergleich von Haemoccult-Test, 64-Zeilen-Multidetektor-CT-Kolonographie und konventioneller Koloskopie beim Darmkrebsscreening: Ergebnisse der “Münchner Darmkrebs-Vorsorgestudie“. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Graser A, Becker CR, Reiser MF, Kolligs FT. Zeitsparende 3D-Befundung bei der CT-Kolonographie mittels einer neuartigen Visualisierungstechnik. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Graser A, Reiser MF, Becker CR. Computerunterstützte Diagnose (CAD) in der CT-Kolonographie. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Koebernik C, Graser A, Neulen J, Motejlek K. An der Regulation der Vaskularisierung des menschlichen Corpus luteum sind wahrscheinlich NF-κB Transkriptionsfaktoren beteiligt. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Graser A, Koebernik C, Neulen J, Motejlek K. Zur Regulation der Angiogenese im menschlichen Corpus luteum werden wahrscheinlich AP-1 Transkriptionsfaktoren benötigt. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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