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Weber MA. [Cost efficiency analysis of CT coronary angiography for exclusion of significant coronary artery stenosis: comparison with conventional invasive coronary angiography before cardiac surgery]. Radiologe 2013; 53:752-4. [PMID: 23975148 DOI: 10.1007/s00117-013-2564-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weber MA, Rehnitz C, Ott H, Streich N. Groin Pain in Athletes. ROFO-FORTSCHR RONTG 2013; 185:e1-e1. [PMID: 23975879 DOI: 10.1055/s-0033-1350589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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53
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Hillengass J, Weber MA, Kilk K, Listl K, Wagner-Gund B, Hillengass M, Hielscher T, Farid A, Neben K, Delorme S, Landgren O, Goldschmidt H. Prognostic significance of whole-body MRI in patients with monoclonal gammopathy of undetermined significance. Leukemia 2013; 28:174-8. [DOI: 10.1038/leu.2013.244] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/24/2013] [Accepted: 08/14/2013] [Indexed: 12/19/2022]
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Abstract
Groin pain in athletes is one of the most difficult to treat clinical entities in sports medicine. The reasons are the amount of differential diagnoses, complexity of pathophysiologic causes and the long time of limited participation in sport. In order to maximize efficient treatment, thorough diagnostics and a clear therapeutic regimen are crucial. To succeed with this issue, a close cooperation between physicians and radiologists is mandatory. MRI is gold standard in the diagnostic work-up of the principal differential diagnoses, such as muscle tears, avulsion injuries, stress fractures, tears of acetabular labrum, and osteitis pubis. The article gives a comprehensive overview of the special anatomy and biomechanics of the pubic region and of typical MRI findings in athletes with groin pain. The use of dedicated imaging protocols is also discussed.
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Neubert A, Fripp J, Engstrom C, Walker D, Weber MA, Schwarz R, Crozier S. Three-dimensional morphological and signal intensity features for detection of intervertebral disc degeneration from magnetic resonance images. J Am Med Inform Assoc 2013; 20:1082-90. [PMID: 23813538 DOI: 10.1136/amiajnl-2012-001547] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Advances in MRI hardware and sequences are continually increasing the amount and complexity of data such as those generated in high-resolution three-dimensional (3D) scanning of the spine. Efficient informatics tools offer considerable opportunities for research and clinically based analyses of magnetic resonance studies. In this work, we present and validate a suite of informatics tools for automated detection of degenerative changes in lumbar intervertebral discs (IVD) from both 3D isotropic and routine two-dimensional (2D) clinical T2-weighted MRI. MATERIALS AND METHODS An automated segmentation approach was used to extract morphological (traditional 2D radiological measures and novel 3D shape descriptors) and signal appearance (extracted from signal intensity histograms) features. The features were validated against manual reference, compared between 2D and 3D MRI scans and used for quantification and classification of IVD degeneration across magnetic resonance datasets containing IVD with early and advanced stages of degeneration. RESULTS AND CONCLUSIONS Combination of the novel 3D-based shape and signal intensity features on 3D (area under receiver operating curve (AUC) 0.984) and 2D (AUC 0.988) magnetic resonance data deliver a significant improvement in automated classification of IVD degeneration, compared to the combination of previously used 2D radiological measurement and signal intensity features (AUC 0.976 and 0.983, respectively). Further work is required regarding the usefulness of 2D and 3D shape data in relation to clinical scores of lower back pain. The results reveal the potential of the proposed informatics system for computer-aided IVD diagnosis from MRI in large-scale research studies and as a possible adjunct for clinical diagnosis.
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Gerigk L, Kristen M, Hielscher T, Nagel AM, Essig M, Erb G, Weber MA. Moderne MRT-Techniken im Management von WHO Grad II Astrozytomen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Weber MA, Bloess K, Burkholder I, Bender D, Schmidmaier G, Kauczor HU, Schoierer O. Die dynamische kontrastverstärkte MRT kann die Vaskularisierung innerhalb des Pseudarthrosenspalts beurteilen und ein gutes klinisches Ergebnis vorhersagen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Weber MA, Bender K, Gall CV, Stange A, Kauczor HU, Zechmann C. Diffusionsgewichtete MRT und 18F-Fluordesoxyglucose PET-CT zur Beurteilung des frühen Ansprechens auf eine neoadjuvante Chemotherapie beim Adenokarzinom des ösophagogastralen Übergangs. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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59
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Bönner G, Bakris GL, Sica D, Weber MA, White WB, Perez A, Cao C, Handley A, Kupfer S. Antihypertensive efficacy of the angiotensin receptor blocker azilsartan medoxomil compared with the angiotensin-converting enzyme inhibitor ramipril. J Hum Hypertens 2013; 27:479-86. [PMID: 23514842 PMCID: PMC3715765 DOI: 10.1038/jhh.2013.6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 12/20/2012] [Accepted: 01/06/2013] [Indexed: 12/31/2022]
Abstract
Drug therapy often fails to control hypertension. Azilsartan medoxomil (AZL-M) is a newly developed angiotensin II receptor blocker with high efficacy and good tolerability. This double-blind, controlled, randomised trial compared its antihypertensive efficacy and safety vs the angiotensin-converting enzyme inhibitor ramipril (RAM) in patients with clinic systolic blood pressure (SBP) 150-180 mm Hg. Patients were randomised (n=884) to 20 mg AZL-M or 2.5 mg RAM once daily for 2 weeks, then force-titrated to 40 or 80 mg AZL-M or 10 mg RAM for 22 weeks. The primary endpoint was change in trough, seated, clinic SBP. Mean patient age was 57±11 years, 52.4% were male, 99.5% were Caucasian. Mean baseline BP was 161.1±7.9/94.9±9.0 mm Hg. Clinic SBP decreased by 20.6±0.95 and 21.2±0.95 mm Hg with AZL-M 40 and 80 mg vs12.2±0.95 mm Hg with RAM (P<0.001 for both AZL-M doses). Adverse events leading to discontinuation were less frequent with AZL-M 40 and 80 mg (2.4% and 3.1%, respectively) than with RAM (4.8%). These data demonstrated that treatment of stage 1-2 hypertension with AZL-M was more effective than RAM and better tolerated.
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Dukic-Stojanovic L, Kessler M, Schenk JP, Weber MA. [Cystic abdominal space-occupying lesion with ileus and whirl sign]. Radiologe 2012; 53:141-4. [PMID: 23254308 DOI: 10.1007/s00117-012-2438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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61
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Weber MA. [Can a splenic abscess be punctured and drained or should it be left alone?]. Radiologe 2012; 52:1091-2. [PMID: 23143157 DOI: 10.1007/s00117-012-2424-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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62
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Kloth JK, Wiedenhoefer B, Stiller W, Burkholder I, Kauczor HU, Ewerbeck V, Weber MA. [Modern digital plain-radiography of the whole spine in scoliosis patients--dose reduction and quality criteria]. ROFO-FORTSCHR RONTG 2012; 185:48-54. [PMID: 23023231 DOI: 10.1055/s-0032-1325352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To reduce the radiation exposure of plain radiographs of the entire spine depending on specific indications, since these are frequently performed examinations of children and young adults with scoliosis and to determine objective quality control criteria to ensure accurate assessment. MATERIALS AND METHODS In this prospective randomized study 323 patients underwent plain-radiography of the entire spine with standard and 50 % reduced dose. In an experimental pilot-study this target-dose was determined using an Alderson-Phantom. The evaluation of the experimental radiographs, as well as, the randomized plain-radiographs was conducted using the following criteria: endplates (Cobb-angle), spinal process and pedicel (rotation), lateral margin of the vertebral body (lateral alignment), identification of C7 / S1 (perpendicular). Two radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If one single criteria was evaluated with a score of 3 or more points or more than 2 criteria with 2 points, the radiograph was scored as "not assessable". The statistical analysis was conducted as a non-inferiority-trial. RESULTS Seven (2.4 %) of the 290 examined x-rays were scored as not assessable. There was no statistic inferiority between the examinations with standard or reduced dose, while singular assessment of the defined criteria was likewise dose-independent. CONCLUSION Plain-radiography of the total spine in patients with scoliosis can be performed with a dose reduction of 50% without a loss of validity. The obtained quality control criteria were clinically applicable.
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Wolf M, Kloth JK, Hähnel S, Rehnitz C, Wiedenhöfer B, Weber MA. [Radiological diagnostics of spinal tumors. Part 2: special diagnostics of intradural tumors and tumor-like lesions]. DER ORTHOPADE 2012; 41:608-17. [PMID: 22871795 DOI: 10.1007/s00132-012-1906-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Intradural tumors are classified into extramedullary and intramedullary localization. A distinct attribution to one of these compartments is essential for finding the appropriate diagnosis. In the radiological evaluation of intradural tumors magnetic resonance imaging (MRI) is the most important method and in contrast to osseous spinal tumors, radiography and computed tomography are of minor importance. According to the globally established WHO grading system, tumors of the central nervous system are histopathologically classified into four grades. Through grades I to IV malignancy and proliferative activity increase. Prognosis is inversely correlated to the WHO grade. Intradural tumors are generally treated by neurosurgeons. Besides neurological symptoms intradural tumors often cause spinal malpositioning. Thus knowledge of the most frequent intradural tumors and their characteristic magnetic resonance findings are important in the orthopedic practice.
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Rehnitz C, Wiedenhoefer B, Noeldge G, Kasperk C, Kauczor HU, Weber MA. [Minimal-Invasive CT-guided spinal interventions--from pain therapy over biopsies to tumor therapy]. ROFO-FORTSCHR RONTG 2012; 184:1002-12. [PMID: 22872602 DOI: 10.1055/s-0032-1313058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
CT-guided spinal interventions have undergone a remarkable evolution during the last view years, leading to a wider range of indications, as well as to the development of highly specialized new procedures. This review article deals with different aspects of spinal CT-guided pain management, biopsy and tumor therapies and emphasizes a selection of practical considerations of important interventions.
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Kloth JK, Weber MA. [Soft tissue swelling of the sternoclavicular joint]. Radiologe 2012; 52:459-62. [PMID: 22584483 DOI: 10.1007/s00117-012-2318-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A 73-year-old woman presented with a swelling of the right sternoclavicular joint the size of a hens egg which had persisted for 2 years. After a corticosteroid injection 8 months previously the swelling was asymptomatic. The magnetic resonance imaging (MRI) scan showed synovialitis of the sternoclavicular joint with edema of the adjacent bone. The constellation is indicative of Tietze syndrome, an inflammation of costochondral junctions of the ribs or chondrosternal joints. The treatment is usually directed at pain relief and benign conditions are often self-limiting.
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Pryce JW, Weber MA, Ashworth MT, Roberts S, Malone M, Sebire NJ. Changing patterns of infant death over the last 100 years: autopsy experience from a specialist children's hospital. J R Soc Med 2012; 105:123-30. [PMID: 22434812 DOI: 10.1258/jrsm.2011.110075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Infant mortality has undergone a dramatic reduction in the UK over the past century because of improvements in public health policy and medical advances. Postmortem examinations have been performed at Great Ormond Street Hospital for over 100 years, and analysis of cases across this period has been performed to assess changing patterns of infant deaths undergoing autopsy. DESIGN Autopsy reports from 1909 and 2009 were examined. Age, major pathology and cause of death was reviewed from these cases and entered into an anonymized database. A subsequent comparative analysis was performed. SETTING All postmortems performed and reported at Great Ormond Street Hospital in 1909 and 2009. PARTICIPANTS Infant deaths, aged 0-365 days, were identified and subsequently analysed for the two years. MAIN OUTCOME MEASURES Comparative proportional analysis of postmortem findings from the two time periods. RESULTS Three-hundred and fifty-seven and 347 autopsy reports were identified from 1909 and 2009 including 178 and 128 infant deaths, respectively. The commonest cause of death in 1909 was infection (74%) compared to 20% of deaths in 2009. The most frequent final 'diagnosis' in 2009 was 'unexplained sudden unexpected infant death (SUDI)', despite a full postmortem including ancillary investigations. In contrast, there were no such cases recorded in 1909, but there were frequent deaths due to gastroenteritis and malnutrition together accounting for 16% of cases, compared to one case of gastroenteritis in 2009. Fifteen percent of 1909 cases had infections which are almost never fatal with appropriate treatment in 2009, including tuberculosis, diphtheria and syphilis. Congenital anomalies were detected with similar frequencies at both time points, (21% and 19% in 1909 and 2009, respectively). CONCLUSION In the UK, significant changes in patterns of pathology have occurred in paediatric autopsy cases performed at a single specialist centre. Fatal infections and malnutrition (both poverty-related) have reduced yet the incidence of congenital anomalies has remained similar.
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Kloth JK, Wiedenhöfer B, Stiller W, Kauczor HU, Ewerbeck V, Weber MA. Referenzwerte und Qualitätskriterien für die digitale Radiographie der Ganzwirbelsäule-Röntgenaufnahmen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rehnitz C, Sprengel SD, Weber MA. Tipps und Tricks der Radiofrequenzablation von spinalen Osteoidosteomen und Osteoblastomen. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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69
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Weber MA, Nagel AM, Wolf MB, Jurkat-Rott K, Semmler W, Kauczor HU, Lehmann-Horn F. Die 3Tesla Magnetresonanztomographie detektiert eine muskuläre Natriumakkumulation und ein permanentes Muskelödem bei Duchenne Muskeldystrophie als eine mögliche Ursache der Muskeldegeneration. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Weber MA, Nagel AM, Wolf MB, Jurkat-Rott K, Kauczor HU, Semmler W, Lehmann-Horn F. Permanent muscular sodium overload and persistent muscle edema in Duchenne muscular dystrophy: a possible contributor of progressive muscle degeneration. J Neurol 2012; 259:2385-92. [PMID: 22544297 DOI: 10.1007/s00415-012-6512-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 04/02/2012] [Accepted: 04/03/2012] [Indexed: 11/29/2022]
Abstract
To assess the presence and persistence of muscular edema and increased myoplasmic sodium (Na(+)) concentration in Duchenne muscular dystrophy (DMD). We examined eight DMD patients (mean age 9.5 ± 5.4 years) and eight volunteers (mean age 9.5 ± 3.2 years) with 3-tesla proton ((1)H) and (23)Na density-adapted 3D-radial MR sequences. Seven DMD patients were re-examined about 7 months later without change of therapy. The eighth DMD patient was re-examined after 5 and 11 months under medication with eplerenone. We quantified muscle edema on STIR images with background noise as reference and fatty degeneration on T1-weighted images using subcutaneous fat as reference. Na(+) was quantified by a muscular tissue Na(+) concentration (TSC) sequence employing a reference containing 51.3 mM Na(+) with 5 % agarose. With an inversion-recovery (IR) sequence, we determined mainly the myoplasmic Na(+). The normalized muscular (23)Na IR signal intensity was higher in DMD than in volunteers (n = 8, 0.75 ± 0.07 vs. 0.50 ± 0.05, p < 0.001) and persisted at second measurement (n = 7, 1st 0.75 ± 0.07, 2nd 0.73 ± 0.06, p = 0.50). When compared to volunteers (25.6 ± 2.0 mmol/l), TSC was markedly increased in DMD (38.0 ± 5.9 mmol/l, p < 0.001) and remained constant (n = 7, 1st 37.9 ± 6.4 mmol/l, 2nd 37.0 ± 4.0 mmol/l, p = 0.49). Muscular edema (15.6 ± 3.5 vs. 6.9 ± 0.7, p < 0.001) and fat content (0.48 ± 0.08 vs. 0.38 ± 0.01, p = 0.003) were elevated in DMD when compared to volunteers. This could also be confirmed during follow-up (n = 7, p = 0.91, p = 0.12). Eplerenone slightly improved muscle strength and reduced muscular sodium and edema. The permanent muscular Na(+) overload in all DMD patients is likely osmotically relevant and responsible for the persisting, mainly intracellular muscle edema that may contribute to the progressive muscle degeneration.
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Flechsig P, Müller S, Weber MA. [Symptomatic foot shortening with subacute soft tissue swelling of the right tibia]. Radiologe 2012; 51:1047-51. [PMID: 22095189 DOI: 10.1007/s00117-011-2242-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 13-year-old girl presented with load-dependent pain of the medial part of the right foot. The medical history revealed no trauma and no sports-related injury. X-ray examinations of the foot and lower leg showed subcortical increased sclerosis at the medial part of the tibia, the medial tarsal bones and of a bunion. Magnetic resonance imaging revealed corresponding findings with localized edema of the bone marrow within the increased subcortical sclerosis but no indications of subcutaneous fibrosis. The constellation is indicative of melorheostosis, a rare benign sclerosis of bones and soft tissue. Subcutaneous fibrosis and limb shortening are also common.
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Kloth JK, Lehner B, Weber MA. [Pathological patella fracture]. ROFO-FORTSCHR RONTG 2012; 184:652-4. [PMID: 22504881 DOI: 10.1055/s-0031-1299486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
The compatibility of family and profession is especially difficult for employees in medical professions because of shift work and overtime. It seems that in the future women are going to represent the majority of medical professionals. Hence, with the manifest lack of physicians social aspects will also play a bigger role in the choice of the place of employment. In most families the classic role model prevails although women are well educated and men also set a high value on the compatibility of family and profession and would like to take parental leave and work in flexible working hours. This represents a chance, especially for radiology.
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Kloth JK, Wiebel M, Weber MA. [Postoperatively increased oxygen demand and hemoptysis after extubation]. Med Klin Intensivmed Notfmed 2012; 107:147-50. [PMID: 22349534 DOI: 10.1007/s00063-011-0043-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 08/26/2011] [Accepted: 09/07/2011] [Indexed: 10/28/2022]
Abstract
A 22-year-old man on postoperative day 1 after open reduction with internal fixation of a distal fibula fracture presented with hemoptysis and increased oxygen demand. X-ray and contrast-enhanced computed tomography revealed bilateral patchy opacities and mediastinal emphysema. After bronchoscopy and bronchoalveolar lavage, a diagnosis of alveolar hemorrhage was made. The medical history revealed regular abuse of marihuana and cocaine.
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Pryce JW, Paine SML, Weber MA, Harding B, Jacques TS, Sebire NJ. Role of routine neuropathological examination for determining cause of death in sudden unexpected deaths in infancy (SUDI). J Clin Pathol 2011; 65:257-61. [DOI: 10.1136/jclinpath-2011-200264] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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