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[Massive lower gastrointestinal hemorrhage after polypectomy due to a colon fistula of a pseudoaneurysm of the splenic artery caused by chronic pancreatitis]. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2015; 53:664-7. [PMID: 26167697 DOI: 10.1055/s-0034-1399722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A life-threatening lower gastrointestinal bleeding is a rare complication due to coloscopic polypectomy. The following case report deals with a severe bleeding that was caused by polypectomy of a villous adenoma in a patient with chronic pancreatitis causing a huge pseudoaneurysm of the splenic artery. After polypectomy a wide iatrogenic communication between the pseudoaneurysm and the colon existed causing massive arterial intraluminal bleeding. Although this was successfully managed by transcatheter arterial embolization via splenic artery, the patient died a few days later caused by disseminated intravasal anticoagulation and multi organ failure.
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[Dysuria and unclear lesional mass in the bladder]. Radiologe 2013; 54:60-2. [PMID: 24193304 DOI: 10.1007/s00117-013-2590-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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3
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[The proliferative myositis in the psoas muscle -- a rare pseudosarcoma in an unusual localization]. ROFO-FORTSCHR RONTG 2013; 186:400-1. [PMID: 24142433 DOI: 10.1055/s-0033-1355779] [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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4
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Magnetic resonance imaging-based diagnosis of congenital ureterocele. ROFO-FORTSCHR RONTG 2013; 185:999-1000. [PMID: 24490237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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5
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Magnetic resonance imaging-based diagnosis of congenital ureterocele. ROFO-FORTSCHR RONTG 2013; 184:999-1000. [PMID: 23801448 DOI: 10.1055/s-0033-1335665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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6
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Wertigkeit der diffusionsgewichteten MR-Bildgebung in der Diagnostik von Lymphknotenmetastasen bei Patienten mit extrahepatischen Cholangiokarzinomen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346382] [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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7
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8
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[Extracranial manifestations of tuberous sclerosis - characteristic findings in computed tomography]. ROFO-FORTSCHR RONTG 2012; 184:465-7. [PMID: 22510750 DOI: 10.1055/s-0031-1299341] [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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9
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Detektion und Charakterisierung fokaler Leberläsionen: Wertigkeit von diffusionsgewichteter MRT, Gd-EOB-DTPA-verstärkter MRT sowie der Kombination beider Methoden. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279261] [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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10
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[74-year-old patient with cystic pancreatic lesions. An endoscopy-based algorithm]. Internist (Berl) 2010; 52:318-23. [PMID: 20941475 DOI: 10.1007/s00108-010-2658-6] [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: 11/27/2022]
Abstract
Often, equivocal pancreatic cystic masses in a patient cannot be clearly identified. We report on a 74-year-old patient who consulted us with size-gaining multi-cystic lesions located at the pancreatic head and tail as well as with an increased CA 19-9 level. By using diagnostic methods as ultrasound, radiological images and innovative endoscopic techniques an intraductal papillary mucinous neoplasm (IPMN) was diagnosed. Evaluation of equivocal cystic lesions requires developing of further strategies as well as integration of new concepts: We present a diagnostic algorithm based on endoscopy that enables us to perform an adapted therapy by having a more accurate evaluation and the opportunity to gain samples where unclear lesions are given.
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11
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Endoscopic treatment of transcolonic misplacement of a percutaneous endoscopic gastrostomy tube. Endoscopy 2010; 42 Suppl 2:E50-1. [PMID: 20157887 DOI: 10.1055/s-0029-1243864] [Citation(s) in RCA: 1] [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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12
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Lebensbedrohliche Komplikationen von Morbus Crohn und Colitis ulcerosa. Dtsch Med Wochenschr 2010; 135:668-74. [DOI: 10.1055/s-0030-1251915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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13
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[Clinically unclear painful swelling of the upper arm]. Radiologe 2009; 50:48-52. [PMID: 20033126 DOI: 10.1007/s00117-009-1963-3] [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: 11/26/2022]
Abstract
In contrast to the intramedullary (80%) and intracortical (14%) subtypes, the subperiostal subtype of aneurysmatic bone cysts (sABC) is relatively rare (6%). Females are affected more frequently than males, whereby the diaphysis is predominantly affected and less frequently the metaphysis of long bones as well as the vertebral column. Especially in conventional radiography sABCs can mimic aggressive lesions. Cross-sectional imaging can potentially reduce the wide range of differential diagnoses. Due to typical imaging features magnetic resonance imaging (MRI) is the most valuable modality to reduce the range of possible differential diagnoses. MRI usually presents a multicystic appearance with a hypointense rim of the lesion, contrast-enhancing cyst walls, fluid levels and edema-like changes in the adjacent tissue. In sABCs with solid components the diagnosis cannot be made with confidence and the suspicion must be confirmed by biopsy. The therapy of primary lesions consists of curettage or the complete excision of the sABC and the defects are subsequently filled with spongiosa or bone cement depending on the size of the lesion.
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Diffusion-weighted magnetic resonance imaging in cervical lymphadenopathy: report of three cases of patients with Bartonella henselae infection mimicking malignant disease. Acta Radiol 2009; 50:914-6. [PMID: 19636985 DOI: 10.1080/02841850903061445] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Diffusion-weighted MR imaging is a potential technique for differentiation between benign and malignant lymph nodes. However, lympadenopathy caused by Bartonella henselae infection showes low ADC values in diffusion weighted MRI as typically seen in malignant disease.
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Fall 1570. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1236075] [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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17
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Fall 1712. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235749] [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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18
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Fall 1774. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235622] [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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19
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Fall 1810. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235867] [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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20
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Fall 1752. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235594] [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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21
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Fall 1748. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235588] [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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22
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Fall 1616. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1236141] [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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23
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Fall 1560. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1236060] [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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24
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Fall 1644. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1235652] [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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25
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Abstract
In recent years continuous advancements in software and hardware technology of modern MRI systems have contributed to substantial progress in the field of pancreatic tumor imaging. Despite technical advances in abdominal MRI, multislice CT still remains the preferential diagnostic tool for pancreatic lesions. In the majority of cases the essential clinical questions can thereby be answered with a high degree of accuracy. However, in dilemma cases state-of-the-art MR imaging can provide relevant information for the diagnosis allowing an optimal therapeutic concept. This report gives an overview on possible applications for MRI in the diagnostic evaluation of malignant pancreatic tumors.
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Infected necrosis in severe pancreatitis--combined nonsurgical multi-drainage with directed transabdominal high-volume lavage in critically ill patients. Pancreatology 2009; 9:280-6. [PMID: 19407483 DOI: 10.1159/000212093] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 08/17/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infection of pancreatic necrosis is a life-threatening complication during the course of acute pancreatitis. In critically ill patients, surgical or extended endoscopic interventions are associated with high morbidity and mortality. Minimally invasive procedures on the other hand are often insufficient in patients suffering from large necrotic areas containing solid or purulent material. We present a strategy combining percutaneous and transgastric drainage with continuous high-volume lavage for treatment of extended necroses and liquid collections in a series of patients with severe acute pancreatitis. PATIENTS AND METHODS Seven consecutive patients with severe acute pancreatitis and large confluent infected pancreatic necrosis were enrolled. In all cases, the first therapeutic procedure was placement of a CT-guided drainage catheter into the fluid collection surrounding peripancreatic necrosis. Thereafter, a second endosonographically guided drainage was inserted via the gastric or the duodenal wall. After communication between the separate drains had been proven, an external to internal directed high-volume lavage with a daily volume of 500 ml up to 2,000 ml was started. RESULTS In all patients, pancreatic necrosis/liquid collections could be resolved completely by the presented regime. No patient died in the course of our study. After initiation of the directed high-volume lavage, there was a significant clinical improvement in all patients. Double drainage was performed for a median of 101 days, high-volume lavage for a median of 41 days. Several endoscopic interventions for stent replacement were required (median 8). Complications such as bleeding or perforation could be managed endoscopically, and no subsequent surgical therapy was necessary. All patients could be dismissed from the hospital after a median duration of 78 days. CONCLUSION This approach of combined percutaneous/endoscopic drainage with high-volume lavage shows promising results in critically ill patients with extended infected pancreatic necrosis and high risk of surgical intervention. Neither surgical nor endoscopic necrosectomy was necessary in any of our patients.
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Vergleich der Detektion und Charakterisierung von Leberläsionen bei Patienten mit gastrointestinalen Karzinomen mittels diffusionsgewichteter MRT (DWI-MRT) und Mehrzeilen-CT (MS-CT). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221408] [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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28
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Vergleich von MS-CT und diffusionsgewichteter MRT in der Detektion von Lebermetastasen bei Patienten mit malignen Pankreastumoren. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221410] [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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29
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[Diffusion-weighted magnetic resonance imaging (DWI-MRI): a new method to differentiate between malignant and benign cervical lymph nodes]. Laryngorhinootologie 2008; 87:850-5. [PMID: 19105126 DOI: 10.1055/s-0028-1105849] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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30
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Lebensbedrohliche Komplikationen bei Chronisch-Entzündlichen Darmerkrankung: eine systematische Auswertung der Aufnahmen auf eine gastroenterologische Intensivstation über 18 Jahre. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2008. [DOI: 10.1055/s-0028-1096460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Successful mycophenolate mofetil therapy in nine patients with idiopathic retroperitoneal fibrosis. Rheumatology (Oxford) 2008; 47:1535-8. [PMID: 18687710 DOI: 10.1093/rheumatology/ken291] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To assess the therapeutic benefit of mycophenolate mofetil (MMF) in retroperitoneal fibrosis (RF). METHODS MMF 2 g/day and prednisone 1 mg/kg were initiated in nine patients with radiological (9/9) and histological verification (2/9) of idiopathic RF. Out of nine patients, seven needed bilateral ureteral stenting due to extensive hydronephrosis. RESULTS All patients experienced regression of radiological extension. Out of seven patients, five were free of ureteral catheters after a mean of 5.6 months and two remained on stenting due to secondary stenosis. Within 6 months mean creatinine and CRP fell from 2.5 to 1.2 mg/dl and from 4.0 to 1.4 mg/dl, respectively. MMF was discontinued after a mean of 27 months. Prednisone was tapered to zero after a mean of 7 months. Side-effects were urinary tract infections in 7/9 patients and impaired glucose tolerance in 3/9. No recurrence occurred after withdrawal of glucocorticoids and MMF in 7/9 patients after a mean overall follow-up of 55 months (range 12-120). CONCLUSIONS Treatment with MMF and glucocorticoids was successful in inducing partial or complete and lasting remission in RF. The results suggest the use of MMF as additional immunosuppressive option.
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Detection and characterization of liver lesions in patients with colorectal cancer with diffusion weighted MR imaging. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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33
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Diffusionsgewichtete MRT ermöglicht die Unterscheidung zwischen malignen und beginen Lymphnknoten bei Prostatakarzinom. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073618] [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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34
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Wertigkeit der diffusionsgewichteten MR-Bildgebung bei der Unterscheidung zwischen malignen und benignen zervikalen Lymphknoten. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073456] [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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35
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MR-Diagnostik von Lebermetastasen: Vergleich einer atemgetriggerten diffusionsgewichteten EPI-Sequenz versus Gadolinium. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073657] [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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36
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Akute Blutung eines seltenen gastrointestinalen Tumors: Magenlipom – CT Befunde. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1074036] [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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CMR 2007: 13.02: Contrast-enhanced magnetic resonance cholangiography using Gd-EOB-DTPA (Primovist®): additional value compared with conventional MRCP sequences. CONTRAST MEDIA & MOLECULAR IMAGING 2007. [DOI: 10.1002/cmmi.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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39
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[Focal nodular liver lesions associated with a congenital portocaval shunt in an adult woman]. Radiologe 2007; 47:163-4, 166. [PMID: 17891851 DOI: 10.1007/s00117-005-1265-3] [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: 10/25/2022]
Abstract
The Abernethy malformation is a rare anomaly with partial or complete congenital absence of the portal vein and subsequent development of extrahepatic portocaval shunts. Diagnosis is usually made in childhood following the finding of liver neoplasms combined with slightly increased liver enzymes. There is a female predominance. Further findings are malformations of the heart, skeletal system and kidneys. Short-term follow-up of the liver lesions is recommended. Progressive disease can be treated by partial liver resection or transplantation. Diagnosis of the Abernethy malformation is based on various imaging modalities. We report the MRI and MRA findings of an Abernethy malformation in a 35-year-old woman with multiple liver cell adenomas and review the 32 previously published cases.
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Abstract
Retention of surgical sponges is rare. They cause either an aseptic reaction without significant symptoms or an exudative reaction which results in early but non-specific symptoms. Even if there are no studies which compare the diagnostic accuracy of the different imaging modalities, CT seems to be the most promising tool to diagnose foreign bodies. However, apart from radio-paque markers there are no specific signs for the existence of surgical sponges in CT. Therefore, an experienced radiologist is needed to differentiate foreign bodies from morphologically quite similar differential diagnoses such as abscess and haematoma.
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A rare case of primary rectal rhabdomyosarcoma in an adult. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2007; 44:1149-52. [PMID: 17115357 DOI: 10.1055/s-2006-927139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report an extremely rare case (1:200 000) of primary rectal rhabdomyosarcoma (RMS) in an adult. In the literature, this case report is the first one dealing with an adult patient. The diagnosis was assessed by computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), endoscopy and histological examination. Neoadjuvant systemic chemotherapy with adriamycin and isofosfamide followed by anterior rectum resection was performed. This article should implicate RMS as a rare differential diagnosis of atypical rectal tumours in adults.
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MR-tomographische Detektion fokaler Leberläsionen: Wertigkeit einer diffusionsgewichteten EPI-Sequenz mit navigatorgestützter Atemtriggerung im Vergleich zu verschiedenen T2-gewichteten TSE-Sequenzen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976960] [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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Charakterisierung fokaler Leberläsionen durch diffusionsgewichtete MR-Bildgebung unter Verwendung einer hoch auflösenden, Navigator-gesteuerten echo-planaren Sequenz. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976900] [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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45
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Kontrastverstärkte MR-Cholangiographie mit Gadolinium-EOB-DTPA (Primovist®): vorläufige Erfahrungen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976794] [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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46
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The role of clinical examination, chest X-ray and central venous pressure in volume assessment in critically ill patients: a comparison with PiCCO-derived data. Crit Care 2007. [PMCID: PMC4095336 DOI: 10.1186/cc5443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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47
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48
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[Accidental diagnosis of hepatic epithelioid hemangioendothelioma]. ROFO-FORTSCHR RONTG 2006; 178:921-3. [PMID: 16894503 DOI: 10.1055/s-2006-926857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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49
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Assessment of the extent of metastases of gastrointestinal carcinoid tumors using whole-body PET, CT, MRI, PET/CT and PET/MRI. Eur J Med Res 2006; 11:58-65. [PMID: 16504962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
OBJECTIVE To assess the diagnostic value of whole-body positron emission tomography (PET), computed tomography (CT), magnetic resonance imaging (MRI), and the fusion of PET and CT (PET/CT) and PET and MRI (PET/MRI) in the detection of metastatic disease of gastrointestinal carcinoid tumors. MATERIALS AND METHODS This prospective study included six patients with extensive nonresectable metastases of gastrointestinal carcinoid tumors which were consecutively examined from the base of the skull to the proximal thigh using a state-of-the-art PET/CT scanner and a 1.5 Tesla whole-body MRI scanner. PET was performed with a carbohydrated F-18-labeled somatostatin-receptor ligand ([ superset18 F]FP-Gluc-TOCA) using a Pico-3D PET scanner. CT was performed with a venous-dominant contrast-enhanced phase using a 16-slice CT scanner. MRI was performed with a coronal T2-weighted Half-Fourier Acquired Single-Shot Turbo Spin Echo (HASTE) sequence, a coronal T2-weighted Turbo-Short Tau Inversion-Recovery (STIR) sequence, a coronal T1-weighted Turbo Spin Echo (TSE) sequence and a high resolution axial T2-weighted TSE sequence. The data sets from PET and CT were fused automatically. The PET and MRI data sets were fused manually. Lesions were rated as metastases if they were not clearly identified as benign lesions according to standard radiological criteria. RESULTS For PET, CT, MRI, PET/CT, and PET/MRI, the lesion-by-lesion based analysis showed an overall detection rate for liver metastases (n = 391) of 49.9% (P<.001), 37.1% (P<.001), 98.2%, 50.9% (P<.001) and 100%, for lymph node metastases (n = 37) of 91.9%, 83.8%, 64.9%, 100% and 97.3% and for osseous metastases (n = 12) of 100%, 8.3% (P<.005), 66.7%, 100% and 100%. CONCLUSIONS PET as single modality revealed the most lymph node and osseous metastases. MRI as single modality revealed the most liver metastases. The combination of molecular/metabolic with anatomical/ morphological information improves the diagnostic accuracy for the detection of metastases in comparison to the single modalities. Whole-body PET/MRI is a very promising diagnostic modality for oncological imaging due to the missing radiation exposure and the high soft tissue resolution of MRI in contrast to CT.
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Importance of diffusion-weighted imaging in the diagnosis of cystic brain tumors and intracerebral abscesses. Neurochirurgie 2006. [DOI: 10.1016/s0028-3770(06)71189-4] [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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