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Demharter J, Vollert K, Bohndorf K. Osteofibröse Dysplasie (OFD) und Adamantinom – seltene Läsionen der Tibia im Kindesalter. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1326849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Demharter J, Vollert K, Bohndorf K. Das subkutane Granuloma anulare. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Vollert K, Demharter J, Bohndorf K. CT-gesteuerte Radiofrequenzablation von Osteoidosteomen im Kindes- und Jugendlichenalter. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1286241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Demharter J, Neukirchen S, Wagner T, Schlimok G, Bohndorf K, Kirchhof K. Wertigkeit der sonografisch gesteuerten Lymphknoten-Stanzbiopsie bei der Subtypisierung maligner Lymphome. ACTA ACUST UNITED AC 2007. [DOI: 10.1055/s-2007-963245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Demharter J, Neukirchen S, Wagner T, Schlimok G, Bohndorf K, Kirchhof K. [Do ultrasound-guided core needle biopsies of lymph nodes allow for subclassification of malignant lymphomas?]. ROFO-FORTSCHR RONTG 2007; 179:396-400. [PMID: 17377872 DOI: 10.1055/s-2007-962917] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE We examined how often ultrasound-guided core needle biopsies of lymph nodes yield subclassification of malignant lymphoma according to World Health Organization (WHO) criteria and help to avoid excisional biopsies. MATERIALS AND METHODS The prospective study included 124 consecutive patients in whom 126 core needle biopsies of lymph nodes were performed to diagnose or rule out malignant lymphoma. If possible, we obtained 5 cylinders with a 14-gauge (G) needle. The pathologists of our institution, partly in cooperation with a lymphoma registry, decided whether a core needle biopsy was sufficient for subclassification or an excisional biopsy was necessary. RESULTS 95 of the 126 core needle biopsies (76.6 %) were performed with a 14-G needle. In 101 biopsies (80.2 %), we obtained at least 5 cylinders. In 120 of the 126 core needle biopsies (95 %), malignant lymphoma was diagnosed and subclassified or ruled out. Of the 64 lymphoma, 60 (94 %) were subclassified. Among them were 41 (93 %) of the 44 primary lymphomas and 19 (95 %) of the 20 recurrent lymphomas. In 5 of 126 cases (4 %), an excisional biopsy was necessary. CONCLUSION With ultrasound-guided core needle biopsy of lymph nodes, lymphoma can be reliably diagnosed and subclassified if preferably 5 cores are obtained with 14-G needles. Excisional biopsy is rarely necessary if core needle biopsy is inconclusive.
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Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg, Augsburg
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Klauser A, Demharter J, De Marchi A, Sureda D, Barile A, Masciocchi C, Faletti C, Schirmer M, Kleffel T, Bohndorf K. Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group. Eur Radiol 2005; 15:2404-10. [PMID: 16132921 DOI: 10.1007/s00330-005-2884-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Revised: 07/16/2005] [Accepted: 07/28/2005] [Indexed: 11/29/2022]
Abstract
The purpose of this study way to assess the value of contrast enhanced gray-scale ultrasound (CEUS) in detection of vascularity in joints of patients with rheumatoid arthritis (RA) in a multicenter study of the International Arthritis Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients (44 men, 69 women; mean age 51+/-14 years) with clinical diagnosis of RA. Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low mechanical index US technique, was performed. CEUS was done by bolus administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was performed for differentiation of active synovitis from inactive intra-articular thickening (synovitis/effusion). With the use of US and PDUS, active synovitis could be differentiated from inactive intra-articular thickening in 68/113 joints (60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints (p<0.0001). Thickness measurement of active synovitis was significantly improved after contrast administration (p=0.008). In conclusion, CEUS improves the differentiation of active synovitis from inactive intra-articular thickening. Since CEUS has shown an ability to improve assessment of vascularized synovial proliferation in RA affected joints, this technique may have further potential in monitoring therapy.
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Affiliation(s)
- Andrea Klauser
- Department of Radiology II and Internal Medicine, Medical University Innsbruck, Innsbruck, 6020, Austria.
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Kleffel T, Demharter J, Wohlgemuth W, Schalm J, Bohndorf K, Kirchhof K. [Comparison of contrast-enhanced low mechanical index (Low MI) sonography and unenhanced B-mode sonography for the differentiation between synovitis and joint effusion in patients with rheumatoid arthritis]. ROFO-FORTSCHR RONTG 2005; 177:835-41. [PMID: 15902633 DOI: 10.1055/s-2005-858194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To test whether contrast-enhanced low mechanical index (low MI) sonography is superior to non enhanced B-Mode sonography in differentiating synovitis and joint effusion. MATERIAL AND METHODS In a retrospective study, 22 patients with proven rheumatoid arthritis underwent B-Mode sonography and low-MI sonography of 25 symptomatic joints of the upper and lower limbs. For low-MI sonography, 5 ml Sonovue (Bracco Altana Pharma GmbH, Konstanz) were injected as an intravenous bolus followed by 10 ml of 0.9 % saline solution. Magnetic resonance imaging (MRI) was obtained additionally in 3 joints. With non-enhanced sonography, we diagnosed a synovitis in case of an echogenic and a joint effusion in case of an anechoic mass. With contrast-enhanced sonography, we diagnosed a synovitis in case of enhancement and a joint effusion in the absence of enhancement of the intraarticular mass. RESULTS In 13 joints, synovitis and joint effusion were differentiated by both non-enhanced and enhanced sonography. In 12 joints, this differentiation was only possible with contrast-enhanced sonography. In 3 patients diagnosed by sonography as having a synovitis, this diagnosis was proven by MRI. CONCLUSION Contrast-enhanced low-MI sonography is superior to non-enhanced B-Mode sonography in differentiating synovitis and joint effusion.
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Affiliation(s)
- T Kleffel
- Klinik für Diagnostische Radiologie und Neuroradiologie, Klinikum Augsburg
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Demharter J, Leissner G, Huf V, Roemer FW, Vollert K, Bohndorf K. Die Behandlung iatrogener femoraler Pseudoaneurysmen durch Thrombininjektion - Ergebnisse bei 54 Patienten. ROFO-FORTSCHR RONTG 2005; 177:550-4. [PMID: 15838761 DOI: 10.1055/s-2005-857967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate ultrasound-guided percutaneous thrombin injection to treat iatrogenic femoral pseudoaneurysms following catheter interventions. MATERIALS AND METHODS In a period of 2 years and 11 months, 55 iatrogenic femoral pseudoaneurysms were treated in 54 patients (male : female = 29 : 25) by percutaneous thrombin injection under continuous color Doppler control. Mean maximum diameter of the perfused lumen was 2.5 cm (SD +/- 1 cm). The injected thrombin doses varied between 10 and 2,000 U (median 200 U). RESULTS Following thrombin injection, the pseudoaneurysm occlusion rate was 100 % (n = 55/55). Complete and persistent occlusion was achieved in 54 of 55 (98 %) pseudoaneurysms. A repeated procedure was necessary in 6 pseudoaneurysms. In one case (2 %), discrete signs of reperfusion were observed after primary occlusion within 24 hours of the initial procedure (lumen diameter 3 x 5 mm), followed by spontaneous thrombosis without further treatment. No complications, in particular no clinically manifest thromboembolic events, were observed. CONCLUSION Ultrasound-guided percutaneous thrombin injection is an effective and safe method for the treatment of iatrogenic post catheterization femoral pseudoaneurysms.
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Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg.
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Schulte-Altedorneburg G, Demharter J, Linné R, Droste DW, Bohndorf K, Bücklein W. Does ultrasound contrast agent improve the diagnostic value of colour and power Doppler sonography in superficial lymph node enlargement? Eur J Radiol 2004; 48:252-7. [PMID: 14652142 DOI: 10.1016/s0720-048x(03)00076-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to analyse whether ultrasound contrast agent (UCA) improves the diagnostic accuracy to differentiate between benign and malignant superficial lymph node enlargement by using colour-coded duplex sonography (CCDS) and power Doppler (PD). METHODS 32 patients with suspected malignant superficial lymph node enlargement prospectively underwent standardised ultrasound examinations using B-mode sonography and native and contrast-enhanced CCDS and PD immediately before biopsy. Solbiati-Index (longitudinal-transverse diameter ratio) and intranodal flow patterns by using different vascularisation types were assessed. Histological and sonographical findings were correlated. RESULTS 27 malignant and 5 benign lymph nodes were found. Solbiati-Index was lower in malignant lymph nodes than in benign nodes (mean 1.5 vs. 2.4, P<0.045). More intranodal flow patterns could be detected after UCA (53 vs. 43) but the number of correctly identified malignant nodes decreased after UCA (26 vs. 24) and the number of correctly identified benign nodes remained constant compared with native CCDS and PD. In 31% of the colour-mode studies, PD was considered to visualise more clearly intranodal vascular flow patterns than CCDS. CONCLUSION despite depicting more intranodal vascular patterns, the use of an ultrasound contrast agent seems not to improve the diagnostic value of CCDS and PD compared with native colour-mode studies in superficial lymph node enlargement.
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Demharter J, Leissner G, Vollert K, Bohndorf K. Die Therapie des iatrogenen Aneurysma spurium der Arteria femoralis durch sonographisch gesteuerte perkutane Thrombininjektion. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Demharter J, Rother T, Vollert K, Bohndorf K. Das Spektrum der Kontrastmittel (KM)-Dynamik von Leberhämangiomen in der KM-Sonographie mit niedriger Sendeleistung. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Demharter J, Müller P, Wagner T, Schlimok G, Haude K, Bohndorf K. Percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. Eur Radiol 2001; 11:276-83. [PMID: 11218028 DOI: 10.1007/s003300000540] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of this study was to evaluate the sensitivity and specificity of percutaneous core-needle biopsy of enlarged lymph nodes in the diagnosis and subclassification of malignant lymphomas. In a 1-year period 158 image-guided percutaneous core-needle biopsies of enlarged lymph nodes were performed on 149 consecutive patients using a Tru-cut needle fired by a biopsy gun. In 135 cases the biopsy findings could be confirmed by histologic examination of additional tissue samples (n = 59) or by correlation with the patient's clinical and radiologic course (n = 76). The final diagnoses were malignant lymphoma in 65 cases, leukemic nodal infiltration in 2, nodal metastases from a solid tumor in 37 and benign changes or no evidence of malignancy in 31 cases. The core-needle biopsies correctly diagnosed 58 of 65 malignant lymphomas, corresponding to a sensitivity of 89% and a specificity of 97%. Fifty-five of the 58 (95%) correctly diagnosed malignant lymphomas could be subclassified on the basis of the core-needle biopsy. Image-guided core-needle biopsy of enlarged lymph nodes with a Tru-cut needle is a useful method for the diagnosis and subclassification of malignant lymphomas.
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Affiliation(s)
- J Demharter
- Department of Radiology, Zentralklinikum Augsburg, Germany
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Demharter J, Wieberneit J, Lindemann F, Bohndorf K. [A rare complication after foreign body ingestion]. Rontgenpraxis 2000; 52:384-7. [PMID: 10803054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg.
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Demharter J. [Ultrasound diagnosis of acute appendicitis--really an additional source of information?]. Rontgenpraxis 1999; 52:130-6. [PMID: 10522454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg.
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Abstract
OBJECTIVE To make a detailed evaluation of the clinical and radiological course of five children with chronic recurrent multifocal osteomyelitis (CRMO). Emphasis was laid on the correlation between clinical data and radiological findings. DESIGN AND PATIENTS Clinical data, histology (n = 11), bone scintigraphy (n = 17), and the plain radiographs (n = 198) of these patients were reviewed. The mean time of observation was 6.6 years (range 1-14.5 years). Thirty-two lesions seen at the time of primary diagnosis (n = 22) or during the course of the disease (n = 10) were evaluated. Twenty-seven foci were located in bone; in five cases the sacroiliac joints were involved. RESULTS Bone scintigrams showed nearly all foci (31/32) and were especially helpful in clinically asymptomatic lesions (14/32) or foci which were radiographically difficult to detect or not seen at all (8/32). Only 14 of 32 foci were locally symptomatic clinically. In all cases with a short interval (< or = 3 weeks) between the onset of local symptoms and evaluation by plain radiographs (n = 5) osteolysis was shown without a sclerotic margin. All bone lesions with a longer duration of local symptoms (n = 7) revealed a variable radiographic pattern: osteolysis with sclerotic rim in three, a mixed lytic-sclerotic lesion in three and pure sclerosis in one. In two cases low back pain could be ascribed to sacroiliitis. CONCLUSION Only careful correlation between clinical, scintigraphy and radiographic features permits an accurate assessment of disease activity in CRMO. The bone lesions detected radiographically soon after the onset of symptoms resemble those of acute osteomyelitis.
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Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum, Augsburg, Germany
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Demharter J, Michl W, Bücklein W, Bohndorf K. [Ultrasound morphologic spectrum of Meckel's diverticulitis--3 case reports and overview of the literature]. Rontgenpraxis 1996; 49:145-8. [PMID: 8766917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- J Demharter
- Klinik für Diagnostische Radiologie und Neuroradiologie, Zentralklinikum Augsburg
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