Nadja Schibany

Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study.

OBJECTIVE To determine the prevalence and clinical impact of rotator cuff tears in asymptomatic volunteers. MATERIALS AND METHODS Sonographic examinations of the shoulder of 212 asymptomatic individuals between 18 and 85 years old were performed by a single experienced operator. The prevalence and location of complete rotator cuff tears were evaluated. The clinical assessment was based on the Constant Score. Magnetic resonance imaging (MRI) of the shoulder was obtained in those patients where US showed rotator cuff pathology. RESULTS Ultrasound showed a complete rupture of the supraspinatus tendon in 6% of 212 patients from 56 to 83 years of age (mean: 67 years). MRI confirmed a complete rupture of the supraspinatus tendon in 90%. All patients reported no functional deficits, although strength was significantly lower in the patient group with complete supraspinatus tendon tear (P < 0.01). CONCLUSION There is a higher prevalence in older individuals of rotator cuff tendon tears that cause no pain or decrease in activities of daily living.

Effect of contrast dose and field strength in the magnetic resonance detection of brain metastases.

PurposeTo compare the diagnostic efficacy of a standard and cumulative triple dose of magnetic resonance (MR) imaging contrast agent in the evaluation of brain metastases using a high-field 3.0 T MR unit versus a standard field 1.5 T MR unit. MethodsTwenty-two patients with suspected brain metastases were examined at both field strengths using identical postcontrast coronal 3D gradient echo with magnetization preparation, which was adjusted separately for each field strength. In both groups initially, iv injection of 0.1 mmol/kg body weight gadolinium chelate (gadodiamide) and thereafter, 0.2 mmol/kg body weight gadodiamide were administered. Subjective assessment of the images was performed independently by 3 neuroradiologists. Objective measurement of signal-to-noise and contrast-to-noise ratios was obtained. ResultsThe subjective assessment of cumulative triple-dose 3.0 T images obtained the best results compared with other sequences, detecting 84 metastases, followed by 1.5 T cumulative triple-dose enhanced images with 81 brain metastases. The objective assessment confirmed those results, showing significantly higher signal-to-noise and contrast-to-noise ratios with 3.0 T than with 1.5 T. ConclusionsCumulative triple-dose images of both field strengths were superior to standard field strengths. However, administration of gadodiamide contrast agent produces higher contrast between tumor and normal brain on 3.0 T than on 1.5 T, resulting in better detection of brain metastases and leptomeningeal involvement.

Detection of focal hepatic lesions: comparison of unenhanced and SHU 555 A-enhanced MR imaging versus biphasic helical CTAP.

The purpose of this study was to compare the diagnostic sensitivity of unenhanced magnetic resonance (MR) imaging, and MR imaging with a new superparamagnetic iron oxide (SPIO)‐enhanced contrast agent (SHU 555 A) with biphasic helical computed tomography during arterial portography (CTAP) in patients with focal liver lesions. Eighteen patients with a total of 91 (78 malignant, 13 benign) proven liver lesions underwent unenhanced short tau inversion recovery (STIR), T2‐weighted (T2‐w) TSE, and SHU 555 A‐enhanced T2‐w turbo spin‐echo (TSE) MR imaging and biphasic helical CTAP. The standard of reference was histopathologic analysis of resected specimens in 59 lesions, intraoperative ultrasound with biopsy in 20 lesions, and CT‐guided biopsy and follow‐up in 12 lesions. Diagnostic performance of the imaging modalities was compared quantitatively and qualitatively by assessing lesion involvement in liver segments. There were 68 lesions detected on unenhanced T2‐w TSE, which resulted in a sensitivity of 75%. With the STIR sequence, 76 lesions were detected, for a sensitivity of 84%, and with SHU 555 A‐enhanced MRI, 84 lesions were detected, for a sensitivity of 92%. CTAP detected 88 lesions, for a sensitivity of 97%. The accuracy for unenhanced T2‐w TSE was 98%, for STIR 99%, for enhanced‐MRI 100%, and for CTAP 95%. The specificity was 100% for SHU 555 A‐enhanced MRI and 95% for CTAP. SHU 555 A‐enhanced MRI was superior to nonenhanced MRI (P < 0.05) and equivalent to CTAP in terms of sensitivity. Due to the absence of false‐positive results on SHU 555 A‐enhanced MRI, the specificity and accuracy of enhanced MRI were higher than those of CTAP, but the difference was not statistically significant (P = 0.134). J. Magn. Reson. Imaging 2000;11:665–672.

Imaging articular cartilage defects in the ankle joint with 3D fat-suppressed echo planar imaging: Comparison with conventional 3D fat-suppressed gradient echo imaging

To shorten the examination time for articular cartilage imaging, using a recently developed three‐dimensional (3D) multishot echo planar imaging (EPI) sequence with fat saturated (FS), compared to aconventional 3D fat‐saturated spoiled gradient echo sequence (3D FS GRE).

Ultrafast magnetic resonance imaging of the brain

The purpose of this study was to compare the diagnostic efficacy of single shot fast spin echo sequence (SSh-FSE), and single shot GRASE-sequence (SSh-GRASE) to the conventional T(2)-weighted fast spin echo-sequence (T(2)-FSE) in the imaging of brain disorders. Thirty three patients with high signal intensity lesions on T(2)-weighted images (n = 28), or intracerebral hemorrhage (n = 5), were examined on a 1.0 T MR scanner, with 23 mT/m gradient strength. The scan time for the conventional T(2)-FSE-sequence was 2 min 57 s, the scan time for the single shot-FSE-, and single shot-GRASE-sequences was 11 sec, and 17 sec, respectively. Twenty-one patients remained still during the examination, whereas 12 could not stay still with consecutive marked motion artifacts. Images were reviewed by three radiologists. Lesion conspicuity, image quality, and artifacts were scored on a subjective scale. Signal-to-noise ratios of lesions and normal tissue and contrast-to-noise ratios (CNR) were measured by region of interest (ROI). In the patient group without motion artifacts conspicuity for lesions > or =5 mm did not show a significant difference on conventional T(2)-FSE, single shot-FSE and single shot-GRASE. Detectability of the smaller lesions was significantly inferior on single shot-FSE-, and single shot-GRASE-sequences in artifact free images. For the patient group with motion artifacts SSh-FSE and SSh-GRASE were markedly superior to the conventional T(2)-FSE. Grey-white differentiation was better on conventional T(2)-FSE. Physiologic ferritin as well as pathologic hemosiderin depositions were slightly darker and therefore better visible on SSh-GRASE than on SSh-FSE. Conventional T(2)-FSE showed significantly more artifacts. In conclusion, SSh-FSE and SSh-GRASE imaging can be used for rapid imaging of the brain in those patients who are claustrophobic or in patients with involuntary movements due to extrapyramidal disorders, as well as in children in whom anesthesia is contraindicated or sedation is not possible.

Preoperative fast MRI of brain tumors using three-dimensional segmented echo planar imaging compared to three-dimensional gradient echo technique

The purpose of this study was to compare the diagnostic efficacy of a newly developed T(1)-weighted three-dimensional segmented echo planar imaging (3D EPI) sequence versus a conventional T(1)-weighted three dimensional spoiled gradient echo (3D GRE) sequence in the evaluation of brain tumors. Forty-four patients with cerebral tumors and infections were examined on a 1.0 T MR unit with 23 mT/m gradient strength. The total scan time for the T(1) 3D EPI sequence was 2 min 12 s, and for a conventional 3D GRE sequence it was 4 min 59 s. Both sequences were performed after administration of a contrast agent. The images were analyzed by three radiologists. Image assessment criteria included lesion conspicuity, contrast between different types of normal tissue, and image artifacts. In addition, signal-to-noise and contrast-to-noise-ratio (C/N) were calculated. The gray-white differentiation and C/N ratio of 3D EPI were found to be inferior to conventional 3D GRE images, but the difference was not statistically significant. In the qualitative comparison, lesion detection and conspicuity of 3D EPI images and conventional 3D GRE images were similar, but a tow-fold reduction of the scanning time was obtained. With the 3D EPI technique, a 50% scan time reduction could be achieved with acceptable image quality compared to conventional 3D GRE. Thus, the 3D EPI technique could replace conventional 3D GRE in the preoperative imaging of brain.

Akute, nicht traumabedingte Veränderungen des unteren Respirationstraktes des Kindes im Thoraxröntgen Erkennen und Verstehen radiologischer Veränderungen

ZusammenfassungDie Diagnostik akuter, nicht traumabedingter Erkrankungen des unteren Respirationstraktes erfordert genaue Kenntnisse der speziellen Anatomie, Physiologie und Pathologie der kindlichen Lunge. Die absolut und auch relativ kleineren Luftwege im Vergleich zum Erwachsenen, aber auch der noch nicht ausgebildete Kollateralkreislauf führen zu pulmonalen Veränderungen, wie sie nur beim Kind vorkommen. Bei den Pneumonien sind Viren nur bei Kleinkindern bis zum 2. Lebensjahr prädominant. Mit zunehmendem Alter treten Bakterien immer mehr in den Vordergrund. Eine Unterscheidung zwischen viralem und bakteriellem Erreger ist im Thoraxröntgen nicht möglich. Häufig ist auch eine fragliche Fremdkörperaspiration abzuklären. Da die meisten Fremdkörper nicht röntgendicht sind, muss auf indirekte Zeichen wie Überblähung und Mediastinalshift geachtet werden. Primäre pulmonale Tumoren zählen zu den Raritäten. Häufiger sind Sekundärblastome, wobei hier die Primärtumoren in der Regel bereits bekannt sind. Neuroblastome und Lymphome können intrapulmonale Pathologien vortäuschen.AbstractThe diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies.

Akute, nicht traumabedingte Veränderungen des unteren Respirationstraktes des Kindes im Thoraxröntgen Erkennen und Verstehen radiologischer Veränderungen: Erkennen und Verstehen radiologischer Veränderungen

ZusammenfassungDie Diagnostik akuter, nicht traumabedingter Erkrankungen des unteren Respirationstraktes erfordert genaue Kenntnisse der speziellen Anatomie, Physiologie und Pathologie der kindlichen Lunge. Die absolut und auch relativ kleineren Luftwege im Vergleich zum Erwachsenen, aber auch der noch nicht ausgebildete Kollateralkreislauf führen zu pulmonalen Veränderungen, wie sie nur beim Kind vorkommen. Bei den Pneumonien sind Viren nur bei Kleinkindern bis zum 2. Lebensjahr prädominant. Mit zunehmendem Alter treten Bakterien immer mehr in den Vordergrund. Eine Unterscheidung zwischen viralem und bakteriellem Erreger ist im Thoraxröntgen nicht möglich. Häufig ist auch eine fragliche Fremdkörperaspiration abzuklären. Da die meisten Fremdkörper nicht röntgendicht sind, muss auf indirekte Zeichen wie Überblähung und Mediastinalshift geachtet werden. Primäre pulmonale Tumoren zählen zu den Raritäten. Häufiger sind Sekundärblastome, wobei hier die Primärtumoren in der Regel bereits bekannt sind. Neuroblastome und Lymphome können intrapulmonale Pathologien vortäuschen.AbstractThe diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies.

Acute, non traumatic patterns in chest radiography of children - recognition and understanding of radiographic appearances

ZusammenfassungDie Diagnostik akuter, nicht traumabedingter Erkrankungen des unteren Respirationstraktes erfordert genaue Kenntnisse der speziellen Anatomie, Physiologie und Pathologie der kindlichen Lunge. Die absolut und auch relativ kleineren Luftwege im Vergleich zum Erwachsenen, aber auch der noch nicht ausgebildete Kollateralkreislauf führen zu pulmonalen Veränderungen, wie sie nur beim Kind vorkommen. Bei den Pneumonien sind Viren nur bei Kleinkindern bis zum 2. Lebensjahr prädominant. Mit zunehmendem Alter treten Bakterien immer mehr in den Vordergrund. Eine Unterscheidung zwischen viralem und bakteriellem Erreger ist im Thoraxröntgen nicht möglich. Häufig ist auch eine fragliche Fremdkörperaspiration abzuklären. Da die meisten Fremdkörper nicht röntgendicht sind, muss auf indirekte Zeichen wie Überblähung und Mediastinalshift geachtet werden. Primäre pulmonale Tumoren zählen zu den Raritäten. Häufiger sind Sekundärblastome, wobei hier die Primärtumoren in der Regel bereits bekannt sind. Neuroblastome und Lymphome können intrapulmonale Pathologien vortäuschen.AbstractThe diagnosis of acute, non-traumatic diseases of the lower respiratory tract requires exact knowledge of the specific anatomy, physiology and pathology of the pediatric chest. The absolutely and relatively smaller airways, as compared with those of adults, and the undeveloped collateral ventilation result in radiological appearances that are unique in children. Viral pneumonia is predominant only in small children up to an age of 2 years. With increasing age, there is a higher incidence of bacterial pneumonia. The differentiation of viral and bacterial etiology of a pneumonia is not possible on the basis of chest radiographs. In acute pediatric imaging, possible aspiration of foreign bodies has to be considered. Since most foreign bodies cannot be detected radiographically, indirect features such as hyperinflation or mediastinal shifts have to be evaluated. Primary lung tumors are rare in children. More common are metastases with known primary tumors. Neuroblastoma or lymphomas may mimic intrapulmonary pathologies.