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  • 1
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    München : Urban und Fischer
    Call number: WN200:44(2) ; H0100:14
    Keywords: Radiology
    Notes: Contents of CD-ROM: 1. Kommentierte Original-IMPP-Prüfungsfragen GK2 und GK3 8/93 - 3/01 ; 2. 7 Fallbeispiele aus der radiologischen Praxis.
    Pages: viii, 601 p. : ill. + 1 CD-ROM
    Edition: 2., erweiterte Auflage.
    ISBN: 3-437-41990-0
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    H0100:14 departmental collection or stack – please contact the library
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  • 2
    Call number: 01-AUSBILDUNGSL:454
    Pages: 394 S.
    Edition: 43. AUFL.
    ISBN: 3-7782-3120-0
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    01-AUSBILDUNGSL:454 departmental collection or stack – please contact the library
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  • 3
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  65. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie; 20190328-20190329; Münster; DOCV 1.1 /20190225/
    Publication Date: 2019-02-26
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
    Keywords: COMBINATION ; evaluation ; ALGORITHM ; VOLUME ; ACCURACY ; SURGERY ; TIME ; PATIENT ; DONOR ; intraoperative ; BODY-WEIGHT ; MR ; FIELD ; MAGNETIC-RESONANCE ; DISPLAY ; arteries ; MR-ANGIOGRAPHY ; magnetic resonance angiography ; ANOMALIES ; contrast-enhanced magnetic resonance angiography ; CT ANGIOGRAPHY ; DIGITAL SUBTRACTION ANGIOGRAPHY ; DIGITAL-SUBTRACTION-ANGIOGRAPHY ; gadobenate dimeglumine ; KIDNEY DONORS ; maximum intensity projection ; MAXIMUM-INTENSITY-PROJECTION ; pathology ; renal angiography ; shaded-surface display ; TRANSPLANT DONORS ; UROGRAPHY ; volume rendering
    Abstract: The aim of this study was to assess the value of contrast- enhanced three-dimensional MR angiography (CE 3D MRA) in the preoperative assessment of potential living renal donors, and to compare the accuracy for the depiction of the vascular anatomy using three different rendering algorithms. Twenty- three potential living renal donors were examined with CE 3D MRA (TE/TR=1.3 ms/3.7 ms, field of view 260-320x350 mm, 384- 448x512 matrix, slab thickness 9.4 cm, 72 partitions, section thickness 1.3 rum, scan time 24 s, 0.1 mmol/kg body weight gadobenate dimeglumine). Magnetic resonance angiography data sets were processed with maximum intensity projection (MIP), volume rendering (VR), and shaded-surface display (SSD) algorithms. The image analysis was performed independently by three MR-experienced radiologists recording the number of renal arteries, the presence of early branching or vascular pathology. The combination of digital subtraction angiography (DSA) and intraoperative findings served as the gold standard for the image analysis. In total, 52 renal arteries were correspondingly observed in 23 patients at DSA and surgery. Other findings were 3 cases of early branching of the renal arteries, 4 cases of arterial stenosis and I case of bilateral fibromuscular dysplasia. With MRA source data all 52 renal arteries were correctly identified by all readers, compared with 51 (98.1%), 51-52 (98.1-100%) and 49-50 renal arteries (94.2-96.2%) with the MIP, VR and SSD projections, respectively. Similarly, the sensitivity, specificity and accuracy was highest with the MRA source data followed by MIP, VR and SSD. Time requirements were lowest for the MIP reconstructions and highest for the VR reconstructions. Contrast-enhanced 3D MRA is a reliable, non-invasive tool for the preoperative evaluation of potential living renal donors. Maximum intensity projection is favourable for the processing of 3D MRA data, as it has minimal time and computational requirements, while having similar or superior accuracy for the depiction of vessel anomalies or pathology compared with VR and SSD, respectively
    Type of Publication: Journal article published
    PubMed ID: 12664119
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  • 5
    Keywords: CANCER ; CANCER CELLS ; CELLS ; EXPRESSION ; CELL ; Germany ; human ; DISEASE ; CDNA ; GENE ; GENE-EXPRESSION ; GENES ; PATIENT ; NF-KAPPA-B ; ACTIVATION ; PHOSPHORYLATION ; treatment ; gene expression ; PCR ; CANCER-CELLS ; PRODUCT ; max ; REGULATOR ; HIGH-LEVEL ; GLYCERALDEHYDE-3-PHOSPHATE DEHYDROGENASE ; REDUCTASE ; BIOLOGICAL-ACTIVITIES ; CEREBELLAR NEURONS ; CHROMOSOMAL INSTABILITY ; Fanconi anemia,GAPDH,redox potential,thioredoxin ; REDOX REGULATION
    Abstract: Cancer cells have high levels of thioredoxin ( Trx) and of glyceraldehyde 3- phosphate dehydrogenase ( GAPDH). Cells from patients with the cancer- prone disease Fanconi anemia ( FA) exhibit reduced Trx levels. We found the activity of GAPDH to correlate directly with the endogenous Trx content and mRNA transcripts for GAPDH and TRx reduced in FA cells. The treatment of cells with reduced human Trx stimulated the synthesis of GAPDH mRNA. Similarly, the transfection of cells with an expression plasmid for Trx increased GAPDH mRNA synthesis. Trx treatment of cells and subsequent analysis of the differential gene expression by human cDNA arrays containing about 50 000 different PCR products resulted in more than 300 up- or downregulated genes. Two representative genes, GAPDH and IkappaBalpha/ MAD- 3, were further investigated to confirm their stimulation by Trx. Trx besides being the major carrier of redox potential of cells is also a regulator of gene expression on the transcriptional level. By regulation via Trx, cells are able to adapt to the prevailing redox conditions. These findings also enlighten the pathophysiology of FA in the respect that the characteristic diminution of Trx that results in the dysregulation of gene expression is a basis for the major symptoms of this disease
    Type of Publication: Journal article published
    PubMed ID: 14730345
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  • 6
    Keywords: CANCER ; GROWTH ; tumor ; Germany ; PATHWAY ; PATHWAYS ; CT ; imaging ; SYSTEM ; SYSTEMS ; TOOL ; VISUALIZATION ; VOLUME ; liver ; RESOLUTION ; SURGERY ; ACQUISITION ; EFFICACY ; RESECTION ; tomography ; SAFETY ; COMPUTED-TOMOGRAPHY ; SEGMENTS ; ultrasound ; inflammation ; pancreas ; review ; TUMOR-GROWTH ; HIGH-RESOLUTION ; SOFTWARE ; CLINICAL-RELEVANCE ; 3D ; surgical planning ; 3-dimensional ; liver and pancreas ; liver surgery ; organ movements ; volumetry
    Abstract: Cross-sectional imaging based on navigation and virtual reality planning tools are well - established in the surgical routine in orthopedic surgery and neurosurgery. In various procedures, they have achieved a significant clinical relevance and efficacy and have enhanced the discipline's resection capabilities. In abdominal surgery, however, these tools have gained little attraction so far. Even with the advantage of fast and high resolution cross-sectional liver and pancreas imaging, it remains unclear whether 3D planning and interactive planning tools might increase precision and safety of liver and pancreas surgery. The inability to simply transfer the methodology from orthopedic or neurosurgery is mainly a result of intraoperative organ movements and shifting and corresponding technical difficulties in the on-line applicability of presurgical cross sectional imaging data. For the interactive planning of liver surgery, three systems partly exist in daily routine: HepaVision2 (MeVis GmbH, Bremen), LiverLive (Navidez Ltd, Slovenia) and OrgaNicer (German Cancer Research Center, Heidelberg). All these systems have realized a half- or full-automatic liver-segmentation procedure to visualize liver segments, vessel trees, resected volumes or critical residual organ volumes, either for preoperative planning or intraoperative visualization. Acquisition of data is mainly based on computed tomography. Three-dimensional navigation for intraoperative surgical guidance with ultrasound is part of the clinical testing. There are only few reports about the transfer of the visualization of the pancreas, probably caused by the difficulties with the segmentation routine due to inflammation or organ-exceeding tumor growth. With this paper, we like to evaluate and demonstrate the present status of software planning tools and pathways for future pre- and intraoperative resection planning in liver and pancreas surgery
    Type of Publication: Journal article published
    PubMed ID: 16123867
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  • 7
    Keywords: Germany ; CT ; DIAGNOSIS ; IMAGES ; VOLUME ; DISEASE ; HEPATOCELLULAR-CARCINOMA ; liver ; DIFFERENTIATION ; TUMORS ; SURGERY ; PATIENT ; CONTRAST ; MR ; MRI ; LESIONS ; NUMBER ; COLORECTAL-CANCER ; metastases ; LOCALIZATION ; LIVER METASTASES ; sensitivity ; specificity ; contrast media ; HELICAL CT ; GUIDELINES ; 2D ; PREOPERATIVE EVALUATION ; ENHANCED MRI ; SIZE ; LIVER-DISEASE ; SCANS ; arterial portography ; FOCAL HEPATIC MASSES ; INTRAOPERATIVE SONOGRAPHY ; oncologic imaging ; SPIRAL-CT
    Abstract: OBJECTIVE. This study compared MR during arterial portography (MRAP) with CT during arterial portography (CTAP) with regard to the detection and differentiation of liver metastases before surgery. MATERIALS AND METHODS. Fifteen patients with liver metastases were enrolled before surgery according to the guidelines of our institutional review board and good clinical practice. After mesentericography, unenhanced scans (Volume Zoom) were performed initially. For CTAP, the contrast medium was injected through the superior mesenteric artery. Images were acquired in portal and delayed enhancement. The MR protocol (1.5 T; Magnetom Symphony) started with T1-weighted fast low-angle shot (FLASH) T2-weighted turbo spin echo (TSE). MRAP followed with gadolinium-enhanced dynamic T1-weighted 3D FLASH. Delayed-phase T1-weighted 2D FLASH axial images were performed 2 min after IV injection of the contrast medium. Qualitative and quantitative evaluation of CTAP and MRAP was performed by three blinded radiologists regarding the number of lesions and their size, localization, and differential diagnosis. RESULTS. The overall sensitivity in detecting liver metastases was 97% with MRAP and 93% with CTAP (p 〉 0.05, not significant [n.s.]). The specificity was calculated to be 97% for MRAP and 82% for CTAP (p 〈 0.0001, statistically significant [s.s.]). The differences in sensitivity were more accentuated if only lesions 10 min or smaller were considered (95% vs 88%, p 〉 0.05, n.s.), for which the respective specificities were 95% and 80% (p 〈 0.0014, s.s.). Improvements in sensitivity and specificity were associated with a higher lesion-to-liver contrast-to-noise ratio (59.4 +/- 51.0 for MRAP vs 10.4 +/- 7.3 for CTAP) and resulted in higher diagnostic confidence in the differential diagnosis of liver lesions (p 〈 0.001, s.s.) and better interobserver agreement (median kappa value, 0.88 vs 0.63). CONCLUSION. MRAP proved to be a reliable method in the preoperative detection of small liver metastases in particular, with a higher sensitivity and specificity than CTAP. If organizational difficulties of MRAP can be overcome, MRAP could be considered instead of CTAP in the preoperative invasive evaluation of metastatic liver disease
    Type of Publication: Journal article published
    PubMed ID: 16714637
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  • 8
    Keywords: AGE, ALGORITHM, ANGIOGRAPHY, Aorta, arterial wall motion, BLOOD, CONTOUR MODEL, CT, CT ANGIOGRAPHY,
    Abstract: Aortic distensibility is a parameter to grade vascular diseases and age-related effects because it is related to the elastic properties of the vessel wall. In this study vascular cross-sectional area changes have been determined using ECG-gated CT to analyse the age dependency of aortic distensibility. Distensibility measurements of the aorta were performed in 31 subjects (28 to 85 years). Time-resolved images were acquired either with a 4- or 16-detector row CT system using a modified CT angiography protocol. Cross-sectional area changes of the aorta were calculated by semiautomatic segmentation, and distensibility values were obtained using additional systemic blood pressure measurements. The aorta could be segmented successfully in all subjects. A decrease of aortic distensibility with age was found (r=0.50). Below (above) the renal arteries, the annual decrease was Delta D (infrarenal) =(- 2.1 +/- 0.7).10(-7)Pa(-1) a(-1), (D (suprarenal) Delta=(-3.5 +/- 1.1).10(-7) Pa-1 a(-1)). Differences between the ages, the youngest third and oldest third studied, were found to be significant ( (suprarenal)=0.003; P (infrarenal) =0.025). An age-dependent decrease of aortic wall elasticity can be determined in a modified routine CT angiography study
    Type of Publication: Journal article published
    PubMed ID: 16741718
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  • 9
    Keywords: Germany ; DIAGNOSIS ; IMAGES ; imaging ; ACCURACY ; NUCLEAR-MEDICINE ; TIME ; PATIENT ; CONTRAST ; CONTRAST AGENT ; MRI ; SEQUENCE ; SIGNAL ; AGE ; WOMEN ; MEN ; sensitivity ; specificity ; CONTRAST-ENHANCED MRI ; echocardiography ; nuclear medicine ; dynamic MRI ; AGENT ; radiology ; HEIGHT ; analysis ; methods ; NUCLEAR ; RECOVERY ; TRANSESOPHAGEAL ECHOCARDIOGRAPHY ; technique ; USA ; EVALUATE ; cardiac imaging ; cardiovascular imaging ; MEDICINE ; - ; PRECESSION ; STEADY-STATE ; congenital anomaly ; dynamic contrast-enhanced MRI ; patent foramen ovale ; SIGNAL INTENSITY
    Abstract: OBJECTIVE. The purpose of this study was threefold: to evaluate the diagnostic accuracy of dynamic contrast-enhanced MRI compared with transesophageal echocardiography ( TEE) in the detection of patent foramen ovale (PFO) and of residual shunts after occlusion of PFO, to define cutoff values for semiquantitative analysis of signal intensity - time curves, and to compare the diagnostic accuracy of visual detection with that of semiquantitative analysis. SUBJECTS AND METHODS. Forty-three patients ( 18 women, 25 men; mean age, 51 +/- 14 years) who underwent TEE for suspicion of PFO ( n = 26, 19 patients with and seven without PFO) or for routine assessment for residual shunt after transcatheter PFO occlusion ( n = 17, nine patients with and eight without residual shunt) were consecutively enrolled to undergo contrast-enhanced MRI ( saturation recovery steady-state free precession sequence). The images were analyzed both visually and semiquantitatively for arrival of contrast agent in the left atrium before arrival in the pulmonary veins during a Valsalva maneuver. TEE results were used as the clinical reference. RESULTS. With an area under the signal intensity - time curve of 0.85, height of the first initial peak in signal intensity in the left atrium proved to be the best discriminator in right-to-left shunt detection. For a cutoff value of 129% ( from baseline signal intensity) for this parameter, sensitivity and specificity were 90% (17/19) and 100% (7/7) in patients without PFO devices and 56% (5/9) and 88% (7/8) in patients with PFO devices. The diagnostic accuracy of both visual assessment and semiquantitative analysis was consistently superior before PFO device implantation than after device implantation. The diagnostic accuracy of visual shunt assessment was better than that of semiquantitative shunt assessment in patients with PFO occluders ( sensitivity, 67% [6/9] correctly diagnosed; specificity, 88% [7/8]) and those without PFO occluders ( sensitivity, 95% [18/19]; specificity, 100% [7/7]). CONCLUSION. At present, MRI cannot replace TEE for the exclusion of potential embolic sources, such as thrombus in the left atrial appendage. However, MRI can be an attractive alternative noninvasive technique if TEE is technically unfeasible or is declined by patients
    Type of Publication: Journal article published
    PubMed ID: 17312077
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  • 10
    Keywords: CANCER ; INVASION ; tumor ; carcinoma ; evaluation ; Germany ; CT ; DIAGNOSIS ; FOLLOW-UP ; SPIRAL CT ; TOOL ; DISEASE ; TUMORS ; computed tomography ; RESOLUTION ; PATIENT ; primary ; NO ; METASTASIS ; adenocarcinoma ; COMPUTED-TOMOGRAPHY ; sensitivity ; specificity ; VESSELS ; QUESTIONNAIRE ; pancreatic carcinoma ; HELICAL CT ; HYDRO-CT ; methods ; ROW CT ; CURVED PLANAR REFORMATIONS ; invasion score ; MULTISLICE SPIRAL CT ; resectability ; VASCULAR INVASION
    Abstract: Objective: It was the aim of this study to evaluate a new infiltration score to determine the resectability of pancreatic carcinomas in preoperative planning. Materials and Methods: Eighty patients with suspected pancreatic tumor were examined prospectively using 16-row spiral CT. The scans were evaluated for the presence of pancreatic carcinoma, peripancreatic tumor extension and vascular invasion using a standardized questionnaire. Invasion of the surgically relevant vessels was evaluated using a new invasion score. The operative and histological findings and the clinical follow-up served as the gold standard. Results: Forty patients had a pancreatic carcinoma, 5 had metastasis of a different primary tumor, and in 35 patients, there was no malignant pancreatic disease. The sensitivity for tumor detection was 100%, with a specificity of 88% for differentiating between malignant and benign pancreatic tumors. Invasion of the surrounding vessels was evaluated correctly using the invasion score, with a sensitivity of 89% and a specificity of 99%. In evaluation of resectability, a sensitivity of 94% and a specificity of 89% were achieved. Conclusion: Using 16-row spiral CT, the invasion score is a valid tool for correctly assessing invasion in relevant vessels in cases of pancreatic carcinoma and for determining resectability. Copyright (C) 2008 S. Karger AG, Basel and IAP
    Type of Publication: Journal article published
    PubMed ID: 18434758
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