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  • Coronary angiography  (1)
  • Immunosuppression  (1)
  • Key words: Helical CT  (1)
  • 1
    ISSN: 1432-1084
    Keywords: Key words: Aneurysm ; Abdominal ; Pulmonary ; Therapy ; Immunosuppression
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. We studied the value of contrast-enhanced CT in the detection of aneurysms in immunocompromised patients suffering from inflammatory diseases eventually complicated by hemorrhage. Contrast-enhanced spiral CT was applied in three patients with immunocompromise due to chemotherapy, alcohol abuse or HIV. They suffered from invasive aspergillosis, chronic pancreatitis with pseudocyst formation, and acute pancreatitis together with HIV-associated lymphadenopathy. Complicating hemorrhage was present in two cases. Contrast-enhanced CT showed aneurysms complicating the underlying inflammatory disease in all three cases. The feeding vessels were identified and the patients with signs of bleeding were subsequently referred for angiography and embolization. Contrast-enhanced spiral CT is suited to detect aneurysms in immunocompromised patients suffering from inflammatory disease. It is recommended in these patients prior to angiography and intervention.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Key words: Coronary vessels ; Calcification ; CT ; Stenosis ; Coronary heart disease ; Coronary angiography ; Helical CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. The aim of this study was to evaluate the clinical relevance of coronary artery calcifications detected by spiral CT, congruence with fluoroscopy (FS) and coronary angiography, and comparison with studies reporting on application of double-helical CT and ultrafast CT. Forty patients underwent spiral CT (2-mm slice thickness, table feed 3 mm/s), coronary angiography, and FS (performed in the usual manner). Stenosis and calcifications were evaluated semiquantitatively. Nineteen patients suffering from a stenosis ≥ 75 % were verified at coronary angiography. All had coronary artery calcification on spiral CT. Fluoroscopy did not detect 8 of 19 patients with a stenosis ≥ 75 % (1 vessel: n = 1; 2 vessels: n = 3; 3 vessels: n = 4). In spiral CT sensitivity was 100 % and specificity was 33 % (FS: 58 and 48 %). Positive predictive value was 83 % for spiral CT (FS: 50 %), and negative predictive value was 100 % (FS: 56 %). A significant linear increase in the calcification score was found for increasing maximal stenosis (p 〈 0.005). Spiral CT is more sensitive than FS in the recognition of hemodynamic relevant stenoses using the detection of coronary artery calcifications. Statistical parameters are comparable to ultrafast-CT. Spiral CT is a suitable non-invasive diagnostic technique in coronary heart disease. Coronary calcifications found incidentally in symptomatic patients at chest CT should be reported to the referring physician for further cardiological workup.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Key words: Helical CT ; Dynamic MR imaging ; Kidney ; Inflammation ; AIDS ; Aspergillosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Renal insufficiency or allergic reactions for X-ray contrast agents are frequent limitations in immunocompromised hosts such as neutropenic or AIDS patients. Due to a better tolerance of contrast agents in MRI, this technique is well suited for investigation of parenchymal organs. We demonstrate an allergic AIDS patient who presented with fever and flank pain. At sonography, anechoic renal lesions were supposed to be non-complicated cysts; however, on T2-weighted MRI, the center was of high signal. Dynamic contrast-enhanced MRI of the kidneys demonstrated an enhancing rim with ill-defined margins. The lesions were supposed to be multiple bilateral abscesses. Due to the multiple dynamic contrast series, a delayed enhancement of renal parenchyma was detectable adjacent to the lesion. This was suggested as accompanying local pyelonephritis and an infectious etiology became more reliable. Aspergillus fumigatus was identified by CT-guided biopsy as the underlying microorganism. The MR appearance of this manifestation has not been described previously.
    Type of Medium: Electronic Resource
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