Multiple Sclerosis Presenting as a Delirium: A Case Report.

Objective: To report a case of multiple sclerosis (MS) with delirium as the first presentation.

Clinical Presentation And Intervention: A 34-year-old female was referred to our department with an acute onset of drowsiness, withdrawal from routine activities and aggression, followed by neurologic deficits after a couple of days. Clinical and radiographic examinations were performed, leading to the initial diagnosis of MS.

[A very rare submucosal tumour of the rectum - primary endometrioid adenocarcinoma of the rectum wall].

A 56-year-old female, with a past history of hysterectomy 13 years previously due to uterine myomata, presented with complaints of pain around the anus of a few months duration. Three years previously she underwent a colonoscopy, which was found to be unremarkable. A high suspicion of a submucosal tumour of the rectum in endoscopic examinations was confirmed by endoscopic ultrasound.

[Self-organizing neural networks for automatic detection and classification of contrast (media) enhancement of lesions in dynamic MR-mammography].

Purpose: Investigation and statistical evaluation of "Self-Organizing Maps," a special type of neural networks in the field of artificial intelligence, classifying contrast enhancing lesions in dynamic MR-mammography.

Material And Methods: 176 investigations with proven histology after core biopsy or operation were randomly divided into two groups. Several Self-Organizing Maps were trained by investigations of the first group to detect and classify contrast enhancing lesions in dynamic MR-mammography.

[Direct percutaneous radiologic jejunostomy (PR) and duodenostomy: a retrospective analysis].

Purpose: To present our experience with direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) for alimentation.

Materials And Methods: A retrospective study identified 24 patients who had undergone percutaneous jejunostomy or duodenostomy guided by CT and fluoroscopy over a period of 9 years. Whenever possible, the jejunum was inflated with a 5 French diagnostic catheter and jejunopexy was performed using Cope anchors (T-fasteners).

[Automatic classification of liver segments according to Couinaud: development of a new algorithm and evaluation spiral CT data].

Purpose: To develop a software tool that analyzes the anatomy of the portal vein branches and assigns segmental and subsegmental branches according to Couinaud's classification system and to evaluate its accuracy.

Materials And Methods: The algorithm was developed in C++ on a PC. The algorithm recognizes the three major branching patterns of the portal vein.

Improved artificial neural networks in prediction of malignancy of lesions in contrast-enhanced MR-mammography.

The aim of this study was to evaluate the capability of improved artificial neural networks (ANN) and additional novel training methods in distinguishing between benign and malignant breast lesions in contrast-enhanced magnetic resonance-mammography (MRM). A total of 604 histologically proven cases of contrast-enhanced lesions of the female breast at MRI were analyzed. Morphological, dynamic and clinical parameters were collected and stored in a database.

[18F-Deoxyglucose PET for the staging of oesophageal cancer: influence of histopathological subtype and tumour grading].

Aim: Evaluation of the influence of histopathologic sub-types and grading of primaries of oesophageal cancer, relative to their size and location, on the uptake of (18)F-deoxyglucose (FDG) as measured by positron emission tomography (PET).

Methods: 50 consecutive patients were evaluated. There were four drop-outs due to previous surgical and/or chemotherapeutical treatments and thus in 46 patients (28 squamous cell carcinomas and 18 adenocarcinomas) a pretherapeutic PET evaluation of the primary including a standard uptake value (SUV) was obtained.

SPET/CT image co-registration in the abdomen with a simple and cost-effective tool.

Fusion of morphology and function has been shown to improve diagnostic accuracy in many clinical circumstances. Taking this into account, a number of instruments combining computed tomography (CT) with positron emission tomography (PET) or single-photon emission tomography (SPET) are appearing on the market. The aim of this study was to evaluate a simple and cost-effective approach to generate fusion images of similar quality.

[Cardiac MRI in suspected myocarditis].

Purpose: To evaluate the potential of ECG-gated breath-hold MRI in diagnosing acute myocarditis.

Material And Methods: Cardiac MRI was performed on 21 consecutive patients with suspected myocarditis. ECG-gated breath-hold T2-weighted images with fat suppression were acquired in 3 standard views.

[Segmental anatomy of the liver in computed tomography: do we localize the lesion accurately?].

Purpose: To evaluate if Couinaud's model using the planes of the major veins is an adequate tool for the presurgical localization of focal liver lesions.

Methods: Biphasic helical CT scans were performed on patients evaluated for liver resection using an increased IV bolus of contrast medium (180 ml lopamidol) and 2 mm image reconstruction increments. During the first evaluation, all liver lesions were localized in the conventional way using the planes of the 3 major hepatic veins and the portal trunks as segmental boundaries.

[Color-coded volume reconstruction for 3-dimensional presentation of CT data].

Purpose: To evaluate a technique of colored three-dimensional reconstructions without segmentation.

Material And Methods: Color-coded volume rendered images were reconstructed from the volume data of 25 thoracic, abdominal, musculoskeletal, and vascular helical CT scans using commercial software. The CT volume rendered voxels were encoded with color in the following manner.

[3D CT of fractures: comparison of volume and surface reconstruction].

Purpose: The comparison of volume rendering (VR) and surface rendering (SSD) for demonstrating fractures from spiral-CT data.

Materials And Methods: Standardized VR and SSD projections were produced from 50 spiral CT scans of 50 consecutive patients with fractures. Appropriate multiplanar reformattings (MPR) were used as the standard.

Hyperplastic callus formation in osteogenesis imperfecta: CT and MRI findings.

Hyperplastic callus formation is a noteworthy condition in patients with osteogenesis imperfecta because it often mimicks osteosarcoma on radiography. The findings of CT and MRI in hyperplastic callus formation have not been reported. In the presented case, MRI demonstrated contrast enhancement and edema of the surrounding soft tisssue, consistent with benign as well as malignant disease.

Dynamic phosphorus-31 magnetic resonance spectroscopy in arterial occlusive disease: effects of vascular therapy on spectroscopic results.

Rationale And Objectives: The aim of the authors' prospective study was to explore therapy-induced changes of muscular metabolism in arterial occlusive disease (AOD).

Materials: Before and after vascular therapy, respectively, 31 patients with AOD were examined by dynamic phosphorus-31 (31P) magnetic resonance spectroscopy (MRS) at 1.5 T; in the magnet, the quadriceps muscle was stressed by an isometric and an isotonic form of exercise until exhaustion, respectively.

[CT angiography in arterial occlusive disease: comparison of 3 rendering techniques].

Purpose: To evaluate different rendering techniques of CT data for the assessment of long vessel segments in peripheral vascular occlusive disease.

Material And Methods: 40 CT angiograms (aortoiliac: n = 20, leg arteries: n = 20) were viewed using three different rendering techniques: 1, maximum intensity projection (MIP); 2, volume rendering (VR); 3, shaded surface display (SSD). CT angiograms were obtained in 6 or 8 projections.

CT angiography versus intraarterial digital subtraction angiography for assessment of aortoiliac occlusive disease.

Objective: The purpose of this study was to evaluate the accuracy of CT angiography (CTA) with a single helical acquisition for assessment of stenoses and occlusions of the iliac arteries.

Subjects And Methods: In our prospective study, intraarterial digital subtraction angiography and IV CTA were performed from the suprarenal aorta to below the femoral bifurcation in 30 patients with vascular occlusive disease. Maximum-intensity-projection images in multiple views were also obtained.

[CT angiography versus intra-arterial DSA in abdominal aortic aneurysms].

Purpose: To evaluate if CT angiography is able to image all features necessary for the preoperative planning of abdominal aortic aneurysms (accessory renal arteries, stenoses or occlusions of renal and iliac arteries, patency of inferior mesenteric artery).

Methods: CT angiography and DSA were performed on 27 patients with abdominal aortic aneurysms. CT angiography was performed using a protocol that covered the abdominal aorta and the pelvic arteries with a single spiral acquisition (contrast dose: 150 ml, collimation: 5 mm, table feed: 7.

[Triphasic spiral CT in the diagnosis of liver diseases: comparison with CT arteriography and CT arterio-portography].

Purpose: Assessment of the diagnostic efficacy of triphasic spiral-CT scanning (TPS-CT) for liver disease evaluation. CT arteriography (CTA) and CT arterio-portography (CTAP) were used as reference, methods which together have the highest sensitivity for detecting tumours and the perfusion conditions of the liver.

Material And Methods: 50 TPS-CT and CTA/CTPA were performed in 49 patients.

[123I]IBZM SPECT for imaging of striatal D2 dopamine receptors in 56 schizophrenic patients taking various neuroleptics.

Objective: The purpose of this study was to compare the binding of various typical and atypical neuroleptics to striatal D2 dopamine receptors in schizophrenic patients.

Method: Fifty-six inpatients with schizophrenia, including 14 with schizoaffective disorder and one with schizophreniform disorder, were evaluated. Fourteen patients were neuroleptic free.

Prospective comparison of CT angiography of the legs with intraarterial digital subtraction angiography.

Objective: The aim of this study was to determine the accuracy of CT angiography (CTA) with a single spiral acquisition for the diagnosis of arterial stenoses and occlusion in patients with peripheral vascular occlusive disease.

Subjects And Methods: In a prospective study, intraarterial digital subtraction angiography and i.v.

[CT and MRI in malignant peripheral neuroectodermal tumors].

To evaluate the diagnostic accuracy of CT and MRI in the diagnosis of malignant peripheral neuroectodermal tumors (MPNT), the imaging data of nine patients with immunehistochemically proven MPNT were retrospectively analyzed. The average age was 24 years (ranging from 5 to 63 years). MRI and CT of all patients showed large tumors with direct infiltration of the surrounding structures.

[Spondylogenic psoas abscess: long-term follow-up after percutaneous drainage].

Iliopsoas abscesses originating from bacterial lumbar spondylodiscitis were successfully treated by CT-guided percutaneous abscess drainage, antibiotics, and immobilization in two patients. Vertebral fusion of the affected segments was observed in both patients in the follow-up period (1 and 6 years, respectively). Percutaneous abscess drainage can replace surgery for iliopsoas abscesses following vertebral osteomyelitis.

[Popliteal aneurysms: clinical aspects and diagnosis].

Purpose: To identify clinical and radiological features allowing an early diagnosis of popliteal aneurysms.

Material And Methods: History, clinical features and radiological findings of 23 patients with 37 aneurysms were reviewed.

Results: 14 patients presented with a history of a sudden onset of rest pain localised in the calf or foot.

Disseminated bone marrow metastases from primary breast cancer: detection and follow-up by radioimmune bone marrow scintigraphy.

Bone scintigraphy of a 40-yr-old patient suffering from primary breast cancer suggested the possibility of diffuse metastases. Bone marrow scintigraphy using 99mTc-labeled monoclonal antibodies (BW 250/183) demonstrated diffuse destruction of bone marrow due to metastatic disease and consecutive bone marrow extension. Bone marrow scintigraphy was highly sensitive in detecting progression of disease in this asymptomatic patient.

[MR tomography and bone marrow scintigraphy in the screening of skeletal metastases in patients with breast carcinoma].

46 patients with recently diagnosed carcinoma of the breast were included in a prospective comparative study of MRI and bone marrow scintigraphy. The aim of the study was to compare these procedures within a histologically unified patient collective. It was shown that MRI was superior to bone marrow scintigraphy in respect of sensitivity (92% vs 58%) and specificity (97% vs.