The postsurgical pancreas.

Background: Partial pancreatic resections are among the most complex surgical procedures in visceral tumor medicine and are associated with a high postoperative morbidity with a complication rate of 40-50 % of patients even in specialized centers.

Methods: Description of typical surgical resection procedures and the resulting postoperative anatomy, typical normal postoperative findings, common postoperative complications, and radiological findings.

Results And Conclusion: CT is the most appropriate imaging technique for rapid and standardized visualization of postoperative anatomy and detection of clinically suspected complications after partial pancreatic resections.

Long-Term Follow-up and Mortality Rate of Patients of the Randomized Freeway Stent Study.

Purpose: This follow-up study was designed as a reopen of the completed Freeway Stent Study and collected mortality and clinical outcome data for at least 5 years after enrollment to evaluate long-term patient safety and treatment efficacy. The primary study enrolled 204 patients with stenosis or occlusion in the superficial femoral artery and proximal popliteal artery. Patients were randomized to primary nitinol stenting followed by standard PTA or primary nitinol stenting followed by FREEWAY™ paclitaxel-eluting balloon PTA.

Endoscopic neo-anastomosis by Rendez-vous technique for the treatment of complete occlusion of bilioenteric anastomoses and distal bile ducts (case series).

Background And Aims: The complete occlusion of bilioenteric anastomoses is a rare and challenging clinical condition. Repeated surgery is burdened with technical difficulties and significant morbidity. We report the first series of completely occluded bilioenteric anastomoses resp.

The Randomized Freeway Stent Study: Drug-Eluting Balloons Outperform Standard Balloon Angioplasty for Postdilatation of Nitinol Stents in the SFA and PI Segment.

Purpose: The prospective randomized multicenter Freeway study evaluated the possible hemodynamic and clinical benefits of primary stent insertion followed by percutaneous transluminal angioplasty (PTA) with drug-eluting balloons (DEB) over post-stent insertion PTA with standard balloons in the treatment of symptomatic femoropopliteal arteriosclerotic lesions.

Methods: In total, 204 patients in 13 centers in Germany and Austria were enrolled and randomized to primary stenting followed by either FREEWAY™ drug-eluting balloon or standard PTA balloon angioplasty. The primary endpoint was the rate of clinically driven target lesion revascularization (TLR) at 6 months; the secondary endpoints include TLR rate at 12 months and primary patency, shift in Rutherford classification, ankle-brachial index (ABI) and major adverse events (MAE) at 6 and 12 months.

Symptoms and clinical course of EHEC O104 infection in hospitalized patients: a prospective single center study.

Objectives: Shiga-toxin producing O157:H7 Entero Haemorrhagic E. coli (STEC/EHEC) is one of the most common causes of Haemolytic Uraemic Syndrome (HUS) related to infectious haemorrhagic colitis. Nearly all recommendations on clinical management of EHEC infections refer to this strain.

Safety, efficacy, and indications of beta-adrenergic receptor blockade to reduce heart rate prior to coronary CT angiography.

For selected indications, coronary computed tomographic (CT) angiography is an established clinical technology for evaluation in patients suspected of having or known to have coronary artery disease. In coronary CT angiography, image quality is highly dependent on heart rate, with heart rate reduction to less than 60 beats per minute being important for both image quality and radiation dose reduction, especially when single-source CT scanners are used. β-Blockers are the first-line option for short-term reduction of heart rate prior to coronary CT angiography.

Prospective study of access site complications of automated contrast injection with peripheral venous access in MDCT.

Objective: The purpose of this article is to prospectively assess the frequency and type of IV injection site complications associated with high-flow power injection of nonionic contrast medium in MDCT.

Subjects And Methods: Contrast-enhanced (300-370 mg iodine/mL) MDCT examinations with high flow rates (up to 8 mL/s) using automatic CT injectors were performed according to standardized MDCT protocols. The location, type, and size (16-24 gauge) of IV catheters and volumes, iodine concentration, and flow rates of contrast medium were documented.

T1-weighted MRI for the detection of coronary artery plaque haemorrhage.

Objective: Hyperintense areas in atherosclerotic plaques on pre-contrast T1-weighted MRI have been shown to correlate with intraplaque haemorrhage. We evaluated the presence of T1 hyperintensity in coronary artery plaques in coronary artery disease (CAD) patients and correlated results with multi-detector computed tomography (MDCT) findings.

Methods: Fifteen patients with CAD were included.

Increasing sampling interval in cerebral perfusion CT: limitation for the maximum slope model.

Rationale And Objectives: The aim of this study was to evaluate increased sampling intervals on cerebral dynamic perfusion computed tomographic (PCT) imaging calculated using software relying on the maximum slope model.

Materials And Methods: PCT data sets from 32 patients with suspected acute stroke were acquired with a sampling interval of 1 image/s. The PCT data sets were modified to simulate sampling intervals of 2, 3, and 4 seconds.

Sonographic follow-up of the access site after arterial angiography: Impact on the detected complication rate.

Objective: This study prospectively evaluated the impact of sonographic follow-up on the detection rate of access site complications in arterial angiography and determined parameters associated with major complications of the access site after arterial angiography.

Methods: Sonographic follow-up (mean +/- SD, 1.46 +/- 1.

A systematic review on the clinical benefit and role of radiofrequency ablation as treatment of colorectal liver metastases.

Aim: To evaluate the role of radiofrequency ablation (RFA) as treatment of colorectal cancer liver metastases (CLMs).

Method: A PubMed literature search for original articles published until August 2008 was performed. Studies with 40 patients, 18 month median follow-up and reported 3 year overall survival (OS) rates after RFA of CLM were selected for analysis.

Update on multidetector coronary CT angiography of coronary stents: in vitro evaluation of 29 different stent types with dual-source CT.

The aim of this study was to test a large sample of the latest coronary artery stents using four image reconstruction approaches with respect to lumen visualization, lumen attenuation, and image noise in dual-source multidetector row CT (DSCT) in vitro and to provide a CT catalogue of currently used coronary artery stents. Twenty-nine different coronary artery stents (19 steel, 6 cobalt-chromium, 2 tantalum, 1 iron, 1 magnesium) were examined in a coronary artery phantom (vessel diameter 3 mm, intravascular attenuation 250 HU, extravascular density -70 HU). Stents were imaged in axial orientation with standard parameters: 32 x 0.

Global left-ventricular function assessment using dual-source multidetector CT: effect of improved temporal resolution on ventricular volume measurement.

The purpose was to compare global left-ventricular (LV) function parameters measured with cine MRI with results from multiphase dual-source CT (DSCT) using 10 and 20 reconstruction phases. Twenty-eight patients with suspected or known CAD underwent DSCT coronary angiography. LV end-diastolic (EDV), end-systolic (ESV) and stroke volumes (SV), and ejection fraction (EF) were determined using LV segmentation and selection of specific phases from DSCT image sets reconstructed either at 5% or 10% steps through the R-R interval.

Automated threshold-based 3D segmentation versus short-axis planimetry for assessment of global left ventricular function with dual-source MDCT.

Objective: The purpose of this study was to evaluate software for threshold-based 3D segmentation of the left ventricle in comparison with traditional 2D short axis-based planimetry (Simpson method) for measurement of left ventricular (LV) volume and global function with state-of-the-art dual-source CT.

Subjects And Methods: Fifty patients with known or suspected coronary artery disease underwent coronary CT angiography. LV end-diastolic, end-systolic, and stroke volumes and ejection fraction were determined from axial images to which 3D segmentation had been applied and from short-axis reformations from 2D planimetry.

Optimal systolic and diastolic reconstruction windows for coronary CT angiography using dual-source CT.

Objective: The purpose of this study was to determine the position of the optimal systolic and diastolic reconstruction intervals for coronary CT angiography using dual-source CT.

Subjects And Methods: In 90 patients, coronary dual-source CT angiography was performed without beta-blocking agents. Data were reconstructed in 5% steps throughout the R-R interval.

Intraindividual comparison of 3D coronary MR angiography and coronary CT angiography.

Rationale And Objectives: To compare the diagnostic value of magnetic resonance (MR) and computed tomography (CT) for the detection of coronary artery disease (CAD) with special regard to calcifications.

Materials And Methods: Twenty-seven patients with known CAD were examined with a targeted, navigator-gated, free-breathing, steady-state free precession MR angiography sequence (repetition time = 5.6 milliseconds, echo time = 2.

Comparison of different iodine concentration contrast media in perfusion computed tomography of the brain: is high iodine concentration useful?

Objectives: To investigate maximum enhancement and visual map quality in cerebral perfusion computed tomography (PCT) with variation of iodine concentration of contrast media (CM).

Materials And Methods: Two groups of 45 patients each, underwent PCT with either 370 mg iodine/mL (30 mL; 6 mL/s) or 300 mg iodine/mL (40 mL; 8 mL/s) CM, respectively, and similar total iodine dose. Parenchymal and vascular enhancement as well as contrast-to-noise ratio of superior sagittal sinus was measured on PCT source images.

Effective methods to correct contrast agent-induced errors in PET quantification in cardiac PET/CT.

Unlabelled: In combined PET/CT studies, x-ray attenuation information from the CT scan is generally used for PET attenuation correction. Iodine-containing contrast agents may induce artifacts in the CT-generated attenuation map and lead to an erroneous radioactivity distribution on the corrected PET images. This study evaluated 2 methods of thresholding the CT data to correct these contrast agent-related artifacts.

Perfusion CT in acute stroke: prediction of vessel recanalization and clinical outcome in intravenous thrombolytic therapy.

This study evaluated perfusion computed tomography (PCT) for the prediction of vessel recanalization and clinical outcome in patients undergoing intravenous thrombolysis. Thirty-nine patients with acute ischemic stroke of the middle cerebral artery territory underwent intravenous thrombolysis within 3 h of symptom onset. They all had non-enhanced CT (NECT), PCT, and CT angiography (CTA) before treatment.

High-resolution magnetic resonance imaging of the temporomandibular joint: image quality at 1.5 and 3.0 Tesla in volunteers.

Purpose: To assess the image quality of a high-resolution imaging protocol for the temporomandibular joint (TMJ) at 3.0 T and to compare it with our standard 1.5 T protocol.

Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia.

Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively.

The effect of dose reduction and feasibility of edge-preserving noise reduction on the detection of liver lesions using MSCT.

The purpose of this study was to assess the effect of dose reduction and the potential of noise reduction filters on image quality and the detection of liver lesions using MSCT. Twenty-nine patients with a total of 40 liver lesions underwent 16-slice CT (120 kV; 180 mAs). Virtual noise was added to CT raw datasets simulating effective mAs levels of 155, 130, 105, 80, 55, 30 and 10 mAs.

Electrocardiogram-independent image reconstruction in cardiac multidetector computed tomography using retrospective motion synchronization.

Objective: We sought to evaluate an electrocardiogram (ECG)-independent image reconstruction technique for coronary computed tomography (CT)-angiography based on cardiac motion.

Materials And Methods: The raw data from 20 patients was reconstructed with both an ECG-gated algorithm and a motion-dependent algorithm that calculates the cardiac motion-function directly from the CT raw data using a center of mass technique. Images were reconstructed in 5% steps over the R-R interval and the cardiac motion-cycle.