Pancreatic head resection for chronic pancreatitis in patients with extrahepatic generalized portal hypertension.

Background: Five percent to 10% of chronic pancreatitis (CP) cases are complicated by portal venous occlusion leading to extrahepatic generalized portal hypertension (GPH). Pancreatic head resections (PHR) are regarded risky or contraindicated in patients with extrahepatic GPH. The aim of our study was to analyze the outcome of patients with extrahepatic GPH undergoing PHR for CP and to propose recommendations for surgical strategy.

[Electronic distribution of patient records and images through PACS: implementation of data protection at the University Hospital in Freiburg].

In large installations of a Picture Archiving and Communication System (PACS), data protection becomes an issue. Above all, not every employee should have access to all data stored in the system. At the Freiburg University Hospital, we developed a concept of dynamic assignment of authorization, assuring that every physician is authorized to the data of all patients under his care.

Evaluation of Lossy data compression of chest X-rays: a receiver operating characteristic study.

Rationale And Objectives: To evaluate the quality of chest radiographs after 32:1 compression/decompression with different image compression algorithms.

Methods: Ten digital (Thoravison) radiographs of an anthropomorphic chest phantom with superimposed simulated nodular lesions (NL) and linear reticular lesions (LL) were obtained. Each radiograph was subdivided into 15 fields; they contained the lesions with a probability of 0.

Epithelioid angiosarcoma of the aorta.

Primary malignant tumors of the aorta are extremely rare. Review of the literature indicates that there are nearly 100 recorded cases of primary malignant tumors of the aorta. The purpose of this article is to present an additional case of the primary malignant tumors of the aorta which initially has been misinterpretated as atherosclerosic disease.

Combined radiofrequency thermal ablation and percutaneous cementoplasty treatment of a pathologic fracture.

Skeletal metastases commonly occur in patients with cancer and treatment is necessary to alleviate pain and prevent complications, such as mobility deficiencies and pathologic fractures. The authors present a patient with a stage IV malignant melanoma and a pathologic fracture of the left tibial plateau treated with radiofrequency heat ablation and percutaneous cementoplasty for defect filling and stabilization. The authors believe that this approach may be an alternative to the standard treatments in palliative-care situations.

Assessment of pulmonary perfusion with ultrafast projection magnetic resonance angiography in comparison with lung perfusion scintigraphy in patients with malignant stenosis.

Rationale And Objective: The aim of this study was to demonstrate and measure perfusion deficits caused by central bronchogenic carcinoma and to compare magnetic resonance angiography (MRA) perfusion data with data of perfusion scintigraphy. The diagnostic value of 2D MRA in detection of malignant pulmonary artery stenosis in comparison with conventional DSA was investigated.

Materials And Methods: Eighteen patients were included in the study.

Pulmonary sequestration: demonstration of blood supply with 2D and 3D MR angiography.

Pulmonary sequestration is a relatively rare but clinically significant congenital anomaly. This disease is a spectrum of disorders involving the pulmonary airways, the arterial supply to the lungs, the lung parenchyma and its venous drainage. Traditionally, the diagnosis of pulmonary sequestration has been made definitively with arterial angiography.

Percutaneous aortic valve replacement: an experimental study. I. Studies on implantation.

Objective: The purpose of this preliminary study was to devise a new surgical procedure for minimally invasive aortic valve implantation with a transluminal technique.

Methods: The new collapsible heart valve was prepared by mounting a porcine aortic valve, taken from a freshly slaughtered pig, into a self-expandable nitinol stent by means of a suture technique. The outer diameter of the valved stent ranged from 15 to 23 mm, and the length ranged from 21 to 28 mm.

Contrast enhanced MR angiography in the assessment of relevant stenoses in occlusive disease of the pelvic and lower limb arteries: diagnostic value of a two-step examination protocol in comparison to conventional DSA.

Introduction/objectives: Contrast-enhanced MRA (ce-MRA) has been claimed by many authors as a replacement of conventional angiography evaluating peripheral arterial occlusive disease. However, reliable detection of relevant stenoses (>70%) has to be provided for planning vascular interventions. Only few data in the literature focuses on this crucial problem.

[Explantation of aortic stent-grafts].

Background: Endoluminal stent graft placement for the treatment of infrarenal aortic aneurysms (AAA) has gained widespread acceptance because it is associated with lower perinterventional morbidity than conventional transabdominal surgery. In this study the long-term morbidity of the procedure was evaluated.

Methods And Results: Between 9/94 and 12/98, 150 patients (age = 69.

Serious complications that require surgical interventions after endoluminal stent-graft placement for the treatment of infrarenal aortic aneurysms.

Background: Endoluminal stent-graft placement for the treatment of infrarenal abdominal aortic aneurysms has gained widespread acceptance because it is associated with lower peri-interventional morbidity than conventional transabdominal surgery. In this study the long-term morbidity of the procedure was evaluated.

Methods And Results: Between September 1994 and December 1998, 150 patients (age, 69.

[Quality assessment using AGIR: results and experience].

Purpose: To evaluate whether a new software from the working group for interventional radiology (AGIR) is an appropriate tool for quality assurance in interventional radiology, and presentation of results acquired within the quality improvement process in 1999.

Patients And Methods: AGIR-defined parameters such as patient data, risk profile, given interventions as well as complications were registered by a recently developed software. Based on monthly data analyses, possible complications were identified and discussed in morbidity and mortality conferences.

[Preoperative examination of potential kidney transplantation donors: value of gadolinium-enhanced 3D MR angiography in comparison with DSA and urography].

Purpose: To assess a contrast-enhanced standardized MRA protocol for the presurgical evaluation of potential renal transplant donors.

Methods: Twenty-three potential donors for renal transplantations were examined with gadolinium-enhanced, two-phase MR angiograms (1.5 T) and DSA/urography for the number of renal arteries, the presence of aberrant arterial and venous branches, renal artery stenoses and anatomy of the renal collecting system and ureters.

Stents for the treatment of aortic aneurysms. Review of devices, technique and results.

The endovascular treatment of abdominal aortic aneurysms has generated a great deal of interest since the early 1990s, and many different devices are currently available. The procedure of endovascular repair has been evaluated in many institutions and the different devices are compared. The first results were encouraging, but complications like endoleak, dislocation or thrombosis of the graft occurred.

Pelvic imaging with a selenium-based detector (Thoravision). Comparison with screen-film radiography in 75 patients.

Objective: To evaluate whether the selenium detector (Thoravision) provides sufficient diagnostic confidence in digital pelvic imaging compared with a conventional screen-film combination.

Methods: In 75 patients, pelvic imaging with conventional screen-film and isodose selenium radiography using a dedicated postprocessing mode was compared independently by three radiologists. The depiction of cortical and cancellous bone was evaluated in the iliac wings, sacral and pubic bones, acetabulum, femoral head, and trochanter.

Chest wall infiltration by lung cancer: value of thin-sectional CT with different reconstruction algorithms.

The aim of this investigation was to evaluate whether thin-sectional CT with different reconstruction algorithms can improve the diagnostic accuracy with regard to chest wall invasion in patients with peripheral bronchogenic carcinoma. Forty-one patients with intrapulmonary lesions and tumor contact to the thoracic wall as seen on CT staging underwent additional 1-mm CT slices with reconstruction in a high-resolution (HR) and an edge blurring, soft detail (SD) algorithm. Five criteria were applied and validated by histological findings.

Contrast-enhanced subtraction MR angiography in occlusive disease of the pelvic and lower limb arteries: results of a prospective intraindividual comparative study with digital subtraction angiography in 76 patients.

Purpose: The purpose of this work was to evaluate the feasibility and clinical use of MR angiography (MRA) for examining the pelvic and lower limb arteries in patients with arterial occlusive disease.

Method: Seventy-six patients with clinical signs of peripheral arterial occlusive disease were included in the study. MRA was performed using a fast contrast-enhanced high-resolution 3D technique that covered the area from the distal abdominal aorta to the distal lower limbs in two examination steps.

Homing of intravenously and intralymphatically injected human dendritic cells generated in vitro from CD34+ hematopoietic progenitor cells.

Dendritic cells (DC) are professional antigen-presenting cells that can be generated in vitro from CD34+ peripheral blood progenitor cells by recombinant cytokines. These cells have potential implications for immunotherapeutic approaches in the treatment of cancer and other diseases. Physiologically, immature DC in the periphery capture and process antigens, then mature to interdigitating DC and migrate to lymphoid organs, where they activate lymphocytes.

Functional MR imaging of the cervical spine in patients with rheumatoid arthritis.

Purpose: To evaluate functional MR imaging in patients with rheumatoid arthritis (RA) involving the cervical spine.

Material And Methods: We used a device that allows MR examination to be made of the cervical spine in infinitely variable degrees of flexion and extension. Dynamic functional MR imaging was performed on 25 patients with RA.

Prospective evaluation of bone marrow signal changes on magnetic resonance tomography during high-dose chemotherapy and peripheral blood stem cell transplantation in patients with breast cancer.

Rationale And Objectives: The authors evaluate bone marrow signal changes on magnetic resonance (MR) imaging during high-dose chemotherapy and peripheral blood stem cell transplantation (PBSCT).

Methods: Fourteen patients with breast cancer without bone metastases underwent four sagittal MR imaging studies with T1-weighted, T2-weighted turbo spin-echo and inversion recovery sequences with short inversion time (STIR) of the lumbar spine: (1) during initial staging, (2) prior to high-dose chemotherapy after two cycles of induction chemotherapy, (3) early after PBSCT with a leukocyte exceeding 2000/microL, and (4) 6 to 8 weeks after PBSCT. Signal intensity ratios of averaged lumbar bone marrow to nucleus pulposus were measured and homogeneity was evaluated visually using a semiquantitative score.

Comparative diagnostic accuracy of magnetic resonance imaging and immunoscintigraphy for detection of bone marrow involvement in patients with malignant lymphoma.

Purpose: To compare the diagnostic accuracy of magnetic resonance imaging (MRI) and immunoscintigraphy (IS) for detection of bone marrow infiltration in malignant lymphoma.

Patients And Methods: In 32 patients with Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL), MRI of the axial skeleton and whole-body IS using technetium-99m (99mTc)-labeled monoclonal antibodies were reviewed and compared with iliac crest biopsies. Criterion for marrow infiltration was a positive biopsy or concordant positive results of MRI and IS.