Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of t... more Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of this study was to longitudinally evaluate viscoelasticity changes in the liver and in kidney allografts in kidney transplant recipients (KTRs) with HCV infection after treatment with direct-acting antiviral agents (DAAs). Fifteen KTRs with HCV infection were treated with DAAs (daclatasvir and sofosbuvir) for 3 months and monitored at baseline, end of treatment (EOT), and 3 (FU1) and 12 (FU2) months after EOT. Shear-wave speed (SWS) and loss angle of the complex shear modulus (φ), reflecting stiffness and fluidity, respectively, were reconstructed from multifrequency magnetic resonance elastography data with tomoelastography post-processing. After virus elimination by DAAs, hepatic stiffness and fluidity decreased, while kidney allograft stiffness and fluidity increased compared with baseline (hepatic stiffness change at FU1: −0.14 m/s, p < 0.01, and at FU2: −0.11 m/s, p < 0.05; flui...
ZusammenfassungDieser Übersichtsartikel stellt detailliert die derzeitigen Einsatzgebiete der Pos... more ZusammenfassungDieser Übersichtsartikel stellt detailliert die derzeitigen Einsatzgebiete der Positronen-Emissions-Tomografie/Computertomografie (PET/CT) bei dem Management von Lungenkarzinom-Patient*innen dar. Hierbei werden Indikationen, Wertigkeit bei Dignitätsbeurteilung und Stadiierung sowie Nutzen, Limitationen und prognostische Relevanz dieses diagnostischen Hybridverfahrens beleuchtet.Darüber hinaus bietet diese Publikation einen Ausblick auf neue Radiotracer und mehrschichtige maschinelle Lernverfahren als konsequente Weiterentwicklungen der PET/CT, welche deren diagnostischen, prädiktiven und prognostischen Zusatznutzen zukünftig noch vergrößern wird.
Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosi... more Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosis and management may result in rapid and catastrophic postpartum hemorrhage and may necessitate hysterectomy or can even be fatal. A 28‐year‐old woman (gravida I, para I) presented with delayed postpartum hemorrhage 10 days after emergency cesarean section. Using transabdominal and transvaginal Color Doppler sonography, we detected a pseudoaneurysm in the posterior uterine wall, which was successfully treated with selective embolization distal and proximal to the lesion with platinum coils. In patients with delayed postpartum hemorrhage—especially after cesarean section—the rare possibility of uterine artery pseudoaneurysm must be kept in mind.
Background Abdominal aortic aneurysm has become increasingly important owing to demographic chang... more Background Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm. Methods We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis. Results The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significant...
Abdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases,... more Abdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA. Two groups of patients (100/group), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis. SRC (73% vs. 57%; p<0.001) and CKD (31% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analy...
Objective To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. Met... more Objective To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. Methods After consensus on definitions/locations of MRI pathologies, four multi-reader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, thirty-three entheses 0-3 separately for soft tissue inflammation and osteitis. Results In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency. Median pairwise single-measure/average-measure ICCs were 0.67/0.80 for status scores and 0.69/0.82 for change scores; kappas ranged 0.35-0.77. Conclusion WBMRI scoring of peripheral arthritis and enthesitis is reliable which encourages further testing and refinement in clinical trials.
Background Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (AS), showing evidenc... more Background Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (AS), showing evidence of sacroiliitis on x-rays, and non-radiographic (nr) axSpA, which is regarded as an early form. To date it is not completely understood whether nr-axSpA shows more inflammation at the beginning that later diminishes or vice versa. Secondly, it is of interest to what extent structural damage is already detectable in the earliest stages of nr-axSpA. Whole-body MRI (wbMRI) is a technique to image the entire axial skeleton in a reasonable amount of time. Objectives To utilise wb-MRI for the evaluation of both active and structural lesions in nr-axSpA in comparison to AS. Methods 75 patients (mean age 33±8 yrs.) with axSpA were recruited as part of the ESTHER trial (1). Baseline data were analysed for the purpose of this evaluation. Symptom duration was less than 5 years and included patients had to be positive for inflammation at spine or sacroiliac joints (SIJ). Patients were scanned with a comprehensive wbMRI protocol and scored for active inflammatory lesions as well as structural changes in the spine and SIJs (Berlin wb-MRI score) (1). Separation into nr-axSpA and AS patients was made on the basis of x-rays (fullfillment of mod. NY X-ray criteria). Results The study cohort consisted of 39 patients with AS and 36 nr-axSpA patients. Clinical characteristics were similar for both groups. In the AS group 92% of the patients showed active inflammatory lesions in the SIJ (score 7.6±6.3), 53% in the spine (score 2.6±4.1), but only 5% showed spinal inflammation without sacroiliitis. MRI-inflammation was found slightly less in he nr-axSpA-group, although this difference was not significant: 94% (score 5.7±5.2), 39% (score 1.1±1.9) and 2%, respectively. The posterior segments of the spine were affected in significantly (p=0.04) more patients in the AS (n=10) than in the nr-axSpA group (n=3). SIJ fatty bone marrow deposition was more frequent (p=0.001) in AS (score of 4.8±3.2) compared to nr-axSpA (score 2.4±2.7) patients. SIJ erosions were non-significantly more common in AS (score 4.2±2.3) than in nr-axSpA (score 3.8±1.8) patients. Bone proliferation on the spine and SIJ were more frequent in the AS vs. nr-axSpA group (p=0.02 and p=0.005, respectively). Conclusions Whole body MRI is feasible method to depict SpA-associated changes of the entire axial skeleton comprehensively. As expected, AS patients show more structural damage on MRI than nr-axSpA patients including fatty bone marrow deposition, erosions, and bone proliferation. However, the amount of active inflammation on MRI is similar for both groups, with only a trend for higher activity scores in the AS group. References Song IH, Hermann KG, Haibel H, Althoff CE, et al. Ann Rheum Dis. 2011 Apr;70(4):590-6. Disclosure of Interest None Declared
BACKGROUND High blood flow and low recirculation rates are central for adequate haemodialysis. A ... more BACKGROUND High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed. OBJECTIVE To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting. MATERIAL AND METHODS After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12.2), access recirculation was evaluated using the urea-based recirculation test. After 30 minutes of haemodialysis, ultrafiltration was stopped and arterial and venous samples were taken. Afterwards, the blood flow rate was reduced to 120 ml/min. Another systemic arterial blood sample was taken 10 seconds after the blood pump was switched off. RESULTS All 20 interventions were performed successfully without complications. The average recirculation rate was 8.1% with a median of 2.5% ranging from 0 to 85.8%. Recirculation rates under 5% were measured in 13 patients and more than 10% recirculation were found in two patients. The median of days between catheter implantation and recirculation assessment was the day following implantation. CONCLUSION The new symmetrical catheter presented low recirculation rates in a clinical setting. Since there is just a single tip, fluoroscopic placement in the right atrium is facilitated.
Whole-body magnetic resonance imaging (WB-MRI) is a relatively new technique that can enable asse... more Whole-body magnetic resonance imaging (WB-MRI) is a relatively new technique that can enable assessment of the overall inflammatory status of people with arthritis, but standards for image acquisition, definitions of key pathologies, and a quantification system are required. Our aim was to perform a systematic literature review (SLR) and to develop consensus definitions of key pathologies, anatomical locations for assessment, a set of MRI sequences and imaging planes for the different body regions, and a preliminary scoring system for WB-MRI in inflammatory arthritis. An SLR was initially performed, searching for WB-MRI studies in arthritis, osteoarthritis, spondyloarthritis, or enthesitis. These results were presented to a meeting of the MRI in Arthritis Working Group together with an MR image review. Following this, preliminary standards for WB-MRI in inflammatory arthritides were developed with further iteration at the Working Group meetings at the Outcome Measures in Rheumatolog...
Biomedizinische Technik. Biomedical engineering, Jan 11, 2017
To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscl... more To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscle, vertebral disc, soft tissue, and other lesions using balanced steady-state free precession (SSFP, balanced fast field echo: bFFE), spoiled and nonspoiled gradient echo (FFE), and turbo spin echo (TSE) sequences for interactive continuous navigation in an open magnetic resonance imaging (MRI) system at 1.0 tesla (T). Twenty-six MR-guided biopsies (five liver, five bone, four muscle, four vertebral disc, one lung, one kidney, one suprarenal gland, and five soft or other tissue) were performed in 23 patients in a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO, Philips Healthcare, Best, the Netherlands). A total of 42 samples were obtained. Depending on lesion size and location, 14-18-gauge MR-compatible biopsy sets with a length of 100 or 200 mm (Somatex Medical, Teltow, Germany), 14-18-gauge MR-compatible semiautomatic biopsy guns with a length of 100 or 150 mm (Invivo, Schwer...
We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear w... more We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear wave speed (SWS) measured by multi-frequency time-harmonic ultrasound elastography (THE) before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation. Ten patients with ascites, cirrhotic liver disease and portal hypertension were prospectively examined with invasive HVPG measurement and THE before and after TIPS implantation. HVPG and SWS decreased after TIPS placement from 20.4 ± 2.2 mmHg to 9.8 ± 4.1 mmHg (mean ± standard deviation) and from 3.87 ± 0.54 m/s to 3.27 ± 0.44 m/s. Mean reduction HVPG was -10.6 ± 3.7 mmHg, p < 0.001; mean reduction SWS was -0.60 ± 0.29 m/s, p < 0.001. A linear correlation was observed between HVPG and SWS (R = 0.59, p = 0.0061). THE-measured SWS is a first potential direct ultrasound marker for liver decompression following TIPS in ascites-associated cirrhotic liver disease and therefore might be suitable to non-invasively detect...
To compare clinical examination versus whole-body magnetic resonance imaging (WB-MRI) of enthesit... more To compare clinical examination versus whole-body magnetic resonance imaging (WB-MRI) of enthesitis in patients with early axial spondyloarthritis during 3 years of continuous etanercept (ETN) treatment. Forty-one patients underwent clinical and WB-MRI examinations for enthesitis at baseline and after 2 and 3 years of treatment. Twenty-one sites were assessed in 4 anatomic regions - anterior chest wall, pelvis, knee, and foot. Clinical examination at baseline detected enthesitis in 57% of the patients (85 lesions, mean 2.1 lesions, SD 2.9), most of them in the pelvis (42 lesions in 17 patients) and anterior chest wall (19 lesions in 10 patients). The proportion of patients with clinically detected enthesitis decreased to 19% at Year 2 (mean 0.5, SD 1.5) and 14% at Year 3 (mean 0.7, SD 1.8). WB-MRI detected enthesitis at baseline in 21% of patients (22 lesions, mean 0.5 lesions, SD 1.1), also most frequently in the pelvis (12 lesions) and anterior chest wall (7 lesions). MRI-positive...
The aim of the study was to test the sensitivity of liver stiffness (LS) measured by time harmoni... more The aim of the study was to test the sensitivity of liver stiffness (LS) measured by time harmonic elastography in large tissue windows to water uptake and post-prandial effects. Each subject gave written informed consent to participate in this institutional review board-approved prospective study. LS was measured by time harmonic elastography in 10 healthy volunteers pre- and post-prandially, as well as before, directly after and 2 h after drinking water. The LS-time function during water intake was measured in 14 scans over 3 h in five volunteers. LS increased by 10% (p = 0.0015) post-prandially and by 11% (p = 0.0024) after pure water ingestion, and decreased to normal values after 2 h. LS was lower after overnight fasting than after 2-h fasting (3%, p = 0.04). Over the time course, LS increased to post-water peak values 15 min after drinking 0.25 L water and remained unaffected by further ingestion of water. In conclusion, our study indicates that LS measured by time harmonic el...
ABSTRACT LEARNING OBJECTIVES 1) Identification of bone and joint disorders that also have skin ma... more ABSTRACT LEARNING OBJECTIVES 1) Identification of bone and joint disorders that also have skin manifestations. 2) Classification of these disorders and their common radiographic characteristics. 3) Differentiation on the basis of their X-ray appearance. 4) Identification of important skin changes in psoriasis, SAPHO syndrome, sclerodermia, and sarcoidosis. ABSTRACT A number of skin diseases also affect the bones and joints and are thus of interest to the radiologist. The focus of the current presentation is on three groups of diseases: rheumatoid diseases, collagen diseases, and granulomatous diseases. For each group, characteristic radiographic features are presented and differentiated along with clinical photographs which demonstrate the skin changes. The first group includes psoriasis and SAPHO syndrome. The many radiological changes occurring in psoriatic arthritis are presented synoptically. These features are grouped in a severity scale also useful for image interpretation in the routine setting. Diseases discussed in the collagen group are scleroderma (including CREST syndrome), dermatomyositis, and Sharp syndrome. In the third group sarcoidosis, multicentric reticulohistiocytosis, and eosinophilic granuloma are presented. The poster aims to help the radiologist to better recognize, familiarize and understand these in part rare disorders
Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of t... more Besides the liver, hepatitis C virus (HCV) infection also affects kidney allografts. The aim of this study was to longitudinally evaluate viscoelasticity changes in the liver and in kidney allografts in kidney transplant recipients (KTRs) with HCV infection after treatment with direct-acting antiviral agents (DAAs). Fifteen KTRs with HCV infection were treated with DAAs (daclatasvir and sofosbuvir) for 3 months and monitored at baseline, end of treatment (EOT), and 3 (FU1) and 12 (FU2) months after EOT. Shear-wave speed (SWS) and loss angle of the complex shear modulus (φ), reflecting stiffness and fluidity, respectively, were reconstructed from multifrequency magnetic resonance elastography data with tomoelastography post-processing. After virus elimination by DAAs, hepatic stiffness and fluidity decreased, while kidney allograft stiffness and fluidity increased compared with baseline (hepatic stiffness change at FU1: −0.14 m/s, p < 0.01, and at FU2: −0.11 m/s, p < 0.05; flui...
ZusammenfassungDieser Übersichtsartikel stellt detailliert die derzeitigen Einsatzgebiete der Pos... more ZusammenfassungDieser Übersichtsartikel stellt detailliert die derzeitigen Einsatzgebiete der Positronen-Emissions-Tomografie/Computertomografie (PET/CT) bei dem Management von Lungenkarzinom-Patient*innen dar. Hierbei werden Indikationen, Wertigkeit bei Dignitätsbeurteilung und Stadiierung sowie Nutzen, Limitationen und prognostische Relevanz dieses diagnostischen Hybridverfahrens beleuchtet.Darüber hinaus bietet diese Publikation einen Ausblick auf neue Radiotracer und mehrschichtige maschinelle Lernverfahren als konsequente Weiterentwicklungen der PET/CT, welche deren diagnostischen, prädiktiven und prognostischen Zusatznutzen zukünftig noch vergrößern wird.
Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosi... more Pseudoaneurysm of the uterine artery is a rare complication of cesarean section. Delayed diagnosis and management may result in rapid and catastrophic postpartum hemorrhage and may necessitate hysterectomy or can even be fatal. A 28‐year‐old woman (gravida I, para I) presented with delayed postpartum hemorrhage 10 days after emergency cesarean section. Using transabdominal and transvaginal Color Doppler sonography, we detected a pseudoaneurysm in the posterior uterine wall, which was successfully treated with selective embolization distal and proximal to the lesion with platinum coils. In patients with delayed postpartum hemorrhage—especially after cesarean section—the rare possibility of uterine artery pseudoaneurysm must be kept in mind.
Background Abdominal aortic aneurysm has become increasingly important owing to demographic chang... more Background Abdominal aortic aneurysm has become increasingly important owing to demographic changes. Some other diseases, for example, cholecystolithiasis, chronic obstructive pulmonary disease, and hernias, seem to co-occur with abdominal aortic aneurysm. The aim of this retrospective analysis was to identify new comorbidities associated with abdominal aortic aneurysm. Methods We compared 100 patients with abdominal aortic aneurysms and 100 control patients. Their preoperative computed tomographic scans were examined by two investigators independently, for the presence of hernias, diverticulosis, and cholecystolithiasis. Medical records were also reviewed. Statistical analysis was performed using univariate analysis and multiple logistic regression analysis. Results The aneurysm group had a higher frequency of diverticulosis (p = 0.008). There was no significant difference in the occurrence of hernia (p = 0.073) or cholecystolithiasis (p = 1.00). Aneurysm patients had a significant...
Abdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases,... more Abdominal aortic aneurysms (AAA) primarily affect elderly men who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA. Two groups of patients (100/group), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis. SRC (73% vs. 57%; p<0.001) and CKD (31% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analy...
Objective To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. Met... more Objective To develop a whole-body MRI-scoring system for peripheral arthritis and enthesitis. Methods After consensus on definitions/locations of MRI pathologies, four multi-reader exercises were performed. Eighty-three joints were scored 0-3 separately for synovitis and osteitis, thirty-three entheses 0-3 separately for soft tissue inflammation and osteitis. Results In the last exercise, reliability was moderate-good for musculoskeletal radiologists and rheumatologists with previously demonstrated good scoring proficiency. Median pairwise single-measure/average-measure ICCs were 0.67/0.80 for status scores and 0.69/0.82 for change scores; kappas ranged 0.35-0.77. Conclusion WBMRI scoring of peripheral arthritis and enthesitis is reliable which encourages further testing and refinement in clinical trials.
Background Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (AS), showing evidenc... more Background Axial spondyloarthritis (axSpA) comprises ankylosing spondylitis (AS), showing evidence of sacroiliitis on x-rays, and non-radiographic (nr) axSpA, which is regarded as an early form. To date it is not completely understood whether nr-axSpA shows more inflammation at the beginning that later diminishes or vice versa. Secondly, it is of interest to what extent structural damage is already detectable in the earliest stages of nr-axSpA. Whole-body MRI (wbMRI) is a technique to image the entire axial skeleton in a reasonable amount of time. Objectives To utilise wb-MRI for the evaluation of both active and structural lesions in nr-axSpA in comparison to AS. Methods 75 patients (mean age 33±8 yrs.) with axSpA were recruited as part of the ESTHER trial (1). Baseline data were analysed for the purpose of this evaluation. Symptom duration was less than 5 years and included patients had to be positive for inflammation at spine or sacroiliac joints (SIJ). Patients were scanned with a comprehensive wbMRI protocol and scored for active inflammatory lesions as well as structural changes in the spine and SIJs (Berlin wb-MRI score) (1). Separation into nr-axSpA and AS patients was made on the basis of x-rays (fullfillment of mod. NY X-ray criteria). Results The study cohort consisted of 39 patients with AS and 36 nr-axSpA patients. Clinical characteristics were similar for both groups. In the AS group 92% of the patients showed active inflammatory lesions in the SIJ (score 7.6±6.3), 53% in the spine (score 2.6±4.1), but only 5% showed spinal inflammation without sacroiliitis. MRI-inflammation was found slightly less in he nr-axSpA-group, although this difference was not significant: 94% (score 5.7±5.2), 39% (score 1.1±1.9) and 2%, respectively. The posterior segments of the spine were affected in significantly (p=0.04) more patients in the AS (n=10) than in the nr-axSpA group (n=3). SIJ fatty bone marrow deposition was more frequent (p=0.001) in AS (score of 4.8±3.2) compared to nr-axSpA (score 2.4±2.7) patients. SIJ erosions were non-significantly more common in AS (score 4.2±2.3) than in nr-axSpA (score 3.8±1.8) patients. Bone proliferation on the spine and SIJ were more frequent in the AS vs. nr-axSpA group (p=0.02 and p=0.005, respectively). Conclusions Whole body MRI is feasible method to depict SpA-associated changes of the entire axial skeleton comprehensively. As expected, AS patients show more structural damage on MRI than nr-axSpA patients including fatty bone marrow deposition, erosions, and bone proliferation. However, the amount of active inflammation on MRI is similar for both groups, with only a trend for higher activity scores in the AS group. References Song IH, Hermann KG, Haibel H, Althoff CE, et al. Ann Rheum Dis. 2011 Apr;70(4):590-6. Disclosure of Interest None Declared
BACKGROUND High blood flow and low recirculation rates are central for adequate haemodialysis. A ... more BACKGROUND High blood flow and low recirculation rates are central for adequate haemodialysis. A new symmetrical tip has been invented promising efficient haemodialysis even if the ports are reversed. OBJECTIVE To evaluate access recirculation of the 'palindrome' catheter and to report initial experiences in a clinical setting. MATERIAL AND METHODS After implantation of the new catheter in 20 patients (male: 14; female: 6; mean age 72 ± 12.2), access recirculation was evaluated using the urea-based recirculation test. After 30 minutes of haemodialysis, ultrafiltration was stopped and arterial and venous samples were taken. Afterwards, the blood flow rate was reduced to 120 ml/min. Another systemic arterial blood sample was taken 10 seconds after the blood pump was switched off. RESULTS All 20 interventions were performed successfully without complications. The average recirculation rate was 8.1% with a median of 2.5% ranging from 0 to 85.8%. Recirculation rates under 5% were measured in 13 patients and more than 10% recirculation were found in two patients. The median of days between catheter implantation and recirculation assessment was the day following implantation. CONCLUSION The new symmetrical catheter presented low recirculation rates in a clinical setting. Since there is just a single tip, fluoroscopic placement in the right atrium is facilitated.
Whole-body magnetic resonance imaging (WB-MRI) is a relatively new technique that can enable asse... more Whole-body magnetic resonance imaging (WB-MRI) is a relatively new technique that can enable assessment of the overall inflammatory status of people with arthritis, but standards for image acquisition, definitions of key pathologies, and a quantification system are required. Our aim was to perform a systematic literature review (SLR) and to develop consensus definitions of key pathologies, anatomical locations for assessment, a set of MRI sequences and imaging planes for the different body regions, and a preliminary scoring system for WB-MRI in inflammatory arthritis. An SLR was initially performed, searching for WB-MRI studies in arthritis, osteoarthritis, spondyloarthritis, or enthesitis. These results were presented to a meeting of the MRI in Arthritis Working Group together with an MR image review. Following this, preliminary standards for WB-MRI in inflammatory arthritides were developed with further iteration at the Working Group meetings at the Outcome Measures in Rheumatolog...
Biomedizinische Technik. Biomedical engineering, Jan 11, 2017
To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscl... more To assess the feasibility, image quality, and accuracy of freehand biopsies of liver, bone, muscle, vertebral disc, soft tissue, and other lesions using balanced steady-state free precession (SSFP, balanced fast field echo: bFFE), spoiled and nonspoiled gradient echo (FFE), and turbo spin echo (TSE) sequences for interactive continuous navigation in an open magnetic resonance imaging (MRI) system at 1.0 tesla (T). Twenty-six MR-guided biopsies (five liver, five bone, four muscle, four vertebral disc, one lung, one kidney, one suprarenal gland, and five soft or other tissue) were performed in 23 patients in a 1.0-T open magnetic resonance (MR) scanner (Panorama HFO, Philips Healthcare, Best, the Netherlands). A total of 42 samples were obtained. Depending on lesion size and location, 14-18-gauge MR-compatible biopsy sets with a length of 100 or 200 mm (Somatex Medical, Teltow, Germany), 14-18-gauge MR-compatible semiautomatic biopsy guns with a length of 100 or 150 mm (Invivo, Schwer...
We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear w... more We investigated the correlation between hepatic venous pressure gradient (HVPG) and liver shear wave speed (SWS) measured by multi-frequency time-harmonic ultrasound elastography (THE) before and after transjugular intrahepatic portosystemic shunt (TIPS) implantation. Ten patients with ascites, cirrhotic liver disease and portal hypertension were prospectively examined with invasive HVPG measurement and THE before and after TIPS implantation. HVPG and SWS decreased after TIPS placement from 20.4 ± 2.2 mmHg to 9.8 ± 4.1 mmHg (mean ± standard deviation) and from 3.87 ± 0.54 m/s to 3.27 ± 0.44 m/s. Mean reduction HVPG was -10.6 ± 3.7 mmHg, p < 0.001; mean reduction SWS was -0.60 ± 0.29 m/s, p < 0.001. A linear correlation was observed between HVPG and SWS (R = 0.59, p = 0.0061). THE-measured SWS is a first potential direct ultrasound marker for liver decompression following TIPS in ascites-associated cirrhotic liver disease and therefore might be suitable to non-invasively detect...
To compare clinical examination versus whole-body magnetic resonance imaging (WB-MRI) of enthesit... more To compare clinical examination versus whole-body magnetic resonance imaging (WB-MRI) of enthesitis in patients with early axial spondyloarthritis during 3 years of continuous etanercept (ETN) treatment. Forty-one patients underwent clinical and WB-MRI examinations for enthesitis at baseline and after 2 and 3 years of treatment. Twenty-one sites were assessed in 4 anatomic regions - anterior chest wall, pelvis, knee, and foot. Clinical examination at baseline detected enthesitis in 57% of the patients (85 lesions, mean 2.1 lesions, SD 2.9), most of them in the pelvis (42 lesions in 17 patients) and anterior chest wall (19 lesions in 10 patients). The proportion of patients with clinically detected enthesitis decreased to 19% at Year 2 (mean 0.5, SD 1.5) and 14% at Year 3 (mean 0.7, SD 1.8). WB-MRI detected enthesitis at baseline in 21% of patients (22 lesions, mean 0.5 lesions, SD 1.1), also most frequently in the pelvis (12 lesions) and anterior chest wall (7 lesions). MRI-positive...
The aim of the study was to test the sensitivity of liver stiffness (LS) measured by time harmoni... more The aim of the study was to test the sensitivity of liver stiffness (LS) measured by time harmonic elastography in large tissue windows to water uptake and post-prandial effects. Each subject gave written informed consent to participate in this institutional review board-approved prospective study. LS was measured by time harmonic elastography in 10 healthy volunteers pre- and post-prandially, as well as before, directly after and 2 h after drinking water. The LS-time function during water intake was measured in 14 scans over 3 h in five volunteers. LS increased by 10% (p = 0.0015) post-prandially and by 11% (p = 0.0024) after pure water ingestion, and decreased to normal values after 2 h. LS was lower after overnight fasting than after 2-h fasting (3%, p = 0.04). Over the time course, LS increased to post-water peak values 15 min after drinking 0.25 L water and remained unaffected by further ingestion of water. In conclusion, our study indicates that LS measured by time harmonic el...
ABSTRACT LEARNING OBJECTIVES 1) Identification of bone and joint disorders that also have skin ma... more ABSTRACT LEARNING OBJECTIVES 1) Identification of bone and joint disorders that also have skin manifestations. 2) Classification of these disorders and their common radiographic characteristics. 3) Differentiation on the basis of their X-ray appearance. 4) Identification of important skin changes in psoriasis, SAPHO syndrome, sclerodermia, and sarcoidosis. ABSTRACT A number of skin diseases also affect the bones and joints and are thus of interest to the radiologist. The focus of the current presentation is on three groups of diseases: rheumatoid diseases, collagen diseases, and granulomatous diseases. For each group, characteristic radiographic features are presented and differentiated along with clinical photographs which demonstrate the skin changes. The first group includes psoriasis and SAPHO syndrome. The many radiological changes occurring in psoriatic arthritis are presented synoptically. These features are grouped in a severity scale also useful for image interpretation in the routine setting. Diseases discussed in the collagen group are scleroderma (including CREST syndrome), dermatomyositis, and Sharp syndrome. In the third group sarcoidosis, multicentric reticulohistiocytosis, and eosinophilic granuloma are presented. The poster aims to help the radiologist to better recognize, familiarize and understand these in part rare disorders
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