Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren最新文献

Intussusception in adult patients is a rare medical finding, which is accompanied by an underlying tumor in some cases. However, no accepted method has been established to identify patients at risk for tumor-related intussusception. This study aimed to identify imaging features as predictors for tumor-related intussusception.CT images of patients with confirmed intussusception were retrospectively acquired between 01/2008 and 12/2022. Available follow-up images and medical health records were evaluated to identify various imaging features, the cause of intussusception, and treatment strategies. Imaging interpretation was conducted by two blinded radiologists. A third radiologist was consulted in cases of disagreement.A total of 71 consecutive patients were included in this study (42 males, 29 females) with a median age of 56 years (interquartile range: 40.5-73.8 years). Enteroenteric intussusceptions in the small bowel were the most common type observed in adult patients. In contrast, colocolic intussusception was more frequently associated with malignancy, and this association was statistically significant (p < 0.05). Among the malignant tumors, adenocarcinoma was the most common, followed by metastases and lymphoma. Additionally, bowel obstruction and wall thickening were significantly correlated with malignancy (p < 0.05). The high negative predictive values (NPVs) and high specificities for ileus (NPV 88.5%, specificity 82.1%), bowel wall thickening (NPV 90.9%, specificity 71.4%), and acute abdomen (NPV 84.6%, specificity 78.8%) suggest that the absence of these features strongly predicts a low probability of malignancy in cases of adult intussusception.Active surveillance with follow-up exams is suitable for asymptomatic and transient intussusception when imaging features suggest a low likelihood of a neoplasm. Additionally, malignancy predictors such as ileus and thickening of the bowel wall in the affected segment could guide tailored treatment. Surgical interventions are essential for symptomatic cases, with adenocarcinoma being the most common malignancy found in colocolic intussusceptions.Intussusception in adults is rare and is often associated with underlying tumors, particularly in colocolic intussusceptions. Key imaging predictors for malignancy include bowel obstruction, wall thickening in the affected segment, and the presence of acute abdomen, with high NPVs and specificities indicating low malignancy risk when these features are absent. Active surveillance is recommended for asymptomatic cases with low neoplasm probability, while surgical intervention is the method of choice for symptomatic patients. · Reschke P, Le Hong QA, Gruenewald LD et al. Malignancy predictors and treatment strategies for adult intestinal intussusception. Fortschr Röntgenstr 2024; DOI 10.1055/a-2434-7932.

To evaluate the current status of the diagnosis of gastrointestinal tumors in Germany by means of a survey of the oncological imaging working group of the German Radiological Society (DRG) with a focus on the CT protocols being used.Radiologists working in outpatient or inpatient care in Germany were invited. The survey was conducted between 10/2022 and 06/2023 using the SurveyMonkey web tool. Questions related to gastrointestinal cancer were asked with regard to the commonly used imaging modalities, body coverage, and contrast agent phases in CT as well as the use of oral or rectal contrast. The results of the survey were analyzed using descriptive statistics.Clear differences were identified regarding the acquired contrast phases in relation to the place of work - outpatient care, smaller hospitals, maximum care hospitals, or university hospitals. Variances were also recognized regarding oral and rectal contrast. Based on the results and international guidelines, proposals for CT protocols were derived.CT protocols in Germany show a heterogeneous picture regarding acquired contrast phases, as well as oral and rectal contrast for the staging of gastrointestinal cancer. Clear recommendations in the respective guidelines would aid in quality assurance and comparability between different centers. · The examination protocols for the staging of gastrointestinal tumors are heterogeneous in Germany.. · The application of oral and rectal contrast is handled differently at the various radiological centers.. · Standardization of imaging should be targeted.. · Gerwing M, Ristow I, Afat S et al. Standardized diagnosis of gastrointestinal tumors: an update regarding the situation in Germany. Fortschr Röntgenstr 2024; DOI 10.1055/a-2378-6451.

This study investigated gender- and personality-specific differences in academic qualifications, research motivation, and options to increase the attractiveness of leadership positions in radiology.A validated questionnaire with 66 questions was distributed via the German Roentgen Society and individually sent to 4,500 radiologists in Germany. Participants were asked about their gender. Personality dimensions were assessed using the OCEAN (Big Five) model. Multivariable regression analyses were employed.Of 510 included participants (women 237 (46.5%)), men were four times more likely to have acquired an associated professorship (AP, Habilitation Privatdozent) ((odds ratio (OR) 4.39 (2.22-8.67)). Also, they planned to achieve an AP more frequently (OR 2.87 (1.47-5.61)). The only gender-specific motivator for an AP was the option to become eligible for the position of chief physician (men OR 2.56 (1.07-6.15)). Mentors increased the probability of acquiring an AP (OR 2.07 (1.13-3.80)) or striving for an AP (4.82 (2.39-9.73)). Female mentees were likelier to have female mentors (OR 4.62 (1.68-12.73)). To increase the attractiveness of leadership positions, female radiologists perceived gender balance at the management level (OR 3.32 (2.28-4.82)), top sharing (OR 2.22 (1.48-3.32)), and better work-life balance (OR 2.02 (1.19-3.43)) as more relevant than male radiologists. More pronounced openness (OR 1.62 (1.10-2.38)) and extroversion (OR 1.45 (1.07-1.97)) were positively associated with planning an AP. More pronounced agreeableness (OR 0.67 (0.50-0.91)) was negatively associated.Research motivation is mainly independent of gender. Academic qualification varies with gender and personality dimensions. Mentoring, female role models, top sharing, and better work-family compatibility could motivate women to pursue academic leadership. · Male radiologists are more frequently motivated to pursue an associated professorship by the option of becoming a chief physician.. · Openness and extroversion make pursuing an associated professorship more likely.. · Role models at the management level, top sharing, and flexible work time are more important for female radiologists.. · Molwitz I, Kemper C, Stahlmann K et al. Gender- and personality-specific differences in academic qualifications, research motivation, and attractiveness of leadership positions: a survey among radiologists from Germany. Fortschr Röntgenstr 2024; DOI 10.1055/a-2415-7337.

Augmented reality (AR) projects additional information into the user's field of view during interventions. The aim was to evaluate the acceptance and clinical feasibility of an AR system and to compare users with different levels of experience. A system was examined that projects a CT-generated 3D model of a phantom into the field of view using a HoloLens 2, whereby the tracked needle is displayed and navigated live. A projected ultrasound image is used for live control of the needle positioning. This should minimize radiation exposure and improve orientation.The acceptance and usability of the AR navigation system was evaluated by 10 physicians and medical students with different levels of experience by performing punctures with the system in a phantom. The required time was then compared and a questionnaire was completed to assess clinical acceptance and feasibility. For statistical analysis, frequencies for qualitative characteristics, location and dispersion measures for quantitative characteristics and Spearman rank correlations for correlations were calculated.9 out of 10 subjects hit all 5 target regions in the first attempt, taking an average of 29:39 minutes for all punctures. There was a significant correlation between previous experience in interventional radiology, years in the profession, and the time required. Overall, the time varied from an average of 43:00 min. for medical students to 15:00 min. for chief physicians. All test subjects showed high acceptance of the system and rated especially the potential clinical feasibility, the simplification of the puncture, and the image quality positively. However, the majority require further training for sufficient safety in use.The system offers distinct advantages for navigation and orientation, facilitates percutaneous interventions during training and enables professionally experienced physicians to achieve short intervention times. In addition, the system improves ergonomics during the procedure by making important information always directly available in the field of view and has the potential to reduce the radiation exposure of staff in particular by combining AR and sonography and thus shortening CT-fluoroscopy times. · AR navigation offers advantages for orientation during percutaneous radiological interventions.. · The subjects would like to use the AR system in everyday clinical practice on patients.. · AR improves ergonomics by making important information directly available in the field of view.. · The combination of AR and sonography can significantly reduce radiation exposure for staff.. · Rohmer K, Becker M, Georgiades M et al. Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology - a simulation-based phantom study. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1080.

Background:  Perivascular spaces (synonym: Virchow-Robin spaces) were first described over 150 years ago. They are defined as the fluid-filled spaces surrounding the small penetrating cerebral vessels. They gained growing scientific interest especially with the postulation of the so-called glymphatic system and their possible role in neurodegenerative and neuroinflammatory diseases.

Methods:  PubMed was used for a systematic search with a focus on literature regarding MRI imaging and evaluation methods of perivascular spaces. Studies on human in-vivo imaging were included with a focus on studies involving healthy populations. No time frame was set. The nomenclature in the literature is very heterogeneous with terms like "large", "dilated", "enlarged" perivascular spaces whereas borders and definitions often remain unclear. This work generally talks about perivascular spaces.

Results:  This review article discusses the morphologic MRI characteristics in different sequences. With the continual improvement of image quality, more and tinier structures can be depicted in detail. Visual analysis and semi or fully automated segmentation methods are briefly discussed.

Conclusion:  If they are looked for, perivascular spaces are apparent in basically every cranial MRI examination. Their physiologic or pathologic value is still under debate.

Key points:   · Perivascular spaces can be seen in basically every cranial MRI examination.. · Primarily T2-weighend sequences are used for visual analysis. Additional sequences are helpful for distinction from their differential diagnoses.. · There are promising approaches for the semi or fully automated segmentation of perivascular spaces with the possibility to collect more quantitative parameters..

Citation format: · Seehafer S, Larsen N, Aludin S et al. Perivascular spaces and where to find them - MRI imaging and evaluation methods. Fortschr Röntgenstr 2024; 196: 1029 - 1036.