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[Difficult start to college - a rare eye disease with an unusual clinical course]. [大学开学难--一种临床过程不寻常的罕见眼病]。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-04 DOI: 10.1055/a-2423-1680
Barbara Greiner, Horst Helbig, Christian Stroszczynski
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引用次数: 0
Acceptance and feasibility of an augmented reality-based navigation system with optical tracking for percutaneous procedures in interventional radiology - a simulation-based phantom study. 基于增强现实技术的光学跟踪导航系统在介入放射学经皮手术中的接受度和可行性--基于模拟的模型研究。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-04 DOI: 10.1055/a-2416-1080
Karl Rohmer, Mathias Becker, Marilena Georgiades, Christine March, Bohdan Melekh, Piotr Sperka, Dominik Spinczyk, Anna Wolińska-Sołtys, Maciej Pech

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.

增强现实(AR)可在干预过程中将额外信息投射到用户视野中。目的是评估 AR 系统的接受度和临床可行性,并对不同经验水平的用户进行比较。该系统使用 HoloLens 2 将 CT 生成的三维模型投射到视野中,从而实时显示和导航追踪的针头。投射的超声图像用于实时控制针的定位。10 名具有不同经验水平的医生和医科学生通过在模型中使用该系统进行穿刺,对 AR 导航系统的接受度和可用性进行了评估。然后对所需时间进行了比较,并填写了一份调查问卷,以评估临床接受度和可行性。在统计分析中,计算了定性特征的频率、定量特征的位置和离散度量以及相关性的斯皮尔曼等级相关性。介入放射学经验、从业年限与所需时间之间存在明显的相关性。总体而言,所需时间从医学生的平均 43 分钟到主任医师的 15 分钟不等。所有测试对象对该系统的接受度都很高,尤其对其潜在的临床可行性、穿刺的简化程度和图像质量给予了积极评价。该系统在导航和定位方面具有明显的优势,便于在培训期间进行经皮介入治疗,并使有专业经验的医生能够缩短介入治疗时间。此外,该系统还能在手术过程中直接显示重要信息,从而改善人体工程学,尤其是通过将 AR 和超声波检查结合起来,缩短 CT-荧光透视检查时间,有可能减少工作人员的辐射暴露。- AR 导航在经皮放射介入过程中的定位方面具有优势。- 受试者希望在日常临床实践中对病人使用 AR 系统。- AR可在视野中直接显示重要信息,从而提高了人体工程学。- AR与超声造影术的结合可显著减少工作人员的辐射暴露。- Rohmer K, Becker M, Georgiades M 等人.基于增强现实技术的导航系统在介入放射学经皮手术中的接受度和可行性--基于模拟的模型研究。Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1080.
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引用次数: 0
Perivascular spaces and where to find them - MR imaging and evaluation methods. 血管周围间隙及其位置--磁共振成像和评估方法。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-02-26 DOI: 10.1055/a-2254-5651
Svea Seehafer, Naomi Larsen, Schekeb Aludin, Olav Jansen, Lars-Patrick Andreas Schmill

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.

背景:血管周围间隙(同义词:Virchow-Robin 间隙)在 150 多年前首次被描述。它们被定义为穿透性小脑血管周围充满液体的空间。随着所谓的 "glymphatic 系统 "的提出以及它们在神经退行性疾病和神经炎症性疾病中可能扮演的角色,它们越来越受到科学界的关注:方法:使用 PubMed 进行系统检索,重点是有关磁共振成像和血管周围间隙评估方法的文献。其中包括有关人体活体成像的研究,重点是涉及健康人群的研究。未设定时间范围。文献中的术语非常不统一,如 "大的"、"扩张的"、"增大的 "血管周围间隙,而边界和定义往往不清楚。本文一般讨论的是血管周围间隙:这篇综述文章讨论了不同序列的 MRI 形态特征。随着图像质量的不断提高,越来越多的微小结构可以被详细描述。本文简要讨论了视觉分析和半自动或全自动分割方法:如果仔细观察,血管周围间隙基本上在每次头颅 MRI 检查中都很明显。其生理或病理价值仍存在争议:- 血管周围间隙基本上在所有头颅 MRI 检查中都能看到。- 主要采用T2-weighend序列进行直观分析。其他序列有助于与鉴别诊断进行区分。- 目前有一些很有前景的方法可用于血管周围空间的半自动或全自动分割,并有可能收集更多的定量参数......:- Seehafer S, Larsen N, Aludin S et al.血管周围空间和在哪里找到它们--核磁共振成像和评估方法》。Fortschr Röntgenstr 2024; DOI: 10.1055/a-2254-5651.
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引用次数: 0
Triangular Fibrocartilage Complex (TFCC) - Anatomy, Imaging, and Classifications with Special Focus on the CUP Classification. 三角纤维软骨复合体 (TFCC) - 解剖、成像和分类,特别关注 CUP 分类。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 DOI: 10.1055/a-2411-8444
Rainer Schmitt, Andreas Steven Kunz, Paul Reidler, Henner Huflage, Nina Hesse

The TFCC consists of several components whose functional significance has been recognized in detail in recent years. Existing classifications are partly incomplete. In addition, the TFCC requires specific and dedicated imaging techniques.This review describes the anatomy and pathoanatomy of the TFCC. The different types of TFCC lesions on MRI as well as MR and CT arthrography are explained and compared with the current literature. In addition, the novel CUP classification is presented and illustrated with image examples.Anatomically and functionally, the articular disc and radioulnar ligaments with their ulnar insertions and the inhomogeneously structured TFCC periphery must be differentiated. For accurate imaging, thin slices with high in-plane resolution and techniques to optimize contrast are required. Plain MRI is exclusively dependent on T2 contrast, while gadolinium-enhanced MRI offers the additional benefit of focal contrast enhancement, e.g., of fibrovascular repair tissue at the lesion site. However, the reference standard continues to be MR and CT arthrography, which should be used for focused indications. The CUP classification, which allows a comprehensive description and categorization of TFCC lesions, is presented and illustrated. · Anatomically, the TFCC consists of the central ulnocarpal disc, the dorsal and palmar radioulnar ligaments, and the ulnocarpal joint capsule including intracapsular ligaments and the meniscus homologue.. · The most important restraining structure of the TFCC is the lamina fovealis, which stabilizes the DRUJ. This structure constitutes the proximal (deep) continuation of the radioulnar ligaments at the ulnar insertion.. · Imaging of the TFCC requires high spatial and contrast resolution due to its minute structures. MR and CT arthrography are the reference standard in imaging.. · The CUP classification clearly describes all structures of the TFCC with the categorization of individual or combined lesion patterns.. · Schmitt R, Kunz AS, Reidler P et al. Triangular Fibrocartilage Complex (TFCC) - Anatomy, Imaging, and Classifications with Special Focus on the CUP Classification. Fortschr Röntgenstr 2024; DOI 10.1055/a-2411-8444.

近年来,人们已详细认识到 TFCC 的几个组成部分的功能意义。现有的分类有部分不完整。本综述介绍了 TFCC 的解剖和病理解剖。本综述介绍了 TFCC 的解剖和病理解剖,解释了 MRI 以及 MR 和 CT 关节造影上不同类型的 TFCC 病变,并与现有文献进行了比较。此外,还介绍了新颖的 CUP 分类法,并通过图像实例进行了说明。从解剖和功能上讲,必须区分关节盘和桡侧韧带及其尺侧插入部以及结构不均匀的 TFCC 周围。要进行精确成像,需要具有高平面分辨率的薄切片和优化对比度的技术。普通核磁共振成像完全依赖于 T2 对比度,而钆增强核磁共振成像则具有局灶对比度增强的额外优势,例如病变部位的纤维血管修复组织。不过,MR 和 CT 关节造影仍是参考标准,应重点用于适应症。CUP 分类法可对 TFCC 病变进行全面描述和分类,本文对其进行了介绍和说明。- 在解剖学上,TFCC 由尺骨中央椎间盘、背侧和掌侧桡尺韧带以及尺关节囊(包括囊内韧带和半月板同源物)组成。- TFCC最重要的约束结构是蜂窝状薄层,它可稳定DRUJ。该结构是尺骨插入处桡尺韧带的近端(深部)延续。- 由于 TFCC 结构微小,因此其成像需要较高的空间分辨率和对比度。MR 和 CT 关节造影是成像的参考标准。- CUP分类清楚地描述了TFCC的所有结构,并对单个或合并病变模式进行了分类。- Schmitt R、Kunz AS、Reidler P 等人.三角纤维软骨复合体(TFCC)- 解剖、成像和分类,特别关注 CUP 分类。Fortschr Röntgenstr 2024; DOI 10.1055/a-2411-8444。
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引用次数: 0
The postsurgical pancreas. 手术后的胰腺
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-02-19 DOI: 10.1055/a-2254-5824
Roman Fischbach, Maximilian Peller, Daniel Perez, Christopher Pohland, Raphael Gübitz

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. The most common complications are delayed gastric emptying, pancreatic fistula, acute pancreatitis, bile leakage, abscess, and hemorrhage. Radiologists must identify the typical surgical procedures, the postoperative anatomy, and normal postoperative findings as well as possible postoperative complications and know interventional treatment methods for common complications.

Key points:   · Morbidity after pancreatic surgery remains high.. · CT is the best method for visualizing postoperative anatomy and is used for early detection of complications.. · Pancreatic fistula is the most common relevant complication after pancreatic resection.. · The ability of a center to manage complications is crucial to ensure the success of therapy..

Citation format: · Fischbach R, Peller M, Perez D et al. The postsurgical pancreas. Fortschr Röntgenstr 2024; 196: 1037 - 1045.

背景:胰腺部分切除术是内脏肿瘤医学中最复杂的外科手术之一,术后发病率高,即使在专业中心,并发症发生率也高达 40%-50%:方法:描述典型的手术切除程序和由此产生的术后解剖结构、典型的正常术后结果、常见的术后并发症以及放射学结果:结果和结论:CT 是胰腺部分切除术后快速、标准化观察术后解剖结构和发现临床疑似并发症的最合适影像技术。最常见的并发症是胃排空延迟、胰瘘、急性胰腺炎、胆汁渗漏、脓肿和出血。放射医师必须识别典型的手术过程、术后解剖、正常的术后结果以及可能出现的术后并发症,并了解常见并发症的介入治疗方法:- 胰腺手术后的发病率仍然很高。- CT是观察术后解剖结构的最佳方法,可用于早期发现并发症。- 胰瘘是胰腺切除术后最常见的相关并发症。- 中心处理并发症的能力是确保治疗成功的关键:- Fischbach R, Peller M, Perez D et al.手术后的胰腺Fortschr Röntgenstr 2024; DOI: 10.1055/a-2254-5824.
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引用次数: 0
[Hibernoma of the lower extremity: a rare lipomatous tumor that can mimic liposarcoma on PET/CT imaging]. [下肢蜂窝织瘤:一种罕见的脂肪瘤,可在 PET/CT 成像中模拟脂肪肉瘤]。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-04-22 DOI: 10.1055/a-2289-4370
Manoj Kakkassery, Susanne Weber-Kuhn, Maya Niethard
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引用次数: 0
Langerhans cell histiocytosis involving the temporal bone with destruction and subsequent reossification of the bony labyrinth boundaries. 累及颞骨的朗格汉斯细胞组织细胞增生症,伴有骨性迷宫边界的破坏和随后的再化生。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-02-19 DOI: 10.1055/a-2254-5536
Katja Döring, Philipp Ivanyi, Heinrich Lanfermann, Athanasia Warnecke, Anja Giesemann

Purpose:  With an incidence between 1-9/100 000 per year, Langerhans cell histiocytosis (LCH) is a rather rare disease from the hemato-oncologic disease spectrum (Hayes et al. 2009). The tumorlike disease with proliferation of histiocytic cells may manifest as localized to one organ or disseminated with infiltration of a wide variety of organs. Approximately 25-30 % of these cases show involvement of the temporal bone (Ni et al. 2017).

Case description:  With vertigo persisting for three years, chronic mastoiditis, and acute progressive hearing loss bilaterally (r > l) for three weeks, a 41-year-old woman presented at an emergency department. The DVT showed extensive bony destruction of large parts of the temporal bone on both sides, involving the vestibular organ, the cochlea, and the internal auditory canal. To confirm the suspicion of a systemic inflammatory process, a PE was performed from the mastoid with bioptic confirmation of an LCH. Systemic therapy was initiated. Post-therapeutic imaging showed almost complete remission with reossification of the preexisting defect zones and the internal auditory canal and labyrinth structures again showed bony margins. Clinically, there was an improvement of the vegetative symptoms with remaining bilateral sensorineural hearing loss.

Discussion:  LCH of the temporal bone is a rare and often misdiagnosed disease due to its nonspecific clinical presentation. Awareness of temporal bone LCH and its occurrence in adults is essential for accurate and consistent diagnosis.

Key points:   · LCH is a rather rare disease from the hemato-oncological spectrum. · Affection of the temporal bone, especially such an extensive one (as in this case report), is rather atypical in adulthood. · Use of systemic therapy resulted in remission. · There was complete reossification of the osseous structures post-therapy. · A cochlear implant was able to be implanted to compensate for hearing loss.

目的:朗格汉斯细胞组织细胞增生症(Langerhans cell histiocytosis,LCH)每年的发病率在 1-9/10 万之间,是血液肿瘤疾病谱中一种相当罕见的疾病(Hayes 等,2009 年)。这种组织细胞增生的肿瘤性疾病可表现为局部器官或浸润多个器官的播散性疾病。其中约 25-30% 的病例表现为颞骨受累(Ni 等人,2017 年):一名 41 岁女性因持续三年的眩晕、慢性乳突炎和急性进行性双侧听力下降(r > l)三周到急诊科就诊。深静脉血栓显示两侧颞骨的大部分都有广泛的骨质破坏,涉及前庭器官、耳蜗和内耳道。为了证实系统性炎症过程的怀疑,对乳突进行了PE检查,并通过活检确认为LCH。随后开始了全身治疗。治疗后的影像学检查显示,患者的病情几乎完全缓解,原有的缺损区重新变小,内耳道和迷宫结构再次出现骨性边缘。临床上,患者的植物神经症状有所改善,但仍存在双侧感音神经性听力损失:讨论:颞骨 LCH 是一种罕见的疾病,由于其临床表现无特异性,常常被误诊。认识颞骨 LCH 及其在成人中的发生对于准确和一致的诊断至关重要:- 要点:LCH 是一种相当罕见的血液肿瘤疾病。- 颞骨受累,尤其是如此广泛的颞骨受累(如本病例报告中的情况),在成年期是相当不典型的。- 采用系统治疗后,病情得到缓解。- 治疗后骨质结构完全恢复。- 植入的人工耳蜗可以弥补听力损失。
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引用次数: 0
Fit fürs Radiologie-PJ: Ein innovatives Filmprojekt für Medizinstudierende. 适合放射学 PJ:面向医学生的创新电影项目。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-09-18 DOI: 10.1055/a-2374-3707
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引用次数: 0
RÖKO 2025 – Abstract-Einreichung bis 4. November 2024 geöffnet! RÖKO 2025 - 摘要提交截止日期为 2024 年 11 月 4 日!
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-09-18 DOI: 10.1055/a-2374-3407
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引用次数: 0
Neue Anforderungen an den ärztlichen Leiter im Medizinischen Versorgungszentrum (Ergänzung zu RöFo 04/2024). 对医疗中心医务主任的新要求(RöFo 04/2024 的补充)。
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-09-18 DOI: 10.1055/a-2374-3470
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引用次数: 0
期刊
Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren
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