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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
Strahlenschutzkurse. 辐射防护课程。
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-2374-4005
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引用次数: 0
[The many different faces of MOGAD in the MRI: From FUEL to FLAMES]. [MRI 中 MOGAD 的多种不同面孔:从燃料到火焰]。
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-2238-6462
Marius Horger, Georg Gohla, Eva-Maria Konrad, David Baur, Markus Kowarik, Nick Farhang, Christer Ruff, Stefan Heckl
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引用次数: 0
Safety, Efficacy and Outcome of Rotational Thrombectomy assisted Endovascular Revascularisation of the Superior Mesenteric Artery in Acute Thromboembolic Mesenteric Ischaemia. 急性血栓栓塞性肠系膜缺血中旋转血栓切除术辅助肠系膜上动脉血管内再通术的安全性、疗效和结果
IF 1.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-10-01 Epub Date: 2024-03-13 DOI: 10.1055/a-2234-0333
Annette Thurner, Dominik Peter, Giulia Dalla Torre, Sven Flemming, Ralph Kickuth

Purpose:  To evaluate the efficacy and safety of percutaneous rotational thrombectomy-assisted endovascular revascularization of acute thromboembolic superior mesenteric artery occlusions in acute mesenteric ischemia.

Materials and methods:  Fifteen cases of percutaneous rotational thrombectomy- assisted (Rotarex S, BD, USA) revascularization were retrospectively analyzed. The etiology was embolic in 40 % of cases and thrombotic in 60 %. A "Thrombectomy in Visceral Ischemia" (TIVI) 5-point score determined vessel patency at presentation, after percutaneous rotational thrombectomy, and after adjunctive technologies. TIVI 3 indicated nearly complete revascularization (minimal residual side branch thrombus). TIVI 4 indicated complete revascularization. Technical success was defined as successful device application and a final TIVI score of 3/4 after adjunctive technologies. Safety and outcome were also analyzed.

Results:  Device application via femoral access was feasible in 100 % of cases and improved flow in 86.7 % of cases (1 × TIVI 0→1, 11 × TIVI 0→2, 1 × TIVI 1→2). There was no change in 13.3 % of cases (2 × TIVI 2→2). Additional devices resulted in further flow improvement in 93.3 % of cases (8 × TIVI 3, 6 × TIVI 4). One recanalization failed (TIVI 2→2→2). After adjunctive technologies (10 × manual aspiration, 11 × angioplasty, 9 × stenting), the technical success rate was 93.3 %. The mean procedure time was 40.5(± 14) minutes for embolism and 72.1(± 20) minutes for thrombosis. There was one device-related major complication (catheter tip fracture) resulting in a device-related safety rate of 93.3 %. The overall major complication rate was 20 %. Surgical exploration (13 ×), bowel resection (9 ×) and Fogarty embolectomy/bypass (3 ×) were also performed. The 30-day mortality rate was 40 %.

Conclusion:  Percutaneous rotational thrombectomy is an effective adjunct for rapid endovascular recanalization of acute thromboembolic superior mesenteric artery occlusions with an acceptable rate of major procedural complications.

Key points:   · Percutaneous rotational thrombectomy-assisted superior mesenteric artery revascularization in acute occlusive mesenteric ischemia is feasible and effective.. · Percutaneous rotational thrombectomy facilitates rapid flow restoration in native and stented superior mesenteric artery segments.. · Brachial access should be considered in the case of steep take-off angles of the superior mesenteric artery..

目的:评估急性肠系膜缺血时经皮旋转血栓切除术辅助血管内再通术治疗急性血栓栓塞性肠系膜上动脉闭塞的有效性和安全性:回顾性分析了15例经皮旋转血栓切除术辅助血管重建术(Rotarex S,美国BD公司)。病因40%为栓塞,60%为血栓。内脏缺血血栓切除术"(TIVI)5 级评分确定了发病时、经皮旋转血栓切除术后和辅助技术后的血管通畅情况。TIVI 3 表示血管几乎完全再通(残留侧支血栓极少)。TIVI 4 表示血管完全再通。技术成功的定义是成功应用设备,以及辅助技术后最终 TIVI 评分达到 3/4。此外,还对安全性和结果进行了分析:结果:100%的病例都能通过股动脉入路应用设备,86.7%的病例血流得到改善(1 × TIVI 0→1,11 × TIVI 0→2,1 × TIVI 1→2)。13.3%的病例(2 × TIVI 2→2)没有变化。在 93.3% 的病例(8 × TIVI 3,6 × TIVI 4)中,附加装置导致血流进一步改善。一次再通畅失败(TIVI 2→2→2)。在采用辅助技术(10 × 人工抽吸术、11 × 血管成形术、9 × 支架植入术)后,技术成功率为 93.3%。栓塞的平均手术时间为 40.5(± 14)分钟,血栓形成的平均手术时间为 72.1(± 20)分钟。发生了一起与设备相关的重大并发症(导管尖端断裂),设备相关安全率为 93.3%。总体主要并发症发生率为 20%。此外,还进行了手术探查(13 例)、肠切除术(9 例)和 Fogarty 栓子切除术/旁路术(3 例)。30天死亡率为40%:结论:经皮旋转血栓切除术是快速血管内再通急性血栓栓塞性肠系膜上动脉闭塞症的有效辅助手段,主要手术并发症发生率可接受:- 要点:经皮旋转血栓切除术辅助急性闭塞性肠系膜缺血的肠系膜上动脉再通术是可行且有效的。- 经皮旋转血栓切除术有助于快速恢复原生和支架置入的肠系膜上动脉段的血流。- 如果肠系膜上动脉的起始角较陡,应考虑从肱骨入路进行手术
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引用次数: 0
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Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren
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