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

There is a lack of clear recommendations regarding enteral contrast agent administration in the context of abdominal computed tomography (CT). A survey among members of the German Radiological Society (DRG) identified a very heterogeneous and indication-specific approach in the clinical routine. The goal of this study is to develop generally applicable recommendations.Recommendations for enteral contrast agent administration were developed by members of the Abdominal Workgroup within the DRG, using methodology comparable to that of an S1 guideline with informal consensus. Relevant clinical indications were systematically identified, categorized, and assessed considering current evidence in the literature and guidelines.There are specific clinical scenarios in which enteral contrast is indicated. Respective recommendations are presented in terms of good clinical practice (GCP). In this context, especially the administration of positive enteral contrast agents for abdominal CT examination is obsolete for many clinical indications. · For many indications, enteral contrast agent administration is not necessary. · In the case of esophageal or gastric tumors, enteral contrast should be achieved using the "hydro-technique". · Positive enteral contrast agents are primarily recommended for diagnosis of gastrointestinal fistulas and anastomoses. · Stadelmann J, Grenacher L, Juchems MS et al. Enteral contrast administration in abdominal computed tomography - Expert recommendations from the Abdominal Workgroup of the German Roentgen Society. Rofo 2025; DOI 10.1055/a-2750-0204.

In this overview we summarize the current state of scientific knowledge on the epidemiology, etiology, clinical symptoms and therapy of post-COVID disease.The study is based on a search of the scientific literature available on PubMed and on our own clinical experience in the post-COVID outpatient clinic.The prevalence of post-COVID disease varies greatly depending on the survey method used. The symptoms of post-COVID are manifold, but fatigue, cardiopulmonary complaints, cognitive deficit, and pain syndromes are prominent. There are currently no surefire symptoms or specific markers that prove the presence of the disease. Therefore, diagnosis is often based on an exclusion of other diagnoses, which requires good interdisciplinary cooperation. Therapy for post-COVID disease is also not specific but is always individual and symptom-oriented. There have been various attempts to explain the pathogenesis of post-COVID, but the mechanisms behind the development of the condition have not yet been conclusively clarified. Persistence of the virus or of viral proteins may cause protracted infection or autoimmunity. Infection and inflammation of the endothelium of the small vessels and the hypercoagulation associated with this may lead to local cytokine dysregulation and organ damage. Further clarification of the pathogenesis of post-COVID and the establishment of effective diagnostic tools and therapeutic approaches are urgently needed. · Post-COVID is a commonly reported condition with variable symptoms. · Interdisciplinary exclusion of other diagnoses and therapy planning are important. · Clarification of pathogenesis and establishment of diagnostic markers are urgently needed. · Reisinger EC, Geerdes-Fenge H, Wossidlo C et al. Long/Post-Covid - An Interdisciplinary Challenge. Rofo 2025; 197: 1388-1393.

Magnetic resonance imaging (MRI) plays a crucial role alongside clinical and neuropsychological assessments in diagnosing dementia. The recent and ongoing advancements in MRI technology have significantly enhanced the detection and characterization of the specific neurostructural changes seen in various neurodegenerative diseases, thereby significantly increasing the precision of diagnosis. Within this context of perpetual evolution, this review article explores the recent advances in MRI with regard to diagnosing dementia.A retrospective literature review was conducted by searching the PubMed and ScienceDirect databases for the keywords "dementia", "imaging", and "MRI". The inclusion criteria were scientific papers in English that revolved around the role of MRI as a diagnostic tool in the field of dementia. A specific time frame was not determined but the focus was on current articles, with an overall of 20 articles dating from the last 6 years (after 2018), corresponding to 55% of the total number of articles.This review provides a comprehensive overview of the latest advances in the radiologic diagnosis of dementia using MRI, with a particular focus on the last 6 years. Technical aspects of image acquisition for clinical and research purposes are discussed. MRI findings typical of dementia are described. The findings are divided into non-specific findings of dementia and characteristic findings for certain dementia subtypes. This provides information about possible causes of dementia. In addition, developed scoring systems that support MRI findings are presented, including the MTA score for Alzheimer's disease with corresponding illustrative figures.The symbiosis of clinical evaluation with high-field MRI methodologies enhances dementia diagnosis and offers a holistic and nuanced understanding of structural brain changes associated with dementia and its various subtypes. The latest advances, mainly involving the emergence of ultra-high-field (7T) MRI, despite having limited use in clinical practice, mark a pragmatic shift in the field of research. · High-field MRI (3T) and specialized sequences allow for the detection of early structural changes indicative of dementia.. · Characteristic neuroanatomical MRI patterns enable the differentiation between various subtypes of dementia.. · Established scales provide added value to the quantification and categorization of MRI findings in dementia.. · Akl E, Dyrba M, Görß D et al. MRI for diagnosing dementia - update 2024. Rofo 2025; 197: 1378-1387.

To determine whether performing a temporary hepatic hilar nerve block in patients undergoing microwave or radiofrequency ablation of primary or secondary hepatic malignancies reduces the requirement for intravenous conscious procedural sedation and analgesia.Fifty patients undergoing percutaneous image-guided liver thermal ablation were included in this single-center prospective randomized controlled trial. The experimental arm received a hepatic hilar nerve block in addition to intravenous medication directly before thermal ablation, whereas the control group underwent thermal ablation solely under intravenous medication, with the possibility of crossover. Student's t-test and analysis of covariance were performed to determine the block's efficacy regarding the intraoperative medication requirement.50 patients (22 females, 28 males) were randomly allocated to two groups without significant differences between the cohorts' baseline patient, clinical, and tumor characteristics. Three control group patients underwent crossover. Initial analysis using Student's t-test revealed no significant intravenous medication reduction in the control group vs. the test group (190 µg vs. 189 µg fentanyl, P = 0.96 and 1.34 mg vs. 1.60 mg Midazolam, P = 0.19). Thus, ANCOVA was performed to accommodate for heterogeneous ablation conditions (ablation time, total energy applied, affected liver capsule area). The adjusted mean fentanyl dosage was 206 µg vs. 184 µg (control group vs. test group), yielding a significant reduction after block (P = 0.020). None of the patients who received a hepatic hilar nerve block experienced any adverse events during a mean follow-up of nearly six months (range: 0-17 months).This prospective randomized trial confirms that a hepatic hilar nerve block can be safely performed before liver tumor thermal ablation as an adjunct to intravenous medication to reduce opioid consumption and manage pain. · First randomized study evaluating hepatic hilar nerve block (HHNB) for liver tumor ablation.. · HHNB significantly reduced opioid use after adjusting for heterogeneous ablation conditions.. · The effect is less pronounced than in retrospective studies. Larger trials are needed.. · Georgiades M, March C, Barajas Ordonez F et al. Hepatic Hilar Nerve Block for Adjunctive Analgesia in Thermal Ablation of Liver Tumors: A Prospective Randomized Controlled Trial. Rofo 2025; 197: 1426-1432.