@article{GilbertMeffertSchmalzletal.2018, author = {Gilbert, F. and Meffert, R. H. and Schmalzl, J. and Weng, A. M. and K{\"o}stler, H. and Eden, L.}, title = {Grade of retraction and tendon thickness correlates with MR-spectroscopically measured amount of fatty degeneration in full thickness supraspinatus tears}, series = {BMC Musculoskeletal Disorders}, volume = {19}, journal = {BMC Musculoskeletal Disorders}, number = {197}, doi = {10.1186/s12891-018-2096-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176116}, year = {2018}, abstract = {Background: The amount of fatty degeneration (FD) has major impact on the clinical result and cuff integrity after rotator cuff repair. A quantitative analysis with magnet resonance imaging (MRI) spectroscopy was employed to analyze possible correlation of FD with tendon retraction, tendon thickness and patients' characteristics in full thickness supraspinatus tears. Methods: Forty-two patients with full-thickness supraspinatus tears underwent shoulder MRI including an experimental spectroscopic sequence allowing quantification of the fat fraction in the supraspinatus muscle belly. The amount of fatty degeneration was correlated with tendon retraction, tendon thickness, patients' age, gender, smoker status, symptom duration and body mass index (BMI). Patients were divided in to three groups of retraction (A) 0-10 mm (n=), (B) 11-20 mm (n=) and (C) < 21 mm (n=) and the means of FD for each group were calculated. Results: Tendon retraction (R = 0.6) and symptom duration (R = 0.6) correlated positively, whereas tendon thickness correlated negatively (R = - 0.6) with the amount of FD. The fat fraction increased significantly with tendon retraction: Group (A) showed a mean fat mount of 3.7\% (±4\%), group (B) of 16.7\% (±8.2\%) and group (C) of 37.5\% (±19\%). BMI, age and smoker-status only showed weak to moderate correlation with the amount of FD in this cohort. Conclusion: MRI spectroscopy revealed significantly higher amount of fat with increasing grade of retraction, symptom duration and decreased tendon thickness. Thus, these parameters may indirectly be associated with the severity of tendon disease.}, language = {en} } @article{GilbertHeintelJakubietzetal.2018, author = {Gilbert, F. and Heintel, T. M. and Jakubietz, M. G. and K{\"o}stler, H. and Sebald, C. and Meffert, R. H. and Weng, A. M.}, title = {Quantitative MRI comparison of multifidus muscle degeneration in thoracolumbar fractures treated with open and minimally invasive approach}, series = {BMC Musculoskeletal Disorders}, volume = {19}, journal = {BMC Musculoskeletal Disorders}, number = {75}, doi = {10.1186/s12891-018-2001-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-175742}, year = {2018}, abstract = {Background: Minimally invasive pedicle screw fixation has less approach-related morbidity than open screw placement and is allegedly less traumatizing on paravertebral muscles, as there is no requirement to mobilize and retract the adjacent muscle portion. The approach-related long-term effects to the morphology of the paravertebral muscles are unknown. The purpose of this study was to compare the long-term amount of fatty degeneration of the multifidus muscle in patients treated with a classical open or a minimally invasive approach. Methods: Fourteen Patients meeting inclusion criteria were selected. In all patients a singular fracture of the thoracolumbar spine with a two-level posterior instrumentation was treated, either using an open approach or a minimally invasive approach. All patients underwent quantitative MRI spectroscopy for quantification of the fatty degeneration in the multifidus muscle as a long-term proof for muscle loss after minimum 4-year follow-up. Clinical outcome was assessed using Oswestry Low Back Pain Disability Questionnaire, SF-36 and VA-scale for pain. Results: The minimally invasive approach group failed to show less muscle degeneration in comparison to the open group. Total amount of fatty degeneration was 14.22\% in the MIS group and 12.60\% in the open group (p = 0.64). In accordance to MRI quantitative results there was no difference in the clinical outcome after a mean follow up of 5.9 years (±1.8). Conclusion: As short-term advantages of minimal invasive screw placement have been widely demonstrated, no advantage of the MIS, displaying a significant difference in the amount of fatty degeneration and resulting in a better clinical outcome could be found. Besides the well-known short-term advantage of minimally invasive pedicle screw placement, a long-term advantage, such as less muscle degeneration and thus superior clinical results, compared to the open approach could not be shown.}, language = {en} } @article{GietzenKunzLuetkensetal.2022, author = {Gietzen, Carsten Herbert and Kunz, Andreas Steven and Luetkens, Karsten Sebastian and Huflage, Henner and Christopoulos, Georgios and van Schoonhoven, J{\"o}rg and Bley, Thorsten Alexander and Schmitt, Rainer and Grunz, Jan-Peter}, title = {Evaluation of prestyloid recess morphology and ulnar-sided contrast leakage in CT arthrography of the wrist}, series = {BMC Musculoskeletal Disorders}, volume = {23}, journal = {BMC Musculoskeletal Disorders}, number = {1}, doi = {10.1186/s12891-022-05241-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-301113}, year = {2022}, abstract = {Background In wrist arthrograms, aberrant contrast material is frequently seen extending into the soft tissue adjacent to the ulnar styloid process. Since the prestyloid recess can mimic contrast leakage in CT arthrography, this study aims to provide a detailed analysis of its morphologic variability, while investigating whether actual ulnar-sided leakage is associated with injuries of the triangular fibrocartilage complex (TFCC). Methods Eighty-six patients with positive wrist trauma history underwent multi-compartment CT arthrography (40 women, median age 44.5 years). Studies were reviewed by two board-certified radiologists, who documented the morphology of the prestyloid recess regarding size, opening type, shape and position, as well as the presence or absence of ulnar-sided contrast leakage. Correlations between leakage and the presence of TFCC injuries were assessed using the mean square contingency coefficient (r\(_{ɸ}\)). Results The most common configuration of the prestyloid recess included a narrow opening (73.26\%; width 2.26 ± 1.43 mm), saccular shape (66.28\%), and palmar position compared to the styloid process (55.81\%). Its mean length and anterior-posterior diameter were 6.89 ± 2.36 and 5.05 ± 1.97 mm, respectively. Ulnar-sided contrast leakage was reported in 29 patients (33.72\%) with a mean extent of 12.30 ± 5.31 mm. Leakage occurred more often in patients with ulnar-sided TFCC injuries (r\(_{ɸ}\) = 0.480; p < 0.001), whereas no association was found for lesions of the central articular disc (r\(_{ɸ}\) = 0.172; p = 0.111). Conclusions Since ulnar-sided contrast leakage is more common in patients with peripheral TFCC injuries, distinction between an atypical configuration of the prestyloid recess and actual leakage is important in CT arthrography of the wrist.}, language = {en} } @article{GerhardHartmannWiegeringBenoitetal.2021, author = {Gerhard-Hartmann, Elena and Wiegering, Verena and Benoit, Clemens and Meyer, Thomas and Rosenwald, Andreas and Maurus, Katja and Ernestus, Karen}, title = {A large retroperitoneal lipoblastoma as an incidental finding: a case report}, series = {BMC Pediatrics}, volume = {21}, journal = {BMC Pediatrics}, doi = {10.1186/s12887-021-02628-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260173}, year = {2021}, abstract = {Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.}, language = {en} } @phdthesis{Gemeinhardt2007, author = {Gemeinhardt, Katharina Christine}, title = {Magnetresonanztomographie und -spektroskopie der Schulter nach Latissimus-dorsi-Transfer unter Ber{\"u}cksichtigung von Sehnenintegrit{\"a}t, Atrophie und fettiger Degeneration der Rotatorenmanschette}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-28035}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2007}, abstract = {Darstellung des Latissimus-dorsi-Transfers mit Hilfe des MRTs. Quantifizierung der fettigen Degeneration mit Hilfe der semiquantitativen Methode nach Goutailler und der 2D-SPLASH-Sequenz.}, subject = {NMR-Tomographie}, language = {de} } @article{GeigerHirtlerGottfriedetal.2017, author = {Geiger, Julia and Hirtler, Daniel and Gottfried, Kristina and Rahman, Ozair and Bollache, Emilie and Barker, Alex J. and Markl, Michael and Stiller, Brigitte}, title = {Longitudinal Evaluation of Aortic Hemodynamics in Marfan Syndrome: New Insights from a 4D Flow Cardiovascular Magnetic Resonance Multi-Year Follow-Up Study}, series = {Journal of Cardiovascular Magnetic Resonance}, volume = {19}, journal = {Journal of Cardiovascular Magnetic Resonance}, number = {33}, doi = {10.1186/s12968-017-0347-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-171119}, year = {2017}, abstract = {Background The aim of this 4D flow cardiovascular magnetic resonance (CMR) follow-up study was to investigate longitudinal changes in aortic hemodynamics in adolescent patients with Marfan syndrome (MFS). Methods 4D flow CMR for the assessment of in-vivo 3D blood flow with full coverage of the thoracic aorta was performed twice (baseline scan t1/follow-up scan t2) in 19 adolescent MFS patients (age at t1: 12.7 ± 3.6 years, t2: 16.2 ± 4.3 years) with a mean follow-up duration of 3.5 ± 1.2 years. Ten healthy volunteers (24 ± 3.8 years) served as a control group. Data analysis included aortic blood flow visualization by color-coded 3D pathlines, and grading of flow patterns (helices/vortices) on a 3-point scale (none, moderate, severe; blinded reading, 2 observers). Regional aortic peak systolic velocities and systolic 3D wall shear stress (WSS) along the entire aortic wall were quantified. Z-Scores of the aortic root and proximal descending aorta (DAo) were assessed. Results Regional systolic WSS was stable over the follow-up duration, except for a significant decrease in the proximal inner DAo segment (p = 0.02) between t1 and t2. MFS patients revealed significant lower mean systolic WSS in the proximal inner DAo compared with volunteers (0.78 ± 0.15 N/m\(^{2}\)) at baseline t1 (0.60 ± 0.18 N/m\(^{2}\); p = 0.01) and follow-up t2 (0.55 ± 0.16 N/m\(^{2}\); p = 0.001). There were significant relationships (p < 0.01) between the segmental WSS in the proximal inner DAo, DAo Z-scores (r = -0.64) and helix/vortex pattern grading (r = -0.55) at both t1 and t2. The interobserver agreement for secondary flow patterns assessment was excellent (Cohen's k = 0.71). Conclusions MFS patients have lower segmental WSS in the inner proximal DAo segment which correlates with increased localized aberrant vortex/helix flow patterns and an enlarged diameter at one of the most critical sites for aortic dissection. General aortic hemodynamics are stable but these subtle localized DAo changes are already present at young age and tend to be more pronounced in the course of time.}, language = {en} } @article{GassenmaierPetritschKunzetal.2015, author = {Gassenmaier, Tobias and Petritsch, Bernhard and Kunz, Andreas S. and Gkaniatsas, Spyridon and Gaudron, Philipp D. and Weidemann, Frank and Nordbeck, Peter and Beer, Meinrad}, title = {Long term evolution of MRI characteristics in a case of atypical left lateral wall hypertrophic cardiomyopathy}, series = {World Journal of Cardiology}, volume = {7}, journal = {World Journal of Cardiology}, number = {6}, doi = {10.4330/wjc.v7.i6.357}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124934}, pages = {357-360}, year = {2015}, abstract = {We are reporting a long-time magnetic resonance imaging (MRI) follow-up in a rare case of cardiac left lateral wall hypertrophy. Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disorder and a significant cause of sudden cardiac death. Cardiac magnetic resonance (CMR) imaging can be a valuable tool for assessment of detailed information on size, localization, and tissue characteristics of hypertrophied myocardium. However, there is still little knowledge of long-term evolution of HCM as visualized by magnetic resonance imaging. Recently, our group reported a case of left lateral wall HCM as a rare variant of the more common forms, such as septal HCM, or apical HCM. As we now retrieved an old cardiac MRI acquired in this patient more than 20 years ago, we are able to provide the thrilling experience of an ultra-long MRI follow-up presentation in this rare case of left lateral wall hypertrophy. Furthermore, this case outlines the tremendous improvements in imaging quality within the last two decades of CMR imaging.}, language = {en} } @article{GassenmaierGorskiAleksicetal.2013, author = {Gassenmaier, Tobias and Gorski, Armin and Aleksic, Ivan and Deubner, Nikolas and Weidemann, Frank and Beer, Meinrad}, title = {Impact of cardiac magnet resonance imaging on management of ventricular septal rupture after acute myocardial infarction}, series = {World Journal of Cardiology}, journal = {World Journal of Cardiology}, doi = {10.4330/wjc.v5.i5.151}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-96562}, year = {2013}, abstract = {A 74-year-old man was admitted to the cardiac catheterization laboratory with acute myocardial infarction. After successful angioplasty and stent implantation into the right coronary artery, he developed cardiogenic shock the following day. Echocardiography showed ventricular septal rupture. Cardiac magnet resonance imaging (MRI) was performed on the critically ill patient and provided detailed information on size and localization of the ruptured septum by the use of fast MRI sequences. Moreover, the MRI revealed that the ventricular septal rupture was within the myocardial infarction area, which was substantially larger than the rupture. As the patient's condition worsened, he was intubated and had intra-aortic balloon pump implanted, and extracorporeal membrane oxygenation was initiated. During the following days, the patient's situation improved, and surgical correction of the ventricular septal defect could successfully be performed. To the best of our knowledge, this case report is the first description of postinfarction ventricular septal rupture by the use of cardiac MRI in an intensive care patient with cardiogenic shock and subsequent successful surgical repair.}, language = {en} } @phdthesis{Gasparyan2020, author = {Gasparyan, Artur}, title = {Quantifizierung pulmonaler Blutflussgeschwindigkeit durch SENCEFUL Magnetresonanztomographie mit bewegter Schichtselektion}, doi = {10.25972/OPUS-21569}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-215693}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Patienten mit chronischen Lungenerkrankungen leiden unter schwerwiegender Symptomatik und bed{\"u}rfen regelm{\"a}ßiger Verlaufskontrollen der Therapie. Dabei sollte zum Schutz der Patienten sowohl auf kanzerogene, ionisierende Strahlung verzichtet als auch der Einsatz potenziell nebenwirkungsreicher Kontrastmittel vermieden werden. Die pulmonale Blutflussgeschwindigkeit im Parenchym stellt einen quantitativen, bildgebenden Biomarker dar, mit dessen Hilfe die Dynamik des Krankheitsgeschehens untersucht werden kann. In dieser Arbeit wurde eine neue Auswertungsmethode vorgestellt, die mit Hilfe kontrastmittelfreier Magnetresonanztomographie die Blutflussgeschwindigkeit im Lungenparenchym quantifizieren kann. Die auf diese Weise bestimmten Ergebnisse entsprechen den Angaben zur Lungenperfusion, wie sie in der Literatur zu finden sind.}, subject = {Kernspintomografie}, language = {de} } @phdthesis{Fuchs2014, author = {Fuchs, Kilian}, title = {Absolutquantifizierung der myokardialen Perfusion mit hochaufl{\"o}sender MRT bei 3 Tesla}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-107015}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2014}, abstract = {In den letzten Jahren hat die myokardiale MR-Perfusionsbildgebung als nichtinvasives Verfahren zur Darstellung von funktionellen Ver{\"a}nderungen des Myokards f{\"u}r die Diagnostik der KHK zunehmend an Bedeutung gewonnen. W{\"a}hrend in den letzten 20 Jahren die kardiale MRT {\"u}berwiegend bei einer Magnetfeldst{\"a}rke von 1,5 T durchge-f{\"u}hrt wurde und dies auch immer noch wird, findet aktuell eine rasante Verbreitung von MR-Systemen h{\"o}herer Feldst{\"a}rken statt. Von der neuen Hochfeldtechnik erhofft man sich vor allem, je nach Anwendung, eine deutliche Verbesserung der Bildqualit{\"a}t mit h{\"o}herer r{\"a}umlicher und zeitlicher Aufl{\"o}sung, wodurch der diagnostische Nutzen noch weiter gesteigert werden k{\"o}nnte. In der vorliegenden Arbeit wurden mittels First-Pass-MR-Bildgebung bei einer Magnet-feldst{\"a}rke von 3 T quantitative Werte f{\"u}r die myokardiale Perfusion von 20 gesunden Probanden unter Ruhebedingungen bestimmt. Sowohl die erhobenen absoluten Perfusionswerte (0,859 ml/g/min im Mittel) als auch die Standardabweichung des mittleren MBF (0,298 ml/g/min) entsprechen den Messungen aus den fr{\"u}heren Publikationen dieser Arbeitsgruppe. In der Gesamtzusammenschau bisher ver{\"o}ffentlichter Perfusionsstudien zeigt sich eine relativ große Variabilit{\"a}t der publizierten Ruhefl{\"u}sse. Dabei liegt der absolute MBF dieser Arbeit im mittleren Wertebereich dieser Streubreite. Er l{\"a}sst sich auch mit den in PET-Studien ermittelten Ergebnissen in Einklang bringen, welche als Goldstandard zur Bestimmung der absoluten myokardialen Perfusion beim Menschen gelten. Die vorliegende Arbeit best{\"a}tigt die bereits in anderen 3 T-Studien untersuchten Vorteile der Hochfeld-MRT. Die h{\"o}here Magnetfeldst{\"a}rke erm{\"o}glicht durch das gr{\"o}ßere SNR eine signifikant bessere r{\"a}umliche Aufl{\"o}sung und besticht vor allem durch die hohe Bildqualit{\"a}t. Dies k{\"o}nnte bei der Erkennung kleiner, subendokardial gelegener Perfusionsdefekte sowie der Erstellung von transmuralen Perfusionsgradienten von Bedeutung sein und verspricht neben einer Reduktion von Partialvolumeneffekten auch eine Verminderung von „dark rim"-Artefakten. Um diese Vorteile entsprechend nutzen zu k{\"o}nnen, wird die Entwicklung von Methoden zur pixelweisen Bestimmung der absoluten Fl{\"u}sse und farblich kodierten Darstellung derselben in Form von Perfusionskarten ein weiterer Schritt in Richtung klinisch einsetzbare Diagnostik sein. Eine Voraussetzung hierf{\"u}r ist die Entwicklung einer exakten und sehr stabilen Bewegungskorrektur in weiterf{\"u}hrenden Studien. Durch den Wechsel zu einer h{\"o}heren Magnetfeldst{\"a}rke von 3 T und den sich daraus ergebenden Vorteilen kann das Potential der MR-Perfusionsbildgebung, insbesondere der Bestimmung quantitativer Perfusionswerte, im Bereich der nichtinvasiven KHK-Diagnostik zuk{\"u}nftig weiter gesteigert werden.}, subject = {Kernspintomographie}, language = {de} }