TY - JOUR A1 - Schmid, Andrea A1 - Lois, Anna-Maria A1 - Metz, Corona A1 - Grunz, Jan-Peter A1 - Veldhoen, Simon T1 - Not all that looks fractured is broken - multipartite humeral epicondyles in children JF - European Radiology N2 - Objective Multipartite epicondyles may mimic fractures in the setting of pediatric elbow trauma. This study examines the prevalence of multipartite epicondyles during skeletal development and their association with pediatric elbow fractures. Materials and methods In this retrospective analysis, 4282 elbow radiographs of 1265 elbows of 1210 patients aged 0–17 years were reviewed. The radiographs were analyzed by two radiologists in consensus reading, and the number of visible portions of the medial and lateral epicondyles was noted. For elbows in which epicondylar ossification was not yet visible, the epicondyles were already fused with the humerus or could not be sufficiently evaluated due to projection issues or because osteosynthesis material was excluded. In total, 187 elbows were included for the lateral and 715 for the medial epicondyle analyses. Results No multipartite medial epicondyles were found in patients without history of elbow fracture, whereas 9% of these patients had multipartite lateral epicondyles (p < 0.01). Current or previous elbow fractures increased the prevalence of multipartite epicondyles, with significant lateral predominance (medial epicondyle + 9% vs. lateral + 24%, p < 0.0001). Including all patients regardless of a history of elbow fracture, multipartite medial epicondyles were observed in 3% and multipartite lateral epicondyles in 18% (p < 0.0001). There was no gender difference in the prevalence of multipartition of either epicondyle, regardless of a trauma history. Conclusion Multipartite medial epicondyles occur in patients with current or previous elbow fractures only, whereas multipartite lateral epicondyles may be constitutional. Elbow fractures increase the prevalence of multipartite epicondyles on both sides, with significant lateral predominance. Key Points • Multipartite medial epicondyles should be considered of traumatic origin. • Multipartite lateral epicondyles may be constitutional. • Elbow fractures increase the prevalence of multipartite epicondyles on both sides with lateral predominance. KW - elbow joint KW - epicondyles KW - bone fractures KW - pediatrics KW - radiography Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-324987 VL - 32 IS - 8 ER - TY - THES A1 - Schmid, Andrea T1 - Diagnostische Genauigkeit der Dual-Energy Computertomographie Angiographie bei Patienten mit peripherer arterieller Verschlusskrankheit T1 - Diagnostic Accuracy of Dual-Energy Computertomography Angiography in Patients with Peripheral Arterial Occlusive Disease N2 - Es wurde die diagnostische Genauigkeit fünf verschiedener Rekonstruktionsalgorithmen der DE-CTA der Becken-Bein-Gefäße von Patienten mit pAVK an einem Dual-Source CT mit dem diagnostischen Goldstandard der DSA verglichen. Die DE-CTA zeigte eine exzellente Sensitivität an Becken- und Beingefäßen hinsichtlich einer korrekten Stenosegraduierung, unabhängig von der Rekonstruktion. Die Standard MPR zeigte insgesamt die besten Ergebnisse und ist deshalb vor allem in nicht eindeutigen Fällen die Methode der Wahl. Die Auswertung von DE-CS MPRs, DE-CS MIPs, gekrümmten MPRs oder die semi-automatische quantitative Stenosegradauswertung bringt keinen Zugewinn an diagnostischer Performance im Vergleich zur visuellen Auswertung der Standard MPR. Das Ausmaß der Gefäßwandverkalkungen und die intraluminale Kontrastierung hatten keinen signifikanten Effekt auf die Sensitivität zur Erkennung signifikanter Stenosen an den Becken- und Beingefäßen. Jedoch verschlechterten sich die Spezifität und die Genauigkeit der Rekonstruktionen, welche auf der DE-Knochen- und DE-Plaqueentfernung basieren, signifikant in stark verkalkten oder nur schwach kontrastierten Gefäßsegmenten. Beim Auswerten von DE-CS Rekonstruktionen ist infolgedessen vor allem in schlecht kontrastierten oder stark verkalkten Gefäßen eine weitere Verifizierung des Befundes nötig, um unnötige invasive DSAs als Folge von falsch positiven CTA-Befunden zu reduzieren. N2 - The diagnostic accuracy of five different DE-CTA recontruction approaches of a dual-source CT in patients with peripheral artery disease were compared, using digital subtraction angiography as reference standard. DE-CTA shows an excellent sensitivity for the detection of lower extremity arterial stenosis, regardless of image reconstruction approach. The standard MPR showed the best results overall and is therefore the method of choice in unclear cases. Thus DE-CS MPRs, DE-CS MIPs, curved MPRs and semi-automatic stenosis grading don’t bring additional value regarding the diagnostic performance in comparison to the standard MPR. The amount of vessel wall calcification and the intraluminal contrast had no significant effect on the sensitivity for the detection of lower extremity arterial stenosis. Specifity and accuracy decreased in reconstructions that relied on DE-bone- and DE-plaque-subtraction significantly in vessels with strong calcification or poor contrasting. When analyzing DE-CS reconstructions for poorly contrasted or strongly calcified vessels a further evaluation is necessary, to avoid invasive DSAs as a result of false positive findings. KW - Dual-Source-Computertomographie KW - Periphere arterielle Verschlusskrankheit KW - Computertomographie Angiographie KW - Dual-Source Computertomography KW - Peripheral Artery Disease KW - Computertomography Angiography Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-251137 ER -