Zhaoehlers7411

. Impact of Patient Alignment on Image Quality in C-Arm Computed Tomography - Evaluation Using an ACR Phantom. Fortschr Röntgenstr 2020; DOI 10.1055/a-1238-2802.

 The term "carpal instability" describes different debilitating wrist conditions, in which the carpus is unable to maintain its physiological range of motion and load transfer. Depending on the cause and location of the dysfunction, four groups can be defined dissociative, non-dissociative, complex, and adaptive carpal instability. As the most common form by far, dissociative carpal instability can further be categorized as dorsal or palmar intercalated segment instability, contingent on the afflicted interosseous ligament.

 This review article outlines the different entities of carpal instability, their pathophysiology, and their clinical presentation. It further discusses the diagnostic significance of different imaging methods as well as the established treatment options for each form of instability in context with the current literature.

 Early detection and treatment of carpal instability are essential for preventing carpal osteoarthritis. Traumatic lesions of the scapholunate interosseous ligament are the most frequent cause of instability. They can occur in an isolated fashion or in context with other carpal injuries. While stress imaging and fluoroscopy facilitate the differentiation between dynamic and static forms of carpal instability, only MRI and CT/MR arthrography can directly reveal the extent of ligament discontinuity.

· Carpal instability can manifest only in motion (dynamic) or at rest (static).. · Dissociative forms must be distinguished from non-dissociative, adaptive, or complex entities.. · Most instabilities are related to traumatic injuries or CPPD arthropathy.. · Fluoroscopy, stress imaging, and MR and CT arthrography are helpful for diagnosis..

· Grunz JP, Gietzen CH, Grunz K et al. Imaging of Carpal Instabilities. Fortschr Röntgenstr 2021; 193 139 - 150.

· Grunz JP, Gietzen CH, Grunz K et al. Imaging of Carpal Instabilities. Fortschr Röntgenstr 2021; 193 139 - 150.

 The purpose of this article is to demonstrate the potential indications, procedural technique and initial results of the transarterial periarticular embolization (TAPE).

 TAPE was performed in three patients with chronic pain in different joints. In the first case the patient suffered from osteoarthritis of the shoulder, in the second case from epicondylitis humeri ulnaris ("golfer-elbow") and in the third case from patellar tendinitis ("jumpers-knee"). Clinical as well as pain assessment was performed pre and post-interventionally.

 TAPE was performed with technical success in all three patients. For vessel access, either a transradial or transfemoral access was chosen. The joint supplying vessels were catheterized superselectively with microcatheters and embolized with Imipenem/Cilastatin diluted in contrast medium. After embolization of the knee the patient demonstrated skin redness, which disappeared within one week. No further complications were noted. All patients reported significant pain reliefe in Germany. Fortschr Röntgenstr 2020; 192 1046 - 1052.

 To assess the effectiveness of pain management with superior hypogastric plexus block (SHPB) compared to epidural anesthesia (EDA) in women requiring uterine artery embolization (UAE).

 In this retrospective, single-center, non-randomized trial we included 79 women with symptomatic uterine fibroids who were scheduled for percutaneous, transcatheter UAE. According to their informed decision, the women were assigned to two different approaches of pain management including either SHPB or EDA. The effectiveness outcome measure was patient reported pain using a numeric rating scale ranging from 1 to 10. The pain score was assessed at UAE, 2 hours thereafter, and at subsequent intervals of 6hours up to 36 hours after intervention.

 Treatment groups did not differ significantly regarding age, pain score for regular menstrual cramps, uterine fibroid size, location, and symptoms of uterine fibroids. During UAE and up to 6 hours thereafter, women who received SHPB experienced stronger pain than those who receivealuation. Fortschr Röntgenstr 2021; 193 289 - 297.

· Malouhi A, Aschenbach R, Erbe A et al. Effectiveness of Superior Hypogastric Plexus Block for Pain Control Compared to Epidural Anesthesia in Women Requiring Uterine Artery Embolization for the Treatment of Uterine Fibroids - A Retrospective Evaluation. Fortschr Röntgenstr 2021; 193 289 - 297.

 To create a fully automated, reliable, and fast segmentation tool for Gd-EOB-DTPA-enhanced MRI scans using deep learning.

 Datasets of Gd-EOB-DTPA-enhanced liver MR images of 100 patients were assembled. Ground truth segmentation of the hepatobiliary phase images was performed manually. Automatic image segmentation was achieved with a deep convolutional neural network.

 Our neural network achieves an intraclass correlation coefficient (ICC) of 0.987, a Sørensen-Dice coefficient of 96.7 ± 1.9 % (mean ± std), an overlap of 92 ± 3.5 %, and a Hausdorff distance of 24.9 ± 14.7 mm compared with two expert readers who corresponded to an ICC of 0.973, a Sørensen-Dice coefficient of 95.2 ± 2.8 %, and an overlap of 90.9 ± 4.9 %. A second human reader achieved a Sørensen-Dice coefficient of 95 % on a subset of the test set.

 Our study introduces a fully automated liver volumetry scheme for Gd-EOB-DTPA-enhanced MR imaging. The neural network achieves competitive concordance with the ground truth regarding ICC, Sørensen-Dice, and overlap compared with manual segmentation. FR 180204 mouse The neural network performs the task in just 60 seconds.

  · The proposed neural network helps to segment the liver accurately, providing detailed information about patient-specific liver anatomy and volume.. · With the help of a deep learning-based neural network, fully automatic segmentation of the liver on MRI scans can be performed in seconds.. · A fully automatic segmentation scheme makes liver segmentation on MRI a valuable tool for treatment planning..

· Winther H, Hundt C, Ringe KI et al. A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI. Fortschr Röntgenstr 2021; 193 305 - 314.

· Winther H, Hundt C, Ringe KI et al. A 3D Deep Neural Network for Liver Volumetry in 3T Contrast-Enhanced MRI. Fortschr Röntgenstr 2021; 193 305 - 314.

 Cross-institutional establishment of standardized protocols for CT and MR imaging of primary liver and pancreas tumors in an oncological center.

 This prospective dual-institution study was approved by the local IRBs. Minimum requirements (phases, sequences, slice thickness) for imaging of primary liver and pancreas tumors were defined and implemented at both sites. Between 06/19 and 08/19 in-house examinations were evaluated in terms of compliance with defined protocols and image quality. In addition, extramural examinations that were demonstrated at interdisciplinary tumor board meetings in the same study period were reviewed. Results were analyzed by means of descriptive statistics, and differences between centers, modalities and organs assessed (Fisher-exact Test, p < 0.05 deemed significant).

 480 data sets (397 internal, 83 extramural) were included in this study and analyzed. Overall protocol compliance for in-house examinations was 93.5 % (371/397 datasets), without statistical significant dancer Center Lower Saxony. Fortschr Röntgenstr 2020; DOI 10.1055/a-1238-2925.

· Römermann I, Al-Bourini O, Seif Amir Hosseini A et al. Cross-insitutional standardization of imaging protocols - A pilot study within the scope of the Comprehensive Cancer Center Lower Saxony. Fortschr Röntgenstr 2020; DOI 10.1055/a-1238-2925.

 Endoscopic ultrasound-directed transgastric endoscopic retrograde cholangiopancreatography (ERCP; EDGE) is an alternative to enteroscopy- and laparoscopy-assisted ERCP in patients with Roux-en-Y gastric bypass anatomy. Although short-term results are promising, the long-term outcomes are not known. The aims of this study were (1) to determine the rates of long-term adverse events after EDGE, with a focus on rates of persistent gastrogastric or jejunogastric fistula; (2) to identify predictors of persistent fistula; (3) to assess the outcomes of endoscopic closure when persistent fistula is encountered.

 This was a multicenter retrospective study involving 13 centers between February 2015 and March 2019. Adverse events were defined according to the ASGE lexicon. Persistent fistula was defined as an upper gastrointestinal series or esophagogastroduodenoscopy showing evidence of fistula.

 178 patients (mean age 58 years, 79 % women) underwent EDGE. Technical success was achieved in 98 % of cases (175/178)n persistent fistulas are identified, endoscopic treatment is warranted, and should be successful in closing the fistula.

 The Performance Indicator of Colonic Intubation (PICI) is a new measure of high-quality colonic intubation. Adequate PICI was defined as cecal intubation without significant discomfort and use of minimal sedation. This study assessed achievement of PICI within the Dutch colorectal cancer (CRC) screening program, and determined the association between PICI and adenoma detection rate (ADR). PICI achievement when using the Dutch median midazolam dose was also assessed.

 This retrospective study was conducted within the Dutch fecal immunochemical test-based CRC screening program. Colonoscopy and pathology data were prospectively collected in a national database. Data between January 2016 through January 2018 were analyzed. Adequate PICI was defined as successful cecal intubation, Gloucester Comfort Scale (GCS) of 1 - 3, and use of ≤ 2.5 mg midazolam.

 107 328 colonoscopies were performed during the study period. Adequate PICI was achieved in 49 500 colonoscopies (46.1 %). In colonoscopies with inadequate PICI, inadequacy was due to higher sedation doses in 87.8 %. Adequate PICI was associated with higher ADR (odds ratio 1.16, 95 % confidence interval 1.12 - 1.20). When using a cutoff of 5 mg midazolam, median dose in this Dutch population, adequate PICI was achieved in 95 410 colonoscopies (88.9  %).

 PICI appeared to be heavily dependent on sedation practice. Because of wide variation in sedation practice between individual endoscopists and countries, the benefit of PICI as a quality indicator is limited.

 PICI appeared to be heavily dependent on sedation practice. Because of wide variation in sedation practice between individual endoscopists and countries, the benefit of PICI as a quality indicator is limited.The proinflammatory cytokine storm associated with coronavirus disease 2019 (COVID-19) negatively affects the hematological system, leading to coagulation activation and endothelial dysfunction and thereby increasing the risk of venous and arterial thrombosis. Coagulopathy has been reported as associated with mortality in people with COVID-19 and is partially reflected by enhanced D-dimer levels. Poor vascular health, which is associated with the cardiometabolic health conditions frequently reported in people with severer forms of COVID-19, might exacerbate the risk of coagulopathy and mortality. Sedentary lifestyles might also contribute to the development of coagulopathy, and physical activity participation has been inherently lowered due to at-home regulations established to slow the spread of this highly infectious disease. It is possible that COVID-19, coagulation, and reduced physical activity may contribute to generate a "perfect storm," where each fuels the other and potentially increases mortality risk.