[show abstract][hide abstract] ABSTRACT: PURPOSE: Head and neck squamous cell carcinoma (HNSCC) may cause a decreased apparent diffusion coefficient (ADC) on diffusion-weighted magnetic resonance imaging (DW MRI) and an increased standardized uptake value (SUV) on fluorodeoxyglucose (FDG) positron emission tomography (PET/CT). We analysed the reproducibility of ADC and SUV measurements in HNSCC and evaluated whether these biomarkers are correlated or independent. METHODS: This retrospective analysis of DW MRI and FDG PET/CT data series included 34 HNSCC in 33 consecutive patients. Two experienced readers measured tumour ADC and SUV values independently. Statistical comparison and correlation with histopathology was done. Intra- and inter-observer agreement for ADC and SUV measurements was assessed. RESULTS: Intraclass correlation coefficient (ICC) analysis showed almost perfect reproducibility (>0.90) for ADC(mean), ADC(min), SUV(max) and SUV(mean) values for intra-observer and inter-observer agreement. Mean ADC(mean) and ADC(min) in HNSCC were 1.05 ± 0.34 × 10(-3) mm(2)/s and 0.65 ± 0.29 × 10(-3) mm(2)/s, respectively. Mean SUV(mean) and mean SUV(max) were 7.61 ± 3.87 and 12.8 ± 5.0, respectively. Although statistically not significant, a trend towards higher SUV and lower ADC was observed with increasing tumour dedifferentiation. Pearson's correlation analysis showed no significant correlation between ADC and SUV measurements (r -0.103, -0.051; p 0.552, 0.777). CONCLUSION: Our data suggest that ADC and SUV values are reproducible and independent biomarkers in HNSCC.
European Journal of Nuclear Medicine 02/2013; · 4.53 Impact Factor
[show abstract][hide abstract] ABSTRACT: OBJECTIVE: The objective of this article is to review the CT and MR angiography features of vascular injuries to the neck with special emphasis on the key diagnostic features of common and less common entities. CONCLUSION: CT and MR angiography are highly efficient for the diagnosis of most arterial and venous traumatic lesions in the acute setting and when patients develop delayed symptoms. Conventional angiography is recommended only for therapeutic purposes or when the diagnosis remains unclear after performing cross-sectional imaging techniques.
American Journal of Roentgenology 06/2011; 196(6):W800-9. · 2.90 Impact Factor
[show abstract][hide abstract] ABSTRACT: Subcutaneous and deep cervical emphysema (SCE) in the head and neck are found in a wide spectrum of conditions. Most of them are seen in patients with midfacial trauma or oropharyngeal infections. Subcutaneous and deep cervical emphysema can also be a symptom of life-threatening mediastinitis and/or necrotizing fasciitis, both of which need immediate surgery. Rarely however does SCE occur in isolation as a consequence of elevated intraoral pressure in combination with or without visible lacerations of the oral mucosa. As a consequence, air penetrates the mucosal tears and results in subcutaneous emphysema even extending down to the mediastinum in severe cases. This article describes a series of five cases of isolated SCE. It discusses the diagnosis, the pathomechanism, the differential diagnosis and the treatment. It underlines the importance of anamnesis and careful physical and laboratory examinations in order to differentiate isolated SCE from more severe conditions such as necrotizing fasciitis or mediastinitis, which necessitate immediate surgery.
Archives of Oto-Rhino-Laryngology 04/2011; 269(1):303-8. · 1.29 Impact Factor
[show abstract][hide abstract] ABSTRACT: This article provides an overview of the imaging findings of diseases affecting the optic nerve with special emphasis on clinical-radiological correlation and on the latest technical developments in MR imaging and CT. The review deals with congenital malformations, tumors, toxic/nutritional and degenerative entities, inflammatory and infectious diseases, compressive neuropathy, vascular conditions and trauma involving the optic nerve from its ocular segment to the chiasm. The implications of imaging findings on patient management and outcome and the importance of performing high-resolution tailored examinations adapted to the clinical situation are discussed.
European journal of radiology 05/2010; 74(2):299-313. · 2.65 Impact Factor
[show abstract][hide abstract] ABSTRACT: We report the occurrence of a bilateral pneumothoraces after unilateral central venous catheterization of the right subclavian vein in a 70-year-old patient. The patient had no history of pulmonary or pleural disease and no history of cardiothoracic surgery. Two days earlier, she had a median laparotomy under general and epidural anaesthesia. Prior to the procedure, the patient was hemodynamically stable and her transcutaneous oxygen saturation was 97% in room air. We punctured the right pleural space before cannulation of the right subclavian vein. After the procedure, the patient slowly became hemodynamically instable with respiratory distress. A chest radiograph revealed a complete left-side pneumothorax and a mild right-side pneumothorax. The right-side pneumothorax became under tension after left chest tube insertion. The symptoms finally resolved after insertion of a right chest tube. After a diagnostic work-up, we suspect a congenital "Buffalo chests" explaining bilateral pneumothoraces and a secondary tension pneumothorax.
[show abstract][hide abstract] ABSTRACT: To demonstrate the use of perfusion CT in patients presenting with a suspected diagnosis of stroke to avoid the administration of inappropriate thrombolytic therapy in stroke-mimicking conditions such as status epilepticus.
We reviewed the imaging studies of four patients presenting with symptoms suggestive of stroke, but finally diagnosed with status epilepticus. Imaging was by a 16-section multidetector CT scanner using a protocol consisting of non-contrast CT, CT angiography and perfusion CT. Color-coded maps allowed calculation of the CBV (cerebral blood volume), CBF (cerebral blood flow) and MTT (mean transit time).
In all four cases, perfusion CT revealed increases in CBF and CBV as well as a decreased MTT, consistent with hyperperfusion linked to status epilepticus with focal deficit-in contrast to the hypoperfusion observed in stroke patients.
The use of perfusion CT accurately detected hyperperfusion in status epilepticus presenting as stroke. In such cases, perfusion CT imaging avoided the administration of potentially harmful thrombolytic therapy to patients experiencing seizures due to different underlying etiologies.
Journal of Neuroradiology 11/2008; 36(1):48-51. · 1.24 Impact Factor