Thomas Schulze

Universität Heidelberg, Heidelberg, Baden-Wuerttemberg, Germany

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Publications (3)11.57 Total impact

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    ABSTRACT: To determine the diagnostic value of non-contrast-enhanced, 3D-high-resolution, ECG-gated, multi-step MR angiography (non-ceMRA) of the lower extremities using a modified turbo-spin-echo technique in comparison to 1.0-molar contrast-enhanced MR angiography (ceMRA) in patients with suspected peripheral vascular disease (PVD). Fifty consecutive patients underwent non-ceMRA before ceMRA within the same session. We assessed examination time, image quality, localisation and severity of stenosis. Examination time was shorter for ceMRA (12 ± 4 min) compared with non-ceMRA (28 ± 6 min, p < 0.001). The image quality of the aorta-iliac, femoral and combined popliteal and lower leg arteries was inferior for non-ceMRA (2.8 ± 0.8/3.3 ± 0.8/3.3 ± 0.9) versus ceMRA (4.7 ± 0.8/4.8 ± 0.6/4.8 ± 0.7) on a 5-point scale with 5 for maximum quality (p < 0.01). CeMRA offered more assessable data sets than non-ceMRA (98% vs. 90%). For detecting stenosis >50% or occlusions of pelvic and femoral arteries using non-ceMRA the sensitivity, specificity, positive and negative predictive values were 94%, 86%, 67% and 98% and for popliteal and lower leg arteries 93%, 87%, 69% and 98%, respectively. We demonstrated that 3D non-ceMRA represents a very promising technique in patients with lower extremities PVD and could be used as an alternative if gadolinium-based contrast agents cannot be administered.
    European Radiology 02/2011; 21(2):434-42. · 4.34 Impact Factor
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    ABSTRACT: The aim of this study is to determine the diagnostic value of high-resolution 3D unenhanced ECG-gated respiratory-navigated MR angiography (MRA) of the renal arteries using a steady-state free precession (SSFP) technique in comparison with 1.0-molar contrast-enhanced MRA in patients with suspected renal artery stenosis. Forty-five consecutive patients underwent unenhanced MRA before contrast-enhanced MRA within the same session. We assessed examination time, image quality, renal artery architecture, and localization and severity of renal artery stenosis. Examination time was shorter for contrast-enhanced MRA (mean ± SD, 12 ± 3 minutes) than for unenhanced MRA (19 ± 3 minutes; p < 0.001). On a 5-point scale, the image quality was similar for contrast-enhanced MRA (3.8 ± 1.0) and unenhanced MRA (4.0 ± 1.3; p = 0.24). Contrast-enhanced MRA offered more assessable data sets than did unenhanced MRA (95% vs 90%); however, unenhanced MRA had more data sets with maximum image quality (49% vs 30%). There was moderate agreement in stenosis grading between both MRA techniques (κ = 0.51; p < 0.001), but in only one case (1.3%) we found mismatch of more than one severity stenosis grade (stenoses > 75%). Sensitivity, specificity, and positive and negative predictive values of unenhanced MRA to detect renal artery stenoses greater than 50% were 75%, 99%, 75%, and 99%, respectively. We show that SSFP 3D unenhanced MRA is a very promising technique for patients with suspected renovascular disease and could be used as an alternative if gadolinium-based contrast agents cannot be administered.
    American Journal of Roentgenology 12/2010; 195(6):1423-8. · 2.90 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the diagnostic value of contrast-enhanced first-pass perfusion MRI in patients with suspected cardiac masses and tumour-like lesions. Twenty patients underwent contrast-enhanced first-pass saturation-recovery steady-state-free-precession perfusion MRI in addition to clinical MRI. Eleven diagnostic parameters were analysed blinded in consensus by three observers: localisation (paracardiac/mural/intracavitary), malignancy (benign/malignant) and first-pass enhancement pattern (homogeneous/heterogeneous as well as non-perfused/hypoperfused/iso-perfused/ hyperperfused). The results were compared to combined references comprising histology, cytology, medical and surgical reports, echocardiography, chest X-ray, coronary angiography and regular MRI. Also, we analysed if additional first-pass perfusion confirmed, changed or reduced the number of differential diagnoses compared to clinical MRI. All cardiac masses or tumour-like lesions were correctly localised and scored as benign lesions. For homogeneous perfused lesions the sensitivity, specificity, positive and negative predictive value was 94/100/100/67%, 100/94/67/100% for heterogeneous perfused lesions, 92/100/100/88% for non-perfused, 100/94/75/100 for hypoperfused, 100/100/100/100% for hyperperfused and for isoperfused lesions. In 17/2/1 cases perfusion MRI confirmed, reduced or increased the number of potential differentials. First-pass perfusion MRI provides valuable information in patients with benign cardiac masses or tumour-like lesions. Further experience is needed to underline these preliminary observations.
    European Radiology 09/2008; 18(8):1617-24. · 4.34 Impact Factor

Publication Stats

21 Citations
11.57 Total Impact Points

Institutions

  • 2010–2011
    • Universität Heidelberg
      • Department of Diagnostic and Interventional Radiology
      Heidelberg, Baden-Wuerttemberg, Germany