Hartmut Becker

Publications of Hartmut Becker

• Spinal metastasis of papillary tumor of the pineal region.

  Authors: Bujung Hong, Makoto Nakamura, Almuth Brandis, Hartmut Becker, Joachim K Krauss

  Clinical neurology and neurosurgery. 11/2010; 113(3):235-8.

• [Hemorrhage after Embolization of a Cerebral AVM.]

  Authors: Hartmut Becker, Claudia Hader, Martin Schumacher

  Klinische Neuroradiologie. 02/2010;

  The report concerns a 36-year-old patient with left temporal arteriovenous malformation (AVM). After interdisciplinary consultation, combined treatment with endovascular embolization and subsequentThe report concerns a 36-year-old patient with left temporal arteriovenous malformation (AVM). After interdisciplinary consultation, combined treatment with endovascular embolization and subsequent stereotactic irradiation was recommended. 2 h following embolization, which was complication-free, there was left temporal bleeding with ventricular tamponade. Once the patient had survived the acute phase with application of external drainage and later implantation of a shunt system, he was left with an organic brain syndrome. His lawyer brought suit against the clinic for improper treatment and inadequate information. The court rejected the suit as without foundation, basing its reasoning essentially on the statements of the neuroradiologic expert.

• Consequences of a Nonrecognized Subarachnoid Hemorrhage.

  Authors: Hartmut Becker

  Klinische Neuroradiologie. 11/2009;

  Report of a 42-year-old woman who had an acute severe headache, sickness, and a short-term seizure. After hospitalization, a computed tomography (CT) study was done and reported as normal. TheReport of a 42-year-old woman who had an acute severe headache, sickness, and a short-term seizure. After hospitalization, a computed tomography (CT) study was done and reported as normal. The discharge home followed after symptomatic treatment for 5 days. 10 days after the first acute onset appeared a second event with similar symptoms. Now, a subarachnoid hemorrhage with an intracerebral bleeding of the left frontal lobe was diagnosed in another hospital. This was suspicious for an aneurysm of the anterior communicating artery. It was treated with coiling and, in addition, an installation of an external cerebrospinal fluid (CSF) drainage was necessary because of a hydrocephalus with development of a temporary CSF leakage. The patient appealed to the fact-finding board for medical liability questions because of the misdiagnosis of the first treating hospital. The board found the adjustment of damages of the patient to be valid and recommended an extrajudicial regulation.

• Performance of a new quantitative method for assessing dural ectasia in patients with FBN1 mutations and clinical features of Marfan syndrome.

  Authors: Bahar Söylen, Kerstin Hinz, Jana Prokein, Hartmut Becker, Jörg Schmidtke, Mine Arslan-Kirchner

  Neuroradiology. 03/2009;

  INTRODUCTION: This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. METHODS: Seventeen patients withINTRODUCTION: This study presents a comparison of established methods for measuring dural ectasia with a new quantitative method of assessing this clinical feature. METHODS: Seventeen patients with an identified mutation in FBN1 were examined for dural ectasia. The results were compared with 17 age- and sex-matched controls. Our images were also evaluated using the two methods of quantifying dural ectasia, namely those of Ahn et al. and of Oosterhof et al. RESULTS: With our method, 80% MFS1 patients and 7% controls fulfilled the criterion for dural ectasia. Using the method of Oosterhof et al., dural ectasia was found in 88% patients with MFS1 and in 47% controls. Using the method of Ahn et al. 76% patients with Marfan syndrome and 29% controls showed dural ectasia. CONCLUSION: We present a novel quantitative method of evaluating MRT images for dural ectasia, which, in our own patient cohort, performed better than those previously described.

• Pneumolabyrinth after cochlear implantation in large vestibular aqueduct syndrome.

  Authors: Ingo O Ott, Burkard Schwab, Hartmut Becker, Peter R. Issing

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 11/2008; 29(7):1037-8.

• Intra-arterial thrombolysis using rt-PA in patients with acute stroke due to vessel occlusion of anterior and/or posterior cerebral circulation.

  Authors: Argyro Tountopoulou, Bjoern Ahl, Karin Weissenborn, Hartmut Becker, Friedrich Goetz

  Neuroradiology. 02/2008; 50(1):75-83.

  INTRODUCTION: The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute stroke dueINTRODUCTION: The aim of our study was to evaluate the safety and efficacy of intra-arterial (IA) thrombolysis using recombinant tissue plasminogen activator (rt-PA) in patients with acute stroke due to occlusion in the anterior or posterior circulation. METHODS: We retrospectively analyzed the clinical and radiological data of 88 consecutive patients with acute ischemic stroke who underwent emergency cerebral angiography for the purpose of subsequent IA thrombolysis. The neurological deficit on admission and discharge was graded using the National Institutes of Health Stroke Scale (NIHSS) score. Baseline computer tomography (CT) scans were examined for any signs indicative of cerebral ischemia. The angiographic findings were classified according to the Thrombolysis in Myocardial Infarction (TIMI) score for myocardial infarction. Follow-up CT scans were examined for hemorrhagic complication. RESULTS: Of the 88 patients who underwent IA thrombolysis, 63 presented with complete or partial arterial occlusion in the suspected perfusion area. In these 63 patients, the median NIHSS score dropped from 15 points on admission to 10 points at discharge. The recanalization rate was 52.6% for partial and complete reperfusion. In-hospital mortality was 20.6% (9.1% for carotid, 44.4% for basilar territory occlusion). Intracerebral bleeding (ICB) occurred in 38.6% of the patients with occlusion in the anterior circulation, resulting in these patients presenting a worse clinical outcome than those without ICB. Only minor extracranial bleedings occurred in 20.6% of patients. Patients with ICB had a significantly higher frequency of ischemic signs on the baseline CT scan. CONCLUSION: Occlusion of a cerebral artery is present in about 75% of the patients eligible for thrombolytic therapy. Intra-arterial thrombolysis using rt-PA in patients with acute ischemic stroke can achieve re-vascularization, although ICB remains the major risk factor affecting its efficacy.

• Primary central nervous system lymphoma presenting as bilateral tumors of the internal auditory canal.

  Authors: Minoo Lenarz, Martin Durisin, Hartmut Becker, Thomas Lenarz, Mohamad Nejadkazem

  Skull base : official journal of North American Skull Base Society ... [et al.]. 12/2007; 17(6):409-12.

  The increasing incidence of central nervous system (CNS) lymphoma in the general population, especially in young adults with AIDS, should alert the otolaryngologist that in future there will be anThe increasing incidence of central nervous system (CNS) lymphoma in the general population, especially in young adults with AIDS, should alert the otolaryngologist that in future there will be an even greater incidence of this rare disease. It may be responsible for hearing loss accompanied by other neurological deficits. CNS lymphoma often has a rapidly progressive course. Early diagnosis and rapid therapy are crucial for a better prognosis. We report a case of primary CNS lymphoma involving both internal auditory canals that presented with sudden deafness and disequilibrium accompanied by facial and abducens nerve palsy.

• Cerebellar atrophy in Schimke-immuno-osseous dysplasia.

  Authors: Thomas Lücke, Johanna M Clewing, Cornelius F Boerkoel, Hans Hartmann, Anibh M Das, Michael Knauth, Hartmut Becker, Frank Donnerstag

  American journal of medical genetics. Part A. 10/2007; 143A(17):2040-5.

  Schimke-immuno-osseous dysplasia is an autosomal-recessive multisystem disorder with the prominent clinical features disproportionate growth failure, progressive renal failure, and T-cellSchimke-immuno-osseous dysplasia is an autosomal-recessive multisystem disorder with the prominent clinical features disproportionate growth failure, progressive renal failure, and T-cell immunodeficiency. Neurological symptoms caused by transient ischemic attacks (TIAs) and strokes are a typical clinical finding in severe SIOD. Cerebral ischemia and white matter changes, moyamoya phenomena and absence of a cerebellar hemisphere and partial absence of the cerebellar vermis have been described in patients with severe SIOD. We present three SIOD patients with atrophy of the caudal parts of the cerebellar vermis (posterior lobule) and of the cerebellar hemispheres. We hypothesize that these cerebellar abnormalities are a continuum of the ongoing vascular disease in severe SIOD.

• Cavernous hemangioma of the internal auditory canal.

  Authors: Minoo Lenarz, Martin Durisin, Petr Kamenetzki, Hartmut Becker, Hans-Heinrich Kreipe, Thomas Lenarz

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 06/2007; 264(5):569-71.

  Hemangiomas rarely occur in the internal auditory canal. These tumors originate from the capillary bed of the epineurium surrounding the nerve and can either compress or infiltrate the nerve.Hemangiomas rarely occur in the internal auditory canal. These tumors originate from the capillary bed of the epineurium surrounding the nerve and can either compress or infiltrate the nerve. Depending on location and the nerve of origin, these lesions can cause severe and progressive sensorineural hearing loss, tinnitus, facial nerve palsy, or vertigo even when they are relatively small. The presence of a small contrast-enhancing tumor in the internal auditory canal accompanied by severe sensorineural hearing loss and facial nerve palsy, should raise the suspicion of a hemangioma. Early recognition and surgical intervention in these benign tumors may improve the chance of preserving the functional integrity of the facial nerve and provides better results after nerve reconstruction. Due to their relative small size, the temporal bone CT-scan may show no evidence of pathological widening of the internal auditory canal or the typical intralesional calcifications at the time of presentation. MRI with Gadolinium is the imaging method of choice and a high index of clinical suspicion is necessary for the diagnosis of these tumors. In this paper we report about a 51-year-old male presented with right-sided sensory-neural deafness and facial nerve palsy, accompanied by severe tinnitus and ipsilateral loss of vestibular function due to a cavernous hemangioma in the internal auditory canal.

• A case of multiple primary tumors of the anterior skull base.

  Authors: Minoo Lenarz, Martin Durisin, Hartmut Becker, Almuth Brandis, Thomas Lenarz

  Skull base : official journal of North American Skull Base Society ... [et al.]. 04/2007; 17(2):153-6.

  We report a case of synchronous olfactory bulb meningioma and undifferentiated carcinoma of the nose and paranasal sinuses that involved and destroyed the anterior skull base and mimickedWe report a case of synchronous olfactory bulb meningioma and undifferentiated carcinoma of the nose and paranasal sinuses that involved and destroyed the anterior skull base and mimicked intracranial invasion by a carcinoma. The heterogeneity of tissue types in the skull base gives rise to a diverse variety of benign and malignant neoplasms which have totally different prognoses. Synchronous development of benign and malignant primary tumors both originating from and involving the skull base at the same location is very rare and may cause confusion for both the skull base surgeon and neuroradiologist.

• Effect of the arterial input function on the measured perfusion values and infarct volumetric in acute cerebral ischemia evaluated by perfusion computed tomography.

  Authors: Sotirios Bisdas, George N Konstantinou, Jessen Gurung, Thomas Lehnert, Frank Donnerstag, Hartmut Becker, Thomas J Vogl, Tong San Koh

  Investigative radiology. 04/2007; 42(3):147-56.

  OBJECTIVES: We sought to evaluate the accuracy of the perfusion computed tomography (PCT) deconvolution-based brain perfusion measurements and the lesions' (infarct and penumbra) volumetric withOBJECTIVES: We sought to evaluate the accuracy of the perfusion computed tomography (PCT) deconvolution-based brain perfusion measurements and the lesions' (infarct and penumbra) volumetric with regard to arterial input function (AIF) selection in patients with acute stroke. MATERIALS AND METHODS: Eighteen consecutive patients with symptoms of acute stroke underwent PCT at admission. Follow-up magnetic resonance imaging was obtained in all patients after 3.6 +/- 1.7 days (range, 1.5-6 days). PCT maps were generated focusing on the anterior cerebral artery (ACA) and branches of the middle cerebral artery (MCA) ipsilateral and contralateral to the ischemic lesion as AIFs. Infarct, penumbra, and total ischemic lesion were delineated on cerebral blood flow (CBF) maps. CBF, cerebral blood volume (CBV), and mean transit time (MTT) were calculated in the ischemic regions as provided by the 3 different AIFs, the normality test was applied for the obtained parameters, and the values were correlated (Pearson's correlation coefficient). Volumes of the ischemic regions (as obtained by the different AIFs) also were correlated and compared (paired t test) to the follow-up infarct volume. RESULTS: The CBF and CBV values obtained by the different AIFs in the infarct, penumbra, and total ischemic lesion were significantly correlated (r=0.94-0.96, P<or=0.01). Only in the infarct region calculated MTT values were correlated (r=0.88-0.91, P<0.05) between the different AIFs groups. High correlation coefficients (r=0.79-0.91, P<0.001) were observed between the admission PCT infarct and total ischemic volume and the MRI follow-up infarct volume. ACA as AIF provided the best correlations (r=0.91, P=0.0002) with the follow-up measurements. No statistically significant difference was found between the 3 different AIF-estimated admission total ischemic volumes and the follow-up infarct volume. CONCLUSIONS: The AIF selection in the ACA as well as in the ipsilateral (to the hypoperfused area) or contralateral branches of the MCA has no statistically significant impact on the calculation of the CBF, CBV values, and the volume estimation of the ischemic region in the acute stroke patients.

• Increase of accuracy in intraoperative navigation through high-resolution flat-panel volume computed tomography: experimental comparison with multislice computed tomography-based navigation.

  Authors: Soenke H Bartling, Martin Leinung, Johannes Graute, Thomas Rodt, Christian Dullin, Hartmut Becker, Thomas Lenarz, Timo Stover, Omid Majdani

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 02/2007; 28(1):129-34.

  HYPOTHESIS: High-resolution imaging, as provided by flat-panel-based volume computed tomography (fpVCT), could increase navigation accuracy and could therefore improve image-guided procedures or makeHYPOTHESIS: High-resolution imaging, as provided by flat-panel-based volume computed tomography (fpVCT), could increase navigation accuracy and could therefore improve image-guided procedures or make novel navigated surgery concepts possible. BACKGROUND: Intraoperative navigation is an accepted tool in head and neck surgery. However, its use is limited in the lateral cranial base because of its low surgical accuracy. Surgical accuracy is substantially influenced by the resolution of the underlying data set. The fpVCT offers a resolution of nearly two times higher than multislice computed tomography (MSCT). Target registration error (TRE), as a measurement for surgical navigation accuracy, should decrease when navigation is based on fpVCT data sets. METHODS: An acrylic glass phantom with 37 fiducial points was scanned in a current MSCT and in an experimental fpVCT. Both data sets were imported in an optical navigation system. Five fiducial points were used for registration, and seven points were used for measuring TRE. The distance between the indicated pointer tip and the corresponding fiducial point in data set was measured as TRE. Registration and TRE measurement were repeated five times for each computed tomographic data set. Average TREs were calculated, and results were compared using t-test. RESULTS: The average TRE using MSCT (0.82 mm [standard deviation, 0.35 mm]) was significantly higher than that using fpVCT (0.46 mm [standard deviation, 0.22 mm]) (p < 0.01). CONCLUSION: Submillimeter surgical navigation accuracy is possible using high-resolution fpVCT. This could be highly beneficial in cranial base surgery navigation.

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• Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease.

  Authors: Sotirios Bisdas, Ole Nemitz, Georg Berding, Karin Weissenborn, Bjoern Ahl, Hartmut Becker, Frank Donnerstag

  European radiology. 11/2006; 16(10):2220-8.

  Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flowTwelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [(15)O]H(2)O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics.

• Flat-panel volume computed tomography for cochlear implant electrode array examination in isolated temporal bone specimens.

  Authors: Soenke H Bartling, Rajiv Gupta, Attila Torkos, Christian Dullin, Grabbe Eckhardt, Thomas Lenarz, Hartmut Becker, Timo Stöver

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 07/2006; 27(4):491-8.

  HYPOTHESIS: Flat-panel based volume computed tomography could improve cochlear implant electrode evaluation in comparison with multislice computed tomography. BACKGROUND: Flat-panel based volumeHYPOTHESIS: Flat-panel based volume computed tomography could improve cochlear implant electrode evaluation in comparison with multislice computed tomography. BACKGROUND: Flat-panel based volume computed tomography offers higher spatial resolution and less metal artifacts than multislice computed tomography. Both characteristics could improve the evaluation of challenging but important questions in cochlear implantation assessment, such as an exact imaging of cochlea, osseous spiral lamina, electrode array position, and single electrode contacts. These questions are not currently fully answered by multislice computed tomography. METHODS: Four isolated temporal bone specimens were scanned in a current multislice computed tomography scanner and in two experimental flat-panel based volume computed tomography scanners before and after cochlea implantation. To compare flat-panel based volume computed tomography and multislice computed tomography, four features were rated according to the following criteria: 1) visibility of the cochlea; 2) visibility of the osseous spiral lamina; 3) discernibility of individual electrode contacts; and 4) the ability to determine the electrode array position relative to scala tympani and scala vestibuli. Layer-by-layer microgrinding pictures were used as the ground truth for verification of imaging findings. RESULTS: Flat-panel based volume computed tomography was superior to multislice computed tomography in all four features rated. The cochlea and facial nerve canal were much better delineated in flat-panel based volume computed tomography. The osseous spiral lamina and single electrode contacts were only visible in flat-panel based volume computed tomography. Assessment of implant position with regard to the cochlear spaces was considerably improved by flat-panel based volume computed tomography. CONCLUSION: Cochlear implantation assessment could be improved by flat-panel based volume computed tomography and, therefore, would be highly beneficial for cochlea implantation research and for clinical evaluation. However, these first results were shown by scanning isolated temporal bone specimens; scanning whole human skull bases might be more challenging.

• Inner ear abnormalities in patients with Goldenhar syndrome.

  Authors: Sotirios Bisdas, Minoo Lenarz, Thomas Lenarz, Hartmut Becker

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 06/2005; 26(3):398-404.

  OBJECTIVE: The objective of this study is to investigate the inner ear malformations in patients with Goldenhar syndrome and to hypothesize the potential embryopathogenesis of these malformations.OBJECTIVE: The objective of this study is to investigate the inner ear malformations in patients with Goldenhar syndrome and to hypothesize the potential embryopathogenesis of these malformations. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fourteen patients with Goldenhar syndrome. INTERVENTIONS: Each patient underwent hearing tests and high-resolution computed tomography (CT) of the temporal bone. In six patients, magnetic resonance imaging of the temporal bone also was performed. RESULTS: Among the 14 patients with Goldenhar syndrome, 13 had outer and middle ear anomalies and 5 (36%) had inner ear malformations, including one case of common cavity. CONCLUSIONS: Our observations regarding inner ear anomalies in Goldenhar syndrome correlate with the reported cases in the literature and may help to hypothesize the embryological origin of these malformations, which can caused by an early developmental arrest in the fourth gestational week. Specialists evaluating patients with Goldenhar syndrome should be aware of the possibility of inner ear malformations, which could be diagnosed earlier with appropriate imaging studies.

• Experimental flat-panel high-spatial-resolution volume CT of the temporal bone.

  Authors: Rajiv Gupta, Soenke H Bartling, Samit K Basu, William R Ross, Hartmut Becker, Armin Pfoh, Thomas Brady, Hugh D Curtin

  AJNR. American journal of neuroradiology. 09/2004; 25(8):1417-24.

  BACKGROUND AND PURPOSE: A CT scanner employing a digital flat-panel detector is capable of very high spatial resolution as compared with a multi-section CT (MSCT) scanner. Our purpose was toBACKGROUND AND PURPOSE: A CT scanner employing a digital flat-panel detector is capable of very high spatial resolution as compared with a multi-section CT (MSCT) scanner. Our purpose was to determine how well a prototypical volume CT (VCT) scanner with a flat-panel detector system defines fine structures in temporal bone. METHODS: Four partially manipulated temporal-bone specimens were imaged by use of a prototypical cone-beam VCT scanner with a flat-panel detector system at an isometric resolution of 150 microm at the isocenter. These specimens were also depicted by state-of-the-art multisection CT (MSCT). Forty-two structures imaged by both scanners were qualitatively assessed and rated, and scores assigned to VCT findings were compared with those of MSCT. RESULTS: Qualitative assessment of anatomic structures, lesions, cochlear implants, and middle-ear hearing aids indicated that image quality was significantly better with VCT (P < .001). Structures near the spatial-resolution limit of MSCT (e.g., bony covering of the tympanic segment of the facial canal, the incudo-stapedial joint, the proximal vestibular aqueduct, the interscalar septum, and the modiolus) had higher contrast and less partial-volume effect with VCT. CONCLUSION: The flat-panel prototype provides better definition of fine osseous structures of temporal bone than that of currently available MSCT scanners. This study provides impetus for further research in increasing spatial resolution beyond that offered by the current state-of-the-art scanners.

• Functional MR imaging of the auditory cortex with electrical stimulation of the promontory in 35 deaf patients before cochlea implantation.

  Authors: Anja M Schmidt, Benno P Weber, Mehdi Vahid, Rene Zacharias, Jürgen Neuburger, Myriam Witt, Thomas Lenarz, Hartmut Becker

  AJNR. American journal of neuroradiology. 03/2003; 24(2):201-7.

  BACKGROUND AND PURPOSE: Promontory testing is used for preoperative assessment of the auditory pathway before cochlear implantation. This method depends on patient cooperation and cannot be used inBACKGROUND AND PURPOSE: Promontory testing is used for preoperative assessment of the auditory pathway before cochlear implantation. This method depends on patient cooperation and cannot be used in children or disabled persons. Promontory stimulation during functional MR imaging (fMRI) provides a new and objective method to test the integrity of the auditory pathway. To evaluate the method, we performed this prospective study in deaf adult patients. METHODS: fMRI of the auditory pathway with electrical stimulation of the promontory was performed in 35 profoundly deaf patients, bilaterally in seven. For safe stimulation inside the MR environment, a specially designed nerve stimulator was used. We acquired nine sections parallel to the sylvian fissure by using an echo-planar pulse sequence (1.5 T). To evaluate the number of pixels in the auditory cortex, areas were counted and the minimum confidence level (p(st) value) was determined. The auditory pathway was called intact when the minimal p(st) value was 10(-5) or when the minimal p(st) value was 10(-4) in at least five activated pixels. RESULTS: Images in 85% of patients reporting an auditory sensation showed activation of the contralateral auditory cortex. In the group of patients reporting no hearing sensation, images in 75% did not show activation. CONCLUSION: This method can prove the intactness of the auditory pathway and help the surgeon in decision making before cochlear implantation. However, a negative finding should not be interpreted as indicating a nonfunctioning auditory pathway. Additional technical refinements and experience are needed to further improve this method.

• 3D-Nachverarbeitung in der CT-Bildgebung des Felsenbeins.

  Authors: Thomas Rodt, Sönke Bartling, Hartmut Burmeister, Kersten Peldschuss, Peter Issing, Thomas Lenarz, Hartmut Becker, Herbert K. Matthies

  Bildverarbeitung für die Medizin 2003, Algorithmen - Systeme - Anwendungen, Proceedings des Workshops vom 9. bis 11. März 2003 in Erlangen; 01/2003

• Virtual endoscopy of the middle ear: experimental and clinical results of a standardised approach using multi-slice helical computed tomography.

  Authors: Thomas Rodt, Sönke Bartling, Anja M Schmidt, Benno P Weber, Thomas Lenarz, Hartmut Becker

  European radiology. 08/2002; 12(7):1684-92.

  Virtual endoscopy (VE) enables non-invasive 3D endoluminal imaging of the middle ear by post-processing of CT data. To optimise the clinical application a standardised approach was evaluated inVirtual endoscopy (VE) enables non-invasive 3D endoluminal imaging of the middle ear by post-processing of CT data. To optimise the clinical application a standardised approach was evaluated in normal and pathologic cases. Data acquisition was performed using multi-slice helical CT in 20 normal patients and 15 patients with malformation or trauma. Virtual endoscopy of the tympanic cavity and 3D images of the ossicles were generated using surface and volume rendering. Qualitative assessment of the representation of anatomical structures was performed in normal patients. In 15 pathological cases the diagnostic benefit was evaluated by comparing the 3D images to the 2D images and intra-operative findings. In all 35 cases 3D imaging was possible using the standardised approach. The ossicular chain as well as the bony and soft tissue structures of the tympanic cavity were visualised in 20 normal patients. In 7 of 8 patients with malformation and 1 of 7 patients with trauma the original diagnosis was changed by 3D imaging. Standardisation and evaluation of the method in normal patients is essential as it enhances the diagnostic reliability. Virtual endoscopy facilitates understanding of the complex anatomy of the middle ear. In cases of suspected malformation and confirmed trauma it is helpful for diagnosis and surgical planning.

• High-resolution computed tomography of temporal bone: Part II: coronal preoperative anatomy.

  Authors: Soenke H Bartling, Vershalee Shukla, Hartmut Becker, Thomas J Brady, Anne Hayman, Rajiv Gupta

  Journal of computer assisted tomography. 29(4):566-9.

  The purpose of this 4-part series is to demonstrate the high-resolution axial and coronal anatomy of temporal bone from a flat-panel detector-based volume computed tomography (CT) scanner (parts IThe purpose of this 4-part series is to demonstrate the high-resolution axial and coronal anatomy of temporal bone from a flat-panel detector-based volume computed tomography (CT) scanner (parts I and II); these imaging planes are then used to outline the effect of different surgical procedures commonly applied to the temporal bone (parts III and IV). The structures that are removed and/or altered in 11 different surgical procedures are color coded and inscribed in axial and coronal sections. Clinically important imaging features and complications after these operations are also discussed. In these high-resolution images, many structures that are below the resolution limit of conventional CT can be seen and localized. It is hoped that this exposition enables one to visualize these structures and surgeries in the mind's eye, even when they fall below the resolution limit using a conventional CT scanner. This article (part II) focuses on the preoperative coronal anatomy.