C Fellbaum

Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Baden-Württemberg, Germany

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Publications (5)25.81 Total impact

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    ABSTRACT: We report on a 49-year-old male patient who was suspected to have a malignant liver tumour with enlarged perihepatic lymph nodes because of CT and ultrasound scanning. To verify the diagnosis and procure a histological specimen, the patient underwent laparotomy. Histologically, an inflammatory pseudotumour could be confirmed. This is a rare disease which can present with fever, abdominal pain, vomiting and weight loss indicating malignancy or abscess. The definite diagnosis is often only verified by surgery.
    Ultraschall in der Medizin 07/2006; 27(3):273-9. · 4.65 Impact Factor
  • Ultraschall in der Medizin 06/2006; 27(3):273-279. · 4.65 Impact Factor
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    ABSTRACT: Non-invasive differentiation of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA) is difficult. The aim of this study was to assess the accuracy of contrast-enhanced phase inversion ultrasound to differentiate between histologically proven FNH and HCA, analysing the arterial and (early) portal venous phase. 32 patients with histological proven FNH (n=24) or HCA (n=8) have been included in this prospective study. Examination technique: Siemens Elegra, phase inversion harmonic imaging (PIHI) with low mechanical index (MI)<0.2-0.3 using SonoVue (BR 1). The contrast enhancing tumour characteristics were evaluated during the hepatic arterial (starting 8-22 s) and early portal venous phase (starting 12-30 s). The image analysis was performed by three examiners. In 23 of 24 patients with FNH the contrast pattern revealed pronounced arterial and (early) portal venous enhancement. Homogeneous enhancement was detected during the hepatic arterial phase in all eight patients with HCA. In contrast to patients with FNH, no enhancement was seen during the portal venous phase. In conclusion, contrast-enhanced phase inversion ultrasound demonstrated pronounced arterial and portal venous enhancement in patients with focal nodular hyperplasia. In contrast, after homogeneous enhancement during hepatic arterial phase, no enhancement during hepatic portal venous phase was detected in patients with hepatocellular adenoma. Therefore, this technique might improve the functional characterization of benign hypervascular focal liver lesions.
    British Journal of Radiology 08/2005; 78(932):704-7. · 1.53 Impact Factor
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    ABSTRACT: Ultrasound is reported to be relatively unreliable in the characterisation of liver tumours. The purpose of this study was to assess the ability of contrast enhanced phase inversion ultrasound (PIUS), a new highly sensitive contrast specific technique, performed during the liver specific phase of Levovist, to differentiate between benign and malignant lesions of the liver. A total of 174 patients with histologically proven liver tumours were prospectively examined with conventional B mode ultrasound and two minutes after intravenous bolus injection of SHU 508A (Levovist). The examination technique comprised: Siemens Sonoline Elegra, phase inversion harmonic imaging (ECI); high mechanical index (1.2-1.7) using a delayed two minute post contrast scanning technique. In all patients with malignant disease, hypoechoic contrast enhancement was seen during the portal venous phase, and convincing but variably less demarcated in 13 patients with hepatocellular carcinoma compared with all patients with liver metastases. The liver tumours proved to be histologically benign in 95 patients and malignant in 79 patients. Homogenous contrast enhancement with a mainly isoechogenic appearance in the portal venous and liver specific late phase was seen in almost all patients with benign liver lesions with the exception of one patient with an inflammatory pseudotumour of the liver and five patients with abscesses. These six exceptions all demonstrated a hypoechoic appearance in the portal venous and liver specific late phase. The ability of unenhanced ultrasonography to characterise liver disease is known to be limited. PIUS performed during the portal venous and liver specific late phase of Levovist may differentiate between benign and malignant liver tumours in most cases, with the exception of, for example, abscesses, scars, necrosis, cysts, and calcifications, which need to be excluded clinically and by conventional B mode ultrasonography.
    Gut 04/2004; 53(3):401-5. · 13.32 Impact Factor
  • D Faust, C Fellbaum, S Zeuzem, C F Dietrich
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    ABSTRACT: Nodular regenerative hyperplasia of the liver (NRHL) is an uncommon non-malignant finding typically associated with haematological or auto-immune disease. The main clinical symptom is portal hypertension in the absence of underlying liver cirrhosis. The pathogenesis of NRHL remains unknown. We report a case of NRHL with cholestasis and progression to liver insufficiency without any underlying disease and no association with systemic disease or drug intake. Cholestasis and liver function tests improved significantly during treatment with ursodeoxycholic acid (750 mg per day). Based on this case, it may be concluded that treatment with ursodeoxycholic acid might be beneficial in patients with NRHL and progression to liver insufficiency.
    Zeitschrift für Gastroenterologie 04/2003; 41(3):255-8. · 1.67 Impact Factor