The Ductus Venosus. / Der Ductus venosus.

BACKGROUND: the ductus venosus (DV) is not well known in general radiology, but it plays a role in the daily work of pediatric radiologists. Consequently all general radiologists who also care for a pediatric department should be familiar with the physiological and pathological findings related to the DV. METHODS: Literature research in Medline, using the keywords "ductus venosus" and "umbilical vein catheter". RESULTS AND CONCLUSIONS: In the first weeks of life the DV is regularly still patent. It should be recognized as DV and not be mistaken for a pathological portosystemic shunt.The ductus venosus is the lead structure for umbilical vein catheters. Radiologists should be able to assess the correct catheter position. Radiologically important findings of an umbilical vein catheter are mainly malposition and intrahepatic extravasation. Agenesis of the DV can lead to intra- or extrahepatic compensatory portosystemic shunts, in which as well as in the case of persistent patency of the DV, there may be the necessity for radiological-interventional or surgical occlusion. KEY POINTS: · In the first weeks of life in infants the Ductus venosus is regularly still patent.. · The Ductus venosus should not be mistaken for a pathological portosystemic shunt.. · An umbilcal vein catheter should project onto the Ductus venosus and end caudal to the right atrium.. · Intrahepatic portosystemic shunts in DV agenesis show a high rate of spontaneous closure postnatally.. CITATION FORMAT: · Born M. The Ductus Venosus. Fortschr Röntgenstr 2021; 193: 521 - 526.

The German Evidence-Based Child Protection Guideline - Imaging in Suspected Child Abuse. / Die deutsche S3-Kinderschutzleitlinie ­ Bildgebung bei Verdacht auf Kindesmisshandlung.

AIM: Development of a fully evidence-based guideline including all aspects of child abuse. METHODS: In a case-based procedure, 144 primary PICO questions were generated from 476 presented cases of child abuse. Literature research was performed in 5 databases (Pubmed, CINHAL, Embase, PsycInfo, Eric) and in the Cochrane Library. The literature was evaluated according to SIGN and AGREE II. RESULTS: 137 recommendations were developed. Those related to imaging procedures are presented and discussed in this article. CONCLUSION: The first fully evidence-based German guideline concerning all aspects of child abuse has been established. For imaging, several relevant new approaches have been proposed. KEY POINTS: · The average radiation exposure is significantly reduced for the whole group of examined children.. · The pelvic view and lateral spine are no longer basic views of the skeletal survey but are only performed additionally in the case of a positive survey.. · Oblique views and a follow-up survey are performed in the case of a negative skeletal survey and ongoing suspicion of child abuse.. CITATION FORMAT: · Born M, Schwier F, Stoever B et al. The German Evidence-Based Child Protection Guideline - Imaging in Suspected Child Abuse. Fortschr Röntgenstr 2020; 192: 343 - 348.

Sensitivity encoding (SENSE) for contrast-enhanced 3D MR angiography of the abdominal arteries.

PURPOSE: To assess sensitivity encoding (SENSE) for contrast-enhanced MR angiography (CE-MRA) of the abdominal arteries in comparison with standard MRA protocols. MATERIALS AND METHODS: In 22 patients MRA of the abdominal arteries was performed twice (once using a standard protocol, and once with the additional use of SENSE). In 10 patients all examination parameters were kept constant (TR/TE/FA = 3.8 msec/1.3 msec/30 degrees ), and a reduction in scan time from 22 to 11 seconds was realized with the use of SENSE. In 12 patients, using SENSE the acquisition matrix was increased from 208 to 416, keeping the scan time constant. Image quality was scored on a five-point scale by three radiologists. Additionally, ROI-based measurements of CNR were performed. RESULTS: For both protocols, image quality was significantly improved using SENSE. The time-reducing SENSE protocol yielded an average score of 4.2 points vs. 3.1 for the standard protocol. Using SENSE to increase the acquisition matrix, an average score of 4.3 was reached vs. 3.2 for the standard protocol (P < 0.05). The number of depictable small vessels and their bifurcations was significantly increased by either of the two SENSE protocols as compared to the standard imaging procedure. CONCLUSION: SENSE for MRA of the abdominal arteries significantly increases image quality and permits a substantial reduction in breath-hold time or a significantly improved spatial resolution.

Noninvasive detection of steno-occlusive disease of the supra-aortic arteries with three-dimensional contrast-enhanced magnetic resonance angiography: a prospective, intra-individual comparative analysis with digital subtraction angiography.

BACKGROUND AND PURPOSE: Concomitant disease of the supra-aortic arteries can influence the outcome of surgical treatment of carotid artery stenosis. However, sensitivity and specificity data of noninvasive contrast-enhanced 3-dimensional (3D) magnetic resonance angiography (CE MRA) for the detection of steno-occlusive disease of the entire supra-aortic arteries including the circle of Willis remain unclear. We aimed to intra-individually compare high-spatial-resolution CE 3D MRA and digital subtraction angiography (DSA) for the assessment of steno-occlusive vascular disease of the supra-aortic arteries. METHODS: CE MRA and DSA of the supra-aortic arteries were prospectively performed in 50 consecutive patients. Intra-individual comparison of CE MRA and DSA was available in 833 arteries. High-spatial-resolution CE MRA comprised a measured voxel size of 0.81 mm x 0.81 mm x 1 mm (0.66 mm3). Steno-occlusive vascular disease of the 833 arteries was assessed independently by 2 radiologists according to the NASCET criteria. RESULTS: CE MRA had a sensitivity of 100% (73/73), a specificity of 99.3% (760/765), a positive predictive value of 93.6% (73/78), and a negative predictive value of 100% (760/760) by using a 70% to 99% threshold of arterial diameter stenosis. For detection of occlusion, sensitivity, specificity, PPV, and NPV value of CE MRA were 100%, respectively. CONCLUSIONS: Noninvasive high-spatial-resolution CE MRA is suited to replace diagnostic DSA for the detection of steno-occlusive disease of the supra-aortic arteries.

Time-of-flight MR angiography: comparison of 3.0-T imaging and 1.5-T imaging--initial experience.

Intracranial three-dimensional time-of-flight (TOF) magnetic resonance (MR) angiography was performed in seven healthy volunteers and eight patients with both 1.5-T and 3.0-T MR systems with standard and high spatial resolutions (true voxel sizes, 0.48 x 0.75 x 2.00 mm and 0.30 x 0.44 x 1.00 mm, respectively). Superior image quality and significantly better depiction of small vessel segments and vascular disease were observed at high-spatial-resolution 3.0-T TOF MR angiography but not at standard 1.5-T or standard 3.0-T TOF MR angiography (P <.01, respectively). Intracranial high-spatial-resolution TOF MR angiography at 3.0-T imaging provides diagnostic improvement in studies of cerebrovascular disease.