[Computed tomography in orbital trauma]. / Zur Computertomographie beim Trauma der Orbita.

The results of CT in 104 patients with traumatic lesions of the orbits have been analysed retrospectively. Eighty-four fractures of the orbital skeleton were diagnosed in 58 patients; in 18 cases there was peri-orbital, retrobulbar or intrabulbar bleeding and two patients had a ruptured globe. A foreign body was demonstrated in 20 cases. Additional fractures of neighbouring paranasal sinuses were present in 22 cases. Mucosal swelling or bleeding in the sinus was found in 59 cases and orbital emphysema in 22 patients. The particular value of CT in the diagnosis of orbital trauma lies in the certainty with which bony injury of the orbit and peri-orbital structures can be demonstrated.

[High-resolution computed tomography in diseases of the inner ear]. / Hochauflösende Computertomographie bei Erkrankungen des Innenohres.

High-resolution CT of the petrous bone was carried out in 259 patients with clinically diagnosed abnormalities of the inner ear; in some the lesions were bilateral. In 62 patients (approximately 20%), the scans showed findings which related to the signs and symptoms. Patients with hearing loss and vestibular neuronitis showed no abnormalities. Amongst the remaining patients, the most common findings were acoustic neuromas (17 cases), cochlear otospongiosis (14 cases), malformations (13 cases) and tumours or cholesteatomas of the labyrinth (13 cases) as well as single rare isolated lesions.

[Adding to the diagnostic possibilities of MR tomography of the TMJ]. / Erweiterungen der diagnostischen Möglichkeiten der MR-Tomographie des Kiefergelenkes.

54 patients with arthrogenous dysfunctions were examined by means of MR tomography. Imaging of the position and shape of the intraarticular soft tissues was achieved in 64 out of the 67 TMJs examined. The results give rise to the expectation that MR tomography can be further developed to provide a reliable diagnostic tool not only for detecting dislocations in the sagittal plane, but also for imaging mediolateral alterations in the disk position, disk perforations and restrictions in the physiologic mobility of the articular disk.

[Computed tomographic volumetry of the orbit in endocrine orbitopathy]. / Computertomographische Volumetrie der Orbita bei endokriner Orbitopathie.

The volumes of the four recti muscles and the orbital fat was measured by CT in 40 normal persons and in 60 patients with clinically confirmed Graves' disease. Compared with normal persons, 42 patients (70%) showed an increase in muscle volume and 28 patients (46.7%) an increase in the amount of fat. In nine patients (15%) muscle volume was normal, but the fat was increased. By using volumetric measurements, the amount of fat in the orbits in patients with Graves' disease could be determined.

[Etiology of eccentric-posterior and centric-anterior displacements of the articular disc]. / Zur Atiologie exzentrisch-posteriorer und zentrisch-anteriorer Verlagerungen des Discus articularis.

40 patients with suspected intraarticular soft tissue displacement have been examined clinically and with the aid of electronic recording methods. The disc position has been verified by means of magnetic resonance tomography. Based on these results and on functional as well as anatomic considerations the development of various forms of articular disc displacement is discussed. Within the pathogenetic considerations particular attention must be paid to the role of dysfunctional excessive mouth opening and the loosening of the posterior cranial attachment of the disc on the base of the skull. This attachment is subjected to individual variations. An intact posterior cranial attachment of the articular disc via the superior stratum of the bilaminar zone at the base of the skull may result in an eccentric posterior displacement under existing dysfunctional loads. On the other hand, lack of repositioning forces due to a weak or loosening attachment may favor the development of centric anterior types of displacement.

[Forms of eccentric posterior displacement of the articular disc]. / Formen exzentrisch-posteriorer Verlagerungen des Discus articularis.

The temporomandibular joints of 40 patients with suspected intraarticular soft tissue displacement have been examined clinically and with the aid of electronic recording methods. The disc position has been verified by means of magnetic resonance tomography. The results demonstrate that Farrar's reciprocal clicking noises, interpreted as an anterior displacement of the articular disc, are not pathognomonic for the presence of a centric anterior displacement, but may also be associated with eccentric posterior disc displacement. Non-invasive imaging procedures show them as posterior displacements of the articular disc in eccentric mandibular positions. Eccentric posterior disc dislocation out of the joint space is associated with reciprocal clicking, i.e. an initial or terminal dislocation click during opening and a terminal repositioning click during closure. Centric anterior dislocation, on the other hand, was not found to be associated with terminal joint clicking during opening.

[Relaxation time measurements in the differential magnetic resonance tomographic diagnosis of liver tumors]. / Relaxationszeitmessungen in der kernspintomographischen Differentialdiagnose von Lebertumoren.

T1-weighted IR sequences and T2-weighted SE sequences and combined SE/IR sequences were carried out in 62 patients with malignant and 50 patients with benign liver tumours and the T1 and T2 relaxation times were measured. IR sequences proved the most sensitive method for imaging focal liver lesions and providing good contrast between liver tissue and tumour. For lesions above 1.5 cm, quantitative MRI achieved an accuracy better than 95% in distinguishing between haemangiomas and malignant lesions. Routine quantitative measurements of relaxation times were sufficiently reproducible for clinical use.

[The value of CT in carcinoma of the lung apex]. / Zur Wertigkeit der CT beim Lungenspitzenkarzinom.

The CT findings in 34 patients with histologically confirmed tumours at a lung apex are described. CT, compared with conventional methods, provides more comprehensive information regarding the localisation and extent of the tumour and of local metastases. On the basis of CT examinations, 28 patients were treated by radiotherapy and in six patients surgery could be carried out.

[Computed tomography and conventional x-ray diagnosis of interstitial lung diseases]. / Computertomographie und konventionelle Röntgendiagnostik bei interstitiellen Lungenerkrankungen.

One hundred and sixty-four patients with pulmonary fibrosis were examined by CT and by conventional radiological methods. Sixty patients had asbestosis, thirty-nine silicosis, forty sarcoidosis and twenty-five had idiopathic pulmonary fibrosis. CT is superior to conventional radiography in evaluating interstitial pulmonary changes, particularly of the pleura and the lung parenchyma. Areas of fibrosis and of emphysema can be demonstrated without any overlap. In sixty-nine patients there were some findings which could only be demonstrated by CT. In asbestosis, silicosis and sarcoidosis the CT classification of the lung parenchyma which we have suggested produces significantly better correlation with vital capacity than can be achieved from conventional chest films, according to the guide-lines of the I.L.O.

[Comparison of papaverine-induced Doppler sonography and angiography in the diagnosis of erectile dysfunction]. / Vergleich von Papaverin-induzierter Doppler-Sonographie und Angiographie in der Diagnostik der erektilen Dysfunktion.

In the course of the evaluation of 500 patients with erectile dysfunction the results of penile Doppler-sonography and penile angiography could be compared in 65 patients, in whom both investigations were carried out under standardized conditions. Criteria for the evaluation of penile Doppler-sonography were the wave form analysis and especially the increase of blood-flow in the investigated arteries after intracavernous injection of papaverine. Criteria for the evaluation of the angiograms were the depiction of the penile arteries as well as the evidence of obstruction and collaterals of the internal iliac and pudendal arteries. In regard to the dorsal penile artery an all over correlation of 96.1% and in regard to the deep penile artery of 92.3% could be found. Based on these findings the conclusion can be drawn that papaverine-induced Doppler-sonography is able to replace penile angiography, thus no longer serving as the golden standard in the diagnosis of arterial insufficiency.

[Hemangioma of the kidney--diagnostic and therapeutic problems]. / Das Hämangiom der Niere--diagnostische und therapeutische Probleme.

Hemangioma of the kidney as one of the possible causes of "essential hematuria" is discussed with special regard to its diagnostic features in the various modern radiological examinations. Still most important is angiography. Typical findings are demonstrated in a case with complete replacement of the parapelvic fat by a large cavernous hemangioma. The various therapeutic possibilities--conservative treatment, embolisation, partial or complete nephrectomy - are discussed.

[Results and complications of CT-guided puncture biopsies with a wide-lumen puncture needle]. / Ergebnisse und Komplikationen perkutaner CT-gesteuerter Punktionen mit einer grosslumigen Punktionsnadel.

The results obtained in 187 CT-guided biopsies using a wide lumen needle are described. Biopsies in the thorax, abdomen, retroperitoneum and in the pelvis have been evaluated. A retrospective analysis of the material has shown an accuracy of 97.8% and sensitivity of 95.8%. The total complication rate was 8%. Amongst 120 biopsies in the thorax, 6.6% developed a pneumothorax. Therapeutic drainage was carried out in fifteen patients.

[Retroperitoneal teratoma. A problem in pediatric urology]. / Das retroperitoneale Teratom. Ein Problem der Kinderurologie.

We report about diagnosis and therapy of a retroperitoneal teratoma in a six years old boy. Further we discuss the histogenetical origin as well as the histological classification. Considering other localisations, teratomas of the retroperitoneum are relatively (4%) rare. Most teratomas are diagnosed at school-age either coincidently or because of a mass lesion. Size and localisation of the tumor do not give any information about its nature. Even with negative tumor markers (alpha1-fetoprotein, beta-HCG) the tumor should be considered malignant until histology proves the contrary. Due to these facts a careful en bloc extirpation and a thorough histological examination of the tumor are always necessary.

[Accuracy of cardiac CT and echocardiography in the diagnosis of space-occupying processes in the heart]. / Treffsicherheit der Kardio-CT und Echokardiographie in der Diagnostik raumfordernder Prozesse des Herzens.

CT of the heart and echocardiography was performed on 107 patients with various space-occupying lesions of the heart. In addition, 27 patients were subjected to angiocardiography. A comparison of the findings has shown that cardio-CT is superior to two-dimensional echocardiography for demonstrating pericardial masses and intracavity thrombi. There was no significant difference as far as intracavity or intramural tumours were concerned. CT and sonography are superior to angiography in the diagnosis of cardiac space-occupying lesions.

[Digital subtraction angiography of the aorta]. / Digitale Subtraktionsangiographie (DSA) der Aorta.

The results of 300 digital subtraction angiographies of the thoracic and abdominal aorta are analysed. Following intraarterial injection of contrast, all examinations were of good quality. Following I-V DSA, two thoracic (1.8%) and two abdominal (1.2%) aortograms were non-diagnostic. Anomalies in the position of the aorta, dilatation (aneurysm) or stenoses (coarctations, arteriosclerosis, occlusions) could be diagnosed by I-V DSA. One I-A DSA was performed for aneurysm of the ascending aorta in order to evaluate function of the aortic valve and for demonstrating the coronary artery origins, and pre-operatively for an aortic dissection.