[Systematics of injuries of the rotator cuff and biceps tendon]. / Systematik der Verletzungen von Rotatorenmanschette und Bizepssehne.

PERFORMANCE: Injuries of the rotator cuff and the biceps tendon demonstrate different patterns, which can be recognized clinically and radiologically. ACHIEVEMENTS: These patterns are impingement syndrome with additional trauma, isolated trauma of the rotator cuff and shoulder dislocation causing rotator cuff tears. Furthermore, it is clinically crucial to evaluate the extent of a rotator cuff injury. PRACTICAL RECOMMENDATION: Magnetic resonance imaging (MRI) is the modality of choice to differentiate these patterns.

[Primary liver tumors : hepatocellular versus intrahepatic cholangiocellular carcinoma]. / Primäre Lebertumoren : Hepatozelluläres vs. intrahepatisches cholangiozelluläres Karzinom.

CLINICAL ISSUE: Hepatocellular carcinoma (HCC) and intrahepatic cholangiocellular carcinoma (ICC) are the most commonly occurring and important primary liver tumors. Originating from one pluripotent liver stem cell both tumor entities can occur in a cirrhotic liver and also in patients without cirrhosis. Several risk factors have been identified as causative for both carcinomas; therefore, tumor screening is advantageous, especially for high-risk patients who could be diagnosed in an early stage to allow curative treatment. Surgical resection, interventional procedures and transplantation are available as curative treatment options when diagnosed in time. STANDARD RADIOLOGICAL METHODS: Common characteristic features and morphology in cross-sectional imaging by ultrasound (US), multidetector computed tomography (CT) and magnetic resonance imaging (MRI) as well as screening aspects are presented and discussed. METHODICAL INNOVATIONS: Recent findings show a better understanding of the carcinogenesis model of both liver tumors originating from one pluripotent liver stem cell. Further developments of modern cross-sectional imaging modalities, especially MRI in combination with diffusion-weighted imaging and intravenous administration of hepatocyte-specific contrast agents enable early detection, exact differentiation, staging and treatment evaluation of HCC and ICC ACHIEVEMENTS: In this article we discuss modern, multiparametric imaging modalities, which allow a complete and reliable diagnosis of the majority of these tumor entities. PRACTICAL RECOMMENDATIONS: Contrast-enhanced MRI, using hepatocyte-specific contrast agents, is currently the most accurate procedure for the noninvasive diagnosis and treatment evaluation of HCC and ICC.

[Modern imaging of liver metastases]. / Moderne Bildgebung der Lebermetastasen.

CLINICAL/METHODICAL ISSUE: The liver is the second most common location of metastases following the lymph nodes. The accurate characterization of focal liver lesions in oncology patients is especially important because of the high prevalence of benign liver lesions and the possibility of co-existing benign and malignant lesions. The exact interpretation of these lesions is crucial for therapeutic decisions and thus for the prognosis of the patient. STANDARD RADIOLOGICAL METHODS: It is essential to detect all focal liver lesions and to distinguish benign from malignant lesions, especially in the management of oncology patients. Numerous imaging modalities are available for these challenges in the daily routine. An extensive understanding of the advantages and limitations of the various imaging modalities and knowledge of the morphology and the typical and atypical appearances of the different metastases is important. METHODICAL INNOVATIONS: This review explains the radiological criteria for various metastases in different modalities. To evaluate the individual prognosis and risk assessment preoperatively, functional imaging is necessary. These personalized pretherapeutic diagnostics are discussed.