[Labral pathologies of the hip joint]. / Labrumpathologie des Hüftgelenkes.

Magnetic resonance imaging (MRI) of the hip joint is performed for the diagnostics of many clinical pathologies. For clarification of pathologies of the hip joint conventional MRI and MR arthrography are used. The use of MRI either with or without the intravenous administration of contrast material is performed to diagnose bone marrow lesions, necrosis of the femoral head, inflammatory and tumorous lesions affecting the hip joint and its components. After the intra-articular administration of a diluted solution of contrast material, which results in distension of the joint, MR arthrography is performed for the diagnosis of intra-articular pathologies, such as lesions of the labrum acetabulare, chondral lesions and free intra-articular bodies. In recent times, MR arthrography is carried out with continuous traction of the limb to be examined because this leads to a distension of the joint and its components and in this way particularly lesions of the labrum with involvement of cartilage can be visualized even better. This article gives an overview of MRI and the accuracy of detecting lesions of the labrum acetabulare and the influence on the therapeutic approach.

Distribution of Mycobacterium avium subsp. paratuberculosis in a Subclinical Naturally Infected German Fleckvieh Bull.

Although it has been known for years that Mycobacterium avium subsp. paratuberculosis (MAP) is detectable in the reproductive organs and semen of infected bulls, only few studies have been conducted on this topic worldwide. This study surveyed the MAP status of a bull, naturally infected due to close contact with its subclinically infected parents over a period of 4 years. From the age of 7 weeks to necropsy, faecal, blood and, after sexual maturity, semen samples were drawn repeatedly. Already at the first sampling day, MAP-DNA was detected in faeces by semi-nested PCR. True infection was confirmed by the detection of MAP-DNA in blood at the age of 40 weeks. In total, MAP-DNA was present in 25% faecal (34/139), 16% blood (23/140) and 5% semen (4/89) samples, including MAP-free intervals of up to 9 weeks. MAP genome equivalents (MAP-GE) of up to 6.3 × 106 /g faeces and 1.8 × 105 /ml blood were determined. Cultivation of MAP occurred only in three of 137 faecal and two of 109 blood, but never in semen samples. Over the whole period, the bull was a serological negative MAP shedder. During necropsy, 42 tissue samples were collected. Neither macroscopic nor histological lesions characteristic of a MAP infection were observed. Cultivation of MAP in tissue sections failed. However, MAP-DNA was spread widely in the host, including in tissues of the lymphatic system (7/15), digestive tract (5/14) and the urogenital tract (5/9) with concentrations of up to 3.9 × 106 MAP-GE/g tissue. The study highlighted the detection of MAP in male reproductive organs and semen. It supports the hypothesis that bulls may probably transmit MAP, at least under natural mating conditions. In artificial insemination, this might not be relevant, due to antibiotics included currently in semen extenders. However, the survivability of MAP in this microenvironment should be investigated in detail.

Texture-Based Analysis of 100 MR Examinations of Head and Neck Tumors - Is It Possible to Discriminate Between Benign and Malignant Masses in a Multicenter Trial?

AIM: To evaluate whether texture-based analysis of standard MRI sequences can help in the discrimination between benign and malignant head and neck tumors. MATERIALS AND METHODS: The MR images of 100 patients with a histologically clarified head or neck mass, from two different institutions, were analyzed. Texture-based analysis was performed using texture analysis software, with region of interest measurements for 2 D and 3 D evaluation independently for all axial sequences. COC, RUN, GRA, ARM, and WAV features were calculated for all ROIs. 10 texture feature subsets were used for a linear discriminant analysis, in combination with k-nearest-neighbor classification. Benign and malignant tumors were compared with regard to texture-based values. RESULTS: There were differences in the images from different field-strength scanners, as well as from different vendors. For the differentiation of benign and malignant tumors, we found differences on STIR and T2-weighted images for 2 D, and on contrast-enhanced T1-TSE with fat saturation for 3 D evaluation. In a separate analysis of the subgroups 1.5 and 3 Tesla, more discriminating features were found. CONCLUSION: Texture-based analysis is a useful tool in the discrimination of benign and malignant tumors when performed on one scanner with the same protocol. We cannot recommend this technique for the use of multicenter studies with clinical data. KEY POINTS: 2 D/3 D texture-based analysis can be performed in head and neck tumors. Texture-based analysis can differentiate between benign and malignant masses. Analyzed MR images should originate from one scanner with an identical protocol.

Dynamic 1.5-T vs 3-T true fast imaging with steady-state precession (trueFISP)-MRI sequences for assessment of velopharyngeal function.

OBJECTIVES: To compare the image quality of MRI scans produced with 1.5- and 3.0-T devices during functional test condition. METHODS: 65 MRI scans obtained with 1.5- (n = 43) or 3.0-T (n = 22) true fast imaging with steady-state precession (trueFISP) sequences from patients with a history of a cleft palate were evaluated. Two experts assessed the MRI scans, independently of each other, and blinded to the MRI technique used. Subjective ratings were entered on a five-point Likert scale. The median planes of three anatomical structures (velum, tongue and pharyngeal wall) were assessed in three functional states (at rest, during phonation of sustained "e" and during articulation of "kkk"). In addition, MRI scans taken during velopharyngeal closure were evaluated. RESULTS: Under blinded conditions, both observers (radiologist and orthodontist) independently rated the quality of 1.5-T scans higher than that of 3.0 T. Statistical analysis of pooled data showed that the differences were highly significant (p < 0.009) in 4 out of 10 test conditions. The greatest differences in favour of 1.5 T were observed for MRI scans of the velum. CONCLUSIONS: 1.5 T used with trueFISP may be preferable over 3.0-T trueFISP for the evaluation of the velopharyngeal structures in the clinical routine.

CD2/CD21 index: a new marker to evaluate udder health in dairy cows.

Lymphocytes play a significant role in the immunological processes of the bovine mammary gland and were found to be the dominant cell population in the milk of healthy udder quarters. The objective of this study was to investigate the quantitative relationship between CD2(+) T and CD21(+) B lymphocytes using flow cytometry. In a first study, quarter foremilk samples from apparently healthy udder quarters [somatic cell counts (SCC) ≤100,000 cells/mL; n=65] were analyzed and compared with diseased quarters (SCC >100,000 cells/mL; n=15). Percentages of CD2(+) T cells were significantly higher in milk samples with SCC ≤100,000 cells/mL than in those with SCC >100,000 cells/mL, whereas percentages of CD21(+) B cells developed in the opposite direction. As a result of this opposing trend, a new variable, the CD2/CD21 index-representing the percentages of CD2(+) cells per CD21(+) cells-was defined. Although diseased quarters with SCC >100,000 cells/mL and the detection of major pathogens revealed generally CD2/CD21 indices <10, values >10 were observed in apparently healthy quarters. Hence, a CD2/CD21 index cutoff value of 10 may be suitable to aid differentiation between unsuspicious and microbiologically suspicious or diseased udder quarters. To test whether CD2/CD21 indices <10 were primarily related to pathogens, quarters with SCC ≤100,000 cells/mL and >100,000 cells/mL with different bacteriological status (culture negative, or minor or major pathogens) were selectively examined in a second biphasic study. In the first trial, 63 udder quarters were analyzed and 55 of these quarters were able to be sampled again in the second trial carried out 14 d later. In both trials, results of the first study were confirmed. Indeed, CD2/CD21 indices <10 were also found in quarters showing SCC ≤100,000 cells/mL and containing minor or major pathogens at the time of the current or previous bacteriological analysis. The results of our examinations indicated a clear relationship between the CD2/CD21 index and the bacteriological status of the mammary gland. In combination with SCC, it offers a new marker for quick differentiation of unsuspicious and microbiologically suspicious or diseased udder quarters.

Differential cell count as an alternative method to diagnose dairy cow mastitis.

Changes in relative cell proportions occurring in diseased mammary glands of dairy cows can be determined using differential cell count (DCC). The present study was carried out in 2 consecutive trials, with 2 goals: (a) to test the consistency of DCC results on subsequent days, and (b) to establish an effective cutoff value for the diagnosis of mastitis. In the first trial, quarter milk and blood samples were taken from 8 healthy cows for 5 consecutive days. Milk samples were tested by somatic cell count (SCC) and bacteriological analysis, and DCC was performed on blood and milk samples by flow cytometer. In the second trial, 16 animals were randomly selected from a different herd and quarter milk samples taken on 3 consecutive milkings. All samples were cyto-bacteriologically analyzed and DCC was performed on the second sampling. In the first trial, mean SCC was 77,770 cells/mL and 4 samples were bacteriologically positive. No fixed or random effect had a significant influence on percentages of individual cell populations or ratios in blood or milk. A cutoff value of 0.495 for logarithmic polymorphonuclear neutrophilic leukocyte:lymphocyte ratio was established. Mean SCC of milk samples collected in the second trial was 543,230 cells/mL, and infection was detected in 53.1% of quarters, mostly caused by Staphylococcus aureus. When the cutoff value was applied to the data along with SCC, sensitivity and specificity of the diagnostic method were 97.3 and 92.3%, respectively.

A longitudinal study to characterize the distribution patterns of Mycobacterium avium ssp. paratuberculosis in semen, blood and faeces of a naturally infected bull by IS 900 semi-nested and quantitative real-time PCR.

Johne's disease is caused by Mycobacterium avium ssp. paratuberculosis (MAP) and has been recognized as an important bacterial infection in ruminants. Although MAP has been detected in semen and within the reproductive organs of bulls, the bacterial distribution and shedding patterns are currently not well characterized. Our investigation was performed to detect and quantify MAP in faeces, semen and blood samples repeatedly drawn from a naturally infected but asymptomatic 18-month-old German Simmental breeding bull candidate over a period of 3 years (June 2007-November 2010). Qualitative and quantitative polymerase chain reaction (PCR) techniques were used to correlate the presence and matrix-specific amounts of MAP. In total, 65 sampling dates were selected. Mycobacterium avium ssp. paratuberculosis was detected intermittently in all matrices with MAP-free intervals of up to 18 weeks by an IS900 semi-nested PCR. The number of MAP-positive results from semen and blood samples was higher than from faecal samples. A quantitative polymerase chain reaction detected the highest MAP contents in faeces (10(3) -10(6) MAP/g), while lower amounts were found in semen and blood samples (10(2) -10(5) MAP/ml). Although no significant agreement was calculated between the presence of MAP in faeces and blood, a statistically significant positive correlation between its occurrence in semen and blood was determined (r = 0.38, P < 0.05, n = 29). The present study contributes to a more detailed understanding of MAP distribution patterns in faeces, semen and blood of a subclinically infected breeding bull candidate. It highlights the possible role of breeding bulls as a source of MAP transmission and indicates the need for further monitoring and hygienic measures to prevent the spread of the infection via semen.

Establishment of a model of Streptococcus iniae meningoencephalitis in Nile tilapia (Oreochromis niloticus).

Streptococcus iniae is an invasive pathogen causing meningitis and other lesions in various fish species. Furthermore, S. iniae is an emerging zoonotic agent that causes cellulitis in man. The aims of this study were to establish an intraperitoneal infection model for S. iniae in Nile tilapia (Oreochromis niloticus) and to develop a new histopathological scoring system to reflect the degree and extent of inflammation as well as the presence of necrosis in the brain and eye. Intraperitoneal administration of 10(6) colony-forming units (CFU) led to 80% mortality and numerous fish developing clinical signs of central nervous system dysfunction. Microscopical examination of four regions of the brain (olfactory bulb, cerebellum, cerebrum and optical lobe) and the eye revealed the presence of lymphohistiocytic leptomeningitis, meningoencephalitis and endophthalmitis. Lesions were dominated by macrophages that often contained intracellular bacteria. Necrosis was recorded in some cases. Bacteriological screening revealed that multiple organs, including brain and eye, were infected with S. iniae and S. iniae colonized the scales and gills in high number. S. iniae was detected in tank water during the first week post infection, suggesting that infected tilapia might shed up to 3 × 10(7) CFU of S. iniae within 24 h. A multiplex polymerase chain reaction allowed confirmation of the challenge strain by detection of the virulence factors simA, scpI, cpsD, pgi, pgm and sagA.

Comparison of joining and constant κ-light chain regions in different cattle breeds.

A comparative transcription analysis of Ig κ-light chains (IGK) of the cattle breeds Holstein Friesian (HF), German Black Pied (GBP), German Simmental (GS) and Aubrac (A) revealed three alleles coding for two putative allotypic variants of IGKC. The amino acid residues p.Asp100Asn and p.Thr116Ala were located at the outer edge of the constant domain as demonstrated by homology-based modelling. Alleles were distributed in unequal frequencies within the breeds examined. While cattle breeds HF, GS, and A possessed all alleles and allotypic variants, GBP exhibited alleles encoding allotypic variant IGKC(a) . All three IGKJ segments were detected in 320 sequences analysed. IGKJ1 was combined predominantly with IGKC. The ORF2 of IGKJ2 was detected for the first time on transcriptional level.

[Robot-assisted biopsies in a high-field MRI system - first clinical results]. / Roboterunterstützte Punktion in einem Hochfeld-Kernspintomografen - erste klinische Ergebnisse.

PURPOSE: The purpose of this study was to examine the clinical use of MR-guided biopsies in patients with suspicious lesions using a new MR-compatible assistance system in a high-field MR system. MATERIALS AND METHODS: Six patients with suspicious focal lesions in various anatomic regions underwent percutanous biopsy in a high-field MR system (1.5 T, Magnetom Espree, Siemens) using a new MR-compatible assistance system (Innomotion). The procedures were planned and guided using T 1-weighted FLASH and TrueFISP sequences. A servopneumatic drive then moved the guiding arm automatically to the insertion point. An MRI compatible 15G biopsy system (Somatex) was introduced by a physician guided by the needle holder and multiple biopsies were performed using the coaxial technique. The feasibility, duration of the intervention and biopsy findings were analyzed. RESULTS: The proposed new system allows accurate punctures in a high-field MR system. The assistance device did not interfere with the image quality, and guided the needle virtually exactly as planned. Histological examination could be conducted on every patient. The lesion was malignant in four cases, and an infectious etiology was diagnosed for the two remaining lesions. Regarding the differentiation of anatomical and pathological structures and position monitoring of the insertion needle, TrueFISP images are to be given preference. The average intervention time was 41 minutes. Lesions up to 15.4 cm beneath the skin surface were punctured. CONCLUSION: The proposed MR-guided assistance system can be successfully utilized in a high-field MR system for accurate punctures of even deep lesions in various anatomic regions.

Flow cytometric differential cell counts in milk for the evaluation of inflammatory reactions in clinically healthy and subclinically infected bovine mammary glands.

Somatic cell counts (SCC) are generally used as an indicator of udder health. In Germany, a cutoff value of 100,000 cells/mL is currently used to differentiate between healthy and diseased mammary glands. In addition to SCC, differential cell counts (DCC) can be applied for a more detailed evaluation of the udder health status. The aim of this study was to differentiate immune cells in milk of udder quarters classified as healthy based on SCC values of <100,000 cells/mL. Twenty cows were selected and 65 healthy udder quarters were compared with a control group of 15 diseased udder quarters (SCC>100,000 cells/mL). Cells were isolated from milk of all quarters to measure simultaneously percentages of lymphocytes, macrophages, and polymorphonuclear neutrophilic leukocytes (PMNL) by flow cytometric analysis. The bacteriological status of all 80 quarters was also determined. Differential cell count patterns of milk samples (n = 15) with extreme low SCC values of ≤ 6,250 cells/mL revealed high lymphocyte proportions of up to 88%. Milk cell populations in samples (n = 42) with SCC values from >6,250 to ≤ 25,000 cells/mL were also dominated by lymphocytes, whereas DCC patterns of 6 out of 41 milk samples with SCC values from ≥ 9,000 to ≤ 46,000 cells/mL indicated already inflammatory reactions based on the predominance of PMNL (56-75%). In 13 of 15 milk samples of the diseased udder quarters (SCC >100,000 cells/mL), PMNL were categorically found as dominant cell population with proportions of ≥ 49%. Macrophages were the second predominant cell population in almost all samples tested in relation to lymphocytes and PMNL. Further analysis of the data demonstrated significant differences of the cellular components between udder quarters infected by major pathogens (e.g., Staphylococcus aureus; n = 5) and culture-negative udder quarters (n = 56). Even the percentages of immune cells in milk from quarters infected by minor pathogens (e.g., coagulase-negative staphylococci; n = 19) differed significantly from those in milk of culture-negative quarters. Our flow cytometric analysis of immune cells in milk of udder quarters classified as healthy by SCC <100,000 cells/mL revealed inflammatory reactions based on DCC.

Is failure of condylar neck osteosynthesis predictable based on orthopantomography?

BACKGROUND: Osteosynthesis failure rates of 11.3% with 1 miniplate, 6.7% with 2 miniplates, and 4.4% with a single Medartis condyle plate were reported in previous studies of our clinic. Current science is still focused on the osteosynthesis material. Besides clinical parameters, conventional radiographs are still the first choice to detect osteosynthesis failures. This study scrutinized several factors assessable in postoperative orthopantomographs which might elevate the risk of osteosynthesis failure. STUDY DESIGN: A total of 136 patients (22 with osteosynthesis failure, 114 without) with 151 mandibular condyle fractures were included in this study. Eight parameters were assessed in postoperative orthopantomographs. RESULTS: The best predictor of osteosynthesis failure was a simplified concept of ramus height. In cases of reduced or normal ramus height, the odds of osteosynthesis failure was significantly (P = .000001) reduced to a 10th. Isolated fractures were significantly more error prone (P = .0009). CONCLUSIONS: Postoperative orthopantomographs depict factors which increase the risk of osteosynthesis failure.

Somatic cell counts and bacteriological status in quarter foremilk samples of cows in Hesse, Germany--a longitudinal study.

Somatic cell counts (SCC) are generally used as an indicator of udder health. Currently in Germany, 100,000 cells/mL is the threshold differentiating infected and noninfected mammary glands. The aim of our study was the detailed analysis of udder health in a representative part of the dairy cow population in Hesse, Germany. Between 2000 and 2008, 615,187 quarter foremilk samples were analyzed. In addition to evaluation of distribution of SCC and prevalence of mastitis pathogens, pathogen prevalence was also calculated depending on SCC. The data indicated that 38% of all samples had SCC >100,000 cells/mL and 62% showed SCC ≤ 100,000 cells/mL; 31% of all samples revealed SCC ≤ 25,000 cells/mL. Coagulase-negative staphylococci were the dominant pathogens in the Hessian quarter foremilk samples (17.17% of all samples) followed by Corynebacterium spp. (13.56%), Streptococcus uberis (8.7%), and Staphylococcus aureus (5.01%). Mastitis pathogens were detected in 83% of all samples with SCC >100,000 cells/mL. However, the prevalence of mastitis pathogens in the SCC range from 1,000 to ≤ 100,000 cells/mL was 8.5% (5.51% minor pathogens, 2.01% major pathogens, and 0.98% other pathogens). For farms producing high quality milk, exceptional hygiene management is compulsory. One of the farms randomly selected showed clearly different results from the Hessian survey. Fifteen percent more samples lay in the SCC range ≤ 100,000 cells/mL with a lower prevalence of mastitis pathogens of 1.91% (1.03% minor pathogens, 0.83% major pathogens, and 0.05% other pathogens). Based on these results, inflammatory processes can obviously be detected in mammary glands of udder quarters healthy according to the current definitions. However, we argue that such inflammation can be detected by examination of the relationship of immune cells in milk.

[The role of the voltage-dependent anion channels in the outer membrane of mitochondria in the regulation of cellular metabolism].

The role of the voltage-dependent anion channels (VDAC) harbored in the outer membrane of mitochondria in the regulation of cellular metabolism was investigated using an experimental model of ethanol toxicity in cultured hepatocytes. It was demonstrated that ethanol inhibits State 3 and uncoupled mitochondrial respirations, decreases the accessibility of mitochondrial adenylate kinase localized in the intermembrane space of mitochondria, and suppresses ureagenic respiration and synthesis of urea in cultured hepatocytes. Increasing the permeability of the outer mitochondrial membrane with closed VDAC with high concentrations of digitonin (> 80 microM), which creates pores in the membrane, allowing the alternative bypass of closed VDAC, and restores all reactions suppressed with ethanol. It is concluded that the effect of ethanol in hepatocytes leads to global loss of mitochondrial functions due to the closure of VDAC, which limits the free diffusion of metabolites into the intermembrane space of mitochondria. Our studies demonstrated that ethanol affects the main mitochondrial functions and revealed the role of VDAC channels in the outer mitochondrial membrane in the regulation of liver specific intracellular processes such as ureagenesis. The data obtained can be used for the development of pharmaceutical drugs that prevent the closure of VDAC in mitochondria of ethanol oxidizing liver, thus protecting liver tissue from the hepatotoxic action of alcohol.

[Cranial nerves - spectrum of inflammatory and tumorous changes]. / Hirnnerven - Spektrum entzündlicher und tumoröser Veränderungen.

Inflammatory processes as well as primary and secondary tumorous changes may involve cranial nerves causing neurological deficits. In addition to neurologists, ENT physicians, ophthalmologists and maxillofacial surgeons, radiologists play an important role in the investigation of patients with cranial nerve symptoms. Multidetector computed tomography (MDCT) and particularly magnetic resonance imaging (MRI) allow the depiction of the cranial nerve anatomy and pathological neural changes. This article briefly describes the imaging techniques in MDCT and MRI and is dedicated to the radiological presentation of inflammatory and tumorous cranial nerve pathologies.

[Imaging of hip joint arthroplasty]. / Bildgebung bei Hüftgelenkendoprothesen.

The hip joint is the largest joint in the human body and consequently, its evaluation by diagnostic imaging is highly important. This includes imaging of hip joint arthroplasty, which is used to avoid joint immobility following a wide spectrum of diseases, such as end-stage degenerative disease, avascular necrosis of the femoral head or post-traumatic fractures. Conventional radiography is still the standard imaging modality for the evaluation of hip arthroplasty both directly following surgery and for periodical follow-up. In the majority of cases conventional radiography enables adequate assessment of early and late complications that can arise following hip arthroplasty, such as loosening, prosthetic or periprosthetic fracture, luxation, infection and soft tissue calcification. If the diagnosis cannot be established by means of radiography, advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), with or without injection of contrast media, may provide additional information. This is particularly true for the depiction of inflammatory processes. Regardless of the imaging modality used patients' clinical symptoms must also be taken into account in order to establish the correct diagnosis.

Can quantitative diffusion-weighted MR imaging differentiate benign and malignant cold thyroid nodules? Initial results in 25 patients.

BACKGROUND AND PURPOSE: The characterization of cold nodules of the thyroid gland is mandatory because approximately 20% of these nodules are of malignant origin. The purpose of this study was to evaluate the distinction of cold thyroid nodules by using quantitative diffusion-weighted MR imaging (DWI). MATERIALS AND METHODS: In 25 patients with cold nodules on scintigraphy and suggestive findings at fine-needle aspiration, thyroid carcinoma was suggested. In these patients, cold nodules and the normal parenchyma of the contralateral thyroid lobe were prospectively investigated with quantitative DWI (echo-planar imaging sequence; maximum b-value, 800 s/mm(2)) before surgery. The differences in the mean apparent diffusion coefficient (ADC) values in benign and malignant nodules were tested by using a Mann-Whitney U test. RESULTS: Histologically, there were 20 carcinomas with a minimum size of 8 mm and 5 adenomas. The mean ADC values (in 10(-3) mm(2)/s) differed significantly among carcinoma, adenoma, and normal parenchyma (P < .05). The ranges (95% confidence interval) of the ADC values for carcinoma (2.43-3.037), adenoma (1.626-2.233), and normal parenchyma (1.253-1.602) showed no overlap. When an ADC value of 2.25 or higher was used for predicting malignancy, the highest accuracy of 88%, with 85% sensitivity and 100% specificity, was obtained. CONCLUSIONS: Quantitative DWI seems to be a feasible tool with which to differentiate thyroid carcinomas from adenomas; however, further studies are required including larger numbers of patients to confirm our results.

[Pathological changes of the hypopharynx in the focus of imaging]. / Pathologische Veränderungen des Hypopharynx im Brennpunkt der Bildgebung.

The spectrum of pathological changes in anatomical sections of the hypopharynx ranges from benign pathologies to hypopharyngeal carcinoma. Beside the clinical status and the endoscopic evaluation performed by ear, nose and throat specialists, imaging techniques play an important role in pre-therapeutic and post-therapeutic diagnostics and in the follow-up of pharyngeal disease patterns, especially for malignant lesions. A conventional x-ray swallow examination, contrast-enhanced multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI), as well as positron emission tomography (PET) and positron emission tomography computed tomography (PET-CT) are applied depending on the medical question and disease. Especially in radiological oncology, it is extremely important in regions which are clinically difficult to assess to determine the exact localization and extent of hypopharyngeal pathologies to plan the optimal therapy for the patient. This article demonstrates the radiological appearance of pathological changes of the hypopharynx and discusses in particular the hypopharynx carcinoma in the focus of pre-therapeutic and post-therapeutic imaging.

[Radiological normal anatomy of the larynx and pharynx and imaging techniques]. / Radiologische Normalanatomie des Larynx und Pharynx sowie bildgebende Techniken.

The larynx and the pharynx represent anatomically as well as functionally a very complex organ which serves as an airway and a nutrition channel. Knowledge of anatomy and anatomical topography is therefore a fundamental basis for the evaluation of any pathological process. Beside the clinical examination and endoscopy performed by ear, nose and throat specialists, imaging techniques play a crucial role in pre-therapeutic and post-therapeutic diagnostics. The radiologist employs a conventional x-ray swallow examination, as well as contrast-enhanced multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), positron emission tomography (PET) and positron emission tomography-computed tomography (PET-CT), depending on the medical problem in question. The following article demonstrates the functional and especially the structural anatomy of the larynx and the pharynx. Furthermore, the broad range of imaging techniques in clinical use is discussed.