Removal of a giant cardiac fibroma from a 4-year-old child.

In an 8-month-old infant presenting with a systolic heart murmur, a cardiac tumor was diagnosed by means of 2-dimensional echocardiography, cardiac catheterization, and magnetic resonance imaging. In the following years, the child developed ventricular arrhythmias, which were controlled with antiarrhythmic drugs. The operation was undertaken when the boy was 4 years and 3 months of age. A tumor of the interventricular septum measuring 45 x 13 x 25 mm was resected in toto. The defect in the ventricular septum was closed with a Dacron patch. The postoperative course was uneventful. Histologic examination classified the tumor as a fibroma.

[Prostatic and bladder cancer--possibilities and limitations of diagnostic imaging]. / Das Prostata- und Harnblasenkarzinom--Möglichkeiten und Grenzen der bildgebenden Diagnostik.

An optimal detection and subsequent documentation of tumour development with imaging methods is achieved with transrectal sonography combined with biopsy. In bladder carcinoma the penetration through the cystic wall and infiltration into adjacent organs and the lymph nodes is detected by computed tomography or better by magnetic resonance tomography.

[Magnetic resonance tomography in heart septal defects. Model studies on parameter optimizing]. / Magnetresonanz-Tomographie bei Herzscheidewanddefekten. Modelluntersuchungen zur Parameteroptimierung.

Various flow phenomena can occur in MR tomography of the heart. In the present study the influence of various examination parameters on the imaging of flow phenomena behind cardiac septum defects was investigated by means of a model. In the examination by fast field echo sequence (FFE) the contrast between poststenotic jet and surrounding area was most pronounced if short echo times (TE 10 ms), a narrow flip angle (d = 10 degrees) and layers of minor thickness (d = 5 mm) had been selected. The number of acquisitions and the flow compensation exercised only slight influence on contrast. Our results point to the possibility of obtaining quantitative information on cardiac septum defects if the influence of examination parameters on the imaging of flow phenomena is accurately known.

[MR angiography]. / MR-Angiographie.

MR angiography allows the imaging of vessels comparable with the vessels imaged with digital angiography. MR-angiograms were also generated by image subtraction. Basis are the different magnetic properties of moved and stationary spins. Contrast media are not required. In recent years the various techniques of image subtraction with the aim of good imaged vessels were developed. The most important are described in this paper.

[Thrombosis due to venous catheters--evaluation using CT]. / Thrombose bei venösen Kathetern--Beurteilung mittels CT.

Venous catheters for therapy and parenteral nutrition can cause thrombosis. A diagnostic elucidation and the evaluation of the extent of the thrombosis is indispensible for therapy decision. Besides phlebography, CT is a means for this. The results of CT-investigations of three patients with severe thrombosis caused by permanent venous catheters are shown. In all cases we were able to achieve the correct diagnosis and a reliable evaluation of the extent of the thrombosis. Small amounts of contrast medium are required and the investigation is tolerated even by seriously ill patients. CT therefore is an alternative to phlebography for the diagnostics and evaluation of the extent of thrombosis of the large veins.

[CT-guided percutaneous puncture and drainage of pericardial effusion]. / CT-gestützte perkutane Punktion und Drainage von Perikardergüssen.

Pericardial fluid can impair cardiac function. If medication is ineffective, puncture and drainage of the fluid is necessary. Three cases of CT-guided puncture and drainage of pericardial fluid are reported. The described technique is quick, of little risk and effective. It is superior to the conventional puncture of the pericardium from the subxiphoidal direction.

Right ventricular volume: cine vs CT measurements.

The volumes of 15 human right ventricular cast specimens were analyzed by computed tomography (CT) and compared with reference volumes and the values obtained by cineradiography. CT volumes were more accurate than those determined by cineradiography. The mean deviation between CT and reference volumes was 3.4%. The differences between cineradiographic values and reference volumes were 14 and 17%, respectively, for the 60 degree LAO projection, area-length method, and biplane 30 degree RAO/60 degree LAO projection, according to the Ferlinz method. The CT and cineradiographic volumes differed significantly in our experiment.

[Diagnosis of the aortocoronary bypass--a comparison of MRT and CT]. / Diagnostik aortokoronarer Bypässe--Ein Vergleich von MRT und CT.

Complaints of angina pectoris after aortocoronary bypass surgery can be due to the obturation of one or more bypasses. The aim of our study was the evaluation of magnetic resonance tomography for the investigation of bypass patency in comparison with computed tomography. We investigated 18 patients. 33 of 35 bypasses were safely detectable with spin-echo techniques and 32 with fast-scan-techniques and presentation in cine-mode. 25 of 33 bypasses were identified as open with the SE-technique, 27 of 32 with the "fast" technique. No safe decision was possible for 4 bypasses with SE-technique and for 1 bypass with the "fast" technique. The results are in good agreement with the reference investigation by CT. For the investigation of bypass patency with MRT neither x-rays nor contrast media are necessary. It is therefore recommended for patients with allergy to contrast media and cases with high radiation risk.

[Perfusion studies of the myocardium using computerized tomography. Comparative studies in normal persons and patients with coronary heart disease]. / Perfusionsuntersuchungen am Myokard mittels Computertomographie. Vergleichende Untersuchungen bei Normalpersonen und Patienten mit koronarer Herzkrankheit.

As a noninvasive method of examination, conventional computer tomography (CT) has assumed an important role in assessment of pathologic anatomy of the heart. In contrast, previously, CT has not been applied for routine investigations of myocardial perfusion. In this study, a new method is described which, with intravenous injection of contrast medium, enables delineation of perfusion differences in the myocardium. Studies were performed in ten healthy male subjects and 71 patients with angiographically-documented coronary artery disease with a Somatom SF (Siemens) with a scanning time of five seconds. Prior to contrast injection, a native scan was obtained in the short axis view of the left ventricle as well as in apical and central view. After injection of 30 ml of contrast medium through a 7F ring catheter positioned in the inferior vena cava, imaging was again performed and then repeated subsequent to administration of 0.5 mg/kg dipyridamole. Quantitative evaluation of the CT images was carried out through circumferential analysis of the apical and central segments. The circumference was divided into 60 segments of six degrees each and for each segment ten density measurements were performed to obtain average values subendocardially, intramurally and subepicardially. After correction for the density value of the ascending aorta in healthy subjects, the density profile was constructed. The density profile of the healthy subjects was designated as the mean value curve. The circumferential profile of patients with coronary artery disease was tested against the mean value curve from which two indexes for description of perfusion disturbances were defined.(ABSTRACT TRUNCATED AT 250 WORDS)