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Stöcklein S, Brandlhuber M, Lause S, Pomschar A, Jahn K, Schniepp R, Alperin N, Ertl-Wagner B. Decreased Craniocervical CSF Flow in Patients with Normal Pressure Hydrocephalus: A Pilot Study. AJNR Am J Neuroradiol 2022; 43:230-237. [PMID: 34992125 PMCID: PMC8985674 DOI: 10.3174/ajnr.a7385] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Normal pressure hydrocephalus is characterized by systolic peaks of raised intracranial pressure, possibly due to a reduced compliance of the spinal CSF spaces. This concept of a reduced spinal CSF buffer function may be reflected by a low cervical CSF outflow from the cranium. The aim of this study was to investigate craniospinal CSF flow rates by phase-contrast MR imaging in patients with normal pressure hydrocephalus. MATERIALS AND METHODS A total of 42 participants were included in this prospective study, consisting of 3 study groups: 1) 10 patients with normal pressure hydrocephalus (mean age, 74 [SD, 6] years, with proved normal pressure hydrocephalus according to current scientific criteria); 2) eighteen age-matched healthy controls (mean age, 71 [SD, 5] years); and 3) fourteen young healthy controls (mean age, 21 [SD, 2] years, for investigation of age-related effects). Axial phase-contrast MR imaging was performed, and the maximal systolic CSF and total arterial blood flow rates were measured at the level of the upper second cervical vertebra and compared among all study groups (2-sample unpaired t test). RESULTS The maximal systolic CSF flow rate was significantly decreased in patients with normal pressure hydrocephalus compared with age-matched and young healthy controls (53 [SD, 40] mL/m; 329 [SD, 175] mL/m; 472 [SD, 194] mL/m; each P < .01), whereas there were no significant differences with regard to maximal systolic arterial blood flow (1160 [SD, 404] mL/m; 1470 [SD, 381] mL/m; 1400 [SD, 254] mL/m; each P > .05). CONCLUSIONS The reduced maximal systolic craniospinal CSF flow rate in patients with normal pressure hydrocephalus may be reflective of a reduced compliance of the spinal CSF spaces and an ineffective spinal CSF buffer function. Systolic craniospinal CSF flow rates are an easily obtainable MR imaging-based measure that may support the diagnosis of normal pressure hydrocephalus.
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Affiliation(s)
| | | | - S.S. Lause
- Department of Dermatology (S.S.L.), Bethesda Hospital, Freudenberg, Germany
| | - A. Pomschar
- Radiological Office (A.P.), Centre for Radiology, Munich, Germany
| | - K. Jahn
- Neurology, and Friedrich-Baur-Institute (FBI) of the Department of Neurology (K.J.)
| | - R. Schniepp
- Neurology (R.S.), Ludwig-Maximilians-University Munich, Munich, Germany
| | - N. Alperin
- Department of Radiology (N.A.), University of Miami, Coral Gables, Florida
| | - B. Ertl-Wagner
- Department of Medical Imaging (B.E.-W.), The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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2
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Niepel KB, Stanislawski M, Wuerl M, Doerringer F, Pinto M, Dietrich O, Ertl-Wagner B, Lalonde A, Bouchard H, Pappas E, Yohannes I, Hillbrand M, Landry G, Parodi K. Animal tissue-based quantitative comparison of dual-energy CT to SPR conversion methods using high-resolution gel dosimetry. Phys Med Biol 2021; 66. [DOI: 10.1088/1361-6560/abbd14] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/30/2020] [Indexed: 12/16/2022]
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3
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Delius M, Hübener C, Flemmer A, Hasbargen U, Ertl-Wagner B, Hertlein L. Lissenecephalie bei dichorialer Zwillingsschwangerschaft – TUBA1A de novo Mutation eines Feten. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- M Delius
- LMU Klinik für Frauenheilkunde und Geburtshilfe, Campus Innenstadt
| | - C Hübener
- LMU München, Frauenklinik Großhadern
| | - A Flemmer
- Kinderklinik der LMU München, Neonatologie, Campus Großhadern
| | | | - B Ertl-Wagner
- The Hospital for Sick Children, Department of Medical Imaging
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4
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Gerb J, Ahmadi SA, Kierig E, Ertl-Wagner B, Dieterich M, Kirsch V. VOLT: a novel open-source pipeline for automatic segmentation of endolymphatic space in inner ear MRI. J Neurol 2020; 267:185-196. [PMID: 32666134 PMCID: PMC7718192 DOI: 10.1007/s00415-020-10062-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/02/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022]
Abstract
Background Objective and volumetric quantification is a necessary step in the assessment and comparison of endolymphatic hydrops (ELH) results. Here, we introduce a novel tool for automatic volumetric segmentation of the endolymphatic space (ELS) for ELH detection in delayed intravenous gadolinium-enhanced magnetic resonance imaging of inner ear (iMRI) data. Methods The core component is a novel algorithm based on Volumetric Local Thresholding (VOLT). The study included three different data sets: a real-world data set (D1) to develop the novel ELH detection algorithm and two validating data sets, one artificial (D2) and one entirely unseen prospective real-world data set (D3). D1 included 210 inner ears of 105 patients (50 male; mean age 50.4 ± 17.1 years), and D3 included 20 inner ears of 10 patients (5 male; mean age 46.8 ± 14.4 years) with episodic vertigo attacks of different etiology. D1 and D3 did not differ significantly concerning age, gender, the grade of ELH, or data quality. As an artificial data set, D2 provided a known ground truth and consisted of an 8-bit cuboid volume using the same voxel-size and grid as real-world data with different sized cylindrical and cuboid-shaped cutouts (signal) whose grayscale values matched the real-world data set D1 (mean 68.7 ± 7.8; range 48.9–92.8). The evaluation included segmentation accuracy using the Sørensen-Dice overlap coefficient and segmentation precision by comparing the volume of the ELS. Results VOLT resulted in a high level of performance and accuracy in comparison with the respective gold standard. In the case of the artificial data set, VOLT outperformed the gold standard in higher noise levels. Data processing steps are fully automated and run without further user input in less than 60 s. ELS volume measured by automatic segmentation correlated significantly with the clinical grading of the ELS (p < 0.01). Conclusion VOLT enables an open-source reproducible, reliable, and automatic volumetric quantification of the inner ears’ fluid space using MR volumetric assessment of endolymphatic hydrops. This tool constitutes an important step towards comparable and systematic big data analyses of the ELS in patients with the frequent syndrome of episodic vertigo attacks. A generic version of our three-dimensional thresholding algorithm has been made available to the scientific community via GitHub as an ImageJ-plugin.
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Affiliation(s)
- J Gerb
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - S A Ahmadi
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany
| | - E Kierig
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - B Ertl-Wagner
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - V Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany. .,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany. .,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany.
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5
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Ertl-Wagner B, Wagner MW. [Magnetic resonance imaging of the brain in neonates and infants]. Radiologe 2019; 59:1097-1106. [PMID: 31748980 DOI: 10.1007/s00117-019-00610-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Magnetic resonance imaging (MRI) is increasingly being used for infants and small children due to rapid sequence protocols, broader scanner availability and good monitoring possibilities. The sequence protocol should always be adapted to the individual clinical needs of the infant or toddler. For some clinical indications, such as control of ventricular width in children with shunted hydrocephalus, ultrafast protocols can be used with a scanning time of just a few minutes. For more complex clinical questions, more extensive sequence protocols are warranted. Particularly for neonates and using a rapid investigation protocol, MRI examinations can very often be performed without sedation. The necessity of using gadolinium-based contrast agents has to be critically deliberated in infants and neonates and has to be exactly tailored to the clinical needs. In many cases MRI examinations of the brain in infants and neonates do not require gadolinium-based contrast agents.
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Affiliation(s)
- B Ertl-Wagner
- Derek Harwood Nash Chair of Pediatric Neuroradiology, Division Head Neuroradiology, SickKids-The Hospital for Sick Children, University of Toronto, 555 University Ave, M5G 1X8, Toronto, Ontario, Canada.
| | - M W Wagner
- Chief Fellow Pediatric Neuroradiology, SickKids-The Hospital for Sick Children, University of Toronto, 555 University Ave, M5G 1X8, Toronto, Ontario, Canada
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6
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Kirsch V, Nejatbakhshesfahani F, Ahmadi SA, Dieterich M, Ertl-Wagner B. A probabilistic atlas of the human inner ear's bony labyrinth enables reliable atlas-based segmentation of the total fluid space. J Neurol 2019; 266:52-61. [PMID: 31422454 DOI: 10.1007/s00415-019-09488-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 12/20/2022]
Abstract
Intravenous contrast agent-enhanced magnetic resonance imaging of the endolymphatic space (ELS) of the inner ear permits direct, in-vivo, non-invasive visualization of labyrinthine structures and thus verification of endolymphatic hydrops (ELH). However, current volumetric assessment approaches lack normalization. The aim of this study was to develop a probabilistic atlas of the inner ear's bony labyrinth as a first step towards an automated and reproducible volume-based quantification of the ELS. The study included three different datasets: a source dataset (D1) to build the probabilistic atlas and two testing sets (D2, D3). D1 included 24 right-handed patients (12 females; mean age 51.5 ± 3.9 years) and D2 5 patients (3 female; mean age 48.8 ± 5.01 years) with vestibular migraine without ELH or any measurable vestibular deficits. D3 consisted of five patients (one female; mean age 46 ± 5.2 years) suffering from unilateral Menière's disease and ELH. Data processing comprised three steps: preprocessing using an affine and deformable fusion registration pipeline, computation of an atlas for the left and right inner ear using a label-assisted approach, and validation of the atlas based on localizing and segmenting previously unseen ears. The three-dimensional probabilistic atlas of the inner ear's bony labyrinth consisted of the internal acoustic meatus and inner ears (including cochlea, otoliths, and semicircular canals) for both sides separately. The analyses showed a high level of agreement between the atlas-based segmentation and the manual gold standard with an overlap of 89% for the right ear and 86% for the left ear (measured by dice scores). This probabilistic in vivo atlas of the human inner ear's bony labyrinth and thus of the inner ear's total fluid space for both ears represents a necessary step towards a normalized, easily reproducible and reliable volumetric quantification of the perilymphatic and endolymphatic space in view of MR volumetric assessment of ELH. The proposed atlas lays the groundwork for state-of-the-art approaches (e.g., deep learning) and will be provided to the scientific community.
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Affiliation(s)
- Valerie Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany. .,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany. .,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
| | - F Nejatbakhshesfahani
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - S-A Ahmadi
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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7
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Gerb J, Ertl-Wagner B, Dieterich M, Kirsch V. P30 Automatic volumetric segmentation of the endolymphatic space calibrated to radiological grading of the endolymphatic hydrops. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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8
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Kierig E, Kirsch V, Becker-Bense S, Gerb J, Ertl-Wagner B, Dieterich M. P01 Endolymphatic hydrops: A common finding in vestibular migraine. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2019.04.657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Roeh A, Bunse T, Lembeck M, Handrack M, Pross B, Schoenfeld J, Keeser D, Ertl-Wagner B, Pogarell O, Halle M, Falkai P, Hasan A, Scherr J. Running effects on cognition and plasticity (ReCaP): study protocol of a longitudinal examination of multimodal adaptations of marathon running. Res Sports Med 2019; 28:241-255. [PMID: 31345073 DOI: 10.1080/15438627.2019.1647205] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Regular moderate physical activity (PA) has been linked to beneficial adaptations in various somatic diseases (e.g. cancer, endocrinological disorders) and a reduction in all-cause mortality from several cardiovascular and neuropsychiatric diseases. This study was designed to investigate acute and prolonged exercise-induced cardio- and neurophysiological responses in endurance runners competing in the Munich Marathon. ReCaP (Running effects on Cognition and Plasticity) is a multimodal and longitudinal experimental study. This study included 100 participants (20-60 years). Six laboratory visits were included during the 3-month period before and the 3-month period after the Munich marathon. The multimodal assessment included laboratory measurements, cardiac and cranial imaging (MRI scans, ultrasound/echocardiography) and neurophysiological methods (EEG and TMS/tDCS), and vessel-analysis (e.g. retinal vessels and wave-reflection analyses) and neurocognitive measurements. The ReCaP study was designed to examine novel exercise-induced cardio- and neurophysiological responses to marathon running at the behavioral, functional and morphological levels. This study will expand our understanding of exercise-induced adaptations and will lead to more individually tailored therapeutic options.
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Affiliation(s)
- A Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - T Bunse
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Lembeck
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Handrack
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - B Pross
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - J Schoenfeld
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - D Keeser
- Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - B Ertl-Wagner
- Department of Clinical Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - O Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - M Halle
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner site Munich, Munich Heart Alliance, Munich, Germany
| | - P Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - A Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - J Scherr
- Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
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Kirsch V, Boegle R, Keeser D, Kierig E, Ertl-Wagner B, Brandt T, Dieterich M. Beyond binary parcellation of the vestibular cortex - A dataset. Data Brief 2019; 23:103666. [PMID: 30788394 PMCID: PMC6369267 DOI: 10.1016/j.dib.2019.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 01/01/2019] [Accepted: 01/07/2019] [Indexed: 10/27/2022] Open
Abstract
The data-set presented in this data article is supplementary to the original publication, doi:10.1016/j.neuroimage.2018.05.018 (Kirsch et al., 2018). Named article describes handedness-dependent organizational patterns of functional subunits within the human vestibular cortical network that were revealed by functional magnetic resonance imaging (fMRI) connectivity parcellation. 60 healthy volunteers (30 left-handed and 30 right-handed) were examined on a 3T MR scanner using resting state fMRI. The multisensory (non-binary) nature of the human (vestibular) cortex was addressed by using masked binary and non-binary variations of independent component analysis (ICA). The data have been made publicly available via github (https://github.com/RainerBoegle/BeyondBinaryParcellationData).
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Key Words
- A1, Primary auditory cortex
- ACC, Anterior cingulate cortex
- BA, Brodmann areal
- C, Common cluster
- CSF, Cerebrospinal fluid
- IC, Independent component
- ICA, Independent component analysis
- IPL, Inferior parietal lobule
- L, Left
- L-I, Laterality-index
- LH, Left-handed
- M/STG, Middle and superior temporal gyrus
- M1, Primary motor cortex
- MR, Magnetic resonance
- MRI, Magnetic resonance imaging
- MST, Medial superior temporal area
- MSTd, Dorsal medial superior temporal area
- MT, Middle temporal area
- OP, Operculum
- OP2, Operculum 2
- P, Parcel
- P-P, Parcel to parcel correlation
- P-RSN, Parcel to resting state network correlation
- PET, Positron emission tomography
- PIVC, Parieto-insular vestibular cortex
- R, Right
- RH, Right-handed
- ROI, Region of interest
- RSN, Resting-state network
- S1, Primary somatosensory cortex
- SD, Standard deviation
- SMA, Supplementary motor area
- STG, Superior temporal gyrus
- SVV, Subjective visual vertical
- TP, Temporo-parietal
- U, Unique voxel
- V1–5, Primary, secondary and tertiary visual cortices
- VOG, Video-oculography
- VOR, Vestibular-ocular reflex
- VPS, Visual posterior sylvian area
- fCBP, Functional connectivity based parcellation
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Affiliation(s)
- V Kirsch
- Department of Neurology, Ludwig-Maximilians Universität, Munich, Germany.,Graduate School of Systemic Neuroscience, Ludwig-Maximilians Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany
| | - R Boegle
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany
| | - D Keeser
- Department of Radiology, Ludwig-Maximilians Universität, Munich, Germany.,Department of Psychiatry, Ludwig-Maximilians Universität, Munich, Germany
| | - E Kierig
- Department of Neurology, Ludwig-Maximilians Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany.,Department of Radiology, Ludwig-Maximilians Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - T Brandt
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians Universität, Munich, Germany
| | - M Dieterich
- Department of Neurology, Ludwig-Maximilians Universität, Munich, Germany.,Graduate School of Systemic Neuroscience, Ludwig-Maximilians Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Kirsch V, Boegle R, Keeser D, Kierig E, Ertl-Wagner B, Brandt T, Dieterich M. Handedness-dependent functional organizational patterns within the bilateral vestibular cortical network revealed by fMRI connectivity based parcellation. Neuroimage 2018; 178:224-237. [DOI: 10.1016/j.neuroimage.2018.05.018] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/19/2022] Open
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Kirsch V, Becker-Bense S, Berman A, Gerb J, Ertl-Wagner B, Dieterich M. P120. MRI of the inner ear enables differentiation of central and peripheral vestibular pathologies in a postoperative ELST patient. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kirsch V, Becker-Bense S, Berman A, Kierig E, Ertl-Wagner B, Dieterich M. P119. Activity-dependent plasticity of the endolymphatic space in vestibular migraine – A single case study. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Kirsch V, Becker-Bense S, Berman A, Kierig E, Ertl-Wagner B, Dieterich M. Transient endolymphatic hydrops after an attack of vestibular migraine: a longitudinal single case study. J Neurol 2018; 265:51-53. [PMID: 29696496 DOI: 10.1007/s00415-018-8870-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 04/10/2018] [Accepted: 04/12/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Valerie Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany. .,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany. .,Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany.
| | - S Becker-Bense
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany
| | - A Berman
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - E Kierig
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians-Universität, Munich, Germany.,Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Unterrainer M, Mahler C, Vomacka L, Lindner S, Havla J, Brendel M, Böning G, Ertl-Wagner B, Kümpfel T, Milenkovic VM, Rupprecht R, Kerschensteiner M, Bartenstein P, Albert NL. TSPO PET with [ 18F]GE-180 sensitively detects focal neuroinflammation in patients with relapsing-remitting multiple sclerosis. Eur J Nucl Med Mol Imaging 2018. [PMID: 29523925 DOI: 10.1007/s00259-018-3974-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE Expression of the translocator protein (TSPO) is upregulated in activated macrophages/microglia and is considered to be a marker of neuroinflammation. We investigated the novel TSPO ligand [18F]GE-180 in patients with relapsing-remitting multiple sclerosis (RRMS) to determine the feasibility of [18F]GE-180 PET imaging in RRMS patients and to assess its ability to detect active inflammatory lesions in comparison with the current gold standard, contrast-enhanced magnetic resonance imaging (MRI). METHODS Nineteen RRMS patients were prospectively included in this study. All patients underwent TSPO genotyping and were classified as high-affinity, medium-affinity or low-affinity binders (HAB/MAB/LAB). PET scans were performed after administration of 189 ± 12 MBq [18F]GE-180, and 60-90 min summation images were used for visual analysis and assessment of standardized uptake values (SUV). The frontal nonaffected cortex served as a pseudoreference region (PRR) for evaluation of SUV ratios (SUVR). PET data were correlated with MRI signal abnormalities, i.e. T2 hyperintensity or contrast enhancement (CE). When available, previous MRI data were used to follow the temporal evolution of individual lesions. RESULTS Focal lesions were identified as hot spots by visual inspection. Such lesions were detected in 17 of the 19 patients and overall 89 [18F]GE-180-positive lesions were found. TSPO genotyping revealed 11 patients with HAB status, 5 with MAB status and 3 with LAB status. There were no associations between underlying binding status (HAB, MAB and LAB) and the signal intensity in either lesions (SUVR 1.87 ± 0.43, 1.95 ± 0.48 and 1.86 ± 0.80, respectively; p = 0.280) or the PRR (SUV 0.36 ± 0.03, 0.40 ± 0.06 and 0.37 ± 0.03, respectively; p = 0.990). Of the 89 [18F]GE-180-positive lesions, 70 showed CE on MRI, while the remainder presented as T2 lesions without CE. SUVR were significantly higher in lesions with CE than in those without (2.00 ± 0.53 vs. 1.60 ± 0.15; p = 0.001). Notably, of 19 [18F]GE-180-positive lesions without CE, 8 previously showed CE, indicating that [18F]GE-180 imaging may be able to detect lesional activity that is sustained beyond the blood-brain barrier breakdown. CONCLUSION [18F]GE-180 PET can detect areas of focal macrophage/microglia activation in patients with RRMS in lesions with and without CE on MRI. Therefore, [18F]GE-180 PET imaging is a sensitive and quantitative approach to the detection of active MS lesions. It may provide information beyond contrast-enhanced MRI and is readily applicable to all patients. [18F]GE-180 PET imaging is therefore a promising new tool for the assessment of focal inflammatory activity in MS.
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Affiliation(s)
- Marcus Unterrainer
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - C Mahler
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - L Vomacka
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - S Lindner
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - J Havla
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - M Brendel
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - G Böning
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany
| | - B Ertl-Wagner
- Institute of Clinical Radiology, University Hospital, LMU Munich, Munich, Germany
| | - T Kümpfel
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany
| | - V M Milenkovic
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - R Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - M Kerschensteiner
- Institute of Clinical Neuroimmunology, University Hospital, LMU Munich, Munich, Germany.,Biomedical Center (BMC), LMU Munich, Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - P Bartenstein
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany.,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, Ludwig-Maximilians University Munich, Marchioninistr. 15, 81377, Munich, Germany. .,Munich Cluster of Systems Neurology (SyNergy), Munich, Germany.
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16
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Franzmeier N, Caballero MÁA, Taylor ANW, Simon-Vermot L, Buerger K, Ertl-Wagner B, Mueller C, Catak C, Janowitz D, Baykara E, Gesierich B, Duering M, Ewers M. Resting-state global functional connectivity as a biomarker of cognitive reserve in mild cognitive impairment. Brain Imaging Behav 2018; 11:368-382. [PMID: 27709513 DOI: 10.1007/s11682-016-9599-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cognitive reserve (CR) shows protective effects in Alzheimer's disease (AD) and reduces the risk of dementia. Despite the clinical significance of CR, a clinically useful diagnostic biomarker of brain changes underlying CR in AD is not available yet. Our aim was to develop a fully-automated approach applied to fMRI to produce a biomarker associated with CR in subjects at increased risk of AD. We computed resting-state global functional connectivity (GFC), i.e. the average connectivity strength, for each voxel within the cognitive control network, which may sustain CR due to its central role in higher cognitive function. In a training sample including 43 mild cognitive impairment (MCI) subjects and 24 healthy controls (HC), we found that MCI subjects with high CR (> median of years of education, CR+) showed increased frequency of high GFC values compared to MCI-CR- and HC. A summary index capturing such a surplus frequency of high GFC was computed (called GFC reserve (GFC-R) index). GFC-R discriminated MCI-CR+ vs. MCI-CR-, with the area under the ROC = 0.84. Cross-validation in an independently recruited test sample of 23 MCI subjects showed that higher levels of the GFC-R index predicted higher years of education and an alternative questionnaire-based proxy of CR, controlled for memory performance, gray matter of the cognitive control network, white matter hyperintensities, age, and gender. In conclusion, the GFC-R index that captures GFC changes within the cognitive control network provides a biomarker candidate of functional brain changes of CR in patients at increased risk of AD.
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Affiliation(s)
- N Franzmeier
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.
| | - M Á Araque Caballero
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - A N W Taylor
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - L Simon-Vermot
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - K Buerger
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Ertl-Wagner
- Institute for Clinical Radiology, Klinikum der Universität München, Ludwig-Maximilian University, Marchioninistraße 15, 81377, Munich, Germany
| | - C Mueller
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - C Catak
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - D Janowitz
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - E Baykara
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - B Gesierich
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Duering
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
| | - M Ewers
- Institut für Schlaganfall-und Demenzforschung (ISD), Ludwig-Maximilians-Universität LMU, Klinikum der Universität München, Feodor-Lynen Straße 17, 81377, Munich, Germany
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17
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Sattler EC, Ertl-Wagner B, Pellegrini C, Peris K, Reithmair M, Schädle N, Ruzicka T, Steinlein OK. Cutaneous melanoma in Birt-Hogg-Dubé syndrome: part of the clinical spectrum? Br J Dermatol 2018; 178:e132-e133. [PMID: 28869776 DOI: 10.1111/bjd.15937] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E C Sattler
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - B Ertl-Wagner
- Department of Radiology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - C Pellegrini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - K Peris
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - M Reithmair
- Institute of Human Genetics, University Hospital, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - N Schädle
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
| | - O K Steinlein
- Institute of Human Genetics, University Hospital, Ludwig-Maximilian University of Munich, Frauenlobstraße 9-11, D-80337, Munich, Germany
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18
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Landgraf MN, König H, Hannibal I, Langhagen T, Bonfert MV, Klose B, Rahmsdorf B, Giese RM, Straube A, von Kries R, Albers L, Ebinger F, Ertl-Wagner B, Kammer B, Körte I, Sollmann N, Krieg S, Heinen F. Migräne im Kindes- und Jugendalter – Gehirn und Muskel? Nervenarzt 2017; 88:1402-1410. [DOI: 10.1007/s00115-017-0428-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Jerin C, Krause E, Ertl-Wagner B, Gürkov R. Clinical features of delayed endolymphatic hydrops and intralabyrinthine schwannoma : An imaging-confirmed comparative case series. English version. HNO 2017; 65:41-45. [PMID: 27492473 DOI: 10.1007/s00106-016-0199-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to compare the clinical history and audiovestibular function test results of patients suffering from intralabyrinthine schwannoma or delayed endolymphatic hydrops (DEH). PATIENTS AND METHODS Five patients diagnosed with intralabyrinthine schwannoma by magnetic resonance imaging (MRI) and five patients diagnosed with DEH by locally enhanced inner ear MRI (LEIM) were retrospectively studied. RESULTS All patients with intralabyrinthine schwannoma or DEH initially presented with hearing loss. Vertigo occurred in two patients with intralabyrinthine schwannoma and in all patients with DEH. While audiometry achieved poorer results for patients with intralabyrinthine schwannomas, vestibular function tests revealed normal results in about half of the patients in both groups. CONCLUSION Patients with intralabyrinthine schwannomas may present with clinical symptoms similar to patients suffering from other inner ear disorders such as delayed endolymphatic hydrops and they may obtain similar findings in audiovestibular function tests. High-resolution magnetic resonance imaging with locally applied contrast agent may provide evidence of both underlying pathologies.
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Affiliation(s)
- C Jerin
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany. .,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany.
| | - E Krause
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany
| | - B Ertl-Wagner
- Institute of Clinical Radiology, Grosshadern Medical Center, University of Munich, Munich, Germany
| | - R Gürkov
- German Center for Vertigo and Balance Disorders, Grosshadern Medical Center, University of Munich, Marchioninistr. 15, 81377, Munich, Germany.,Department of Otorhinolaryngology - Head and Neck Surgery, Grosshadern Medical Center, University of Munich, Munich, Germany
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20
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Abstract
New clinical and technological advances in the field of magnetic resonance imaging (MRI) and targeted image-guided biopsy techniques have significantly improved the detection, localization and staging as well as active surveillance of prostate cancer in recent years. Multiparametric MRI (mpMRI) is currently the main imaging technique for the detection, characterization and diagnostics of metastasizing prostate cancer and is of high diagnostic importance for local staging within the framework of the detection of prostate cancer.
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Affiliation(s)
- D Nörenberg
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland.
| | - O Solyanik
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - B Schlenker
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - G Magistro
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - B Ertl-Wagner
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - D A Clevert
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - C Stief
- Urologische Klinik und Poliklinik, Klinikum der Universität München, Campus Großhadern, München, Deutschland
| | - M F Reiser
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
| | - M D'Anastasi
- Institut für Klinische Radiologie, Klinikum der Universität München, Campus Großhadern, Marchioninistrasse 15, 81377, München, Deutschland
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21
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Ingrisch M, Schneider M, Nörenberg D, Negrao de Figueiredo G, Maier-Hein K, Suchorska B, Reiser M, Tonn J, Ertl-Wagner B. Prognostische Information aus präoperativen MR-Daten von Patienten mit Glioblastomen: eine Radiomics-Studie. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Ingrisch
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - M Schneider
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - D Nörenberg
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | | | - K Maier-Hein
- Deutsches Krebsforschungszentrum, Medizinische und Biologische Informatik, Heidelberg
| | - B Suchorska
- Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München
| | - M Reiser
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - J Tonn
- Klinikum der Universität München, Neurochirurgische Klinik und Poliklinik, München
| | - B Ertl-Wagner
- Klinikum der Universität München, Institut für Klinische Radiologie, München
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22
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Fabritius M, Schuler F, Höhne C, Reiser M, Ertl-Wagner B, Sommer W, Thierfelder K, Kunz W. Prädiktiver Wert der CT-Perfusionsbildgebung bei akuter Kleinhirnischämie für die Entstehung eines malignen Kleinhirnödems. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- M Fabritius
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - F Schuler
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - C Höhne
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Neurologische Klinik und Poliklinik, München
| | - M Reiser
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - B Ertl-Wagner
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - W Sommer
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - K Thierfelder
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
| | - W Kunz
- Ludwig-Maximilians-Universität, Klinikum der Universität München, Institut für klinische Radiologie, München
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Schöppe F, Stöcklein S, Reiser M, Rossi A, Ertl-Wagner B. Zerebrale Mikroblutungen und kortikale Siderose bei pädiatrischen Patienten mit Down-Syndrom. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Schöppe
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - S Stöcklein
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - M Reiser
- Klinikum der Universität München, Institut für Klinische Radiologie, München
| | - A Rossi
- Istituto Giannina Gaslini, Abteilung für Neuroradiologie, Genua (Italien)
| | - B Ertl-Wagner
- Klinikum der Universität München, Institut für Klinische Radiologie, München
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Woersching J, Helbich K, Kumpf U, Ertl-Wagner B, Padberg F, Keeser D. P123 Repeated measure stability of prefrontal transcranial direct current stimulation (tDCS) on functional MRI connectivity in healthy subjects. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Keeser D, Weidinger E, Linhardt A, Palm U, Hasan A, Kirsch B, Pogarell O, Karali T, Paolini M, Ertl-Wagner B, Müller N, Falkai P, Padberg F. P276 Transcranial Direct Current Stimulation (tDCS) replaces Electroconvulsive Therapy (ECT) in a patient with corpus callosum agenesis and catatonic schizophrenia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ertl-Wagner B, Barkhausen J, Mahnken AH, Mentzel HJ, Uder M, Weidemann J, Stumpp P. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany. ROFO-FORTSCHR RONTG 2016; 188:1017-1023. [PMID: 27760438 DOI: 10.1055/s-0042-116026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Purpose: Radiology represents a highly relevant part of undergraduate medical education from preclinical studies to subinternship training. It is therefore important to establish a content base for teaching radiology in German Medical Faculties. Materials and Methods: The German Society of Radiology (DRG) developed a model curriculum for radiological teaching at German medical universities, which is presented in this article. There is also a European model curriculum for undergraduate teaching (U-level curriculum of the European Society of Radiology). In a modular concept, the students shall learn important radiological core principles in the realms of knowledge, skills and competences as well as core scientific competences in the imaging sciences. Results: The curriculum is divided into two modules. Module 1 includes principles of radiation biology, radiation protection and imaging technology, imaging anatomy as well as the risks and side effects of radiological methods, procedures and contrast media. This module is modality-oriented. Module 2 comprises radiological diagnostic decision-making and imaging-based interventional techniques for various disease entities. This module is organ system-oriented. Conclusion: The curriculum is meant as a living document to be amended and revised at regular intervals. The curriculum can be used as a basis for individual curricular development at German Medical Faculties. It can be integrated into traditional or reformed medical teaching curricula. Key Points: • Radiology is an integral and important part of medical education.• The German Society of Radiology (DRG) developed a model curriculum for teaching radiology at German Medical Faculties to help students develop the ability to make medical decisions based on scientific knowledge and act accordingly.• This curriculum can be used for individual curricular development at medical departments. It is divided into two modules with several chapters. Citation Format: • Ertl-Wagner B, Barkhausen J, Mahnken AH et al. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany. Fortschr Röntgenstr 2016; 188: 1017 - 1023.
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Affiliation(s)
- B Ertl-Wagner
- Institute of Clinical Radiology, Ludwig Maximilians University - Großhadern Campus, Munich, Germany
| | - J Barkhausen
- Department of Radiology and Nuclear Medicine, University Hopsital Schleswig Holstein Luebeck Campus, Germany
| | - A H Mahnken
- Diagnostic and Interventional Radiology, Philipps University, Marburg, Germany
| | - H J Mentzel
- Paediatric Radiology, Institute for Diagnostic and Interventional Radiology, Jena, Germany
| | - M Uder
- Radiological Institute, University Hospital Erlangen, Germany
| | - J Weidemann
- Institute of Diagnostic and Interventional Radiology, Hannover Medical School, Germany
| | - P Stumpp
- Clinic and Policlinic for Diagnostic and Interventional Radiology, Leipzig, Germany
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Bismarck AV, Franz M, Delius M, Ertl-Wagner B, Hübener C, Deppe C, Mahner S, Hasbargen U. Interobserver Variabilität bei MRT-Pelvimetrien in der Geburtshilfe. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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28
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Franz M, Bismarck AV, Delius M, Ertl-Wagner B, Hübener C, Deppe C, Mahner S, Hasbargen U. MRT-Pelvimetrie zur Prognoseeinschätzung für die vaginale Geburt in Risikokollektiven. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mann C, Karl K, Ertl-Wagner B, Weigand H, Thaler C. Laparoscopic Chromopertubation, Myomectomy with Opening of the Uterine Cavity and Hysteroscopy during the Early Implantation Phase of an Undetected Pregnancy: Delivery of a Child with a Complex Brain Malformation. Geburtshilfe Frauenheilkd 2016; 76:906-909. [DOI: 10.1055/s-0042-106086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- C. Mann
- Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
| | - K. Karl
- Prenatal Diagnosis, Department of Obstetrics and Gynecology, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany; now: Prenatal Diagnosis Munich, Tegernseer Landstr. 64, 81541 Munich, Germany
| | - B. Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - H. Weigand
- Department of Pediatric Neurology Ludwig-Maximilians-University Hospital, Munich, Germany
| | - C. Thaler
- Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Maistr. 11, 80337 Munich, Germany
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Jerin C, Krause E, Ertl-Wagner B, Gürkov R. Klinische Eigenschaften von „delayed endolymphatic hydrops“ und intralabyrinthärem Schwannom. HNO 2016; 64:911-916. [DOI: 10.1007/s00106-016-0198-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bader I, Decker E, Mayr JA, Lunzer V, Koch J, Boltshauser E, Sperl W, Pietsch P, Ertl-Wagner B, Bolz H, Bergmann C, Rittinger O. MKS1 mutations cause Joubert syndrome with agenesis of the corpus callosum. Eur J Med Genet 2016; 59:386-91. [PMID: 27377014 DOI: 10.1016/j.ejmg.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/25/2016] [Accepted: 06/28/2016] [Indexed: 11/17/2022]
Abstract
Joubert syndrome (JS) is a clinically and genetically heterogeneous ciliopathy characterized by episodic hyperpnea and apnea, hypotonia, ataxia, cognitive impairment and ocular motor apraxia. The "molar tooth sign" is pathognomonic of this condition. Mutations in the MKS1 gene are a major cause of Meckel-Gruber syndrome (MKS), the most common form of syndromic neural tube defects, frequently resulting in perinatal lethality. We present the phenotype and genotype of a child with severe JS and agenesis of the corpus callosum (ACC). In our patient, a next generation sequencing (NGS) approach revealed the following two variants of the MKS1 gene: first, a novel missense variant [ c.240G > T (p.Trp80Cys)], which affects a residue that is evolutionarily highly conserved in mammals and ciliates; second, a 29 bp deletion in intron 15 [c.1408-35_1408-7del29], a founder mutation, which in a homozygous state constitutes the major cause of MKS in Finland. We review the MKS1-variants in all of the eleven JS patients reported to date and compare these patients to our case. To our knowledge, this is the first patient with Joubert syndrome and agenesis of the corpus callosum where a potentially causal genotype is provided.
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Affiliation(s)
- Ingrid Bader
- Clinical Genetics Unit, Children's Hospital, Paracelsus Medical University, Salzburg, Austria; kbo-Kinderzentrum, Technische Universität München, Germany.
| | - E Decker
- Bioscientia, Center for Human Genetics, Ingelheim, Germany
| | - J A Mayr
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - V Lunzer
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - J Koch
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | | | - W Sperl
- Children's Hospital, Paracelsus Medical University, Salzburg, Austria
| | - P Pietsch
- kbo-Kinderzentrum, Technische Universität München, Germany
| | - B Ertl-Wagner
- Institute for Clinical Radiology, Ludwig-Maximilians-University Munich, Germany
| | - H Bolz
- Bioscientia, Center for Human Genetics, Ingelheim, Germany
| | - C Bergmann
- Bioscientia, Center for Human Genetics, Ingelheim, Germany; Children's University Hospital, Zürich, Switzerland
| | - O Rittinger
- Clinical Genetics Unit, Children's Hospital, Paracelsus Medical University, Salzburg, Austria
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Thierfelder KM, Sommer WH, Ertl-Wagner B, Beyer SE, Meinel FG, Kunz WG, Buchholz G, Reiser MF, Janssen H. Prediction of Stent-Retriever Thrombectomy Outcomes by Dynamic Multidetector CT Angiography in Patients with Acute Carotid T or MCA Occlusions. AJNR Am J Neuroradiol 2016; 37:1296-302. [PMID: 26869467 DOI: 10.3174/ajnr.a4694] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 12/07/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The selection of patients for endovascular therapy is an important issue in stroke imaging. The aim of this study was to determine the predictive value of 3 different dynamic CT angiography parameters, occlusion length, collateralization extent, and time delay to maximum enhancement, for latest generation of stent retriever thrombectomy recanalization outcomes in patients with acute ischemic stroke. MATERIALS AND METHODS In this study, subjects were selected from an initial cohort of 2059 consecutive patients who had undergone multiparametric CT, including whole-brain CT perfusion. We included all patients with a complete occlusion of the M1 segment of the MCA or the carotid T and subsequent intra-arterial stent retriever thrombectomy. Dynamic CT angiography was reconstructed from whole-brain CT perfusion raw datasets. Angiographic outcome was scored by using the modified TICI scale; and clinical outcome, by using the modified Rankin Scale. Logistic regression analyses were performed to determine independent predictors of a favorable angiographic (mTICI = 3) and clinical outcome (mRS ≤2). RESULTS Sixty-nine patients (mean age, 68 ± 14 years; 46% men) were included for statistical analysis. In the regression analysis, a short occlusion length was an independent predictor of favorable angiographic outcome (OR, 0.41; P < .05). Both collateralization grade (OR, 1.00; P > .05) and time delay to peak enhancement (OR, 0.90; P > .05) failed to predict a favorable angiographic outcome. None of the dynamic CT angiography predictors were significantly associated with clinical outcome on discharge (OR, 0.664-1.011; P = .330-.953) or at 90 days (OR, 0.779-1.016; P = .130-.845). CONCLUSIONS A short occlusion length as determined by dynamic CT angiography is an independent predictor of a favorable angiographic outcome of stent retriever thrombectomy in patients with ischemic stroke.
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Affiliation(s)
- K M Thierfelder
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - W H Sommer
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - B Ertl-Wagner
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - S E Beyer
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - F G Meinel
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - W G Kunz
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | | | - M F Reiser
- From the Institute for Clinical Radiology (K.M.T., W.H.S., B.E.-W., S.E.B., F.G.M., W.G.K., M.F.R.)
| | - H Janssen
- Department of Neuroradiology (H.J.), Ludwig-Maximilian University Hospital, Munich, Germany
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Chrobok A, Länger A, Karch S, Keeser D, Lehmann K, Leicht G, Mulert C, Eser-Valeri D, Ertl-Wagner B, Dieterich M, Rupprecht R, Pogarell O. Anticipatory anxiety in phobic postural vertigo patients – functional indicators for anxiety-related disorder. Pharmacopsychiatry 2015. [DOI: 10.1055/s-0035-1558006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pomschar A, Moritz K, Schwarz F, Kümpfel T, Braun F, Reiser M, Ertl-Wagner B. Vergrößerte Adenoide bei Patienten mit Multipler Sklerose. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kunz W, Havla L, Sommer W, Dietrich O, Ertl-Wagner B, Reiser M, Thierfelder K. Detektion kleiner intrakranieller Gefäßverschlüsse durch eine hochaufgelöste Wavelet-basierte CT-Angiografie bei Patienten mit akutem ischämischem Infarkt. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ertl-Wagner B. Entzündliche ZNS-Erkrankungen des Kindes. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pomschar A, Weiß J, Neumaier K, Li M, Flatz W, Ertl-Wagner B, Peller M, Reiser M, Notohamiprodjo M. Dosisverteilung bei der Videofluoroskopie des Schluckaktes – eine Phantom Studie mit einem modernen Flachdetektor System und Dosis sparenden Techniken. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ertl-Wagner B. Karzinome der Larynx und Hypopharynx. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hetterich H, Bayerl C, Peters A, Meisinger C, Kramer H, Ertl-Wagner B, Reiser M, Bamberg F. Evaluation eines dreistufigen MRT-Protokolls zur Erkennung und Charakterisierung der Steatosis hepatis in einer gesunden Referenzpopulation. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Beyer SE, Thierfelder KM, von Baumgarten L, Rottenkolber M, Meinel FG, Janssen H, Ertl-Wagner B, Reiser MF, Sommer WH. Strategies of collateral blood flow assessment in ischemic stroke: prediction of the follow-up infarct volume in conventional and dynamic CTA. AJNR Am J Neuroradiol 2015; 36:488-94. [PMID: 25523589 DOI: 10.3174/ajnr.a4131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Collateral blood flow is an important prognostic marker in the acute stroke situation but approaches for assessment vary widely. Our aim was to compare strategies of collateral blood flow assessment in dynamic and conventional CTA in their ability to predict the follow-up infarction volume. MATERIALS AND METHODS We retrospectively included all patients with an M1 occlusion from an existing cohort of 1912 consecutive patients who underwent initial multimodal stroke CT and follow-up MR imaging or nonenhanced CT. Collateralization was assessed in both conventional CT angiography and dynamic CT angiography by using 3 different collateral grading scores and segmentation of the volume of hypoattenuation. Arterial, arteriovenous, and venous phases were reconstructed for dynamic CT angiography, and all collateral scores and the volume of hypoattenuation were individually assessed for all phases. Different grading systems were compared by using the Bayesian information criterion calculated for multivariate regression analyses (Bayesian information criterion difference = 2-6, "positive"; Bayesian information criterion difference = 6-10, "strong"; Bayesian information criterion difference = >10, "very strong"). RESULTS One hundred thirty-six patients (mean age, 70.4 years; male sex, 41.2%) were included. In the multivariate analysis, models containing the volume of hypoattenuation showed a significantly better model fit than models containing any of the 3 collateral grading scores in conventional CT angiography (Bayesian information criterion difference = >10) and dynamic CT angiography (Bayesian information criterion difference = >10). All grading systems showed the best model fit in the arteriovenous phase. For the volume of hypoattenuation, model fit was significantly higher for models containing the volume of hypoattenuation as assessed in the arteriovenous phase of dynamic CT angiography compared with the venous phase (Bayesian information criterion difference = 6.2) and the arterial phase of dynamic CT angiography (Bayesian information criterion difference = >10) and in comparison with conventional CT angiography (Bayesian information criterion difference = >10). CONCLUSIONS The use of dynamic CT angiography within the arteriovenous phase by using quantification of the volume of hypoattenuation is the superior technique for assessment of collateralization among the tested approaches.
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Affiliation(s)
- S E Beyer
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
| | - K M Thierfelder
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
| | | | - M Rottenkolber
- Department of Medical Informatics, Biometry and Epidemiology (M.R.), Ludwig Maximilians University Munich, Munich, Germany
| | - F G Meinel
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
| | - H Janssen
- Neuroradiology (H.J.), Ludwig Maximilians University Hospital Munich, Munich, Germany
| | - B Ertl-Wagner
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
| | - M F Reiser
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
| | - W H Sommer
- From the Institute for Clinical Radiology (S.E.B., K.M.T., F.G.M., B.E.-W., M.F.R., W.H.S.)
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Kirsch V, Keeser D, Hergenroeder T, Erat O, Ertl-Wagner B, Brandt T, Dieterich M. Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex. Brain Struct Funct 2015; 221:1291-308. [PMID: 25552315 DOI: 10.1007/s00429-014-0971-x] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 12/17/2014] [Indexed: 11/29/2022]
Abstract
Structural and functional interconnections of the bilateral central vestibular network have not yet been completely delineated. This includes both ipsilateral and contralateral pathways and crossing sites on the way from the vestibular nuclei via the thalamic relay stations to multiple "vestibular cortex" areas. This study investigated "vestibular" connectivity in the living human brain in between the vestibular nuclei and the parieto-insular vestibular cortex (PIVC) by combined structural and functional connectivity mapping using diffusion tensor imaging and functional connectivity magnetic resonance imaging in 24 healthy right-handed volunteers. We observed a congruent functional and structural link between the vestibular nuclei and the ipsilateral and contralateral PIVC. Five separate and distinct vestibular pathways were identified: three run ipsilaterally, while the two others cross either in the pons or the midbrain. Two of the ipsilateral projections run through the posterolateral or paramedian thalamic subnuclei, while the third bypasses the thalamus to reach the inferior part of the insular cortex directly. Both contralateral pathways travel through the posterolateral thalamus. At the cortical level, the PIVC regions of both hemispheres with a right hemispherical dominance are interconnected transcallosally through the antero-caudal splenium. The above-described bilateral vestibular circuitry in its entirety takes the form of a structure of a rope ladder extending from the brainstem to the cortex with three crossings in the brainstem (vestibular nuclei, pons, midbrain), none at thalamic level and a fourth cortical crossing through the splenium of the corpus callosum.
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Affiliation(s)
- V Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians University, Marchioninistraße 15, 81377, Munich, Germany. .,Graduate School of Systemic Neuroscience, Ludwig-Maximilians University, Munich, Germany. .,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians University, Munich, Germany.
| | - D Keeser
- Department of Radiology, Ludwig-Maximilians University, Munich, Germany.,Department of Psychiatry, Ludwig-Maximilians University, Munich, Germany
| | - T Hergenroeder
- Department of Neurology, University Hospital, Ludwig-Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | - O Erat
- Department of Neurology, University Hospital, Ludwig-Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians University, Munich, Germany.,Department of Radiology, Ludwig-Maximilians University, Munich, Germany
| | - T Brandt
- German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians University, Munich, Germany.,Clinical Neuroscience, Ludwig-Maximilians University, 81377, Munich, Germany
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians University, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience, Ludwig-Maximilians University, Munich, Germany.,German Center for Vertigo and Balance Disorders-IFBLMU, Ludwig-Maximilians University, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Ertl-Wagner B. [European curriculum for further education in radiology]. Radiologe 2014; 54:1106, 1107-10. [PMID: 25398573 DOI: 10.1007/s00117-014-2685-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The European training curriculum for radiology of the European Society of Radiology (ESR) aims to harmonize training in radiology in Europe. Levels I and II constitute the centerpiece of the curriculum. The ESR recommends a 5-year training period in radiology with 3 years of level I and 2 years of level II training. The undergraduate (U) level curriculum is conceived as a basis for teaching radiology in medical schools and consists of a modality-oriented U1 level and an organ-based U2 level. Level III curricula provide contents for subspecialty and fellowship training after board certification in radiology. The curricular contents of all parts of the European Training Curriculum are divided into the sections knowledge, skills as well as competences and attitudes. The European training curriculum is meant to be a recommendation and a basis for the development of national curricula, but is not meant to replace existing national regulations.
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Affiliation(s)
- B Ertl-Wagner
- Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland,
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Ertl-Wagner B, Hoffmann RT, Brüning R, Dichgans M, Reiser MF. Supraaortale Gefäßdiagnostik mit dem 16-Zeilen-Multidetektor-Spiral-CT. Untersuchungsprotokoll und erste Erfahrungen. Radiologe 2014; 42:728-32. [PMID: 12244474 DOI: 10.1007/s00117-002-0786-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The newly developed 16-slice multi detector row computed tomography (MDCT) allows for isotropic imaging at rotation times under 500 ms. We aim to describe our first experiences with this novel technology in the diagnostic imaging of the craniocervical vascular system. METHODS The craniocervical vascular system of 8 consecutive patients was examined with a standardized protocol with the new 16-slice MDCT. The volume covered included the carotid arteries from their origin at the aortic arch and the intracranial arterial and venous vessels in their entirety. Homogeneity of contrast, contrast-to-parenchyma ratios, image quality and radiation doses were assessed. RESULTS A homogeneous vessel-to-parenchyma ratio was reached in the carotids as well as in the intracranial arterial and venous vessels. Image quality was rated as excellent in all patients. The estimated mean effective radiation dose amounted to 2.31 mSv +/-0.57, the mean dose length product to 608 mGy*cm +/-151. CONCLUSION The newly developed 16-slice MDCT technology appears to be a promising tool in the diagnostic assessment of the cervicocranial vessels.
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Affiliation(s)
- B Ertl-Wagner
- Institut für Klinische Radiologie, Klinikum der Universität München, Grosshadern, Germany.
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Pomschar A, Alperin N, Schwarz F, Körte I, Reiser M, Ertl-Wagner B. Wie beeinflusst die Angulation des Halses die MR-basierte Quantifizierung des jugular venösen Blutflusses? ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Braun F, Braun T, Martin Hempel J, Krause E, Müller J, Berghaus A, Reiser M, Ertl-Wagner B. Stellenwert einer routinehaften Röntgen-Stellungskontrolle nach Cochlea-Implantation. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Glioblastoma multiforme (GBM) is the most common and most aggressive primary tumor of the brain. In recent years newer therapeutic approaches have been developed. To allow for an optimized treatment planning it is important to precisely delineate necrotic tissue, edema and vital tumor tissue and to identify the most aggressive parts of the GBM. The magnetic resonance (MR) portion of an MR-positron emission tomography (PET) examination in patients with GBM should consist of both structural and functional sequences including diffusion-weighted and perfusion sequences. The use of (18)F-fluorodeoxyglucose ((18)F-FDG) is limited in patients with gliomas as glucose metabolism is already physiologically high in parts of the brain but (18)F-FDG is nevertheless a commonly used radiopharmaceutical for neuro-oncological questions. (18)F-fluorothymidine reflects the cellular activity of thymidine kinase 1 and correlates with the expression of KI-67 as an index of mitotic activity. The nitroimidazole derivatives (18)F-fluoromisonidazole and (18)F-fluoroazomycin arabinoside ((18)F-FAZA) allow the detection of hypoxic areas within the tumor. In recent years amino acid tracers, such as (18)F-fluoroethyltyrosine are increasingly being used in the diagnosis of gliomas. The simultaneous PET-MR image acquisition allows new approaches, e.g. motion correction by the simultaneous acquisition of MR data with a high temporal resolution and an improved quantification of the PET signal by integrating the results of functional MR sequences. Moreover, the simultaneous acquisition of these two time-consuming methods leads to reduced imaging times for this, often severely ill patient group.
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Affiliation(s)
- B Ertl-Wagner
- Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377 München, Deutschland.
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Chrobok A, Länger A, Karch S, Lehmann K, Keeser D, Eser-Valeri D, Ertl-Wagner B, Dieterich M, Rupprecht R, Pogarell O. EPA-1581 - Anxiety-related neuronal responses in phobic postural vertigo. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78737-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Keeser D, Kirsch V, Blautzik J, Karch S, Kupka M, Rauchmann B, Paolini M, Ertl-Wagner B, Pogarell O. EPA-1677 – The interaction of functional mri connectivity and resting state eeg in the course of the day. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)78821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Schaffer M, Hofstetter A, Ertl-Wagner B, Batash R, Pöschl J, Schaffer P. Treatment of astrocytoma grade III with Photofrin II as a radiosensitizer. Strahlenther Onkol 2013; 189:972-6. [DOI: 10.1007/s00066-013-0430-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 07/18/2013] [Indexed: 01/22/2023]
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