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Aghakhanyan G, Rullmann M, Rumpf J, Schroeter ML, Scherlach C, Patt M, Brendel M, Koglin N, Stephens AW, Classen J, Hoffmann KT, Sabri O, Barthel H. Interplay of tau and functional network connectivity in progressive supranuclear palsy: a [ 18F]PI-2620 PET/MRI study. Eur J Nucl Med Mol Imaging 2022; 50:103-114. [PMID: 36048259 DOI: 10.1007/s00259-022-05952-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 12/16/2021] [Accepted: 08/23/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE Progressive supranuclear palsy (PSP) is primary 4-repeat tauopathy. Evidence spanning from imaging studies indicate aberrant connectivity in PSPs. Our goal was to assess functional connectivity network alterations in PSP patients and the potential link between regional tau-burden and network-level functional connectivity using the next-generation tau PET tracer [18F]PI-2620 and resting-state functional MRI (fMRI). MATERIAL AND METHODS Twenty-four probable PSP patients (70.9 ± 6.9 years, 13 female), including 14 Richardson syndrome (RS) and 10 non-RS phenotypes, underwent [18F]PI-2620 PET/MRI imaging. Distribution volume ratios (DVRs) were estimated using non-invasive pharmacokinetic modeling. Resting-state fMRI was also acquired in these patients as well as in thirteen older non-AD MCI reference group (64 ± 9 years, 4 female). The functional network was constructed using 141 by 141 region-to-region functional connectivity metrics (RRC) and network-based statistic was carried out (connection threshold p < 0.001, cluster threshold pFDR < 0.05). RESULTS In total, 9870 functional connections were analyzed. PSPs compared to aged non-AD MCI reference group expressed aberrant connectivity evidenced by the significant NBS network consisting of 89 ROIs and 118 connections among them (NBS mass 4226, pFDR < 0.05). Tau load in the right globus pallidus externus (GPe) and left dentate nucleus (DN) showed significant effects on functional network connectivity. The network linked with increased tau load in the right GPe was associated with hyperconnectivity of low-range intra-opercular connections (NBS mass 356, pFDR < 0.05), while the network linked with increased tau load in the left cerebellar DN was associated with cerebellar hyperconnectivity and cortico-cerebellar hypoconnectivity (NBS mass 517, pFDR < 0.05). CONCLUSIONS PSP patients show altered functional connectivity. Network incorporating deep gray matter structures demonstrate hypoconnectivity, cerebellum hyperconnectivity, while cortico-cortical connections show variable changes. Tau load in the right GPe and left DN is associated with functional networks which strengthen low-scale intra-opercular and intra-cerebellar connections and weaken opercular-cerebellar connections. These findings support the concept of tau load-dependent functional network changes in PSP, by that providing evidence for downstream effects of neuropathology on brain functionality in this primary tauopathy.
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Affiliation(s)
- Gayane Aghakhanyan
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany. .,Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.
| | - M Rullmann
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - J Rumpf
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - M L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences & Clinic for Cognitive Neurology, University of Leipzig, Leipzig, Germany
| | - C Scherlach
- Department of Neuroradiology, University of Leipzig, Leipzig, Germany
| | - M Patt
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - M Brendel
- Department of Nuclear Medicine, University Hospital of Munich, LMU Munich, Munich, Germany
| | - N Koglin
- Life Molecular Imaging GmbH, Berlin, Germany
| | | | - J Classen
- Department of Neurology, University of Leipzig, Leipzig, Germany
| | - K T Hoffmann
- Department of Neuroradiology, University of Leipzig, Leipzig, Germany
| | - O Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - H Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
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Roschke E, Kluge T, Stallkamp F, Roth A, Zajonz D, Hoffmann KT, Sabri O, Kluge R, Ghanem M. Use of PET-CT in diagnostic workup of periprosthetic infection of hip and knee joints: significance in detecting additional infectious focus. Int Orthop 2021; 46:523-529. [PMID: 34618195 PMCID: PMC8840933 DOI: 10.1007/s00264-021-05218-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2021] [Indexed: 12/15/2022]
Abstract
Introduction The diagnosis and management of periprosthetic knee and hip infections as well as the identification and management of possible additional infectious foci is of great importance for successful therapy. This study analyses the importance of 18F deoxyglucose PET-CT (PET-CT) in the identification of additional infectious focus and subsequent impact on management of periprosthetic infection (PPI). Material and methods A retrospective analysis of the clinical data and findings in the period from January 2008 to December 2018 was carried out. One hundred and four patients with in-hospital treatment due to PPI of a hip or knee joint were identified and included in this study. All patients underwent a standardized clinical examination and further surgical and antibiotic therapy. The reevaluation of performed PET-CTs was specifically carried out with regard to the local PPI or detection of secondary foci. Results PET-CT successfully verified the PPI in 84.2% of the patients. A total of 78 possible additional foci were detected in PET-CT in 56 (53.8%) of the examined patients. Predilection sites for possible secondary foci were joints (42.3%), pulmonary (15.4%), ear-nose-throat (15.4%), spine (11.5%), and the musculocutaneous tissues (11.5%). Fifty-four positive PET-CT findings were confirmed clinically with need of additional adequate treatment. Conclusion PET-CT is a valuable diagnostic tool to confirm periprosthetic joint infection. At the same time, the whole-body PET/CT may detect additional foci of infection with impact on subsequent treatment strategy. PET was of special value in detecting infections at distant locations far from the primary infected joint in significant number. These distant infection locations can be potential cause of a re-infection. This clearly reflects the need of their diagnosis.
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Affiliation(s)
- E Roschke
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - T Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - F Stallkamp
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - A Roth
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - D Zajonz
- Klinik Für Orthopädie, Unfallchirurgie Und Wiederherstellungschirurgie, Zeißigwaldkliniken Bethanien Chemnitz, Chemnitz, Germany
| | - K T Hoffmann
- Klinik Und Poliklinik Für Diagnostische Und Interventionelle Radiologie, Institut Für Neuroradiologie, Leipzig, Germany
| | - O Sabri
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - R Kluge
- Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - M Ghanem
- Klinik Und Poliklinik Für Orthopädie, Unfallchirurgie Und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
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Friedrich B, Gawlitza M, Fahnert J, Quäschling U, Kahn T, Lobsien D, Hoffmann KT. Interventional Ischemic Stroke Treatment--A (R)evolution. ROFO-FORTSCHR RONTG 2015; 188:259-67. [PMID: 26529266 DOI: 10.1055/s-0041-106899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED In recent years ischemic stroke caused by an intracranial vessel occlusion has become a treatable disease. Over decades intravenous thrombolysis by recombinant tissue plasminogen activator was the only accepted causal treatment of ischemic stroke supported by the results of randomized, controlled trials. However, there has been continuous development of endovascular treatment strategies over recent years. Today there are 5 prospective, randomized multicenter studies showing the highly significant superiority of endovascular, mechanical recanalization over intravenous thrombolysis in cases of acute occlusion of an intracranial vessel of the anterior circulation. In all those studies endovascular treatment resulted in a tremendous increase in functional independence together with a reduction of mortality without a significant increase in complications. This article reviews the developments resulting in the current data and gives an overview of the present studies focusing on endovascular stroke treatment. KEY POINTS • In the last 20 years ischemic stroke due to an main stem occlusion has become a potentially treatable disease. • Several in 2015 published randomized Multicenter trials could prove the superiority of endovascular, mechanical recanalization over i.v. thrombolysis alone. • Acute ischemic stroke due to a main stem occlusion should be treated with swift endovascular stent-retriever based recanalization in specialized neurovascular centers.
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Affiliation(s)
- B Friedrich
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Germany
| | - M Gawlitza
- Department of Neuroradiology, University Hospital Leipzig, Germany
| | - J Fahnert
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Germany
| | - U Quäschling
- Department of Neuroradiology, University Hospital Leipzig, Germany
| | - T Kahn
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Germany
| | - D Lobsien
- Department of Neuroradiology, University Hospital Leipzig, Germany
| | - K-T Hoffmann
- Department of Neuroradiology, University Hospital Leipzig, Germany
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Lobsien D, Ettrich B, Sotiriou K, Classen J, Then Bergh F, Hoffmann KT. Whole-brain diffusion tensor imaging in correlation to visual-evoked potentials in multiple sclerosis: a tract-based spatial statistics analysis. AJNR Am J Neuroradiol 2014; 35:2076-81. [PMID: 24994830 DOI: 10.3174/ajnr.a4034] [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: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Functional correlates of microstructural damage of the brain affected by MS are incompletely understood. The purpose of this study was to evaluate correlations of visual-evoked potentials with microstructural brain changes as determined by DTI in patients with demyelinating central nervous disease. MATERIALS AND METHODS Sixty-one patients with clinically isolated syndrome or MS were prospectively recruited. The mean P100 visual-evoked potential latencies of the right and left eyes of each patient were calculated and used for the analysis. For DTI acquisition, a single-shot echo-planar imaging pulse sequence with 80 diffusion directions was performed at 3T. Fractional anisotropy, radial diffusivity, and axial diffusivity were calculated and correlated with mean P100 visual-evoked potentials by tract-based spatial statistics. RESULTS Significant negative correlations between mean P100 visual-evoked potentials and fractional anisotropy and significant positive correlations between mean P100 visual-evoked potentials and radial diffusivity were found widespread over the whole brain. The highest significance was found in the optic radiation, frontoparietal white matter, and corpus callosum. Significant positive correlations between mean P100 visual-evoked potentials and axial diffusivity were less widespread, notably sparing the optic radiation. CONCLUSIONS Microstructural changes of the whole brain correlated significantly with mean P100 visual-evoked potentials. The distribution of the correlations showed clear differences among axial diffusivity, fractional anisotropy, and radial diffusivity, notably in the optic radiation. This finding suggests a stronger correlation of mean P100 visual-evoked potentials to demyelination than to axonal damage.
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Affiliation(s)
- D Lobsien
- From the Departments of Neuroradiology (D.L., K.-T.H., K.S.)
| | - B Ettrich
- Neurology (B.E., F.T.B., K.S., J.C.), University and University Hospital Leipzig, Leipzig, Germany
| | - K Sotiriou
- From the Departments of Neuroradiology (D.L., K.-T.H., K.S.) Neurology (B.E., F.T.B., K.S., J.C.), University and University Hospital Leipzig, Leipzig, Germany
| | - J Classen
- Neurology (B.E., F.T.B., K.S., J.C.), University and University Hospital Leipzig, Leipzig, Germany
| | - F Then Bergh
- Neurology (B.E., F.T.B., K.S., J.C.), University and University Hospital Leipzig, Leipzig, Germany
| | - K-T Hoffmann
- From the Departments of Neuroradiology (D.L., K.-T.H., K.S.)
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Reiss-Zimmermann M, Streitberger KJ, Sack I, Braun J, Arlt F, Fritzsch D, Hoffmann KT. High Resolution Imaging of Viscoelastic Properties of Intracranial Tumours by Multi-Frequency Magnetic Resonance Elastography. Clin Neuroradiol 2014; 25:371-8. [PMID: 24916129 DOI: 10.1007/s00062-014-0311-9] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 04/29/2014] [Indexed: 12/24/2022]
Abstract
PURPOSE In recent years Magnetic Resonance Elastography (MRE) emerged into a clinically applicable imaging technique. It has been shown that MRE is capable of measuring global changes of the viscoelastic properties of cerebral tissue. The purpose of our study was to evaluate a spatially resolved three-dimensional multi-frequent MRE (3DMMRE) for assessment of the viscoelastic properties of intracranial tumours. METHODS A total of 27 patients (63 ± 13 years) were included. All examinations were performed on a 3.0 T scanner, using a modified phase-contrast echo planar imaging sequence. We used 7 vibration frequencies in the low acoustic range with a temporal resolution of 8 dynamics per wave cycle. Post-processing included multi-frequency dual elasto-visco (MDEV) inversion to generate high-resolution maps of the magnitude |G*| and the phase angle φ of the complex valued shear modulus. RESULTS The tumour entities included in this study were: glioblastoma (n = 11), anaplastic astrocytoma (n = 3), meningioma (n = 7), cerebral metastasis (n = 5) and intracerebral abscess formation (n = 1). Primary brain tumours and cerebral metastases were not distinguishable in terms of |G*| and φ. Glioblastoma presented the largest range of |G*| values and a trend was delineable that glioblastoma were slightly softer than WHO grade III tumours. In terms of φ, meningiomas were clearly distinguishable from all other entities. CONCLUSIONS In this pilot study, while analysing the viscoelastic constants of various intracranial tumour entities with an improved spatial resolution, it was possible to characterize intracranial tumours by their mechanical properties. We were able to clearly delineate meningiomas from intraaxial tumours, while for the latter group an overlap remains in viscoelastic terms.
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Affiliation(s)
- M Reiss-Zimmermann
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
| | - K-J Streitberger
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - I Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - J Braun
- Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - F Arlt
- Department of Neurosurgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - D Fritzsch
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - K-T Hoffmann
- Department of Neuroradiology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
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Gawlitza M, Quäschling U, Hobohm C, Otto J, Voigt P, Hoffmann KT, Lobsien D. Hyperintense basilar artery on FLAIR MR imaging: diagnostic accuracy and clinical impact in patients with acute brain stem stroke. AJNR Am J Neuroradiol 2014; 35:1520-6. [PMID: 24812014 DOI: 10.3174/ajnr.a3961] [Citation(s) in RCA: 8] [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] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE FLAIR-hyperintense vessels are known to be a sign of sluggish collateral blood flow in hemispheric vessel occlusion. Additionally, they seem to have a prognostic implication. The aim of the current study was to evaluate the hyperintense configuration of the basilar artery (FLAIR-hyperintense basilar artery) as a marker of basilar artery occlusion and as a predictor of patient outcome. MATERIALS AND METHODS We retrospectively identified 20 patients with basilar artery occlusion who initially underwent MR imaging with subsequent DSA. The diagnostic accuracy of the FLAIR-hyperintense basilar artery sign was tested by 4 independent readers in a case-control design, and the relation among FLAIR-hyperintense basilar artery and DWI posterior circulation-ASPECTS, patient outcome, and patient survival was evaluated. To grade the extent of the FLAIR-hyperintense basilar artery sign, we generated a score by counting the number of sections from the basilar tip to the foramen magnum in which a hyperintense signal in the vessel lumen was present multiplied by the section thickness. RESULTS The FLAIR-hyperintense basilar artery sign showed moderate sensitivity (65%-95%) but very good specificity (95%-100%) and accuracy (85%-93%) for the detection of basilar artery occlusion. Substantial or excellent inter-reader agreement was observed (Cohen κ, 0.64-0.85). The FLAIR-hyperintense basilar artery inversely correlated with the posterior circulation-ASPECTS (r = -0.67, P = .01). Higher FLAIR-hyperintense basilar artery scores were associated with patient death (28.3 ± 13.7 versus 13.4 ± 11.1, P < .05). CONCLUSIONS The FLAIR-hyperintense basilar artery sign proved to be a valuable marker of vessel occlusion and may substantially support the diagnosis of basilar artery occlusion. The established FLAIR-hyperintense basilar artery score may be helpful for the prediction of individual patient survival.
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Affiliation(s)
- M Gawlitza
- From the Departments of Neuroradiology (M.G., U.Q., K.-T.H., D.L.)Diagnostic and Interventional Radiology (M.G., J.O., P.V.)
| | - U Quäschling
- From the Departments of Neuroradiology (M.G., U.Q., K.-T.H., D.L.)
| | - C Hobohm
- Neurology (C.H.), University Hospital Leipzig, Leipzig, Germany
| | - J Otto
- Diagnostic and Interventional Radiology (M.G., J.O., P.V.)
| | - P Voigt
- Diagnostic and Interventional Radiology (M.G., J.O., P.V.)
| | - K-T Hoffmann
- From the Departments of Neuroradiology (M.G., U.Q., K.-T.H., D.L.)
| | - D Lobsien
- From the Departments of Neuroradiology (M.G., U.Q., K.-T.H., D.L.)
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Fritzsch D, Schäfer A, Reiss-Zimmermann M, Trampel R, Turner R, Hoffmann KT. 7T-MRT bei Morbus Wilson und Messung von cerebralen Kupferablagerungen mittels Quantitative Susceptibility Mapping (QSM). ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373600] [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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Reiss-Zimmermann M, Streitberger KJ, Sack I, Arlt F, Gawlitza M, Hoffmann KT. Zerebrale multifrequente MR-Elastografie – invivo Gewebecharakterisierung intrakranieller Raumforderungen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373602] [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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Reiss-Zimmermann M, Streitberger KJ, Sack I, Arlt F, Gawlitza M, Hoffmann KT. Zerebrale MR-Elastografie zur Charakterisierung des Perifokalsaums bei Glioblastomen versus intraaxiale Metastasierung. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373349] [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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Werner P, Vilia Z, Saur D, Patt M, Sattler B, Jochimsen T, Lobsien D, Then Bergh F, Dreyer A, Boltze J, Classen J, Hoffmann KT, Sabri O, Barthel H. Etablierung der kombinierten [15O]H2O-PET/MRT am Großtiermodell und bei Patienten mit (sub)akutem Schlaganfall. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371193] [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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Weise D, Fritzsch D, Kronenberger A, Rumpf JJ, Hoffmann KT, Schwarz J, Walter U, Classen J. Vergleich von transkranieller Sonografie des Hirnparenchyms und suszeptibilitätsgewichteter 3 Tesla MRT Bildgebung bei Patienten mit M. Parkinson. KLIN NEUROPHYSIOL 2014. [DOI: 10.1055/s-0034-1371180] [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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Voigt P, Lobsien D, Hoffmann KT. Morphologische Charakteristika primärer ZNS-Lymphome in der cerebralen Magnetresonanztomografie. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346665] [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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Preuss M, Hirsch W, Hoffmann KT, Bernhard MK, Siekmeyer M, Kiess W, Meixensberger J, Wurm RE, Merkenschlager A. Effectiveness of bevacizumab for radiation-induced cerebral necrosis in children. Pediatr Neurosurg 2013; 49:81-5. [PMID: 24435068 DOI: 10.1159/000357447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Accepted: 11/15/2013] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Bevacizumab has been reported to effectively reduce cerebral edema caused by radiation therapy. However, only limited data with a short follow-up in tumor patients are available so far. PATIENTS AND METHODS Two children suffering from hemorrhage from arteriovenous malformation (AVM) have been treated with stereotactic radiotherapy and developed radiation-induced cerebral edema with deteriorating neurological status despite maximized steroid therapy. Bevacizumab administration at 5 mg/kg body weight was initiated every 2 weeks. RESULTS Bevacizumab treatment rapidly ameliorated the neurological deficits, malignant edema and prevented catastrophic complications. Corticoid therapy could be reduced and discontinued. However, after 18 months, both patients showed identical or worse neurological status than before bevacizumab therapy. AVM radiation therapy had been successful to completely obliterate AVMs. DISCUSSION In our limited experience, bevacizumab may be an effective and safe option for rescue therapy for malignant cerebral edema on the basis of radiation-induced necrosis especially in patients who experience rapid deterioration despite corticoid therapy and/or intolerable steroid side effects. Despite the fact that functional improvement could not be achieved in long-term outcome patients significantly stabilized and improved during periods of acute deterioration. In order to determine the long-term effectiveness of bevacizumab further investigation in placebo-controlled studies with a higher number of patients are required.
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Affiliation(s)
- M Preuss
- Department of Neurosurgery, University Hospital Leipzig, Leipzig, Germany
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Lobsien D, Sotiriou K, Ettrich B, Then Bergh F, Hoffmann KT. Diffusionstensorbildgebung (DTI) der Sehstrahlung in Korrelation zu visuell evozierten Potentialen (VEP) bei Patienten mit Encephalomyelitis Disseminata (ED). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311153] [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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Gawlitza M, Gragert J, Lobsien D, Quäschling U, Fritzsch D, Hoffmann KT. FLAIR-hyperintenses Gefäßzeichen, Infarktgröße und Mismatch - eine prospektive Beobachtungsstudie beim nicht mit Lyse oder Thrombektomie behandelten akuten ischämischen Schlaganfall. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311081] [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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Eibach S, Krug H, Lobsien E, Hoffmann KT, Kupsch A. Preoperative treatment with Botulinum Toxin A before total hip arthroplasty in a patient with tetraspasticity: Case report and review of literature. NeuroRehabilitation 2011; 28:81-3. [PMID: 21447907 DOI: 10.3233/nre-2011-0635] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report on a patient with tetraspasticity due to perinatal cerebral palsy requiring total hip joint endoprosthesis because of hip dysplasia. In order to minimize the risk of postoperative luxation Botulinum Toxin A was injected preoperatively into hip flexor and adductor muscles guided by CT-fluoroscopy. Outcome measures included muscle tone, limb position and self-reported pain relief. Seven days post injections the tone of the right hip flexor and adductor muscles improved from three to one points on the five-point Modified Ashworth Scale (MAS), the spastic joint position improved from 45° to 20° in flexion and from 20° to 10° in adduction, and the patient was free of pain. Ten days after injection of Botulinum Toxin operation of total hip joint arthroplasty was performed without complication. Improvement of spasticity sustained for another eight weeks. Subsequent Botulinum Toxin A injection three months post surgery resulted in identical results. This case demonstrates a new preoperative indication for Botulinum Toxin A in patients with an increased muscle tone at the hip who have to undergo total hip joint endoprosthesis to reduce the risk of postoperative luxation.
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Affiliation(s)
- S Eibach
- Department of Neurology, Charité Universitätsmedizin Berlin, Germany
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Fritzsch D, Blisse K, Hobohm C, Lobsien D, Hoffmann KT. Charakterisierung lakunärer Infarkte im zeitlichen Verlauf in der MRT. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279610] [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: 10/18/2022]
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Lobsien D, Dreyer A, Boltze J, Hoffmann KT. Detektierbarkeit von eisenmarkierten Stammzellen mit suszeptibilitätsgewichteten und T2*-gewichteten Sequenzen im 3Tesla-MRT In vitro und in vivo im Schafmodell. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279241] [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: 10/18/2022]
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Reiss-Zimmermann M, Gutberlet M, Köstler H, Hoffmann KT. 12-Kanal versus 32-Kanal-Kopfspule: wie viel mehr SNR erreichen 20 weitere Kanäle? ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253008] [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: 10/19/2022]
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Reiss-Zimmermann M, Weber D, Helm J, Hoffmann KT. Veränderungen von fraktioneller Anisotropie und Liquorfluss bei Patienten mit Normaldruck-Hydrocephalus nach lumbaler Liquordrainage. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252540] [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: 10/19/2022]
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Weber D, Kendziorra K, Kahn T, Hoffmann KT. Das von Hippel-Lindau-Syndrom – eine seltene Erkrankung mit multiplen Organmanifestationen, die mehrere bildgebende Verfahren herausfordert. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253084] [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: 10/19/2022]
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Lobsien D, Fritzsch D, Hoffmann KT. Zerebrale venöse Thrombosen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253083] [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: 10/19/2022]
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Fritzsch D, Oberbeck M, Lobsien D, Schwarz J, Hoffmann KT. Suszeptibilitätsgewichtete Bildgebung zerebraler Kerngebiete im 3Tesla-MRT bei Patienten mit idiopathischem Parkinson-Syndrom. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252539] [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: 10/19/2022]
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Schönecker T, Kupsch A, Kühn AA, Schneider GH, Hoffmann KT. Automated optimization of subcortical cerebral MR imaging-atlas coregistration for improved postoperative electrode localization in deep brain stimulation. AJNR Am J Neuroradiol 2009; 30:1914-21. [PMID: 19713324 DOI: 10.3174/ajnr.a1741] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The efficacy of deep brain stimulation in treating movement disorders depends critically on electrode localization, which is conventionally described by using coordinates relative to the midcommissural point. This approach requires manual measurement and lacks spatial normalization of anatomic variances. Normalization is based on intersubject spatial alignment (coregistration) of corresponding brain structures by using different geometric transformations. Here, we have devised and evaluated a scheme for automated subcortical optimization of coregistration (ASOC), which maximizes patient-to-atlas normalization accuracy of postoperative structural MR imaging into the standard Montreal Neurologic Institute (MNI) space for the basal ganglia. MATERIALS AND METHODS Postoperative T2-weighted MR imaging data from 39 patients with Parkinson disease and 32 patients with dystonia were globally normalized, representing the standard registration (control). The global transformations were regionally refined by 2 successive linear registration stages (RSs) (ASOC-1 and 2), focusing progressively on the basal ganglia with 2 anatomically selective brain masks, which specify the reference volume (weighted cost function). Accuracy of the RSs was quantified by spatial dispersion of 16 anatomic landmarks and their root-mean-square errors (RMSEs) with respect to predefined MNI-based reference points. The effects of CSF volume, age, and sex on RMSEs were calculated. RESULTS Mean RMSEs differed significantly (P < .001) between the global control (4.2 +/- 2.0 mm), ASOC-1 (1.92 +/- 1.02 mm), and ASOC-2 (1.29 +/- 0.78 mm). CONCLUSIONS The present method improves the registration accuracy of postoperative structural MR imaging data into MNI space within the basal ganglia, allowing automated normalization with increased precision at stereotactic targets, and enables lead-contact localization in MNI coordinates for quantitative group analysis.
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Affiliation(s)
- T Schönecker
- Department of Neuroradiology, Campus Virchow, Charite-University Medicine, Berlin, Germany.
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Braun M, Finke C, Ostendorf F, Lehmann TN, Hoffmann KT, Ploner C. Lesion type determines memory deficits in humans with hippocampal damage. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1072942] [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: 10/21/2022]
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Krug H, Eibach S, Hoffmann KT, Kupsch A. Preoperative intramuscular injection of botulinum toxin prior to hip surgery in a patient with cerebral palsy. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-1032246] [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: 10/21/2022]
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Weinberg G, Hoffmann KT, Pohle C, Hampel DJ, Schindler R. Back pain in a haemodialysis patient with severe atherosclerosis. Nephrol Dial Transplant 2007; 22:3349-51. [PMID: 17804461 DOI: 10.1093/ndt/gfm546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- G Weinberg
- Department of Nephrology, Charité - Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
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Finke C, Braun M, Ostendorf F, Lehmann TN, Hoffmann KT, Kopp UA, Ploner CJ. Visuell-räumliche Kurzzeitgedächtnisdefizite nach hippokampalen Läsionen beim Menschen. KLIN NEUROPHYSIOL 2007. [DOI: 10.1055/s-2007-976317] [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: 10/21/2022]
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Grieser C, Gartenschläger S, Stiepani H, Kämena A, Lehmkuhl L, Lopez Hänninen E, Felix R, Hamm B, Hoffmann KT. Mehrzeilen-CT-Angiographie am 64-Zeilen-CT: Beurteilung der vertebrobasilären Gefäße, Schichtdicke 0,625 oder 1,25mm? ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977355] [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: 10/21/2022]
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Hoffmann KT, Islam T, Bruhn H, Schmidt S, Lüdemann L, Trottenberg T, Kupsch A. Charakterisierung kortikaler Repräsentationsmuster bei fokaler Dystonie mit der funktionellen MRT bei 3,0 Tesla. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977191] [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: 10/21/2022]
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Gassmann K, Hoffmann KT, Dietze U. Farbsinnstörung nach Kopfschussverletzung. Ophthalmologe 2006; 103:1050-2. [PMID: 16432732 DOI: 10.1007/s00347-005-1303-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- K Gassmann
- Augenklinik Berlin-Marzahn, Brebacher Weg 15, 12683 Berlin.
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Dudeck O, Jordan O, Hoffmann KT, Okuducu AF, Husmann I, Kreuzer-Nagy T, Tesmer K, Podrabsky P, Bruhn H, Hilborn J, Rüfenacht DA, Doelker E, Felix R. Embolization of experimental wide-necked aneurysms with iodine-containing polyvinyl alcohol solubilized in a low-angiotoxicity solvent. AJNR Am J Neuroradiol 2006; 27:1849-55. [PMID: 17032855 PMCID: PMC7977908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND PURPOSE To evaluate the ready-to-use iodine-containing polyvinyl alcohol (I-PVA) dissolved in the low angiotoxic solvent N-methyl pyrrolidone (NMP) for embolization of porcine wide-necked aneurysms. METHODS Fourteen broad-based carotid sidewall aneurysms were surgically constructed in 7 swine. I-PVA (40%) in NMP was injected under temporary balloon occlusion bridging the aneurysm neck. After 4 weeks, follow-up angiography, multisection CT angiography (MSCTA), and 3T MR imaging including MR angiography (MRA) sequences were performed. Afterward, harvested aneurysms were investigated histopathologically. RESULTS The liquid embolic was well visible under fluoroscopy and displayed a favorable precipitation pattern, allowing for controlled polymer delivery. Ten aneurysms (71%) were initially completely occluded, whereas in 1 aneurysm, a minimal polymer leakage was observed. The other 4 aneurysms (29%) were almost completely occluded. One animal suffered a lethal rebleeding from the anastomosis after uneventful embolization. Aneurysms embolized with I-PVA could be discriminated well from the parent artery without beam-hardening artifacts on MSCTA, and no susceptibility artifacts were encountered on MR imaging. Histologic examination revealed all aneurysms covered with a membrane of fibroblasts and an endothelial cell layer while a moderate intraaneurysmal inflammatory response to the polymer was observed. CONCLUSION I-PVA dissolved in NMP has proved its effectiveness for the embolization of experimental wide-necked aneurysms. This precipitating liquid embolic offers several interesting features in that it needs no preparation before use and no radiopaque admixtures, the latter allowing for artifact-free evaluation of treated aneurysms with MSCTA and MRA. Moreover, it uses NMP as a solvent, which has only a low angiotoxicity.
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Affiliation(s)
- O Dudeck
- Department of Radiology, Charité, Campus Virchow Clinic, Berlin, Germany.
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Dudeck O, Jordan O, Hoffmann KT, Okuducu AF, Tesmer K, Kreuzer-Nagy T, Rüfenacht DA, Doelker E, Felix R. Organic solvents as vehicles for precipitating liquid embolics: a comparative angiotoxicity study with superselective injections of swine rete mirabile. AJNR Am J Neuroradiol 2006; 27:1900-6. [PMID: 17032862 PMCID: PMC7977874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND AND PURPOSE The organic solvent dimethyl-sulfoxide (DMSO), as a commonly used vehicle for nonadhesive liquid embolics, is not devoid of local angiotoxic effects. We compared microvascular toxicities of superselective infusions of DMSO with potentially more compatible solvents in swine rete mirabile. METHODS Fourteen swine underwent angiography for superselective catheterization of 28 arteries of the rete while electrocardiography and intra-arterial pressure were continuously monitored. The investigated solvents were DMSO, dimethyl isosorbide (DMI), ethyl lactate, glycofurol 75, N-methyl pyrrolidone (NMP), and solketal. Control infusion of saline ruled out catheter induced vasospasm in all cases. Each artery of the rete was infused only once with 0.8 mL of one of the solvents over 60 seconds. Acute angiographic and hemodynamic consequences were evaluated. Blood samples were assessed for signs of intravascular hemolysis. Brains and retia were harvested for gross and histopathologic investigation. RESULTS On the basis of the angiographic data, DMSO induced the most pronounced vasospasm with the longest recovery period of all solvents investigated. Ethyl lactate, glycofurol 75, and solketal elicited less severe vasospasms and accordingly resolved much more quickly. DMI and NMP induced only minimal vasospasms with comparably short duration. No solvent caused significant hemodynamic alterations or hemolysis. Gross inspection of brains showed no abnormalities, whereas histopathologic examination revealed mostly nonspecific findings. One rete exposed to solketal displayed possible causal histotoxic changes. CONCLUSION DMI and NMP produced far less vasospasm than DMSO. No changes in hemodynamic or hemolytic parameters and no histopathologic findings were observed with infusion of these solvents.
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MESH Headings
- Alkenes/toxicity
- Angiography, Digital Subtraction
- Animals
- Blood Circulation/drug effects
- Cerebral Arteries/drug effects
- Cerebral Arteries/pathology
- Chemical Precipitation
- Dimethyl Sulfoxide/toxicity
- Drug Combinations
- Embolization, Therapeutic/methods
- Endothelium, Vascular/diagnostic imaging
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/pathology
- Female
- Glycerol/toxicity
- Hemolysis
- Isosorbide/toxicity
- Lactates/toxicity
- Muscle, Smooth, Vascular/diagnostic imaging
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/pathology
- Polyethylene Glycols/toxicity
- Pyrrolidinones/toxicity
- Solvents/toxicity
- Swine
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Affiliation(s)
- O Dudeck
- Department of Radiology, Charite, Campus Virchow Clinic, Berlin, Germany.
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Chen CC, Kühn AA, Hoffmann KT, Kupsch A, Schneider GH, Trottenberg T, Krauss JK, Wöhrle JC, Bardinet E, Yelnik J, Brown P. Oscillatory pallidal local field potential activity correlates with involuntary EMG in dystonia. Neurology 2006; 66:418-20. [PMID: 16476944 DOI: 10.1212/01.wnl.0000196470.00165.7d] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The pathophysiology of dystonia is unclear. The authors recorded local field potentials (LFPs) from deep brain stimulation electrodes implanted in the pallidum of 13 dystonic patients. LFP power correlated with the level of dystonic EMG in the sternocleidomastoid, with maximal positive correlations at the lower contacts of pallidal electrodes. The data suggest that the neuronal synchronization indexed by LFP oscillations in the globus pallidus may be mechanistically linked to dystonic EMG activity.
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Affiliation(s)
- C C Chen
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London, UK
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Meyer T, Schwan A, Dullinger JS, Brocke J, Hoffmann KT, Nolte CH, Hopt A, Kopp U, Andersen P, Epplen JT, Linke P. Early-onset ALS with long-term survival associated with spastin gene mutation. Neurology 2006; 65:141-3. [PMID: 16009903 DOI: 10.1212/01.wnl.0000167130.31618.0a] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [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: 11/15/2022] Open
Abstract
The authors report a 73-year-old patient with a natural history of early-onset ALS for 49 years presenting with limb and bulbar amyotrophy and a pyramidal syndrome. Analysis of the locus SPG4 identified a heterozygous duplication mutation (c.304_309dupGCCTCG) within exon 1 of the spastin gene. We propose that sequence alterations of spastin may comprise a genetic risk factor in a greater spectrum of motor neuron disorders including clinical variants of ALS.
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Affiliation(s)
- T Meyer
- Department of Neurology, University Hospital, Berlin, Germany.
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Hasper D, Storm C, Seehofer D, Hoffmann KT, Oppert M, Krüger A. Both sides of the story - cerebral infarction after intra-abdominal bleeding. Intensive Care Med 2006; 32:340-341. [PMID: 16432669 DOI: 10.1007/s00134-005-0008-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2005] [Accepted: 11/09/2005] [Indexed: 11/30/2022]
Affiliation(s)
- D Hasper
- Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - C Storm
- Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - D Seehofer
- Department of General-, Visceral- and Transplantation Surgery, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - K T Hoffmann
- Department of Radiology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Oppert
- Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Krüger
- Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
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Grieser C, Hoffmann KT, Gartenschläger S, Lehmkuhl L, Kämena A, Nolte CH, Knollmann F, Lopez-Hänninen E, Felix R. 64-Zeilen-CT: Computertomographischer Perfusionsmuster und CT Angiographien bei Patienten mit zerebraler Ischämie. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940609] [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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Nolte CH, Gruss J, Steinbrink J, Kivi A, Hoffmann KT, Kupsch A, Villringer A. Ultrasound perfusion imaging of cysts in the midbrain. Ultraschall Med 2005; 26:527-9. [PMID: 16453225 DOI: 10.1055/s-2005-858527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
AIM Cerebral ultrasound perfusion examinations have been focused on the diencephalic plane. We describe perfusion abnormalities in the mesencephalon. METHOD Phase-Inversion-Harmonic-Imaging (PIHI, Siemens Sonoline Elegra) was performed in a patient with ponto-mesencephalic cysts, that was defined by MRI. The signal increase (bolus kinetics, SonoVue) was quantified for peak-signal-increase (PSI) and time-to-peak (TTP). RESULTS PSI and TTP could be quantified for the ipsi- and contralateral posterior cerebral arteries, the ipsilateral middle cerebral artery, the mesencephalon and the ipsilateral temporal lobe. The contrast agent influx was diminished or extinct in the area of the cysts. PSI and TTP delineated the area of the cystic structure well. CONCLUSION PIHI in the mesencephalic plane is feasible and allows identification of pathological structures within the mesencephalon.
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Affiliation(s)
- C H Nolte
- Department of Neurology, University Hospital Charite Berlin.
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Abstract
BACKGROUND Immunoadsorption (IA) is occasionally applied in patients with acute relapses of multiple sclerosis (MS). This pilot study was undertaken to determine whether IA might help in secondary progressive and relapsing-remitting multiple sclerosis. DESIGN IA was performed at 1-week intervals in 12 patients with secondary progressive or relapsing-remitting MS. These patients had an extended disability status scale (EDSS) score of 4.5-7 and an EDSS increase of 0.5 within 6 months before inclusion in the study despite conventional drug therapy. The change in the EDSS and that in the MS functional composite (MSFC) score, which consisted of quantitative tests of arm function, ambulation, visual acuity and cognition, served as the primary outcome variables, which were measured at baseline and at 3, 6 and 12 months. Changes in quality of life and cerebral lesions by magnetic resonance imaging (MRI) were also assessed at baseline and after the last immunoadsorption (month 3). RESULTS A significant reduction of the median EDSS change was observed after the treatment period, which reversed 3 months after the immunoadsorptions had been stopped. Ten of 12 patients remained stable during the first year of follow-up with no significant changes of the MSFC scores. No significant changes in magnetic resonance imaging T2-hyperintense brain lesions or in the number of gadolinium-positive lesions and in the patients' quality of life were observed. Western blot analyses demonstrated a reduction of serum myelin-specific antibodies, which were collected in the adsorber eluates. CONCLUSIONS Removal of immunoglobulins, including myelin-specific antibodies by immunoadsorption, seems to delay disease progression as defined by EDSS, MSFC and MRI, while the patients' quality of life did not deteriorate.
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Oliver O, Tesmer K, Jordan O, Hoffmann KT, Husmann I, Pech M, Rüfenacht D, Felix R. Volumenzunahme von experimentellen Seitwandaneurysmen durch die endovaskuläre Einbringung von Flüssigembolisat unter Ballonokklusion des Trägergefäßes: Nachweis mittels 16-Zei. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868333] [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: 10/19/2022]
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Denecke T, Rau B, Hoffmann KT, Hildebrandt B, Ruf J, Gutberlet M, Hünerbein M, Felix R, Wust P, Amthauer H. Comparison of CT, MRI and FDG-PET in response prediction of patients with locally advanced rectal cancer after multimodal preoperative therapy: is there a benefit in using functional imaging? Eur Radiol 2005; 15:1658-66. [PMID: 15806369 DOI: 10.1007/s00330-005-2658-4] [Citation(s) in RCA: 172] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2004] [Revised: 12/08/2004] [Accepted: 12/20/2004] [Indexed: 12/16/2022]
Abstract
The aim of this study was to compare CT, MRI and FDG-PET in the prediction of outcome of neoadjuvant radiochemotherapy in patients with locally advanced primary rectal cancer. A total of 23 patients with T3/4 rectal cancer underwent a preoperative radiochemotherapy combined with regional hyperthermia. Staging was performed using four-slice CT (n=23), 1.5-T MRI (n=10), and (18)F-FDG-PET (n=23) before and 2-4 weeks after completion of neoadjuvant treatment. Response criteria were a change in T category and tumour volume for CT and MRI and a change in glucose uptake (standard uptake value) within the tumour for FDG-PET. Imaging results were compared with those of pretherapy endorectal ultrasound and histopathological findings. Histopathology showed a response to neoadjuvant therapy in 13 patients whereas 10 patients were classified as nonresponders. The mean SUV reduction in responders (60+/-14%) was significantly higher than in nonresponders (37+/-31%; P=0.030). The sensitivity and specificity of FDG-PET in identifying response was 100% (CT 54%, MRI 71%) and 60% (CT 80%, MRT 67%). Positive and negative predictive values were 77% (CT 78%, MRI 83%) and 100% (CT 57%, MRI 50%) (PET P=0.002, CT P=0.197, MRI P=0.500). These results suggest that FDG-PET is superior to CT and MRI in predicting response to preoperative multimodal treatment of locally advanced primary rectal cancer.
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Affiliation(s)
- T Denecke
- Klinik für Strahlenheilkunde und PET-Zentrum Berlin Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin, 13353, Germany.
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Valencia R, Hoffmann KT, Stroszczynski C. Akuter Arteria-cerebri-anterior-Infarkt: Korrelation eines Infarkt-Frühzeichens im nativen CCT mit CT-Perfusion, CT-Angiographie und konventioneller Angiographie. ROFO-FORTSCHR RONTG 2005; 177:283-5. [PMID: 15666240 DOI: 10.1055/s-2004-813736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Out of a total of 550 children followed up at our spina bifida center, we report on 81 patients who were reoperated upon for secondary tethered cord syndrome between 1993 and 2000. In four cases with preceding severe progressive scoliosis, untethering was followed by surgical correction and stabilization of curvatures. In 77 patients, the indication for surgery was based on late progressive neurological deterioration. The current clinical relevance of competing etiologic factors such as symptomatic Chiari malformation, hydromyelia, and shunt dysfunction, requiring different clinical management, had been previously carefully excluded. The children underwent magnetic resonance imaging (MRI) or myelo-computed tomography (m-CT) to identify the morphologic extent of tethering and any associated spinal malformations such as dermoid tumors (19 cases) or diastematomyelia (9 cases). Surgery became faster and safer through bilateral dural incision, undercutting arachnoid adhesions along the tethered area, although this procedure increased the need for dural grafting. Complete release of the conus medullaris and cauda equina was achieved in a total of 75 cases (93 %) including those who had undergone prophylactic surgery. A mean follow-up of 4.8 years in 77 patients operated upon for late progressive neurological deterioration confirmed stabilization of presenting symptoms in 65 cases (84 %) with 20 of them (26 %) even showing significant improvement. In 12 patients (16 %), including all cases of incomplete untethering (n = 4), there was further deterioration.
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Affiliation(s)
- H Haberl
- Department of Neurosurgery, Charité Medical School, Humboldt University, Berlin, Germany.
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Nitsche MA, Niehaus L, Hoffmann KT, Hengst S, Liebetanz D, Paulus W, Meyer BU. MRI study of human brain exposed to weak direct current stimulation of the frontal cortex. Clin Neurophysiol 2004; 115:2419-23. [PMID: 15351385 DOI: 10.1016/j.clinph.2004.05.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine whether weak transcranial direct current stimulation (tDCS), which is an interesting new tool inducing prolonged cortical excitability shifts in humans, induces brain edema, disturbance of the blood-brain barrier or structural alterations of the brain detectable by magnetic resonance imaging (MRI). METHODS In 10 healthy individuals, tDCS, which is known to alter cortical excitability for about 1 h, was applied over motor and pre-frontal cortices. contrast-enhanced t1-, t2-, and diffusion-weighted mri was performed immediately before, 30 and 60 min after tdcs. RESULTS MRI performed 30 and 60 min after tDCS did not show pathological signal alterations in pre- and post-contrast-enhanced T1-weighted and diffusion-weighted MR sequences. CONCLUSIONS tDCS protocols which are known to result in cortical excitability changes persisting for an hour after stimulation do not induce brain edema or alterations of the blood-brain barrier or cerebral tissue detectable by MRI. SIGNIFICANCE These results deliver further evidence for the safety of the currently applied tDCS protocols in humans.
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Affiliation(s)
- M A Nitsche
- Department of Clinical Neurophysiology, Georg-August-University, Robert-Koch-Str. 40, 37075 Goettingen, Germany.
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Fischbach F, Hoffmann KT, Pech M, Neumann F, Ricke J, Bruhn H. Efficacy of Contrast Medium Use at 3.0 T: A Study Employing Different T1-weighted Pulse Sequences. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-820811] [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: 10/19/2022]
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Müller M, Fischbach F, Hoffmann KT, Bruhn H. Is there a relevant gain in the depiction of the delicate structures of the brainstem by MR imaging at 3.0-T compared to 1.5-T? ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-820815] [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: 10/19/2022]
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Dudeck O, Hoffmann KT, Jordan O, Heise M, Meyer R, Rüfenacht D, Doelker E, Felix R. Embolisation von experimentellen breitbasigen Seitwandaneurysmen mit „Radiopaque Polymer“, einem neuen homogen röntgendichten Flüssigembolisat. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827628] [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: 10/19/2022]
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Fischbach F, Hoffmann KT, Pech M, Neumann F, Ricke J, Felix R, Bruhn H. Vergleich verschiedener T1-gewichteter Puls- Sequenzen hinsichtlich ihrer Effizienz in der Kontrastmittelanreicherung bei 3.0 Tesla. ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827934] [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: 10/19/2022]
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Denecke T, Amthauer H, Rau B, Hoffmann KT, Ruf J, Felix R, Wust P. Neoadjuvante Therapie des Rektumkarzinoms: Response Evaluation mit Multislice-CT, 1, 5T-MRT, oder FDG-PET? ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827828] [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: 10/19/2022]
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Müller M, Fischbach F, Hoffmann KT, Bruhn H. Gibt es einen relevanten Zugewinn in der Darstellbarkeit feiner Hirnstammstrukturen durch die Magnetresonanztomographie bei 3.0 Tesla gegenüber 1.5 Tesla? ROFO-FORTSCHR RONTG 2004. [DOI: 10.1055/s-2004-827484] [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: 10/19/2022]
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