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  • 1
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    Secondary tension pneumothorax in a COVID-19 pneumonia patient: a case report
    Springer Science and Business Media LLC ; 2020
    In:  Infection Vol. 48, No. 6 ( 2020-12), p. 941-944
    Details
    In: Infection, Springer Science and Business Media LLC, Vol. 48, No. 6 ( 2020-12), p. 941-944
    Abstract: Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed pneumothorax in rare cases, but tension pneumothorax has only been reported once. Case presentation A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided tension pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the pneumothorax and the patient was discharged after 9 days of treatment. Conclusion Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute tension pneumothorax. Level of evidence V
    Type of Medium: Online Resource
    ISSN: 0300-8126 , 1439-0973
    URL: Article
    DOI: 10.1007/s15010-020-01457-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2006315-5
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  • 2
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    Sequelae of Premature Birth in Young Adults : Incidental Findings on Routine Brain MRI
    Springer Science and Business Media LLC ; 2021
    In:  Clinical Neuroradiology Vol. 31, No. 2 ( 2021-06), p. 325-333
    Details
    In: Clinical Neuroradiology, Springer Science and Business Media LLC, Vol. 31, No. 2 ( 2021-06), p. 325-333
    Abstract: Qualitative studies about the abnormalities appreciated on routine magnetic resonance imaging (MRI) sequences in prematurely born adults are lacking. This article aimed at filling this knowledge gap by (1) qualitatively describing routine imaging findings in prematurely born adults, (2) evaluating measures for routine image interpretation and (3) investigating the impact of perinatal variables related to premature birth. Methods In this study two board-certified radiologists assessed T1-weighted and FLAIR-weighted images of 100 prematurely born adults born very preterm (VP 〈 32 weeks) and/or at very low birth weight (VLBW 〈 1500 g) and 106 controls born at full term (FT) (mean age 26.8 ± 0.7 years). The number of white matter lesions (WML) was counted according to localization. Lateral ventricle volume (LVV) was evaluated subjectively and by measurements of Evans’ index (EI) and frontal-occipital-horn ratio (FOHR). Freesurfer-based volumetry served as reference standard. Miscellaneous incidental findings were noted as free text. Results The LVV was increased in 24.7% of VP/VLBW individuals and significantly larger than in FT controls. This was best identified by measurement of FOHR (AUC = 0.928). Ventricular enlargement was predicted by low gestational age (odds ratio: 0.71, 95% CI 0.51–0.98) and presence of neonatal intracranial hemorrhage (odds ratio: 0.26, 95% CI 0.07–0.92). The numbers of deep and periventricular WML were increased while subcortical WMLs were not. Conclusion Enlargement of the LVV and deep and periventricular WMLs are typical sequelae of premature birth that can be appreciated on routine brain MRI. To increase sensitivity of abnormal LVV detection, measurement of FOHR seems feasible in clinical practice.
    Type of Medium: Online Resource
    ISSN: 1869-1439 , 1869-1447
    URL: Article
    DOI: 10.1007/s00062-020-00901-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2232347-8
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  • 3
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    Speech perception as a function of cochlear coverage—comparison in bimodally hearing cochlear implant patients. German version
    Springer Science and Business Media LLC ; 2023
    In:  HNO Vol. 71, No. 8 ( 2023-08), p. 504-512
    Details
    In: HNO, Springer Science and Business Media LLC, Vol. 71, No. 8 ( 2023-08), p. 504-512
    Abstract: Hearing success in bimodally hearing patients with a cochlear implant (CI) and a hearing aid (HA) exhibits different results: while some benefit from bimodal CI and HA, others do not. Objective The aim of this study was to investigate hearing success in terms of speech perception in bimodally fitted patients in relation to the cochlear coverage (CC) of the CI electrodes. Materials and methods Using the OTOPLAN software (CAScination AG, Bern, Switzerland), CC was retrospectively measured from CT scans of the temporal bone of 39 patients, who were then categorized into two groups: CC ≤ 65% (CC 500 ) and CC  〉  65% (CC 600 ). Monaural speech intelligibility for monosyllables at a sound pressure level (SPL) of 65 dB in open field was assessed at various timepoints, preoperatively with HA and postoperatively with CI, and compared between the groups. In addition, speech intelligibility was correlated with CC in the entire cohort before surgery and during follow-up (FU). Results Overall, no significant differences in speech intelligibility were found between CC 500 and CC 600 patients at any of the FU timepoints. However, both CC 500 and CC 600 patients showed a steady improvement in speech intelligibility after implantation. While CC 600 patients tended to show an earlier improvement in speech intelligibility, CC 500 patients tended to show a slower improvement during the first 3 months and a steeper learning curve thereafter. The two patient groups converged during FU, with no significant differences in speech intelligibility. There was no significant relationship between unimodal/unilateral free-field speech intelligibility and CC. However, patients with a CC of 70–75% achieved maximum speech intelligibility. Conclusion Despite a nonsignificant correlation between CC and speech discrimination, patients seem to reach their maximum in unimodal/unilateral speech understanding mainly at 70–75% coverage. However, there is room for further investigation, as CC 500 was associated with a shorter cochlear duct length (CDL), and long and very long electrodes were used in both groups.
    Type of Medium: Online Resource
    ISSN: 0017-6192 , 1433-0458
    URL: Article
    DOI: 10.1007/s00106-023-01330-w
    RVK:
    XA 45800
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459183-2
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  • 4
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    Anatomical Variations of the Epitympanum and the Usable Space for Middle Ear Implants Analyzed With CT-assisted Imaging Using a Tablet-based Software
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Otology & Neurotology Vol. 43, No. 4 ( 2022-04), p. e454-e460
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 43, No. 4 ( 2022-04), p. e454-e460
    Abstract: To evaluate interindividual anatomical variations of the epitympanum and the usable space for implantation of active middle ear implants (AMEI) as well as the usefulness of a tablet-based software to assess individual anatomy on computed tomography (CT) scans. Patients: CT scans of 126 patients, scheduled for cochlea implantation (50.8% men; 0.6–90.0 yr) without middle ear malformations or previous middle ear surgery and with slice thickness ≤0.7 mm were analyzed. Main Outcome Measures: Since no standardized measurements to assess the size of the epitympanum are available, relevant distances were defined according to anatomical landmarks. Three independent raters measured these distances using a tablet-based software. Interrater correlation was computed to evaluate the quality of the measurement process. Descriptive data were analyzed for validation and for evaluation of interindividual anatomical variations. Influence of age and sex on the taken measurements was assessed. Results: No relevant correlation between age or sex and the anatomy of the epitympanum was found. Interrater correlation ranged from Spearman's ρ  = 0.3–0.9 and there were significant differences between individual rater results for various combinations. Descriptive data revealed high interindividual anatomical variance of the epitympanum, especially regarding the distance between incus and skull base. Conclusion: The reported descriptive data regarding the anatomy of the epitympanum emphasizes the importance of preoperative planning, especially since the height of the epitympanum showed great interindividual variance potentially limiting implantation of AMEIs. The herein used tablet-based software seems to be convenient for preoperative assessment of individual anatomy in the hand of otosurgeons.
    Type of Medium: Online Resource
    ISSN: 1531-7129 , 1537-4505
    URL: Article
    DOI: 10.1097/MAO.0000000000003486
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2058738-7
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  • 5
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    Monitoring treatment effects in lung cancer-bearing mice: clinical CT and clinical MRI compared to micro-CT
    Springer Science and Business Media LLC ; 2020
    In:  European Radiology Experimental Vol. 4, No. 1 ( 2020-12)
    Details
    In: European Radiology Experimental, Springer Science and Business Media LLC, Vol. 4, No. 1 ( 2020-12)
    Abstract: Compared to histology-based methods, imaging can reduce animal usage in preclinical studies. However, availability of dedicated scanners is limited. We evaluated clinical computed tomography (CT) and magnetic resonance imaging (MRI) in comparison to dedicated CT (micro-CT) for assessing therapy effects in lung cancer-bearing mice. Methods Animals received cisplatin ( n = 10), sham ( n = 12), or no treatment ( n = 9). All were examined via micro-CT, CT, and MRI before and after treatment. Semiautomated tumour burden (TB) calculation was performed. The Bland-Altman, receiver operating characteristic (ROC), and Spearman statistics were used. Results All modalities always allowed localising and measuring TB. At all modalities, mice treated with cisplatin showed a TB reduction ( p ≤ 0.012) while sham-treated and untreated individuals presented tumour growth ( p 〈 0.001). Mean relative difference (limits of agreement) between TB on micro-CT and clinical scanners was 24.7% (21.7–27.7%) for CT and 2.9% (−4.0–9.8%) for MRI. Relative TB changes before/after treatment were not different between micro-CT and CT ( p = 0.074) or MRI ( p = 0.241). Mice with cisplatin treatment were discriminated from those with sham or no treatment at all modalities ( p ≤ 0.001). Using micro-CT as reference standard, ROC areas under the curves were 0.988–1.000 for CT and 0.946–0.957 for MRI. TB changes were highly correlated across modalities ( r ≥ 0.900, p 〈 0.001). Conclusions Clinical CT and MRI are suitable for treatment response evaluation in lung cancer-bearing mice. When dedicated scanners are unavailable, they should be preferred to improve animal welfare.
    Type of Medium: Online Resource
    ISSN: 2509-9280
    URL: Article
    DOI: 10.1186/s41747-020-00160-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2905812-0
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  • 6
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    AI for Doctors—A Course to Educate Medical Professionals in Artificial Intelligence for Medical Imaging
    MDPI AG ; 2021
    In:  Healthcare Vol. 9, No. 10 ( 2021-09-28), p. 1278-
    Details
    In: Healthcare, MDPI AG, Vol. 9, No. 10 ( 2021-09-28), p. 1278-
    Abstract: Successful adoption of artificial intelligence (AI) in medical imaging requires medical professionals to understand underlying principles and techniques. However, educational offerings tailored to the need of medical professionals are scarce. To fill this gap, we created the course “AI for Doctors: Medical Imaging”. An analysis of participants’ opinions on AI and self-perceived skills rated on a five-point Likert scale was conducted before and after the course. The participants’ attitude towards AI in medical imaging was very optimistic before and after the course. However, deeper knowledge of AI and the process for validating and deploying it resulted in significantly less overoptimism with respect to perceivable patient benefits through AI (p = 0.020). Self-assessed skill ratings significantly improved after the course, and the appreciation of the course content was very positive. However, we observed a substantial drop-out rate, mostly attributed to the lack of time of medical professionals. There is a high demand for educational offerings regarding AI in medical imaging among medical professionals, and better education may lead to a more realistic appreciation of clinical adoption. However, time constraints imposed by a busy clinical schedule need to be taken into account for successful education of medical professionals.
    Type of Medium: Online Resource
    ISSN: 2227-9032
    URL: Article
    DOI: 10.3390/healthcare9101278
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2721009-1
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  • 7
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    Prevalence and clinical relevance of extra-cardiac findings at cardiac magnetic resonance imaging
    Elsevier BV ; 2013
    In:  Journal of Cardiovascular Magnetic Resonance Vol. 15 ( 2013-01), p. P267-
    Details
    In: Journal of Cardiovascular Magnetic Resonance, Elsevier BV, Vol. 15 ( 2013-01), p. P267-
    Type of Medium: Online Resource
    ISSN: 1097-6647
    URL: Article
    DOI: 10.1186/1532-429X-15-S1-P267
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 2578881-4
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  • 8
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    Vascular and extravascular findings on magnetic resonance angiography of the thoracic aorta and the origin of the great vessels
    Wiley ; 2014
    In:  Journal of Magnetic Resonance Imaging Vol. 40, No. 4 ( 2014-10), p. 988-995
    Details
    In: Journal of Magnetic Resonance Imaging, Wiley, Vol. 40, No. 4 ( 2014-10), p. 988-995
    Abstract: To investigate the presence of relevant vascular and incidental extravascular findings in patients undergoing magnetic resonance angiography (MRA) of the thoracic aorta and origin of the great vessels. Materials and Methods In all, 165 consecutive patients (mean age 61 ± 12 years) underwent 1.5 T MRA of the thorax. Two researchers identified vascular and incidental extravascular findings. Clinically relevant vascular findings were defined. Extravascular findings were categorized as minor (Group A, without change in patient treatment), intermediate (Group B, unclear clinical relevance, requiring additional investigations), and major (Group C, causing a change in patient treatment). Results A total of 306 relevant vascular findings were found in our cohort. A total of 397 extravascular findings were observed among the patients and were classified as Group A findings in 81.9% (325/397 findings, observed in 146 of 165 patients), as Group B findings in 15.4% (61/397 findings, observed in 52 of 165 patients), and as Group C in 2.8% of findings (11/397). The clinically relevant Group C findings were observed in 6.7% of patients (11/165), comprising eight previously unknown neoplasms (4.8% of 165), two patients with hemodynamically relevant pericardial effusion (1.2% of 165), and one patient with spondylodiscitis (0.6% of 165) detected by MRA. Conclusion Relevant vascular and extravascular findings were found in patients referred for thoracic MRA. Most extravascular findings can be categorized by MRA as minor, while others required further diagnostics since they may be malignant or otherwise clinically relevant. J. Magn. Reson. Imaging 2014;40:988–995 . © 2013 Wiley Periodicals, Inc .
    Type of Medium: Online Resource
    ISSN: 1053-1807 , 1522-2586
    URL: Issue
    URL: Article
    DOI: 10.1002/jmri.v40.4
    DOI: 10.1002/jmri.24442
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 1497154-9
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  • 9
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    Structured reporting has the potential to reduce reporting times of dual-energy x-ray absorptiometry exams
    Springer Science and Business Media LLC ; 2020
    In:  BMC Musculoskeletal Disorders Vol. 21, No. 1 ( 2020-12)
    Details
    In: BMC Musculoskeletal Disorders, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2020-12)
    Abstract: In recent years, structured reporting has been shown to be beneficial with regard to report completeness and clinical decision-making as compared to free-text reports (FTR). However, the impact of structured reporting on reporting efficiency has not been thoroughly evaluted yet. The aim of this study was to compare reporting times and report quality of structured reports (SR) to conventional free-text reports of dual-energy x-ray absorptiometry exams (DXA). Methods FTRs and SRs of DXA were retrospectively generated by 2 radiology residents and 2 final-year medical students. Time was measured from the first view of the exam until the report was saved. A random sample of DXA reports was selected and sent to 2 referring physicians for further evaluation of report quality. Results A total of 104 DXA reports (both FTRs and SRs) were generated and 48 randomly selected reports were evaluated by referring physicians. Reporting times were shorter for SRs in both radiology residents and medical students with median reporting times of 2.7 min (residents: 2.7, medical students: 2.7) for SRs and 6.1 min (residents: 5.0, medical students: 7.5) for FTRs. Information extraction was perceived to be significantly easier from SRs vs FTRs ( P   〈   0.001). SRs were rated to answer the clinical question significantly better than FTRs ( P   〈   0.007). Overall report quality was rated significantly higher for SRs compared to FTRs ( P   〈   0.001) with 96% of SRs vs 79% of FTRs receiving high or very high-quality ratings. All readers except for one resident preferred structured reporting over free-text reporting and both referring clinicians preferred SRs over FTRs for DXA. Conclusions Template-based structured reporting of DXA might lead to shorter reporting times and increased report quality.
    Type of Medium: Online Resource
    ISSN: 1471-2474
    URL: Article
    DOI: 10.1186/s12891-020-03200-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041355-5
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  • 10
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    Online Resource
    Variation of the cochlear anatomy and cochlea duct length: analysis with a new tablet-based software
    Springer Science and Business Media LLC ; 2022
    In:  European Archives of Oto-Rhino-Laryngology Vol. 279, No. 4 ( 2022-04), p. 1851-1861
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 279, No. 4 ( 2022-04), p. 1851-1861
    Abstract: In cochlear implantation, thorough preoperative planning together with measurement of the cochlear duct length (CDL) assists in choosing the correct electrode length. For measuring the CDL, different techniques have been introduced in the past century along with the then available technology. A tablet-based software offers an easy and intuitive way to visualize and analyze the anatomy of the temporal bone, its proportions and measure the CDL. Therefore, we investigated the calculation technique of the CDL via a tablet-based software on our own cohort retrospectively. Methods One hundred and eight preoperative computed tomography scans of the temporal bone (slice thickness  〈  0.7 mm) of already implanted FLEX28™ and FLEXSOFT™ patients were found eligible for analysis with the OTOPLAN software. Measurements were performed by two trained investigators independently. CDL, angular insertion depth (AID), and cochlear coverage were calculated and compared between groups of electrode types, sex, sides, and age. Results Mean CDL was 36.2 ± 1.8 mm with significant differences between sex (female: 35.8 ± 0.3 mm; male: 36.5 ± 0.2 mm; p  = 0.037), but none concerning side or age. Differences in mean AID (FLEX28: 525.4 ± 46.4°; FLEXSOFT: 615.4 ± 47.6°), and cochlear coverage (FLEX28: 63.9 ± 5.6%; FLEXSOFT: 75.8 ± 4.3%) were significant ( p   〈  0.001). Conclusion A broad range of CDL was observed with significant larger values in male, but no significant differences concerning side or age. Almost every cochlea was measured longer than 31.0 mm. Preoperative assessment aids in prevention of complications (incomplete insertion, kinking, tipfoldover), attempt of atraumatic insertion, and addressing individual necessities (hearing preservation, cochlear malformation). The preferred AID of 720° (two turns of the cochlea) was never reached, opening the discussion for the requirement of longer CI-electrodes versus a debatable audiological benefit for the patient in his/her everyday life.
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-021-06889-0
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1459042-6
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