[en] Radiological reference information: complete, quality-assured, clear and up-to-date. The constant increase in knowledge and the high workload in medicine make the rapid availability of quality-assured information indispensable for safe and efficient patient care. This work is part of the interdisciplinary reference series, which is specifically designed to meet the needs of clinically active physicians. In the context of interdisciplinary overlaps, this work exchanges content with other reference works. Benefit from a comprehensive and up-to-date work with all important neuroradiological clinical pictures of the brain. Your advantages at a glance: Medical expertise at the highest level: Quality-assured information from renowned editors and authors. Maximum practical relevance: Concrete and precise instructions for optimal patient care in the clinic and practice. High degree of clarity: Clear and consistent structuring of the chapters for quick reference and lasting memorisation. Focus on the essentials: The contents are optimised for quick access, no tedious searching in long text passages. We bring the information to the point for you. The ideal companion for all radiologists in clinics and practices - diagnose quickly and safely! The content of the book is available to you digitally in the knowledge platform eRef at no additional cost (access code in the book). With the free eRef app, you always have numerous contents at hand, even offline.

[en] The book on neuroradiology covers the following topics: methods and normal diagnostic findings, brain malformations and development disorders, epilepsy diagnostics, traumatic consequences, carcinomas and tumor-like diseases, vascular diseases, infections and inflammations, demyelinising and degenerative diseases, spinal carcinomas and tumor-like diseases, spinal blood vessel diseases, demyelinising and degenerative diseases of the spinal cord, degenerative diseases of the vertebral column, other diseases of vertebral column and spinal cord, interventions in the head (therapy), spinal interventions (therapy), radiation protection, neuroradiological expertises

No abstract available

[en] The prevalence or cerebral aneurysms is estimated at 2 %. Out of these aciniform aneurysm, 0,1 % rupture each year. The 30-day-mortality after a subarachnoid hemorrhage (SAH) is estimated at 45 %. Additionally, about 50 % of the patients suffer from severe persistent neurologic deficits. The most reliable way to prevent rupture is early detection and prophylactic therapy of an unruptured aneurysm. For this, knowledge of the different imaging methods currently available and their diagnostic potential is highly desirable. This review describes the potential of CT, MRI and catheter angiography in diagnosing cerebral aneurysms, as well as therapy planning and follow-up care of patients. Based on this, some recommendations are made for management of patients with SAH.

[en] This book describes the pathoanatomical, pathophysiological, and imaging features of vascular malformations and aneurysms of the brain and the modern, minimally invasive endovascular methods and techniques employed in their treatment. Individual chapters are devoted to developmental venous malformations, cavernomas and capillary telangiectasias, pial arteriovenous malformations, dural arteriovenous malformations, and intracranial aneurysms. Each chapter is subdivided into four principal sections on pathology, clinical presentation, diagnostic imaging, and therapy, ensuring a standardized approach throughout. All chapters in this 2nd revised edition of Intracranial Vascular Malformations and Aneurysms have been thoroughly updated. The book is richly illustrated with numerous informative CT, MR and DSA images, including high-end 7-Tesla MR images. (orig.)

[en] To evaluate the dose-reduction potential with different lens protectors for patients undergoing cranial computed tomography (CT) scans. Eye lens dose was assessed in vitro (α-Al_2O_3:C thermoluminescence dosemeters) using an Alderson-Rando phantom"R in cranial CT protocols at different CT scanners (SOMATOM-Definition-AS+"R (CT1) and SOMATOM-DefinitionFlash"R (CT2)) using two different lens-protection systems (Somatex"R (SOM) and Medical Imaging Systems"R (MIS)). Summarised percentage of the transmitted photons: (1) CT1 (a) unenhanced CT (nCT) with gantry angulation: SOM = 103%, MIS = 111%; (2) CT2 (a) nCT without gantry angulation: SOM = 81%, MIS = 91%; (b) CT angiography (CTA) with automatic dose-modulation technique: SOM = 39%, MIS = 74%; (c) CTA without dose-modulation technique: SOM = 22%, MIS = 48%; (d) CT perfusion: SOM = 44%, MIS = 69%. SOM showed a higher dose-reduction potential than MIS maintaining equal image quality. Lens-protection systems are most effective in CTA protocols without dose-reduction techniques. Lens-protection systems lower the average eye lens dose during CT scans up to 1/3 (MIS) and 2/3 (SOM), respectively, if the eye lens is exposed to the direct beam of radiation. Considering both the CT protocol and the material of lens protectors, they seem to be mandatory for reducing the radiation exposure of the eye lens. (authors)

[en] Treatment of wide-necked aneurysms by endovascular coil embolization usually requires mechanical aids in order to protect the parent artery from occlusion due to extension of coils or thrombosis. Endovascular stents are one tool that can be deployed to solve this essentially mechanical problem. The effect of a stent placed in the situation may also act as a hemodynamically active flow diverter. Endovascular stents used in other circumstances are prone to the unwanted side effect of neoinitmal proliferation, but this phenomenon should be seen as a potential asset for ''aneurysmal stents'' because it may lead to a reaction that contributes to vessel wall healing. (orig.)

[en] Basilar tip aneurysms are the most frequent type of aneurysm in the posterior circulation. Specifically, if wide-necked, they remain a significant therapeutic challenge. On the endovascular side, stents may help to overcome many of these technical challenges. However, if both P1 segments encroach into the aneurysm neck, sometimes stent placement from the middle of the basilar artery to one P1 segment is not enough. Therefore, some groups recommend the use of the so-called Y-stent technique, with one stent passing through the interstices of another stent in a Y-configuration thus remodelling the basilar tip. We describe a patient with a broad-based basilar tip aneurysm and a single, very tortuous vertebral artery which did not allow the use of the vertebrobasilar system as the straight route to the aneurysm. Because of the well-known high surgical risk we decided to navigate the stent through the internal carotid artery and via the posterior communicating artery into the contralateral P1 segment and placed the stent at right angles to the aneurysm from one P1 segment to the contralateral one. The outcome in the patients was excellent without any ischemic lesions. Horizontal stent placement in wide-necked basilar tip aneurysms may be a therapeutic alternative if the regular route via the vertebral arteries is not feasible. (orig.)

[en] To investigate dual-energy CT of hypovascular liver metastases (LMs) with special focus on window settings (WSs). The aim of the study is to investigate the extent to which adapted WSs and the low-energy images of DECT improve the visibility especially of smaller LMs. 30 patients with LMs of colorectal cancer were investigated with DECT of the liver. In each patient contrast-enhanced DECT imaging with portal-venous delay was performed. The total number, mean number and conspicuity (1= excellent - 5 = poor) of LMs were documented on 80-kVp images and virtual 120-kVp images with different WSs (25/200 HU, 50/200, 75/200 HU, 25/350 HU, 50/350 HU, 75/350 HU, 25/500 HU, 50/500 HU, 75/500 HU). The attenuation (HU) of LMs and several anatomic regions and the background noise on 80 kVp images and virtual 120 kVp images were documented. Signal (liver)/noise and liver/LM ratio (SNR/LLMR) were calculated. The total number of LMs depending on size (<1cm, 1-2cm, >2cm) on 80 kVp images and virtual 120 kVp images with previously investigated best and regular WSs were documented. The highest total number, mean number per patient and total number of LMs <1cm were detected with the WS 25/350 HU on 80kVp images (7.0; p = 0.02/218; p = 0.01/64;p<0.001) compared to the WS 75/200 HU on virtual 120 kVp images and the regular WS 50/350 HU on 80 kVp images and virtual 120 kVp images. The best conspicuity of LMs on 80 kVp images was documented with the WS 25/350 HU compared to the best WS on virtual 120 kVp images with 75/200 HU (1.2 vs. 2.5; p = 0.01). HU of normal liver, aorta, SNR and LLMR differed significantly between 80 kVp images and virtual 120 kVp images (128.1 vs. 93.6; < 0.05/192.8 vs. 131.4; < 0.05/10.3 vs. 8.1; p < 0.05/2.8 vs. 2.1; p < 0.05). Low kVp images of DECT datasets are more precise in detecting hypovascular liver metastases than virtual 120 kVp images. Dedicated window settings have a relevant influence on conspicuity.

[en] The aim of this prospective study was to examine the diagnostic value of dual-energy CT (DECT) in the assessment of response of HCC after radioembolisation (RE). 40 HCC patients with 82 measurable target lesions were included in this study. At baseline and follow-up examination target lesions were evaluated with (IU), AASLD and Choi measurement criteria. Disease control was defined as the sum of complete response (CR), partial response (PR), progression disease (PD) and stable disease (SD). With Choi and IU more patients were considered than PR and less than PD and SD. According to AASLD more patients were measured as SD and PD than PR. 26/40 patients were classified as PR with IU. In contrast measurements with AASLD in only 8/26 patients were also classified as PR. 6/12 SD patients measured with IU were measured as PD with AASLD. 4/26 patients classified with IU as PR were described as SD with CHOI, 10/14 SD patients measured with CHOI were SD according to IU, the other 4 patients were PR with IU. 2/4 PD patients according to CHOI were SD with IU. More patients by IU were classified as SD versus PD and PR versus SD. We attribute this to the more detailed consideration of the HU differences between the virtual native and contrast-enhanced series generated by DECT. Iodine uptake (IU) in HCC measured and visualized with DECT is a promising imaging method for the assessment of treatment response after radioembolisations. —dual energy CT of hypervascular tumors such as HCC allows to quantify contrast enhancement without native imaging. —this can be used to evaluate the therapy response after Radioembolization