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Papers by Andrea Klauser

Research paper thumbnail of Meralgia paraesthetica: Ultrasound-guided injection at multiple levels with 12-month follow-up

European Radiology, 2015

To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneou... more To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneous nerve (LFCN) at different levels in meralgia paraesthetica (MP) patients. The study was approved by the university ethics committee and informed oral and written consent were obtained from all patients. Between June 2008 and August 2013, 20 patients with symptoms of MP, including nine men (mean age, 61.33 years) and 11 women (mean age 61.18 years), were treated with US-guided injection of steroids along the LFCN at three different levels in a mean of 2.25 sessions. A visual analogue scale (VAS) was used to measure symptoms before, immediately after and 12 months after treatment. Complete resolution of symptoms was documented in 15/20 patients (mean VAS decreased from 82 to 0), and partial resolution in the remaining five (mean VAS decreased from 92 to 42), which was confirmed at 12-month follow-up. By using the different levels of injection approach overall significantly better symptom relief was obtained (p < 0.05). The outcome of US-guided injection along the LFCN can be further improved by injections at different levels (p < 0.05), which was confirmed at 12-month long-term follow-up. • Meralgia paraesthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve. • Ultrasound proved effective in diagnosis and in guiding injection therapy. • Injection at the anterior superior iliac spine has been used previously. • Multiple injections along the nerve course were used in this study. • Long-term follow-up (12 months) confirmed the results.

Research paper thumbnail of Improved non-calcified plaque delineation on coronary CT angiography by sonogram-affirmed iterative reconstruction with different filter strength and relationship with BMI

Cardiovascular diagnosis and therapy, 2015

To prospectively compare non-calcified plaque delineation and image quality of coronary computed ... more To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m(2)] were investigated. CCTA was performed using 128-slice dual-source CT. Images were reconstructed with standard FBP and sinogram-affirmed IR using different filter strength (IR-2, IR-3, IR-4) (SAFIRE, Siemens, Germany). Image quality of CCTA and a non-calcified plaque outer border delineation score were evaluated by using a 5-scale score: from 1= poor to 5= excellent. Image noise, contrast-to-noise ratio (CNR) of aortic root, left main (LM) and right coronary artery, and the non-calcified plaque delineation were quantified and compared among the 4 image reconstructions, and were compared between different BMI groups (BMI <28 and ≥28). Statistical analy...

Research paper thumbnail of Sonographic cross-sectional area measurement in carpal tunnel syndrome patients: can delta and ratio calculations predict severity compared to nerve conduction studies?

European radiology, Jan 10, 2015

To evaluate the accuracy of two different sonographic median nerve measurement calculations in pr... more To evaluate the accuracy of two different sonographic median nerve measurement calculations in predicting carpal tunnel syndrome (CTS) severity in a study population with clinically and electrophysiologically confirmed CTS. 643 wrists of 427 patients (325 females and 102 males, age range: 17-90 years, mean ± SD: 57.9 ± 14.7) were included with CTS diagnosis based on clinical and nerve conduction studies (NCS). Cross-sectional area (CSA) measurement of the median nerve was performed at the carpal tunnel level (CSAc) and at the pronator quadratus muscle level (CSAp). Two parameters were calculated: delta (∆-CSA), which is the difference between proximal and distal measurements, and ratio (R-CSA), calculated by dividing distal over proximal measurements. Patients were classified into mild, moderate and severe CTS based upon NCS. The mean ∆-CSA (4.2 ± 2.6, 6.95 ± 2.2 and 10.7 ± 4.9 mm(2)) and mean R-CSA (1.5 ± 0.4, 1.95 ± 0.4 and 2.4 ± 0.7) values were significantly different between al...

Research paper thumbnail of The diagnostic and prognostic value of coronary CT angiography in asymptomatic high-risk patients: a cohort study

Open heart, 2014

To prospectively assess the value of coronary CT angiography (CTA) in asymptomatic patients with ... more To prospectively assess the value of coronary CT angiography (CTA) in asymptomatic patients with high 'a priori' risk of coronary artery disease (CAD). 711 consecutive asymptomatic patients (61.8 years; 40.1% female) with high 'a priori' risk of CAD were prospectively examined with a coronary calcium score (CCS) and CTA. Coronary arteries were evaluated for atherosclerotic plaque (non-calcified and calcified) and stenosis (mild <50%, intermediate 50-70% or high-grade >70%). Coronary Segment Involvement Score (SIS, total number of segments with plaque) and nc (non-calcified) SIS were calculated. Primary end points were major adverse cardiac events (ST-elevation MI, non-ST-elevation MI and cardiac death); secondary end points were coronary revascularisation and >50% stenosis by invasive angiography. Of 711 patients, 28.3% were negative for CAD and 71.7% positive (CAD+) by CTA (15.6% had plaques without stenosis, 23.9% mild, 10.7% intermediate and 21.5% high-gr...

Research paper thumbnail of Inflammatory low back pain: high negative predictive value of contrast-enhanced color Doppler ultrasound in the detection of inflamed sacroiliac joints

Arthritis and rheumatism, Jan 15, 2005

To determine the value of microbubble contrast agents for color Doppler ultrasound (CDUS) compare... more To determine the value of microbubble contrast agents for color Doppler ultrasound (CDUS) compared with magnetic resonance imaging (MRI) in the detection of active sacroiliitis. An observational case-control study of 103 consecutive patients (206 sacroiliac [SI] joints) with inflammatory low back pain according to the Calin criteria and 30 controls (60 SI joints) without low back pain was conducted at the University Hospital of Innsbruck. All patients and controls underwent unenhanced and contrast-enhanced CDUS and MRI of the SI joints. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of unenhanced and contrast-enhanced CDUS were evaluated. Forty-three patients (41%) with 70 of 206 SI joints (34%) and none of the controls nor the 60 control SI joints demonstrated active sacroiliitis on MRI. Unenhanced CDUS showed a sensitivity of 17%, a specificity of 96%, a PPV of 65%, and an NPV of 72%; contrast-enhanced CDUS showed a sensitivity of 94...

Research paper thumbnail of Workshop report: clinical diagnosis and imaging of sacroiliitis, Innsbruck, Austria, October 9, 2003

The Journal of rheumatology, 2004

Research paper thumbnail of Sonographic Findings in Trigger Fingers and Outcome of Sonographically Guided Injection

Purpose: Shoulder Impingement Syndrome (SIS) is a common shoulder problem in athletes involving o... more Purpose: Shoulder Impingement Syndrome (SIS) is a common shoulder problem in athletes involving overhead sports. The aim of this study was to explore changes in subacromial space (SAS) with real-time ultrasonography and their associations with shoulder rotator strength.

Research paper thumbnail of Sonoelastography: Musculoskeletal Applications

Research paper thumbnail of Is Sonoelastography of Value in Assessing Tendons?

Seminars in Musculoskeletal Radiology, 2010

Sonoelastography is a newly introduced ultrasound technique that evaluates tissue elasticity and ... more Sonoelastography is a newly introduced ultrasound technique that evaluates tissue elasticity and thus provides additional information to that offered by conventional ultrasound images. In the musculoskeletal field, sonoelastography can help improve estimation of tendon stiffness.

Research paper thumbnail of Renal perfusion changes before and after ESWL: evaluation with color doppler ultrasound in comparison with Magnetic Resonance (MR) perfusion imaging, scintigraphy and big-endothelin-1

European Urology Supplements, 2002

Research paper thumbnail of Imaging and Interpretation of Axial Spondylarthritis: The Radiologist's Perspective—Consensus of the Arthritis Subcommittee of the ESSR

Seminars in Musculoskeletal Radiology, 2014

This article reflects the radiologist's perspective on the imaging and interpretation of axial sp... more This article reflects the radiologist's perspective on the imaging and interpretation of axial spondylarthritis (SpA). The arthritis subcommittee of the European Society of Skeletal Radiology provides a consensus for the following questions: When and how should we image? How should we analyze the images? How should we interpret the imaging findings? To answer these questions, we address the indications in imaging axial SpA and the different imaging techniques, with a special focus on magnetic resonance imaging protocols. The value of different imaging modalities is discussed. For adequate image analysis, knowledge of the anatomy and the pathologic changes in chronic and acute inflammation of the sacroiliac joints and the spine is mandatory. Differential diagnoses of inflammatory lesions of the sacroiliac joints and the spine are addressed due to their importance in image interpretation.

Research paper thumbnail of Training Musculoskeletal Ultrasound Specialists: European Education and Clinical Guidelines: Work in Progress

The Practice of Radiology Education, 2010

Page 1. 143 T. Van Deven et al. (eds.), The Practice of Radiology Education, DOI: 10.1007/978-3-6... more Page 1. 143 T. Van Deven et al. (eds.), The Practice of Radiology Education, DOI: 10.1007/978-3-642-03234-9_10, © Springer Verlag Berlin Heidelberg 2010 Training Musculoskeletal Ultrasound Specialists: European Education and Clinical Guidelines: Work in ...

Research paper thumbnail of US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons

Ultraschall in der Medizin (Stuttgart, Germany : 1980), 2011

To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lava... more To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lavage using a two-needle technique with 16 - 18 G needles in the treatment of patients with calcific tendinopathy in the shoulder, elbow, hip, and knee by radiological and clinical follow-up. A retrospective chart review was performed and 40 patients (13 male, 27 female; mean age, 53.5 years; range 24 -74 years) were identified as having received US-guided perforation and lavage due to symptomatic calcific tendinopathy of the rotator cuff tendons, triceps, extensor and flexor tendons at the elbow, rectus femoris tendon and patellar tendons. The radiographic outcome was assessed by comparison of the size and quality of the calcification before and 6 weeks after the procedure. On US images, the quality of the acoustic shadow was assessed, together with other alterations of the tendon and surrounding tissue. Patients were interviewed by telephone to assess the clinical outcome regarding pre-tr...

Research paper thumbnail of Remitting seronegative symmetrical synovitis with pitting edema of the hands: Ultrasound, color doppler ultrasound, and magnetic resonance imaging findings

Arthritis and Rheumatism, 2005

Research paper thumbnail of Laparoscopic pyeloplasty for UPJ obstruction with crossing vessels: contrast-enhanced color Doppler findings and long-term outcome

Urology, 2002

To evaluate, in the present long-term follow-up study, contrast-enhanced color Doppler imaging (C... more To evaluate, in the present long-term follow-up study, contrast-enhanced color Doppler imaging (CDI) findings and the clinical outcome of patients with crossing vessels at the obstructed ureteropelvic junction (UPJ), who underwent laparoscopic pyeloplasty. In a previous study, contrast-enhanced CDI proved capable of detecting crossing vessels at the UPJ. A total of 23 patients, who had undergone laparoscopic pyeloplasty and displacement of crossing vessels for UPJ obstruction at least 2 years before this study (mean 27 months), underwent contrast-enhanced CDI, intravenous urography, and renography. Contrast-enhanced CDI was performed using intravenously administered Levovist to assess the displacement of the vessels relative to the UPJ. All patients completed analog follow-up pain scales and quality-of-life assessment questionnaires. RESULTS. Contrast-enhanced CDI revealed a cranial displacement (mean 1.3 cm) of the crossing vessels from the UPJ in all 23 cases. Intravenous urography showed a decrease in the degree of hydronephrosis, with a success rate of 100% in low-grade and 86% in high-grade hydronephrosis. The split renal function improved from 39.7% to 48.1%. Analog pain scale measurements demonstrated a mean improvement in pain of 92% (range 73% to 100%) and a mean quality-of-life score of 94 (range 78 to 100). Our series of patients with crossing vessels at the UPJ treated by laparoscopic pyeloplasty showed an excellent long-term successful outcome. Contrast-enhanced CDI allows for preoperative detection, as well as postoperative assessment, of the displacement of the crossing vessel. We recommend that the presence of a crossing vessel be routinely determined preoperatively, because it may influence the choice of treatment modality and thereby the clinical outcome.

Research paper thumbnail of Fusion of Real-time US with CT Images to Guide Sacroiliac Joint Injection in Vitro and in Vivo 1

Radiology, 2010

To evaluate if image fusion, a technology matching realtime ultrasonography (US) and a previously... more To evaluate if image fusion, a technology matching realtime ultrasonography (US) and a previously obtained computed tomographic (CT) scan, is a feasible aid for sacroiliac (SI) joint injections in cadavers and patients.

Research paper thumbnail of Carpal Tunnel Syndrome Assessment with US: Value of Additional Cross-sectional Area Measurements of the Median Nerve in Patients versus Healthy Volunteers 1

Radiology, 2009

To improve accuracy in the diagnosis of carpal tunnel syndrome (CTS) by comparing cross-sectional... more To improve accuracy in the diagnosis of carpal tunnel syndrome (CTS) by comparing cross-sectional area (CSA) measurements of the median nerve obtained at the level of the carpal tunnel (CSAc) with those obtained more proximally (CSAp), at the level of the pronator quadratus muscle.

Research paper thumbnail of Achilles Tendon Assessed with Sonoelastography: Histologic Agreement

Radiology, 2013

To compare and determine the level of agreement of findings at conventional B-mode ultrasonograph... more To compare and determine the level of agreement of findings at conventional B-mode ultrasonography (US) and sonoelastography of the Achilles tendon with findings at histologic assessment. This study was conducted with the approval of the institutional review boards, and all cadavers were in legal custody of the study institution. Thirteen Achilles tendons in 10 cadavers (four male, six female; age range, 70-90 years) were examined with B-mode US and sonoelastography. B-mode US grading was as follows: Grade 1 indicated a normal-appearing tendon with homogeneous fibrillar echotexture; grade 2, a focal fusiform or diffuse enlarged tendon; and grade 3, a hypoechoic area with or without tendon enlargement. Sonoelastography grading was as follows: Grade 1 indicated blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). Twenty-five biopsy specimens from representative lesions of the middle and distal thirds of the Achilles tendons were evaluated histologically. The concordance of B-mode US grading compared with sonoelastographic grading was assessed by using κ analysis. With B-mode US and sonoelastography, all 11 tendon thirds of histologically normal tendons were verified as normal (grade 1). Sonoelastography depicted 14 of 14 (100%) tendon thirds with histologic degeneration (grade 2 or 3), whereas B-mode US could depict only 12 of 14 (86%) lesions (grade 2 or 3). Only moderate agreement between B-mode US and sonoelastography was seen (κ = 0.52, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Sonoelastography might help predict signs of histopathologic degeneration of Achilles tendinosis, potentially more sensitively than B-mode US.

Research paper thumbnail of 18F-Fluorodeoxyglucose-positron emission tomography: A new explorative perspective

Experimental Gerontology, 2003

18F-Fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) is a new functional imaging tec... more 18F-Fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) is a new functional imaging technique available for clinical and experimental use. 18F-FDG-PET studies can be used for screening, localization and follow-up of hypermetabolic processes including malignancies, infections and autoimmune processes. For several years it has been applied in oncological, cardiological and neurological patients, but nowadays an increasing number of studies favours its use in patients

Research paper thumbnail of Are Transition Zone Biopsies Still Necessary to Improve Prostate Cancer Detection?

European Urology, 2005

Objectives: The present retrospective study was designed to investigate the value of transition z... more Objectives: The present retrospective study was designed to investigate the value of transition zone (TZ) biopsies for prostate cancer (PC) detection rate in a combined contrast enhanced color Doppler targeted (CECD) and gray-scale systematic biopsy (SB) approach. Methods: PSA screening participants totalling 1475 with tPSA of >1.25 ng/ml (fPSA 18%) were assessed. Ten SB and additionally 5 or fewer CECD were performed. The impact of TZ biopsies on the PC detection rate and the biological significance of the detected TZ-cancers were analyzed. Results: Out of 1475 biopsied patients, 395 (26.8%) were identified as PC patients; 5925 biopsy cores from these patients were analyzed. In 86 patients (21.8% of PC), we found 102 PC-positive cores in the TZ, and only in 9 of them solitary TZ-cancers without any other PC-location (2.3% of PC or 0.6% of all investigated patients). Pathologic findings after retropubic prostatectomy (RPE) revealed multifocal adenocarcinoma including involved peripheral zone (PZ) in eight of these nine patients, and solitary TZ-cancer in one patient. There was no positive correlation between prostate volume and TZ-detection rate and no patient with solitary TZ-PC after rebiopsy. Conclusion: Biopsy revealed 9 solitary TZ cancers (1.8%) and RPE revealed only one of them to be truly TZconfined cancer (0.6%). Furthermore PC-detection did not improve, even in patients with rebiopsy, and there was no correlation between detection of TZ-cancers and prostate volume. A combined use of CECD and SB to investigate participants of a PSA-screening program suggests that TZ-biopsies do not improve PC detection rate and are therefore unnecessary. #

Research paper thumbnail of Meralgia paraesthetica: Ultrasound-guided injection at multiple levels with 12-month follow-up

European Radiology, 2015

To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneou... more To evaluate the efficacy of ultrasound (US)-guided injections around the lateral femoral cutaneous nerve (LFCN) at different levels in meralgia paraesthetica (MP) patients. The study was approved by the university ethics committee and informed oral and written consent were obtained from all patients. Between June 2008 and August 2013, 20 patients with symptoms of MP, including nine men (mean age, 61.33 years) and 11 women (mean age 61.18 years), were treated with US-guided injection of steroids along the LFCN at three different levels in a mean of 2.25 sessions. A visual analogue scale (VAS) was used to measure symptoms before, immediately after and 12 months after treatment. Complete resolution of symptoms was documented in 15/20 patients (mean VAS decreased from 82 to 0), and partial resolution in the remaining five (mean VAS decreased from 92 to 42), which was confirmed at 12-month follow-up. By using the different levels of injection approach overall significantly better symptom relief was obtained (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). The outcome of US-guided injection along the LFCN can be further improved by injections at different levels (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), which was confirmed at 12-month long-term follow-up. • Meralgia paraesthetica is an entrapment neuropathy of the lateral femoral cutaneous nerve. • Ultrasound proved effective in diagnosis and in guiding injection therapy. • Injection at the anterior superior iliac spine has been used previously. • Multiple injections along the nerve course were used in this study. • Long-term follow-up (12 months) confirmed the results.

Research paper thumbnail of Improved non-calcified plaque delineation on coronary CT angiography by sonogram-affirmed iterative reconstruction with different filter strength and relationship with BMI

Cardiovascular diagnosis and therapy, 2015

To prospectively compare non-calcified plaque delineation and image quality of coronary computed ... more To prospectively compare non-calcified plaque delineation and image quality of coronary computed tomography angiography (CCTA) obtained with sinogram-affirmed iterative reconstruction (IR) with different filter strengths and filtered back projection (FBP). A total of 57 patients [28.1% females; body mass index (BMI) 29.2±6.5 kg/m(2)] were investigated. CCTA was performed using 128-slice dual-source CT. Images were reconstructed with standard FBP and sinogram-affirmed IR using different filter strength (IR-2, IR-3, IR-4) (SAFIRE, Siemens, Germany). Image quality of CCTA and a non-calcified plaque outer border delineation score were evaluated by using a 5-scale score: from 1= poor to 5= excellent. Image noise, contrast-to-noise ratio (CNR) of aortic root, left main (LM) and right coronary artery, and the non-calcified plaque delineation were quantified and compared among the 4 image reconstructions, and were compared between different BMI groups (BMI <28 and ≥28). Statistical analy...

Research paper thumbnail of Sonographic cross-sectional area measurement in carpal tunnel syndrome patients: can delta and ratio calculations predict severity compared to nerve conduction studies?

European radiology, Jan 10, 2015

To evaluate the accuracy of two different sonographic median nerve measurement calculations in pr... more To evaluate the accuracy of two different sonographic median nerve measurement calculations in predicting carpal tunnel syndrome (CTS) severity in a study population with clinically and electrophysiologically confirmed CTS. 643 wrists of 427 patients (325 females and 102 males, age range: 17-90 years, mean ± SD: 57.9 ± 14.7) were included with CTS diagnosis based on clinical and nerve conduction studies (NCS). Cross-sectional area (CSA) measurement of the median nerve was performed at the carpal tunnel level (CSAc) and at the pronator quadratus muscle level (CSAp). Two parameters were calculated: delta (∆-CSA), which is the difference between proximal and distal measurements, and ratio (R-CSA), calculated by dividing distal over proximal measurements. Patients were classified into mild, moderate and severe CTS based upon NCS. The mean ∆-CSA (4.2 ± 2.6, 6.95 ± 2.2 and 10.7 ± 4.9 mm(2)) and mean R-CSA (1.5 ± 0.4, 1.95 ± 0.4 and 2.4 ± 0.7) values were significantly different between al...

Research paper thumbnail of The diagnostic and prognostic value of coronary CT angiography in asymptomatic high-risk patients: a cohort study

Open heart, 2014

To prospectively assess the value of coronary CT angiography (CTA) in asymptomatic patients with ... more To prospectively assess the value of coronary CT angiography (CTA) in asymptomatic patients with high 'a priori' risk of coronary artery disease (CAD). 711 consecutive asymptomatic patients (61.8 years; 40.1% female) with high 'a priori' risk of CAD were prospectively examined with a coronary calcium score (CCS) and CTA. Coronary arteries were evaluated for atherosclerotic plaque (non-calcified and calcified) and stenosis (mild <50%, intermediate 50-70% or high-grade >70%). Coronary Segment Involvement Score (SIS, total number of segments with plaque) and nc (non-calcified) SIS were calculated. Primary end points were major adverse cardiac events (ST-elevation MI, non-ST-elevation MI and cardiac death); secondary end points were coronary revascularisation and >50% stenosis by invasive angiography. Of 711 patients, 28.3% were negative for CAD and 71.7% positive (CAD+) by CTA (15.6% had plaques without stenosis, 23.9% mild, 10.7% intermediate and 21.5% high-gr...

Research paper thumbnail of Inflammatory low back pain: high negative predictive value of contrast-enhanced color Doppler ultrasound in the detection of inflamed sacroiliac joints

Arthritis and rheumatism, Jan 15, 2005

To determine the value of microbubble contrast agents for color Doppler ultrasound (CDUS) compare... more To determine the value of microbubble contrast agents for color Doppler ultrasound (CDUS) compared with magnetic resonance imaging (MRI) in the detection of active sacroiliitis. An observational case-control study of 103 consecutive patients (206 sacroiliac [SI] joints) with inflammatory low back pain according to the Calin criteria and 30 controls (60 SI joints) without low back pain was conducted at the University Hospital of Innsbruck. All patients and controls underwent unenhanced and contrast-enhanced CDUS and MRI of the SI joints. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of unenhanced and contrast-enhanced CDUS were evaluated. Forty-three patients (41%) with 70 of 206 SI joints (34%) and none of the controls nor the 60 control SI joints demonstrated active sacroiliitis on MRI. Unenhanced CDUS showed a sensitivity of 17%, a specificity of 96%, a PPV of 65%, and an NPV of 72%; contrast-enhanced CDUS showed a sensitivity of 94...

Research paper thumbnail of Workshop report: clinical diagnosis and imaging of sacroiliitis, Innsbruck, Austria, October 9, 2003

The Journal of rheumatology, 2004

Research paper thumbnail of Sonographic Findings in Trigger Fingers and Outcome of Sonographically Guided Injection

Purpose: Shoulder Impingement Syndrome (SIS) is a common shoulder problem in athletes involving o... more Purpose: Shoulder Impingement Syndrome (SIS) is a common shoulder problem in athletes involving overhead sports. The aim of this study was to explore changes in subacromial space (SAS) with real-time ultrasonography and their associations with shoulder rotator strength.

Research paper thumbnail of Sonoelastography: Musculoskeletal Applications

Research paper thumbnail of Is Sonoelastography of Value in Assessing Tendons?

Seminars in Musculoskeletal Radiology, 2010

Sonoelastography is a newly introduced ultrasound technique that evaluates tissue elasticity and ... more Sonoelastography is a newly introduced ultrasound technique that evaluates tissue elasticity and thus provides additional information to that offered by conventional ultrasound images. In the musculoskeletal field, sonoelastography can help improve estimation of tendon stiffness.

Research paper thumbnail of Renal perfusion changes before and after ESWL: evaluation with color doppler ultrasound in comparison with Magnetic Resonance (MR) perfusion imaging, scintigraphy and big-endothelin-1

European Urology Supplements, 2002

Research paper thumbnail of Imaging and Interpretation of Axial Spondylarthritis: The Radiologist's Perspective—Consensus of the Arthritis Subcommittee of the ESSR

Seminars in Musculoskeletal Radiology, 2014

This article reflects the radiologist's perspective on the imaging and interpretation of axial sp... more This article reflects the radiologist's perspective on the imaging and interpretation of axial spondylarthritis (SpA). The arthritis subcommittee of the European Society of Skeletal Radiology provides a consensus for the following questions: When and how should we image? How should we analyze the images? How should we interpret the imaging findings? To answer these questions, we address the indications in imaging axial SpA and the different imaging techniques, with a special focus on magnetic resonance imaging protocols. The value of different imaging modalities is discussed. For adequate image analysis, knowledge of the anatomy and the pathologic changes in chronic and acute inflammation of the sacroiliac joints and the spine is mandatory. Differential diagnoses of inflammatory lesions of the sacroiliac joints and the spine are addressed due to their importance in image interpretation.

Research paper thumbnail of Training Musculoskeletal Ultrasound Specialists: European Education and Clinical Guidelines: Work in Progress

The Practice of Radiology Education, 2010

Page 1. 143 T. Van Deven et al. (eds.), The Practice of Radiology Education, DOI: 10.1007/978-3-6... more Page 1. 143 T. Van Deven et al. (eds.), The Practice of Radiology Education, DOI: 10.1007/978-3-642-03234-9_10, © Springer Verlag Berlin Heidelberg 2010 Training Musculoskeletal Ultrasound Specialists: European Education and Clinical Guidelines: Work in ...

Research paper thumbnail of US-guided therapy of calcific tendinopathy: clinical and radiological outcome assessment in shoulder and non-shoulder tendons

Ultraschall in der Medizin (Stuttgart, Germany : 1980), 2011

To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lava... more To analyze the effectiveness and complication rate of ultrasound (US)-guided perforation and lavage using a two-needle technique with 16 - 18 G needles in the treatment of patients with calcific tendinopathy in the shoulder, elbow, hip, and knee by radiological and clinical follow-up. A retrospective chart review was performed and 40 patients (13 male, 27 female; mean age, 53.5 years; range 24 -74 years) were identified as having received US-guided perforation and lavage due to symptomatic calcific tendinopathy of the rotator cuff tendons, triceps, extensor and flexor tendons at the elbow, rectus femoris tendon and patellar tendons. The radiographic outcome was assessed by comparison of the size and quality of the calcification before and 6 weeks after the procedure. On US images, the quality of the acoustic shadow was assessed, together with other alterations of the tendon and surrounding tissue. Patients were interviewed by telephone to assess the clinical outcome regarding pre-tr...

Research paper thumbnail of Remitting seronegative symmetrical synovitis with pitting edema of the hands: Ultrasound, color doppler ultrasound, and magnetic resonance imaging findings

Arthritis and Rheumatism, 2005

Research paper thumbnail of Laparoscopic pyeloplasty for UPJ obstruction with crossing vessels: contrast-enhanced color Doppler findings and long-term outcome

Urology, 2002

To evaluate, in the present long-term follow-up study, contrast-enhanced color Doppler imaging (C... more To evaluate, in the present long-term follow-up study, contrast-enhanced color Doppler imaging (CDI) findings and the clinical outcome of patients with crossing vessels at the obstructed ureteropelvic junction (UPJ), who underwent laparoscopic pyeloplasty. In a previous study, contrast-enhanced CDI proved capable of detecting crossing vessels at the UPJ. A total of 23 patients, who had undergone laparoscopic pyeloplasty and displacement of crossing vessels for UPJ obstruction at least 2 years before this study (mean 27 months), underwent contrast-enhanced CDI, intravenous urography, and renography. Contrast-enhanced CDI was performed using intravenously administered Levovist to assess the displacement of the vessels relative to the UPJ. All patients completed analog follow-up pain scales and quality-of-life assessment questionnaires. RESULTS. Contrast-enhanced CDI revealed a cranial displacement (mean 1.3 cm) of the crossing vessels from the UPJ in all 23 cases. Intravenous urography showed a decrease in the degree of hydronephrosis, with a success rate of 100% in low-grade and 86% in high-grade hydronephrosis. The split renal function improved from 39.7% to 48.1%. Analog pain scale measurements demonstrated a mean improvement in pain of 92% (range 73% to 100%) and a mean quality-of-life score of 94 (range 78 to 100). Our series of patients with crossing vessels at the UPJ treated by laparoscopic pyeloplasty showed an excellent long-term successful outcome. Contrast-enhanced CDI allows for preoperative detection, as well as postoperative assessment, of the displacement of the crossing vessel. We recommend that the presence of a crossing vessel be routinely determined preoperatively, because it may influence the choice of treatment modality and thereby the clinical outcome.

Research paper thumbnail of Fusion of Real-time US with CT Images to Guide Sacroiliac Joint Injection in Vitro and in Vivo 1

Radiology, 2010

To evaluate if image fusion, a technology matching realtime ultrasonography (US) and a previously... more To evaluate if image fusion, a technology matching realtime ultrasonography (US) and a previously obtained computed tomographic (CT) scan, is a feasible aid for sacroiliac (SI) joint injections in cadavers and patients.

Research paper thumbnail of Carpal Tunnel Syndrome Assessment with US: Value of Additional Cross-sectional Area Measurements of the Median Nerve in Patients versus Healthy Volunteers 1

Radiology, 2009

To improve accuracy in the diagnosis of carpal tunnel syndrome (CTS) by comparing cross-sectional... more To improve accuracy in the diagnosis of carpal tunnel syndrome (CTS) by comparing cross-sectional area (CSA) measurements of the median nerve obtained at the level of the carpal tunnel (CSAc) with those obtained more proximally (CSAp), at the level of the pronator quadratus muscle.

Research paper thumbnail of Achilles Tendon Assessed with Sonoelastography: Histologic Agreement

Radiology, 2013

To compare and determine the level of agreement of findings at conventional B-mode ultrasonograph... more To compare and determine the level of agreement of findings at conventional B-mode ultrasonography (US) and sonoelastography of the Achilles tendon with findings at histologic assessment. This study was conducted with the approval of the institutional review boards, and all cadavers were in legal custody of the study institution. Thirteen Achilles tendons in 10 cadavers (four male, six female; age range, 70-90 years) were examined with B-mode US and sonoelastography. B-mode US grading was as follows: Grade 1 indicated a normal-appearing tendon with homogeneous fibrillar echotexture; grade 2, a focal fusiform or diffuse enlarged tendon; and grade 3, a hypoechoic area with or without tendon enlargement. Sonoelastography grading was as follows: Grade 1 indicated blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). Twenty-five biopsy specimens from representative lesions of the middle and distal thirds of the Achilles tendons were evaluated histologically. The concordance of B-mode US grading compared with sonoelastographic grading was assessed by using κ analysis. With B-mode US and sonoelastography, all 11 tendon thirds of histologically normal tendons were verified as normal (grade 1). Sonoelastography depicted 14 of 14 (100%) tendon thirds with histologic degeneration (grade 2 or 3), whereas B-mode US could depict only 12 of 14 (86%) lesions (grade 2 or 3). Only moderate agreement between B-mode US and sonoelastography was seen (κ = 0.52, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Sonoelastography might help predict signs of histopathologic degeneration of Achilles tendinosis, potentially more sensitively than B-mode US.

Research paper thumbnail of 18F-Fluorodeoxyglucose-positron emission tomography: A new explorative perspective

Experimental Gerontology, 2003

18F-Fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) is a new functional imaging tec... more 18F-Fluorodeoxyglucose-positron emission tomography (18F-FDG-PET) is a new functional imaging technique available for clinical and experimental use. 18F-FDG-PET studies can be used for screening, localization and follow-up of hypermetabolic processes including malignancies, infections and autoimmune processes. For several years it has been applied in oncological, cardiological and neurological patients, but nowadays an increasing number of studies favours its use in patients

Research paper thumbnail of Are Transition Zone Biopsies Still Necessary to Improve Prostate Cancer Detection?

European Urology, 2005

Objectives: The present retrospective study was designed to investigate the value of transition z... more Objectives: The present retrospective study was designed to investigate the value of transition zone (TZ) biopsies for prostate cancer (PC) detection rate in a combined contrast enhanced color Doppler targeted (CECD) and gray-scale systematic biopsy (SB) approach. Methods: PSA screening participants totalling 1475 with tPSA of >1.25 ng/ml (fPSA 18%) were assessed. Ten SB and additionally 5 or fewer CECD were performed. The impact of TZ biopsies on the PC detection rate and the biological significance of the detected TZ-cancers were analyzed. Results: Out of 1475 biopsied patients, 395 (26.8%) were identified as PC patients; 5925 biopsy cores from these patients were analyzed. In 86 patients (21.8% of PC), we found 102 PC-positive cores in the TZ, and only in 9 of them solitary TZ-cancers without any other PC-location (2.3% of PC or 0.6% of all investigated patients). Pathologic findings after retropubic prostatectomy (RPE) revealed multifocal adenocarcinoma including involved peripheral zone (PZ) in eight of these nine patients, and solitary TZ-cancer in one patient. There was no positive correlation between prostate volume and TZ-detection rate and no patient with solitary TZ-PC after rebiopsy. Conclusion: Biopsy revealed 9 solitary TZ cancers (1.8%) and RPE revealed only one of them to be truly TZconfined cancer (0.6%). Furthermore PC-detection did not improve, even in patients with rebiopsy, and there was no correlation between detection of TZ-cancers and prostate volume. A combined use of CECD and SB to investigate participants of a PSA-screening program suggests that TZ-biopsies do not improve PC detection rate and are therefore unnecessary. #