Radiology
Spectrum of examinations
- Magnetic resonance imaging (MRI)
- Multi-line spiral computed tomography
- Conventional x-ray diagnosis
- Ultrasonography diagnostics
- Angiography (digital subtraction angiography)
- Interventions
- Nuclear medical diagnostics
Magnetic resonance imaging (MRI)
Magnetic resonance imaging (MRI), formerly referred to as magnetic resonance tomography (the classical Greek words 'τομος' and 'γραφειν' mean 'cut' or 'slice' and 'scratch', 'scribe' or 'paint', respectively), is a method used to visualise the inner structures of the body. The MRI provides high-resolution section images which help to improve the analysis of organs and mutations of organs. One advantage of an MRI scan is that it is harmless to the patient. It uses strong magnetic fields and non-ionising radiation in the radio frequency range and does not involve doses of ionising radiation. Thus, the original name for this medical technology, 'nuclear magnetic resonance tomography', is somewhat misleading, and the word 'nuclear' has almost universally been dropped to prevent the patients from associating the examination with radiation exposure.
Functional magnetic resonance imaging is usually abbreviated to fMRI (in German: fMRT).
Spectrum of examinations performed by the department:
- MRI of the brain:
- Diagnosis of apoplectic stroke
- Tumour diagnosis and differential diagnosis
- Inflammation-associated mutations
- MRI of the spinal column
- Tumour diagnosis and differential diagnosis
- Inflammation-associated mutations
- Diagnosis of disc prolapse
- Unclear fractures, osseous lesions
- Special form: MR myelography
- (Visualisation of the spinal canal)
- MR mammography
- Tumour diagnosis and differential diagnosis
- MRI of the abdomen
- Tumour diagnosis and differential diagnosis
- Special method for the diagnosis of all abdominal organs:
- Liver, pancreas, kidneys and urinary tract, adrenal glands, genitals
- Diagnosis of the colon: particularly chronic inflammatory diseases
- Diagnosis of the bile ducts: MRCP
- Non-invasive form of visualisation of biliary and pancreatic ducts.
- MRI examinations of joints and limbs
- Injuries of sinews, muscles, ligaments etc.
- Inflammatory-associated mutations (e.g. rheumatism)
- Unclear fractures
- MRI of the heart
- Functional diagnostics with cardiovascular diseases
- Morphology
- Valve function
- Blood flow rate
- MR angiography
- Diagnosis of the vessels in case of impaired perfusion and problems concerning the vascular morphology in any part of the body (arterial vessels).
Computed tomography
Computed tomography (the classical Greek words 'τομος' and 'γραφειν' mean 'cut' or 'slice' and 'scratch', 'scribe' or 'paint', respectively) is performed by using a gamma camera to acquire multiple x-ray pictures from multiple angles which are then reconstructed using computed algorithms, yielding a 3D-dataset (Voxel data set). Computed tomography is used for tumour diagnosis and staging, post-operative classification of fractures and control of success as well as emergency diagnosis (acute abdominal discomfort, accidents, pulmonary embolism, aortic dissections), in particular.
The 16-line technology used allows the examination of vast bodily regions as well as their multiplanar and 3D reconstruction in no time.
In principle, all bodily regions can be examined:
- Cranial computed tomography (CCT)
- Plain CCT
- Diagnosis of apoplectic stroke (ischemia)
- In case of suspected inner-cranial bleeding
- Plain CCT with contrast agents
- Tumour diagnosis and diagnosis of metastases
- Paranasal sinuses
- In case of inflammations which are resistant to treatment DD Tumo
- Cranial face and cranial base
- Confirmation or exclusion of fractures after an accident
- Examination of the petrous bone
- CT of the neck
- CT of the neck with contrast agents
- Tumour detection and staging
- CT of the upper part of the body
- CT thorax
- Tumour diagnosis of the lungs and the mediastinal cavity
- Diagnosis of the parenchyma, in case of infiltration, chronic mutations of the lungs. Virtual bronchoscopy
- Angiography of the arteria pulmonalis
- In case of suspected pulmonary embolism
- In preparation:
- CT of the cardiac vessels (coronary angiography)
- Diagnosis of mutations of the coronary arteries
- Noninvasive alternative to the diagnostic heart catheter
- CT of the abdominal cavity
- CT of the abdomen
- Tumour detection and staging
- In case of retention, abscess
- Clarification of injury consequences
- CT of the liver
- Special tumour diagnosis of the liver
- Pancreas (hydro-CT)
- Special tumour diagnosis of the pancreas
- CT of the colon (hydro-´CT) with rectal application of contrast agents
- In case of suspected tumours, inflammatory mutations within the lesser pelvis
- CT of the bony skeleton
-
- Spinal column (cervical, thoracic, lumbar spine, coccygeal bone)
- Diagnosis of fractures, disc prolapses, oesteolysis
- Vascular diagnostics (CT-angiography)
-
- Angiography of the aorta
- Presumption of dissection
- Preoperative diagnosis of aneurysms
- Interventional therapy
-
- CT-controlled pain therapy (blocks of facette-joints)
- CT-controlled inserting of a drainage in case of abscesses
- CT-controlled biopsy for tumour diagnosis
- Further CT examinations / interventions in case of specific problems
Angiography
Angiography is a medical imaging technique in which x-rays are used to visualise bloodfilled structures. A contrast agent, which absorbs x-rays, is injected into the vessels which afterwards can be seen as shadow picture on the x-ray film. This resulting picture is called angiogram.
The contrast radiography of veins is called phlebography, the contrast radiography of arteries angiography.
The contrast radiography of coronary arteries is called coronary angiography. If varicose veins are visualised via direct puncture of the respective vessel, we speak of varicography.
Angiography is mainly used for the diagnosis of important vascular diseases.
Diseases of the arteries:
- Arteriosclerosis and consecutive disorders (compression of vessels, e.g. coronary heart disease, carotid stenosis, peripheral occlusion of arteries)
- Accute occlusions of arteries, e.g. cardiac infarction
- Sacculation of vessels, (aneurysms)
- Injured arteries
- Malformation of arteries
Diseases of veins:
- Thrombosis
- Varicosis
Furthermore, angiography sometimes is used to clarify the course of important vessels before an operation.
An important advantage of the angiography is that interventions can be performed while examining the vessels.
Occluded vessels can be widened (angioplasty), blood clot can be dissolved and aneurysms can be eliminated, and, in certain circumstances, shifted catheters can be readjusted.
Conventional x-ray diagnosis (roentgenography)
'Roentgen' (named after the German physicist Wilhelm Roentgen) is a medical technique using electromagnetic radiation to view inner structures of the body. The word stands for:
- The process of penetrating through the body via x-rays,
- The visualisation of this penetration via a fluorescent screen or an image intensifier (fluoroscopy),
- The recording of the penetration of the body on appropriate photographic film (radiography),
- The recording of the penetration of the body by means of electronic sensors, e.g. CCDs (digital radiography),
In the field of medicine, roentgenography is used to identify anomalies within the body. It is a powerful diagnostic tool that helps analysing disorders of many kinds.
Since the human (and animal) body is made up of various tissues with differing densities, x-rays can be used to reveal the internal structure of the body on film by highlighting these difference using the absorption of x-ray photons by the denser substances. Thus, x-rays are very often used in case of suspected bone fracture: if the x-ray picture shows a discontinuity of the bone structure, the presumption is confirmed.
Quite often, patients are given contrast agents before the x-ray examination. This is, because there are some structures which cannot be defined otherwise. Partly, the function of an organic system can be visualised by using contrast agents, such as in urography. Depending on the respective problem, a variety of substances and ways of administration is used.
(Top of page)Ultrasonography
Ultrasonography (also known as echography) is a medical technology that uses ultrasound for the visualisation of tissues of the human or animal body as well as for the scanning of technical structures.
Since its introduction in the 1970s, ultrasonography has become the most frequently used medical imaging technique. Its main advantage in comparison to conventional radiology is that the ultrasound waves used mean no harm to the patient. It can therefore be used for very sensitive tissue, such as with embryos. Furthermore, the examination rarely causes any pain or discomfort to the patient.
Ultrasonography is the most important imaging technique for the differential diagnosis of an acute abdomen, gall stones or the analysis of vessels as to perfusion, particularly in the legs. It is the standard procedure for the examination of the thyroid gland, the heart, the kidneys and the bladder.
Ultrasonography is an appropriate means for first analysis and staging in case of medical or radiotherapeutic treatment of malign diseases.
It helps detecting regions suspicious for cancer as well as obtaining information as to whether those focuses are malign, or not. In addition, it can be used to guide therapeutic procedures, such as biopsies or cytologiesy (withdrawal of specimen of free liquid).
(Top of page)Interventions
The use of minimal-invasive radiological intervention adds further therapeutic possibilities to the imaging techniques used:
- Vascular interventions
- PTA
- Lysis treatment
- Procedures for embolisation
- Biliary drainage (PTCD)
- Drainage of abscesses
- Ultrasonography or CT controlled biopsies
- Interventional pain therapy
- Blocks of facette-joints
- Periradicular therapy
- Sympathicolosis
Nuclear medicine
Nuclear medicine is a branch of medicine and medical imaging that uses radiopharmaceuticals for diagnosis, therapy and scientific purposes. A radiopharmaceutical is a radionuclide or a chemical compound of a nuclide and other substances.
How a radiopharmaceutical is used in nuclear medicine mainly depends on two factors:
- Radiactivity (collapse rate and spontaneous radiation)
- Parmacokinetics (distribution within the organism, metabolism, elimination)
The diagnostic procedures of nuclear medicine (such as planar scintiscanning, positron-emission tomography (PET) and single-photon-emission computed tomography (SPECT)) are based upon the detection of gamma rays or annihilation radiation emitted by the administered radiopharmaceutical ('tracer').
These procedures visualise the function of an organ or organic system, whereas static imaging techniques mainly show the structure of the respective organ.
In bone scanning, for instance, a radiopharmaceutical (Technetium-99m-methylendiphosphonate) is used that is absorbed by bone cells (osteoblasts), in particular. Ordinary bone tissue shows low activity in the resulting scan, which is due to normal physiologic activity; hence, high activity is suspicious of pathological processes which can be due to healing fractures, cancer, benign tumours, arthrosis or the inflammation of the respective bone.
Dynamic examinations are a further example for the functional character of nuclear medicine. In renal function scintiscanning, for example, a series of pictures is taken in intervals between one and 60 seconds over a period of 20 to 40 minutes. The absorption and excretion of the radiopharmaceutical in different organs can then be visualised in charts which makes the analysis of the excretion performance of one kidney compared to the other possible.
The department of nuclear medicine is equipped with a dual-head gamma camera which is able to perform scintiscanning of all organs as well as SPECT and PET examinations.
Untersuchungsspektrum
- Magnetresonanztomographie
- Mehrzeilen-Spiralcomputertomographie
- Konventionelle Roentgendiagnostik
- Ultraschalldiagnostik
- Angiographie (digitale Subtraktionsangiographie)
- Interventionelle Eingriffe
- Nuklearmedizinische Diagnostik
Head physician:
Thomas Hess MD
Specialist in diagnostic radiology
Phone: +49.6431.292-4550
Fax: +49.6431.292-4566
e-mail: t.hess@st-vincenz.de
Assistant medical directors:
Juergen Bomert
Specialist in radiology, special field: nuclear medicine
Phone: +49.6431.292-4552
e-mail: j.bomert@st-vincenz.de
Andrea Leidermann-Jost MD
Specialist in diagnostic radiology
Phone: +49.6431.292-4553
e-mail: a.leidermann-jost@st-vincenz.de
Kay Becker MD
Specialist in diagnostic radiology
Phone: +49.6431.292-4554
e-mail: k.becker@st-vincenz.de
Specialist in nuclear medicine:
Marita Schmidt
Residents:
Peter Schmitz
Marc Bussian MD
Bernhard Woelk
Further assistants:
Medical laboratory technician for diagnostic and interventionist radiology:
Gabriele Wilhelm
Deputy: Heinz Dorn
Senior medical laboratory technician for nuclear medicine:
Karin Hoss
Deputy: Daniela Stillger