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Radiology

Spectrum of examinations

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:

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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:

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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:

Diseases of veins:

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:

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.

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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).

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Interventions

The use of minimal-invasive radiological intervention adds further therapeutic possibilities to the imaging techniques used:

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:

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.

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