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Primary aldosteronism (PA) is the most common detectable cause of secondary hypertension. The majority of patients have either an adrenal aldosterone-producing adenoma (APA) or bilateral adrenal hyperplasia (BAH) demanding different therapeutic approaches. Screening tests and imaging cannot reliably distinguish between a unilateral or bilateral PA.
This review article gives an overview concerning etiology, diagnostics, and therapeutic options of PA, and reviews the indication, the technique, and relevance of selective adrenal venous sampling (AVS) in the context of the current literature and the authors’ experience.
AVS can verify or exclude a unilaterally dominated secretion with a high success rate. Patients with PA and a unilateral APA can be treated curatively by adrenalectomy.
AVS is an established diagnostic examination for differentiation of unilateral from bilateral adrenal disease in patients with PA.
· Selective adrenal venous sampling (AVS) is a safe, reliable, and minimally invasive method to detect a unilateral or bilateral adrenal adrenal gland disease.. · Verification of lateralization by AVS has direct therapeutic relevance for patients with primary aldosteronism (PA).. · AVS can be performed with low radiation exposure, without contrast medium, and with a high success rate when performed by an experienced interventional radiologist..
· Loberg C, Antoch G, Stegbauer J et al. Update Selective adrenal venous sampling (AVS) – Indication, technique, and significance. Fortschr Röntgenstr 2020; DOI 10.1055/a-1299-1878.
· Loberg C, Antoch G, Stegbauer J et al. Update Selective adrenal venous sampling (AVS) – Indication, technique, and significance. Fortschr Röntgenstr 2020; DOI 10.1055/a-1299-1878.
The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman.
Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology.
Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo or fetus caused by the radiation is low and tcedure for calculating radiation exposures and the associated risks for the unborn child.. · Using the two-step model, only a simple assessment based on the first step is necessary for most prenatal radiation exposures.. · With the given tables it is possible to estimate individual risks for the unborn child taking into account the radiation exposure.. · Only in the rare case that the first estimate results in a uterine dose larger 20 mSv a more accurate calculation is necessary..
· Fiebich M, Block A, Borowski M et al. Prenatal radiation exposure in diagnostic and interventional radiology. check details Fortschr Röntgenstr 2020; DOI 10.1055/a-1313-7527.
· Fiebich M, Block A, Borowski M et al. Prenatal radiation exposure in diagnostic and interventional radiology. Fortschr Röntgenstr 2020; DOI 10.1055/a-1313-7527.Due to its excellent intrinsic soft tissue contrast, magnetic resonance imaging allows excellent visualization and anatomical separation of therapy-relevant risk structures such as the mesorectal fascia, local lymph nodes, and vascular structures in patients with rectal carcinoma. This makes magnetic resonance imaging (MRI) a valuable evaluation method for further therapeutic stratification. In particular, MRI is indispensable for the decision to refrain from neoadjuvant therapy and to choose a primary surgical approach. In addition to the oncologically generally relevant T-, N-, and M-criteria, two further parameters are included the extramural vascular infiltration and the circumferential resection margin. Due to the significant impact of MRI on further therapeutic decision-making, standardized MR image quality is considered essential. KEY POINTS · Magnetic resonance imaging is a valuable evaluation method for further therapeutic stratification.. · Critical anatomic landmarks for evaluation are circumferential resection margins.. CITATION FORMAT · Attenberger UI, Clasen S, Ghadimi M et al. Importance and Qualitative Requirements of Magnetic Resonance Imaging for Therapy Planning in Rectal Cancer – Interdisciplinary Recommendations of AIO, ARO, ACO and the German Radiological Society. Fortschr Röntgenstr 2021; 193 513 - 520.
To date, didactic lecturing is a common method of university medical training. However, higher levels of competence to solve complex issues are hardly to be achieved with a largely passive learning style. We established and evaluated a heutagogical blended learning concept to investigate self-determined learning with a multimedia-based, interactive approach in the lecture room to teach clinical radiology.
In the 2019/2020 winter semester, we included 266 medical students in their fourth academic year in our prospective, observational study. Students participated in a series of 11 radiological lectures given by 10 lecturers. They were requested to prepare for lectures by watching learning videos. During the lecture, students had to answer key-feature questions (KFQ) in small groups and to jointly submit their answers by means of an audience response system (ARS). After each lecture and the exam, we conducted surveys and compared results with a historical control group. A focus group interview with lecturroom” concept for radiological lectures was rated high by students.. · Most students were satisfied with the multimedia and interactive elements of lectures.. · Lecturers considered heutagogical learning demands as appropriate for later clinical requirements..
· Teichgräber U, Ingwersen M, Mentzel H et al. Impact of a Heutagogical, Multimedia-Based Teaching Concept to Promote Self-Determined, Cooperative Student Learning in Clinical Radiology. Fortschr Röntgenstr 2020; DOI 10.1055/a-1313-7924.
· Teichgräber U, Ingwersen M, Mentzel H et al. Impact of a Heutagogical, Multimedia-Based Teaching Concept to Promote Self-Determined, Cooperative Student Learning in Clinical Radiology. Fortschr Röntgenstr 2020; DOI 10.1055/a-1313-7924.