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Nuklearmedizin 1984; 23(05): 213-220
DOI: 10.1055/s-0038-1624247
Originalarbeiten – Original Articles
Schattauer GmbH

Die Bedeutung der Kernspintomographie in der heutigen Diagnostik[*]

Significance of Nuclear Magnetic Resonance Imaging in Present-Day Diagnosis
B. Hünerniann
1   Aus der Praxis für Nuklearmedizin, Köln-Weiden, Bundesrepublik Deutschland
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Further Information

Publication History

Eingegangen: 03 August 1984

Publication Date:
11 January 2018 (online)

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Zusammenfassung

An einem Kernspintomographen, der mit einem supraleitenden 0,3-Tesla-Magneten ausgerüstet ist, wurden bisher ca. 500 Patienten untersucht. Basierend auf dieser Erfahrung sowie auf einer Zusammenstellung der Literatur wird über die derzeitigen, bereits klinisch einsetzbaren Möglichkeiten der Kernspintomographie berichtet. Die Darstellung in drei Schichtebenen, der hohe Weichteilkontrast und das unterschiedliche Signalverhalten von neoplastischem und gesundem Gewebe führen zu hervorragenden diagnostischen Ergebnissen in allen Organbereichen. Den Schwerpunkt der kernspintomographischen Untersuchungen bildet z. Zt. noch das zentrale Nervensystem, wobei die Diagnostik von Prozessen der hinteren Schädelgrube und des Spinalkanals sowie von Fehlbildungen im zervikokranialen Übergangsbereich eine überragende Bedeutung besitzt. Das Fehlen standardisierter Aufnahmeparameter sowie die noch weiter zu entwickelnde Erfahrung der Untersucher erlaubt einen routinemäßigen Einsatz der Kernspintomographie nur in begrenztem Umfang. Dennoch sollten die Vorteile dieses Verfahrens – keine invasive Technik, keine ionisierenden Strahlen, keine jodhaltigen Röntgenkontrastmittel – bei gezielter Indikation in klinisch bereits abgesicherten Bereichen dem Patienten auch zum jetzigen Zeitpunkt nicht vorenthalten werden.

Summary

Up to now, a total of 500 patients were examined using a nuclear magnetic resonance imaging system which utilizes a 0.3 Tesla magnet. These data together with others reported in the literature show the possible clinical applications of this technique. Images in 3 projections, high soft-tissue contrast, and different NMR signals lead to outstanding diagnostic visualization of regular tissue and malignant lesions. NMR is currently centred on the central nervous system. Of great importance is its ability to detect lesions in the posterior fossa and in the spinal canal as well as malformations in the cervicocranial area. The routine use in clinical practice is limited by the lack of standardized imaging parameters and of experience by the examiner himself. But because NMR has the advantages of not being an invasive technique and avoiding radiation or iodinecontaining contrast media, patients should, even at this early stage and given a clear indication, not to be deprived of these advantages.

* Herrn Prof. Dr. med. Dr. rer. nat. h. c. C. Winkler zum 65. Geburtstag.


 

  • Literatur

  • 1 Axel L. Surface coil magnetic resonance imaging. J. Computer Ass. Tomogr 1984; 8: 381-4.
    Google Scholar
  • 2 Bewermeyer H, Dreesbach H. A., Hünermann B, Heiss W. D. NMRimaging of familial basilar impression. J. Computer Ass. Tomogr. (im Druck 1984).
    Google Scholar
  • 3 Bradley W. G., Yadley R. A., Wycoff R. R. The appearance of different forms of brain edema on NMR. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 57-8.
    Google Scholar
  • 4 Bradley W. G., Waluch V, Henderson R. W., Bryan D. C., Kassabian J. P. NMR imaging of the pelvis at 0.35 Tesla. Radiology 1983; 149: 145.
    CrossrefPubMedGoogle Scholar
  • 5 Bryan P. J., Butler H. E., Lipuma J. P., Resnick M. I., El Yousef S. J., Cohen A. M., Lieberman J. M., Haaga J. R., Cohen J, Andriole J. G., Alfidi R. J. NMR of the prostate. Radiology 1983; 149: 145.
    CrossrefPubMedGoogle Scholar
  • 6 Bydder G. M., Steiner R. E., Young I. R., Hall A. S., Thomas D. J., Marshall J, Pallis C. A., Legg N. J. Clinical NMRimaging of the brain: 140 cases. Amer.-J. Radiol 1982; 139: 215-36.
    Google Scholar
  • 7 Bydder G. M., Steiner R. E. NMR imaging of the brain. Neuroradiology 1982; 23: 231-40.
    CrossrefPubMedGoogle Scholar
  • 8 Bydder G. M., Steiner R. E., Thomas D. J., Marshall J, Gilderdale D. J., Young I. R. Nuclear magnetic resonance imaging of the posterior fossa: 50 cases. Clin. Radiol 1983; 34: 173-88.
    CrossrefPubMedGoogle Scholar
  • 9 Carr D. H., Brown J, Leung A. W.-L, Pennock J. M. Iron and gadolinium chelates as contrast agents in NMR imaging. J. Computer Ass. Tomogr 1984; 8: 385-9.
    Google Scholar
  • 10 Genant H. K., Moon K, Helms C, Morris J. M. NMR in the diagnosis of lumbar disc rupture. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 81-2.
    Google Scholar
  • 11 Coin C. G., Fayetteville M. D., Damadian R. Diagnosis of degeneration and herniation of the nucleus pulposus by nuclear magnetic resonance (NMR). Radiology 1983; 149: 237.
    Google Scholar
  • 12 Daniels D. L., Herfkins R, Koehler P. R., Millen S. J., Shaffer K. A., Williams A. L., Haughton V. M. Magnetic resonance imaging of the internal auditory canal. Radiology 1984; 151: 105-8.
    CrossrefPubMedGoogle Scholar
  • 13 Daniels D. L., Grogan J. P., Williams A. L., Haughton V. M. NMR detection of multiple sclerosis involving the spinal cord. Radiology 1983; 149: 237.
    Google Scholar
  • 14 van Dijk P. Direct cardiac NMR imaging of heart wall and blood flow velocity. J. Computer Assisted Tomography 1984; 8: 429-36.
    CrossrefPubMedGoogle Scholar
  • 15 Dillon W, Mills C. M., Brant-Zawadzki M, Crooks L, Kaufmann L. Spin-echo imaging of the nasopharynx: Normal and pathologic anatomy. Scient. Program. 2nd. Ann. Meet, Soc. of NMR in Med. San Francisco: 1983: 113.
    Google Scholar
  • 16 Dixon W. T. Chemical shift imaging with proton NMR at 0.35 Tesla. Radiology 1983; 149: 238.
    Google Scholar
  • 17 Fletcher B. D., Jacobstein M. D., Nelson A. D., Riemenschneider T. A., Alfidi R. J. Gated magnetic resonance imaging of congenital cardiac malformations. Radiology 1984; 150: 137-40.
    CrossrefPubMedGoogle Scholar
  • 18 Fletcher B. D., Scoles P. V., Nelson A. D. Osteomyelitis in children: Detection by magnetic resonance. Radiology 1984; 150: 57-60.
    CrossrefPubMedGoogle Scholar
  • 19 Friedmann G, Steinbrich W. Ist die Kernspintomographie bereits eine Routinemethode?. Zbl. Radiol 1984; 128: 115.
    Google Scholar
  • 20 George C. R., Jacobs G, Mac Intyre W. J., Lorig R. J., Kramer D. M., Go R. T., Nose Y, Meaney T. F. NMR analysis of fluid mechanics in large vessels. Radiology 1983; 149: 28.
    Google Scholar
  • 21 George C. R., Jacobs G, Mac Intyre W. J., Lorig R. J., Go R. T., Nose Y, Meaney T. F. Magnetic resonance signal intensity patterns obtained from continuous and pulsatile flow models. Radiology 1984; 151: 421-8.
    CrossrefPubMedGoogle Scholar
  • 22 Mc Ginnis B. D., Brady T. J., New P. F.J, Buonanno F. S., Pykett I. L., de la Paz R. L., Kistler J. P., Taveras J. M. Nuclear magnetic resonance (NMR) imaging of tumors in the posterior fossa. J. Computer Ass. Tomogr 1983; 7: 575-84.
    Google Scholar
  • 23 Go R. T., Mac Intyre W. J., Yeung H. N., Kramer D. M., Geisinger M, Chilcote W, George C, O’Donnell J. K., Moodie D. S., Meaney T. F. Volume planar gated cardiac magnetic resonance imaging: A correlative study of normal anatomy with thallium-201 SPECT and cadaver sections. Radiology 1984; 159: 129-35.
    Google Scholar
  • 24 Gross M, Beach P. D. The simultaneous occurrence of renal carcinoma cyst: Problems in management. South, med. J 1971; 64: 1059-62.
    CrossrefPubMedGoogle Scholar
  • 25 Grossmann R. I., Wolf G, Biery D, Mc Grath J, Kundel H, Aronchick J, Zimmermann R. A., Goldberg H. I., Bilaniuk L. T. Gadolinium enhanced nuclear magnetic resonance images of experimental brain abscess. J. Computer Ass. Tomogr 1984; 8: 204-7.
    Google Scholar
  • 26 Hans J. S., Kaufmann B, Alfidi R. J., Yeung H. N., Benson J. E., Haaga J. R., El Yousef S. J., Clampitt M. E., Bonstelle C. T., Huss R. Head trauma evaluated by magnetic resonance computed tomography: A comparison. Radiology 1984; 150: 71-7.
    CrossrefPubMedGoogle Scholar
  • 27 Heller M, Moon K. L., Helms C. A., Schild H, Chafetz N. I., Rodrigo J, Jergesen H. E., Genant H. K. NMR imaging of femoral head necrosis. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 152-3.
    Google Scholar
  • 28 Herfkens R. J., Higgins C. B., Hricak H, Lipton M. J., Crooks L. E., Lanzer P, Botvinick E, Brundage B, Sheldon P. E., Kaufmann L. Nuclear magnetic resonance imaging of the cardiovascular system: Normal and pathologic findings. Radiology 1983; 147: 749-59.
    CrossrefPubMedGoogle Scholar
  • 29 Hilal S. K., Maudsley A. A., Simon H. E., Wittekoek S. In vivo NMR imaging of phosphorus. Radiology 1983; 149: 255.
    Google Scholar
  • 30 Hricak H, Tanagho E. A., Williams R. D., Schmidt R. A., Crooks L. E. The value of multiplanar NMR imaging of the male pelvis. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 171.
    Google Scholar
  • 31 Hricak H, Filly R. A., Margulis A. R., Moon K. L., Crooks L. E., Kaufmann L. Nuclear magnetic resonance imaging of the gallbladder. Radiology 1983; 147: 481-4.
    CrossrefPubMedGoogle Scholar
  • 32 Hricak H, Williams R. D., Moon K. L., Moss A. A., Alpers C, Crooks L. E., Kaufmann L. Nuclear magnetic resonance imaging of the kidney: Renal masses. Radiology 1983; 147: 765-72.
    CrossrefPubMedGoogle Scholar
  • 33 Hricak H, Crooks L, Sheldon P, Kaufmann L. Nuclear magnetic resonance imaging of the kidney. Radiology 1983; 146: 425-32.
    CrossrefPubMedGoogle Scholar
  • 34 Johnson M. A., Pennock J. M., Bydder G. M., Steiner R. E., Thomas D. J., Hay ward R, Bryant D. R. T., Payne J. A., Levene M. I., Whitelaw A, Dubowitz L. M.S, Dubowitz V. Clinical NMRimaging of the brain in children: Normal and neurologic disease. Amer. J. Neuroradiol 1983; 4: 1013-26.
    Google Scholar
  • 35 Kneeland J. B., Saddekni S, Sos T. A., Westcott J. L., Cahill P. T. Initial experience with cardiac gating on 0.5-T NMR imaging system. Radiology 1983; 149: 47.
    Google Scholar
  • 36 Knopp R, Schmidt H, Biersack H. J., Winkler C. Untersuchung zur Technik der Kernspinresonanz-(NMR)-Tomographie - Parametische T2-Darstellung (Spin-Spin-Relaxation). NUC-Comp 1982; 13: 289-90.
    Google Scholar
  • 37 Kressel H, Axel L, Thickman D, Pollack H. M., Banner M. C., Arger H. P., Edelstein W. Resistive (0.12-T) NMR imaging of renal disease. Radiology 1983; 149: 216.
    Google Scholar
  • 38 Kutzim H, Buschsieweke V, Fuchs M. Phasenbezogene NMR-Studien des Herzens (Ermittlung ventrikulärer Funktionsparameter und deren Darstellung in Funktionalbildern). Zbl. Radiol 1984; 128: 115.
    Google Scholar
  • 39 Lanzer P, Botvinick E. H., Schiller N. B., Crooks L. E., Arakawa M, Kaufmann L, Davis P. L., Herfkens R, Lipton M. J., Higgins C. B. Cardiac imaging using gated magnetic resonance. Radiology 1984; 150: 121-7.
    CrossrefPubMedGoogle Scholar
  • 40 Leung A. W.-L, Steiner R. E., Young I. R. NMR imaging of the liver in two cases of iron overload. J. Computer Ass. Tomogr 1984; 8: 446-9.
    Google Scholar
  • 41 Leung A, Steiner R. E., Young I. R. NMR-imaging of the kidney. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 217.
    Google Scholar
  • 42 Levene M. I., Whitelaw A, Dubowitz V, Bydder G. M., Steiner R. E., Randell C. P., Young I. R. Nuclear magnetic resonance imaging of the brain in children. Brit. med. J 1982; 285: 774-6.
    CrossrefPubMedGoogle Scholar
  • 43 Lipuma J. P., Brian P. J., Cohen A. M., Butler H. E., El Yousef S. E., Haaga J. R., Alfidi R. J., Hau T, Miraldi F. D. Renal transplant NMR. Radiology 1983; 149: 216.
    Google Scholar
  • 44 Modic M. T., Weinstein M. A., Pavlicek W, Starnes D. L., Duchesneau P. M., Boumphrey F, Hardey R. J. Nuclear magnetic resonance imaging of the spine. Radiology 1983; 148: 757-62.
    CrossrefPubMedGoogle Scholar
  • 45 Modic M. T., Weinstein M. A., Dengal F, Pavlicek W, Duchesneau P. M., Boumphrey F, Ngo F. Q.H, Hardy R. Magnetic resonance scanning of intervertebral disk disease. Radiology 1983; 149: 71.
    Google Scholar
  • 46 Moon K. L., Genant H. K., Helms C. A., Chafetz N. I., Crooks L. E., Kaufmann L. Musculoskeletal applications of nuclear magnetic resonance. Radiology 1983; 147: 161-71.
    CrossrefPubMedGoogle Scholar
  • 47 Moss A. A., Goldberg H. I., Stark D. B., Davis P. L., Margulis A. R., Kaufmann L, Crooks L. E. Hepatic tumors: Magnetic resonance and CT appearance. Radiology 1984; 150: 141-7.
    CrossrefPubMedGoogle Scholar
  • 48 Pfannenstiel P, Meves M, Rinck P. A. et al.: Gegenwärtiger Stand der NMR-Tomographie bei Untersuchungen des Gehirns und des Rückenmarks. Zbl. Radiol 1984; 128: 114.
    Google Scholar
  • 49 Price A. C., Runge V. M., Smith G. D., Allen J. H., Partain C. L., James A. E. NMR imaging of the pituitary gland at 0.5 Tesla. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 3.
    Google Scholar
  • 50 Runge V. M., Clanton J. A., Lukehart C. M., Jones M. M., Partain C. L., James A. E. NMR contrast agent design. Radiology 1983; 149: 98.
    Google Scholar
  • 51 Schörner W, Felix R, Laniado M, Lange L, Weinmann H-J, Claussen C, Fiegler W, Speck U, Kazner E. Prüfung des kernspintomographischen Kontrastmittels Gadolinium-DTPA am Menschen. Fortschr. Röntgenstr 1984; 140: 493-500.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 52 Singer J. R., Crooks L. E. NMR blood flow measurements combined with imaging. Scient. Program. 2nd. Ann. Meet. Soc. of NMR in Med. San Francisco: 1983: 338.
    Google Scholar
  • 53 Smith F. W., Mc Lay K, Rainer C, Clarke P, Hutchison J. M. S, Mallard J. R. Proton imaging in the management of head and neck tumours. Scient. Program, en2nd. Ann. Meet. Soc. of NMR in Med. 1983. San Francisco: 345.
    Google Scholar
  • 54 Spring D. B. Pelvic sidewall anatomy: NMR and CT correlation. Radiology 149 1983; 144.
    CrossrefGoogle Scholar
  • 55 Stark D. D., Moss A. A., Goldberg H. I., Davis P. L., Federle M. P. Magnetic resonance CT of the normal and diseased pancreas: A comparative study. Radiology 1984; 150: 153-62.
    CrossrefPubMedGoogle Scholar
  • 56 Stark D. D., Bass N. M., Moss A. A., Bacon B. R., Mc Kerrow J. H., Cann C. E., Brito A, Goldberg H. I. Nuclear magneticc resonance imaging of experimentally induced liver disease. Radiology 1983; 148: 743-51.
    CrossrefPubMedGoogle Scholar
  • 57 Stark D. D., Goldberg H. I., Moss A. A., Bass N. M. Chronic liver disease: Evaluation by magnetic resonance. Radiology 1984; 150: 149-51.
    CrossrefPubMedGoogle Scholar
  • 58 Steiner R. E., Bydder G. M. Nuclear magnetic resonance in gastroenterology. Clin. Gastroenterol 1984; 13: 265-79.
    Google Scholar
  • 59 Ullrich C. G., Easton E. J., Salmon R. B., Parsons R. G., Grubb W. L., Floyd G. M., Patel R. F. Nuclear magnetic resonance scanning of the spinal cord. Radiology 1983; 149: 144.
    CrossrefGoogle Scholar
  • 60 Wehrli F. W., Mc Fall J. R., Shutts D, Breger R, Herfkens R. J. Mechanism of contrast in NMR imaging. J. Computer Ass. Tomogr 1984; 8: 369-80.
    Google Scholar
  • 61 Young I. R., Hall A. S., Pallis C. A., Bydder G. M., Legg N. J., Steiner R. E. Nuclear magnetic resonance imaging of the brain in multiple sclerosis. Lancet 1981; 14: 1063-6.
    Google Scholar
  • 62 Young I. R., Clarke G. J., Bailes D. R., Pennock J. M., Doyle F. H., Bydder G. M. Enhancement of relaxation rate with paramagnetic contrast agents in NMR imaging. J. Computer Ass. Tomogr 1981; 5: 543-7.
    Google Scholar
  • 63 Zeitler E, Schuierer G, Wojtowycz M, Reichenberger H, Wirth A, Stetter E, von Wulfen H. EKG-getriggerte NMR-Tomographie des Herzens. Fortschr. Röntgenstr 1984; 140: 487-93.
    Article in Thieme ConnectPubMedGoogle Scholar