Visceral artery aneurysms (VAA) are relatively rare disease patterns. With regard to the aetiology two different entities of VAA can be distinguished: (i)  real VAA, where arteriosclerosis plays an important role, particular in elderly patients, and (ii)  pseudo-aneurysms. Here, previous abdominal trauma or former inflammatory processes are considered to be the responsible factors for their occurrence. Most frequently, VAA are located in the splenic (60%) and common hepatic artery (20-50%). The common hepatic artery (80%) and the pancreatico-duodenal artery (75%) feature the highest rupture rates. Generally all VAA with a diameter exceeding 2 cm should be treated. Special attention has to be paid to young pregnant women (particularly multipara) who bear the highest risk of VAA rupture, especially during the third trimenon. Early therapy is essential to avoid fatal consequences for mother and foetus. Basically, interventional, endovascular (embolisation, stent) or surgical (resection with direct vessel anastomosis, graft interposition, aneurysmorraphy, ligature) therapy options exist. The choice of the intervention should be adapted to the patient's individual risk profile. In our own series of VAA (n=19; 1996-2007), we evaluated both interventional and surgical procedures as valid therapy regimens with regard to the patients clinical condition.

In contrast to B-mode sonography, RTE is able to detect and visualize peripheral, non-pleural adherent pulmonary lesions.

Retroperitoneal fibrosis represents a rare inflammatory disease. About two thirds of all cases seem to be idiopathic (= Ormond's disease). The remaining one third is secondary and may be ascribed to infections, trauma, radiation therapy, malignant diseases, and the use of certain drugs. Up to 15 % of patients have additional fibrotic processes outside the retroperitoneum. The clinical symptoms of retroperitoneal fibrosis are non-specific. In sonography retroperitoneal fibrosis appears as a retroperitoneal hypoechoic mass which can involve the ureters and thus cause hydronephrosis. Intravenous urography and MR urography can demonstrate the typical triad of medial deviation and extrinsic compression of the ureters and hydronephrosis. CT and MRI are the modalities of choice for the diagnosis and follow-up of this disease. The lesion typically begins at the level of the fourth or fifth lumbar vertebra and appears as a plaque, encasing the aorta and the inferior vena cava and often enveloping and medially displacing the ureters. In unenhanced CT, retroperitoneal fibrosis appears as a mass that is isodense with muscle. When using MRI, the mass is hypointense in T 1-weighted images and of variable intensity in T 2-weighted images according to its stage: it may be hyperintense in early stages, while the tissue may have a low signal in late stages. After the administration of contrast media, enhancement is greatest in the early inflammatory phase and minimal in the late fibrotic phase. Dynamic gadolinium enhancement can be useful for assessing disease activity, monitoring response to treatment, and detecting relapse. To differentiate retroperitoneal masses, diffusion-weighted MRI may provide useful information.

We report two cases of inflammatory pseudotumors of the urinary bladder, one case of a chronic granulomatous pseudotumor (CGT) and one case of a pseudosarcomatous myofibroblastic (fibromyxoid) tumor (PMT). Both tumors resembled malignancies such as rhabdomyosarcomas regarding clinical appearance and imaging findings and represent rare urinary bladder tumors. The imaging findings on unenhanced and contrast-enhanced MRI as well as histological specimen are presented. Final diagnosis was made following elective surgery. Differential diagnosis of urinary bladder tumors as well as the imaging findings of these clinically comparable cases are discussed. Awareness of these benign lesions may prevent patients from inappropriate therapies such as chemotherapy or radiation therapy.

Zusammenfassung Ziel: Effizienz der Strahlenschutzmittel bez?glich der Augenlinsendosis des Untersuchers bei fluoroskopischen Interventionen. Material und Methoden: Ein Patientenphantom wurde an einer DSA-Anlage exponiert. Dosismessungen erfolgten mittels Ionisationskammer in Augenposition des Untersuchers. Die Messungen imitierten fluoroskopische Interventionen, wobei die Reduktion der Streustrahlung durch den tischmontierten Strahlenschutz (Untertisch-Vorhang und ?bertisch-Aufsatz) beurteilt wurde. Die Effizienz der deckenmontierten Bleiacrylglasscheibe wurde im Streustrahlungsfeld eines Quaderphantoms bestimmt. Die Schutzwirkung verschiedener Bleiglasbrillen und Bleiacrylglasvisiere wurde durch Thermolumineszenzdosimetrie an einem Kopfphantom in Direktstrahlung evaluiert. Ergebnisse: Die Exposition der Linse bei radiologischen Untersuchungen von ca. 110???550??Sv wird durch den Untertisch-Vorhang nur gering reduziert. Durch Vorhang plus Aufsatz kann die Linsendosis bei Interventionen am Abdomen in PA-Projektion etwa um den Faktor 2 reduziert werden. In?25?-LAO ergibt sich ein Reduktionsfaktor zwischen 1,2 und 5. Die AP-Projektion ergibt die h?chsten Dosiswerte, auch ist die Wirkung des tischmontierten Strahlenschutzes minimal. Die deckenmontierte Bleiacrylglasscheibe reduziert die Linsendosis bei optimaler Positionierung etwa um den Faktor 30.?Die Bleiglasbrillen und -visiere reduzieren die Linsendosis maximal um den Faktor 8???10. Je?nach Design der untersuchten Modelle ist die Schutzwirkung geringer, insbesondere f?r Strahlungen am Kopfphantom aus laterokaudaler Richtung. Teils werden sogar Erh?hungen der Linsendosis durch die Visiere beobachtet. Schlussfolgerung: Die Exposition der Augenlinse kann bei konsequenter Anwendung der Strahlenschutzmittel auch unterhalb der neuen Grenzwerte der ICRP gehalten werden.

Congenital seminal vesicle cysts associated with ipsilateral renal agenesis or dysplasia are rare malformations. Even though they are more often diagnosed today due to the introduction of advanced, sectional imaging techniques as CT and MRI, no reliable data about the prevalence of this malformation are available. This study reports seven consecutive cases, with long-term follow-up in five cases (26-119 months, mean 52 months). All patients underwent sonography, excretory urography, CT and MRI. Only two of seven patients presented nonspecific symptoms of the lower urinary tract; five were asymptomatic. In all cases sonography revealed the cystic character of the retrovesical enlargement. The anatomy of the lower pelvis was most accurately shown on MRI, which depicted the ectopic insertion of the ureter into the seminal vesicle in five cases. Cysts demonstrated high signal intensities in T1- and T2-weighted spin-echo images. In five cases the CT density was over 40 HU. Whereas one patient (15 years) presented significant enlargement of the cysts 10 years after primary diagnosis with compression of the urinary bladder, four patients showed no changes of their malformation in the follow-up examinations. The present data therefore support the concept of treating only symptomatic patients.

Contrast medium-induced nephropathy (CIN) continues to be one of the most common causes of hospital-acquired acute renal failure. Since most of the clinical studies on the prophylactic use of different drugs to prevent CIN produced disappointing results, hydration remains the mainstay of prophylaxis. A number of recent prospective randomized trials provided further evidence of the effectiveness of hydration and relevant information regarding the optimization of hydration protocols. It was shown that a bolus hydration solely during examination is not sufficient to prevent CIN. In addition, isotonic 0.9 % saline was superior to the commonly used half-isotonic 0.45 % saline in another trial. An outpatient hydration protocol including oral hydration before the examination followed by forced intravenous hydration over 6 hrs. beginning 30 to 60 min. prior to examination seems to be comparable to the usual hydration over 24 hrs. Another hydration protocol, which could also be very attractive especially for outpatients, included the infusion of sodium bicarbonate. In a recent trial, hydration with sodium bicarbonate, given as a bolus for 1 hr. prior to examination followed by an infusion for 6 hrs. after examination, was more effective than hydration with sodium chloride for the prophylaxis of CIN. However, there is still a lack of large-scale, multi-center trials comparing different hydration protocols and investigating their influence on clinically relevant endpoints such as mortality or the need for dialysis.

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