Primary sarcoma of the pulmonary artery is a rare tumor which must be considered in differential diagnosis of pulmonary embolism. The data of the 93 cases published up to now is evaluated synoptically after a report on a primary sarcoma of the pulmonary artery. Modern diagnostic imaging methods (pulmonary DSA, perfusion scintigraphy, echocardiography, computer tomography, nuclear magnetic resonance tomography) may corroborate the suspicion of a sarcoma of the pulmonary artery. With a median survival time of 1.5 months, the prognosis of patients with primary sarcomas of the pulmonary artery must be regarded extremely poor. After tumor excision, the median survival time of the patients could be prolonged (statistically significant; p less than 0.01) to ten months. The significance of adjuvant chemotherapy and/or radiotherapy cannot be appraised at present.

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The purpose of this phase III clinical trial was to compare two different extracellular contrast agents, 1.0 M gadobutrol and 0.5 M gadopentate dimeglumine, for magnetic resonance imaging (MRI) in patients with known or suspected focal renal lesions. Using a multicenter, single-blind, interindividual, randomized study design, both contrast agents were compared in a total of 471 patients regarding their diagnostic accuracy, sensitivity, and specificity to correctly classify focal lesions of the kidney. To test for noninferiority the diagnostic accuracy rates for both contrast agents were compared with CT results based on a blinded reading. The average diagnostic accuracy across the three blinded readers ('average reader') was 83.7% for gadobutrol and 87.3% for gadopentate dimeglumine. The increase in accuracy from precontrast to combined precontrast and postcontrast MRI was 8.0% for gadobutrol and 6.9% for gadopentate dimeglumine. Sensitivity of the average reader was 85.2% for gadobutrol and 88.7% for gadopentate dimeglumine. Specificity of the average reader was 82.1% for gadobutrol and 86.1% for gadopentate dimeglumine. In conclusion, this study documents evidence for the noninferiority of a single i.v. bolus injection of 1.0 M gadobutrol compared with 0.5 M gadopentate dimeglumine in the diagnostic assessment of renal lesions with CE-MRI.

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We report a rare case of large innominate vein aneurysm in a young women clinically presenting with persistent dry cough and retrosternal pressure. Chest X-ray showed a mediastinal widening leading to thoracic computed tomography, MRI, and phlebography. Initial conservative treatment with regular follow-up was performed. Upon aneurysm growth and recurrent pulmonary infection we decided to surgically resect the aneurysm via a minimally invasive approach.

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Diagnose und Behandlung von Gefäûerkrankungen waren in den letzten Jahren einem erheblichen Wandel unterworfen. Minimal invasive, endovaskuläre und perkutane Verfahren treten zunehmend in Wettstreit mit konventionellen operativen Methoden [2]. Für die Primär-und Sekundärprophylaxe stehen neue potente Medikamente zur Verfügung. Neben deutlich verbesserten Diagnose-und Behandlungsmöglichkeiten zeigen die demographischen und epidemiologischen Daten, dass sich in den nächsten 20 Jahren der Bedarf an Gefäûbehandlungen, insbesondere bei Patienten mit einer peripheren arteriellen Verschlusserkrankung, verdoppeln wird.Auf der anderen Seite stehen die Strukturen der Krankenhäuser aufgrund der Finanzkrise der Sozialkassen sowie des verstärkten Wettbewerbes der Leistungserbringer zunehmend zur Disposition. Von Seiten der Krankenhausadministration entsteht vielerorts ein zunehmender Druck, die Fächer und Abteilungsgrenzen durchlässiger zu gestalten und interdisziplinäre Diagnose-, Behandlungs-und Stationsbereiche einzuführen.