Skip to main content
Erschienen in: European Radiology 10/2015

01.10.2015 | Magnetic Resonance

Veins in plaques of multiple sclerosis patients – a longitudinal magnetic resonance imaging study at 7 Tesla –

verfasst von: Assunta Dal-Bianco, Simon Hametner, Günther Grabner, Melanie Schernthaner, Claudia Kronnerwetter, Andreas Reitner, Clemens Vass, Karl Kircher, Eduard Auff, Fritz Leutmezer, Karl Vass, Siegfried Trattnig

Erschienen in: European Radiology | Ausgabe 10/2015

Einloggen, um Zugang zu erhalten

Abstract

Objective

To monitor the venous volumes in plaques of patients with multiple sclerosis (MS) compared to an age-matched control group over a period of 3.5 years.

Methods

Ten MS patients underwent an annual neurological examination and MRI. Susceptibility-weighted imaging (SWI) combined with fluid-attenuated inversion recovery (FLAIR) or FLAIR–like contrast at 7 Tesla (7 T) magnetic resonance imaging (MRI) was used for manual segmentation of veins in plaques, in the normal-appearing white matter (NAWM) and in location-matched white matter of 9 age-matched controls. Venous volume to tissue volume ratio was assessed for each time point in order to describe the dynamics of venous volumes in MS plaques over time.

Results

MS plaques, which were newly detected during the study period, showed significantly higher venous volumes compared to the preplaque area 1 year before plaque detection and the corresponding NAWM regions. Venous volumes in established MS plaques, which were present already in the first scans, were significantly higher compared to the NAWM and controls.

Conclusions

Our data underpin a relation of veins and plaque development in MS and reflect increased apparent venous calibers due to increased venous diameters or increased oxygen consumption in early MS plaques.

Key points

Longitudinal 7 T Magnetic Resonance Imaging study of intralesional veins in MS patients.
Venous volumes are significantly increased in newly detected and established MS plaques.
Venous volumes in established MS plaques show a trend to decrease with time.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Frischer JM, Bramow S, Dal-Bianco A, Lucchinetti CF, Rauschka H et al (2009) The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain 132:1175–1189PubMedCentralCrossRefPubMed Frischer JM, Bramow S, Dal-Bianco A, Lucchinetti CF, Rauschka H et al (2009) The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain 132:1175–1189PubMedCentralCrossRefPubMed
2.
Zurück zum Zitat Rindfleisch E (1863) Histologisches Detail zur grauen Degeneration von Gehirn und Rückenmark. Arch Pathol Anat Physiol Klin Med (Virchow) 26:474–483CrossRef Rindfleisch E (1863) Histologisches Detail zur grauen Degeneration von Gehirn und Rückenmark. Arch Pathol Anat Physiol Klin Med (Virchow) 26:474–483CrossRef
3.
Zurück zum Zitat Putnam T (1933) The pathogenesis of multiple sclerosis, a possible vascular factor. N Engl J Med 209:786–790CrossRef Putnam T (1933) The pathogenesis of multiple sclerosis, a possible vascular factor. N Engl J Med 209:786–790CrossRef
4.
Zurück zum Zitat Putnam T (1937) Vascular architecture of the lesions of multiple sclerosis. Arch Neurol Psychiatr 38:1–15CrossRef Putnam T (1937) Vascular architecture of the lesions of multiple sclerosis. Arch Neurol Psychiatr 38:1–15CrossRef
5.
Zurück zum Zitat Fog T (1964) On the vessel-plaque relationships in the brain in multiple sclerosis. Acta Neurol Scand Suppl 40(SUPPL 10):19–15 Fog T (1964) On the vessel-plaque relationships in the brain in multiple sclerosis. Acta Neurol Scand Suppl 40(SUPPL 10):19–15
6.
Zurück zum Zitat Waksman BH (1964) Local reaction of cellular hypersensitivity. Ann N Y Acad Sci 116:1045–51CrossRefPubMed Waksman BH (1964) Local reaction of cellular hypersensitivity. Ann N Y Acad Sci 116:1045–51CrossRefPubMed
7.
8.
Zurück zum Zitat Tallantyre EC, Brookes MJ, Dixon JE, Morgan PS, Evangelou N et al (2008) Demonstrating the perivascular distribution of MS lesions in vivo with 7-Tesla MRI. Neurology 70:2076–2078CrossRefPubMed Tallantyre EC, Brookes MJ, Dixon JE, Morgan PS, Evangelou N et al (2008) Demonstrating the perivascular distribution of MS lesions in vivo with 7-Tesla MRI. Neurology 70:2076–2078CrossRefPubMed
9.
Zurück zum Zitat Kollia K, Maderwald S, Putzki N, Schlamann M, Theysohn JM et al (2009) First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5 T and 7 T. AJNR Am J Neuroradiol 30:699–702CrossRefPubMed Kollia K, Maderwald S, Putzki N, Schlamann M, Theysohn JM et al (2009) First clinical study on ultra-high-field MR imaging in patients with multiple sclerosis: comparison of 1.5 T and 7 T. AJNR Am J Neuroradiol 30:699–702CrossRefPubMed
10.
Zurück zum Zitat Mistry N, Dixon J, Tallantyre E, Tench C, Abdel-Fahim R et al (2013) Central veins in brain lesions visualized with high-field magnetic resonance imaging: a pathologically specific diagnostic biomarker for inflammatory demyelination in the brain. JAMA Neurol 70:623–628CrossRefPubMed Mistry N, Dixon J, Tallantyre E, Tench C, Abdel-Fahim R et al (2013) Central veins in brain lesions visualized with high-field magnetic resonance imaging: a pathologically specific diagnostic biomarker for inflammatory demyelination in the brain. JAMA Neurol 70:623–628CrossRefPubMed
11.
Zurück zum Zitat Tallantyre EC, Morgan PS, Dixon JE, Al-Radaideh A, Brookes MJ et al (2009) A comparison of 3 T and 7 T in the detection of small parenchymal veins within MS lesions. Invest Radiol 44:491–494CrossRefPubMed Tallantyre EC, Morgan PS, Dixon JE, Al-Radaideh A, Brookes MJ et al (2009) A comparison of 3 T and 7 T in the detection of small parenchymal veins within MS lesions. Invest Radiol 44:491–494CrossRefPubMed
12.
Zurück zum Zitat Gaitan MI, Maggi P, Wohler J, Leibovitch E, Sati P et al (2014) Perivenular brain lesions in a primate multiple sclerosis model at 7-tesla magnetic resonance imaging. Mult Scler 20:64–71CrossRefPubMed Gaitan MI, Maggi P, Wohler J, Leibovitch E, Sati P et al (2014) Perivenular brain lesions in a primate multiple sclerosis model at 7-tesla magnetic resonance imaging. Mult Scler 20:64–71CrossRefPubMed
13.
Zurück zum Zitat Ge Y, Zohrabian VM, Grossman RI (2008) Seven-tesla magnetic resonance imaging: new vision of microvascular abnormalities in multiple sclerosis. Arch Neurol 65:812–816PubMedCentralPubMed Ge Y, Zohrabian VM, Grossman RI (2008) Seven-tesla magnetic resonance imaging: new vision of microvascular abnormalities in multiple sclerosis. Arch Neurol 65:812–816PubMedCentralPubMed
14.
Zurück zum Zitat Kau T, Taschwer M, Deutschmann H, Schonfelder M, Weber JR et al (2013) The "central vein sign": is there a place for susceptibility weighted imaging in possible multiple sclerosis? Eur Radiol 23:1956–1962CrossRefPubMed Kau T, Taschwer M, Deutschmann H, Schonfelder M, Weber JR et al (2013) The "central vein sign": is there a place for susceptibility weighted imaging in possible multiple sclerosis? Eur Radiol 23:1956–1962CrossRefPubMed
15.
Zurück zum Zitat Sinnecker T, Bozin I, Dorr J, Pfueller CF, Harms L, et al. (2012) Periventricular venous density in multiple sclerosis is inversely associated with T2 lesion count: a 7 Tesla MRI study. Mult Scler 19(3):316–325 Sinnecker T, Bozin I, Dorr J, Pfueller CF, Harms L, et al. (2012) Periventricular venous density in multiple sclerosis is inversely associated with T2 lesion count: a 7 Tesla MRI study. Mult Scler 19(3):316–325
16.
Zurück zum Zitat Ge Y, Zohrabian VM, Osa EO, Xu J, Jaggi H et al (2009) Diminished visibility of cerebral venous vasculature in multiple sclerosis by susceptibility-weighted imaging at 3.0 tesla. J Magn Reson Imaging 29:1190–1194PubMedCentralCrossRefPubMed Ge Y, Zohrabian VM, Osa EO, Xu J, Jaggi H et al (2009) Diminished visibility of cerebral venous vasculature in multiple sclerosis by susceptibility-weighted imaging at 3.0 tesla. J Magn Reson Imaging 29:1190–1194PubMedCentralCrossRefPubMed
17.
Zurück zum Zitat Grabner G, Dal-Bianco A, Schernthaner M, Vass K, Lassmann H et al (2011) Analysis of multiple sclerosis lesions using a fusion of 3.0 T FLAIR and 7.0 T SWI phase: FLAIR SWI. J Magn Reson Imaging: JMRI 33:543–549CrossRefPubMed Grabner G, Dal-Bianco A, Schernthaner M, Vass K, Lassmann H et al (2011) Analysis of multiple sclerosis lesions using a fusion of 3.0 T FLAIR and 7.0 T SWI phase: FLAIR SWI. J Magn Reson Imaging: JMRI 33:543–549CrossRefPubMed
18.
Zurück zum Zitat Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP et al (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol 58:840–846CrossRefPubMed Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP et al (2005) Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria". Ann Neurol 58:840–846CrossRefPubMed
19.
Zurück zum Zitat Pruessner JC, Li LM, Serles W, Pruessner M, Collins DL et al (2000) Volumetry of hippocampus and amygdala with high-resolution MRI and three-dimensional analysis software: minimizing the discrepancies between laboratories. Cereb Cortex 10:433–442CrossRefPubMed Pruessner JC, Li LM, Serles W, Pruessner M, Collins DL et al (2000) Volumetry of hippocampus and amygdala with high-resolution MRI and three-dimensional analysis software: minimizing the discrepancies between laboratories. Cereb Cortex 10:433–442CrossRefPubMed
20.
Zurück zum Zitat Vincent RD JA, Sled JG, Baghdadi L, Neelin P, Evans AC (2004) MINC 2.0: a modality independent format for multidimensional medical images. Proceedings of the 10th Annual Meeting of the Organization for Human Brain Mapping, Budapest, Hungary (abstract WE 323) Vincent RD JA, Sled JG, Baghdadi L, Neelin P, Evans AC (2004) MINC 2.0: a modality independent format for multidimensional medical images. Proceedings of the 10th Annual Meeting of the Organization for Human Brain Mapping, Budapest, Hungary (abstract WE 323)
21.
Zurück zum Zitat Rauscher A, Sedlacik J, Barth M, Haacke EM, Reichenbach JR (2005) Nonnvasive assessment of vascular architecture and function during modulated blood oxygenation using susceptibility weighted magnetic resonance imaging. Magn Reson Med: Off J Soc Magn Reson Med / Soc Magn Reson Med 54:87–95CrossRef Rauscher A, Sedlacik J, Barth M, Haacke EM, Reichenbach JR (2005) Nonnvasive assessment of vascular architecture and function during modulated blood oxygenation using susceptibility weighted magnetic resonance imaging. Magn Reson Med: Off J Soc Magn Reson Med / Soc Magn Reson Med 54:87–95CrossRef
22.
Zurück zum Zitat Davies AL, Desai RA, Bloomfield PS, McIntosh PR, Chapple KJ et al (2013) Neurological deficits caused by tissue hypoxia in neuroinflammatory disease. Ann Neurol 74:815–825CrossRefPubMed Davies AL, Desai RA, Bloomfield PS, McIntosh PR, Chapple KJ et al (2013) Neurological deficits caused by tissue hypoxia in neuroinflammatory disease. Ann Neurol 74:815–825CrossRefPubMed
23.
24.
Zurück zum Zitat Mews I, Bergmann M, Bunkowski S, Gullotta F, Bruck W (1998) Oligodendrocyte and axon pathology in clinically silent multiple sclerosis lesions. Mult Scler 4:55–62CrossRefPubMed Mews I, Bergmann M, Bunkowski S, Gullotta F, Bruck W (1998) Oligodendrocyte and axon pathology in clinically silent multiple sclerosis lesions. Mult Scler 4:55–62CrossRefPubMed
25.
Zurück zum Zitat Bjartmar C, Wujek JR, Trapp BD (2003) Axonal loss in the pathology of MS: consequences for understanding the progressive phase of the disease. J Neurol Sci 206:165–171CrossRefPubMed Bjartmar C, Wujek JR, Trapp BD (2003) Axonal loss in the pathology of MS: consequences for understanding the progressive phase of the disease. J Neurol Sci 206:165–171CrossRefPubMed
26.
Zurück zum Zitat Kornek B, Storch MK, Weissert R, Wallstroem E, Stefferl A et al (2000) Multiple sclerosis and chronic autoimmune encephalomyelitis: a comparative quantitative study of axonal injury in active, inactive, and remyelinated lesions. Am J Pathol 157:267–276PubMedCentralCrossRefPubMed Kornek B, Storch MK, Weissert R, Wallstroem E, Stefferl A et al (2000) Multiple sclerosis and chronic autoimmune encephalomyelitis: a comparative quantitative study of axonal injury in active, inactive, and remyelinated lesions. Am J Pathol 157:267–276PubMedCentralCrossRefPubMed
27.
Zurück zum Zitat Frischer JM, Bramow S, Dal-Bianco A, Lucchinetti CF, Rauschka H et al (2009) The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain J Neurol 132:1175–1189CrossRef Frischer JM, Bramow S, Dal-Bianco A, Lucchinetti CF, Rauschka H et al (2009) The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain J Neurol 132:1175–1189CrossRef
28.
Zurück zum Zitat Bakshi R, Miletich RS, Kinkel PR, Emmet ML, Kinkel WR (1998) High-resolution fluorodeoxyglucose positron emission tomography shows both global and regional cerebral hypometabolism in multiple sclerosis. J Neuroimaging 8:228–234CrossRefPubMed Bakshi R, Miletich RS, Kinkel PR, Emmet ML, Kinkel WR (1998) High-resolution fluorodeoxyglucose positron emission tomography shows both global and regional cerebral hypometabolism in multiple sclerosis. J Neuroimaging 8:228–234CrossRefPubMed
29.
Zurück zum Zitat Brooks DJ, Leenders KL, Head G, Marshall J, Legg NJ et al (1984) Studies on regional cerebral oxygen utilisation and cognitive function in multiple sclerosis. J Neurol Neurosurg Psychiatry 47:1182–1191PubMedCentralCrossRefPubMed Brooks DJ, Leenders KL, Head G, Marshall J, Legg NJ et al (1984) Studies on regional cerebral oxygen utilisation and cognitive function in multiple sclerosis. J Neurol Neurosurg Psychiatry 47:1182–1191PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Blinkenberg M, Rune K, Jensen CV, Ravnborg M, Kyllingsbaek S et al (2000) Cortical cerebral metabolism correlates with MRI lesion load and cognitive dysfunction in MS. Neurology 54:558–564CrossRefPubMed Blinkenberg M, Rune K, Jensen CV, Ravnborg M, Kyllingsbaek S et al (2000) Cortical cerebral metabolism correlates with MRI lesion load and cognitive dysfunction in MS. Neurology 54:558–564CrossRefPubMed
31.
Zurück zum Zitat Varga AW, Johnson G, Babb JS, Herbert J, Grossman RI et al (2009) White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis. J Neurol Sci 282:28–33PubMedCentralCrossRefPubMed Varga AW, Johnson G, Babb JS, Herbert J, Grossman RI et al (2009) White matter hemodynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis. J Neurol Sci 282:28–33PubMedCentralCrossRefPubMed
32.
Zurück zum Zitat Adhya S, Johnson G, Herbert J, Jaggi H, Babb JS et al (2006) Pattern of hemodynamic impairment in multiple sclerosis: dynamic susceptibility contrast perfusion MR imaging at 3.0 T. Neuroimage 33:1029–1035PubMedCentralCrossRefPubMed Adhya S, Johnson G, Herbert J, Jaggi H, Babb JS et al (2006) Pattern of hemodynamic impairment in multiple sclerosis: dynamic susceptibility contrast perfusion MR imaging at 3.0 T. Neuroimage 33:1029–1035PubMedCentralCrossRefPubMed
33.
Zurück zum Zitat Ge Y, Law M, Johnson G, Herbert J, Babb JS et al (2005) Dynamic susceptibility contrast perfusion MR imaging of multiple sclerosis lesions: characterizing hemodynamic impairment and inflammatory activity. AJNR Am J Neuroradiol 26:1539–1547PubMed Ge Y, Law M, Johnson G, Herbert J, Babb JS et al (2005) Dynamic susceptibility contrast perfusion MR imaging of multiple sclerosis lesions: characterizing hemodynamic impairment and inflammatory activity. AJNR Am J Neuroradiol 26:1539–1547PubMed
34.
Zurück zum Zitat Law M, Saindane AM, Ge Y, Babb JS, Johnson G et al (2004) Microvascular abnormality in relapsing-remitting multiple sclerosis: perfusion MR imaging findings in normal-appearing white matter. Radiology 231:645–652CrossRefPubMed Law M, Saindane AM, Ge Y, Babb JS, Johnson G et al (2004) Microvascular abnormality in relapsing-remitting multiple sclerosis: perfusion MR imaging findings in normal-appearing white matter. Radiology 231:645–652CrossRefPubMed
35.
Zurück zum Zitat D'Haeseleer M, Cambron M, Vanopdenbosch L, De Keyser J (2011) Vascular aspects of multiple sclerosis. Lancet Neurol 10:657–666CrossRefPubMed D'Haeseleer M, Cambron M, Vanopdenbosch L, De Keyser J (2011) Vascular aspects of multiple sclerosis. Lancet Neurol 10:657–666CrossRefPubMed
36.
Zurück zum Zitat Wuerfel J, Sinnecker T, Ringelstein EB, Jarius S, Schwindt W et al (2012) Lesion morphology at 7 Tesla MRI differentiates Susac syndrome from multiple sclerosis. Mult Scler 18:1592–1599CrossRefPubMed Wuerfel J, Sinnecker T, Ringelstein EB, Jarius S, Schwindt W et al (2012) Lesion morphology at 7 Tesla MRI differentiates Susac syndrome from multiple sclerosis. Mult Scler 18:1592–1599CrossRefPubMed
37.
Zurück zum Zitat Bagnato F, Hametner S, Yao B, van Gelderen P, Merkle H et al (2011) Tracking iron in multiple sclerosis: a combined imaging and histopathological study at 7 Tesla. Brain 134:3602–3615CrossRefPubMed Bagnato F, Hametner S, Yao B, van Gelderen P, Merkle H et al (2011) Tracking iron in multiple sclerosis: a combined imaging and histopathological study at 7 Tesla. Brain 134:3602–3615CrossRefPubMed
38.
Zurück zum Zitat Gaitan MI, de Alwis MP, Sati P, Nair G, Reich DS (2013) Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins. Neurology 80:145–151PubMedCentralCrossRefPubMed Gaitan MI, de Alwis MP, Sati P, Nair G, Reich DS (2013) Multiple sclerosis shrinks intralesional, and enlarges extralesional, brain parenchymal veins. Neurology 80:145–151PubMedCentralCrossRefPubMed
39.
Zurück zum Zitat Muller K, Kuchling J, Dorr J, Harms L, Ruprecht K, et al. (2014) Detailing intra-lesional venous lumen shrinking in multiple sclerosis investigated by sFLAIR MRI at 7-T. J Neurol 261(10):2032–2036 Muller K, Kuchling J, Dorr J, Harms L, Ruprecht K, et al. (2014) Detailing intra-lesional venous lumen shrinking in multiple sclerosis investigated by sFLAIR MRI at 7-T. J Neurol 261(10):2032–2036
40.
Zurück zum Zitat Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G et al (2009) Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 80:392–399PubMedCentralCrossRefPubMed Zamboni P, Galeotti R, Menegatti E, Malagoni AM, Tacconi G et al (2009) Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 80:392–399PubMedCentralCrossRefPubMed
41.
Zurück zum Zitat Macgowan CK, Chan KY, Laughlin S, Marrie RA, Banwell B (2014) Cerebral arterial and venous blood flow in adolescent multiple sclerosis patients and age-matched controls using phase contrast MRI. J Magn Reson Imaging: JMRI 40:341–347CrossRefPubMed Macgowan CK, Chan KY, Laughlin S, Marrie RA, Banwell B (2014) Cerebral arterial and venous blood flow in adolescent multiple sclerosis patients and age-matched controls using phase contrast MRI. J Magn Reson Imaging: JMRI 40:341–347CrossRefPubMed
42.
Zurück zum Zitat Barkhof F, Wattjes MP (2013) Multiple sclerosis: CCSVI deconstructed and discarded. Nat Rev Neurol 9:661–662CrossRefPubMed Barkhof F, Wattjes MP (2013) Multiple sclerosis: CCSVI deconstructed and discarded. Nat Rev Neurol 9:661–662CrossRefPubMed
43.
Zurück zum Zitat Meyer-Schwickerath R, Haug C, Hacker A, Fink F, Seidel D et al (2011) Intracranial venous pressure is normal in patients with multiple sclerosis. Mult Scler 17:637–638CrossRefPubMed Meyer-Schwickerath R, Haug C, Hacker A, Fink F, Seidel D et al (2011) Intracranial venous pressure is normal in patients with multiple sclerosis. Mult Scler 17:637–638CrossRefPubMed
44.
Zurück zum Zitat Zivadinov R, Poloni GU, Marr K, Schirda CV, Magnano CR et al (2011) Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency. BMC Neurol 11:128PubMedCentralCrossRefPubMed Zivadinov R, Poloni GU, Marr K, Schirda CV, Magnano CR et al (2011) Decreased brain venous vasculature visibility on susceptibility-weighted imaging venography in patients with multiple sclerosis is related to chronic cerebrospinal venous insufficiency. BMC Neurol 11:128PubMedCentralCrossRefPubMed
Metadaten
Titel
Veins in plaques of multiple sclerosis patients – a longitudinal magnetic resonance imaging study at 7 Tesla –
verfasst von
Assunta Dal-Bianco
Simon Hametner
Günther Grabner
Melanie Schernthaner
Claudia Kronnerwetter
Andreas Reitner
Clemens Vass
Karl Kircher
Eduard Auff
Fritz Leutmezer
Karl Vass
Siegfried Trattnig
Publikationsdatum
01.10.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3719-y

Weitere Artikel der Ausgabe 10/2015

European Radiology 10/2015 Zur Ausgabe

Mammakarzinom: Brustdichte beeinflusst rezidivfreies Überleben

26.05.2024 Mammakarzinom Nachrichten

Frauen, die zum Zeitpunkt der Brustkrebsdiagnose eine hohe mammografische Brustdichte aufweisen, haben ein erhöhtes Risiko für ein baldiges Rezidiv, legen neue Daten nahe.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.