Radiology at the Ebersberg District Clinic is upgrading

Created: 01/10/2022, 3:10 PM

Marco Heinz, who has been Head of Radiology at the Ebersberg District Clinic for five years, in front of a mobile and a permanently installed X-ray machine.

© District Clinic Ebersberg

Five years ago, Dr.

Marco Heinz took over the position of chief physician in radiology at the Ebersberg district clinic.

Since then, the specialist department has been able to continuously expand its technical standards and competencies.

A milestone was the commissioning of the new "Ambition X" MRI machine at the end of November.

We spoke to Heinz about possible radiological diagnosis and therapy methods.

Dr.

Heinz, what has changed in radiology in the last five years?

Well, we can say that we now have very good, state-of-the-art equipment.

Three years ago the clinic got a new, more modern device for mammography, an important instrument in breast cancer screening, and with the "Ambition X" we can now fall back on an MRI that provides radiologists with high-resolution images and the patient more comfort and safety, because the tube has a diameter of around 70 centimeters, ten centimeters more than the old one and a length of around one meter.

Please explain what an MRI is.

MRT is the abbreviation for "magnetic resonance imaging". It is often referred to as magnetic resonance imaging. It is a diagnostic procedure that, unlike computed tomography (CT), does not work with X-rays, but examines the patient in a homogeneous magnetic field. What happens there is the following: bones, soft body tissue, organs and all other components of our body each have a different number of hydrogen atoms and therefore different electromagnetic properties. In the homogeneous magnetic field of the MRI tube, all atoms in the body are arranged in one direction like compass needles. The MRI sends out additional magnetic impulses, audible as loud hammering, which disrupt this arrangement. If the impulses are suspended,The atoms rearrange themselves and during this process send out signals that the MRI translates into images. Since each type of tissue reacts differently, we can easily distinguish between them.

CT is also an imaging examination method. When is a CT done and when is an MRI done?

An MRI is traditionally performed during an examination of the joints and spine, because the condition of the ligaments and tendons involved can be assessed better than with a CT. But MRI is also used to examine soft tissue, liver, kidney and adrenal gland tumors, as well as for examinations of the head, for example in stroke patients, in order to be able to assess the extent of the brain damage. However, this usually only happens after a CT scan, which is performed in acute cases to rule out bleeding in the brain. In general, a CT is ideal for diagnosing emergencies, for example a fall on the head, very severe abdominal pain that could be caused by a life-threatening illness, or for patients who have suffered a serious traffic accident.The whole body can be x-rayed in just a few minutes and the image results are also there in just one or two minutes. Overall, a CT is much faster than an MRI.

How much time does an MRI usually take?

That depends on the organ to be examined. For example, in order to see the spatial arrangement of a tumor and to be able to assess whether it is malignant or not, we need two-dimensional slice images, that is, the impulses are set in several sequences of two to five minutes each. The entire examination therefore takes at least 15 minutes, or up to an hour for a heart examination. The advantage is that the images are of a very high quality. For example, we can also display the exact course of tendons or blood vessels. Another advantage of MRI is that the patient is not exposed to X-rays. However, there is a restriction for patients with cardiac pacemakers or metal implants. You must always carry an ID with you that decideswhether and for how long you can have an MRI.

The tasks of radiology also go beyond diagnostics, right?

Right. We also work therapeutically in various areas. In a special X-ray room, known as angiography, we can use a catheter to identify constrictions in blood vessels and treat them immediately. Permanent infusion catheters are also implanted there, for example. Together with Prof. Dr. Thomas Bernatik, Chief Physician of Internal Medicine I, we also treat blockages of the bile ducts in the liver and the surrounding tissue. This is usually done endoscopically via the duodenum, but if this is not possible for medical reasons, we in radiology can open the constriction from the outside with the help of an X-ray device directly via the small biliary tract of the liver. Furthermore, we have carried out certain cancer therapies often and successfully in the last five years.Tumors up to about three centimeters in size in the liver and kidneys can be treated by thermal ablation in radiology. With the help of microwave technology, they are quasi "burned".

Can all radiological examinations and therapies also take place during the corona pandemic?

Yes, we could and fortunately can offer all services continuously.

We also examine corona patients.

In the first two waves, when rapid PCR tests were not yet possible, we diagnosed suspected cases using CT.

Doctors had found out that the lungs of a corona infection show a very specific image on CT.

Of course, we are also consulted, for example, to assess the course of a pulmonary embolism, circulatory disorders or other concomitant diseases of the viral infection.

Our findings help the intensive care physicians adjust the medication.

The Bavarian State Government has provided us with another mobile X-ray device so that we can quickly follow these processes on the Covid stations using an X-ray.

Are there any future plans in radiology?

Our next goal is a second CT machine in the planned new central emergency room.

This is necessary because the number of patients continues to rise and a quick diagnosis in the immediate vicinity of the emergency room is very important.

The interview was conducted by Sybille Föll

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