Thesis problem: Cone beam computed tomography (CBCT) can provide images with identical information and considerable dose reduction compared with reasonably low costs compared to multislice computed tomography (MSCT) especially where multiple follow up imaging studies are needed. The purpose of this study was to evaluate the diagnostic usefulness of CBCT, using i-CAT®'s software, for detection of the anatomical landmarks of the external, middle and inner ear to answer this question whether MSCT Can be replaced by dental CBCT for evaluation of the temporal bone. Material and methods: Cone beam computed tomography (CBCT) images of 63 subjects made with the same machine, with unknown clinical histories and no evidence of pathosis on CBCT images, were evaluated by two oral and maxillofacial radiologists retrospectively. Seven anatomical points (scutum, oval window, incudomalleolar joint, the tympanic/horizontal and mastoid/vertical segments of the facial nerve, anterior and posterior crura of stapes) of the right and left temporal bone (total of 120 temporal bones) were evaluated. The results were provided as percentage of the points identified by each radiologist. The intra and inter observer agreement were calculated using kappa statistic. Results: The scutum, the tympanic/horizontal segment of the facial nerve canal and the oval window of the right and left temporal bone of 63 cases (total 126 temporal bones) were visualized by the first observer as well-defined structures in 100%, 96.03% and 100% of the cases, respectively. The tympanic/horizontal segment of the facial nerve canal was visualized as a poorly-defined structure in 2.38 % and could not be identified in 1.59% of the cases. The anterior and posterior crura of stapes, the mastoid/vertical segments of the facial nerve canal and the incudomalleolar joint were visualized as well-defined structures in 24.60%, 53.17%, 99.21% and 57.94% of the cases, as poorly defined structures in 32.54%, 41.27%, 0.79% and 39.68% of the cases respectively. The anterior and posterior crura of stapes, the mastoid/vertical segments of the facial nerve canal and the incudomalleolar joint could not be identified in 42.86%, 5.56%, 0% and 2.38% of the cases respectively. The intra- and inter-observer agreement ranged from strong for tympanic/horizontal and mastoid/vertical segments of the facial nerve canal to poor for the anterior and posterior crura of stapes and also the incudomalleolar joint. Conclusion: The i-CAT CBCT machine is a promising replacement for MSCT in evaluation of the temporal bone where there is no need for evaluation of the anterior and posterior crura of stapes and the incudomalleolar joint which are the smallest anatomical structures in the temporal bone. Other CBCT machines with higher contrast to noise ratio should be evaluated for detection of those anatomical structures since CBCT can reduce the patient dose substantially where multiple follow up CT studied are needed. Key words: Computed tomography; cone beam CT; multislice helical CT; middle ear; inner ear; temporal bone.

Fragestellung: Wie nützlich ist das Mehrschicht-Spiral-CT bei der Diagnostik der Darmischämie? Studiendesign: Retrospektive Studie Patientenkollektiv: 112 Patienten, die in einem Zeitraum von drei Jahren bei Verdacht auf Darmischämie in einem Mehrschicht-Spiral-CT untersucht wurden. Ergebnis: Bei den 112 Verdachtsfällen handelte es sich in 26 Fällen um eine Darmischämie. Das CT erkannte davon 24 (92%), ein Fall wurde falsch negativ (4%) befundet und ein Fall (4%) wurde als unklar eingestuft. Von den 86 Fällen ohne Darmischämie wurden 77 (89%) korrekt erkannt, drei (4%) wurden falsch positiv befundet und 6 (7%) Fälle wurden als unklar eingestuft. Die Ergebnisse der bei manchen Patienten zusätzlich durchgeführten Sonografie – und Röntgenuntersuchungen waren erheblich schlechter (Sono: Sensitivität: , Spezifität: ; Röntgen: Sensitivität: , Spezifität: ). Die erhobenen Laborparameter (Leukozyten, Lactat, D-Dimere) waren zur Beurteilung, ob es sich um eine Darmischämie handelt, nicht spezifisch genug. Schlussfolgerung: Das Mehrschicht-Spiral-CT ist mit einer Sensitivität von 92% und einer Spezifität von 97% gut zur Erkennung einer Darmischämie geeignet. Unklare Fälle sind mit hoher Wahrscheinlichkeit nicht operationswürdig. / Objective: To verify the diagnostic importance of helical CT in the diagnosis of mesenteric ischemia. Design: Retrospective study Subjects: 112 patients, who where examined by helical CT during a 3-year-period, with suspected mesenteric ischemia. Main Outcome: 26 cases proved to be mesenteric ischemia. Helical CT was diagnostic in 24 (92%) cases, wrong in one (4%) case and uncertain in one (4%) case. No ischemia was correctly diagnosed in 77/86 (89%) cases, wrongly in three (4%) and 6 (7%) were uncertain. Sonografie and plain film radiographs were taken on some patients, but the results were unsatisfactory. Sonography: Sensitivity: 0%, specificy: 85,7%. Plain film radiographs sensitivity: 0%, specificy: 100%. Results of laboratory test were of little diagnostic value (white blood cell count, lactate, d-dimere). Conclusions: Helical CT is a valuable tool for detecting mesenteric ischemia with a sensitifity of 92% and a specificy of 97%. Suspected mesenteric ischemia which cannot be proved by helical CT are most probable non surgical cases.