Radiologia diagnostica最新文献

Modern methods for treatment of ventricular tachycardia require the exact knowledge of the position of the electrode catheter during intracardiac electrophysiological investigations. X-ray positioning in several projections facilitates the localisation of tachycardia with an accuracy of 4-8 cm2. From eight cadaver hearts schematic diagrams of the right ventricle for two dimensional echocardiography were derived. Endocardiac ventriculocartography under sonographic control was applied in 27 patients 45 times. With this method we were able to detect the electrode catheter in 42 of 45 (93%) patients effectively. Sonographic control facilitates not only the localisation of tachycardia without radiation burden but also its correlation with anatomic ventricular structure which is not possible by roentgenology. 3 negative results were due to negative echoes. In 3 of 5 cases the fulguration of the ventricular tachycardia focus under echo control was possible. Sonographic check up therefore is predilection method for endocardiac ventricular cardiography and can be recommended.

MR angiography allows the imaging of vessels comparable with the vessels imaged with digital angiography. MR-angiograms were also generated by image subtraction. Basis are the different magnetic properties of moved and stationary spins. Contrast media are not required. In recent years the various techniques of image subtraction with the aim of good imaged vessels were developed. The most important are described in this paper.

Since the introduction into practice in may 1986 at the Institute of Cardiovascular Diagnostics we performed 45 valvuloplasties until March 1990 in 34 children (6.2 +/- 4.9 years old) and 11 adults (29.5 +/- 9.6 years) with valvular pulmonary stenosis. The invasively obtained pressure gradient at the valve diminished from 83.4 +/- 30.7 mm Hg to 35.7 +/- 19.0 mm Hg. Intraoperative complications in three patients (short term asystole, severe bradycardia, increase of right ventricular pressure to 300 mm Hg after valvuloplasty) were controlled, but demanded the end of the intervention. No significant insufficiency of pulmonary valves after valvuloplasty was seen. 18 patients were clinically investigated 14.6 +/- 9.4 months after intervention. The late results for these patients proved the method as a long term curing treatment. According to our present results pulmonary valvuloplasty is the alternative method for valve surgery especially in critical pulmonary valve stenosis in newborns.

The results of clinical roentgenological investigations of 52 patients with cervical lipoma were analyzed. The authors describe the radiographic appearance and the investigation techniques for circumscript lipoma in the subcutaneous tissue, in the muscles and for a large diffuse symmetric lipomatosis. In the diagnostics of cervical lipoma x-ray investigations have a leading role.

Clinics and self inspection of the breast have not led to improved diagnostics of breast carcinoma. Diagnostics imaging meanwhile has become the turning point of tumour detection at a prognostically favourable stage. Mammography is the recognized method for the diagnostics of breast disease. For the detection of early occult breast carcinoma it is the method of choice. In mammographically dense breasts, difficulties occur. Here sonography is used for differentiation of cystic and solid space occupations. With fine needle biopsy a preoperative dignity evaluation is more and more possible. Radiation planning becomes more effective. Computed tomography is more important for primary diagnostics and the spreading of the disease. Magnetic resonance (MRT) becomes important in case of discrepancies between clinical mammographic and cytologic results. For the problematic differentiation of scars and recurrences Gadolinium-MRT is the favoured method. In short surveys the scope of the various imaging methods is shown.

In our study therapy induced early and late effects on the breast were investigated with mammography. All patients with breast carcinoma were treated with conserving surgery and then irradiated. Criterium for the evaluation of the changes was a postoperative mammogram for comparison with the found changes. Severe limitations for the diagnosis of tumour recurrence did not result for this form of therapy.

From 192 gymnastic athletes and 216 swimmers the spine radiographs were evaluated. The risks for a too early start of high performance training in gymnastics for the spine are shown. Juvenile osteochondroses before the 10 year were found. Requirements for the elimination of spine diseases are pointed out.

By experimental variation of scattered radiation (various field sizes with and without grid) it is shown, that even under defined experimental conditions there is little or negligible influence of scattered radiation on the photographic density of films. The variation is less than 5% for tube voltages between 55 and 120 kV (Exposure control system Robotron type 20041). Variations of film density connected with changes of focal spot size are explained by changes of kVp (insufficient tube load compensation) and by differences of energy sensitivity of ionization chambers and screen-film combinations as well as differences in exposure time for different focal sizes. Short exposure times below 200 ms and constant tube voltages result in equal film exposure, if different focal sizes are used.