The American journal of roentgenology, radium therapy, and nuclear medicine最新文献

Dysphagia is a relatively infrequent complication of vagotomy in the postoperative period. The most common form is a transient post-vagotomy dysphagia which requires not treatment other than the temporary exclusion of solid food. Accurate diagnosis is possible on the basis of clinical history and typical roentgenographic findings. The onset of dysphagia characteristically occurs with the first ingestion of solid foods on the seventh to fourteenth postoperative days. A barium swallow examination reveals persistent tapered narrowing of the therminal three to four centrimeters of the esophagus. Most cases are relieved in two to six weeks without clinical or roentgenographic residua. Five cases of transient postvagotomy dysphagia are presented.

Pontine astrocytomas may fungate, encircling the basilar artery and pontomesencephalic vein and intruding between these structures and the clivus. The tumor thus may prevent anterior displacement of these vascular structures against the clivus or produce paradoxical posterior displacement. However, the pontine arteries are usually swept forward by the tumor nodules to lie anterior to the basilar artery. These arteries are also stretched as they encircle the enlarged pons, losing their normal undulations. An increased posterior extent of the vessels may be seen, presumed due to hypertrophy or displacement or both. These findings seem highly specific for the diagnosis of fungating pontine astrocytoma.

Whole body transmission-emission scanning was carried out using a whole body camera. A disk source 30 cm in diameter filled with 99mTc was used for transmission scanning. Correct interpretation of emission scanning requires accurate anatomical orientation of the images. The value of whole body transmission-emission scanning is emphasized.

The mitral valve can be visualized as if looking directly into the valvular orifice by obtaining roentgenograms directed obliquely through the heart at a 25 degree superior elevation, with the patient rotated 60 degrees in the right anterior oblique direction. This view was based upon trigonometrical calculations of the spatial orientation of the annulus of prosthetic mitral valves in 25 patients. Calculations based upon measurement in these patients indicate that the area of the orifice of the mitral valve can be shown with less than ten percent error due to distortion of the projected image in 80 percent of patients. During the injection of contrast material into the left ventricle, orifice-view roentgenorgram serve as a useful adjunct to satndard ventriculograms. Such views permit assessment of the size of the mitral annulus and the degree of stenosis. Plain orifice-view roentgenograms of heavily calcified mitral valves permit measurement of the area circumscribed by calcium in such patients. The measurements indicate an upper limit of the possible size of the functional orifice. Therefore, this roentgenographic technique serves in a practical fashion as a non-invasive method for the assessment of the severity of mitral stenosis in such individuals.

The clinical and roentgenographic features of six cases of Amanita mushroom poisoning were reviewed. The roentgenographic manifestations included adynamic ileus (three patients) and small, irregularly shaped kidneys secondary to the healing process of acute tubular necrosis (one patient). Intestinal pseudo-obstruction can result from many medical problems and mushroom poisoning should be considered in its differential diagnosis.

Accurate localization of lesions seen on computerized tomographic scans obtained with the EMI unit is often difficult due to a paucity of reliable landmarks and to varying head angulation. A simple and accurate system of transposing the location of any particular lesion to a roentgenogram obtained with the scanner tube is described.