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

The roentgenologic diagnosis and differentiation of mediastinal neurogenic tumors are possible on the chest roentgenogram as a rule. The soft tissue mass may be ill-defined and the tumor "ghost-like" in the case of primary neuroblastoma, but it is usually obvious in ganglioneuroma and metastatic disease. The presence of calcifications differentiates neurogenic tumors from other posterior mediastinal tumors of childhood. They are common in primary and rare in secondary disease. Rib erosions and displacement are striking in neuroblastoma (after a few months of age), more subtle in ganglioneuroma, and absent with secondary involvement. In 3 out of 7 posterior mediastinal neuroblastomas the diagnosis and treatment were delayed, as the adjacent rib changes were not appreciated for some time. "Dumbbell" shaped tumors are usually associated with vertebral changes and myelography is indicated even in the absence of neurologic deficit. Thoracic deformity and disability subsequent to laminectomy, radiation therapy, or both, are present in all survivors.

Blood flow in the left external iliac artery was measured by means of a densitometric technique in 21 patients with arteriosclerosis of the lower extremities and in 21 controls. Normal flow volumes were (mean +/- S.D.) 604 +/- 104 ml./min. for males and 478 +/- ml./min. for females. Flow volume was significantly lower in the patients with ischemia of the legs. There was no correlation between flow volume through the artery and the degree of stenosis at its narrowest point. The diameter of the iliac artery and the flow volume were significantly larger in males than in females; however, flow velocity was significantly larger in females.

Because chemical and transcatheter embolizations for control of bleeding were inappropriate, electrocoagulation through a guidewire was used for arterial occlusion. The power was alternating current. The effectiveness of the procedure was confirmed by arteriograms done immediately and 5 months later.

In children who undergo nephrectomy for Wilms' tumor, compensatory renal hypertrophy occurs rapidly despite concomitant irradiation and chemotherapy. Review of preoperative and postoperative intravenous pyelograms of 21 children showed all to have significant enlargement of the remaining kidney. Sixty-five per cent renal hypertrophy occurred during the first 2 months after nephrectomy; by 11 months, renal hypertrophy is complete and renal growth is no longer accelerated.

The circumaortic renal collar is a potentially hazardous anomaly of the left renal vein. Failure to recognize the dorsal component during retroperitoneal surgery may lead to hemorrhage, nephrectomy or death. The angiographer can make a significant contribution in documenting this anomally in patients who are candidates for surgery in this area.

The term minimal deviation hepatoma has been applied to a specific clinical, pathological, and angiographic entity. It is a tumor, composed of atypical cells, which is neither frankly malignant nor so well organized as a benigh tumor. This lesion occurs in females with otherwise normal livers and has a relatively benign course, although life threatening hemorrhage may occur. The diagnosis may be strongly suggested in the presence of hypervascularl or hypovascular discrete masses without evidence of frank malignancy, with a defect in the colloid liver scan and with normal liver function tests. Surgical resection when possible and aggressive chemotherapy may be corrective in many cases.

Electronic stimulation of the external and sphincter muscle was successful in preventing premature evacuation of barium in 28 of 30 patients. All of them were unable on 1 or more occasions to retain the barium during previously attempted studies by conventional methods. None of the patients had an underlying neurologic problem affecting the anal sphincter. No adverse reactions were noted.

The limited form of Wegener's granulomatosis is described as a complication in 2 cases of chronic ulcerative colitis. The coexistence of ulcerative colitis and the limited form of Wegener's granulomatosis raises the question of a common etiologic basis, possibly an immunologic defect. Awareness of such an association may help shed further light on the etiology of both disorders.

Thermography appears to be a useful supporting aid to classical methods of examination in the clarification of the problems of acute abdominal disease. In a study of 100 patients thermography was in support of the true diagnosis in acute appendicitis in 63 per cent, in acute biliary tract disease in 59 per cent, and, in an attempt to differentiate between tumor and periappendicular abscess, assistance was rendered by thermography in 53 per cent of patients. However, some uncertainty exists because carcinoma often produces in its environment an inflammatory reaction, which causes an increase of temperature visible in the thermogram. In the present series thermography produced a finding supporting the correct diagnosis in 59 per cent. Errors occurred most often in obese patients, who have thick abdominal covers. Thermography also has an obvious application in the localizing of postoperative suppurative foci.