Acta radiologica: diagnosis最新文献

Magnetic resonance imaging of the temporomandibular joint (TMJ) was performed on two normal volunteer subjects and two symptomatic subjects using a 0.15 T resistive magnet. A spin echo pulse sequence with a TE of 38 ms and a TR of 500 ms was employed. The TMJ meniscus is a low signal structure, and the bilaminar zone behind it is a relatively high signal structure. In normal closed mouths, the demarcation between meniscus and bilaminar zone is located at the vertex position above the mandibular condyle. When the condyle translates, the posterior portion of the meniscus bulges into the joint space. Dislocated meniscus can be identified by a gray mass anterior to the condylar head. The joint space is filled with the higher signal of the bilaminar zone. In non-reducible dislocations, the meniscus remains anterior to the condylar head with opening of the mouth. Reduced dislocations appear similar to normal joints in the open mouth.

In a prospective study a barium examination combined with food stimulation was compared with the acid reflux test in 30 consecutive patients with symptoms of gastro-oesophageal reflux. Both methods were further compared with endoscopy and histology. Gastro-oesophageal reflux could be demonstrated by the radiologic examination in 22 patients and by the acid reflux test in 23 patients. By combining the two methods gastro-oesophageal reflux could be demonstrated in 27 patients. Comparing the two methods with symptoms, endoscopy, and histology they seemed to be of equal value. Accordingly, a food-stimulated barium examination is recommended as the first method for demonstrating gastro-oesophageal reflux because it is simple and well-tolerated by the patient.

A radiologic investigation was performed in 26 patients subjected to colectomy, mucosal proctectomy and endorectal ileo-anal anastomosis after the creation of an ileal reservoir. The patients had suffered from ulcerative colitis or familial polyposis. The reservoir and its efferent leg was best demonstrated by contrast enema. The size and position of the reservoir and the efferent leg was demonstrated, and stenoses, abscesses and fistulae could be identified. Examination of the small bowel with a contrast medium showed slight dilatation of the ileum orally to the reservoir in all instances and one patient had a stenosis at the junction of the afferent leg of the reservoir. Erect and supine projections of the abdomen showed gas in the intestine and fluid levels in the reservoir. These radiographic findings should not be confused with ileus or pelvic abscess. Radiology was of great value in disclosing postoperative complications.

Percutaneous transluminal angioplasty of iliac and femoral arteries was in 17 patients combined with selective intra-arterial streptokinase treatment. The patients were divided into two groups, one given low dose long-term therapy and the other high dose short-term therapy. The experiences obtained during an observation period of over one year revealed greater benefit from high dose short-term therapy. It seems that the major cause of complications must be attributed to the development of a high level of streptokinase antibodies during low dose long-term therapy.

In an investigation of 94 plastic casts of temporal bone specimens a wide range of variations both in the general outline of the pyramid and in the anatomy of its specific structures was found. Attempts were made to estimate the transverse and vertical dimensions of the petrous bone. Both the mastoid and the perilabyrinthine pneumatization correlated to the dimensions of some structures, but not to the size and shape of the semicircular canals.

A digital system for transmission of images over telephone lines using a 256 X 256 X 6 bits matrix provided for communication between a county hospital and a university hospital is presented. During a three-month period radiologic diagnostic problems encountered in 62 patients (computed tomography in 46 and conventional radiography in 16) were referred by transmitting selected images from each examination. Transmission of computed tomograms was performed without significant degradation of image quality and there was no loss of diagnostic information. Deterioration of image quality was noticed when conventional films especially those of the chest, were digitized and transmitted, though in no instance were they non-diagnostic. The consultations gave valuable information to the transmitting radiologist in approximately 50 per cent of the cases. Review by the consulted radiologists of all original films in each of the examinations 6 months later did not improve the diagnostic results. Thus, a few carefully selected images, digitized and transmitted over telephone lines, may be sufficient for adequate consultation.

A double blind urographic study with the ionic contrast medium metrizoate or the non-ionic medium iohexol was performed on 69 insulin dependent diabetic patients. Metrizoate caused 24 per cent and iohexol 11 per cent mild adverse reactions and metrizoate a significant decrease in creatinine clearance values. Thus iohexol turned out to be better tolerated by these diabetic patients than metrizoate.

Quantitative radiologic measurements of the second left metacarpal bone were performed on 63 normal men and 71 normal women, 105 patients with non-dialyzed chronic renal failure and on 32 chronic hemodialyzed men and women. For prospective analysis 42 non-dialyzed patients and 31 patients on chronic hemodialysis were available. Measurements of the total width, medullary cavity and combined cortical thickness at the midshaft of the metacarpal bone were made on postero-anterior hand radiographs with a readout of 0.1 mm using a direct reading needle-tipped calliper. Hereafter the cortical area and metacarpal bone mass were calculated. Mean values of the various parameters in the patient groups were compared with mean values of age-matched normal controls. For the prospective analysis the calculated, yearly change of the various parameters during the observation period were compared with the yearly change in normal persons, being estimated by regression analysis between age and radiologic values. Measurements of the amount of bone in normals and in patients with chronic renal failure were reliable, the intraobserver variation coefficient varying from 0.7 to 2.5 per cent and the interobserver variation coefficient from 1.0 to 5.8 per cent. Changes in thickness of the soft tissue of the hand only slightly affected the values, a change of 10 mm resulted in a change of one per cent of the measured and calculated values. Metacarpal bone mass was significantly reduced in normal men and women older than 50 years of age compared with younger persons.(ABSTRACT TRUNCATED AT 250 WORDS)

A hypothesis is formulated about the mechanisms causing adverse reactions to contrast media. Contrast media act in two ways. They stimulate the mast cells to release histamine and leukotrienes, and they inhibit the enzymes which otherwise degrade leukotrienes. Thus individuals, especially those with a history of allergy, are easily exposed to undue amounts of leukotrienes and these are responsible for the adverse reactions.

Thirty-seven patients with angiographically or operatively confirmed acute, chronic or postoperative aortic dissection were examined by means of dynamic CT and the results compared with those obtained by angiography and ultrasonography (US). The diagnostic accuracy was 87 per cent for CT, 97 per cent for angiography, and 76 per cent for US, although US was only available in less than half of the cases. The highest accuracy (95%) of CT was achieved in the pre-operative group, which is comparable with the 97 per cent accuracy achieved using angiography. Three patients in the postoperative group had false negative CTs, resulting in an overall accuracy of 82 per cent as compared with 100 per cent for angiography. Despite its diagnostic capacity, CT could not define the complete extent of dissection in four patients. The descending thoracic aorta was the area most difficult for CT examinations because of frequent artifacts in the images.