Ceskoslovenska radiologie最新文献

The authors present their first experience with lung DSA in a group of 75 patients. The examination was most frequently performed by instilling a contrast medium into central, less frequently into peripheral veins. The most frequent indications included tumorous lung diseases and mediastinal tumours before an operation treatment, a suspected pulmonary embolism, lung and vascular malformation. Intravenous DSA proved to be also useful in the evaluation of pathological changes of thoracic aorta.

The paper summarizes the experience in performing dilatation of benign stanoses of oesophagus of different origin. In the period from October 1985 through September 1987, 215 dilatation interventions were performed in 25 patients. The paper establishes necessary principles before the dilatation, evaluates the course and effect of dilatation in relation to the technique used and outlines a recommendation for rational procedure for safe execution of the therapeutic procedure.

A polarographic method was used to follow the changes in oxygenation of a tumour of uterus cervix after intracavital irradiation by 252Cf by a physical dose of 2 Gy, applied at the beginning of a therapeutic cycle of combined radiotherapy. The results reached are compared with the results of tumour oxygenation in the course of a conventional therapeutic procedure. It has become apparent that even after the irradiation of a tumour of uterus cervix by a small dose of gamma-neutron radiation with 252Cf there is, beginning with 2nd week of therapy, a significant reoxygenation of the tumour population. The changes of oxygenation after a conventional irradiation have been less marked and reached, in the 4th week of therapy, only marginally significant increase. Differences in reoxygenation of tumours of uterus cervix were confirmed by analysis of the oxygen test. The importance of tumour reoxygenation after the application of 252Cf source of radiation for facilitation of its regression in a combined treatment with Californium-252 and gamma irradiation is discussed.

Forty three patients were treated for cancer of prostate by irradiation at the Radiotherapeutic Ward of the Research Institute of Clinical and Experimental Oncology in the years 1976 to 1981. The five-year period of survival in patients with a localized tumorous disease was 45%. The authors analyzed causes of unsuccessful therapy and evaluated complications of the therapy, the latter being mostly early postirradiation reactions. Possibilities of improving the results of treatment in optimizing the radiotherapy of the localized prostate cancer are outlined.

The authors performed, in the period of 10/1980 to 12/1985, 102 PTA interventions in 95 patients in the peripheral region. The lasting clinical improvement of early and long-term duration was expressed by the Life-table method. In the whole cohort, 95% of patients proved to be improved clinically in the early period (3 months after the intervention), while 70% of patients were improved for long-term period (up to 66 months). The authors also compare the results reached in PTA of pelvis vascular bed and femoropopliteal region. In the PTA of pelvis vascular bed, improved clinical condition in the early period was reached in 95% of patients, long-term improvement was observed in 73% of individuals. In PTA of femoropopliteal region the early period showed improvement in 96% of patients, the long-term period indicated improvement in 52% of subjects.

In a native examination of lumbar region by computer tomography, hernia or a sequester of the disc may be imitated, in addition to cicatricing postoperation conditions, also by a convolute of varicose extended epidural veins. An unambiguous confirmation that the tissue in frontal epidural space is based on such pathological anatomical condition is possible if a repeated tomogram is made immediately after the administration of a contrast medium into a femoral vein while inferior vena cava has been compressed.

Space conditions in the spine canal play the decisive role in the origin of neurological difficulties connected with pressure on the spinal cord and its radices. For the diagnosis of spinal stenosis the dimensions of the spine canal are of importance: sagital, interpedicular, interarticular and the width of lateral recessus of the spine canal. The diagnostics of spinal stenosis is based on the anterior-posterior and lateral picture of the spine, CT examination and contrast examination of the spine canal--myeloradiculography. CT is included in the diagnostic algorhythm on the 2nd place after picture of the spine in classical projections. The anvantage of CT in its non-invasiveness, illustration without projection distortion and high sensitivity and specificity of the examination. Myeloradiculography is indicated for cases of uncertain findings with CT or discrepancy of the CT picture and clinical condition. It may be presumed that in the near future the CT examination will be required in the diagnosis of spine stenosis more frequently by the physicians.

In dilating oesophageal stenoses by balloon catheters it becomes necessary to adapt the technique of the intervention to the type and degree of stenosis and condition of the patient. The dilatation may be successfully performed even in very narrow postinflammation, postoperation and postcorrosion stenoses. The dilatation is usually performed for the period of 30 minutes, the shortest period between interventions being twice in a week, being followed by weekly or several weeks intervals. In a careful application of the balloon catheters transnasally or transorally it becomes possible to decrease the unpleasant feelings of the patient and possible complications to a minimum.

Stenosis or even occlusion of truncus coeliacus represents the most frequent cause in the development of collateral blood circulation with caudiocranial flow through extended pancreatic-duodenal arcades. In a group of 32 patients with such mesenteric-coeliacal collateral circulation their arteriographic picture was evaluated. The authors evaluated differences and specific diagnostic contribution of individual visualization methods for demonstration of arteries. The non-invasive visualization methods are of exceptional contribution in the examination of abdominoretroperitoneal region by considerably decreasing the needs of invasive angiographic examination of catheterization technique. This leads to a decrease in the number of diagnosed chronically developed viscerovisceral arterial collateral circulations of various etiologies. Ultrasonography and computer tomography well depicts morphological changes in the aorta diameter as well as unpaired visceral arteries in the segment of their branching. The viscerovisceral arterial collateral circulations, however, may not be detected or at least not to a sufficient degree. They are represented in detail in the whole course only by selective arteriography. The authors draw attention to supplementary role of arteriography within the framework of non-invasive visualization methods.

In a seven-month boy the authors diagnosed a concretion in the choledochus cyst and cystic dilation of intrahepatic bile ducts by ultrasonography. The finding was verified by surgery.