Ceskoslovenska radiologie最新文献

Anastomoses between carotid and vertebrobasilar vascular bed in extracranial region are less usual compensatory anastomoses of the brain vascular bed. They are either langer compensatory arteries--a. hypoglossica primitiva or a. proatlantica or smaller anastomoses between a. carotis externa and a. vertebralis. A precise differential diagnosis is difficult, as it requires selective catheterization of a. carotis externa, interna, a. vertebralis, or arcography. The paper demonstrates two cases. In a 75 years old man with symptoms of vertebrobasilar insufficiency there was a substantial filling of the whole vertebrobasilar vascular bed in puncture of a. carotis communis. In a 14 years old girl with coarctation of the aorta, acute hemiplegia and occlusion of a. carotis interna in supraclinoideal area there was a conspicuous abnormal filling of large veins in dorsal part of the neck and filling of the atlas loop of a. vertebralis. Selective catheterization could not be performed. The author is of the opinion that the case was an anastomosis between a. occipitalis and a. vertebralis.

The authors compared the autopsy and tomographic findings of meatus acusticus int. In addition to the dimensions of meatus acusticus int. the authors also evaluated its shape and measured the distance between fossa jugularis and lower wall of fundus. The mean values of six parameters observed and measured on the cadavers and the tomograms differed in the following way: three parameters up to 0.5 mm and three by 0.8 mm, 1.1 mm and 1.2 mm, respectively. In eight patients the tomograms were evaluated as pathological; these were described in detail and put into relation to CT, CT-cisternomeatographic or the operation finding.

The tuberous sclerosis is a rare hereditary disease which mostly becomes manifest in a triad of symptoms: epilepsy, mental defects and skin changes of the adenoma sebaceum Pringle type. There may be an atypical clinical picture without neurological or psychiatric signs, in 50% of cases also without skin changes. Bone changes in tuberous sclerosis are asymptomatic and present in up to 50% of patients. Their finding in patients without basic known symptoms may be the cause of mistaking it for osteoplastic metastases. A case like that was described in the case history part of the communication. The knowledge of the possibilities of these changes in tuberous sclerosis may considerably ease differential diagnosis by suitable indication of computer tomography of the brain with the finding of typical calcifications.

The diagnosis of tissue parasitoses has remained complicated until the present time for variability of clinical picture. Their incidence been increasing due to aimed and accidental findings of foci in parenchymal organs employing new methods of visualization such as computer tomography and especially ultrasonography whose advantage is a good detection rate, availability and a possibility to follow the dynamics of parasitosis development. The authors present a survey of ultra-sonographic findings of the liver in cases of tissue parasitoses occurring in Czechoslovakia, while using their own image documentation. If a focal affection in the liver is established the differential diagnosis considerations should also take into account a tissue parasitosis, whose ultrasound picture may be nonspecific.

The authors described and evaluated clinical and CT pictures of five children with persistence of hyperplastic primary vitreous body originating due to regression of embryonal hyaloid vascular system. It becomes clinically manifest especially in leucocoria, reduced globe of the eye, prolonged ciliary processi and the formation of fibrovascular changes behind the lens. CT picture is characterized by a) increased density of vitreous body, b) dense stripes going in retrolental direction and in the course of the Cloquet canal, c) microphthalmus, d) absence of calcifications and e) facultative changes on the lens and anterior chamber. These signs represent an important criterium for differentiating persistence of hyperplastic primary vitreous body from retinoblastoma.

Results of a retrospective study from the years 1961 to 1986 have been presented based on hospitalization of 292 patients with benign tumours of the lungs and bronchi verified by histology. The prevailing tumours in the cohort were chondrohamartomas (62.0%) and carcinoids (21.9%). The tumours were localized more frequently inside the parenchyma (75.7%) than inside the bronchi (24.3%). The patients were men in 59.9% and women in 40.1%, the mean age during hospitalization being 48.8 years. In 60.6% of the patients the tumours were detected during an accidental radiographic examination, the tumour increased in size over several years of observation in 22.6% of the patients. A total of 280 patients (95.5%) were surgically treated, the tumour was removed in the bronchoscopic way in nine cases, two patients could not be operated on for advanced processes and one patient refused the operation. In 83.2% of the patients the surgical intervention was smaller than lobectomy, larger interventions prevailed in endobronchial localization making 54% on the whole, bronchial carcinoids being 71% of these.

Percutaneous transluminal angioplasty (PTA) takes its stable position in the therapy of obliterating arterial diseases. Its indication areas considerably extend. The authors present a survey of their experience and the results of PTA of arteries supplying the brain and upper extremities. This surgery was made in 29 patients on 31 arteries. The authors consider PTA on a. subclavia as a method of choice. In the angioplasty on a. vertebralis there is a very low risk in correctly indicated cases. An atherosclerotic stricture of a. carotis interna is not considered suitable for PTA for the risk of embolism from the exulcerated plaques. However, the method may be used with advantage in the stenosis based on fibromuscular dysplasia and in some cases of early restenoses in a. carotis interna after previous endarterectomy. The authors arrive at the conclusion that PTA, if correctly indicated, is a safe method even in arteries supplying the brain and upper extremities. No complication was observed in the reported group.

The investigation studied the relation of 99mTc-pyrophosphate incorporation (99mTc-PYP) into experimental, 48-hours old myocardial infarction in dogs to tissue vascular supply and to the extent of necrotic tissue. The experimental myocardial infarction was induced in five animals during an operation by the ligation RIVA. The myocardial blood supply was measured in tissue samples, taken from transverse sections of the infarction by means of 86Rb captation. The extent of myocytolysis was measured by depletion of tissue creatine kinase (CK). In the subendocardial layer of the infarction it became obvious that 99mTc-PYP incorporation was proportional to the decrease of tissue blood supply. No relation between the extent of necrosis and the incorporation of the radioactive chemical was demonstrated. The accumulation of 99mTc-PYP requires the necrosis to be present, but its extent apparently does not influence the intensity of incorporation. In the subepicardial infarction layer there was neither a relation of the radioactive chemical cumulation to the blood flow, nor to the extent of the necrosis proved.

The authors compared the results in the regression of uterus cervix tumour after intracavital therapy with gamma-neutron irradiation by 252cf and conventional sources of radiation gamma 226Ra in the course of a combined radiotherapy procedure. On the basis of a randomized study in 20 patients for a group it became obvious that due to the irradiation of the tumour in the initial phase of therapeutic cycle by physical dose 2 Gy of neutron component of 252Cf in the point A there was an increased regression of the tumour process causing in the 6th week since the beginning of the therapy a significant difference in the size of the tumours in both groups of patients. The time period required for 50% tumour reduction from the beginning of the therapy proved to be 23 days in patients treated with the 252Cf nuclide as compared with 48 days in the group of patients after conventional therapy.