Radiologia clinica最新文献

80 patients with carcinoma of the nasopharynx classified according to TNM categories who have been treated in the RRTI between January 1947 and January 1966 are discussed. During 1947-1957 patients were treated by orthovoltage, and after this period by cobalt machine. The actuarial 5-year survival rate was 35%. Various factors such as age, sex, sign and symptoms, TNM classification, histology and type of treatment are discussed and related to the incidence of:local recurrence 27% (20/73); regional recurrence 29% (17/58); invasion of the base of the skull 21% (16/78); regional metastases 38% (30/78); distant metastases 49% (38/78), and to 5-year survival 33% (26/80). An overview is given of the present method of treatment in the RRTI based on the data in literature and obtained in this analysis.

We tried to classify the anastomoses between the coeliac and the superior mesenteric artery into four groups: anastomoses in the pancreatico-duodenal region, Bühler's longitudinal anastomoses, anastomoses in the hepatic region and atypical cases. The possible causes of origin are shortly discussed.

75 angiographic examinations were done in 64 children aged 1 day to 16 years; 41 with various liver diseases and 23 with normal lives. The angiographic diagnosis was accurate in 95% of 44 patients where proof was established by surgery and/or biopsy. Properly used hepatic angiography is a reasonably safe procedure of great value in diagnosing and planning the surgical management of liver masses. It is also a useful tool in the diagnosis of diffuse hepatic processes of neoplastic, inflammatory or degenerative origin.

The early and late radiological features of damage to the stomach and duodenum caused by acid ingestion are described based on our experience with ten patients. The radiological features of early corrosive damage to the stomach caused by acid are: gastric atony, thickened mucosal folds and mural filling defects representing mucosal edema, mural hematoma and necrosis. Similar changes, although to a lesser degree, can be seen in the duodenum. Within a few weeks after ingestion there is rapid progression to antropyloric stenosis, leading to gastric outlet obstruction. The clinical and radiological picture of corrosive gastritis may closely resemble that of malignancy of the stomach. Acid ingestion, particularly with suicidal intent, is not a rare occurrence, and the radiologist has an important part in its diagnosis, evaluation and management.

The authors devised their own craniometric method of determining the normal position of the venous angle on the lateral phlebogram. The fundamental principles of the method are as follows: (1) two auxiliary lines; i.e. (a) a horizontal line the nasion - the tuberculum sellae (N-TS); (b)a diagonal line the nasion - the tabula interna (N-Ti); (2) the two auxiliary lines form the angle alpha, which is equal to 20.44+/- 4.2 degree; (3) the proportional position of the venous angle (the point of intersection S on the diagonal N-Ti) is the ratio of the distance N-S to the total length of the diagonal N-Ti,i.e.: (formula: see text). The value is equal to 49.8 +/- 4.6%. The present method takes into consideration both the length and the height of the skull, has a small statistical dispersion and is simpler than the other available methods.

Arterial injuries attributed to irradiation are most frequent about the head and neck and are invariably triggered by infection, infarction, or fistulas. Vascular changes from surgery or invasive behavior of tumor can also contribute to local vascular insufficiencies. It is quite possible in humans that irradiation can accelerate the aging processes in atherosclerotic vessels. The case reported is unusual in that rather routine, postoperative, pelvic irradiation was given for pelvic soft tissue and bone carcinomatosis, only to be followed in 6 months to 1 year by vascular insufficiency symptoms in the lower extremities. Symptoms progressed to the point that surgical correction was contemplated, but then postponed when signs and symptoms improved following cessation of smoking. The patient had had no previous history of a Reynaud's diathesis. Although histologic proof is lacking (patient continues to do generally quite well 5 years following palliative treatment), field films and subsequent angiographic abnormalities can be superimposed almost exactly. Neither author is entirely happy with the diagnosis of 'radiation arteritis' for the reasons discussed, but the coincidence of radiation fields and areas of arterial damage makes the role of irradiation indicating.

Spontaneous pneumothorax is an uncommon complication of lung metastatic disease. In most of the cases reported until today, the primary disease was a sarcoma (osteogenic sarcoma, soft tissue sarcoma, hemangioendotheliosarcoma, and Ewing's sarcoma). An exceptional case of spontaneous pneumothorax in a patient suffering from carcinoma of the breast with lung metastases, is herein presented. The pneumothorax developed immediately after regression of lung metastases during administration of combined chemotherapy. Some etiological factors, as well as the rarity of this complication and its treatment, are also discussed.

The appearance of lung metastases and their distribution in the axial plane was studied on radiographs of formalin-vapour inflated fixed lungs. The results show that the vast majority of lung metastases are to be found at the periphery of the lung, irrespective of cavitation or of their shape or size. This distribution cannot be explained by hydro-dynamic factors, but may be related to the susceptibility of metastases in different parts of the lung. the metastases were also analysed as to their appearances, namely well-defined nodular, star-like, ill-defined edge and cavitating. No definite correlation with distribution was apparent but when extremely numerous, metastases were usually less than 1 cm in diameter with ill-defined margins. This could be due to their rapidity of growth.

The angiographic findings in 18 patients with endocrine tumors of the pancreas are analyzed. A literature review (262 cases) is performed in order to assess the accuracy of angiography in diagnosing islet cell tumors, in particular multiple and small (less than 1 cm) lesions. Problems of differential diagnosis of pancreatic and extrapancreatic structures and lesions are discussed.