Radiologia clinica最新文献

This is the first of two articles which discuss the radiological features of asymptomatic mediastinal pseudo-tumours of vascular origin, detected accidentally on routine chest X-rays. With a view to possible subsequent surgery, it is of vital importance not to confuse a vascular pseudo-tumour of the meadiastinum with a neoplasm. The radiological appearances of the penetrated chest X-ray, and oesophagographic and tomographic findings, are fairly characteristic. The tomographic features are given special attention. A distinction is made between vascular pseudo- tumours of arterial and of venous origin. The first article discusses pseudo-tumours of arterial origin, the majority of which are based on a tortuous descending aorta, buckling innominate artery, aneurysm of the aorta or congenital anomalies of the aortic arch and its major branches.

Detailed computerized calculations of 28 radium tongue implants permit the conclusion that dose-time adjustment especially when geometry is poor, increases the chance of recurrence. The overdosage volume in the vicinity of the needles could be calculated and is small. Because of greater adaptability of afterloading iridium techniques and better results according to others, our patients are now treated with a combination of external beam treatment and iridium implant.

A case of histologically verified medulloblastoma occurring in an 88-year-old woman is described. A search of the literature indicates that with respect to age this case is unique. Further, 33 histologically verified cases of medulloblastoma reported in the literature are analyzed with respect to incidence and prognosis as a function of histological type, tumor location, age and sex. The statistical study has confirmed the relative relationships found by Chatty and Earle in their analysis of 105 cases in 1971 and has further indicated a tendency for male desmoplastic differentiation. A survey of an additional 216 cases in the literature reveals an improvement in average survival from 25 to 27 months since 1971, possibly reflecting refined therapeutic techniques. The changing survival expectany with surviving interval has been computed at 10 months per survival year.

Selective arterial embolization with Gelfoam was performed in 45 cases of hypernephroma. In 33 cases this technique has been utilized as preoperative procedure and almost always (97%) nephrectomy was facilitated: 97% of the cases had slight or moderate operative bleeding; in 82% of the cases separation of the tumor-containing kidney from adjacent tissues was easy. Embolization has been employed in 12 inoperable patients and was effective mainly in management of bleeding. Angiographic controls after embolization (from 13 to 162 days) were performed 8 times and it was assessed that the efficacy of the procedure on primary tumor growth is limited in time by renal artery revascularization. The embolized patients never presented severe complications, except several episodes of transitory renal failure.

In our series of 110 patients, 22 developed a total of 32 gastrointestinal complications after renal transplantation, leading to a fatal issue in 9 (41%). Upper gastrointestinal bleeding is to be regarded as the principal complication which, particularly in combination with liver failure due to Australia antigen positive hepatitis, led to death. Other complications were pancreatitis, diffuse oesophagitis, ileus, fistulae with abscesses, and malignancy. The radiological findings, pathogenesis and therapeutic results are discussed.

From April 1971 to September 1977, 94 children with acute lymphocytic leukemia, in whom a complete clinical and hematologic remission had been obtained received preventive cranial irradiation at the University Clinic for Radiotherapy of Vienna. So far, only in 2 of the 94 patients an initial meningeal relapse occurred. After a minimum follow-up time of 3 years, the rate of primary CNS relapse is 8%. The combination of cranial irradiation and methotrexate intrathecally, beginning currently in the first month of the complete remission, seems to be the most effective and least hazardous regimen to prevent meningeal and CNS leukemia.

The authors describes the plain film radiographic changes due to traumatic, perirenal hemorrhage in 43 patients. The direct effect of the hematoma: (1) partially or completely obscures the kidney; (2) usually obscures adjacent lumbar muscles, and (3) often produces a tilt of the lumbar spine to the affected side. The mass effect of the hematoma displaces adjacent organs and varies with its supra- or inframesocolic position.

100 patients with a known history of choledocholithiasis were selected. The main reasons for performing ERCP were the presence of severe jaundice or insufficient information obtained with intravenous cholangiography. Analysis is made of the various complications due to the presence of common bile duct stones. A surprisingly high incidence of choledochoduodenal fistulas was seen; two types of such fistulas can be recognized. A brief discussion is given of etiological factors involved. ERCP is also very useful in the evaluation of surgical anastomosis and complications due to surgery such as narrowing or complete ligation of the common bile duct. Finally, pancreatitis, another complication of choledocholithiasis, is evaluated with ERCP, showing the importance of reflux from the common bile duct into the pancreatic ducts in the etiology of this condition.

2 cases of malignant melanoma with lymph node metastases evaluated by lymphography and arteriography are reported. This combination of methods established the extent of lymphatic dissemination which neither method alone had managed, irrespective of the sequence of the examinations.

A diagnostic method is presented for the quantitative determination of fat absorption. The method utilizes breath analysis of radioactive 14CO2 and involves the measurement of both the fat and fatty acid absorption curves, whereby the fat absorption curve is directly compared to the fatty acid absorption curve for a particular patient. The test results are standardized by fitting all measurements to a gamma-density function.