Radiologia clinica最新文献

With reference to a patient with Caroli's disease (segmentally dilatated intrahepatic bile ducts), the clinical features of this rare but serious disease are described. The condition differs from other cystic dilatations of the bile ducts in that only the intrahepatic bile ducts are involved. Its pathogenesis is obscure. It is suspected that an embryonic developmental disorder in the wall of the bile ducts causes cysts via physiological periodical increases of pressure. The diagnosis is made accidentally by cholangiography via the T-drain during or after cholecystectomy. When Caroli's disease is suspected, echography can be a valuable diagnostic aid.

Discussion of the humeral head compression and the pectoralis minor compression as a possible reflection of the thoracic outlet compression syndrome. Pictures of both compressions on the axillary artery are presented.

4 patients in whom ante mortem diagnosis of bone metastases was made, suffering from primary carcinoma of endometrium, cervix, ovary and vulva, respectively, are herein presented. The different routes of spread of these tumors, as well as a review of the incidence of bone metastases in gynecological malignancies are discussed.

62 Patients with uterine carcinoma of cervix treated with high-dose large-volume full-pelvic irradiation given through co-axial-opposing pair portals over the anterior and posterior pelvis. Of these patients, 29 also received a single course of intracavitary radium supplementary to external beam irradiation. Only the severe complications which required surgical intervention have been analyzed, In the group of 33 patients who received only external irradiation, 4 developed such complications (12.1%).The overall incidence of those complications was about 19.3%. It is concluded that the treatment with hidh-dose large-volume full-pelvic irradiation technique, utilizing two opposing parallel pelvic portals, carries an incidence of morbidity 3-4 times the acceptable level and should be discouraged. Alternative techniques are discussed.

Improved catheterization technique and new laboratory methods have increased the value of venography in the diagnosis of tumors, especially of hormone-producing tumors. A review of catheterization techniques for the diagnosis of tumors of the adrenal glands, pancreas, parathyroid glands and orbit is presented with examples of findings.

(1) In all, 70 patients with carcinoma of the oral cavity and oropharynx have been treated utilizing one or more of several interstitial iridium-192 afterloading techniques. (2) After an 18-month minimum follow-up period, local control is still maintained in 9 of 10 patients with T1 and T2 lesions (UICC), in 17 of 22 patients with T3 lesions, and in 21 of 38 patients reirradiated for recurrent disease. The complication rate of 29% in the reirradiated patients, though high, is considered acceptable in these essentially hopeless cases. (3) This preliminary report is made to stimulate interest in the role of interstitial iridium-192 afterloading techniques. We feel they deserve evaluation in a controlled study of other head and neck cancer management techniques (including external irradiation, surgical resection and adjunctive chemotherapy).

This paper discusses the possibility of using arthrography of the humeroscapular joint for further differentiation of the syndrome of humeroscapular periarthritis. A description of the normal arthrogram is followed by a discussion of the arthrographic features of rupture of the rotator cuff, rupture of the long biceps tendon, and anomalies of the joint capsule.

Gastric cancer is a common cause of death in the Netherlands. The prognosis is generally poor at the time of diagnosis. The designation early gastric cancer (EGC) refers to a gastric carcinoma which does not infiltrate beyond the submucosa. This definition is not influenced by absence or presence of metastases or by the diameter of the tumour. The 5-year survival of EGC is 90% or more. In the Netherlands too, the diagnosis can regularly be made if--in the case of persistent vague upper abdominal complaints--an optimal radiological examination of the stomach is done. At even the slightest radiological suspicion, or if complaints persist in spite of negative radiological findings, gastroscopic examination and multiple aimed biopsies should follow. Personal observations in ten cases are presented.

The benefits of the direct-puncture carotid angiography with the proximal-compression technique are not fully evaluated if not compared with a more simple diagnostic procedure, i.e. the femoral-catheter technique. In order to discuss this, a case history of a patient who underwent simultaneously both types of examination is presented.