Radiologia clinica最新文献

On the bases of 25 patients examined by orbital venography, computer tomography, (CT scanning) and sometimes carotid angiography, the diagnostic value of each of these methods is evaluated. The data obtained are compared with the corresponding information from the literature. In view of the findings it can be stated that CT scanning can be regarded as the primary neuroradiological examination in cases of exophthalmos. Orbital venography gives supplementary information in cases of varices and venous malformations. Angiography is the method which supplies the maximum of information when cavernous sinus fistulae are clinically suspected. With reference to 3 patients it is explained that in such selective angiography of the internal and external carotid and the vertebral artery is indicated.

Metrizamide (Amipaque) is a new water-soluble contrast medium for myelography. It differs from the conventional contrast media in that, because of its lower toxicity, it can be used also for cervical and thoracic myelography. The method of examination in myelography with water-soluble contrast media differs in some respects from that in myelography with oil-soluble contrast media. For the thoracic region, tomography is highly recommendable. After a description of the method of examination used, some examples of the abnormalities found are presented.

The possibilities for reducing in Van de Geijn's computer program the original limitations for the size and the position within the field of shielding blocks are explored. New methods are presented which are based on experimental measurements as well as more theoretical approaches, without need for any change in the program itself. Two typical clinical examples are presented and the precision obtained critically investigated.

Apart from plain X-rays of the orbit, the principal radiological methods of examination of exophthalmos are: orbital phlebography, carotid arteriography and, recently, computer tomography. The value of each of these methods is discussed with reference to four patients suffering from exophthalmos of varying aetiology. Computer tomography supplies the most comprehensive information on localization and extent of retro-orbital processes as causes of exophthalmos. Phlebography would seem to be the method of choice in demonstrating processes close to the osseous boundaries of the orbit. Information on the aetiology of retro-orbital processes is rarely obtained by radiological methods. In this respect carotid arteriography would seem to make the most important contribution.

The accuracy of the mammography was studied on 655 breasts which were investigated and biopsied or treated surgically shortly afterward. The mammography reports were classified according to the confidence level of the statements. In 279 cases the mammography was interpreted as positive for malignancy. A total of 224 malignant tumors were found. In 30 cases the malignant lesion was missed on the mammograms. The diagnoses made with a high degree of certainty were correct in 90% of the cases. The sensitivity of the mammography was 86.6% at a specificity of 80.7% for malignant tumors. The value of mammography for the diagnosis of chronic mastopathy could not be determined objectively. The sensitivity for solitary benign tumors or cysts was 80%.

This article outlines several ways of achieving adequate visualization of the epidural venous plexus in the diagnosis of lumbar disc herniation. Preference is expressed for simultaneous injection of contrast medium via two catheters selecttively introduced into the lateral sacral segmental veins or into the left and right internal iliac veins. For visualization of the epidural veins, the investigator has a choice of over 20 different procedures. The position of choice of the catheter tip(s) can vary during the examination, dependent on diagnostic problems or technical catheterization problems. Epidural venography should be regarded as a very accurate, relatively simple method of demonstrating disc herniations in the lumbar region. This method is especially recommendable in cases that are clinically suspect but have a negative or dubious caudogram. The risk of complications is very small. It is also a good method for azygography. It is possible to perform the examination on outpatients.