50 Patienten w u r d e n in d e r unmi t te lbaren postoperat iven Phase n a c h Nierentransplantat ioi i rnit d e r farbkodierten Duplexsonographie un te rsucht . Dieses Verf a h r e n ist e i n e Weiterentwicklung d e r konventionellen L)uplexsonographie lind e rmögl ich t n e b e n d e r I>arstellung d e r Weichteile im Real-time-Bild d ie s imul tane Abbildung d e r Blutbewegung ü b e r die g a n z e Bildfläche. Bei allen Patienten k o n n t e mi t d ieser Methode die Durchblutung d e s Transp lan ta tes s icher dargestel l t w e r d e n . F ü r die Frages tel lung d e r Perfusion d e r 'Transplantatniere k a n n die fa rbkodierte I>uplexsonographie d ie Szint igraphie u n d .Angiog r a p h i e e rse tzen . Eine s ichere Untersche idung zwischen e i n e r akuten tubulären Nekrose u n d e i n e r a k u t e n Rejektion mit Hilfe d e r Spekt ru inana lyse d e s Blutflusses a u s d e n Nierenar te r ien ist nicht möglich.
Bei 13 Patienten mit einseitiger Obstruktion einer der Aa. carotis internae war die Hemisphärendurchblutung unter Huhebedingungen symmetrisch. Nach Stimulation mit l g Acetazolamid hat der Rlutfluß auf der gesunden Seite um 47 % zugenommen. Die Hemisphäre distal der Karotisobstruktion zeigte bei 8 Patienten (Gruppe A) gleichmäßigen Perfusionsanstieg, was auf eine ausreichende Perfusionsreserve schließen Iäßt. Bei 5 Patienten (Gruppe B) ist es zu einer signifikanten Asymmetrie mit Minderdurchblutung auf der Seite mit Gefaßpathologie gekommen. Dies deutet auf eine verminderte Perfusionsreserve hin. Das Auftreten einer interhemisphänschen Differenz im Acetazolamid-Stimulationstect kann als Entscheidungskriterium für die Thrombendarteriektomie herangezogen werden.
The findings on MR tomography in 31 vascular malformations of the central nervous system are described; 26 of these had angiography and 24 were examined by CT. There were 19 A-V angiomas, 7 cavernomas and 5 large aneurysms. MRT provided a correct diagnosis in 29 out of 31 cases, angiography succeeded in 19 out of 26 cases and CT in 20 of 24. MRT was superior to CT and angiography. Nevertheless, it cannot replace arteriography, since this is the only method for demonstrating the vascular supply of angiomas and small aneurysms can be demonstrated only by arteriography.
: Transient osteoporosis of the hip is a syndrome that does not seem to be widely known; this is also true for its radiological appearance. It is often mistaken for avascular necrosis of the femoral head, metastatic or inflammatory disease. These differential diagnoses lead to more or less invasive procedures, although transient osteoporosis does not require more than immobilisation for complete remission. MRI was done in 38 patients with acute hip pain, 13 had femoral head necrosis and 8 transient osteoporosis. Follow-up studies via MRI in patients with transient osteoporosis revealed 3 stages (diffuse, focal, residual) during the clinical course of which stage II is similar to femoral head necrosis but always without the typical sclerotic rim.
The radiological and clinical findings of 12 patients with ectopic gastric mucosa in the duodenal bulb are presented. This is a defined disease with characteristic radiological features: multiple small nodular defects of the contrast medium of 1-3 mm diameter. Histology shows complete heterotopia. Pathogenesis and clinical significance are discussed with reference to the literature on this subject.
Observation d'une femme de 54 ans. Description des donnees de la gastroscopie, du repas baryte, de la tomodensitometrie et de l'autopsie
Conventional methods of thyroid diagnosis, such as scintigraphy, differentiate between hot and cold areas, but within cold areas no distinction between malignant and benign changes is possible. Angiodynography provides a new method which gives the usual sonographic information and also indicated variations in blood-flow in the organ. Various diagnostic methods--thyroid scintigraphy, conventional sonography, fine-needle biopsy and angiodynography--have been compared in patients with focal thyroid disease. It has been shown that it is possible to differentiate between malignant and benign lesions on the basis of their vascularisation.
The sonographic appearances of the pleura were studied in 20 normals and in eight patients with radiologically confirmed pneumothoraces. In all 20 normals it was possible to demonstrate the respiratory excursion of the visceral pleura. Moreover, the margin between pleura and aerated lung parenchyma was marked by artifacts resembling a comet's tail. In all eight patients with pneumothoraces pleural air could be inferred by the absence of pleural movement and of the comet-tail artifacts. In emergency situations, where it is not possible to obtain radiographs, or to obtain them with sufficient speed, sonography may make a crucial contribution to the diagnosis of a pneumothorax.
The value of non contrast computed tomography for the early diagnosis and staging of acute pancreatitis has been investigated in 90 patients. The volume of the pancreas and of extra-pancreatic inflammatory infiltrates was statistically significantly larger in necrotising pancreatitis than in interstitial pancreatitis. The extent of intrapancreatic hypodensity (below 40 HU) showed no significant correlation with the pathologically determined extent of pancreatic necrosis. Densitometry of the extrapancreatic infiltrate indicates its nature with considerable accuracy (oedematous-inflammatory or haemorrhagic-necrotising).
By using surface coils and a high resolution matrix, the images from MR tomography of small objects can be greatly improved. Normal subjects have been examined in order to demonstrate the usefulness of MR tomography for the examination of bones and soft tissues in the normal hand.
lnlroduclion Iniraiibdi)iniiii~I blrediiig is ii wrllkiiowii c.oiiipli<:ii-tiori of anticoagulant thcrapy. the retropcritoneurn. abdoiniiial wall. gostrointestinal tract. mrsrntery and prritcinral e,;lvity bring Ihr c:cim-moiinstlocatioiis affcctcd (2). At presciit CTscan 1s thc radiological pro-c:cidurc ol'choice to denionstrate and localise this pathologic cntity ( 5 . 0 . 8. C)). Wo rrport ihr casr of ii youiig iiiüii witli a vriitriculoperitoi~~~ül sliuiit (VPS) on anticoagulant tlierapy for a congenilal deficit ofariti-tlirornbin III who developed siiddnn i~bdoiriirial disterisioii aiid acutr aiiaeiiiia. A CT abdoiiiinal scan dcnionstiatcd an unsuspcctcd ccrcbro-spinal fluid ((:CF) pseiidocyst containing large haemorrhagic areas iiisidr it. To our kiiowledge. sponlaneoiis haernorrhage iii aii abdoini-iial CSF pseudocyst secondary to anticoagulant therapy has not been previously drscribrd.
The purpose of this report is to describe the technique of suprasternal and parasternal mediastinal sonography. Via the suprasternal approach, the supraaortic region, the paratracheal region and the aorticopulmonary window can be evaluated. The parasternal approach in right and left decubitus position is suitable for imaging the anterior mediastinum, pericardial and subcarinal spaces. The proportion of technically inadequate examinations of the different mediastinal compartments varies between 4 and 15%. The main indications for mediastinal sonography are described from our experience in the last 4 years.
