[Ambiguous CT finding in a fulminant pneumococcal meningitis].
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Biomedical subjects
Publications and source records attributed to B Kober.
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Radiological diagnosis of bone metastases comprises multifarious examinations of varying diagnostic value. The incidence and topography of osseous metastases, as well as the x-ray morphological pattern, are described and the ranking of the various radiological methods discussed in detail. The diagnostic procedure to be followed in osseous metastases is explained on the basis of clinical examples, and the value of the individual methods in assessing the therapeutic effect is subjected to critical evaluation.
The osteotropic radionuclides 89Sr and 32P are now mainly used in the treatment of bone metastases. This therapy is palliative and is mainly directed at alleviating pain. The indications, procedure, treatment result and side effects are described as discussed. Bone metastases of iodinophilous thyroid carcinomas represent a special case. These can be treated selectively with 131I. However, complete regression of the tumour by means of radioactive iodine is only rarely achieved in bone metastases. Nevertheless, the complaints and symptoms are definitely alleviated even with relatively small radiation doses, similar to the therapy employing strontium.
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Frequency and location of "cold lesions" has been analysed in 1000 consecutive bone scans. Among the 554 abnormal cases there were 18 (1,8% of the total) with localized diminished activity due to metastatic lesions and 5 (0,5%) secondary to radiation osteitis. 10 of the 18 patients with metastatic disease had pure defects while 8 showed a reactive margin. It is pointed out that the quality of the examination is crucial for the demonstration of such defects and that single scans of the different regions of the skeleton are superior to a whole body scan. The survey of the literature shows that "cold lesions" are predominant in malignant bone diseases, however no relation exists to a definite histology.
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