[Informational value of 3-dimensional secondary section reconstruction of skeletal findings in roentgen computer tomography].
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Biomedical subjects
Publications and source records attributed to F Heuck.
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The effect of respiratory movement of abdominal organs on computer tomography is illustrated. Methods for an objective evaluation of the reproducibility of tomograms are presented. A procedure for the quantitative determination of the respiratory movement of abdominal organs using computer tomography is described.
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The past decade has shown an increase in the number of rare primary hepatic tumors, such as focal nodular hyperplasia (FNH), and hepatocellular adenoma and carcinoma. Some examples serve to demonstrate the value of scintigraphy, ultrasound, angiography and CT in the diagnosis of these lesions. Furthermore, the value of the radiographic finding for treatment and follow-up studies is pointed out--in conservative as well as surgical treatment.
A method for the in vivo investigation of the mineral distribution in human vertebral bodies by the aid of computed tomography is presented. The attenuation coefficients resulting from transversal tomograms of vertebral spongiosa are compared with the results of bone ashing from in vitro investigations. Computed tomography values, ash weights and photodensitometric values show a high degree of correlation.
Initially, the history of radiographic diagnosis of the gallbladder is reviewed. Then, examples are given to demonstrate morphology and topography of a normally and an abnormally developed gallbladder. Then, CT findings of pathology of the biliary system are demonstrated, such as calculi, inflammation, hydrops and neoplasia. A postulation is made that not only should CT be used in cholestasis but also in a nonvisulized cholecystrogram. The value and the limitations of CT are pointed out, as well as the necessity to always include the evaluation of bile ducts and gallbladder in the analysis of obscure clinical upper abdominal findings.
Initially, the hitherto existing radiographic methods of investigating the adrenal gland are demonstrated. Whole body CT opens a third dimension--in addition to being a non invasive method without risk. The normal CT findings of the adrenal gland are described, as well as the normal variants in shape and position. With help of morphometry and image manipulation, measurements of the size of the adrenal gland in 20 healthy patients were made and are being listed; and the respective normal variants as well as hypo- and hyperplasia are pointed out. Some examples serve to illustrate pathologic conditions, such as inflammation and benign and malignant primary and secondary neoplasia. Finally, the value of adrenal gland CT is discussed in reference to the other existing respective radiographic methods.
Primary varicosis is due to congenital or acquired defects of the venous wall and valves. Subjective patient complaints are often different and even in contrast to clinical findings. The combination of insufficiency of the large superficial veins and insufficiency of the perforating veins often leads to chronic venous insufficiency with crural ulceration. Phlebography is indicated prior to surgery in order to evaluate the deep and the perforating veins and to check for variants. The recurrance rate for varicosis is low if all insufficient superficial and perforating veins are made functionless.
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Morphology of solid, lamellar and spicular periosteal reactions of benign and malignant primary and metastatic bone tumors in x-ray-pictures with regard to common and specific characteristics of different bone tumors is presented. The specific behaviour of the periosteum itself and of the subperiosteal region as an expression of the reactive biodynamics in skeletal neoplasia is demonstrated; and the diagnostic value of the radiograph is explained. The possibilities but also the limitations of sophisticated radiologic image analysis in establishing a differential diagnosis and a diagnosis of bone tumors and other bone lesions are discussed.
CT can clearly demonstrate dilation of intra- and extra-hepatic bile ducts due to mechanical obstruction. Note is made that the intrahepatic bile must not necessarily participate in dilation in obstructive jaundice. The cause in 27 cases observed in our institutions was as follows: 16 pancreatic tumors; 1 stone; 2 extrahepatic bile duct obstructions; 4 liver lesions (tumor and cirrhosis) and 4 with cause unknown. Furthermore, CT is helpful in the evaluation of hepatogenic non-obstructive jaundice such as due to primary liver cell carcinoma (hepatoma), metastases to the liver and advanced cirrhosis of the liver. The value of CT in the evaluation of different types of cholestasis is demonstrated by several exemplary cases; and the problems of differential diagnosis are pointed out.
The radiographic pattern of multiple disseminated pulmonary nodules is especially difficult to interpret. There are some special forms of primary and secondary lung neoplasia which present as small nodular lesions of various distribution. Alveolar cell carcinoma and bronchogenic carcinoma with intracanalicular spread or small nodular or even miliary type lesions serve as well known examples. The radiographic morphology of small disseminated nodular foci of pulmonary metastases of primary lung tumors as well as of tumors outside the lung is being discussed. Even very subtle film analysis, observation of all radiological signs, as well as the clinical picture and the laboratory data, provides only limited help for the differential diagnosis.
Periosteal reaction is frequently the first sign of systemic disease affecting the skeleton, including generalized osteopathia. It can be generalized, focal, monostotic or polyostotic and shows solid, lamellary or interrrupted spiculae-like reaction. A reliable diagnosis is possible from the interpretation of these changes, as for instance with spiculae: Very dense and evenly arranged spiculae are only seen in hemolytic anemias and metastases of neurogenic tumors. Onionskin like periosteal reaction with simultaneous transformation of the diaphyseal cortex are difficult to interpret. However, in case of hyperparathyreoidism, subperiosteal resorption and transformation of the diaphyseal cortex permit precise diagnosis. Follow-up examinations have prognostic and therapeutic value. The knowledge of the different morphology of periosteal reaction associated with systemic disease (including generalized osteopathias) is important in diagnostic radiology.
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The normal flow values through healthy or moderately narrowed coronary arteries, which had been determined by a new method of cine radiography, together with a computer, were published in this Journal in 1976. In the present paper we report the results of further studies of flow velocity and flow volume through high-grade coronary artery stenosis of severity III and III--IV. Compared with the results obtained on normal and mildly stenosed arteries, measurements at rest through severely stenosed coronaries showed an almost constant flow. The first results on aorto-coronary vein graft measurement are described.
This new X-ray method is based on the densitometric measurement of the speeds and the flow of injected contrast media during an angiographic examination of the vessels and the parenchyma of the kidney. Pairs of highly sensitive photoconductive cells and a Wheatstone bridge circuit are used. Minimal doses of contrast media can be detected before vascular reaction influences the renal circulation. The measurement of various parameters allows the simultaneous hemodynamic analysis of kidney function and of factors related to the morphological substrate.