[A precision quotient method for densitometric evaluation of Roentgen cinefilms (author's transl)].
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Biomedical subjects
Publications and source records attributed to F Heuck.
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General and specific roentgen morphologic criteria of secondary metastases are described and characteristic appearances of metastatic disease demonstrated by examples. Early detection of tumor metastases and limitations of different radiologic methods are discussed. Various dynamic ways of development in bone metastasis during the course of malignant disease are described and different biologic growth properties of various tumors documented by different reaction of bone tissue. The high diagnostic value of radiologic follow up examinations for control of therapeutic results is emphasized. This applies for judgement of secondary metastatic as well as for the underlying malignant disease. Analysis of the bone structure of the Tela ossea of macro- and microradiologic films is presented for illustration.
The process of disappearance of small inflammatory pulmonary lesions is demonstrated by way of miliary tuberculosis. The dynamics of the healing process are described by the roentgenographic morphology, and the alterations of remaining pulmonary infiltrates to scars within the anatomical pulmonary structures are illustrated. The concept of apparent complete restitution is explained and the importance of the recognition of late pulmonary alterations is emphasized.
The frequency of congenital and acquired diverticula is discussed with reference to geographical aspects, their location and the function of the colon in diverticular disease. The X-ray findings in the presence of complications are demonstrated. Radiological differential diagnosis is discussed with special reference to cinematographic analysis of function. The possiblity of the simultaneous appearance of polyposis and carcinoma in diverticular diseases is indicated. A sensitive radiologic diagnostic procedure is important for planning of the optimal treatment.
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Coronary blood flow was measured by a cine densitometric method using a newly developed system incorporating computer data analysis. The first results concerning front and wave velocity of a selectively injected contrast bolus are reported. Average absolute flow volumes in the right coronary artery are 114 ml. per minute, in the left coronary artery, 88 ml per minute (RIVA = 52 ml/min., RC = ml/min.). There is good agreement with the results of dye dilution and isotope wash out techniques, but the latter are more complicated and less easily reproduced and therefore less suitable for routine use. The results are critically evaluated.
The physical basis of quotient densitometry is described. All stages are discussed, beginning with the production of the x-rays, their attenuation by the patient, their effect on the radiographic film, and the evaluation of the film by projection and its measurements by a photo cell in a Wheatstone bridge. Two values were obtained, one consisting of the signal together with background fog, the other of the background alone. By an analysis of the relationships of these measurements, obtained from specially separated points on the radiograph, it is possible to eliminate artefacts to a large extent.
In radio-cine-densitometry, random variations can be smoothed and reduced in two ways: temporal (frame to frame) and spatial (each frame). Both methods may, however, alter the signal measurements. The advantage of quotient cine-densitometry depends on the elimination of interference or random variations without changing the signal. Elimination of the variations occurs during signal recording. Amongst others the following are eliminated: variations in mains voltage, uneven development, absorption by other tissues and organs. A more suitable signal-to-noise ratio can be obtained. If an artery or a vein are opacified simultaneously it is possible, by means of quotient cine densitometry, to distinguish the arterial and venous phase and to analyse these separately from the overlying tissues.
In the present paper, the degree of resolution which can be achieved with quotient cine-densitometry is described. The accuracy of the procedure is illustrated. The superiority of this method over video-densitometry is pointed out.
Various expressions of the speed of flow of blood in arteries are discussed, such as instantaneous speed, integral speed, pulse wave speed (phase speed) and velocity of a moving front. The flow profile of the abdominal aorta was obtained by cine-densitometry, bearing in mind the above considerations, and the densitometric curves have been analysed. Differences of the flow velocities in different persons have been interpreted as a result of these theoretical considerations. The effects of the point of measurement, the distance over which the measurement was carried out and the pulse wave length on velocity were examined. In order to obtain a median blood stream velocity by angio-cine-densitometry, repeated injections of small volumes of contrast medium (random sampling method) are recommended.
The theoretical basis for measuring speed of flow in vessels of conscious patients obtained by estimating dilution of injected contrast is described. Previously, measurements at two separate points had to be carried out in order to obtain a flow profile, but with the present method, a single measurement point is adequate. If contrast is distributed evenly in the circulation during its flow to the periphery, the measurement can be carried out at some distance from the point of injection. The ability to select ones point of measurement makes it possible to avoid areas covered by overlying shadows and eliminates the difficulties inherent in measurements in curved vessels.
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Diagnostic radiological procedures in tumors of the adrenals are demonstrated and correlated to their clinical symptoms. Radiographic findings and special symptoms are described in 21 cases. Various investigative methods are demonstrated and their diagnostic value and approach in cases of adrenal diseases are debated. Differential diagnostic problems of tumors of the adrenals are discussed also.
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