[Computed tomography of renal transplants].
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Biomedical subjects
Publications and source records attributed to F Kolmannskog.
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The computed tomography findings in 10 patients with pseudocysts or abscesses following acute pancreatitis are described. Computed tomography was of great value in demonstrating the type and extension of the pancreatic lesion. Endoscopic retrograde cholangiopancreatography was attempted in six cases, and the information gained about the pancreatic disease hardly justified the potential hazards of pancreatic duct filling. Endoscopic retrograde cholangiography may be indicated to demonstrate calculi of the bile ducts when other methods have failed.
Physical properties of photofluorography using an image intensifier tube with an input field of 30, 23 or 17 cm and 100 mm film were analysed and compared with full-size film in abdominal angiography. Factors influencing the image quality are discussed. The quality of the 100 mm films comes rather close to that of full-size films. When 17 and 23 cm input fields are sufficient, image intensifier photofluorography may replace full-size radiography. The 30 cm input field may be used in examinations of large vessels, to shorten exposure times in obese patients and in some special projections.
Endoscopic retrograde cholangiography (ERC) was performed in 28 patients with hepatobiliary disease associated with ulcerative colitis. The films were reviewed and correlated with diagnoses at liver biopsy. Thirteen patients with extrahepatic as well as intrahepatic bile duct abnormalities had characteristic cholangiographic findings compatible with sclerosing cholangitis, together with cholangiocarcinoma in one patient. Six patients had intrahepatic bile duct involvement only, and the cholangiographic abnormalities differed from those of sclerosing cholangitis. In 5 of these patients cirrhosis of the liver was found at biopsy or clinically. The result indicates that in patients with hepatobiliary disease suggested in association with ulcerative colitis, ERC gives valuable information.
Computer tomography and nephroangiography were performed in 5 patients with angiomyolipoma of the kidneys. CT was characteristic in all cases by demonstrating areas of fat in the tumor, and the extent of the neoplasm could be assessed preoperatively. Nephroangiography was of value as a preoperative demonstration of the vascular anatomy. In one case with a hemorrhage which nearly masked the fat component at CT, angiography added diagnostic information.
During a 3-year period 39 patients with chronic pancreatitis were subjected to roentgen examinations and exocrine pancreatic function tests (EPFT). Computer tomography (CT) was carried out in 36 of these, and revealed pancreatic disease in 29, while characteristic findings of chronic pancreatitis were demonstrated in 24 patients. CT was particularly valuable in diagnosing intra and extrapancreatic pseudocysts and pancreatic abscesses complicating chronic pancreatitis. At endoscopic retrograde pancreatography (ERP) pathologic alterations were demonstrated in 23 of 24 patients, and was diagnostic for chronic pancreatitis in 20 patients. The cannulation failed in 7 patients. The results indicate that ERP cannot be replaced by CT. ERP is still needed for detailed demonstration of the pancreatic duct system, especially preoperatively. Conventional films of the abdomen, EPFT and angiography were the least sensitive tests.
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Postirradiation changes of a liver containing a lesion as demonstrated by computed tomography (CT) is described. After treatments of 2,000 and 3,000 rad (20 and 30 Gy), the size of the mass decreased and CT showed a region with low attentuation and sharp, straight borders, corresponding to the radiation portal.
Fifty patients with testicular tumor were subjected to computer tomography, lymphography, cavography, and retrograde phlebography of the left renal and testicular veins followed by urography. The yield of computer tomography in detecting metastases of the iliac, lumbar and thoracolumbar regions was compared with that of the other examinations, and was particularly high in the upper part of the retroperitoneal space.
In a 5-year period 48 (14%) of 336 patients with ulcerative colitis were found to have hepatobiliary disease. The bile ducts were examined in 35 of these patients, and optimal visualization of both intra- and extra-hepatic bile ducts was obtained in 26. Duct changes compatible with sclerosing cholangitis were found in 14 patients. This finding of sclerosing cholangitis in 4% of all patients admitted with ulcerative colitis by far exceeds previous estimations on the incidence of sclerosing cholangitis in ulcerative colitis. The entire colon was usually affected, and the symptoms of the bowel disease were most often mild or moderate. The age at the onset of the colitis was usually below 20 years in patients with combined ulcerative colitis and hepatobiliary disease. In most patients the hepatobiliary disease gave no symptoms. Biochemical data and the histological findings in the liver biopsies did not distinguish between patients with hepatobiliary disease with and without sclerosing cholangitis. Our follow-up study has so far shown that most patients with sclerosing cholangitis remain asymptomatic for a considerable period of time.
Following translumbar aortography fifteen patients were examined by computed tomography which revealed retroperitoneal hematomas in seven cases. Further follow-up in four of these showed gradual reduction of the hematomas in three, while in one an examination 7 days after aorthography showed progression. During operation, rupture of the aorta occurred, and the patient died on the first postoperative day.
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From a total of 1 560 CT examinations of the thorax and abdomen transverse sections illustrating various normal and abnormal venous structures were selected. The radiologic importance of these structures is pointed out.