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PubMedDate not supplied

[X-ray characteristics of acute intestinal obstruction in middle-aged and elderly patients].

The authors presented clinical and x-ray findings of 188 patients with mechanical intestinal obstruction (92 of them were middle-aged and advanced in years and 96 were under 60). A combined program of x-ray examination included 3 stages: panoramic polypositional roentgenography of the chest and abdominal cavity, dynamic x-ray control over the state of the abdominal cavity, and contrast study of the G.I. tract. A distinctive feature of the x-ray symptomatology of intestinal obstruction in middle-aged and old patients was the absence of classical x-ray symptoms in some cases during panoramic roentgenography of the abdominal cavity. In patients over 60, x-ray symptomatology was characterized by marked colon distension and intestinal distension of various degree in 77.1%

Acute Disease↗
PubMed1989

Diagnosis of pedal osteomyelitis in diabetic patients using current scintigraphic techniques.

Seventy-seven diabetic patients with suspected osteomyelitis of the foot were evaluated by three-phase bone scintigraphy (TPBS), indium 111-labeled white blood cell scintigraphy (WBCS), roentgenography, or some combination thereof. Retrospective analysis after clinical and pathologic follow-up indicated that the sensitivity of TPBS alone in the diagnosis of osteomyelitis was 100%, with a specificity of only 38% and an accuracy of 63%; the sensitivity of WBCS alone was 100%, with a specificity of 78% and an accuracy of 87%; and the combination of TPBS and WBCS yielded a sensitivity of 100%, with a specificity of 79% and an accuracy of 87%. Roentgenography yielded a sensitivity of 69%, with a specificity of 82% and an accuracy of 76%. The results of this study demonstrate that WBCS is superior to TPBS in the diagnosis of osteomyelitis in the diabetic foot, and TPBS adds little when viewed in conjunction with WBCS. Based on our observations and because of the high prevalence of neuropathic joint disease and other causes of false-positive bone scans, we believe that WBCS alone is adequate for evaluation of suspected pedal osteomyelitis in diabetic patients, particularly when the suspected lesion is located in the tarsometatarsal region in contrast to the toe region (7% vs 44% specificity and 28% vs 69% accuracy, respectively, for TPBS in these two regions, compared with 100% vs 68% specificity and 100% vs 80% accuracy, respectively, for WBCS in the same two regions).

Adult↗
PubMed1989

[Bone scintigraphy as an aid in the early diagnosis of suspected fracture].

Bone scintigraphy with 99 m Tc-diphosphonate combined with a carefully taken history, clinical examination and appropriate roentgenography is very helpful in the diagnosis of fractures which are not revealed by roentgenography (fractures of cancellous bone, stress fractures). Definitive diagnosis can be made 3-4 days following the accident. Bone scintigraphy is particularly useful for the diagnosis and accurate localisation of small fractures. By facilitating early and accurate diagnosis allows timely and appropriate treatment. Follow up examinations with radionuclide imaging and quantification of uptake reveal process of healing.

Bone and Bones↗
PubMed1988

The diagnosis of sarcoidosis.

The diagnosis of sarcoidosis depends on the clinical and radiologic features along with histologic evidence of epithelioid-cell granulomas on biopsy. The amount of histologic support required varies inversely with the certainty with which the pattern of clinical features is recognized. It is essential to exclude other recognized causes of granulomatous disease. On the basis of our experience and that of other workers, we believe that sarcoidosis must be considered in the differential diagnosis when optic nerve thickening is encountered on CT, MRI or echography. Chest roentgenography is the easiest way to confirm the diagnosis. However, as many as 15% of patients will have a normal x-ray film, and other tests may be needed to help confirm the diagnosis. Biopsy of the involved tissues may be the only way to make the diagnosis. Once a provisional diagnosis is made, investigation for systemic sarcoidosis should include chest roentgenography, determination of the serum ACE level, 67Ga scanning, pulmonary function studies, testing for delayed skin reactions (with tuberculin, C. albicans, Trichophyton and mumps virus) and blood studies (determination of the erythrocyte sedimentation rate and levels of immunoglobulins, albumin, calcium and alkaline phosphatase). Finally, conjunctival biopsy is simple to do and is quite useful in supporting the diagnosis if no other tissue is readily available.

Biopsy↗
PubMed1987

Selective preoperative evaluation for possible N2 disease in carcinoma of the lung.

The efficacy of computed tomography and surgical mediastinal exploration in determining tumor resectability were retrospectively evaluated in 92 consecutive patients with non-small cell lung carcinoma. Status of mediastinal nodes was ultimately determined by surgical mediastinal exploration or thoracotomy. Patients were divided into three groups on the basis of chest roentgenography: Group I comprised 30 patients with peripheral T1 or T2 lesions with normal hilar and mediastinal shadows. Only one patient was found to have an involved node. Chest roentgenography had an accuracy rate of 96% and computed tomography, 93%. Thoracotomy is recommended without either computed tomography or surgical mediastinal exploration in this group. Group II comprised 47 patients with T1 or T2 lesions with an abnormal hilus, an abnormal mediastinal shadow, or either the hilus or mediastinum obscured by overlying parenchymal disease. Computed tomography revealed mediastinal nodes 1 cm or greater in size (abnormal node group) in 21 patients (45%) and smaller than 1 cm (normal node group) in 26 patients (55%). Surgical mediastinal exploration was performed in the abnormal node group and involved nodes were found in 17 of 21 patients (81%). In the normal node group, thoracotomy only was performed and no involved nodes were found. Computed tomography is recommended in all patients in Group II. Patients in the normal node group may be subjected to thoracotomy only and those in the abnormal node group should undergo surgical mediastinal exploration as the next diagnostic step before thoracotomy. Group III comprised 15 patients with grossly abnormal mediastinal shadows. Findings from computed tomography were abnormal in all 10 patients in whom it was done. Surgical mediastinal exploration was done in all 15 and yielded abnormal results in 14. It is recommended in this group that computed tomography is unnecessary and surgical mediastinal exploration should be the only diagnostic procedure. Thus, in potentially resectable non-small cell lung carcinoma, the use of computed tomography and surgical mediastinal exploration should be selective and should be determined by appropriate initial interpretation of the chest roentgenogram.

Carcinoma, Non-Small-Cell Lung↗
PubMed1988

A clinicopathologic study of bony spurs on the pes anserinus.

Nineteen cases of exostoses located on part of the pes anserinus were studied clinically and histologically. All lesions were resected during surgery between 1965 and 1985. In these 19 cases, 14 had involvement of the tibia only at the insertion of the pes anserinus. Five had multiple exostoses with pes anserinus involvement. All exostoses occurring only in pes anserinus showed an icicle appearance in roentgenography and had no detectable cartilage cap. On the other hand, exostoses in patients with multiple exostoses (osteochondromas) showed varying appearances in roentgenography and had cartilage caps on their surfaces. Exostoses occurring only in the pes anserinus may or may not be osteochondromata and could be classified as pes anserinus bony spurs.

Adolescent↗
PubMed1987

[Early diagnosis of bronchial carcinoma using thoracic roentgen imaging and sputum cytology].

Chest roentgenography and sputum cytology have been used for the early detection of lung cancer since the beginning of the 1950s. Surprisingly, the yield of screening is sufficiently high. In view of the estimated prevalence of lung cancer of 0.5-2% in high risk persons, the detection rate was 0.32-0.95% in three large randomized clinical trials (Cooperative Pilot Study of the American Cancer Society and Veterans Administration 1969, Canadian study of Grzybowski and Coy 1970, National Cancer Institute Cooperative Early Lung Cancer Detection Program 1984). Screening by chest roentgenogram was superior to sputum cytology. More than 70% of all lung cancers were detected by roentgenography alone. Adding sputum cytology, 10-20% more cancers were found. Lung cancers which were additionally detected by cytology were slowly-growing, central squamous cell carcinomas with good prognosis. The sensitivity of chest X-rays varied between 49 and 77% and the sensitivity of sputum cytology between 33-52%. Specificity was higher, the range being 95-99% for chest X-rays and 96-99% for sputum cytology. The costs per lung cancer detected and treated are very high. To these are added the costs which arise from the evaluation of false positive results. The prognosis of lung cancer detected by screening is good: more patients survive, and they live longer than unscreened patients. The overall 5-year survival of patients screened by chest X-rays and sputum cytology of the NCI-study was 35-55% compared with only 15% of patients not screened. However, whether long survival means reduced mortality is uncertain, since long survival only reflects early detection.

Adult↗
PubMed1987

Needle localization and biopsy of nonpalpable lesions of the breast.

Two hundred and three consecutive needle hookwire guided biopsies for nonpalpable lesions of the breast were performed upon 174 patients over a three year period. Patients ranged in age from 25 to 83 years (a mean of 55.4 years). Malignant growths of the breast were found in 44 of 203 specimens taken for biopsy. Sixty-six per cent of malignant lesions were in situ and 34 per cent were invasive carcinoma. The chance of a biopsy containing a malignant lesion was 17.5 per cent if the biopsy was done because of a discrete density on mammography, 22.1 per cent for microcalcifications and 29.6 per cent if both were present. The incidence of Stage I disease in 24 patients undergoing dissection of the axillary lymph node was 79.2 per cent. Specimen roentgenography was done in 165 biopsies. Anesthesia time was increased an average of 5.8 minutes by specimen roentgenography. In 198 instances, the mammographic lesion was present in the specimen taken for biopsy intended to remove it. Minor complications of needle hookwire insertion occurred in two patients. The mortality rate was nil.

Adult↗
PubMed1987

Femoral anteversion.

Biplane roentgenography, axial roentgenography, and fluoroscopy are the usual roentgenographic methods of measuring femoral anteversion. These methods use a strict geometrical definition of anteversion. The computerized tomography method of measuring anteversion that was developed recently, and is now widely used, does not adhere to the accepted definition of anteversion and has not been tested for accuracy in a large series. In the present study, the widely used computerized-tomography method of measuring anteversion was tested on thirty-two femoral specimens. With that method, anteversion was consistently underestimated by an average of 10 degrees compared with direct measurements and was reproducible only to within +/- 3.6 degrees. Therefore, a new method of measuring anteversion using computerized tomography was developed. It was shown to be accurate to +/- 1 degree, as tested on the same specimens. This study demonstrated geometrically why the currently practiced computerized-tomography method of selecting the points that are used to define the axis of the femoral neck is not consistent with geometrical definitions of anteversion. A more accurate method for both defining the axis of the femoral neck and measuring femoral anteversion is described and recommended for clinical use.

Cadaver↗
PubMed1987

A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma.

Computed tomography, magnetic resonance imaging, chest roentgenography, and mediastinoscopy were compared prospectively as staging modalities to assess mediastinal node status in 84 patients with presumed operable bronchogenic carcinoma. Computed tomography was associated with a sensitivity of 71.0%, a specificity of 87.7% and an overall accuracy of 82.1%. Magnetic resonance imaging did not provide any advantage over computed tomography in the assessment of mediastinal node status. The accuracy of computed tomography was not dependent on cell type of the primary tumor. Although chest roentgenography had a sensitivity of 80.7%, the overall accuracy of 57.1% was unacceptably low. The sensitivity (87.1%), specificity (100%), positive (100%) and negative (93.0%) predictive values, and accuracy (95.2%) of mediastinoscopy exceeded those observed with all other modalities. We continue to recommend mediastinoscopy as the most accurate staging investigation in the routine management of patients with bronchogenic carcinoma.

Carcinoma, Bronchogenic↗
PubMed1977

Upper airway obstruction in euthyroid goiter.

Although it is recognized that an enlarged thyroid may occasionally cause tracheal compression, the incidence in euthyroid goiter is unknown. Twenty patients with nontoxic goiter were investigated for upper airway obstruction. Although none of them had dyspnea as a chief complaint, on direct questioning 9/20 had a history of shortness of breath on exertion and choking sensation. Upper airway obstruction was detected in 7/20 (35%) by roentgenography, 12/20 (60%) by flow volume loop (FVL), and in 16/20 (80%) by combined roentgenography and FVL. After therapy for goiter, there was a reduction in the size of the goiter and an improvement in FVL in the whole group. The statistically significant change occurred in peak expiratory flow (P less than .01) and peak inspiratory flow (P less than .05). These findings and the change in configuration of the curve suggested less upper airway compression. We conclude that goiter often causes unsuspected upper airway obstruction, usually slow in onset and not noticed by the patient.

Adult↗
PubMed1978

Lung tomography in cancer patients. Full-lung tomograms in screening for pulmonary metastases.

In a retrospective study of the cases of 415 patients with various malignant neoplasms, full-lung tomography and conventional chest roentgenography were compared for accuracy in the detection of pulmonary metastases. Sufficient information was available on 410 patients to permit confirmation as to whether pulmonary metastases were present at the time of screening chest roentgenographic and tomographic examinations. On screening by routine chest roentgenography, metastases were detected in 36 patients, 66.7% of the total with confirmed metastatic disease. Screening by full-lung tomography identified metastases in 51 (94.4%). Fifteen patients with normal chest roentgenograms had metastatic lesions on tomograms. Metastases were detected in 8.8% by chest roentgenograms and in 12.4% by tomograms in a population of cancer patients with a 13.2% incidence of pathologically confirmed metastatic lesions.

Adolescent↗
PubMed1982

[Role of echocardiography in preoperative diagnosis of organic defects of the tricuspid valve in patients with rheumatic mitral heart defects].

The results of investigations by echoCG, ECG, FCG, sphygmography, roentgenography, including cardiac catheterization, of 16 patients with rheumatic mitral-tricuspid disease of the heart were compared. The organic injuries of the tricuspid valves (OITV) were confirmed during operation. With respect to preoperative diagnosis of OITV the sensitivity of echoCG was equal to 94 %, polycardiography--81 %, roentgenography--54 %, cardiac catheterization--94 %. Thus, echoCG proved to be the most accurate method of the primary asanguineous diagnosis of an organic injury of the tricuspid valve. The echocardiographic diagnosis of OITV included the symptoms of constriction of the right atrioventricular orifice and fibrous alterations of the valve cusps. Possible technical errors of the methods in respect to the detection of OITV are discussed.

Adult↗
PubMed1980

[Topographic-anatomical data on the arteria testicularis, arteria ductus deferentis and arteria cremasterica in the boar].

In studies on the vascularization of the testes in boars 112 testes were used. The topographic-anatomical conditions of the arteries were studied by means of roentgenography, stereo-roentgenography, the corrosive method and by gel and Indian ink injection. The arising of the aa, testiculares from the abdominal aorta and the length of the convolution of the testicular artery varies in the boar. The rr. epididymales arise partly from the rectal part of the testicular artery, partly from the convolution. Most frequently the arising from the upper third of the convolution was observed. A case has been stated with high release of the Rr. epididymales. The loops of the latter envelope the entire convolution of the testicular artery. Division of the marginal part of the testicular artery occurs in most cases at the transition of the margo epididymis into the margo liver. The 2 rr. testiculares formed by the division of the marginal part of the testicular artery are not always of the same thickness. Only 1 of them reaches the frontal part of the testis. In the boar anastomoses are formed between the testicular and the epididymal branches. The authors failed to prove th accessory artery of the testis in the material. In the boar, the course and ramification of the centripetal and centrifugal arteries coincides with that in the ram. An independent branch of the epididymal artery was observed, forming an independent a radiate centripetalis. In the boar, the artery of the seminiferous duct anastomoses with the branches from the caudal epididymal branch and with the cremasteric artery.

Angiography↗
PubMedDate not supplied

[Sialography with direct multiple image enlargement and the processing of the sialograms on an analog computer].

To extend the potentialities of sialography, we used roentgenography with direct multiple amplification of the image by Reis microfocal portable x-ray diagnostic device and analyzed this image by analog UAR-1 computer operating in a high-frequency harmonization mode. The basic feature of such roentgenography is spatial stratification of the object shadow simultaneously forming its spatial image. High-frequency harmonization of an x-ray image essentially improved its contrast, this permitting detection of small formations poorly shown on sialogram, the contours of these formations and relationships between them. A total of 85 patients were examined using this method. Analysis of the resultant sialograms showed that using this method it is possible to assess the status of small structures of the gland, detect the changes in the pharyngeal process of the parotid gland. Sialogram direct projection is no longer needed.

Computers, Analog↗
PubMedDate not supplied

[Differential diagnosis of benign spinal neoplasms].

The authors analyze problems arising in differential diagnosis of benign spinal tumors not adequately described in available literature. The most characteristic x-ray symptoms of rare spinal tumors are presented. Methods of radiologic investigation such as polipositional roentgenography, tomography, roentgenography with direct image amplification are described in detail. A total of 102 observations of benign spinal tumors are analyzed: osteoblaclastomas responsible for 14.7% of osteoblastoclastomas, angiomas responsible for 66.7% of cases, osteochondroma occurring in 6.7% of cases, chordomas and osteoid ostema occurring in 10.7 and 1.0% of cases, respectively.

Adolescent↗
PubMedDate not supplied

Complications of intra-cardial placement of silastic central venous catheter in pediatric patients.

UNLABELLED: A three-year prospective study was undertaken to determine the incidence and early complications from intra-cardiac placement of percutaneous central venous catheter (CVC). CVC was inserted by using "Catheter-through-needle" technique, and the insertion length was measured by body surface landmark. CVC course and tip location were routinely checked by roentgenography. Echocardiography was performed in case of arrhythmia. After analysis of 784 CVCs, 104 (13.3%) were proved to be intra-cardial, as located by either roentgenography or echocardiography. However, catheters passed via the upper trunk (14.5%) were significantly (p < 0.05) more intra-cardially located than those via the lower trunk (4.8%). Catheters which passed via the right upper trunk veins (basilic, cephalic, or external jugular veins) were also more intra-cardially located than those via their left veins counterparts, but the finding was not statistically significant (p > 0.05). The mean body weight (3.1 +/- 2.4 kg) in the intra-cardial placement group was significantly (p < 0.05) less than that in the non-intracardial placement group (7.9 +/- 4.5 kg). In intra-cardial placement patients, 32 cases (30.8%) had episode(s) of cardiac arrhythmia including 31 premature ventricular depolarization and 1 supra-ventricular tachycardia. All cases showed the presence of intra-ventricular catheter. All arrhythmias ceased abruptly after the catheters were pulled from the hearts. No other early complications were observed. CONCLUSIONS: the incidence of the intracardiac placement of CVC is high, especially in small infants or when the insertion via the upper trunk. Short term intra-cardiac catheter placement has a benign clinical course except that the intraventricular catheter may cause arrhythmia. However, this kind of arrhythmia can be resolved spontaneously by withdrawing the catheter.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Potentialities of some x-ray methods in sternal osteomyelitis].

X-Ray examination of 85 patients (63 with sternal osteomyelitis) carried out to plan a surgical intervention should be based on a complex of special methods including roentgenography in the lateral projection, spot roentgenography in oblique projection, and tomography with transverse direction of the x-ray tube movement. Employment of transverse direction of smearing in tomography helps imaging the sternum in the direct frontal projection, mapping the destructive changes, and comparing the results of other examinations with this map. X-Ray computer-aided tomography and osteoscintigraphy are advisable to assess the changes in soft tissues and the process activity. Such an approach appears to be the most useful in planning surgical strategy in patients with sternal osteomyelitis.

Humans↗