Hungarian Radiology - 2003;77(01)

Hungarian Radiology

JANUARY 20, 2003

[Heterotopic pregnancy]

SARLÓS Géza, VARGA Tamás, HEGEDŰS Géza

[INTRODUCTION - Simultaneous presence of intrauterine and extrauterine gestations is very rare. CASE REPORT - A 26 year old multiparous woman known to be 10 weeks pregnant presented with severe abdominal pain. Transabdominal sonography revealed a concomitant ectopic pregnancy with large amount of intraperitoneal fluid. Cardiac activities of both the intrauterine and the ectopic fetuses were clearly visible on abdominal ultrasound. Emergency laparoscopy confirmed intraabdominal hemorrhage and rupture of the left fallopian tube. The laparoscopic salpingectomy did not affect the ongoing intrauterine pregnancy. The woman subsequently delivered a healthy infant. CONCLUSION - Though heterotopic pregnancy especially without previous ovarian hyperstimulation is extremely rare. The confirmation of an intrauterine pregnancy does not exclude a co-existing ectopic pregnancy as well as in case of extrauterine pregnancy the simultaneous presence of an intrauterine pregnancy must be considered.]

Hungarian Radiology

JANUARY 20, 2003

[Ultrasonographic twin peak sign]

JAKOBOVITS Ákos

[INTRODUCTION - Author describes ultrasonographic twin peak sign in order to differentiate dichorial-diamniotic from monochronic-diamnotic pregnancy in early gestation. In case of dichorial pregnancy the chorial tissue is forming a triangle shape. In case of monochorial twins the two amnion layers are forming a ”T” shape. CASE REPORT - The first case represents a dichorionic pregnancy, while the second case is an example of monochorionic placental formation. CONCLUSION - The twin peak sign has clinical significance, because dichorionic pregnancies carry less risk of gestational and labor complications.]

Hungarian Radiology

JANUARY 20, 2003

[A paradox of articular protective phenomenon: more serious-damaged rudimentary hand in rheumatoid arthitis]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - The joints have been secured from rheumatoid arthritis by diminution of biomechanical effeciency. This effect was analyzed and named articular protective phenomenon three decades ago. CASE REPORT - A case of bilateral rheumatoid arthritis associated with unilateral developmental abnormality hand and bronchial asthma in a 35 year old female patient is presented. Her left 2nd, 3rd, 4th and 5th metacarpal bones moreover her fingers had not evolved. The patient has been treated by antiasthmatic steroid drugs for five years. Rheumatoid disorders of the affected left hand were more severe, than the abnormality of the normal upper limb. Eight years later the most severe bony lesions (ankylosis and mutilation) appeared on this side, only. CONCLUSION - The patient's hand was not saved by inborn bone defect in rheumatoid arthritis. The absence of articular protective phenomenon can be explained by the undisturbed innervation of limb, the motility of hypotrophic carpus besides to steroid-induced suppression.]

Hungarian Radiology

JANUARY 20, 2003

Hungarian Radiology

JANUARY 20, 2003

Hungarian Radiology

JANUARY 20, 2003

Hungarian Radiology

JANUARY 20, 2003

Hungarian Radiology

JANUARY 20, 2003

[Stroke prevention: Experience with endovascular therapy of carotid artery stenosis]

SZENTGYÖRGYI Réka, VÖRÖS Erika, PÓCSIK Anna, MAKAI Attila, BARZÓ Pál, SZTRIHA László, SZIKRA Péter, PALKÓ András

[INTRODUCTION - Carotid artery stenting as an alternative to carotid endarterectomy is still not accepted by many Hungarian vascular surgeons. The purpose of our study was to prove that carotid artery stenting is effective in the treatment of primary atherosclerotic lesions and it carries a low risk of complications. PATIENTS AND METHODS - 149 patients (86 men, 63 women, 33-82 years old, mean age 57.5 years) were evaluated angiographically. 146 primary atherosclerotic lesions, and 8 post-endarterectomy restenoses were considered for carotid artery stenting. All patients had significant, over 60% stenosis according to NASCET criteria. Atherosclerotic plaques were classified as smooth, irregular and ulcerated. Subtotal occlusions (stenoses over 95%) were noted. The necessity of pre- or postdilation and the types of stent used were registered. Procedural success and periprocedural complication rates were noted. Followup colour Doppler sonography was performed at 1, 6 and 12 months. RESULTS - Subtotal occlusions were detected in 28% of the lesions. Procedural success rate was 149/150 (99%). Stenting was carried out in 86% with Monorail Carotid Wallstent. Predilation or use of protecting device was avoided in 96%. Postdilation was avoided in 6 cases of ulcerated plaques to prevent distal embolisation. Residual stenosis was always less than 30%. Stroke occured in 2.6%, TIA in 0.7%. Two of our patients developed restenosis. CONCLUSION - Carotid artery stenting is a safe alternative to carotid endarterectomy for most patients with primary atherosclerotic stenosis, as it can be carried out with clinical complication rate as low as published in the ACAS.]