Hungarian Radiology - 2007;81(03-04)

Hungarian Radiology

JUNE 20, 2007

[Investigation of colon transit with radiopaque m]

WENINGER Csaba, KIRÁLY Ágnes

[The constipation is a frequent disorder, which often requires gastroenterological examination. Colon transit study and defecography are indicated in case of making difference between slow colon transit time and outlet obstruction. The method, the mode of administration of the radiopaque markers and the evaluation of the radiological study are discussed. Radiopaque markers ingested on the first day are followed by abdominal X-ray taken at regular times. The normal value of the colon transit time is less than 70 hours. The etiology of constipation has to be clarified by functional examinations, since the treatment of outlet obstruction is different from slow transit constipation. To determine the large bowel transit time is necessary also in the differential diagnosis of slow colon transit. The method is a simple, reliable and easily reproducible.]

Hungarian Radiology

JUNE 20, 2007

[Multisegmental tuberculous spondylodiscitis in a patient with Helicobacter pylori infection]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - Prospective randomized examination has been verified association between asymptomatic chronic Helicobacter pylori infection and systemic vascular inflammation and endothelial dysfunction in certain cases. CASE REPORT - A case of a 71 year-old female patient is described with proven coexisting primary tuberculous bronchoadenitis, secondary tuberculous spondylodiscitis and Helicobacter pylori infection as a cause of uncertain abdominal disorder. The patient's height decreased by 9 cm during 6 months, since the onset of the symptoms. The diagnosis was based on respiratory function test, positive rapid ureal test, bronchoscopy, cytologic and microbiological examinations. On dorsolumbal spinal plain films showed wedge, biconcave crus and mass deformities of nine vertebras. High serum level of CRP and C3 complement was suggestive of acute reactive inflammation. Before the introduction of drug therapy an MR examination was planned, however the patient died of an acute myocardial infarct on the 8th day after admission The postmortem findings proved the presence of pulmonary and vertebral tuberculosis, there was no evindence of aortocoronal and spinal vasculitis. The epispinal tissues were not involved. CONCLUSION - The patient’s case history, autopsy findings and the literature data are suggestive of the role chronic Helicobacter pylori infection in the development of spondylodiscitis and the deterioration of the disease.]

Hungarian Radiology

JUNE 20, 2007

[Imaging of mesenterial panniculitis - Case report]

KOVÁCS Anita, KISS Ildikó, PALKÓ András

[INTRODUCTION - Mesenterial panniculitis is a rare benign disorder, however it is important to be familiar with, because of the difficulties in differential diagnosis. Authors describe the characteristic imaging signs of the disease based on their two cases. CASE REPORTS - Two male patients (72 and 62 years old) presented with uncertain abdominal pain and weight loss. Acute pancreatitis, chronic gastritis and duodenitis are noted in their case history. The laboratory parameters were normal and the physical examination revealed a palpable epigastrial terime in both patients. Abdominal ultrasound and CT examinations depicted different degree of mesenterial infiltration with lymph node enlargement. Histological analysis of the biopsy sample proved the process to be benign in the first patient. The mass was surgically removed in the second one and histology proved mesenterial panniculitis. CONCLUSION - Mesenterial panniculitis is a benign, chronic non-specific inflammatory disorder. Its appearance may simulate malignant diseases, thus making differential diagnosis is important. Abdominal ultrasound, CT and result of image guided biopsy play an important role in the diagnosis, in case of which conservative therapy and regular follow-up is sufficient.]

Hungarian Radiology

JUNE 20, 2007

[The quality control of radiological equipments in Hungary]

PELLET Sándor, PORUBSZKY Tamás, BALLAY László, GICZI Ferenc, MOTOC Anna Mária, VÁRADI Csaba, TURÁK Olivér, GÁSPÁRDY Géza

Hungarian Radiology

JUNE 20, 2007

[Sonographic appearance of the cytostatic therapyrelated hepatic injury]

JÓKÚTI László, VARGA Edit, KARÁDI Zoltán, KOVÁCS GÁBOR

[INTRODUCTION - The correlation between biochemical parameters and sonographic appearance of the liver in children and young adults receiving cytostatic therapy was investigated. PATIENTS AND METHODS - 104 (54 male, 50 female) patients at the hemato-oncologic unit of 2nd Department of Pediatrics, Semmelweis University Budapest were enrolled into this prospective, single-blind, uncontrolled study: patients’ ages were between 2.0 and 32.7 years (mean 12.2 yrs, ± SD 5.7). 69 patients received chemotherapy for acute lymphoblastic leukemia (ALL), 35 patiens for osteogenic osteosarcoma (OSC). The time interval between the initiation of the cytostatic therapy and the examination was between 1 month and 16 years (mean 3.9 yrs). Ultrasonography was performed after 5-8 hours of fasting, without sedation. Echogenicity, distal attenuation of liver parenchyma and Doppler waveforms of the hepatic vein branches were evaluated. Alanine-aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activity were measured in peripheric blood samples. Statistical correlation was analysed between sonographic appearance and biochemical parameters of the liver. RESULTS - 35 patients had at least one sonographic abnormality: of these, 9 had elevated enzyme activity. Among the 69 patients with normal ultrasound findings, only 2 had increased enzyme activity (Chi square test, p=0.001). When tested against enzyme activity, echogenicity and attenuation showed significant (p=0.002 and p=0.01, respectively), Doppler waveform in the hepatic vein branches showed marginally significant correlation (p=0.05). All three ultrasound parameters had low sensitivity regarding the elevation of enzyme levels, however attenuation and hepatic vein waveform proved to be specific (both 94%) for enzyme level elevation and all three showed high negative predictive values (96%, 93% and 92%, respectively). When combining all three sonographic parameters in a single variable, correlation was even higher (p=0.001), sensitivity became acceptable (82%) and negative predictive value increased further to 97%. CONCLUSIONS - The authors conclude that a correlation exists between three simple sonographic indicators (echogenecity, distal attenuation, Doppler waveforms of the HVs) and liver injury detected by biochemical parameters. Due to the low sensitivity of the ultrasound parameters to confirm of the presence of diffuse liver injury is not possible. However, the combined use of the ultrasound and biochemical parameters a good negative predictive power can be achieved and therefore this is a useful tool in the follow-up for hepatic status.]

Hungarian Radiology

JUNE 20, 2007

[Correlation of clinical parameters with myocardial perfusion grades in acute myocardial infarct patients]

UNGI Tamás, JÓNÁS Zsuzsanna, UNGI Imre, SASI Viktor, ZIMMERMAN Zsolt, PALKÓ András

[INTRODUCTION - The prognosis after opening the obstructed infarct-related coronary artery is influenced by several factors. In routine clinical practice revascularization is considered to be successful when the restoration of epicardial blood flow is complete. However, functional impairment in the myocardium can occur even with open epicardial arteries. There are two angiographic parameters closely related to myocardial viability: myocardial blush grade (MBG) that describes the quantity of contrast material in the myocardium, and TIMI myocardial perfusion grade (TMP) that describes its outflow dynamics. Our goal was to assess the prognostic value of these two parameters in the framework of a prospective clinical study. PATIENTS AND METHODS - We compared the two parameters based on visual estimation (MBG and TMP) with those characterizing myocardial impairment, such as ejection fraction (EF), wall motion score index (WMSI), creatine-kinase release and chest pain score in 22 patients with acute myocardial infarction and successful revascularization. Our results were obtained by Spearman's rank correlation and χ2-tests at a confidence interval of 95%. RESULTS - Close correlation with TMP was found in case of both parameters measured by echocardiography (EF: r=0.59, p=0.02; WMSI: r=-0.51, p=0.046). These results were supported by the correlation with creatinekinase release (r=-0.54, P=0.01). By the present number of patients, MBG does not show significant correlation with the measured clinical parameters. Presence of chest pain is associated neither with TMP nor with MBG. CONCLUSIONS - Assessing myocardial perfusion by visual evaluation provides useful prognostic information. The extent of chest pain does not indicate myocardial dysfunction. The clearence of the dye (used in TMP definition) is more characteristic to myocardial viability than maximal contrast density (used in MBG definition).]

Hungarian Radiology

JUNE 20, 2007

Hungarian Radiology

JUNE 20, 2007

Hungarian Radiology

JUNE 20, 2007

Hungarian Radiology

JUNE 20, 2007

[Radiological diagnostics in head and neck malignancies - Onco Update, 2006]

GŐDÉNY Mária, BODOKY György

[Imaging plays a crucial role in defining disease burden and thus therapy planning in head and neck cancer (HNC). Lately accuracy of pretreatment staging has become critical since non-surgical therapy has become a widely accepted treatment possibility. The referring clinician is responsible for accurate data collection, pretreatment staging, evaluation of therapy response and post-treatment evaluation of the HNC. Correctness of these highly depends on the expertise and experience of the evaluating radiologist therefore being familiar with the latest literature is essential. This article is a review of papers published in 2005 and 2006 focusing on the clinical significance of the latest imaging results in head and neck cancer diagnostics.]

Hungarian Radiology

JUNE 20, 2007