Hungarian Radiology

[23RD CONGRESS OF THE SOCIETY OF HUNGARIAN RADIOLOGISTS, ABSTRACTS]

OCTOBER 20, 2006

Hungarian Radiology - 2006;80(05-06)

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[Statement of the board of the Society of Hungarian Radiologists]

LOMBAY Béla, PALKÓ András

Hungarian Radiology

[World congress of pediatric radiology - Montreal]

KIS Éva

Hungarian Radiology

[The value of multislice computed tomography in the diagnosis of pulmonary embolism and in differential diagnostics]

BODROGI Nándor, BARANYAI Tibor

[INTRODUCTION - The multislice CT (MSCT) pulmonary angiography has been used increasingly in the diagnosis of pulmonary embolism with worldwide application and nowadays it can be considered as a gold standard technique. At the author's department a single slice CT has been used from 1993 and a 10 slice CT system with 24 detector-lines was installed in 2004. The authors summarize the advantages of MSCT in the diagnosis and differential diagnosis of pulmonary embolism and its role in the follow-up of cases and the significant increase of the diagnostic safety. PATIENTS AND METHODS - 2576 chest MSCT examinations were performed between 16 February 2004 and 20 June 2005. In 261 cases pulmonary MSCT angiography was made due to suspected pulmonary embolism. In 7 cases the indication of the CT was different, but due to the findings (pulmonary embolism) this group of patients is discussed in this paper. 268 cases were evaluated retrospectively. In 12 patients, CT could not be performed due to contrast agent allergy or because of seriously impaired renal function. In 2 cases it was not possible to establish a venous access. The therapeutical result was monitored upon the request of the clinicians. The pulmonary MSCT angiography was performed in accordance with a detailed acquisition and reconstruction protocol. In the reprocessing stage the 2D (MPR) reconstruction in different directions was an important step. In addition, three-dimensional MIP was used and VRT reconstruction was also made, if needed. Bolus tracking was applied in order to achieve a good contrast phase. RESULTS - In 116 out of 268 cases pulmonary embolism was detected by pulmonary MSCT angiography. In 7 patients pulmonary embolism was not the primary diagnosis. Pathological changes could not be detected in 55 cases (20.5%) and embolism was not proven later in these patients. No false negative study was recognized. In one case, after the death of the patient the autopsy failed to prove the presence of pulmonary embolism, this represents one false positive diagnosis. In 97 patients pulmonary embolism was not detected, however other findings were found relating to the complains of the patients and thus proper therapy could be introduced. CONCLUSION - Pulmonary MSCT angiography proved to be a highly accurate method for the diagnosis and for exclusion of pulmonary embolism and also in the evaluation of its extent. MSCT can be used in monitoring the result of the therapy. In addition, MSCT gives an opportunity to detect other acute pathological conditions of the chest, thus value of the study is significant in the differential diagnosis.]

Hungarian Radiology

[The role of ultrasonography and X-ray examinations in the diagnosis of gallstone ileus in preoperative stage]

FARKAS József, KÁNYA László, LUDVIG Zsuzsanna, BENDE Sándor

[INTRODUCTION - Gallstone ileus develops in elderly patients as a result of complication of cholelithiasis and causes 1-3% of mechanical ileus. Due to its variable presentation and in many cases insidious and intermittent symptoms it is difficult to establish the diagnosis which is often delayed. The mortality rate is high and early diagnosis is essential. The role of X-ray, abdominal ultrasound and recently CT has been emphasized. The role of imaging studies was evaluated in the preoperative diagnosis of gallstone ileus based on their surgically proven cases. PATIENTS AND METHODS - From 1st January 1988 to 30th June 2004 nineteen operations were performed on seventeen patients suffering from gallstone ileus. The average age of the patients was 74.2 years, male/female ratio was 4/13. Ultrasound examination was performed in all cases before the operation. Plane X-ray examination also was carried out except in two cases. CT study was not performed preoperatively. The calculi were removed through an enterotomy whole. In four cases gall bladder were also removed and the biliary fistula was closed. The disease was diagnosed on the basis of symptoms described by Rigler. If two signs from the three was present the diagnosis was established. RESULTS - 17 cases out of 19 mechanical ileus were diagnosed, in one case acute cholecystitis and in one incarcerated abdominal wall hernia was suspected before surgery. Small bowel obstruction was found in all cases (jejunum in six cases, ileum in 13). In five cases multiple calculi were seen in the bowels. Two patients had to undergo surgery twice because of gallstone ileus. It is noted that in eight cases (42.1% of total operations) gallstone ileus was diagnosed before the operation. In seven cases ultrasound played a crucial role in establishing diagnosis. In one case gas was detected in the biliary tract and in six, gallstone was directly seen in the small bowel with ultrasound. CONCLUSIONS - In the preoperative diagnosis of gallstone ileus more and more is expected from appropriate radiological examinations. If diagnosis is primarily based on the physical examination, an illusion of clinical improvement can be created, and the delay of surgical treatment can lead to decompensation of elderly patients with increased mortality rate. A thorough radiological examination can show the stone in the bowel lumen, and observation of the indirect signs together with clinical state can considerably improve the results. The rate of correct diagnosis of gallstone ileus before sugery in our patients can be considered an average and similar to the published data in medical literature.]

Hungarian Radiology

[Virtual reality in medicine]

SZÁNTÓ Dezső

All articles in the issue

Related contents

Lege Artis Medicinae

[LAM 30: 1990–2020. Facing the mirror: Three decades of LAM, the Hungarian medicine and health care system]

KAPÓCS Gábor

Clinical Neuroscience

[The Comprehensive Aphasia Test in Hungarian]

ZAKARIÁS Lilla, RÓZSA Sándor, LUKÁCS Ágnes

[In this paper we present the Comprehensive Aphasia Test-Hungarian (CAT-H; Zakariás and Lukács, in preparation), an assessment tool newly adapted to Hungarian, currently under standardisation. The test is suitable for the assessment of an acquired language disorder, post-stroke aphasia. The aims of this paper are to present 1) the main characteristics of the test, its areas of application, and the process of the Hungarian adaptation and standardisation, 2) the first results from a sample of Hungarian people with aphasia and healthy controls. Ninety-nine people with aphasia, mostly with unilateral, left hemisphere stroke, and 19 neurologically intact control participants were administered the CAT-H. In addition, we developed a questionnaire assessing demographic and clinical information. The CAT-H consists of two parts, a Cognitive Screening Test and a Language Test. People with aphasia performed significantly worse than the control group in all language and almost all cognitive subtests of the CAT-H. Consistent with our expectations, the control group performed close to ceiling in all subtests, whereas people with aphasia exhibited great individual variability both in the language and the cognitive subtests. In addition, we found that age, time post-onset, and type of stroke were associated with cognitive and linguistic abilities measured by the CAT-H. Our results and our experiences clearly show that the CAT-H provides a comprehensive profile of a person’s impaired and intact language abilities and can be used to monitor language recovery as well as to screen for basic cognitive deficits in aphasia. We hope that the CAT-H will be a unique resource for rehabilitation professionals and aphasia researchers in aphasia assessment and diagnostics in Hungary. ]

Lege Artis Medicinae

[A short chronicle of three decades ]

KAPRONCZAY Katalin

[Hungarian professional periodicals started quite late in European context. Their publish­ing, editing and editorial philosophy were equally influenced by specific historical and political situations. Certain breaking points of history resulted in termina­tion of professional journals (War of In­de­pendence 1848-1849, First and Se­cond World Wars), however there were pe­riods, which instigated the progress of sciences and founding of new scientific journals. Both trends were apparent in years after the fall of former Hungarian regime in 1990. The structure of book and journal publishing has changed substantially, some publishers fell “victim” others started successfully as well. The latters include the then-established publishing house Literatura Medica and its own scientific journal, Lege Artis Me­di­cinae (according to its subtitle: New Hun­garian Medical Herald) issued first in 1990. Its appearance enhanced significantly the medical press market. Its scientific publications compete with articles of the well-established domestic medical journals however its philosophy set brand-new trends on the market. Concerning the medical community, it takes on its problems and provides a forum for them. These problems are emerging questions in health care, economy and prevention, in close interrelation with system of public health institutions, infrastructure and situation of those providing individual health services. In all of them, Lege Artis Medicinae follows consequently the ideas of traditional social medicine.]

Lege Artis Medicinae

[History of vaccine production in Hungary ]

ÓCSAI Lajos

[This study presents the complete history of the Hungarian vaccine production, partly in association with the process of fighting vaccine-preventable infectious diseases, and underlines the fact that every government actively contributed to the age-adjusted mandatory vaccination schedule of the past 140 years. It demonstrates the various achievements from the smallpox lymph production through the launch of diphtheria serum production at Phylaxia and the establishment of the National Public Health Institute (OKI) with its vaccine production and the later institutional transformation of OKI into Humán as economic corporation to its closure. Among all OKI’s vaccine production activities, this study focuses on the production of influenza vaccines, due to its international importance in the 1960s and 1970s. The vaccine production against diphtheria tetanus and pertussis stands out from Humán’s activities, and the tetanus component of this vaccine is still used in the products of a multinational vaccine manufacturer. ]

Lege Artis Medicinae

[Diagnosis and treatment of microvascular coronary heart disease. Specialities of conditions in Hungary]

SZAUDER Ipoly

[Invasive investigations show that in two-thirds of patients the myocardial ischaemia persists without obstructive coronary disease and any other heart conditions (INOCA). The underlying cause may be microvascular dysfunction (CMD) with consecutive microvascular coronary disease (MVD) and microvascular or epicardial vasospastic angina (MVA). The modern practice of clinical cardiology while using the developed non-invasive cardiac imaging permits exact measuring of the coronary flow with its characteristic indices. All of these improve the diagnosing of CMD-induced myocardial ischemia and provide opportunity to determine primary MVD cases. Since the recognition and treatment of MVD is significantly underrep­resented in the Hungarian medical care, the primary stable microvascular angina (MVA) is described in detail below with its modern invasive and non-invasive differential diagnosis and treatment, concerning especially its frequency provoked by high blood pressure and female coronary heart diseases. There are highlighted all recommended diagnostic procedures available under domestic conditions.]