Hungarian Radiology

[Follow-up of infants undergoing pyeloplasty: renal ultrasound and diuresis renography changes]

KIS Éva1, NYITRAI Anna1, VÁRKONYI Ildikó1, BÁRTFAI Katalin2, GYÖRKE Tamás3, MÁTTYUS István1, VEREBÉLY Tibor1

AUGUST 20, 2003

Hungarian Radiology - 2003;77(04)

[INTRODUCTION - The authors reviewed their experience after pyeloplasty in infants, according to the follow-up results of ultrasound and nuclear renography. PATIENTS AND METHODS - During the period 1988-2001 184 infants underwent pyeloplasty for ureteropelvic junction (UPJ) obstruction. Patients (n=91) with unilateral UPJ obstruction and normal contralateral kidney were included in this study. Patients ages at surgery were between 1 day-36 months. Preoperative evaluation included ultrasound examinations and diuretic renograms. Follow-up ultrasound examinations were done after 3, 6, 12 months, later yearly. Depending on the result of the ultrasound examination isotope scan were done. RESULTS - The pelviureteric obstruction were detected prenatally at 65 cases (71%). Preoperative ultrasound revealed grade 3-4 pyelocaliectasis in all patients. All patients had obstruction on preoperative renography, nine kidneys had no function, in 37 cases (41%) hydronephrotic kidneys had diminished function. Nine patients underwent nephrectomy because of non-functioning kidney. Eighty two infants underwent pyeloplasty. Grade of hydronephrosis improved in 56% of kidneys and dilatation was the same one year after pyeloplasty in 44% of kidneys. Five years after pyeloplasty 91% of kidneys, after eight years 97% of hydronephrosis improved or cured. Postoperative renography showed improvement in drainage in all preoperatively obstructed kidneys. The renal function improved only in 22% of cases at the end of the first postoperative year, and no further improvement were detected later on. CONCLUSION - Pyeloplasty in infant ages significantly cured the drainage early after surgery. The resolution of hydronephrosis is relatively slow, but after eight years dilatation cured or improved in most of the affected kidneys. Improvement of the renal function was detected only in small part of the cases.]

AFFILIATIONS

  1. Semmelweis Egyetem, Általános Orvostudományi Kar, Gyermekklinika, Budapest
  2. Fôvárosi Szent Imre Kórház, Budapest
  3. Semmelweis Egyetem, Általános Orvostudományi Kar, Radiológiai Klinika, Budapest

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[Our experiences with the use of phosphor plate X-ray system and PACS]

BARTA H. Miklós, BERENTEY Ernő, FORNET Béla, FORRAI Gábor

[In this study the experiences, the advantages and disadvantages of a full digital radiology department are presented. The conventional radiology and the spot films of gastroenterologic studies are exposed on phosphor plates since 1999 at our department. Two work-stations are used for making the reports and six viewing-stations are installed at distant departments. A central server organizes the data and pictures flow and the archive system consists of magnetooptical discs in a juke-box. The conventional X-ray methods are fully integrated in the system. The number of hardcopies is dramatically decreased. The clinicians may easily access the images on the viewingstations. Possibility of teleradiology and teleconsultation is integrated in the system. The quality of the examinations is improved and became uniform. The images of different methods (CT, fluoroscopy) are stored also in digital format. The disadvantages are the high cost of installation, a new workflow and reporting habits must be initiated. A problem of one element can cause the breakdown of the whole system. The new technics, the digital world forces us to develope and define new technical standards in order to obtain uniform quality.]

Hungarian Radiology

[40th Congress of the European Association of Pediatric Radiology Genova, 2-6th June 2003.]

KIS Éva

Hungarian Radiology

[Radial scar associated with lobular neoplasia in the breast]

ERDŐSI Éva, HERTELENDY Ágnes, GREXA Erzsébet, ANGA Béla, VARGA Zoltán

[INTRODUCTION - The authors are presenting the case of a 55-year-old female patient with breast abnormalities of unclear morphology. CASE REPORT - The lesion seen in the left breast was characteristic of radial scar in which, however, numerous, but not clearly benign microcalcifications were detected. During histological examination a radial scar associated with a small lobular neoplasia was diagnosed. However, these microcalcifications were not related to the malignancy. CONCLUSION - In radial scar extensive benign microcalcifications may develop. Nevertheless we should bear in mind that in 10-30% of cases this disorder can be associated with malignancy even without mammographic signs. The final diagnosis, however, should always be made on the basis of histological examination.]

Hungarian Radiology

[The congress of ESGAR was a success in Budapest]

MESTER Ádám

Hungarian Radiology

[Cheirospondyloenchondromatosis]

IGNYS Anna, MALGORZATA Krajewska-Walasek, MARIKOVA Olga, IVO Marik, KAZIMIERZ Kozlowski

[The term of cheirospondyloenchondromatosis (CHE) was coined by Spranger et al. This generalised, distinctive form of enchondromatosis is characterised by mild to moderate dwarfism, short hands and feet with beaded fingers, prominent large joints and frequently mental deficiency. Major radiographic features include generalised mild platyspondyly, generalised enchondromatosis with marked involvement of hands and feet and small ilia with eroded crests and acetabular roofs. We report three patients with this rare, severe form of enchondromatosis and stress some differences between our patients and the classical description of Spranger et al.]

All articles in the issue

Related contents

Clinical Neuroscience

The applications of transcranial Doppler in ischemic stroke

FINNSDÓTTIR Herdis, SZEGEDI István, OLÁH László, CSIBA László

Background: This overview provides a summary of the applications of transcranial Doppler (TCD) in ischemic stroke. Results: A fast-track neurovascular ultrasound protocol has been developed for detecting occlusion or stenosis. The technique is more reliable in the carotid area than in the posterior circulation. By monitoring the pulsatility index the in­crea­sed intracranial pressure can be diagnosed. TIBI score was developed for grading residual flow. TCD has been shown to accurately predict complete or any recanalization. Regarding recanalization, TCD has a sensitivity of 92%, a specificity of 88%, a positive predictive value of 96%, a negative predictive value of 78% and an overall accuracy of 91%, respectively. Sonothrombolysis seemed to be a promising application but randomized controlled trials have shown that it does not improve clinical outcome. TCD examination can detect microembolic signals (MES) which are associated with an increased risk of stroke. Micro­em­boli were detected in symptomatic and asymptomatic carotid artery stenosis and during carotid endarterectomy. The number of microemboli can be decreased by antithrombotic therapy. Contrast en­chan­ced examination and Valsalva maneuver with continuous TCD monitoring can accurately screen for right-to-left shunt.

Hungarian Radiology

[Ultrasound of the acute pediatric scrotum]

COLEY D. Brian

[Proper evaluation of the acute scrotum, like any condition, starts with a history and physical examination by an experienced clinician. Often this is all that is needed to arrive at an accurate diagnosis, which then allows prompt and appropriate treatment. However, the true nature of the underlying disease producing scrotal pain is not always clear, and the consequences of error (testicular loss) are undesirable. Ultrasound is the single most useful imaging tool for imaging the scrotum. While nuclear medicine studies can help assess blood flow, the combination of anatomic detail provided by modern ultrasound equipment and the ability to assess blood flow and perfusion with color Doppler makes ultrasound invaluable. Properly performed and interpreted, ultrasound provides very high sensitivity and specificity for acute scrotal conditions. Understanding of the conditions that produce acute scrotal pain in children will improve one’s diagnostic abilities. The most important diagnosis to consider is testicular torsion, since untreated this will result in testicular death. While testicular torsion can occur at any age, it is most common in the perinatal and peripubertal age groups. Torsion of a testicular appendage is a frequent cause of scrotal pain in prepubertal males. The sonographic findings can mimic epididymitis, but diligent and focused sonographic examination can make the diagnosis. Epididymitis typically affects postpubertal males, but can be seen in younger patients with functional or anatomic urinary tract anomalies. Sonographic evaluation of the post-traumatic painful scrotum can help to differentiate injuries that can be managed conservatively and those that require surgery. Less common causes of scrotal pain include hernias and hydroceles, vasculitis, and idiopathic edema. Understanding the characteristic sonographic features of these conditions allows the examining physician to make more accurate and confident diagnoses. It is hoped that this review article will help to promote this understanding.]

Lege Artis Medicinae

[The role of MRI in the diagnosis of tumours]

GŐDÉNY Mária

[Imaging is important in the evaluation of tumour detection, staging to determine the response to therapy, to follow the patient to find an early recurrent tumour. The ability to assess cancer spread has been revolutionized by advances of digital imaging modalities, such as digital ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). MRI is the method of choice for detecting and evaluating brain, spine, head and neck and musculoskeletal tumours, but it is complementary in the investigation of the thorax. US and CT remains the primary test for imaging the abdomen, while MRI plays a subsidiary role as a problem solving technique. In the evaluation of focal liver disease numerous prior reports have documented a superior performance of MRI compared to CT and US in the detection of primary and metastatic liver tumours. MRI is gaining more and more importance in imaging of the pelvis. Breast MRI is increasingly used as an adjunct to conventional imaging modalities. Several recent developments in MRI have altered the role of this imaging, and it is often the preferred choice among diagnostic tools for the detection and characterization of tumour cases.]

Hungarian Radiology

[Ethiopathogenesis of polycystic ovarian syndrome and imaging diagnostics of polycystic ovary]

JAKAB Attila, MOLNÁR Zsuzsanna, TÓTH Zoltán

[Polycystic ovarian syndrome is a heterogenous syndrome with a wide variety of endocrine and metabolic abnormalities and clinical symptoms. It is considered as the most frequent endocrine disorder in women in reproductive age and the most common cause of anovulatory infertility. Key features include menstrual cycle disturbance, hyperandrogenism and obesity. There are many extraovarian aspects to the pathophysiology of polycystic ovarian syndrome, but ovarian dysfunction is central. The underlying unique feature of the ovarian morphology gives the significance of the ultrasound examination. At a recent consensus meeting, a refined definition of the polycystic ovarian syndrome was agreed, encompassing a description of the morphology of the polycystic ovary. The subjective appearance of polycystic ovary should not be substituted for the definition. Further, a woman having polycystic ovary in the absence of menstrual disorder or hyperandrogenism (asymptomatic polycystic ovary) should not be considered as having polycystic ovarian syndrome, until more is known about the situation. Since ultrasound description of polycystic ovary morphology has central role in the diagnosis, and untreated polycystic ovarian syndrome carries long term health risks, the increasing attention to ovarian morphology may offer an effective tool to decrease women`s morbidity. This review outlines the background and feature of ovarian morphology in polycystic ovarian syndrome, and details the current ultrasound definition of polycystic ovary.]

Hungarian Radiology

[Breast malignancies: review of the year 2008/2009 radiological diagnostics and therapy news - Onco Update, 2010]

FORRAI Gábor

[Systematic review of the recent articles of the years 2008/2009 about breast tumours’ radiological diagnostics and guided therapy, the actual place of the imaging and interventional methods are presented.]