Hungarian Radiology

[LETTERS]

TÓKA Magdolna, KENÉZ József, LOMBAY Béla

DECEMBER 20, 2006

Hungarian Radiology - 2006;80(07-08)

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Hungarian Radiology

[Initial experiences with TOF MR and contrastenhanced MR angiography of the supraaortic arteries]

TASNÁDI Tünde, KARDOS Klára

[INTRODUCTION - 95 MR angiographic examinations of the supraortic arteries were performed at the Rethy Pal Hospital, Bekescsaba between February 2003 and May 2005. The aim of this publication is to analyse the clinical benefit of contrast-enhanced MR angiography compared to duplex ultrasound and to evaluate the role of TOF MR angiography in the diagnostics of the carotid arteries. We compared the results of contrast-enhanced MR angiography, TOF MR angiography and duplex ultrasound. MATERIAL AND METHOD - 95 patients were examined by CE MR angiography following carotid duplex US in 59 cases and TOF MR angiography in 88 cases. Duplex US was done using LOGIQ 400 PRO system, MR angiography were performed by 1.5 T Siemens Magnetom Symphony unit. RESULTS - Stenosis of the internal carotid artery was confirmed in 67 cases and stenosis of the common carotid artery was seen in 10 cases. Bilateral ICA stenoses were detected in 17 patients and bilateral CCA stenoses could be revealed in 3 cases. The ICA stenosis was mild in 22 (33%), moderate in 18 (27%), and serious in 27 cases (40%). Occlusion was seen in 10 cases (15%). CE MR angiography showed stenosis at the origin of the CCA in 5 patients, at the origin of the vertebral and the subclavian artery in 10-10 cases that could not be detected by duplex ultrasound. Subclavian artery stenosis was seen in 15 patients, 7 of them presented subclavian steal syndrome. 13 patients had vertebral artery stenosis, 7 of them bilateral. 13 of the 20 VA stenoses were mild, 4 were found to be moderate and 3 were serious. In four patients the vertebral arteries were occluded. In six questionable cases MR angiography solved the problem. Reversed flow could be detected in 5 cases with duplex ultrasound suggestive of subclavian steal syndrome, which was later confirmed by TOF and CE MR angiography. TOF MR angiography showed stenosis on reconstructed images, which was not confirmed by neither duplex US or CE MR angiography. Paraganglioma was detected in one patient. CONCLUSION - In case of calcified plaques and abnormal arterial-course CE MR angiography contributes significantly to the detection of the stenosis. In cases with moderate and serious stenosis duplex ultrasound and MR angiography provided similar results. In case of occlusions the results of the two modalities were the same. The contrast-enhanced MR angiography gives the possibility to show the aortic origin of the supraaortic arteries in contrast to the duplex US and TOF MR angiography. To establish the diagnosis of subclavian steal syndrome the directional sensitivity of TOF MR angiography and duplex US is helpful adjunct to CE MR angiography.]

Hungarian Radiology

[Computer tomography based planning by personal computer in surgery of forefoot]

HUSZANYIK István, HEGEDŰS Franciska, RÓDE László

[BACKGROUND - In contradiction to traditional osteographic registrations CT pictures give the possibility of precise and size proportional measurements. Three-dimensional reconstructions can help in imaging of stereoscopic structures, however later reediting is not possible. Authors elaborated a CT based system for planning surgical interventions with personal computer. MATERIALS AND METHODS - The new method is described using a forefoot surgery model. The measurements were based on three subcapital osteotomy of 1st metatarsus. The length of 1st metatarsus, the 1st-2nd metatarsus index, the 1st-2nd intermetatarsal angle, and dorsoplantar movement of 1st-2nd metatarsal head were determined. RESULTS - The postoperative result of correction and pathologic bone movement can also precisely determined by this method. CONCLUSION - This method seems to be practical for elaboration of other new operating techniques, predicting and verifying their results before clinical use.]

Hungarian Radiology

[Measurements on radiologic equipments for quality and safety - 3rd Interdisciplinary Forum]

GÁSPÁRDY Géza

Hungarian Radiology

[Ultrasound diagnostics - Further development?]

LOMBAY Béla

Hungarian Radiology

[Professors for European Hungary - Professional Conference]

LOMBAY Béla

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[Based on recent evidences, for what kind of diseases are the Hungarian thermal waters beneficial?]

BENDER Tamás

[Hungary has extremely favorable geothermal facilities, resulting in a leadership role in the usage of thermal water for medical purposes and for publishing medical studies. In the recent decades, a total of 40 balneological subject studies were published in English language journals with impact factors, among these 25 original articles dealing with musculoskeletal disorders, as well as inflammatory and metabolic parameters, dermatological and gynecological diseases; besides these, five experimental works and ten reviews, editorial letters, and other issues. In addition, 20 papers have been published in Hungarian medical journals on the topic of musculoskeletal disorders, including six double-blind clinical studies and six single-blind studies. Based on the published domestic and foreign publications, as other studies have not refuted, Hungarian mineral waters, irrespective of mineral content and concentration of the water, have pain killing effect at patients suffering from degenerative musculoskeletal disorders, chronic low back pain and sometimes improve the quality of life of the patients. Based on small number of data the sulfur and salt bath may be beneficial for dermatologic and gynecologic disorders, while carbon dioxide bath, dry carbonic snow, and mofetta may be beneficial in cardiac and vascular rehabilitation; radon bath and radon cave affect the endocrine system; however, to prove it, a study of a large number of patients are required. ]

Hungarian Radiology

[LETTERS]

PALKÓ András, LUZSA György

Lege Artis Medicinae

[How can the specialists be contacted? Ways of communication in the specialist-patient consultation]

MOLNÁR Regina, PAULIK Edit, SÁGI Zoltán, KÖVES Béla

[Consulting the specia­list means face-to-face meetings traditionally. Nowadays patients do not need to go to the outpatient clinic to see the doctor since many new communication options have already been available. The aim of our study was to explore how typically doctors and patients use other options (as phone call or e-mail) beside face-to-face appointments in the outpatient clinic. We conducted a focus group interview with specialists and health workers and an in-depth interview with the chief nurse of an outpatient clinic in Budapest. The specialist-patient consultation is mostly face-to-face in the specialist’s office in the presence of the nurse, whose role is complex and pivotal. Fur­ther­more, the landline phone is an essential device, as the patients can reach the specialist or nurse in their office hours. The application of e-mail or mobile phone is incidental. The website of the outpatient clinic provides practical information to patients. Traditional postal letters, leaflets, and publications are also typical for providing information. The doctors’ opinion was rather heterogeneous about the pa­tients’ Internet usage and about the on­line contact with patients. Beside increasing the capacities the deliberate and organized introduction and application of technical de­vices, may reduce the overburdening of health professionals.]