Hungarian Radiology

[Metal objects in the MR]


APRIL 20, 2003

Hungarian Radiology - 2003;77(02)

[During magnetic resonance imaging the patient is exposed to three different types of electromagnetic radiation: static magnetic field, gradient or time varying magnetic fields and radiofrequency electromagnetic fields. The potential risks associated with performing MRI in patients with ferromagnetic implants, materials, or devices are related to the possibility of movement or dislodgement, to the induction of electrical currents and to the heating. The majority of metallic implants are considered to be safe for MRI, but patients with cardiac pacemakers, ferromagnetic aneurysm clips, cochlear implants, implantable drug infusion pumps should not be examined by MRI.]



Further articles in this publication

Hungarian Radiology

[The ECR 2003 Image Solving Meeting]

PALKÓ András

Hungarian Radiology

[Treatment of ureter stenosis of the transplanted kidney using invasive radiological methods]

DOROS Attila, WESZELITS Viola, PUHL Mária, RUSZ András, JANSEN Judit

[INTRODUCTION - Stenosis, occlusion and necrosis of the ureter after kidney transplantation occur in 2-13%. The therapeutic choices are surgery or minimally invasive endourological and percutaneous procedures. We analysed our therapeutic plan and results using percutaneous dilatation and stenting. PATIENTS AND METHODS - The patients after kidney transplantation are regularly examined by ultrasound. In cases of suspected obstruction we perform scintigraphy and CT-urography, and if indicated, we place percutaneous nephrostomy. Between July of 2000 and September of 2002, 15 stenosis in 14 patients were dilated and stented percutaneously. RESULTS - We found one restenosis after 6 months due to compression. This patient underwent surgery, but after the operation another stenosis has developed. We treated it percutaneously. One nephrectomy had to be performed due to serious infection. In one patient stent migration occured and surgical intervention was performed. 12 patients have free urine passage and good kidney function as a result of percutaneous therapy. CONCLUSION - We have good results with percutaneous ureter dilatation and stenting, but our follow-up time (31 months) must be longer for the evaluation of long-term results. The percutaneous treatment can partly replace endourological and surgical methods or can be combined with each other.]

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Clinical Oncology

[Long-term central venous access devices in oncology]


[Long-term central venous access devices are essential in the management of oncology patients, as they minimize the discomfort caused by frequent venipuncture and cannulation. Indications of application of central venous accesses, possibilities of implantations, immediate and long term complications, they prevention and obviation has been reported based on guidelines and relevant publications. Long term implantable central venous accesses handled by well-trained and exercised team, working with principles of maintenance, these manipulations are effective and safe, therefore suitable in oncological practice.]

Clinical Neuroscience

[99-mTc-HMPAO single photon emission computed tomography examinations in genetically determined neurometabolic disorders]

ARANKA László, AMBRUS Edit, VÖRÖS Erika, SVEKUS András, KÓBOR Jenõ, BEREG Edit, PALATKA János, PÁVICS László

[The aim of our study was to determine regional cerebral blood flow (rCBF) abnormalities in different types of enzymopathies. Patients and methods - Among the patients with genetically determined enzymopathies 3 patients had aminoacidopathies, and 11 had different types of encephalopathies, from which 10 had mitochondrial encephalomyopathy (MEMP), and 1 patient had hyperuricaemic encephalopathy. Besides the mentioned 14 patients, 1 had ceroid lipofuscinosis and another patient had tuberous sclerosis. The further distribution of the MEMP patients’ group was the following - 5 patients had MEMP with lactic acidosis, 5 had Leigh’s disease (subacute necrotizing encephalopathy), from which 1 had cytochrome-c-oxidase deficiency (COX). Additionally in all patients were performed cerebral MRI and SPECT examination 10 min. after intravenous administration of 20 Mbq/kg 99 mTc-HMPAO. Results - Fourteen out of 16 SPECT findings were pathologic, showing decreased focal frontal/temporal/temporoparietal cerebral blood perfusion. Aminoacidopathic group - all the 3 patients revealed pathologic signs from the aminoacidopathic patients’ group. Among them the ornithine transcarbamylase (OTC) heterozygous female patient with left-sided hemiparesis caused by hyperammonemic stroke at 10 month-age, showed right sided temporoparietal, occipital and left frontal hypoperfusion, nearly 6 years after the cerebral vascular attack. This finding might be resulted because of diaschisis. Mitochondrial encephalo-myopathic (MEMP) group - all the four patients with MEMP and lactic acidosis showed focal hypoperfusion in the temporal region, while the perfusion was normal in the COX deficient patient and in 2 Leigh’s disease (subacute necrotizing encephalopathy) patients. In the remaining 1 Leigh’s patient frontotemporal hypoperfusion was found. In all patients there were non specific structural abnormalities detected by MRI - cortical and subcortical atrophy, and scattered demyelination foci. In the case of ceroid lipofuscinosis the MRI showed cerebral atrophy and cerebellar hypoplasia, and the SPECT showed right frontal and occipital hypoperfusion, bilateral parietal physiological riping process. The patient with tuberous sclerosis showed bilateral temporo-occipital hypoperfusion. Conclusion - 1. SPECT images demonstrated hypoperfusion rCBF changes in 14 out of all 16 patients. 2. Regional cerebral/cerebellar hypoperfusion was detected by SPECT in mitochondrial encephalomyopathies, with lactate acidosis and aminoacidopathies giving high informative value about the cerebral perfusion.]

Clinical Neuroscience

[Severe intracranial hypotension in an adolescent with Marfan syndrome. Case report]

ROSDY Beáta, KOLLÁR Katalin, MÓSER Judit, VÁRALLYAY György, KORDÁS Mariann

[Spontaneous intracranial hypotension is a rare complication of connective tissue disorders. One of them is Marfan syndrome. It predisposes the patient to meningeal diverticula. Possibly after minor unrecognised head trauma or secondary to Valsalva manoeuvre cerebrospinal fluid leak from meningeal diverticula can happen. It causes postural headache. We describe a 15 year old adolescent female newly diagnosed with Marfan syndrome, who presented with intractable postural headache. Our patient's brain MRI showed bilateral frontal subdural effusion, narrow ventricles, downward displacement of the brainstem, enlarged cervical venous plexi, dural ectasias and wide nerve root sleeves. Radionuclide cisternography demonstrated CSF leaks at multiple sites. She could not be treated conservatively, but was successfully treated by epidural saline injections. Control brain and cervical MRI confirmed her healing, too. At the two and half year follow up visit, she was completely well. So we recommend this easiest technic to use before epidural autolog blood patches.]

Clinical Neuroscience

[Neurological and psychiatrical prospects of apathy]


[During his long practice as head physician of a neurological and psychiatrical department with over 100 beds performed the examination and department of more than a hundred thousand patients. Based on the acquired experience and the data of the most recent literature he treats every aspect of the apathy syndrome. He emphasizes the multidisciplinary approach during both establishing the causes and the examination and treatment of patients. In order to clarify the diagnosis consultations with other disciplines must be used as well as the the knowledge provided by the now essential CT, MRI, PET, SPECT. The author discusses the international therapeutical possibilities and practice after the recently alredy possible exact diagnosis.]

Clinical Neuroscience

[Posterior ischaemic optic neuropathy]

BOÓR Krisztina, KOVÁCS Krisztina, RÓZSA Anikó, PÁNCZÉL Gyula, SZILVÁSSY Ildikó, GÁCS Gyula

[Here one case report of the posterior ischaemic optic neuropathy, a rare and underdiagnosed form of the non arteritic ischaemic optic neuropathy is presented, to underline the value of the MRI in the diagnosis. The ischaemic optic neuropathy is the infarction of the optic nerve. Depending on the affected segment of optic nerve (optic nerve head or retrobulbar segment) two subclasses exist: the anterior (AION) and the posterior (PION) ischaemic optic neuropathy. Ischaemic optic neuropathy characterized by sudden, painless, mononuclear loss of vision, and/or visual field defect, that is accompanied by a diagnostic picture of the optic disc fundus only in the case of the AION. The diagnosis of the PION is based on a diagnosis of exclusion described by Hayreh in 1981. The macular and retinal laesions, the etiological role of toxic agent, the compression and the inflammation of the optic nerve all have to be excluded. The differential diagnosis between the PION and the retrobulbar neuritis is more difficult. Nowadays, in addition to the case history and the clinical data the diagnosis of the PION could be confirmed with help of VEP (visual evoked potential) and MRI. In the case of an old woman who had a sudden, painless visual loss of left eye we confirmed the diagnosis of PION with MRI which was presumed after had excluding other etiological factors.]