Hungarian Radiology

[Omental infarction diagnosed with ultrasonography]

VÁRKONYI Ildikó, VÖRÖS Péter, SZÉKELY Eszter

OCTOBER 20, 2009

Hungarian Radiology - 2009;83(03)

[INTRODUCTION - Omental infarction is a rare entity, mimicking symptoms of acute appendicitis. Although omental infarction has typical morphology, both on sonography and CT, it is rarely diagnosed preoperatively. CASE REPORT - A 4-years-old girl presenting with right lower quadrant abdominal pain underwent abdominal sonography, which revealed normal appendix and a superficial hyperechoic solid mass at the site of the pain. The patient underwent laparotomy which confirmed the presumed diagnosis of partial omental necrosis. The necrotic tissue was resected, the appendix was normal. After uneventful postoperative course the child became symptom -free and was discharged. CONCLUSION - The sonomorphology of omental infarction is typical. The suspicion of this entity should be considered as a differential diagnosis of appendicitis, especially if normal appendix can be visualized.]

COMMENTS

0 comments

Further articles in this publication

Hungarian Radiology

[Lifelong learning and teaching]

LOMBAY Béla

Hungarian Radiology

[Role of imaging in the managment of colorectal cancer]

JEDERÁN Éva, GŐDÉNY Mária

[Colorectal cancer is the third most common cancer worldwide and the second most common cause of cancer death in Hungary. Diagnosis requires the examination of the entire large bowel by means of radiological and/or endoscopic techniques. Colorectal cancer primarily develops from adenomatous polyp over a period of 10-15 years. Tumour staging is crucial for the prognosis and for the planning of the most suitable anticancer therapy. The role of imaging in colorectal cancer is increasing with the change in complex tumour therapy. With advances in ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI) techniques accuracy of imaging has improved. The accuracy of CT improved with the advent of the multislice technique (MDCT). Sensitivity and specificity of CT colonography (CTC) in colon polyps and cancer is over 90%, therefore it is one of the screening tools. Accuracy of the CTC is comparable to the optical colonoscopy, complements conventional colonoscopy well and it is an effective tool in the right hands. Endorectal US (ERUS) depicts the anatomic layers of the rectal wall with high degree of accuracy, therefore it is the best method for the evaluation of the lower tumour stage. High resolution MRI is the most suitable technique for predicting rectal tumor stage, therefore it has been established as the standard for preoperative assessment of rectal cancer.]

Hungarian Radiology

[Colorectal cancer screening: Lessons from the American experience]

BAFFY György, TÁRNOKI Dávid László, TÁRNOKI Ádám Domonkos, BAFFY Noémi

[Colorectal cancer is one of the most common malignancies of our times. The disease takes many years to develop and is typically preceded by polyp formation, which allows timely screening and diagnosis. A number of tests and procedures have been developed to screen for colorectal cancer and its premalignant conditions. However, apparent heterogeneity of the disease, redundancy of the available screening modalities, as well as costs and potential pitfalls of these preventive measures require careful strategic planning. In the United States, recent advances in the campaign for colorectal cancer screening provide important lessons that may guide similar initiatives in Hungary.]

Hungarian Radiology

[Ways of imaging the expression of vascular endothelial growth factor and its receptor]

KOROM Csaba, KARLINGER Kinga

[The vascular endothelial growth factor (VEGF) and its receptors (VEGFR) signal-transduction pathway play a key role in the regulation of angiogenesis. It was originally isolated as a selective mitogen for endothelial cells and as a powerful vascular permeability increasing factor. The vascular imaging techniques make the quantification and localization of blood vessels possible. They have been used to assess blood flow, oxygenation, and vascular permeability. Also, they can be used to examine the molecular and cellular difference in the vascular wall. To evaluate tumour vascularity, a multimodality approach is expanding. VEGF as the primary mediator for vascular-permeability is indirectly measurable with DCE-MRI (dynamic contrastenhanced MRI). MRI investigation can determine the ratio of deoxyhemoglobin/oxyhemoglobin in order to localize the hypoxic regions in vivo (BOLD [blood oxygen-level dependent] sequence and OMRI [Overhauser MRI]). In molecular MRI (mMRI), contrast agent-mediated alteration of tissue relaxation times can allow for the detection and localization of molecular disease markers. To localize the expression of VEGFR with SPECT and PET, antibodies and VEGF isoforms can be marked with isotopes. VEGFR is an excellent candidate for targeted ultrasound imaging since it is almost exclusively expressed on activated endothelial cells. Optical imaging is a relatively cheap method suitable so far primarily for small animal studies.]

Hungarian Radiology

[Portal embolisation prior to liver resection]

MÓZES Péter, MÉSZÁROS György, TÓTH Judit, SÁPY Péter

[INTRODUCTION - By partial embolisation of the vena portae the number of the patients suitable for radical liverresection can be enhanced, the safety of the operation can be increased, the subsequent results improved. The method is based on the experience that when blocking the circulation of the portal system in special segments of the liver, the other part of the organ tries to substitute the functional deficiency by hypertrophy. Vena portae embolisation is justified in cases when the liver substance remaining after the planned operation is critically small. PATIENTS AND METHODS - The authors carried out vena portae embolisation at Debrecen University Medical and Health Science Centre since October 2003 on six patients. Assessments were made studying the volume of the whole liver, the lobe affected by embolisation and that of the unaffected lobe, by CT-volumetry. The average age of the patients (four men and two women) was 63 years (51-67 years). The hepatic tumour was an extended metastasis localised to one lobe in five cases, and HCC in one of the patients. In each case we carried out closing the right lobe’s portal system. RESULTS - In five cases the left lobe showed increase following the portal embolisation of the right lobe intended to be removed. On the average four-six weeks passed between the two CT-examinations. The growth of the left lobe was an average of 42% (min. 11.8%, max. 75.6%). CONCLUSION - In selected patients the embolisation of the vena portae system of the tumorous liver-segments is a suitable method for enlargening the size of the liver substance remaining after an extensive resection.]

All articles in the issue

Related contents

Clinical Oncology

[Hematopoetic stem cell transplantation for pediatric non-hematological solid tumors]

HAUSER Péter, KRIVÁN Gergely

[High-dose chemotherapy followed by stem cell rescue or allogeneic stem cell transplantation in the treatment of solid tumor with non-hematologic origin applied for more than three decades. High-dose chemotherapy with stem cell rescue is the part of standard fi rst line therapy for several chemosensitive tumors with unfavorable outcome (neuroblastoma, Ewing-sarcoma, medulloblastoma), and also successfully applied in certain therapy-resistant or recurrent solid tumors (germ cell tumors, Wilmstumor). Allogeneic transplantation with reduced intensity conditioning is still not successful in terms of survival in pediatric solid tumors with non-hematological origin. In present paper results of autologus and allogeneic stem cell transplantation in different pediatric solid tumor are discussed.]

Journal of Nursing Theory and Practice

[Application of „The Parental Belief Scale for Parents of Hospitalized Children” questionnaire in Hungarian language]

MIKLÓSI Mónika, PERCZEL FORINTOS Dóra

[Aim of the study: Beliefs about parental role and efficacy was shown to be important in adaptation to child’s hospitalization; there is a lack of adequate measure of this construct, however. Our aim was the evaluation of the Hungarian version of The Parental Belief Scale for Parents of Hospitalized Children (PBS; Melnyk, 1994) assessing parents’ beliefs about their ability to understand and predict their children’s behaviours and emotions, as well as to participate in their children’s care during hospitalization. Sample and methods: The Hungarian version of the PBS was evaluated using a back-translation process. One hundred parents of hospitalized children in Heim Pál Children’s Hospital, Department of Surgery and Traumatology fulfilled the measure along with questionnaires regarding demographics, general parental self-efficacy and state-anxiety. Results: The Hungarian version of the PBS showed excellent internal consistency (α=0,94), and good stability (r=0,85 p<0,001). A significant positive correlation of medium effect size was found between PBS scores and general parental self-efficacy (r=0,30 p=0,025). Parent’s state anxiety was significantly negatively related to their self-efficacy beliefs regarding hospital setting (r=-0,48 p<0,001). Conclusion: The Hungarian version of the PBS was shown to be a reliable and valid instrument for measuring efficacy-beliefs of parents of hospitalized children.]

Clinical Neuroscience

[99 M TC HMPAO SPECT in children with intractable epilepsy]

NEUWIRTH Magdolna, BORBÉLY Katalin, KOPCSÁNYI Zsuzsanna

[We examined the role of HMPAO SPECT examinations in presurgical evaluation of children with intractable partial epilepsy. SPECT studies (ictal, interictal) were performed on 31 children aged 1-18 years. The focus was restricted in 18 cases and extensive, ie, a whole hemisphere or some lobes, in 4 cases. SPECT indicated pathological changes in the relevant areas in 15 of 18 cases, but in 9 children with temporal epilepsy in all. The focus was extensive in 4 cases, e.g. in 3 children with Rasmussen syndrome. SPECT was pathologic in all of them when MRI did not yet show hemiatrophy of the brain. In 3 cases of partial epilepsy MRI did not demonstrate lesion, the focus was not well-defined by EEG, in contrast to SPECT. Thus it can be stated that SPECT provides valuable information on presurgical evaluation in children with intractable partial epilepsy.]

Clinical Neuroscience

[Endo-sonographic anatomy of the ventricular system]

REISCH Róbert, RESCH Klaus, PERNECZKY Axel

[A preclinical cadaver study was performed to test a transendoscopic sonographic probe for neurosurgery. In 25 fresh post-mortem adult human cadaver with a total of 39 endo-sonographic dissections in the ventricular system were carried out. A sonograph with an outer diameter of 6 F was used and radial sonograms were made by a realtime image technique. First results showed precise imaging, comparable to a CT in a neighbouring area of 3 cm. In this publication, the authors describe the endo-neurosonographic anatomy of the ventricular system. The sonographic probe was advanced through the working canal of a ventriculoscope, then the endoscopic and sonographic imaging were compared. Results were documented by paralell sonographic and endoscopic photo and video recordings. Based on the authors experience, it is revealed that the additional sonographic view could also be used as a navigation tool.]

Lege Artis Medicinae

[Risk assessment for child sexual abuse in the American legal practice]

KÓRÁSZ Krisztián

[The paper gives introspection into the child sexual abuse risk assessment practice in the USA by reviewing the literature. According to the definition of the World Health Organization, sexual assault is considered to be any act involving a child in a sexual activity if he or she can not be considered as prepared for the child's age or development. The author also makes an attempt to present some issues and pos­sible solutions regarding the current practice. ]