Hungarian Radiology

[Prenatal detection of campomelic dysplasia by sonography]


OCTOBER 20, 2007

Hungarian Radiology - 2007;81(05-06)

[INTRODUCTION - The campomelic dysplasia is a disorder characterized by short and bowed lower limbs resulting in dwarfism. CASE REPORT - In the case of a 21-year-old primipara woman the second screening ultrasonography raised the suspicion of short and bowed lower limbs of the fetus, at the 19th week of the pregnancy. Repeated examinations proved the presence of short and bowed femurs and tibias and abnormal echogenecity of the bones. The upper limbs were almost normal in length. During the 19th week of pregnancy, after a genetic analysis in agreement of the parents the pregnancy was interrupted without any complication. Photography and Xray of the fetus confirmed the diagnosis. CONCLUSION - Fetal ultrasonography should include exact size measurement and observation of the shape of the long bones, making possible the early detection of limb anomalies. The anomaly being proven by positive genetic analysis the pregnancy can be interrupted at the parents' request.]



Further articles in this publication

Hungarian Radiology

[Pancreas transplantation: Indication, surgery, complications, diagnostic imaging and outcome]

NÉMETH Andrea, DOROS Attila, HARTMANN Erika, WESZELITS Viola, DABASI Gabriella, LANGER Róbert, MÁTHÉ Zoltán, JÁRAY Jenő

[Diabetes mellitus is often leading to chronic microvascular and macrovascular complications. At present time, wholepancreas transplantation is the only option to achieve long-term insulin independence. Therefore, simultaneous kidney-pancreas transplantation has become the preferred treatment option for selected patients with type I diabetes mellitus and renal failure. In this review authors describe the indications and main types of pancreas transplantation: simultaneous pancreaskidney transplantation, renal transplantation first then pancreas transplantation, pancreas transplantation alone, islet-cell transplantation, and deal with surgical technical aspects. The immunological, metabolic, inflammatory, technical and late complications are also datailed as well as the outcome of the operations. The importance of the various imaging techniques is emphasized. The rate of mortality and complications are significantly higher after simultaneous kidney-pancreas transplantation than those after kidney transplantation alone. The role of the radiologist is to promote a successful outcome by early detection of the complications.]

Hungarian Radiology

[Technical aspects of MR urography based on two cases]

HORVÁTH László, BOGNER Péter, NAGY Gyöngyi, BAJZIK Gábor, VANDULEK Csaba, REPA Imre

[Intravenous urography has been the gold standard in diagnostic radiology studying the urogeintal system. However, ultrasound and other cross-sectional imaging methods have brought major change in this area. Beside modern (multislice) CT examinations the methods of MR urography are more frequently applied making possible both static and dynamic examinations beyond the wellknown advantages of MR imaging. The authors describe two complemetary methods of MR urography which provide a complete evaluation of the urinary system. The first method is aimed to image stationary fluid by using heavily T2 weighted turbo spin echo pulse sequences. This measurement well depicts the dilations of the excretory system even with little or no excretion of urine. The second method is analogous with the traditional IVU, as the excretion of a less nephrotoxic gadolinium based contrast medium followed by a T1 weighted gradient echo pulse sequence (possibly dynamic) helps to visualise the renal cavities and the urinary pathways. Normal renal function is a prerequisite when using this technique in order to visualise normal and obstructed urinary pathway disorders. The use of MR urography together with traditional MR methods may significantly reduce the number of invasive examinations and methods based on X-ray radiation exposure. MR urography may be exceptionally important in the uroradiological study of distensions of renal cavities in pediatric cases, pregnant women and renal transplant patients or in case of contrast material allergy.]

Hungarian Radiology

[Tarsal coalitions in our adult patients]


[INTRODUCTION - Tarsal coalition is an abnormal bony, cartilaginous or fibrous union between two or three bones of the mid and hindfoot. It occurs mostly (90%) in the calcaneonavicular and talocalcaneal joints. Coalitions are usually detected in the second decade of life, but several cases are noted in children and in later adulthood. Estimated incidence is 1-2% of the total population. CASE REPORTS - Cases of unilateral tarsal coalitions (five calcaneonavicular, three talocalcaneal) in four male and three female patients are presented. The average age of the patients is 30 years. The radiologic diagnosis was based on the secondary signs seen on the lateral plain films of the feet. These signs are parallel with clinical symptoms, in contrary to the primary radiologic signs. The two types of the anomaly coexisted in a female patient. CONCLUSION - Routine lateral not-magnified pedal radiographs are valuable screening tool for tarsal coalitions.]

Hungarian Radiology

[Professor Mózes Péter was awarded professor emeritus title]


Hungarian Radiology

[MRI-guided prostate brachytherapy: First Hungarian experiences based on a canine study]


[INTRODUCTION - Modern radical radiotherapy can be an effective alternative of radical prostatectomy in low risk patients with prostate tumor. Our objective was to demonstrate the feasibility of transperineal MR-guided prostate interventions in an open MR unit and to present our early clinical experiences on canines. METHODS AND MATERIALS - The procedures were performed on 5 canines in an open-configuration 0.35T MR scanner. For interventions an MR compatible custom-made device was used. The canines were placed in the right lateral decubitus position. Template reconstruction, trajectory planning, target and OAR delineation were based on T2 FSE images. For image guidance and target confirmation, fast spoiled gradient-echo (FSPGR) sequence was used. MR compatible coaxial needles were inserted through the perineum to the base of the prostate. After satisfactory position was confirmed, brachytherapy catheters were placed through the coaxial needles, which were then removed. RESULTS - Mean and standard deviation of the needle displacements was 2.2 mm±1.2 mm, with a median of 2 mm. 96% of the errors were less than 4.0 mm. Implantation induced prostate motion was measured with a mean of 10.3 and 2.3 mm in cranio-caudal and transverse directions. Significant movement was only observed during the first 4 needle insertions. The average time needed for each step was: anesthesia 15 minutes, setup and positioning 15 minutes, initial imaging 15 minutes, template registration and projection 15 minutes, contouring, trajectory planning, insertion of 10 needles 60 minutes. CONCLUSION - Based on our canine model experiences our method seems to be a promising approach for performing feasible, accurate, reliable and high-quality prostate MR guidance within a reasonable time span. We plan to introduce MR-guided biopsy and brachytherapy in human patients in the near future.]

All articles in the issue

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Hungarian Radiology

[Recent results of breast diagnostics - Onco update 2004]


[The purpose of this overview is to demonstrate the recent results of breast diagnostics and the place of the imaging and interventional methods. Review of the most recent articles (September 2002- December 2003) in the following subjects: breast screening, digital mammography, computer assisted diagnosis, breast ultrasound, breast MRI, scintimammography, positron emission tomography, guided biopsies, other interventions, new diagnostical methods, percutaneous tumour ablation. Experiences about breast diagnostic methods are accumulating year-to-year rapidly. Therefore the current examination algorithm is changing continuously. New diagnostic and therapeutic modalities are entering in the daily routine. These are the reasons why the up-to-date knowledge of the literature is mandatory.]

Hungarian Radiology

[Frequency and diagnosis of pediatric air gun injuries]


[INTRODUCTION - Air guns are frequently given to children as toys. Air guns have a pellet caliber of 0.17 or 0.22 and are propelled by compressed gas. Though they have little penetrating effect, they may cause life threatening injuries. Our purpose was to evaluate the frequency and the development of the diagnostic opportunities in children with air gun injuries during the last 30 years (1971-2000). PATIENTS AND METHODS - 52 patients (39 boys and 13 girls) were admitted to our pediatric surgery department due to of air gun injuries. The average age was 9 years (range 2 to 14 years). During the first fourteen years conventional X-ray (plain film and fluoroscopy), since 1984 ultrasonography and later (1986) CT has also been used for the diagnosis. RESULTS - In the first ten years 12 patients, in the second decade 18 patients and in the third ten years 22 patients were admitted and treated with air gun injuries. The sites of injury included upper, lower extremities (n=23), head (n=10), neck (n=5), chest (n=9) and the abdomen (n=5). The majority of patients had superficial injury and Xray plain films in different views were obtained, only. Major complication occured in 10 cases: bone fracture (n=1), soft tissue abscess (n=4) pneumothorax and hemothorax (n=4), bowel perforation (n=1). In these cases ultrasonography and/or CT was performed and they were helpful to establish the correct diagnosis. CONCLUSION - The general conception that air guns are toys, is basically wrong. The practice of placing air guns in the hands of children by their parents is very dangerous. On the basis of our results, the frequency of air gun injuries in children increased significantly in the last decade and the injuries were more serious than before (due to thew technologic modification of air gun). Ultrasonography and CT have important role in the diagnosis, but conventional X-ray remains the basic method in most of cases.]

Journal of Nursing Theory and Practice

[Obstructive sleep apnea syndrome: how we screen and diagnose?]


[The obstructive sleep apnea syndrome (OSAS) is known to cause obstructive apneas and hypopneas mostly with desaturations and/or arousals caused by repetitive collapse of the upper airway system during sleep. The disorder negatively affects sleep efficacy and daytime neurocognitive functions as well as increases cardiovascular risks. The typical clinical presentation is excessive daytime sleepiness and loud snoring interrupted by brief pauses of breathing. Its prevalence is 2-4% in the general population. It may be a causative factor in some disorders such as therapy resistant hypertension, nocturnal cardiac arrhythmias, stroke, cognitive decline or depression. Significance of the disorder is highlighted by the fact that its risk must be evaluated by the family doctors during the examination of medical suitability for driving licence in Hungary. ]

Lege Artis Medicinae

[Screening for depression and suicidal risk in family and general medical practice]

RIHMER Zoltán, SZILI Ilona, KALABAY László, TORZSA Péter

[According to both international and national studies the point prevalence of diagnosed major depression requiring treatment is 6-10 percent in general practice. As un­treated depression is the most important risk factor for suicide, early detection and effective management of depression (especially depression which predisposes sui-cide) are critical in prevention. According to international and national studies the re-cognition of major depression in primary care significantly contributes to the decline of suicide mortality. In our article we present two short questionnaires used for re-cognising depression and acute suicide risk and we describe their use in family/ general practice. We aim to raise awareness of the need of a systematic, nationwide sui-cide prevention programme which is supported on government level as well. ]

Hypertension and nephrology

[Health Protective Screening Program of Hungary 2010-2020. Metabolic syndrome - Results in 2010-2012]

KÉKES Ede, BARNA István, DAIKI Tenno, DANKOVICS Gergely, KISS István

[1 597 163 health assessments were performed on 65267 persons as a part of screening program. 132 964 participants were participated in our lifestyle advice program. The number of questionnaire responses for health statue were 3 717 480 during three years. This publication presents the results of metabolic disorders explored by screening. The metabolic syndrome was characterized by visceral obesity, abnormal glucose level and elevated blood pressure. Reasonable suspicion of metabolic syndrome was occured in 33-38% of subjects. Where the positive criteria was present, there were higher values of investigated parameters (waist, glucose, cholesterol, systolic blood pressure, uric acide level) compared with those of negative criteria.]