Hungarian Radiology

[Radiologic diagnosis of the diseases of the pediatric gynecology]

LÓRÁND Ágnes, HARKÁNYI Zoltán, LOVAS Györgyi, HÉJJ Ildikó

APRIL 10, 2005

Hungarian Radiology - 2005;79(02)

[The basic examination of the pediatric pelvic organs is the transabdominal ultrasound which provides useful information about the anatomy and the pathological changes and in the vast majority of cases it is sufficient for treatment planning and to establish the diagnosis. Additional examinations are needed in case of complex developmental anomalies, in suspition of tumor, in staging and follow up examinations of tumors. Among the modern imaging methods the use of CT and MRI can be considered. The authors described the most frequent diseases in their practice and gave a brief overview on anatomical and physiological basics which is necessary for the exact interpretation of the examinations.]

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[A small piece of renaissance]

LOMBAY Béla

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[Radiological diagnostics of the pancreas neoplasms - Onco Update 2005]

FORRAI Gábor, BODOKY György

[Authors reviewed the recent results of pancreas tumour radiological diagnostics and the place of the imaging and interventional methods. Systematical review of the most recent articles were summarized (July 2003-December 2004) in the following subjects: the etiology and clinico-pathology, general diagnostic and therapeutical questions of early pancreatic neoplasms, abdominal ultrasound, computed tomography, multidetector computed tomography, magnetic resonance imaging, MR-cholangiopancreatography, endoscopic retrograde cholangiopancreatography, endoscopic ultrasound, intraductal ultrasound, endoscopic ultrasound-guided cytology, percutaneous biopsy, positron emission tomography, positron emission tomography - computed tomography, special pancreatic tumours. Experiences about the pancreas 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 practice. These are the reasons why the up-to-date knowledge of the literature is mandatory.]

Hungarian Radiology

[Early detection of adult femoral head necrosis]

GION Katalin, PALKÓ András

[Adult avascular femoral head necrosis is common in young adulthood, and in 80% of cases affects male patients. The disease is bilateral in 40-80 %, and it may take several years to develop on the contralateral side. Late diagnosis and lack of early therapy can cause progressive disease and finally movement restraint. The diagnosis in early stage is crucial for choosing the most effective strategy in therapy. It is important to be aware of pathogenesis, clinical course and the differential diagnostic options of the disease, and these should be associated to the diagnostic findings at different imaging modalities. Based on this concept, we conclude that MR examinaton is the method of choice for the early (reversible) stage assessment. MRI of the hip is also able to evaluate and follow up the healthy contralateral side without further strain.]

Hungarian Radiology

[Dudoenum obstruction caused by duodenal diaphragm]

RUDAS Gábor, SEKYRA Pavel, PUMBERGER Wolfgang, POVYSIL Brigitta

[INTRODUCTION - Duodenum obstruction is a rare gastrointestinal developmental anomaly. It may be complete or incomplete. The incomplete or intrinsic form is often caused by an intraluminal membrane or web duodenal stenosis. The passage is existed with the help of a small perforated lake. Clinically the leading sign is the vomiting. CASE REPORT - A three days old baby admitted because of vomiting. Abdominal X-Ray and US could not found any reason of vomiting but the gastrointestinal contrast series had diagnostic value. Surgery proved the radiological diagnosis. CONCLUSION - For the diagnosis the conventional XRay and ultrasound is not sufficient in every case, the gold standard is the gastrointestinal contrast examination.]

Hungarian Radiology

[Czech dysplasia metatarsal type]

IVO Marik, MARIKOVA Olga, DANA Zemkova, MIROSLAV Kuklik, KAZIMIERZ Kozlowski

[We report a further female patient with the recently described new bone disease, Czech dysplasia metatarsal type. Czech dysplasia metatarsal type (CDMT) is an autosomal dominant debilitating disorder. Its constant phenotypic trait is hypoplasia/ dysplasia of the 3rd and/or 4th toes. “Congenital hip dysplasia” or “hip disease” is commonly evoked in the family history. The clinical course may be severe, incapacitating the patients early in life, or progress slowly with increasing hip and spine pain. This girl's phenotype and radiographic findings are similar to the seven previously reported cases.]

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[MR imaging of acute disseminated encephalomyelitis and multiple sclerosis in children. A review (in English language)]

PATAY Zoltán

[Inflammatory diseases of the central nervous system (CNS) are relatively rare in children, but their relevance to public health is considerable due to frequent and significant long term morbidity and even mortality. As in adults, acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) and their variants are the most common entities in this group of pathologies in the pediatric patient population. Recent efforts have focused on establishing standardized diagnostic criteria schemes to facilitate the diagnosis and differential diagnosis of these diseases, however especially with multiple sclerosis those have not been fully validated yet for disease occurring in children. In recent decades the role of MRI has been constantly increasing in the diagnostic work-up of suspected inflammatory diseases of the CNS as well as in the follow-up of patients with confirmed disease. Currently, MRI is the first-line diagnostic imaging modality in ADEM and MS and is fully integrated in the most widely used diagnostic criteria schemes, but it has a key role in clinical therapeutic research trials as well. This paper provides an update on the current concepts and strategies of MRI in inflammatory diseases of the CNS, as well as a review of the imaging semiology of the various disease entities and variants with emphasis on clinical and imaging particularities relevant to the pediatric patient population.]

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Marchiafava-Bignami disease: Report of three cases

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Marchiafava-Bignami disease (MBD) is a rare alcohol-associated disorder characterized by demyelination and necrosis of the corpus callosum. We report three patients who had history of chronic alcoholism, different clinical presentation and MRI findings consistent with the diagnosis of Marchiafava-Bignami disease.

Hungarian Radiology

[Isolated gallbladder rupture following blunt abdominal trauma]

PÉTER Lívia

[INTRODUCTION - Gallbladder injuries following blunt abdominal trauma occur rarely and are usually associated with damage to other abdominal organs. Isolated rupture of the gallbladder is extremely rare. CASE REPORT - A 42-year old intoxicated male patient suffered a blunt abdominal trauma 4 days before the admission. The physical examination was of normal and no specific laboratory values were found. Ultrasound examination demonstrated the gallbladder with hyperechoic thickened wall and inhomogenous content. Beside of the gallbladder fluid collection was detected with irregular margins. To prove the diagnosis of gallbladder injury computed tomography was carried out. Break of the gallbladder wall and hight density lumen content, corresponding to blood was detected. Around the gallbladder an irregular fluid collection was seen, which reached the level of the transverse section of the mesocolon. Computed tomography excluded traumatic lesion of other parenchimal abdominal organs. Surgery confirmed the radiological diagnosis. CONCLUSION - The patient with isolated gallbladder injury had a multiphasic clinical course. Sometimes the diagnosis has to be established at a relatively asymptomatic stage. The basic methods of the diagnostics are the ultrasound examination and computed tomography.]

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[MAGNETIC RESONANCE IMAGING IN ABDOMINAL DIAGNOSTICS]

PALKÓ András

[Magnetic resonance imaging (MRI) plays more and more important role in the abdominal imaging diagnostics since fast measurement sequences have become available making it possible to avoid movement artifacts and resulting in better quality and more informative images of the abdominal parenchymal organs and most segments of the gastrointestinal tract. The greatest advantage of MRI is that it is able to create images of adequate geometric resolution and excellent tissue characterization capacity without the use of ionizing radiation and iodinated contrast media. Today MRI is applied mostly in those cases when previous data suggest that computed tomography will not be informative or the results of recent imaging examinations (x-ray, ultrasound, computed tomography) do not provide sufficient diagnosis. Presumably MRI will be used with increasing frequency as the first or single best method of choice in the near future. Beased on these facts in abdominal diagnostics, MRI may be considered as a problem-solving modality which plays an outstanding role in the detection, differential diagnosis, staging and follow-up of many neoplastic and inflammatory lesions.]

Hungarian Radiology

[Role of ultrasound in the diagnosis of Crohn’s disease]

KUKLA Edit, BEVÍZ József, MAKULA Éva, PALKÓ András, VÁRKONYI Ágnes, FÜZESI Kristóf

[INTRODUCTION - The peak incidence of Crohn’s disease is the second and third decades of life. Twenty-five percent of new cases occur in individuals less than 20 years of age. Typically the clinical presentation of Crohn’s disease is not different in children from in adults. The sudden onset of the disease with serious symptoms is not rare in pediatric patients The signs of acute abdomen, the rapid deterioration of the patient's physical condition needs urgent surgical intervention. Ultrasound is the first imaging method of choice can reveal specific signs of the disease and early accurate diagnosis can be established. The radiation burden can be decreased on this way and the unnecessary surgical intervention can be avoided. CASE REPORT - A child who presented typical signs of acute appendicitis was investigated first by ultrasound. Based on this investigation the diagnosis of Crohn’s disease was suspected, but unfortunately the adequate diagnosis was established only 5 months later after appendectomy and right sided hemicolectomy. CONCLUSION - Authors draw the attention to the importance of the ultrasound investigation in the diagnosis of Crohn’s disease in the childhood.]