Hungarian Radiology

[Radiological diagnostics in bone metastases]


SEPTEMBER 20, 2008

Hungarian Radiology - 2008;82(05-06)

[Imaging plays a crucial role in defining bone metastases, and thus, therapy planning. We are responsible for accurate data collection, pre-treatment evaluation, evaluation of therapy response and post-treatment evaluation. Precision highly depends on the expertise and experience of the evaluating radiologist, and therefore, being familiar with the latest literature is essential. The bone status can be detected well by bone scan, analysed by conventional X-ray examination and by the cross sectional digital imaging modalities. The whole body PET/CT functional imaging is becoming increasingly popular in the metastatic workup of patients and for monitoring response to therapy. MRI has been found to be the most accurate method for bone metastasis in most comparative evaluations in the literature. This article is a review of the latest papers focusing on the clinical significance of the imaging results in bone metastasis diagnostics.]



Further articles in this publication

Hungarian Radiology


Hungarian Radiology

[The bubble-sign of spontaneous pneumoperitoneum]


[INTRODUCTION - Pneumoperitoneum is a reliable indicator of serious underlying damage. There are four etiologic categories of extraluminal-intraperitoneal gas collections: spontaneous, iatrogenic, traumatic and criminal perforations. The erect posteroanterior chest radiograph is the most sensitive plain film projection for detecting pneumoperitoneum and it may show 0.5-1 ml free abdominal gas when meticulous radiographic techniques (lateral, oblique, air-gap, lordotic, inspiratory and expiratory exposures) are used. The appearances of extraluminal gas collections are specified by physical rules and individual preferences. The bubble-sign is an uncommon, pathognomonic phenomenon. CASE REPORT - A case of an 86 years old female patient with spontaneous pneumoperitoneum, diagnosed on the basis of the bubble-sign is presented. On erect, lordotic inspiratory chest film, right medial inversion of diaphragm, left pleural effusion, emphysema, cardiomegaly and aortectasia were observed. The bubble-sign and hydromediastinum became evident in the right phrenicocostal angle on expiratory view. Our patient expired before the surgical intervention.The postmortem demonstrated double peptic duodenal ulcers; the older ulcer had penetrated and encapsulated in the hepatoduodenal ligament, while the more recent one perforated through the intraperitoneal space. CONCLUSION - Routine upright chest films are valuable screening tools for uncommon signs of pneumoperitoneum, also.]

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[Results of the elections held to elect new members of the Society of Hungarian Radiologists]

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[PURPOSE - To demonstrate the recent results in radiological diagnostics of pancreas, and the actual place of the imaging and interventional methods. METHOD - Systematic review of the most recent articles from the last year in the following subjects: acute, chronic and autoimmune pancreatitis, pancreatic cancer and other tumors, PET and special imaging problems in pancreas transplantation. RESULTS - Annually, experience in pancreatic diagnostical methods are accumulating rapidly. Therefore, there is a continuous change in the examination algorithm with new diagnostic and therapeutic modalities making their way into the daily routine. Some of the algorithms become obsolete within a few years and their further application is considered mismanagement. Some other methods become obligatory steps in the diagnostics. These are the reasons why up-to-date knowledge of the literature is mandatory.]

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Clinical Neuroscience



[The most frequent neurological manifestations of the Acquired Immunodeficiency Syndrome- (AIDS) are Cerebral Toxoplasmosis, Primary Central Nervous System Lymphoma (PCNSL), Progressive Multifocal Leukoencephalopathy (PML) and AIDS-encephalitis (AIDS-dementia complex, multinucleated giant cell encephalitis, HIV-encephalopathy). Neurological complications usually occur in the advanced stages of the disease, and they are uncommon in the beginning as presenting illness, but may result in lifethreatening condition or in death. Rarely the disease presents as a neuropsychiatric illness in an undiagnosed AIDS patient, delaying a proper diagnosis. We present the case of a 34 years old patient treated for AIDS-related Toxoplasma-encephalitis in our department. His illness started as an acute psychosis followed by rapid mental and somatic decline, leading to death in three months. His HIV-seropositivity was not known at his admission, and the extraneural manifestations were slight. The diagnosis was established by serology, imaging methods and histopathological investigation. After presenting the medical history and results of autopsy studies of the patient we discuss the problems of the differential diagnosis, especially regarding the findings of the imaging methods.]

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[Imaging of mesenterial panniculitis - Case report]

KOVÁCS Anita, KISS Ildikó, PALKÓ András

[INTRODUCTION - Mesenterial panniculitis is a rare benign disorder, however it is important to be familiar with, because of the difficulties in differential diagnosis. Authors describe the characteristic imaging signs of the disease based on their two cases. CASE REPORTS - Two male patients (72 and 62 years old) presented with uncertain abdominal pain and weight loss. Acute pancreatitis, chronic gastritis and duodenitis are noted in their case history. The laboratory parameters were normal and the physical examination revealed a palpable epigastrial terime in both patients. Abdominal ultrasound and CT examinations depicted different degree of mesenterial infiltration with lymph node enlargement. Histological analysis of the biopsy sample proved the process to be benign in the first patient. The mass was surgically removed in the second one and histology proved mesenterial panniculitis. CONCLUSION - Mesenterial panniculitis is a benign, chronic non-specific inflammatory disorder. Its appearance may simulate malignant diseases, thus making differential diagnosis is important. Abdominal ultrasound, CT and result of image guided biopsy play an important role in the diagnosis, in case of which conservative therapy and regular follow-up is sufficient.]

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