Hungarian Radiology

[The possibilities of CT and MR imaging in hydrocarbon research]

BOGNER Péter, FÖLDES Tamás, ZÁVODA Ferenc, REPA Imre

OCTOBER 20, 2003

Hungarian Radiology - 2003;77(05)

[INTRODUCTION - Cross-sectional medical imaging techniques were applied on geological samples (cores) in order to reveal their morphological and functional properties. Our aim was to reveal those CT and MRI methods that are capable to characterize certain petrophysical parameters and can be correlated with core morphology. MATERIALS AND METHODS - Similarly to pre- and postcontrast scanning in human diagnostic imaging CT scans of core samples were obtained in dry and flooded state, that helped to define and calculate morphological and functional parameters. Several MRI sequences were also tested, mainly spin-echos with short echo time. RESULTS - Several hundred meters of core samples have been examined in the last three years. Effective porosity can be calculated from CT data, that characterizes oil/gas storage capacity of the given geological formation. CT information is superior to conventional petrophysical methods due to its spatial resolution. Nevertheless, we can not quantify permeabilty yet, but describe it qualitatively. We found only limited use of medical MR imaging methods. DISCUSSION - Cross-sectional imaging, primarily CT scanning was introduced to the Hungarian oil and gas industry in the last three years. It seems that the method will be used more and more frequently through the entire process of oil/gas exploitation. Our further goals include the implementation of the CT measurements in other areas like environment control, and further develope measurement conditions.]

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Hungarian Radiology

[Role of the first ultrasound examination in the diagnosis of hilar cholangiocarcinoma]

LUKOVICH Péter, WINTERNITZ Tamás, KÁRTESZI Hedvig, ILLYÉS György, KUPCSULIK Péter

[INTRODUCTION - Hilar cholangiocarcinoma (Klatskin tumour) rarely causes obstructive jaundice, because rarely thought of that cause during medical examinations. Because the small size of the tumour in the biliary duct and the proximity of other components of the porta hepatis tumour cannot be detected by ultrasound, CT and MRI examinations in a significant part of the cases, which makes the diagnosis more difficult. PATIENTS, METHODS AND RESULTS - In the present study we have analysed the findings of the first abdominal ultrasound examination carried out on 38 patients who had undergone resection due to hilar cholangiocarcinoma during the period 1991-2002. The presence of the tumour could be proved only in 18.2% of the cases. The recognition of the secondary symptoms (dilated intrahepatic biliary ducts, choledochus of normal diameter) is also considered very low (68.2% and 50% respectively). From the viewpoint of the operability of the Klatskin tumour the relationship between the tumour and the blood vessels is important. Only one researcher has made declaration in this sense. The difficulty of detecting the tumour and the incorrect evaluation of the secondary signs led to the wrong ultrasound diagnosis in 82% of the cases, leading the examination astray. CONCLUSIONS - The correctly interpreted ultrasound examination accompanied by a Doppler study - even if it cannot document the tumour - provides evidence of a proximity biliary duct constriction and based on the secondary signs it defines the diagnosis of the Klatskin tumour. In order to judge operability MR-cholangiography is the next modality of choice. In lack of obvious sign of inoperability surgical exploration is justified. In case of an early diagnosis the 25-45% rate of 5-year survival, which is considered a very good result in gastrointestinal tumours, improves further.]

Hungarian Radiology

[A Travel from the Present to the Future A Radiology Assistant in Denmark Viborg, 18 March to 13 May 2002]

GERGELY Márta

Hungarian Radiology

[Peritoneal encapsulation associated with lipophage and foreign body granulomas]

SZÁNTÓ Dezső, SZŰCS Gabriella, DITRÓI Edit

[INTRODUCTION - Peritoneal encapsulation is a rare developmental anomaly in which the ileal loops are encased in an accessory peritoneal compartment between the omentum and mesocolon. CASE REPORT - A 44 year old foreign female patient presented a history of recurrent abdominal pain, distension, constipation and suppurative inflammation of abdominal anterior wall. She had a 2nd type diabetes and three similar episodes in the last nine months from her abdominomural war-injury, only. Extension revealed an independent of peristaltic rushes protrusion in the left anterior abdominal wall. On the abdominal plain films we saw a metaloid foreign body in the left subcostal plane and a globular calcareous deposit in the intertubercular one. The family physician of the patient informed us about the further follow up. At the laparatomy peritoneal encapsulation furthermore foreign body and lipophage granulomas were found. Histology of these granulomas proved the diagnosis. CONCLUSION - The speciality of case is the association of an uncommon developmental anomaly with lipophage and foreign body granulomas with pyogenous inflammation of the abdominal wall.]

Hungarian Radiology

[Ultrasound is not a stetoscope]

HARKÁNYI Zoltán

[Introduction of the small size, portable ultrasound machines opened new opportunities in ultrasound imaging. The optimal application of these equipments and the new problems related to the use are widely discussed in the literature. This brief review summarizes the advantages, main indication and limitations of the method. The single most important aspect for the patient is that emergency ultrasound examination should be available regardless of the profession of the doctors. The most difficult question is how to provide and control an optimal education and training for the doctors. Possible solutions are also discussed. It is predictable that the availablity of the portable ultrasound studies will significantly increase the number of examinations, therefore economical consequences must also be considered. The author disagree with the conception, which states that ultrasound machine can be used as a stetoscop in the doctor's pocket.]

Hungarian Radiology

[György Csákány MD has Passed Away 1920-2003]

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Hungarian Radiology

[Radiological diagnosis of lung cancer - 2005 Literature review Onco Update 2005]

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Hungarian Radiology

[Can magnetic resonance imaging play a role in planning the method of delivery after Caesarean section?]

GERGELY István, CSÉCSEI Károly, DORFFNER Roland, BARANYAI Tibor

[INTRODUCTION - The number of Caesarean sections has been dramatically increasing worldwide, and also in Hungary in the last decade. In case of pregnancy following a preliminary Caesarean section it is always questioned if repeated Caesarean section or vaginal birth is required. The authors try to draw a conclusion from the thickness and the structure of the uterinal scar. The aim of the current study is to assess the additional role of uterinal MR examination undertaken between two births. PATIENTS AND METHODS - During our retrospective preliminary study T2 weighted sagittal images of uterinal MR examinations of 13 female patients were analysed. The presence of scar line was evaluated for thickness (millimetres, mm). This measurement was compared with the surgical report following consequent Caesarean section. Thus, a correlation was made between the surgical scar found at the repeated Caesarean section and the structure of the uterine scar seen by MR examination (between two births) which could play a role in the indication of the next birth. RESULTS - Three of our 13 patients gave birth via vagina (VBAC), and 10 via repeated Caesarean sections. According to the descriptions of the surgical scar the scars thinned out in six cases, whereas they made thickness in four. According to the appearance of the place of incision the scar was homogeneous and hypointens in nine cases, and inhomogeneous but basically hypointense in one case. According to the description of surgery in the MR examination the thinned out scar was thinner than 6 mm in 4 cases, and thicker than 6 mm in two cases. According to the description of surgery in the MR examination the nonthinned out scar was thinner than 6 mm in three cases, and thicker than 6 mm in one case. In two patients of three who gave birth via vagina the scar was thicker than 6 mm in the MR examination, and thinner than 6 mm in one case, the MR appearance of the scar was homogeneous and hypointens in two cases and complied with the original zonal anatomy in one case. CONCLUSION - In case repeated Caesarean section is not necessary from the aspect of the foetus or the mother, uterinal MR examination is of an additional significance in the complex indication of birth following a previous Caesarean section. The thickness, structure and signal intensity of the uterinal scar may provide a useful additional information.]

Hungarian Radiology

[MR-guided ultrasound surgery]

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[The powerful union of focused ultrasound surgery and magnetic resonance imaging has created a new approach to noninvasive surgery. Using this integrated therapy delivery system the physician can achieve correct localisation of tumors, optimal targeting of acoustic energy, real time monitoring of energy deposition, and the means to accurately control the deposited thermal dose within the entire tumor volume. The advantages of MRI over ultrasound guidance in controlling focused ultrasound surgery lie in the more sensitive detection of tumor target, the real time detection of tissue temperature, and the confirmation of thermally-induced tissue changes - powerful features that eventually can replace the traditional surgical approach. Applying software that connects the therapy and imaging system, the physician can generate an entire plan from quantifying temperature changes to positioning the therapy transducer. The non-invasive debulking of tumors without disturbing adjacent, functionally intact structures is thereby accomplished. Ongoing clinical trials involving the treatment of breast fibroadenoma, localized breast cancers, and uterine fibroids have been most encouraging. But nowhere has the application of MRI-guided focused ultrasound surgery been more compelling than in brain, where not only tumor treatment is possible but also the focal, transient, reversible breakdown of the blood-brain-barrier. The implications of this mechanism for targeted intra-cerebral tumor therapy or other non-oncologic applications are clearly enormous. In addition to tumor treatment, MRI-guided focused ultrasound surgery has other potential clinical applications such as vascular occlusion, targeted drug delivery, and targeted gene therapy. FUS is not a new idea but the emergence of MRI based guidance has accelerated the progres of focused ultrasound surgery technology, certain weaknesses remain including excessively long treatment times, body and organ motion, and difficulties in finding acoustic windows at certain anatomic locations. Nevertheless, the successful clinical implementations of this method is already in progress.]