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Clinical Neuroscience

NOVEMBER 30, 2009

[Myelination disturbance in a patient with hyperuricemia and hyperserotoninemia combined with 18q deletion syndrome]

LÁSZLÓ Aranka, VÖRÖS Erika, BUGA Klára, HORVÁTH Katalin, MAYER Péter, OSZTOVICS Magda†, PÁVICS László, SVEKUS András, PATTERSON C. Marc

[We previously reported a male patient with an 18q21.3 deletion, hyperuricemia and typical symptoms of the Lesch- Nyhan syndrome who lacked hypoxanthine-guanine-phosphoribosyl- transferase (HGPRT) deficiency. The patient developed progressive peripheral neuropathy in additon to his profound mental retardation and self-injurious behavior. At the age of 23 years MR imaging revealed globally delayed myelination with relative sparing of the corpus callosum and frontal lobes. They were focal hyperintensities suggestive of gliosis. Multimodality evoked potentials found evidence of impaired central and peripheral conduction. Single photon emission computed tomographic (SPECT) imaging demonstrated left frontal hyperperfusion and under it a temporoparietal hypoperfusion.]

Hungarian Radiology

JUNE 20, 2006

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

BALÁZS György

[Our aim is to review the radiologic literature of lung cancer of 2004 and some remarkable publications from 2003. There are three main groups in the recent publications dealing with lung cancer’s radiology. The first group comprises those reviews and metaanalyses which focus on the overall utility and reliability of routinely applied modalities such as CT and MRI. In the second group we find original articles reporting on the experience with new modalities. This group is dominated by publications dealing with positron emission tomography and the first clinical results of combined PET-CT technology. In the third part we review those articles dealing with lung cancer screening. Radiological lung cancer screening is in the focus of interest again, mainly due to the introduction of low-dose CT which is undoubtadly the most sensitive radiological modality for the early detection of lesions, however, its clinical utility is debated. The papers referred are basically sceptic, but this is not the end, because controlled long term follow-up studies are still in progress. Part of the publications report on the first clinical results of new methods, while others give valuable additional data regarding the performance of “well established” radiological modalities.]

Hungarian Radiology

OCTOBER 20, 2004

[Pelvic computed tomography in staging of prostate cancer before surgery]

BERCZI Csaba, TÓTH György, VARGA Attila, FLASKÓ Tibor, KOLLÁR József, TÓTH Csaba

[PURPOSE - The aim of the study was to measure the sensitivity and specificity of computed tomography for local staging in patients underwent radical perineal prostatectomy. PATIENTS AND METHODS - 160 patients were involved in the study. Rectal digital examination, measurement of prostate specific antigen, prostate biopsy, CT, ultrasound, chest X-ray examination and bone scintigraphy were performed in every case before radical prostatectomy. RESULTS - The average preoperative prostate specific antigen concentration was 15.8 ng/ml before surgery. The average Gleason score of biopsies was 3.19. CT showed extraprostatic infiltration in 14 patients (pericapsular invasion n: 6, seminal vesicula n: 3, bladder infiltration n: 5, lymph node metastasis n: 2). The histological examination proved extraprostatic invasion of the tumour in 35 cases (pericapsular invasion n: 35, seminal vesicula n: 25, bladder infiltration n: 5). The cancer was localized in the prostate in 125 patients. Sensitivity and specificity of CT for pericapsular invasion were 14% and 98%, for infiltration of seminal vesicula 12% and 100%, and for bladder infiltration 20% and 97%. There was not a significant difference between the prostate specific antigen values (p=0.94) in cases when the tumour was confined to the prostate and when the cancer showed extraprostatic infiltration. There was significant difference between the Gleason score values between the two groups (p=0.008). CONCLUSION - The sensitivity of CT for local spread of prostate cancer is very low, thus CT is not a suitable method for the local staging before surgery.]

Lege Artis Medicinae

JANUARY 20, 2001

[The role of MRI in the diagnosis of tumours]

GŐDÉNY Mária

[Imaging is important in the evaluation of tumour detection, staging to determine the response to therapy, to follow the patient to find an early recurrent tumour. The ability to assess cancer spread has been revolutionized by advances of digital imaging modalities, such as digital ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). MRI is the method of choice for detecting and evaluating brain, spine, head and neck and musculoskeletal tumours, but it is complementary in the investigation of the thorax. US and CT remains the primary test for imaging the abdomen, while MRI plays a subsidiary role as a problem solving technique. In the evaluation of focal liver disease numerous prior reports have documented a superior performance of MRI compared to CT and US in the detection of primary and metastatic liver tumours. MRI is gaining more and more importance in imaging of the pelvis. Breast MRI is increasingly used as an adjunct to conventional imaging modalities. Several recent developments in MRI have altered the role of this imaging, and it is often the preferred choice among diagnostic tools for the detection and characterization of tumour cases.]

Hungarian Radiology

DECEMBER 20, 2007

[Abdominal and thoracal manifestations of posttransplantation lymphoproliferative disorder in children]

VÁRKONYI Ildikó, NYITRAI Anna, MAGYAROSY Edina, RÉNYI Imre, SZEBERÉNYI Júlia, KIS Éva

[INTRODUCTION - Posttransplantation lymphoproliferative disorder is a secondary disease of transplanted patients, usually with good response to reduction of immunsuppressive therapy. PATIENTS AND METHODS - The lymphoproliferative disorder was diagnosed in four children among 139, renal, liver and lung transplanted patients. Clinical data (original disease, transplanted organ, age and time elapsed since transplantation at the diagnosis of the disorder) and imaging findings (chest X-ray, thoracal and abdominal computed tomography scans) were analysed retrospectively. RESULTS - Thoracal and abdominal forms were the most frequent manifestations of posttransplantation lymphoproliferative disorder in our patients. Following features have been diagnosed on imaging studies: multiple liver nodules (two cases), multiple nodules in the renal parenchyma (two cases), splenomegaly (two cases), bowel wall thickening (two cases). Retroperitoneal and mesenteric lymph node enlargement was found in all patients. Thoracal manifestations were as follows: mediastinal lymphadenopathy (two cases), hilar mass (one case), multiple pulmonary nodules (one case). Renal rupture with perirenal hematoma in one case, hilar mass envolving the main bronchus in one case, hepatic abscesses necessitating drainage in one case, and bowel wall necrosis in one case were the complications of posttransplantation lymphoproliferative disorder. CONCLUSION - Presenting symptoms are aspecific, often mimicking infection. Posttransplantation lymphoproliferative disorder has to be excluded if aspecific symptoms in a transplanted patient are present, or the patient does not react properly on antibiotics. First step investigations include chest X-ray and abdominal sonography. Neck, chest and abdominal CT are mandatory for detecting all manifestations, for staging the disease and to determine the best localization of obligatory biopsy.]

Hungarian Radiology

APRIL 10, 2005

[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

DECEMBER 20, 2003

[Small bowel perforation due to blunt abdominal trauma in case of an inguinal hernia]

GION Katalin, SÉLEI Ágnes, CSÁSZÁR József, PALKÓ András

[INTRODUCTION - The injury of fixed bowel loops occurs more frequently due abdominal trauma. Authors review the CT signs of bowel injury in conjunction of the presented case. PATIENTS, METHODS - The inguinal hernia of the male patient was present for approximately 30 years prior the abdominal trauma. Due to the trauma the fixed small bowel loop became perforated. CT examination, beside using the conventional methods established the diagnosis of bowel wall perforation and the site of the perforation was localized before surgery. CONCLUSIONS - CT provied additional information compared to X-ray and US in the localization of the lesion due to the blunt abdominal trauma.]

Clinical Neuroscience

SEPTEMBER 30, 2010

[Devic syndrome - case report, diagnostic and therapeutic principles]

ILJICSOV Anna, BARSI Péter, VÁRALLYAY György, TÁTRAI Erika, SOMFAI Gábor Márk, BERECZKI Dániel, RUDAS Gábor, SIMÓ Magdolna

[Neuromyelitis optica (NMO, Devic-syndrome) is a rare, relapsing autoimmun disease of the central nervous system, which is distinguished from other demyelinating disorders by a recently identified, specific autoantibody. By demonstrating the anti-aquaporin-4 IgG in the serum, a heterogenous group of syndromes can be defined, called NMO-spectrum. In the future, optical coherence tomography may support this diagnosis besides the clinical features, imaging examinations and presence of serum antibody. Early recognition and treatment can improve clinical outcome even in serious condition. Long-term immunosuppressive therapy is advised to prevent further relapses and to stabilize or improve clinical status. Hereby, we report a case of a 51-year-old woman, under treatment for 1.5 years. We summarize the up-to-date knowledge about the pathomechanism, diagnostic strategy and therapy of neuromyelitis optica. We review recent findings and the diagnostic value of a new, non-invasive ophtalmological examination, the optical coherence tomography. According to the first results, this method may be helpful in the early differential diagnosis of optic neuritis.]

Lege Artis Medicinae

JUNE 20, 2005

[DIAGNOSTIC POSSIBILITIES IN HEAD AND NECK MRI]

GŐDÉNY Mária

[Digital cross-sectional imaging techniques, especially computed tomography (CT) and magnetic resonance imaging (MRI) play an important role in the diagnosis of pathologic conditions affecting the head and neck. MRI, because of its superb soft tissue contrast resolution and multiplanar imaging ability gives the most information regarding the origin and the extent of a laesion, intracranial extension, perineural-, as well as bone marrow involvement and play key role in the management of different diseases. Careful observation of the characteristic radiological features usually leads to correct diagnosis, however, some of the lesions are not typical, looking very similar and can be difficult to differentiate from each other. The purpose of the present article is to provide an overview of the most common pathologic conditions examined with MRI.]

Hungarian Radiology

OCTOBER 20, 2004

[Radiologic imaging in the diagnosis and follow up of malignant lymphomas]

PETRI Klára, HORVÁTH Anikó, MOLNÁR Zsuzsa, VÁRADY Erika, SCHNEIDER Tamás, ROSTA András, GŐDÉNY Mária

[Certain viral infections, gene mutations and immune suppression are likely to play some role in the development of malignant lymphomas. The clinical stage at the time of diagnosis is a decisive factor of prognosis. The evaluation of the nodal and extranodal manifestation of the disease is performed by standardized imaging techniques. Most frequent extranodal manifestation involves the bone marrow, the lung and the gastrointestinal tract. Different imaging techniques are indispensable in monitoring the effectiveness of the treatment and in long term follow up.]