[Role of perfusion imaging in computed tomography in diagnostics of cerebral gliomas]. / Rola obrazowania perfuzji w tomografii komputerowej w diagnostyce glejaków osrodkowego ukladu nerwowego.

CT perfusion is a new diagnostic method which enables imaging of the hemodynamics of tissues and organs. Until now most of the publications have been focused on the use of this technique to assess acute stroke. The aim of the presented work is to show the role of CT perfusion in the diagnosis of cerebral gliomas. These tumors are characterized by intensive vascularity which results in an increased blood volume (CBV), blood flow (CBF) and permeability surface (PS) values in perfusion CT examination. A correlation has been reported between perfusion parameters and the histopathological tumor grade. CT perfusion provides morphological and functional information which is useful in the diagnosis, planning treatment strategies and monitoring of the therapeutic effect in cerebral gliomas.

The integration of the computer advisory system together with neuroimaging procedures, neurophysiological markers and psychological cognitive tests in order to obtain evidence based system for the physician treating affective disturbance.

WHO has classified depression disturbances--due to widespread existence and serious medical consequences and resulting social and economic effects--as a priority health problem in all the developed countries. The significance of the depression disturbances is fully comparable to such illnesses as heart diseases, cancer and HIV infection. The research made in the USA (NIMH programmer) shows that first contact doctors are not able to detect depression in relation to 50-70% of the people ill with it. Also the research made in other countries shows that a doctor properly identifies only one out of four persons with clear indications of depression. The wrong choice of the antidepressant drug may result in inefficient therapy and in growing risk of suicide. In 1993 the analysis of 50 best selling medicines in the EU made by two Italian pharmacologists showed that in France and Italy in over 45% of the cases the medicines with doubtful efficiency are applied. The aim of our project is to build a European network, which will integrate the research capabilities of a group of research institutes and university departments to provide an infrastructure for creation of the computer advisory system for diagnostics of affective disorders. This network will integrate our original computer expert advisory system called "Salomon" with modem brain imaging techniques and neurophysiological methods, which allows for the delineation of specific subtypes and particular episodes of mental disorders and their neural bases will be studied by state-of-the art (high tech) imaging techniques. This approach will lead to new investigatory, diagnostic and therapeutic techniques.

Extracolonic findings at CT colonography - additional advantage of the method.

BACKGROUND: In virtual colonoscopy (VC) we are capable to assess all organs located between a diaphragm and pelvic bottom. This report provides a breakdown of extracolonic pathological findings in VC performed in standard indications. MATERIAL/METHODS: We reviewed 71 consecutive VC (29 men and 42 women) performed using double-slice scanner General Electric High Speed NX/I Pro. Pathological findings were presented in a tabular form illustrated by sample images. RESULTS: Extracolonic findings were found in 53 cases (74.6%), and were equally frequent in subgroups with pathological colon and free from colon lesions. Renal cysts occurred most often. In 15 cases the extracolonic pathologies were clinically important, most of them tumors. CONCLUSIONS: VC is found to be a very useful tool in the detection and evaluation of extracolonic pathologies.

Evaluation of contrast-enhanced FLAIR sequence in MR assessment of intracranial tumours.

BACKGROUND: Magnetic resonance (MR) has become the most important imaging method in the diagnosis of intracranial tumours. However, conventional MR protocol often fails to obtain all morphological details which are necessary for precise planning of the treatment. Therefore, there are attempts of introducing other MR techniques, to gain new information concerning tumour morphology. One such technique is FLAIR sequence. In previous papers we presented the value of plain FLAIR in patients with intracranial tumours. The aim of the present study was evaluation of contrast enhanced FLAIR (CE FLAIR) in assessment of intracranial tumours. MATERIAL/METHODS: MR examinations, including conventional T1 (pre-and postcontrast) and T2 images, as well as plain and contrast-enhanced FLAIR sequences were performed in 27 patients with intracranial tumours. In all patients the degree and localization of contrast enhancement in post-contrast T1-weighted sequence (CE T1w) and CE FLAIR images have been compared. RESULTS: Contrast enhancement of the tumour in both CE T1-w and CE FLAIR sequences was found in 18 patients. In 5 patients the enhancement was visible only on T1-weighted images, while in 2 cases only on FLAIR images. Among 18 patients, who demonstrated enhancement both in T1-weighted and FLAIR sequences, in 9 cases the effect of enhancement was better on T1-weighted images, in 7-CE FLAIR gave superior results, and in 2 patients - both methods were equivalent. In the whole material in 9 cases CE-FLAIR was superior in 14-inferior and in 4-equal to CE-T1-w. Among 9 cases in which CE- FLAIR was superior, in 7 patients the enhancement concerned the border of the tumour or postoperative cave. CONCLUSIONS: Contrast-enhanced FLAIR has limited value in assessment of intracranial tumours and should be used as a supplementary technique if there are difficulties in evaluation of tumour morphology in other sequences.

[Virtual colonography in CT and MRI examinations]. / Wirtualna kolonoskopia w badaniach TK i MR.

The paper presents new ways of visualizing internal structures of the large intestine. Use of spiral computed tomography (CT) or magnetic resonance imaging (MRI) combined with appropriate software leads to imaging that can be compared with colonoscopy or double contrast enema. The authors discuss patients' preparation, methods for CT and MRI variants, indications, advantages and costs.

Stereotactic methods in interdisciplinary diagnosis and treatment of posterior fossa tumours.

For over 2 years, we have had access to latest generation apparatus and software for planning and stereotactic treatment as well as for x-rays treatment. Until now, we have carried out over 100 procedures. These included 52 stereotactic biopsies of neoplasms, some of them located within the structures of the posterior fossa. In this report, we have discussed the possibilities and effectiveness of diagnosis and treatment of tumours located in different structures, including posterior cave. In the study, we used stereotactic methods. We have described biopsies of the following tumours: cerebellar hemisphere tumour (diagnosed as "metastatic atypic planoepitheliale carcinoma" in a patient with coexisting orbit lymphoma), a bifocal lesion (located in cerebellar hemisphere and cerebellar peduncle, diagnosed as pilocytic astrocytoma of WHO malignancy grade II/III), and lesion (located in the pons, diagnosed as pilocytic astrocytoma WHO grade II).