[Marketing mix in a radiology department: challenges for future radiologists in management]. / Marketingmix in een dienst radiologie: uitdagingen voor de toekomstige radioloog in management.

Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

Post-traumatic thrombosis of a segmental branch of the inferior mesenteric vein.

We report the case of man with post-traumatic thrombosis in a segmental branch of the inferior mesenteric vein with secondary venous congestion and ischemia of the sigmoid colon. We discuss the current imaging modalities for diagnosing venous thrombosis and their relative significance.

Testicular plasmacytoma, an unusal testicular tumor.

We report the case of a 78-year-old man with recent diagnosis of Kahler disease and a non-tender swollen left hemiscrotum. Ultrasound findings showed an intratesticular, hypervascular hypoechoic lesion. MRI imaging demonstrated general appearance of a malignant lesion. Specific characteristics however, could not be withheld on MRI. Orchidectomy was performed and plasmacytoma was demonstrated at pathological examination. Although plasmacytoma of the testis is extremely rare, it should be included in the differential diagnosis taking into account the ultrasound and MRI appearances, especially in elderly patients with known Kahler disease.

Spontaneous rupture: a rare complication of hepatic hemangiomas.

Hepatic lesions are one of the possible visceral causes of spontaneous hemoperitoneum. Hepatic hemangiomas are congenital vascular malformations and are the most common benign tumours of the liver. Most cases are asymptomatic. Although they seldom rupture, it is important to diagnose them as their global mortality rate is high. An accurate diagnosis of a hemangioma as cause of a hemoperitoneum would result in correct clinical decision making and treatment.

Diffuse pseudoangiomatous stromal hyperplasia of the breast: a case report and a review of the radiological characteristics.

Pseudoangiomatous stromal hyperplasia is a benign mesenchymal tumor of the breast. It is a rare condition and until a few years mainly described in pathological and surgical literature. Here, we provide a case report of PASH and an overview of its radiological features.

Spontaneous resolution of a solitary osteochondroma.

Spontaneous regression or resolution of a solitary osteochondroma is infrequent. A case of a surprisingly fast and complete resolution of an osteochondroma of the distal ulna in a 7-year-old boy is presented, with a review of previously reported cases.

Pulmonary alveolar proteinosis.

A 23-year-old man was admitted to the hospital because of dyspnea. Chest X-ray showed reticulo-nodular opacities. The crazy paving appearance on high-resolution CT was highly suggestive of pulmonary alveolar proteinosis. Histologic examination confirmed the diagnosis. Pulmonary alveolar proteinosis is a rare disease but an important diagnosis to make as treatment with pulmonary lavage is curative in a large proportion of patients.

Non-Hodgkin's lymphoma of the prostate in a young male.

A case of non-Hodgkin's lymphoma (NHL) involving the prostate and the urinary bladder in a 24-year-old male is reported. Although none of the currently available imaging modalities is specific for the diagnosis of NHL of the prostate, this diagnosis must be considered because of its amenability to treatment. The heterogeneity of the mass at CT and MRI might be suggestive of high-grade NHL. The patient was treated with intensive combination chemotherapy.