Three-dimensional computed tomography reconstruction in treatment planning for large ameloblastoma.

A case of an unusually large mandibular ameloblastoma is reported in which standard radiologic examination failed to provide adequate visualization of the tumor's limits because of overlapping structures and the presence of compound shadows. Computed tomography imaging and three-dimensional reconstruction proved invaluable in the treatment planning of this large lesion, because it allowed the surgeon to visualize and comprehend the geography of the tumor and its relationship to surrounding structures and soft tissues and to formulate a surgical plan. Use of this technique helped ensure complete excision of the tumor without excessive removal of uninvolved tissue.

The value of magnetic resonance imaging in the staging of musculoskeletal tumours.

In view of the changes that are occurring in the management of musculoskeletal tumours and the importance of precise pre-operative staging, a study to determine the value of magnetic resonance imaging (MRI) as a modality for this purpose was undertaken. Sixty-four patients were examined and 70 MRI examinations were carried out. Fifteen cases were found to be benign and 49 malignant. As a result of the accuracy of these MRI examinations and their remarkable similarity with the pathological specimens, which was shown to be statistically significant (P less than 0,005), we propose a modification to the sequence of the diagnostic staging modalities for musculoskeletal tumours.

The value of magnetic resonance imaging in multiple sclerosis in South African-born patients.

The results of magnetic resonance imaging (MRI) in supporting the diagnosis of multiple sclerosis in 24 South African-born white patients were studied. MRI confirmed the diagnosis in 87.5% of cases. It appears that MRI is useful in strengthening the diagnosis of multiple sclerosis in patients with clinically established disease. This study supports the validity of the clinical diagnosis of multiple sclerosis in South African patients and stresses the need for re-evaluation of the incidence and prevalence of multiple sclerosis in this country.

Two years of mid-trimester amniocentesis in Johannesburg.

During a 2-year period 438 mid-trimester amniocenteses were performed on women at risk of producing an abnormal infant. The commonest indications were advanced maternal age (61% of cases), neural tube defects (18%) and Down syndrome (11%). A 92,5% follow-up revealed a spontaneous abortion rate of 3% (1,5% if abortions within 8 days of the procedure were considered). Premature birth occurred in 4,4% of cases, neonatal death or stillbirth in 0,7%, and birth defects which were detectable by amniocentesis in 2%. Abnormalities were detected in 4,9% of cases, so that 95,1% of the patients were reasured by the results obtained. No defects diagnosable by amniocentesis were missed.

Ultrasound aspiration biopsy transducer amniocentesis.

Amniocentesis through an ultrasound aspiration biopsy transducer was performed 156 times. The technique is described and our results are presented. By closely monitoring the fetus and the needle entry into the amniotic cavity, we have avoided serious complications. The importance of adequate genetic counselling for the procedure is stressed, as most cases fall into the second trimester group, and the procedure is indicated in order to try to prevent inheritable disorders. The importance of continual monitoring of the fetus before, during and after the procedure is pointed out, and recommendations are made to avoid difficulties and complications in amniocentesis.