Experience with iopamidol in myeloradiculography.

Myeloradiculography with Iopamiro 300 produced by Bracco was carried out in 110 patients. In 97.2% the diagnostic evidence produced was excellent. It was difficult to make an exact diagnosis in 2.7% of cases, in whom there was a strong dilution as the contrast material moved from the lumbar into the cervical area of the spine. The side effects were slight and occurred only in a small proportion of patients. No neurotoxic complications or psychological changes were observed.

[Initial experience of an endocrinologist with the treatment of hypophyseal adenomas with the Leksell gamma knife]. / Prvé zkusenosti endokrinologa s lécbou hypofyzárních adenomu Leksellovým gama nozem.

BACKGROUND: Surgery of pituitary adenomas is not quite satisfactory so far and in some patients it is associated with a high risk. Conventional radiotherapy is only partly successful. Only few hospitals have experience with treatment of pituitary adenomas with Leksell's gamma knife. The objective of the presented paper is to give an account of the authors' own results of treatment of pituitary adenomas by irradiation with Leksell's gamma knife. METHODS AND RESULTS: The treated group comprised 13 patients (6 women, 7 men, 25-72 years old, median 44 years) with a pituitary adenoma. Hormonally active acromegaly was recorded in 9 patients, a prolactinoma in one female patient, afunctional adenoma in 3 patients. Twelve patients had been operated already previously, 3 of them twice. For visualization of the pituitary magnetic resonance (NMR) was used on a Magnetom apparatus 1.5 Tesla, Siemens Co. before surgery and one year after surgery. As hormonal indicators the following were examined: growth hormone (GH) profile in the course of the day and during the thyroliberin test (TRH), insulin-like growth factor I (IGF I), the prolactin level, the thyrotropin level (TSH) during the thyrotropin releasing hormone test (TRH) test the thyroxine level (T4) and the triiodothyronine level (T3), the plasma concentration of adrenocorticotropin (ACTH), the cortisol level, plasma testosterone level and 17-beta estradiol level. Complete recovery was achieved only in one female patient with acromegaly 18 months after irradiation, and in one patient with a prolactinoma a partial decline of hormone levels was recorded without detectable changes in the size of the adenoma. Only one female patient developed hypopituitarism. No other complications were recorded. CONCLUSIONS: Stereotactic irradiation with Leksell's gamma knife is valuable for treatment of pituitary adenomas and it is well tolerated therapy. Its effect is manifested only after several months. Complications in the sense of hypopituitarism may occur.

[Magnetic resonance imaging of the postoperative status in children with congenital heart defects]. / Zobrazení pooperacních stavu detí s vrozenou srdecní vadou magnetickou rezonancí.

The justification of examinations by magnetic resonance and the results of visualization of cardiac and vascular structures in relation to the performed surgical operation were evaluated retrospectively in 24 children after surgery of congenital heart disease. Thirteen patients had an operation of coarctation or a double aortic arch and four had an operation of an anomaly of the branch of the pulmonary artery-its loop or atresia. Seven patients had operations, mostly complicated inborn heart disease, of the common arterial trunk and transposition of the large arteries with a conduit, tricuspidal atresia after Fontan's or Glenn's modified operation and ligature of an aortal aneurysm. At the time of examination the patients were 4 to 18 years old. Spin echo sequences obtained by basic reconstructions of T1 and possibly T2 weighted images on a 1.5 T Magnetom apparatus Siemens proved an excellent visualization in the area of the large arteries and the capacity of detailed visualization of cardiac structures, incl. changes of the vascular wall in relation to the performed operation. Magnetic resonance examinations provided accurate information on central anastomoses and conduits as well as on changes of the vascular lumen. The investigation confirmed that magnetic resonance is suitable for visualization of postoperative changes and findings of morphological structures in particular at sites of cardiovascular anastomoses where magnetic resonance supplements the visualization capacity of echocardiography and substitutes invasive examinations where only an angiographic examination is needed. In eight instances the examination was supplemented by invasive assessment of haemodynamic conditions.

[Aneurysms of the deep veins of the lower extremities: a rarity or just a less common aspect of other pathological conditions?]. / Aneuryzmata hlubokých zil dolních koncetin: rarita nebo jen méne obvyklá soucást jiných patologickýcha stavu?

The authors demonstrate four observations of aneurysms of the deep veins of the lower extremities and their differential diagnostic problems. They draw attention to basic technical conditions of their phlebographic visualization and discuss the main mechanisms of their pathogenesis.

Importance of digital subtraction angiography in the imaging of locomotor tumors.

Digital subtraction angiography (DSA) performed with modern sophisticated equipment has been improved substantially in its ability to document also small vessels and pathologic vascularization patterns in tumorous conditions of the locomotor apparatus. Its domain is in imaging vascular patterns hidden by structural (mainly sclerotic) shadows in their vicinity. In 152 patients out of the total patient collective in the Bone Tumor Register in Prague having a bone tumor or a tumor-like condition, DSA proved to be a mild method of choice for the diagnostic imaging of vascular patterns of the lesions and/or combined diapeutic interventions and has not lost its raison d'être in the era of CT and MRI.

[Possibilities of diagnostic imaging in nephroblastomatosis]. / Moznosti zobrazovací diagnostiky u nefroblastomatózy.

Nephroblastomatosis means persisting embryonic, undifferentiated cells of renal blastoma which may give rise to a nephroblastoma. The foci of nephroblastomatosis create intrarenal nodi or a subcapsular border. The present scanning methods make it possible to correctly differentiate nephroblastomatosis in most cases and to differentiate it from most lesions previously hard to recognize from each other, while CT and arteriography represent the most sensitive methods. The main problem of differential diagnosis is still to differentiate nephroblastomatosis from nephroblastoma. For solving this problem it is frequently necessary to use more diagnostic methods including invasive arteriography and biopsy. It is the only way to prevent damage of the child by incorrect and most by too radical therapy. For the danger of the development of nephroblastoma even after regression of nephroblastomatosis in the X-ray picture a long-term observation is necessary, the ultrasound examination being the method of choice.

Classification of calf muscle MR images by texture analysis.

AIM: To evaluate a method of texture analysis (TA) for the description of magnetic resonance (MR) images of healthy and diseased calf muscles and to compare this method with standard radiological evaluation. METHODS: A total of 93 subjects (20 controls, seven healthy children of hypertonic parents, five diabetic patients and 61 subjects with muscle malfunction of various origin) underwent MR imaging of the calf muscle and texture analysis of images was performed. The results of TA were analysed by t-statistics and principal component analysis. Images of subjects were divided into four groups according to the assessment of three radiologists and this categorization of subjects was compared with the results from TA. RESULTS: We extracted seven features (from a total number of 282) which were successfully used for the description of the texture of T1w MR images of calf muscles. The results of classification by TA are in 80% agreement with the categorization made by the radiologists. In some cases, TA is able to describe changes not apparent by visual inspection. CONCLUSION: The TA of MR images of calf muscles can be used for the objective description of changes in muscles and could help radiologists to distinguish between healthy and diseased tissue.