The radiology of external carotid-internal carotid anastomosis.

Surgical anastomosis between branches of the external and internal carotid arteries may be beneficial in selected cases of transient ischaemic attacks and reversible ischaemic neurological deficit. It is the responsibility of the radiologist, at the time of initial angiographic evaluation, to recognise patients who might benefit from this procedure. Postoperatively, angiography is valuable in assessing the surgical results. This report describes the investigations necessary for the adequate evaluation of these patients in both the pre- and post-operative state.     

The role of computed tomography in the staging of bladder cancer.

Computed tomography of the pelvis has been performed in 60 patients with epithelial bladder tumours. The CT findings have been compared with the clinical staging (T-stage), lymphography (N-stage) and wherever possible the surgical staging (P-stage). Although the intraluminal tumour was visualised in a high proportion of examinations, the greatest value of CT is in the accurate delineation of the extravesical extension of the growth. This is likely to be the primary role of CT in the staging of bladder cancer. Difficulties in detecting invasion of contiguous organs, particularly the prostate, and the failure to demonstrate nodal involvement within the pelvis were noted. The technique has clear advantages over more invasive investigations and the additional information provided over and above clinical staging is seen as a major advance in the assessment of these tumours.     

A retrospective study of the role of radiotherapy in the treatment of soft-tissue sarcoma

One hundred and forty patients with soft-tissue sarcoma were seen between 1965 and 1974 and the pathology has been reviewed in 93 cases. One hundred and eight patients were treated radically. Their overall survival rate was 53% at 5 years and 41% at 10 years. Overall local control was 63% but primary local control varied considerably with treatment, being highest for those receiving surgery and post-operative radiotherapy. The poor prognosis of patients with paravertebral tumours is confirmed.     

1-Alpha-hydroxy vitamin D in dialysis bone disease: radiological changes after 6 and 12 months of treatment

Biochemical, radiological and histological indicators of dialysis bone disease were studied before, 6 months (58 patients) and 12 months (48 patients) after starting treatment with 1 alpha-OH D3. Radiographic healing of subperiosteal erosions was seen after 6 months in 60% and after 12 months in 77% of affected patients. Radiographic improvement, however, was not significantly related to reductions in resorptive surfaces seen on quantitative bone histology, nor to changes in plasma concentrations of immunoreactive parathyroid hormone. Metastatic calcification appeared or increased in 43% of patients after 6 months and 52% after 12 months. Periosteal new bone developed or increased in 14% of patients after 6 months and 17% after 12 months. Both metastatic calcification and periosteal new bone formation were associated with high plasma phosphate concentrations, but not with plasma calcium, alkaline phosphatase or parathyroid hormone concentrations. Treatment with 1 alpha-OH D3 produces radiological improvement in the majority of patients with dialysis bone disease, but the lack of correlation with histological changes confirms the need for regular radiographic examination. Metastatic calcification and periosteal new bone formation probably represent toxicity of 1 alpha-OH D3 but may be minimised by phosphate restriction.