Hypofluorescent spots in indocyanine green angiography of peau d‘orange and fundus

Purpose. Hypofluorescent spots were seen inindocyanine green (ICG) angiography of peau dorangefundus in eyes with angioid streaks. Origin of the hypofluorescentspots were examined with attention to their correlationwith a peau dorange appearance of the central fundususing a computer-assisted image comparison system. Methods. ICG angiography was performed in 5 patientshaving peau dorange appearance of fundus using ascanning laser ophthalmoscope (SLO) and a digitalvideo-fundus camera. The same central fundus areas corresponding to hypofluorescent spots in an ICGangiogram were then digitally identified in afluorescein angiogram and in a red-free picture in all10 eyes of the 5 patients. Monochromatic lightobservation was also performed with a dark fieldobservation using a SLO to see subretinal orintrachoroidal pigment clumping. Results. In no patient, the areas identified withhypofluorescent spots did show relevant changes ina fluorescein angiogram or a red-free picture. SLOexamination revealed not perfusion defect at the sameareas. The dark field observation showed no pigmentclumping at the peripapillary and papillomacularbundle regions where hypofluorescent spots were seen.Conclusions: Hypofluorescent spots seen in ICGangiograms did not show exact consistency with peau dorange changes in their location and shape. Perfusion defects or blocking by pigments were not acause of hypofluorescent spots. The scatteredhypofluorescent spots were considered to be relevantwith irregular affinity of the fundus to ICG dye.     

Facial haemangioma,agenesis of the internal carotid artery and dysplasia of cerebral cortex: case report

We describe a girl with a facial haemangioma, associated with other vascular anomalies: agenesis of the internal carotid artery, cerebral cortical dysplasia and hypoplasia of the cerebral hemisphere on the same side of the angioma. We studied the patient by conventional arteriography, T1- and T2-weighted MRI and magnetic resonance angiography.     

Survey on the use of pulmonary scintigraphy, spiral CT and conventional pulmonary angiography for suspected pulmonary embolism in the British Isles

AIM: To determine current clinical practice in the radiological diagnosis of acute pulmonary embolism and assess the use of spiral volumetric computed tomography. METHOD: A survey of 327 acute hospitals including cardiothoracic and orthopaedic tertiary referral centres was undertaken to assess current utilization of lung scintigraphy, spiral computed tomography and pulmonary angiography in the investigation of suspected pulmonary embolism. Responses were received from 215/327 (66%) centres. RESULTS: Lung scintigraphy was provided by 208 hospitals (144 on-site and 64 off-site). Spiral CT services were provided by 111 (52%) hospitals (on- or off-site), 142 (66%) units had access to angiographic facilities. Sixty-three centres out of 215 (29%) offered both on-site lung scintigraphy and spiral CT while only 41/215 (19%) hospitals were able to undertake all three tests on-site. On average, 501 perfusion (Q) or ventilation-perfusion (V/Q) scintigrams were performed per hospital per year with 26 spiral CT studies and just 4.6 pulmonary angiograms. CONCLUSION: These data suggest that lung scintigraphy is frequently the only imaging test in patients other than chest radiography, despite the large number of indeterminate results reported in most series.     

Die Magnetresonanztomographie in der Dentalradiologie (Dental-MRT)

Zusammenfassung Ziel dieses Beitrags ist die Vorstellung der Untersuchungsm?glichkeiten des Ober- und Unterkiefers mittels Magnetresonanztomographie (Dental-MRT) und ihre Anwendung bei der Diagnose zahnmedizinischer Erkrankungen. Sieben gesunde Probanden, 5 Patienten mit Pulpitis, 9 Patienten mit dentogenen Zysten, 5 Patienten nach Zahntransplantationen und 12 Patienten mit atrophem Unterkiefer wurden untersucht. Axiale T1- und T2-gewichtete Gradientenecho- und Spinecho-Sequenzen in 2D und 3D-Technik wurden durchgeführt. Nach der Untersuchung wurden zus?tzliche Panoramaschnitte und orhoradiale Rekonstruktionen des Ober- und Unterkiefers, unter Verwendung einer gebr?uchlichen Dental-Software, angefertigt. Der gesamte Ober- oder Unterkiefer, Z?hne, Pulpa und der Inhalt des Mandibularkanals k?nnen gut dargestellt werden. Patienten mit einer Entzündung der Zahnwurzel k?nnen ein deutliches Knochenmarks?dem in der Periapikalregion zeigen. Bei Patienten mit odontogenen Zysten ist die Beziehungen zu den umgebenden Kieferstrukturen gut darstellbar. Nach Kontrastmittelgabe zeigt sich ein Enhancement in der Zahnpulpa. Die Dental-MRT ist ein nützliches Verfahren zur anatomischen Darstellung des Kieferbereichs und zahnmedizinischer Erkrankungen.      

A case of totally cystic fibroepithelial polyp of the renal pelvis

Fibroepithelial polyps are the most frequently observed mesenchymal tumors of the renal pelvis. We report on one case of fibroepithelial polyp of the renal pelvis with unusual CT findings of totally cystic structure with septations. Received: 27 July 1998; Revised: 6 January 1999; Accepted: 8 February 1999     

Time-resolved MR angiography of the upper abdomen: initial clinical experience

In this study, thirty-eight patients with a variety of upper abdominal diseases were examined with three-dimensional time-resolved MR angiography (7 sec/data set). Visualisation of arterial and venous anatomy was excellent in the majority of patients. Moreover, subtraction images could be calculated and organ perfusion could be assessed. It is concluded that this technique opens new perspectives for a comprehensive evaluation of vascular and parenchymal disease. Received: 14 April 1998; Revision received: 23 October 1998; Accepted: 9 November 1998     

Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stent-graft placement

Accidental trauma frequently involves the extremities, and can extend to involve their blood supply, causing exsanguinating hemorrhage and pseudoaneurysm in the involved blood vessel. This is traditionally managed by surgical repair. We report a case in which control of life-threatening hemorrhage and exclusion of a large, post-traumatic pseudoaneurysm in the superficial femoral artery was performed by a commercially available stent-graft, without complication. This treatment method may be a safe and effective alternative to surgery in selected patients. Received: 10 February 1998; Revision received: 31 March 1998; Accepted: 20 April 1998     

CT of blunt trauma of the pancreas in adults

In order to describe the CT findings in pancreatic injury and to evaluate the sensitivity of this technique, we performed a retrospective study. During a 5-year period (1993–1997), eight patients (five males and three females; age range 10–47 years) were investigated with CT. Endoscopicretrograde cholangiopancreatography (ERCP) was obtained in two patients, pre- and intra-operatively, respectively. Among the standard laboratory tests obtained at admission, the value of serum amylase was reviewed. The imaging findings, especially those obtained with CT, were correlated with the surgical findings, when available (in seven of eight patients). At admission, diagnosis of pancreatic injury was missed at CT in three of eight patients (37.5 %); thus, the sensitivity of CT for pancreatic injury was 62.5 %. ERCP showed rupture of the pancreatic duct in the two cases in which it was performed. Serum amylase was elevated at admission in four of eight patients, resulting in a sensitivity of 50 %. After surgery, an enterocutaneous fistula developed in one case, and was managed conservatively. One patient died from brain injury. Proper implementation of the CT technique and accurate film reading is mandatory to establish the diagnosis of pancreatic contusion. No correlation between CT features and type of outcome of surgical management could be established. On retrospective review of the CT examinations, it appeared that two of the three false-negative results could have been avoided. Therefore, proper CT technique and accurate film reading are mandatory in establishing the diagnosis of pancreatic injury. Received: 10 June 1998; Revision received: 26 October 1998; Accepted: 30 October 1998     

Multiple hepatic angiolipomas: a case report and review of literature

Follow-up of two hepatic angiolipomas in a patient without evidence of tuberous sclerosis is reported. Initially, the lesions presented as homogenously enhancing masses, which were nearly isodense to normal liver tissue on plain CT scans. Focal nodular hyperplasia was assumed. One year later, fat was detected in the growing tumors and percutaneous core biopsy revealed hepatic angiolipomas. Natural history of these rare lesions is unknown, and this is to the best of our knowledge the first observation of fatty metamorphosis in such a benign, mesenchymal hepatic neoplasm. Received: 8 October 1997; Revision received: 19 March 1998; Accepted: 11 May 1998     

非瓣膜性心房纤颤与老年脑梗死

目的　探讨非瓣膜性心房纤颤（ＮＶＡＦ）对老年缺血性脑卒中临床表现、预后的影响。方法　将５８ 例合并ＮＶＡＦ的老年急性缺血性脑卒中患者（ＡＦ组）与３０２ 例不合并ＡＦ患者（ＮＡＦ组）进行临床分析。结果　发现ＮＶＡＦ组有以下特点：（１）病情重,进展快,死亡率较高;（２）神经系统损害较严重;（３）腔隙性脑梗死发生率低;（４）颈内动脉闭塞常见;（５）预后差。结论　ＮＶＡＦ是引起老年缺血性脑卒中的危险因素,而且是影响其预后的重要因素。