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1903. Unusual radiographic changes of a gout patientJelena Markota, 2004, strokovni članek Povzetek: Background. Gout is a metabolic disorder that results in hyperuricemia and accumulation of uric acid crystals (urats) in tissues, especially joint cortilage. The gouty arthritis presents as acute attacks of arthritis leading eventually to chronic gouty arthritis. In 80% of cases it first occurs in the matatarsophalangeal (MTP) joint of the great toe and is more frequent in mnle population. Case report. We present a case of unusual radiographic changes accompanying gouhy arthritis. A 63 year old female complained about swelling of the first MTP joint on the right, right knee, about stiffness of feet and hands' digits and about backache. First symptoms started to appear 30 years ago. In the time of examination radiographs displayed degenerative changes of the majority of presented joints, bilateral sacroiliitis and osseous ankylosisof both insteps. Microscopic examination showed urate crystals in thesamples of the synovial fluid aspirated from the knee. The histological findings of the synovial tissue after the synovectomy were also in favour of gouty arthritis. Conclusions. Radiographs are the most irnportant imaging modality in the diagnostic process of gout. However, radiographic differentialdiagnosis can be difficult, since the findings overlap with other conditions which cause arthritis and osteoarthritis especially in longstandinggout, elderly patients and females. The diagnosis must be often confirmed with the help of Inboratory and histological findings. Objavljeno v DiRROS: 13.02.2024; Ogledov: 265; Prenosov: 48 Celotno besedilo (6,47 MB) |
1904. Radiographic, computed tomographic and magnetic resonance imaging appearances of primary V-cutting zone of resorption of lumbar vertebral body in Paget's diseaseVladimir Jevtič, 2004, strokovni članek Povzetek: Background. Paget's disease of bone typically demonstrates three evolutionary phases with the characteristic radiographic findings. The incipient stage is manifested by an advancing lytic zone of resorption. Unlike the skull and the long bones the primary advancing zone of rarefication has not been clearly demonstrated within the spine and pelvis. Case report. A 62-year-old man with histologically proved polyostotic Paget's disease was admitted to the hospitaldue to the exacerbation of pain at the toracolumbar junction with deterioration during the night. Due to slight elevation of acid phosphatase and clinical signs indicating prostatic hypertrophy the possibility of metastatic prostatic carcinoma has been raised. A bone scintigraphy with technetium phosphonate showed the expected marked increased uptake affecting numerous bones with the typical radiographic signs of Paget's disease. Besidesthese findings, there was also moderate focal accumulation within the right dorsal half of the vertebral body of L1. Conventional tomography, computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated theprimary cutting zone of resorption affecting the same region. Conclusions. We present a unique case of Paget's disease with primary V-cutting zone withinthe undeformed vertebral body of L1 and spontaneous progression to the midphase of the disease on a three year follow-up. Objavljeno v DiRROS: 13.02.2024; Ogledov: 284; Prenosov: 70 Celotno besedilo (6,47 MB) |
1905. Clinical importance of portal venous gas detected by abdominal sonography : a report of two casesPrimož Gregorič, Alenka Višnar-Perovič, 2004, strokovni članek Povzetek: Background. Portal venous gas (PVG) can be a sign of serious disease and a predictor of poor clinical outcome. However, it ean also occur as a transient phenomenon with little clinical significance, especially following blunt abdominal trauma and various diagnostic and therapeutic procedures. Case reports. We describe two patients with PVG detected on abdominal sonography, who had very similar sonographic findings but a completely different clinical outcome. The first patient was a 70-year-old man in whom PVG was the consequence of mesenteric infarction; the patient died in hospital shortly after the admission. Our second patient was a 26-year-old man who was injured in a motor vehicle accident. He was clinically stable and needed no aggressivetreatment. PVG proved to be a transient phenomenon that cleared spontaneously within a day. Conclusions. Doppler sonography is a sensitive andspecific modality for the detection of PVG. In patients with a serious underlying disease, sonography can identify the cause of PVG, so that the appropriate therapy may be undertaken without delay. If the aetiology is unclear, the decision to undertake further expensive and potentially harmful diagnostic procedures should be based on the patient's clinical status. Objavljeno v DiRROS: 13.02.2024; Ogledov: 299; Prenosov: 83 Celotno besedilo (163,53 KB) |
1906. Interventional radiological management of complications in renal transplantationPeter Popović, Katarina Šurlan Popović, 2004, pregledni znanstveni članek Povzetek: Background. The most frequent radiologically evaluated and treated complications in renal transplantation are perirenal and renal fluid collection and abnormalities of the vasculature and collecting system. Renal and perirenal fluid collection is usually treated successfully with percutaneous drainage. Doppler US, MRA and digital subtraction angiography (DSA) are most important in the evaluation of vascular complications of renal transplantation and management of the endovaseular therapy. Conclusions. Stenosis, the most common vascular complication, occurs in 1% to 12% of transplanted renal arteries and represents a potentially curable cause of hypertension following transplantation and/or renal dysfunction. Treatment with percutaneous transluntinal renal angioplasty (PTRA) or PTRA with stent has been technically successful in 82 to 92% of the cases, and graft salvage rate has ranged from 80-100%. Complications such as arterial and vein thrombosis are uncommon. Intrarenal A/V fistulas and pseudoaneurysms are occasionally seen after biopsy, the treatment reguires superselective embolisation. Urologic complications are relatively uncommon; they consist predominantly of the urinary leaks and urethral obstruction. Interventional treatment consists of percutaneous nephrostomy, balloon dilation, insertion ofthe double J stents, metallic stent placement and external drainage of the extrarenal collections. The aim of the paper is to review the role of interventional radiology in the management of complications in renal transplantation. Objavljeno v DiRROS: 13.02.2024; Ogledov: 288; Prenosov: 74 Celotno besedilo (327,82 KB) |
1907. Magnetic resonance angiography of the portal venous systemPavel Berden, 2004, strokovni članek Povzetek: Background. Imaging of the portal venous system is necessary in different clinical conditions. Three-dimensional (3D) contrast-enhanced magnetic resonance angiography (MRA) is useful in obtaining high quality portal vein images. A fast gradient-echo MR imaging sequence with minimum repetition time and echo time is used. Up to 40 ml of paramagnetic contrast is injected into peripheral vein as a bolus. The Arrival of contrast medium in the aorta is preferably detected with an automated system, when breath-hold sequence is started, and repeated two times, to depict arterial and venous phase. Maximum-intensity-projection (MIP) imaging is the usual postprocessing method.Conclusions. In patients with portal hypertension, MRA can present collateral pathway and patency of the portal vein or portosystemic shunt. In portal vein thrombosis MRA provides information about the location and length of portal vein obstruction and helps in therapeutic strategy decision. MRA is a proper technique in Budd-Chiari syndrome, where it is important to determinethe location and length of hepatie outflow obstruction. MRA is a verygood modality before liver transplantation to depict vascular anatomy and portal vein patency, and after liver transplantation to image possible liver complications. Its limitations include inappropriate positioning of the 3D acquisition slab, respiratory motion artefacts, and metal implants (e.g. pacemaker). Objavljeno v DiRROS: 13.02.2024; Ogledov: 377; Prenosov: 80 Celotno besedilo (250,81 KB) |
1908. Radiologic imaging of acute pancreatitisMojca Glušič, Erika Brenčič, Peter Popović, 2004, strokovni članek Povzetek: Background. Acute pancreatitis comprises a broad spectrum of inflammatory changes in the gland and has a variety of causes. The most common are alcoholism and biliary tract disease. This paper discusses the current concepts of diagnosis and the relationship between morphology as depieted by imaging, pancreatic function tests and treatment planning. Conclusions. Our understanding of the morphologic changes produced by the inflammatory process has expanded in the last decade as more sophisticated imaging techniques have been used for evaluation. Objavljeno v DiRROS: 13.02.2024; Ogledov: 294; Prenosov: 71 Celotno besedilo (163,66 KB) |
1909. Sonographycally guided hydrostatic reduction of childhood intussusceptionDubravka Vidmar, Alenka Višnar-Perovič, 2004, izvirni znanstveni članek Povzetek: Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels getcompressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called target-within-a-target patfern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle o f normal saline was hung up 1 m over the examination desk.We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. (Abstract truncated at 2000 characters). Objavljeno v DiRROS: 13.02.2024; Ogledov: 331; Prenosov: 76 Celotno besedilo (203,04 KB) |
1910. History of the Clinical institute of radiology in Ljubljana on its 80th anniversary (1923-2003) : Historia magistra vitaeVladimir Jevtič, 2004, strokovni članek Povzetek: Backgraund. The manuscript presents a short history of the Clinical Radiology Institute in Ljubljana, University Clinical Centre, and the leading radiological institution in Slovenia since its establishment in 1923. Throughout its history the Institute has been faced with numerous obstacles. Its major problems have always included the lack of professional and economical independence, which has made it difficult for the Institute to keepup with the fask technological development of the world's radiology, as well as the shortage of radiologists and radiographers with the consequence ofthe excessive work load and difficulties in educational and research activities. Despite some serious problems the expertise of the Institute's Ieadership, together with the enthusiasm of all radiologists and radiographers, has enabled a continuous professional and technological development which is the basis of today's high quality diagnostic and interventional radiology. Many of the remarkable aehievements would not have been possible without some extraordinary personalities who laid down the solidfoundations of today's lnstitute. Conclusions. Eighty years of Clinical Radiology Institute in Ljubljana is a history of the successful development ofthe republic's leading radiological institution, a success based on determination, unity and the professional integrity af all its members and management. Ključne besede: Ljubljana Objavljeno v DiRROS: 13.02.2024; Ogledov: 405; Prenosov: 90 Celotno besedilo (708,13 KB) |