A Magyar Radiológia Online soron következő száma igazi csemegének ígérkezik - a főszerkesztő bevezetője.
Introduction Nerves show the same morphologic changes under compression. Case report We describe the morphologic changes of the nerve in temporal course in an acute carpal tunnel syndrome after hyperventilation tetany. Conclusion High-resolution sonography is suited for the imaging of peripheral nerve lesions.
INTRODUCTION Fournier's gangrene is a rare, rapidly progressive specific form of necrotizing fasciitis that involves the soft tissues of the genital and perianal regions. The infection may spread from these regions along the abdominal wall or towards the lower limbs and has a very high mortality rate. History of the patient, the clinical features and the imaging techniques all together help to recognize the condition and to localize the affected area. CASE REPORT We present the case of a thirty- year-old male patient, who had on admission a swollen left lower limb. Deep venous thrombosis was excluded by Doppler US. A few days later an other US examination revealed the fasciitis of the left thigh and the scrotum, originating from the deep gluteal bed-sore of the patient. A CT was performed to define the extent of the process and help the planning of the surgical intervention. The patient has recovered well after the operation. CONCLUSION Due to the high mortality rate of Fournier’s gangrene it is essential to recognize this condition in time and to provide the appropriate surgical intervention or antibiotic therapy. Imaging modalities play a very important role in the diagnosis of Fournier's gangrene.
Purpose Real-time ultrasonographic elastography is a new imaging technique which is used in characterizing the difference in hardness between pathologic and normal tissue. The purpose of our study was to evaluate the diagnostic performance of real-time ultrasonographic elastography and Doppler ultrasonography (DUS) individually and combined in differentiation of benign and malignant cervical lymph nodes (LN). Patients and methods Fifty-one patients (12 men, 39 women) referred for fineneedle aspiration or surgical biopsies of suspected cervical lymph nodes were examined with gray scale ultrasonography, power DUS, and real-time ultrasonographic elastography. During DUS examination vascularity and resistance index (RI) values were evaluated. A five-group elastographic colour code pattern was used to evaluate the ultrasonographic elastograms for LN (pattern 1, an absent or a very small hard area; pattern 2, hard area <45%; pattern 3, hard area ≥45%; pattern 4, peripheral hard and central soft areas; pattern 5, hard area occupying entire solid component with or without soft rim). In addition, strains of LN and surrounding muscles were measured on elastograms, and the muscle-to-LN ratio (strain index) was calculated. Real-time ultrasonographic elastography and DUS results were compared with the final diagnosis obtained by fineneedle aspiration cytology analysis and/or by surgical pathology. The diagnostic potential of the examined criteria for malignancy was evaluated with univariate analysis and multivariate generalized estimating equation regression p≤0.05 indicated statistical significance. Results A strain index higher than 2.45 and colour pattern 4-5 had high utility in malignant LN classification with 93.8% sensitivity, 89.5% specificity (p<0,001). The results were significantly better than those obtained by using DUS characterization – that is, RI greater than 0.57 – which had 8.9% sensitivity (p<0,001). Conclusion Real-time ultrasonographic elastography had 93.8% sensitivity and 89.5% specificity in the differentiation of benign and malignant cervical LN in patients referred for fineneedle aspiration or surgical biopsies with suspicion of malignancy. Real-time ultrasonographic elastography and DUS in addition to gray scale ultrasonography may improve the differential diagnosis of LN.
Introduction High tibial osteotomy (HTO) is a generally accepted treatment for medial unicompartmental osteoarthritis of the knee with varus alignment. The clinical result is affected by the correction of the varus malalignment. The degree of correction appears to be dependent not only on correction performed on tibia but also on the orientation of the distal femur. The valgus orientation of the distal femur can be associated with postoperative over-correction and varus orientation of the distal femur with postoperative under-correction. Patients and methods We performed radiological assessment of 82 knees preoperatively and after closing wedge high tibial osetotomy (CWO) in the 10th postoperative week, in the 12th postoperative month and at the time of the final follow-up (23-54 months)on a standing weight-bearing anteroposterior radiograph. Pre and postoperatively we measured the orientation of the distal femur, described as the lateral angle between the anatomic axis of the femur and the distal articular surface of the femur (FC-FS). We subdivided the knees into 3 groups based on the orientation of the distal femur. In group A the FC-FS was 83-85° (normal orientation of the distal femur), in group B the FC-FS was ≤82° (valgus orientation of the distal femur) in group C the FC-FS was ≥86° (varus orientation of the distal femur). Pre- and postoperatively we measured the lateral angle between the anatomic axis of the tibia and the proximal articular surface of the tibia (TP-TS) and the lateral angle between the distal articular surface of the femur and the proximal articular surface of the tibia (the articular component of the varus deformity FC-TP) in all groups. We determined the anatomical femorotibial angle (FTA) as a sum of FC-FS, TP-TS and FC-TP. Results In the first ten postoperative weeks -with significant osseous correction happened in the three groups - the articular component also decreased significantly in groups A and B, but did not change in group C. Between the postoperative 10th and the final follow-up examinations we did not notice significant osseous correction loss in any groups. In groups A and B the articular correction loss was not significant, at the same time in group C we noted significant articular correction loss. Conclusion At valgus orientation of the distal femur the CWO results in greater correction of the limb's anatomical axis than the osseal correction performed on the tibia. This additional correction equals the (preoperatively unpredictable) amount of the articular correction. At varus orientation of the distal femur the CWO results in less correction of the limb's anatomical axis than the osseal correction performed on the tibia. This difference equals the (preoperatively unpredictable) loss of articular correction.
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Aktuális lapszám Magyar Radiologia Online 2012. 3. évfolyam 4. szám |
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Archívum 2012. 3. évfolyam 3. szám 2012. 3. évfolyam 2. szám 2012. 3. évfolyam 1. szám |
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Impresszum Impressum |
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Instrukciók... A tudományos kéziratok összeállítása |
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