Radiology

Fill, William L.; Lamiell, James M.; Polk, Norman O.

doi: 10.1148/133.2.289pmid: 573913

The radiographic findings and method of investigation are presented in the retrospective and prospective study of 221 descendents of an individual affected with von Hippel-Lindau disease. Among 42 affected individuals, most of the reported manifestations were found, such as cerebellar hemangioblastoma, retinal angioma, and renal cell carcinoma. A new manifestation, pancreatic carcinoma, was also seen. Although pheochromocytoma is common in some reported families, no cases were found in this group. An organized multidisciplinary approach is necessary to effectively identify and treat individuals affected with this disease. Index terms Cerebellum, neoplasms Familial conditions Kidney neoplasms Pancreas, neoplasms Retina, neoplasms (Skull and contents, Hippel-Lindau Syndrome, 10. 1834)

Kallsher, Lester

doi: 10.1148/133.2.297pmid: 493512

Xeromammographic false negatives were analyzed to ascertain the cause of the errors and determine what corrective measures could be taken. Of 52 cancers miscalled, 52% were not visualized and 48% were categorized as misinterpretations. The causes of these errors are discussed. The error rate in all but 8% of the former group appears to be irreducible, yet errors discussed in the latter group are thought to be correctable in a high percentage of cases. Recommendations to reduce the number of false negatives in this group are presented. Index terms Breast neoplasms, diagnosis Diagnostic radiology, observer performance Mammography Xeroradiography

Glazer, Gary M.; Margulis, Alexander R.

doi: 10.1148/133.2.303pmid: 493513

A case of annular pancreas diagnosed by endoscopic retro-grade cholangiopancreatography (ERCP) is described and the etiology of the abnormality considered. Annular pancreas is an anomaly of the ventral pancreas, and probably due to the persistence of the left ventral bud; the dorsal pancreas plays no apparent role in its development. In the diagnosis of annular pancreas, it appears that ERCP provides unequivocal evidence in some, quite possibly all, cases. Index terms Cholangiopancreatography, indications Pancreas, abnormalities (Pancreas, annular head, 771.1491) (Pancreas, congenital anomaly, 771–3.130) (Liver, biliary system, transduodenal cholangiography, 761.1227)

Suoranta, Hannu; Standertskjöld-Nordenstam, Carl-Gustaf; Lähde, Seppo

doi: 10.1148/133.2.307pmid: 493514

The effectiveness of simethicone in reducing the amount of gastrointestinal gas was investigated with abdominal radiographs in a double-blind study of 169 patients receiving either simethicone or a placebo randomly. There was no statistically significant difference between the two groups. Although simethicone may relieve clinical symptoms and accelerate the transit time of gas, it does not reduce the amount of gas in the gastrointestinal tract. This study indicates that simethicone is not helpful in preparing the patient for radiological examination of the abdomen. Index terms Abdomen, preparation Abdomen, radiography Simethicone

Andersen, Jørn Falk; Madsen, Poul Erik Rørbaek

doi: 10.1148/133.2.309pmid: 493515

The diagnostic significance of a routine preliminary plain radiograph of the right upper abdominal quadrant prior to oral cholecystography was evaluated retrospectively. The plain radiograph was decisive in the diagnosis in only one case out of 1,022 consecutive cholecystographic examinations (0.1 %) (95% confidence limits: 0.00–0.55 %). The sensitivity of oral cholecystography, now approximately 90%, would drop by only 0.43% (95% confidence limits: 0.01–2.14%) if the routine plain radiograph were omitted. Index term Gallbladder, radiography (Liver, biliary system, oral cholecystography, 76. 1221)

Tsukaguchi, Isao; Sato, Kenji; Ohara, Shuichi; Okada, Yasutaka; Sato, Tadayuki

doi: 10.1148/133.2.311pmid: 493516

Lymph node metastasis was evaluated angiographically in 151 patients with gastric cancer. In 20 % of the patients with nodal metastases, abnormally staining masses were demonstrated by angiography. Superselective angiography is useful in confirming the presence of lymph node involvement. Index terms Angiography, indications Lymph nodes, neoplasrna (Lymphatics, stomach metastases, 99.8323) Neoplasms, metastases Stomach, neoplasms, 72.321

Roche, Alain; Franco, Dominique; Dhumeaux, Daniel; Bismuth, Henri; Doyon, Dominique

doi: 10.1148/133.2.315pmid: 227010

Two successive hepatic arterial embolizations were performed in a patient with hypercalcemia secondary to hepatocellular carcinoma. The first procedure was performed on an emergency basis due to a cardiovascular episode and was immediately beneficial. The second procedure, performed five months later for a recurrence, was effective in 3 days; 13 months later, there had been no recurrence. Index terms Arteries, hepatic Embolism, therapeutic, 9. 129 (Hepatic artery, therapeutic embolization, 952.129) Liver, neoplasms, 761.321

Fara, John W.; Barth, Klemens H.; White, Robert I.; Bynum, Turner E.

doi: 10.1148/133.2.317pmid: 115058

Mesenteric vascular effects of prostaglandins B 2 and F 2 α were studied and compared to those of vasopressin in the dog, cat and baboon. Vasopressin reduced superior mesenteric blood flow (SMBF) 80–100%, and significantly increased hepatic arterial blood flow and systemic arterial pressure. Prostaglandin B 2 produced vasodilatation at low doses and biphasic vasodilatation/vasoconstriction at high doses. Prostaglandin F 2 α elicited only vasoconstriction, reducing SMBF, left gastric, and inferior mesenteric blood flow 80–100%. Systemic arterial pressure was not significantly changed. Thus, vasopressin and prostaglandin F 2 α are equally effective mesenteric vasoconstrictors. Because of reduced systemic effects, prostaglandin F 2 α has excellent potential as a mesenteric vasoconstrictor to control gastrointestinal hemorrhage. Index terms Gastrointestinal tract, hemorrhage, 95.710 Prostaglandin. Vasomotor system, drug effects Vasopressin (Vascular system, pharmacological adjunct, 9.127) (Gastrointestinal vessels, constrictor adjunct, 95.1271)

Madayag, Manuel A.; Ambos, Marjorie A.; Lefleur, Richard S.; Bosniak, Morton A.

doi: 10.1148/133.2.321pmid: 493517

Inferior vena cavography plays an important role in the staging of renal cell carcinoma. The renal angiograms and inferior vena cavograms in a series of patients with renal cell carcinoma were reviewed to determine which patients require cavography. Our findings show that renal angiography is of great value in suggesting tumor involvement of the renal vein or vena cava, and that the decision to do cavography can be made from the angiographic findings. In the series of 172 patients with renal carcinoma, 15 or 9% had inferior vena cava involvement. Index terms Kidney neoplasms, metastases Veins, renal Venae cavae, neoplasms (Kidney, adenocarcinoma, 81.324) (Inferiorvenacava, metastatic neoplasm, 982.330)

Castaneda-Zuniga, Wilfrido; Zollikofer, Christoph; Valdez-Davila, Oscar; Nath, P. H.; Amplatz, Kurt

doi: 10.1148/133.2.327pmid: 493518

Diffuse areas of narrowing and dilatation involving the main renal artery are the most common angiographic findings in fibromuscular dysplasia (FMD), together with the presence of renal artery stenosis. The development of false aneurysms of the renal artery and arteriovenous fistulas are uncommon manifestations. Large, partially thrombosed and calcified renal artery aneurysms are described and their differential diagnosis is stressed. Index terms Aneurysm, renal, 961.730 Renal arteries, fibrodysplasia, 961.722 Renal arteries, hypertension.961.723