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  • 1
    ISSN: 1279-8517
    Keywords: Paranasal sinuses, anatomy ; Paranasal sinuses, childhood ; Paranasal sinuses, MR-Imaging ; Sphenoid bone
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Afin de démontrer les aspects fondamentaux du développement du sinus sphénoïdal pendant l'enfance, nous avons revu l'aspect en IRM du sinus sphénoïdal de 401 patients agés de moins de 15 ans. L'étude de la moelle osseuse, le développement de la pneumatisation, la croissance et le cloisonnement du sinus sphénoïdal ont été explorés en séquences pondérées en T1 et en T2. Le sinus sphénoïdal se présente, en séquence pondérée en T1, avec un signal faible et uniforme (moelle osseuse rouge) chez tous les enfants agés de moins de 4 mois. Ce signal hypo-intense devient hyper-intense (transformation de la moelle osseuse) à partir du 4 ème mois. Le début de la pneumatisation est noté à 13–15 mois. A l'âge de 43–48 mois, la partie antérieure du sinus sphénoïdal est pneumatisée chez 85 % des enfants. La pneumatisation est complète chez tous les patients agés de plus de 10 ans. La croissance dans chaque direction de l'espace est caractéristique. L'apparition d'un septum médian est observée à une fréquence variable par tranche d'âge, avec un maximum de 77 %. Les variations existent dans 4,5 % à 20 % des cas. La connaissance de ce phénomène peut servir de référence pour évaluer le développement normal et anormal du sinus sphénoïdal et être d'un grand intérêt dans le diagnostic et le traitement des affections du sinus sphénoïdal et des régions voisines chez l'enfant.
    Notes: Summary To obtain baseline standards of normal age-related development of the sphenoid sinus during childhood magnetic resonance images of the sphenoid sinus in 401 patients less than 15 years old were reviewed. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformely low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypo- to hyperintense (bone marrow conversion) started at age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13–15 months. By age 43–48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. The recognition of this phenomenon may serve as a reference for evaluating normal and abnormal development of the sphenoid sinus and may be of great value for diagnostic and therapeutic management of pathologic conditions of the child's sphenoid sinus and its surrounds.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1084
    Keywords: Breast radiography ; Prostheses ; Postoperative neoplasms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of our study was to evaluate mammographic image quality of various methods of reconstructive breast surgery with specific reference to the possibility of diagnosis of recurrent tumors. A total of 39 patients who underwent breast reconstruction following modified radical mastectomy were subject to clinical and mammographic examination. Three groups were formed: (a)autonomous tissue reconstruction (TRAM flap; n = 9), (b) submuscular silicon gel prostheses (n = 21), and (c) supramuscular silicon gel prostheses (n = 9). Mammographic image quality of the groups was compared by two radiologists working together using a point system where five specific criteria were valued and scored. The result was tabulated into three quality levels: good, acceptable, and limited. Mammograms were assessed as good, acceptable, or limited, respectively, as follows: group I: 7(77.8%), 1(11.1%), (111.1%): group II. 4 (19%), 11 (52.4%), 6 (28.6%)l; group III: 3 (33.3%), 4 (44.5%), 2 (22.2%). The TRAM-flap method of reconstruction displays a high degree of mammographie image quality and therefore is preferable with respect to early diagnosis of recurrent tumors.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1084
    Keywords: Endometriosis ; Bladder ; Ultrasonography ; Computed tomography ; Cesarean section
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report ultrasonographic and CT findings in a patient with endometriosis of the bladder wall after cesarean section. Endometriosis is defined as ectopic endometrial tissue which responds to the endocrine changes of the menstrual cycle [1]. The incidence of the condition may be as high as 20% of all menstruating women [2]. The most common locations of endometriosis are in the true pelvis, particularly the fallopian tubes and the ovaries. The sacrouterine ligaments and Douglas' cul-de-sac are also frequently affected. Rarer sites of endometriotic implants include the gastrointestinal tract, urogenital organs, and extraabdominal sites. The diagnosis is suggested by the results of modern imaging techniques and the usually typical clinical findings and is confirmed by histopathology of a surgical specimen. The literature contains few reports on ultrasound and computed tomography (CT) findings in patients with endometriosis [3, 4].
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Ganglioneuroma, adult presentation ; Parapharyngeal tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ganglioneuroma, a rare benign tumour, very occasionally presents in adult life. We report a case with the additional unusual feature of a retropharyngeal location.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1920
    Keywords: Lumbar disk surgery ; Vascular complications ; Angiography ; Computed tomography ; Sonography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Vascular injuries in lumbar disk surgery, although rare, are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important that surgeons and radiologists be aware of these potentially fatal complications and develop an appropriate symptom-based diagnostic paradigm. We reviewed 8099 consecutive cases of lumbar disk surgery, performed over a 14-year period at a single institution, for postoperative vascular complications. We identified four patients (0.05%) with lumbar disk surgery-related vascular complications: intraoperative lacerations of the abdominal aorta and median sacral artery, an arteriovenous fistula between the left common iliac artery and vein detected 19 days postdiskectomy, and a partially thrombosed aortic aneurysm with an arteriovenous fistula between the aneurysm and the inferior vena cava, diagnosed 11 months after surgery. The majority of cases in the literature of vascular injury in lumbar disk surgery were reported prior to 1965. Diagnostic approaches described in that period do not reflect the great range of diagnostic techniques available today. Angiography remains the gold standard for diagnosis and guidance as to surgical repair. However, a high index of suspicion based on clinical signs and/or the use of sonography or CT is important in the detection of these complications.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1920
    Keywords: Key words Lumbar disk surgery ; Vascular complications ; Angiography ; Computed tomography ; Sonography ; Magnetic resonance imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Vascular injuries in lumbar disk surgery, although rare, are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important that surgeons and radiologists be aware of these potentially fatal complications and develop an appropriate symptom-based diagnostic paradigm. We reviewed 8099 consecutive cases of lumbar disk surgery, performed over a 14-year period at a single institution, for postoperative vascular complications. We identified four patients (0.05 %) with lumbar disk surgery-related vascular complications: intraoperative lacerations of the abdominal aorta and median sacral artery, an arteriovenous fistula between the left common iliac artery and vein detected 19 days postdiskectomy, and a partially thrombosed aortic aneurysm with an arteriovenous fistula between the aneurysm and the inferior vena cava, diagnosed 11 months after surgery. The majority of cases in the literature of vascular injury in lumbar disk surgery were reported prior to 1965. Diagnostic approaches described in that period do not reflect the great range of diagnostic techniques available today. Angiography remains the gold standard for diagnosis and guidance as to surgical repair. However, a high index of suspicion based on clinical signs and/or the use of sonography or CT is important in the detection of these complications.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1920
    Keywords: Key words Ganglioneuroma ; adult presentation ; Parapharyngeal tumours
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Ganglioneuroma, a rare benign tumour, very occasionally presents in adult life. We report a case with the additional unusual feature of a retropharyngeal location.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1439-6327
    Keywords: Cycle ergometry ; Myocardial function ; Left ventricular ejection fraction ; Radionuclide ventricular scintigraphy ; Inflection of heart rate/performance curve
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The heart rate/work performance (f c/W) curve is usually S-shaped but a flattening at the top is not always seen. By means of radionuclide ventricular scintigraphy, the left ventricular ejection fraction (LVEF) of 15 sports students was investigated. The behaviour of the f c/W curve during cycle ergometry with increasing exercise intensities was examined. During exercise, the LVEF showed a distinct initial increase reaching roughly constant values at stress levels below-maximum, and sometimes even falling again. The inflections of the f c/W curve and left ventricular ejection fraction/performance curve (LVEFPC) were calculated from a second degree polynomial fit. From this function, the slopes of the tangents at the points of aerobic threshold and maximum performance were calculated together with the differences of the angles as a measure of the f c/W curve and LVEFPC inflections. It follows that the f c/W curve inflection became less pronounced or was even absent altogether when the decrease in LVEF towards the end of the ergometer exercise became more distinct. A significant negative correlation was found between the existence and extent of the f c/W curve inflection and the stress-dependent myocardial function, expressed as the inflection of the LVEFPC (P〈0.01, r=0.673). Thus, it would seem that the absence of a f c/W curve inflection was related to a diminished stress-dependent myocardial function.
    Type of Medium: Electronic Resource
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