The value of interrupting the migrating motor-complex (MMC) and computer-assisted technique in HIDA cholescintigraphy was studied in 10 healthy subjects. Sequential scintigrams were sufficient for evaluating biliary-bowel transit time, visualization of the gall bladder and liver wash-out. However, the point of dynamic equilibrium between net uptake and emptying of the tracer of the gall bladder and hepatic areas, required computer assisted technique. Finally, interruption of the MMC resulted in biliary-bowel transit within one hour in all, but only gall bladder visualization in 8, whereas in the fasting state the gall bladder was visualized in all, but with prolonged biliary-bowel transit in one subject.

Eighteen patients clinically suspected of having acoustic neurinoma were studied in both orbitomeatal and clivoaxial (CA) (the plane perpendicular to clivus) CT scanning planes during the same sessions. On the CA cuts there were highly significantly less (p less than 0.001) artifacts. Also, the tentorium was highly significantly (p less than 0.001) better visualized on the CA cuts. CA cuts could be recommended in cases when artifacts disturb the diagnostics of posterior fossa pathology or when detailed topographic information about pathologic anatomy round the tentorium is needed.

Patients suffering from "coral reef arteriosclerosis" are presented, the lesions being visualised via CT and angiography. This disease is characterised by an almost complete occlusion of the median ventricular aorta due to extreme, irregularly structured calcareous masses in the vascular lumen. The review of the literature points to the possible aetiology and pathogenesis of this disease pattern.

The outcome of an aortic dissection is either endothelialisation of the false lumen forming a so-called double aorta, or thrombosis of the sack leading to fibrosis. Healing of an aortic dissection, particularly if thrombosis and organisation have obliterated the dissected segment, is rare and there are only a few case reports on this finding. We report on a case where spontaneous resolution of the false lumen of Type B aortic dissection was demonstrated by serial contrast enhanced computed tomography after antihypertensive medical treatment.

The purpose of this study was to analyze how many angiographic projections are needed in the diagnosis of hemodynamically significant stenoses of the femoral bifurcation. A total of 134 femoral bifurcations were examined with triplanar angiography in 67 patients (45 men and 22 women). The patients, ranging in age from 42 to 81 years (mean 63), suffered from incapacitating symptoms of peripheral arterial disease. The contralateral posterior oblique projection proved to be the most valuable in the assessment of hemodynamically significant arterial stenoses of the femoral bifurcation. An AP projection added information on stenoses of the inlets of the deep femoral artery in 9% of cases and on stenoses of the inlets of the superficial femoral artery in 6% of cases. An arteriographic examination should be started with a contralateral posterior oblique projection and this view will suffice in most cases.

Examinations of 39 men between 14 and 18 years of age revealed that half of the cases of pubertal gynaecomastia are false gynaecomasties. In reality, the patients are suffering from fibrous mastosis. It is shown that gynaecomastia is mostly accompanied by left-sided varicocele, whereas in varicocele complaints there are only few cases of gynaecomastia. It is concluded that in pubertal gynaecomastia it is necessary to determine whether the disease is merely a temporary fibrosis that will heal by itself, or whether it is a sign of some other, graver disease. On the other hand, the state of the testicles and the scrotum should be considered in every case. Surgery of pubertal gynaecomastia is considered unnecessary; however, invasive treatment of the varicocele is very important. The importance of psychological care of the patients is stressed.

During a period of three months, 400 patients with normal kidneys were examined by ultrasound. An evaluation of 14 parameters was made including renal volume (RV), the correlation RV-weight, RV-height, and RV-age of the patients, the quantitative measurement of the renal parenchyma, and the influence of hydration and bladder distension on the sonographic diagnosis of hydronephrosis. In 40 cases, comparison with an additional contrast urography study permitted us to obtain the radiographic magnification index. We present 10 figures including measurement of the absolute parenchymal thickness, parenchymo-sinusal ratio, pyelocalyceal distension and we illustrate the four grades of our hydronephrosis classification.

Computerised serial densitometry (CSD) of renal angiomyolipoma (AML) and its three tissue components was done in order to find out whether this procedure could help in differential diagnosis and provide better data for the understanding of AML presentation in CT imaging. It was found that AML detection in plain scan tomography requires a fat fraction of more than 50%. Angiomyolipomas with a fat fraction of less than 50% need computerised serial densitometry to enable differentiation from other unidentified tumours. The criteria to be used in these cases are 1) the low curve level and 2) the presence and slim shape of the initial circulatory peak. The principle of using standard densitometric curves of single tissue components and cells in in vivo tissue analysis might gain significance in the noninvasive, computerised qualitative and quantitative analysis of the composition of tumours and organs thus creating new possibilities for the diagnosis, follow-up and prognosis of diseases.

Treatment with percutaneous nephrostomy (PN) without co-existing stents was attempted in 18 patients with urinary fistulas and leakages. Seven patients were cured by PN alone. Two of these developed a ureteral stricture at the site of the lesion: one showed no impairment of urinary flow on the follow-up, the other needed continuous urological surveillance. In the remaining 6 cases PN provided temporary relief of the associated urinary stasis. Percutaneous nephrostomy could not be applied in 5 cases because of the lack of renal pelvic dilatation. Only catheter related complications occurred. Because of its easy and little traumatic technique, simple PN could be used as the primary therapeutic approach in such lesions.

A case of a right renal artery in a 70-year-old man is presented. Ultrasound shows an anechoic lesion surrounded by hyperechoic areas in the kidney and pulsed doppler ultrasound (US) provides a noninvasive diagnosis of a renal aneurysm.

The author reports on a large asymptomatic renal haemangioma that was found accidentally in the course of a preoperative CT examination. The radiological visualisation in plain CT, in serial CT as well as in selective angiography is presented. The finding is discussed and compared with the observations reported so far in the literature in respect of this rare benign tumour.

Ultrasound-guided fine needle aspirates from 52 malignant renal tumours and 128 benign expansions taken in 1982-1988 were analyzed retrospectively. There were three suspicious aspirates (class III) suggesting a possibility of malignancy among the cases of benign renal expansions and seven false negative aspirates (C I-II) among the malignancies. The accuracy, sensitivity and specificity of the method for differentiating malignant cases from benign ones were 94.1%, 85.1% and 97.5% respectively. Cytology was correct in 86% of the radiologically equivocal cases and in 63.6% of the small renal neoplasms. Aspiration cytology identifies haemorrhagic cysts and infectious conditions, but is not reliable for the detection of malignancy in a multilocular cyst.

In three juvenile patients, one female and two males aged 14 to 21 years, there were recent deep vein thromboses of the lower limbs due to previous infrahepatic occlusion of the inferior vena cava associated with a shrunken left kidney without clinical manifestation of a nephrotic syndrome. Possible reasons and impacts of this probably congenital peculiar vascular syndrome are discussed. Radiodiagnostic management in juvenile patients with recurrent venous thromboses of the lower part of the body is explained with special respect to secondary phenomena of other retroperitoneal organs like adrenals, inner pelvis and testicles.

Retroperitoneal fibrosis is a rare entity of various causes. The clinical findings are not specific. In some cases the diagnosis is suggested by the characteristic appearance on urography. The purpose of this investigation is to evaluate the typical ultrasound and CT findings of patients with retroperitoneal fibrosis. A discussion of the current diagnostic procedure and treatment is presented.

The authors report on two cases of multicentric glioblastoma multiforme, one of them being a trilocular glioblastoma, whereas in the second case a second focus developed contralaterally. Both patients received whole skull radiation of 40 Gy. The patient who suffered from the primarily unilocal tumour was given a tumour boost. The article reports on the imaging via CT and MR.