摘要:

In October last year a working party of the Royal College of Radiologists (RCR) published its report on manpower and staffing in the United Kingdom (RCR, 1991). Its main conclusion, perhaps pre-dictably, is that there are far too few of us, though the public at large will be alarmed no doubt to hear that despite the fact that cancer is a leading cause of death (over 200 000 deaths per year, and rising) the UK has fewer consultants in clinical oncology per head of population than anywhere in the developed world apart from Portugal and Turkey. On average our consultants see well over twice the number of patients per year than our colleagues in Europe or the United States; even the recommended workload statistic from the RCR of 350 new patients annually would still be well above the 200–250 seen by American or European radiotherapists. At present we are nowhere near, with an average of 560 new patients per year, 12 new cancer patients every working week.

DOI:10.1259/0007-1285-65-771-B21

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractThe demonstration of a fluid-fluid level (FFL) within an osseous lesion on computed tomography (CT) has been reported as suggestive of an aneurysmal bone cyst (ABC) although FFLS have also been rarely found in association with other lesions. This study was conducted to determine the frequency of FFLS on CT in a group of ABCs and a series of patients presenting to a major tertiary referral centre for the treatment of bone tumours. An FFL was present on CT in 21 (84%) of the 25 ABCs and in 17 was multiple. FFLs are typical of the mid (“blow-out”) or late phase of development of an ABC and not the incipient (“permeative”) stage or where the internal architecture of the tumour has been disrupted by biopsy or previous surgery. In a 3-year period, 16 ABCs were found in 491 bone lesions referred to a bone tumour treatment centre. CT of the ABCs revealed FFLs in 14 (87.5%) cases. Within the same period, 728 CTs of these and other bone lesions were performed and FFLs were identified in two further cases: a massive telangiectatic osteosarcoma and a conventional osteosarcoma following chemotherapy. The diagnostic significance of an FFL on CT for ABC is: sensitivity = 87.5%, specificity = 99.7%, positive predictive value = 87.5%, negative predictive value = 99.7%, accuracy = 99.4%. An FFL within a bone lesion on CT remains strongly suggestive of an ABC although the radiologist should be wary of a rare telangiectatic osteosarcoma.

DOI:10.1259/0007-1285-65-771-193

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractComputed tomographic (CT) studies performed within a general oncology service in 104 consecutive patients with prostatic carcinoma were reviewed retrospectively to assess the incidence and distribution of lymphadenopathy. All patients were staged with CT at initial presentation, had normal skeletal scintigrams and were candidates for radical radiotherapy. The likelihood of lymphadenopathy was associated with increasing T-stage. 57 of the 92 (62%) patients without lymph node enlargement had local disease confined to the prostate (T2 or less) compared with only two of the 12 (17%) patients with enlarged nodes. Lymph node enlargement was more likely with a primary tumour of poorly differentiated histology. 12 patients (11.5%) had lymphadenopathy by established CT criteria; six with pelvic nodal enlargement alone and six with enlargement of pelvic and retroperitoneal nodes. In all patients pelvic nodal enlargement predominated and no patient had isolated retroperitoneal lymphadenopathy. Our findings indicate that CT staging studies of prostatic cancer do not need to include the retroperitoneum if there is no lymphadenopathy at or below the aortic bifurcation.

DOI:10.1259/0007-1285-65-771-199

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

Abstract180 previously untreated consecutive patients with liver tumours (308 lesions), including 104 hepatocellular carcinomas (148 lesions), 43 metastases (116 lesions) and 33 haemangiomas (44 lesions), were studied to determine the value of duplex sonography in the differentiation of hepatocellular carcinoma from other tumours. For lesions measuring ≤ 5 cm in diameter, hepatocellular carcinoma demonstrated the highest rate and haemangioma demonstrated the lowest rate of Doppler signals from within the lesions. To differentiate malignancy from haemangioma, the presence or absence of Doppler signals from these lesions were used as criteria. The specificity and positive predictive value were very high (100%, 100%), but the sensitivity, negative predictive value and accuracy were low (61.5%, 48.3%, 71.7%, respectively). With one exception, all lesions measuring<3 cm in diameter with detectable Doppler signals were hepatocellular carcinoma. Using these results it is possible to differentiate hepatocellular carcinoma from metastases and haemangioma with high sensitivity, specificity, positive and negative predictive value, and accuracy (80.8%, 96.4%, 95.5%, 84.4%, 88.9%, respectively, for metastases; 80.8%, 100%, 100%, 81.5%, 89.6%, respectively, for haemangioma). We conclude that Doppler signals from within a lesion in combination with its size can aid differentiation of hepatocellular carcinoma from two other kinds of common hepatic tumour.

DOI:10.1259/0007-1285-65-771-202

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractRenal ultrasound examinations and intrarenal arterial Doppler studies were performed on 48 patients with normal renal tracts and 20 patients presenting with acute renal colic resulting from ureteric calculus, 14 of whom had urographic evidence of renal obstruction. The mean resistance index (RI) of the Doppler waveforms obtained on the 14 obstructed kidneys (70.4 ± 6.22) was significantly higher than the mean RI of the 96 normal kidneys (62.4 ± 6.43). The mean difference between the RIs of the obstructed kidneys and their contralateral non-obstructed kidneys (8.37 ± 4.43) was also significantly higher than the differences in RI seen between pairs of normal kidneys (2.70 ± 1.71). Five out of 14 obstructed kidneys showed no pelvicalyceal dilatation and could not have been shown to be obstructed on conventional sonography. Four of these five had RI changes suggestive of obstruction and thus 13 of 14 obstructed kidneys would have been identified as obstructed by a combination of Doppler and conventional sonographic findings. 10 of the 14 obstructed kidneys were re-examined after passage of a urinary calculus and nine showed a reduction in the RI of the previously obstructed kidneys. The 10th subsequently required ureterolithotomy.

DOI:10.1259/0007-1285-65-771-207

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractBone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA) has been measured in 394 healthy normal women. BMD is highest at the end of the 3rd decade and declines from 45 to 75 years by 0.0095 g/cm2/year in the lumbar spine and by 0.0052–0.0078 g/cm2/year in the upper femur depending on the site. BMD appears to increase in the 8th decade. Reproducibility (coefficient of variation (CV) of repeated measurements) was lowest in the lumbar spine (1.45%) and highest in Ward's triangle (4.29%). CV was not influenced by age at any site and by osteoporosis only in the femoral neck. BMD increased from L2 to L4 but the increase could not wholly be accounted for by the size of the vertebra, suggesting that the posterior elements were contributing to the observed increase of bone density.

DOI:10.1259/0007-1285-65-771-213

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractSurgical specimens from 75 patients with colorectal cancer were examined within 15 min of removal with a 7.5 MHz linear-array transducer. The echo pattern of 139 lymph nodes was analysed to evaluate previous criteria of malignancy and to establish other possible criteria, which could be testedin vivo. The pathologist examined each node without knowledge of the sonographic finding. Malignant nodes were larger than benign nodes. Of 21 nodes less than 5 mm in diameter, 20 were benign. Round nodes were malignant more often (45/78) than ovoid nodes (6/61). A homogeneous echo pattern was associated with malignancy in 39 of 82 nodes in contrast to 12 of 57 with a heterogeneous pattern. Thirty-one nodes were ovoid as well as heterogeneous and all of these were benign. A hyperechoic centre was found in 14 nodes of which two were malignant. The highest predictive value for malignancy (59%) was obtained by combining the discriminative properties of shape, homogeneity and echogenicity.Keywords: Colorectal carcinoma, Lymph nodes, Ultrasonography

DOI:10.1259/0007-1285-65-771-218

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractThis paper describes the clinical and radiological findings in three infants with agenesis of a single lung. In the two cases of right lung agenesis, severe gastro-oesophageal reflux was present. In these two cases, contrast-medium-enhanced computed tomography (CT) excluded vascular compression of major airways in one patient but demonstrated mild compression in the other. Conventional CT in the case of left lung agenesis demonstrated posterior herniation of the contralateral right lung.

DOI:10.1259/0007-1285-65-771-221

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractA survey has been performed to investigate typical radiation dose levels for children undergoing a number of common radiological examinations. Doses have been assessed using a Diamentor ionization chamber to measure dose–area product, and by attaching thermoluminescent dosemeters to the patient's skin to determine entrance and organ doses. The survey has been automated by using a personal computer for data collection and storage. Doses have been monitored for a large number of children, primarily in a dedicated paediatric X-ray room, and the results presented can be used as a baseline for making comparative measurements elsewhere. Entrance skin doses were found to range from 0.3 mGy to 5.7 mGy for radiographic examinations, and values of dose–area product from 3 to 225 cGy cm2. The corresponding dose ranges for fluoroscopic examinations are 7.4–26.2 mGy and 130–1241 cGy cm2.

DOI:10.1259/0007-1285-65-771-225

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY

摘要:

AbstractThe conventional aluminium filtration of a general purpose X-ray tube in a district general hospital was replaced by an erbium filter for a 2-month period. The resulting reduction in skin dose was measured for a number of examinations using thermoluminescent dosimetry. The change in effective dose equivalent was calculated from these measurements and compared with previous theoretical estimates. The use of the erbium filter had no effect on radiograph quality. It was concluded that the use of an erbium filter resulted in a worthwhile reduction in radiation dose, and was a cost-effective method of dose reduction.

DOI:10.1259/0007-1285-65-771-232

出版商:The British Institute of Radiology    

年代:1992

数据来源: WILEY