摘要:

AbstractPre-operative thallium–technetium subtraction scintigraphy of 50 patients with primary hyperparathyroidism, which was subsequently proven on histology to be due to an adenoma, was compared with operative findings. Six scans were negative and seven uninterpretable. Of the remaining 37 patients, 34 had correct scan prediction of the anatomical locations of the adenomas. On examination of the origins of the adenomas, all six scintigraphic predictions of upper adenomas corresponded to tumours arising from the upper gland found at operation. Of the 25 lower predictions, there was one false positive and 16 were correct,i.e.of lower gland origin, but eight were found to originate from the upper gland. This misinterpretation is thought to be due to the prolapse of an adenoma arising from the upper gland towards the lower pole of the thyroid, thereby mimicking a lower lesion on the scan.

DOI:10.1259/0007-1285-64-757-1

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractFive hundred consecutive attempted lower limb angioplasties for ischaemic disease (370 patients, mean age 65.6 years, range 33–91 years) were reviewed. Significant complications occurred in 44 cases (8.8%). Nine patients (1.8%) underwent emergency surgery related to a complication. A further 12 patients (2.4%) underwent elective surgery related to a complication. In addition, four patients died within 30 days of the procedure; one following surgery performed because of a complication of angioplasty, one following a myocardial infarction, one following severe bleeding associated with subsequent thrombolytic therapy and one during emergency surgery related to a complication of angioplasty. A correlation was found between complication rate and age. This relationship was independent of the approach to, the position of, and the severity of the treated lesion. Elderly patients are at increased risk of complication in lower limb angioplasty.

DOI:10.1259/0007-1285-64-757-5

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractBased on three-dimensional acquisition of three sequences sensitive to one flow-direction, abdominal magnetic resonance phase-contrast angiography (MRA) was performed in 13 volunteers and 20 patients. The subjects received no antiperistaltic medication and were allowed to breath normally during the three acquisition periods of 11 minutes. The frequency of demonstration of the normal aorta, superior mesenteric and right and left renal arteries was 100%/100%/91%/100%, and of the inferior vena cava, splenic, superior mesenteric and portal veins was 92%/67%/92%/100%, respectively, whereas other abdominal vessels were seen less constantly. In renal artery stenosis or occlusion, MRA detected eight out of nine pathological arteries, missed only a minimal stenosis and was never false positive. In all 10 cases of portal hypertension, MRA demonstrated the venous collaterals detected by conventional angiography and in six cases showed more collaterals, particularly paravertebral vessels. A Budd–Chiari syndrome was investigated as well. If the accuracy of MRA can be proved in larger studies, it may become an important diagnostic tool in evaluating abdominal vascular pathology, such as renal artery stenosis or portal hypertension.

DOI:10.1259/0007-1285-64-757-10

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractPatients presenting with a right iliac fossa (RIF) mass are a diagnostic problem. The objective of this study was to assess the role of ultrasound (US) in their investigation. A prospective series of 50 patients presenting with a clinically suspected RIF mass was examined by US and the findings correlated with the final diagnosis. There was a positive finding in 34 patients (68%). Ultrasound correctly identified the organ of origin in 33 (97%) and was able to guide the patients' further management. In 12 cases no abnormality was found in the RIF, of which 11 had no positive findings at follow-up and one was shown to have an unrelated abnormality at laparotomy. In four cases the findings were due to normal variants. Ultrasound is the imaging modality of first choice in patients presenting with a RIF mass.

DOI:10.1259/0007-1285-64-757-17

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractThe organ or tissue doses were determined with a phantom measurement for 12 types of CT scanners widely used in Japan. Two types of thermoluminescent dosimeters were used for the dose determinations in a Rando woman phantom. The effective dose equivalents recommended by the International Commission on Radiological Protection were calculated using the measured organ or tissue doses. It was found that the CT scanners currently available give quite different organ or tissue doses. When selecting the optimum technical factors for scanning, therefore, it is important to take into consideration the balance of the image quality and the radiation exposure to patients.

DOI:10.1259/0007-1285-64-757-20

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractThis is the first of a series of papers in which we shall explore some insights into the biological changes which accompany the treatment of human tumours which may be obtained through estimation of volume changes in relation to treatment. We have adopted a working hypothesis that regression slopes reflect the composition of individual tumours and, indirectly, their intrinsic growth rate rather than the effectiveness of treatment. The breast has proved to be a suitable site for measurement and our interpretation of the results has led to the development of a new style of management for carcinoma of the breast: measurement based sequential therapy (MBST). In this paper the method of measurement and detailed statistical evaluation of the quality of the data from 262 patients (263 tumours) is presented. Exponential regression lines have been fitted to describe volume changes in relation to treatment by radiation, chemotherapy and hormones. A simple classification of steepness of slopes is introduced.

DOI:10.1259/0007-1285-64-757-29

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractWe report uptake of a thymidine analogue 125-Iodine-5-iodo-2′-deoxyuridine (125IUdR) by nude mice bearing human xenografts of choriocarcinoma or colonic cancer. When125IUdR was given alone, uptake by intestinal tissues was 5–10 times greater than by the tumours as measured by tissue γ counting. This ratio was reversed when hydroxyurea or cytosine arabinoside were used as inhibitors of ribonucleotide reductase and were given in combination with 5-fluorouracil or methotrexate to inhibit thymidine synthesis shortly before injecting125IUdR. Counting the radioactivity in tissues removed 24 hours after125IUdR gave tumour to highest normal tissue ratios of up to 15:1, but the corresponding nuclear grain counts, which is probably a more reliable indicator of selective uptake into DNA, were in excess of 100: 1. The addition of unlabelled IUdR to the regimen only reduced the uptake ofl25IUdR when given in relatively large amounts. For this approach to be exploited it is concluded that the tumour must be resistant at the cell level to the inhibitor of DNA synthesis eitherde novoor as a result of prior exposure to it. This inhibitor can then be used to block uptake of the potentially toxic nucleoside analogue by normal renewal tissues while it is taken up by the resistant cancer cells. By inhibiting synthesis of the corresponding normal nucleosides with inhibitors to which the cancer cells are not resistant, incorporation of the toxic analogues into tumour DNA was enhanced. Although125IUdR is a convenient agent for exploring this approach and is highly cytotoxic when incorporated in DNA, the clinical potential of reverse role chemotherapy probably lies with the development of toxic non-radioactive nucleoside analogues.

DOI:10.1259/0007-1285-64-757-37

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractFor the purposes of evaluation of the therapeutic potential of the radiohalogenated thymidine analogue125IUdR, estimation of the radiation dose to the tumour cells and normal tissues is important. To determine the dose to any tissue from the radionuclide125I is not simple, since the major emissions are very short-range Auger electrons. The cytotoxicity of125I is strongly dependent on the position of the decay relative to the DNA, the principal target for cell sterilization. Estimates of the cytotoxicity of125I based on the traditional MIRD recommended formulation (ICRU Report 32, 1979) may produce gross underestimates if it is incorporated into the DNA via the thymidine precursor125IUdR. In this work, tissue count and autoradiography (ARG) data from studies by Bagshawe et al were used to estimate tissue doses following the administration of125IUdR to LS174/T (a colorectal carcinoma) and CC3 (a choriocarcinoma) tumour-bearing animals, after a hydroxyurea block of the normal tissue turnover. The tumour cell toxicity is estimated from ARG data on the degree of125I incorporation into the cell nucleus. Major drawbacks with125I for this type of therapy are the long 60-day half-life, leading to radiological and waste disposal problems and the extreme short range of the radiotoxic effects. Possible alternative radiohalogens,123I,77Br,131I and211At, are suggested in place of125I in the thymidine analog iododeoxyuridine. Dose calculations are performed and cytotoxicities estimated on the assumption that their biological retention characteristics are the same as for125IUdR.

DOI:10.1259/0007-1285-64-757-45

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

AbstractThe direct effects of sodium iothalamate on renal vascular resistance (RVR) were examined using the isolated perfused rat kidney experimental model. A concentration-dependent biphasic change in RVR was produced with the hyperosmolar solution of sodium iothalamate [(Conray 420), 420 mgl/ml, 2500 mOsmol/kg/H2O]. The response characterized by an initial fall followed by a prolonged increase in RVR on discontinuation of the iothalamate infusion. No significant change in RVR was observed when iothalamate was infused as an iso-osmotic solution (60 mgl/ml, 280 mOsmol/kg/H2O) at a rate of 0.525 ml/min. to produce a concentration of 4.2 mgl/ml in the renal perfusate. We conclude that sodium iothalamate can exert direct biphasic effects on RVR which are mediated by its hyperosmolality rather than its chemical content.

DOI:10.1259/0007-1285-64-757-50

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY

摘要:

Calcification within the spleen has many different manifestations and aetiologies. We report a single case of a patient with Stage IV Hodgkin disease who developed splenic calcification following chemotherapy. A search of the literature has failed to reveal a previous report of this phenomenon.A 43-year-old man presented with a 6-month history of increasing painless swelling in the left side of his neck. Latterly this had been accompanied by the development of further smaller cervical nodules. He was otherwise asymptomatic.On examination, mobile rubbery lymph nodes were confirmed in the left cervical and supra-clavicular regions, the largest being up to 1 cm in diameter. Smaller nodes were also found in the left axilla and both inguinal regions. One of the nodes in the left posterior cervical triangle was removed and histological examination revealed mixed cellularity Hodgkin disease.A plain radiograph of the chest demonstrated no abnormality and computed tomography (CT) of the thorax and abdomen was performed to delineate the extent of the disease. There was no evidence of mediastinal or other lymph node enlargement; the liver and spleen were normal in size and shape and contained no focal abnormality (Fig. 1). A bipedal lymphogram was performed which demonstrated an unusual and suspicious appearance in the proximal inguinal regions. Lymph node biopsy revealed no evidence of disease. The patient was therefore staged as IA mixed cellularity Hodgkin disease.

DOI:10.1259/0007-1285-64-757-55

出版商:The British Institute of Radiology    

年代:1991

数据来源: WILEY