Ivabradine versus metoprolol for heart rate reduction before coronary computed tomography angiography.

Several studies have demonstrated the correlation of heart rate (HR) and image quality in coronary computed tomography angiography. Beta-blocker administration is critical because of its negative inotropic effect. Ivabradine is a selective HR-lowering agent that exclusively inhibits the I(f) current in sinoatrial node cells without having any effect on cardiac contractility or atrioventricular conduction.

Retroperitoneal lymph node dissection in patients with high risk testicular cancer.

Purpose: In patients with testicular cancer the percent of embryonal carcinoma and lymphovascular invasion in the primary tumor have been identified as risk factors for occult metastatic disease. We reviewed differences between primary and post-chemotherapy retroperitoneal lymph node dissection in patients at high risk.

Materials And Methods: Patients who underwent retroperitoneal lymph node dissection at our institution from 1993 to 2006 were identified and the clinical charts were reviewed.

Computer-assisted quantitative assessment of power Doppler US: effects of microbubble contrast agent in the differentiation of breast tumors.

Rationale And Objectives: To objectively quantify the effects of a microbubble contrast agent to differentiate breast tumors with power doppler ultrasound and to compare these results with color doppler ultrasound (CD US).

Methods: In 47 patients a microbubble contrast agent was injected intravenously. Computer-assisted quantitative assessment of the color pixel density was performed to evaluate the increase in Doppler signals.

Effects of a microbubble contrast agent on breast tumors: computer-assisted quantitative assessment with color Doppler US--early experience.

Purpose: To evaluate objectively the effects of a microbubble contrast agent on the color Doppler ultrasound (US) examination of breast lesions.

Materials And Methods: Forty-seven patients aged 23-71 years underwent color Doppler US before and after intravenous injection of a microbubble contrast agent. A 3-minute computer-assisted assessment of the color pixel density (CPD) was used to evaluate objectively the increase in the number of color Doppler US signals, the transit time of the microbubble bolus, and the potential additional differential diagnostic information.

[Prevalence of abdominal aortic aneurysms: a sonographic screening study].

Purpose: To determine the prevalence of abdominal aortic aneurysms (AAA) in males above 60 years of age.

Methods: 1043 males of 60 years of age or older underwent sonographic examinations of the abdominal aorta. All of the candidates had volunteered for the examination, and special care was taken to avoid preselection of the candidates.

[Diagnostic imaging after liver transplantation].

Introduction: Orthotopic liver transplantation (OLT) has become an accepted treatment for end-stage liver disease. However, postoperative complications result in significant patient morbidity and mortality. Early detection and treatment of these complications is therefore of utmost importance.

Intraoperative and early postoperative colour Doppler sonography after carotid artery reconstruction: follow-up of technical defects.

We studied 50 patients with intraoperative colour-coded Doppler sonography (CCDS) after carotid artery reconstruction. Technical defects could be detected in 19 cases (38 %): residual plaques in 9, flaps in 8 and strictures in 2. In 9 cases (18 %) the carotid endarterectomy was revised.

Pseudopericardial effusions in heart transplant recipients.

Background: The objective of this study was to determine the nature of sonographically observed band-shaped, homogeneous, almost echo-free structures located ventral to the right ventricle of the heart in heart transplant recipients.

Methods: A total of 212 consecutive heart transplant recipients was evaluated sonographically.

Results: In 18 of the 212 patients (8.

Coefficient of variation: a powerful Doppler ultrasonographic parameter for detection of renal artery stenosis.

The aim of our study was to objectively compare the effectiveness of various Doppler parameters in the diagnosis of renal artery stenosis. In three sheep, variable degrees of renal artery stenosis were induced and renal segmental arteries were investigated using pulsed Doppler sonography. In each animal the standard deviation of the instantaneous peak velocity within one cardiac cycle normalized by the mean peak velocity (coefficient of variation) had significantly higher normalized regression coefficients (k* = -0.

Stenoses of the first segment of the vertebral artery: difficulties in angiographic diagnosis.

Pathology at the origin of the vertebral artery may be the cause of incapacitating vertebrobasilar insufficiency (VBI). Preoperative diagnosis is made primarily on angiographic criteria. We compared intraoperative and angiographic findings in 30 patients and found important diagnostic discrepancies in patients with a caudal, ventral or dorsal origin of the vertebral artery.

Intrarenal Doppler ultrasonography: which vessel should be investigated?

The aim of our study was to determine whether the site of intrarenal Doppler measurement influences diagnosis of renal artery stenosis. In an experimental test, three sheep with variable degrees of renal artery stenosis were investigated. In each animal, the resistive index from renal segmental arteries correlated better with mean pressure gradient (r = 0.

Quantification of pleural effusions: sonography versus radiography.

Purpose: To develop a practical method of estimating the volume of pleural effusions with sonography.

Materials And Methods: Fifty-one patients underwent sonography of the pleural space while supine. Sonographic results and results of lateral decubitus radiography were compared with actual effusion volumes.

Determination of optimal time window for liver scanning with CT during arterial portography.

Purpose: To determine the optimal time window for scanning the liver with computed tomography (CT) during arterial portography (CTAP).

Materials And Methods: After vasodilation and contrast medium injection into the superior mesenteric artery (80 mL at 5 mL/sec), 25 repeated scans were obtained at a single level within 83 seconds in 13 patients. Attenuation was measured on every scan, and time-attenuation curves were created.

Knee function after operation for malignancy of the distal femur. Quadriceps muscle mass and knee extension strength in 21 patients with hinged endoprostheses.

We evaluated quadriceps muscle mass and knee extension strength in 21 patients after resection and endoprosthetic replacement of the distal femur for malignant bone tumor. In all cases, a modular cementless, hinged prosthesis had been used. The mean follow-up period was 4 (2-9) years.

[Stenoses and occlusions of the abdominal aorta in patients less than 40-years old].

Stenosis or occlusion of the abdominal aorta in patients under 40 years of age is either due to a congenital malformation (abdominal aortic coarctation) or due to idiopathic aortitis (Takayasu's arteritis). Some authors, however, consider abdominal aortic coarctation as a subtype of Takayasu's arteritis. We evaluated 9 of our cases and 108 well-documented cases from the literature to help decide the question whether abdominal aortic coarctation is an entity of its own or a subtype of Takayasu's arteritis.

[Ultrasound-guided needle biopsies of thoracic space-occupying lesions].

This study is concerned with the results and experience gained from performing ultrasound-guided needle biopsies of thoracic masses in 56 patients. The accuracy of the biopsy results were related to the certainty of the method, the visibility of the biopsy needle on real time images, the effect of biopsy needle thickness and tumour size. Correct diagnosis was achieved in 84.

[The radiologic clinical picture of primary bone lymphoma].

Primary lymphoma of bone is a rare form of non-Hodgkin lymphoma which involves a single bone and has a relatively good prognosis following radiation therapy. We observed 17 histologically verified cases and found 97 cases in the literature. This rare tumour may occur at any time in adults and usually affects the metaphyses of long bones.

Duplex sonography of mammary tumors: a prospective study of 75 patients.

Seventy-five breast neoplasms have been examined with duplex sonography to establish the optimal threshold value of systolic peak flow velocity to differentiate benign from malignant tumors. It could be shown that a systolic peak flow of > or = 0.2 m/s (Doppler angle corrected to 0 degrees) provides the best relationship between sensitivity and specificity concerning characterization of tumors.

[The technic of adrenal biopsy. Ultrasound versus CT as the guidance method].

Forty-seven needle biopsies of the adrenal glands have been performed under ultrasound or CT guidance. The aim was to clarify the best guidance method, the best approach, the choice of biopsy needle and possible complications. Analysis of the results provided the following answers: 1.

["Pseudo-dissection" in an abdominal aortic aneurysm].

Sonography of 52 patients with aneurysms of the abdominal aorta revealed in 7 cases hypoechoic crescent-like zone between parietal thrombus and the aortic wall which simulated aortic dissection. Duplex-sonography was performed in all cases and no flow could be detected in this area. In two patients intraoperatively several milliliters of a serous fluid could be aspirated from this zone which confirmed the suggestion of seroma within the parietal thrombus.

Age-associated changes of the triangular fibrocartilage of the wrist: evaluation of the diagnostic performance of MR imaging.

To define the appearance of degenerative changes of the triangular fibrocartilage (TFC) of the wrist on magnetic resonance (MR) images, the TFCs in one wrist of each of 30 healthy subjects in three age groups (20-35, 36-50, and greater than 50 years) and six TFCs from fresh cadavers were examined by means of coronal T1-weighted spin-echo sequences. Histologic findings were compared with findings on MR images in the cadaveric TFCs. It was proved that patches or lines of signal hyperintensity within the cadaveric TFCs were caused by degenerative changes and tears.

[The problem of the closed abdominal injury in polytrauma patients].

The histories of 66 patients with blunt abdominal trauma requiring surgery in the period from 1985 to 1989 were analysed. The patients were divided into three groups on the basis of the other injuries present. Group I, isolated blunt abdominal trauma and blunt abdominal trauma with slight concomitant injuries (18 patients, ISS 17.

Prospective clinical study with in vitro endothelial cell lining of expanded polytetrafluoroethylene grafts in crural repeat reconstruction.

A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperation were entered into the study.

[Aneurysms of the portal vein: an evaluation of 21 cases].

Reviewing 17 cases from the literature and 4 own cases we tried to throw light on the clinical and radiological appearance of the aneurysms of portal vein. The evaluation was performed in respect of sex, age, size, localisation and eventual combination with a portal hypertension. It appears that these aneurysms can be found at any age and that there is no sexual preference.