Acta radiologica
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Randomized Controlled Trial Comparative Study Clinical Trial
Ultrasonographic findings after conservative treatment of acute appendicitis and open appendicectomy.
In a randomized study we investigated the effects of antibiotics as the only treatment in acute appendicitis. Forty patients were examined, 19 after antibiotic treatment (one operated due to perforation) and 21 after surgery. All patients were examined prior to randomization, after 10 days and after 30 days. ⋯ In 5 of the 8 patients the appendix was still visualized after 1 month. Three of these 5 had recurrent appendicitis within a year. It is concluded that US can be used not only in diagnosing acute appendicitis, but also in the evaluation of treatments such as antibiotics.
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The MR image artifacts caused by minute metallic particles were investigated by imaging small powdered iron quantities from 0.01 mg to 1.7 mg in water phantoms. Images with T1-weighted GRE 3-D and T2-weighted SE 2-D sequences were reconstructed with 5 MR imagers: at 0.04 T, 0.1 T (2 scanners), 1.0 T and 1.5 T. ⋯ It appeared to behave independently on the MR imager system for all iron samples. This study shows that even microscopic magnetic particles cause a notable distortion in the MR image independently of the MR equipment used.
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To evaluate the efficacy of i.v. contrast medium administration in MR imaging at 1.5 T in patients with craniopharyngiomas, MR studies of 10 men and 6 women with pathologically proven craniopharyngiomas were made. The MR images were obtained as 3- to 5-mm-thick coronal (n = 13) or axial (n = 3) Tl-weighted images (T1WI) prior to and following i.v. Gd-DTPA administration. ⋯ PD and T2WI demonstrated cystic tumor components not seen on unenhanced T1WI. There were significant differences (p < 0.004) on 2-tailed Student's t-test comparing tumor conspicuity on contrast medium-enhanced T1WI with unenhanced T1WI, PD and T2WI. Optimal tumor delineation on MR imaging of patients with craniopharyngiomas justifies the use of i.v. contrast medium.
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Sixty-two patients with pelvic fractures were evaluated by conventional radiography and CT. A correct pathoanatomic classification of the fractures was most often obtained by conventional radiography, but CT added information regarding acetabular fractures and involvement of the posterior part of the pelvic ring. Besides, CT was essential in the detection of intraarticular fragments and lesions of the femoral head. Classification of pelvic ring fractures by the pattern of traumatic forces was easily obtainable by conventional radiography, but often difficult to achieve by CT.
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Multiple injury patients with blunt abdominal trauma (n = 110) were examined by abdominal CT. An i.v., but not peroral, contrast medium was used, thereby eliminating the delay caused by administering peroral contrast medium and any subsequent delay in making the diagnoses and beginning operative treatment. Eighteen patients underwent emergency laparotomy after the initial CT examination. ⋯ The bowel and mesenteric lesions presented as intra-abdominal blood, and the hemoperitoneum was discovered in every patient with these lesions. Fourteen patients also initially had positive abdominal CT findings; 10 of them underwent an additional abdominal CT within 3 days, but the repeat studies did not reveal any lesions in need of surgery. Omission of the oral contrast medium did not jeopardize making the essential diagnoses, but it did save time.