Der Radiologe
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We present eight patients with bronchial injuries. The pertinent radiographic findings were subdivided into: (1) signs pertinent to the bronchial tree; (2) signs due to airleak; (3) signs made in the subtended lung. The radiologist plays an important role in the early diagnosis of this severe injury.
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If properly performed, modern high-resolution real-time ultrasonography will disclose subtle differences in the texture of thyroid tissue and thereby enable the examiner to suggest a diagnosis. Nevertheless, there is often a need for a more specific diagnosis of solid or semisolid thyroid lesions - especially when the lesion might be malignant. Ultrasonically guided fine-needle aspiration biopsy (UG-FNB) allows a final cytological and/or histological diagnosis to be made in patients with benign or malignant space-occupying growths even if they are small. ⋯ Since the tip of the needle can be visualized on the scan, the needle may be advanced or withdrawn during aspiration so it is possible to empty the cyst completely. The use of ultrasound in the follow-up of patients with thyroid cyst puncture is mandatory to evaluate the results. Surgical therapy should be reserved for large cysts causing space-occupying complications.
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After perforating eye injury the retention of a foreign body in the orbits has to be excluded. Wooden foreign bodies mostly have negative density on CT, which increases later as a result of granulomatous changes. On MRI, pieces of wood appear with low signal intensity, and only in some cases is a collar-shaped structure recognizable, allowing differentiation from gas. Soon after orbital trauma with splinters of wood, therefore CT allows better differentiation of pieces of wood from intraorbital gas by measurement of their density, whereas MRI, makes it possible to demonstrate wooden foreign bodies in older injuries in spite of granulomatous changes.
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Chest CT scans were obtained in 86 patients suffering from serious blunt or penetrating chest trauma. The finding of mediastinal widening was by far the most common CT indication. ⋯ Aortography is still indicated, even when CT findings are normal if aortic laceration is clinically suspected. Despite all of the technical problems combined with CT examinations in the critically ill patient, we consider CT a valuable diagnostic tool for certain problems in the traumatized patient.
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A case of mediastinal bronchogenic cyst is discussed. CT showed high absorption values, while in MRI very short T1 values were found. The reasons for these findings are discussed.