Der Radiologe
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In childhood blunt trauma to the chest wall is more frequent than penetrating injuries. Most of these are the result of traffic accidents. Solitary or serial rib fractures are seen more often than fractures of the sternum. ⋯ The prognosis also depends on the concurrent injuries. The initial evaluation of an injured child is based on the chest X-ray and abdominal ultrasound examination. Additional information can be obtained by a CT scan in mediastinal injuries.
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Depending on the clinical symptomatology, computed tomography (CT) is the predominant examination technique. CT reliably shows live-threatening intra- or extracerebral hemorrhage. ⋯ In many cases localized edema can be identified, but because of the normally very narrow cortical sulci in children and younger people, the general post-traumatic brain swelling is often diagnosed only retrospectively. Magnetic resonance tomography is more sensitive than CT concerning subtle changes in the depth of the white matter and should be used for follow-up studies as a supplementary examination.
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Transvaginal ultrasound is the method of first choice in patients with a suspected ovarian tumor. Computed tomography (CT) and magnetic resonance (MR) imaging are supplementary imaging procedures for the diagnostic evaluation of ovarian tumors. The major indications for a CT or MR examination are unclear ultrasound findings, the differential diagnosis of lesions and tumor staging. ⋯ CT and MR imaging use identical morphological criteria for the differentiation of benign and malignant ovarian tumors; MR imaging is not superior to CT. For the staging of ovarian carcinomas, CT is the preferred imaging procedure. Contrast-enhanced MR imaging might be better for the evaluation of peritoneal carcinosis than other modalities.
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Salivary gland tumors are rare. One-fifth are malignant. The parotid is the gland most often affected, particularly in adenomas. ⋯ Aggressive and extensive tumors are irradiated postoperatively. Malignancies not operated upon are irradiated primarily. Facial nerve paralysis can be rehabilitated by different nerve repair or static surgical techniques.
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Measurements of blood flow velocity in the basal cerebral arteries during functional testing by means of transcranial Doppler sonography are reviewed. Special emphasis is placed on cerebrovascular reserve capacity, which we determined in two groups of patients with obstructive cerebrovascular disease and in normal persons. We discuss the value of functional testing during endovascular neuroradiological procedures.