No abstract

Of a total of 191 magnetic resonance breast studies performed since March 1984, 82 were performed with gradient-echo fast low-angle shot (FLASH) sequences and fast imaging with steady precession (FISP). These techniques permit imaging of thin and contiguous sections, resulting in high resolution of the parenchymal structure. Intravenous injection of 0.1 mmol/kg of gadolinium diethylenetriamine-pentaacetic acid dimeglumine (50% of the dose used in spin-echo sequences) aided in detection of carcinomas as small as 3 mm in dense breast tissue. In 25 patients, dynamic studies were performed at short intervals after the injection of contrast medium in an attempt to differentiate more reliably between breast tissue types. All six malignant tumors found in these 25 patients showed enhancement characterized by a sudden increase in signal intensity on the order of 100% within the first 2 minutes after injection and a much slighter increase thereafter. Sixteen benign lesions showed a substantially different pattern of enhancement. Further studies are required to confirm these findings.

The results of selective phlebography of the spermatic vein are reported in 580 infertile men with abnormal sperm morphology and suspected varicoceles. Percutaneous transvenous retrograde sclerotherapy of the internal spermatic vein was performed in 260 of the patients. Follow-up phlebography in 109 patients 3 to 6 months after treatment revealed a persistent varicocele in only 3% of them.

No abstract

Sclerosis of the spermatic vein for male infertility and varicoceles was carried out in 84 patients by a percutaneous method. If the catheter is correctly placed in the spermatic vein, sclerosis is possible in almost all cases, as was shown by controlled examinations after periods of more than three months. Together with the radiologic changes, there was also an improvement in the spermatologic parameters. 58% of the patients examined after three months were regarded as fertile.

No abstract

Percutaneous transluminal angioplasty (Dotter technique) was used in 2,942 cases of iliofemoral atheromatous disease. Results varied with the characteristics of the obstructing lesion (length and location) and the clinical stage of ischemia (claudication, rest pain, gangrene). Based on the foregoing, angioplasty is done either as the preferred primary treatment or for the relief of clinically advanced disease in patients unsuitable for high risk surgery. Success is favored by the use of aggregation inhibitors and single-use Teflon or balloon catheters; complications are few.

We evaluated the diagnostic accuracy and complications of digital subtraction angiography (DSA) in a series of clinical trials conducted on patients primarily with cerebral vascular disease and those evaluated before and after surgery or percutaneous transluminal angioplasty. Double-blind studies of the carotid-vertebral arteries of 300 of the 2,200 patients using DSA imaging and a variety of ionic and nonionic contrast agents showed that although subjects tolerated the injection of nonionic contrast better than ionic, nonionic contrast administration did not lead to better image quality. Of 764 patients receiving ionic contrast media, 3.3% had mild-to-serve adverse reactions; of 350 injected with nonionic contrast agents, 1.7% had mild-to-severe adverse reactions. If the sole consideration is safety, use of ionic contrast media is justified.