Currently, Doppler ultrasound and contrast angiography are the main imaging procedures being used to evaluate arterial bypass shunts. IV radionuclide total body arteriography (TBA) is another useful imaging procedure for evaluation of bypass shunts. The authors reviewed 33 patients, 19 women and 14 men, ranging in age from forty-three to eighty-five, who had TBA done after arterial bypass surgery. Ten patients had multiple shunts and 5 had multiple follow-up studies. In total there were 80 shunts, including 43 femoropopliteal, 16 axillofemoral, 1 axillopopliteal, 13 crossover femorofemoral, and 7 aortofemoral shunts. Sixty-two of the 80 shunts were patent, 14 were occluded, and 4 had partial occlusion. The results were confirmed by Doppler studies, contrast angiograms, and/or surgical exploration without false positives or false negatives. Since the radiotracer used was 99mTc-labeled red blood cells, a MUGA study can also be performed immediately following TBA in the same injection. Twenty-eight patients had gated cardiac blood pool studies (MUGA) done; 16 had abnormal wall motion and diminished ventricular function. TBA requires only a single IV injection of radiotracer (less than 1 cc) in the upper limb. The imaging times for total body arterial and perfusion images are seventy seconds and five minutes respectively. Both total body arterial and perfusion images clearly demonstrated the entire course of shunts (single or multiple); underlying and coexisting arterial abnormalities, e g, occlusive disease (27 patients), or aneurysm (3 patients); and related perfusion changes in the extremities. TBA has unique features. It permits a complete, excellent visualization of the bypass graft without the hazard of contrast media injection. It is a simple and a virtually noninvasive procedure, particularly useful for preoperative workups and postoperative follow-ups.
Mit 4 AbbildungenGütgemann und Parchwitz haben sich kürzlich mit dem röntgenologischen Nachweis von Magen. varizen beschäftigt. Sie weisen darauf hin, daß 20-50% von Leberzirrhotikern durch Varizenbiutungen aus Osophagus und Magen ad exitum kommen. Daraus erhebt sich die Forderung, baldmöglichst die Erkennung von Varizen anzustreben, um rechtzeitig therapeutisch eingreifen zu können. Im einzelnen sei auf die erwähnte Arbeit verwiesen.Daß Varizen im Magen so selten erkannt werden, liegt einmal in der Schwierigkeit der Fornixdarstcllung überhaupt bzw. seiner Beurteilung begründet; zum anderen dürfte zu wenig bekannt sein, daß bei Abflußstörung der portalen Strombahn Varizen im Magen und nur dort auftreten können.Heruntergeladen von: NYU. Urheberrechtlich geschützt.
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