AIMS: To retrospectively evaluate the technical features, efficacy, accuracy, appropriate complications, and relationships among monitored parameters of computed tomography-guided biopsies of the retroperitoneum-located processes. METHODS: From December 2008 to December 2018, 208 percutaneous biopsy procedures for tumors, sized 14 - 190 mm in diameter (median size 57.5 mm), were performed on patients with suspected retroperitoneal tumorous process on imaging examinations. The patients were men in 124 cases and women in 84 cases, aged 20 to 90 years (median age 63.2 years). Skin to lesion distance was variable; from 43 cm to 178 cm (median length 108.5 cm). RESULTS: In 202 cases (97.1%) results were true positive or true negative; only 6 interventions (2.9%) were histologically false negative and had to be confirmed surgically. DLBCL and metastatic disease to the retroperitoneal lymphatic nodes were the most common diagnoses (23.1% each); lymphoma types were verified in 40.9% of cases. 7 complications in total were revealed, 6 of which were minor hemorrhages, and in one case ureteral injury was detected. A statistically significant relationship between the hypervascular process and complication incidence (P=0.00166) and needle gauge (P=0.01427) was identified. CONCLUSION: Percutaneous CT-guided biopsy performed in patients with a suspected retroperitoneal tumorous process had a high accuracy in establishing the correct diagnosis including histological subtyping. Simultaneously, the complication rate was low.

• MeSH
• diagnostické techniky a postupy statistika a číselné údaje   MeSH
• dospělí MeSH
• intervenční radiografie metody   statistika a číselné údaje   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• počítačová rentgenová tomografie metody   statistika a číselné údaje   MeSH
• retroperitoneální nádory diagnóza   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ultrazvukem navigovaná biopsie metody   statistika a číselné údaje   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

PURPOSE OF THE STUDY The study aimed to map the use of imaging techniques and results reporting in polytrauma patients by the trauma centres in the Czech Republic. MATERIAL AND METHODS The representatives of radiology departments and units of all 12 trauma centres in the Czech Republic completed a questionnaire regarding the imaging in polytrauma patients. RESULTS The Focused Assessment with Sonography for Trauma (FAST) as an initial imaging is used by all the centres, the WholeBody CT scan (WBCT) is the dominant imaging technique everywhere and all the centres have standards in place for its performance. The WBCT examination protocol varies across the centres, just like the evaluation procedures of the CT scan and reporting of the results over to the indicating physicians. In majority of centres, there is a high percentage of WBCT with normal findings. One of the centres which uses also X-rays as a part of imaging algorithm, reports a notably higher percentage of WBCT positive findings. DISCUSSION When considering the radiation dose, data and time necessary for WBCT, work required to assess the WBCT and a large number of negative findings, it is disputable whether in a number of cases the WBCT is a suitable method for polytrauma patient examination. Similar conclusions have been drawn also by other authors who recommend that the WBCT is always used for unconscious polytrauma patients, in whom a clinical examination is virtually impossible. In the other cases, based on the clinical parameters the other imaging techniques and the focused CT (and in the indicated cases also the wholebody CT) can be safely used. CONCLUSIONS he diagnostic procedure in a polytrauma patient is not uniform in trauma centres and even the procedure for urgent reporting of crucial WBCT findings to clinical physicians has not been standardised. In a number of cases the indication for WBCT seems to be unnecessary. A more careful consideration of indications for imaging examinations based on the clinical finding may reduce the radiation exposure of patients while maintaining the diagnostic accuracy. A structured report on WBCT in polytrauma is not used even though it is recommended by the European Society of Radiology. Key words:polytrauma, diagnostic imaging, Whole-Body Computed Tomography, structured report.

• MeSH
• lidé MeSH
• počítačová rentgenová tomografie metody   statistika a číselné údaje   MeSH
• polytrauma diagnostické zobrazování   epidemiologie   MeSH
• průzkumy zdravotní péče MeSH
• radiační expozice MeSH
• retrospektivní studie MeSH
• traumatologická centra statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH

• Klíčová slova
• FRAX,
• MeSH
• absorpční fotometrie metody   MeSH
• Albers-Schönbergova nemoc diagnóza   MeSH
• anamnéza metody   statistika a číselné údaje   MeSH
• ankylózující spondylitida komplikace   MeSH
• biologické markery analýza   MeSH
• denosumab aplikace a dávkování   farmakologie   škodlivé účinky   MeSH
• diferenciální diagnóza MeSH
• fraktury kostí epidemiologie   etiologie   mortalita   prevence a kontrola   MeSH
• glukokortikoidy škodlivé účinky   MeSH
• hormonální substituční terapie MeSH
• inhibitory kostní resorpce aplikace a dávkování   farmakologie   klasifikace   škodlivé účinky   MeSH
• klinická studie jako téma MeSH
• kombinovaná farmakoterapie MeSH
• komorbidita MeSH
• komplikace diabetu MeSH
• kosti a kostní tkáň patologie   MeSH
• kostní denzita MeSH
• krček femuru patologie   MeSH
• kyselina zoledronová aplikace a dávkování   škodlivé účinky   MeSH
• lidé MeSH
• ligand RANK antagonisté a inhibitory   MeSH
• nežádoucí účinky léčiv MeSH
• osteomalacie diagnóza   etiologie   farmakoterapie   MeSH
• osteoporóza chemicky indukované   diagnóza   epidemiologie   etiologie   farmakoterapie   klasifikace   patofyziologie   MeSH
• Pagetova kostní nemoc diagnóza   farmakoterapie   patofyziologie   MeSH
• páteř patologie   MeSH
• počítačová rentgenová tomografie metody   statistika a číselné údaje   MeSH
• postmenopauzální osteoporóza farmakoterapie   patofyziologie   MeSH
• remodelace kosti MeSH
• revmatoidní artritida komplikace   patofyziologie   MeSH
• riziko MeSH
• systémy pro podporu klinického rozhodování MeSH
• teriparatid aplikace a dávkování   farmakologie   MeSH
• vápník aplikace a dávkování   MeSH
• věkové faktory MeSH
• vitamin D aplikace a dávkování   farmakologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

The paper deals with modeling the liver perfusion intended to improve quantitative analysis of the tissue scans provided by the contrast-enhanced computed tomography (CT). For this purpose, we developed a model of dynamic transport of the contrast fluid through the hierarchies of the perfusion trees. Conceptually, computed time-space distributions of the so-called tissue density can be compared with the measured data obtained from CT; such a modeling feedback can be used for model parameter identification. The blood flow is characterized at several scales for which different models are used. Flows in upper hierarchies represented by larger branching vessels are described using simple 1D models based on the Bernoulli equation extended by correction terms to respect the local pressure losses. To describe flows in smaller vessels and in the tissue parenchyma, we propose a 3D continuum model of porous medium defined in terms of hierarchically matched compartments characterized by hydraulic permeabilities. The 1D models corresponding to the portal and hepatic veins are coupled with the 3D model through point sources, or sinks. The contrast fluid saturation is governed by transport equations adapted for the 1D and 3D flow models. The complex perfusion model has been implemented using the finite element and finite volume methods. We report numerical examples computed for anatomically relevant geometries of the liver organ and of the principal vascular trees. The simulated tissue density corresponding to the CT examination output reflects a pathology modeled as a localized permeability deficiency.

• MeSH
• analýza metodou konečných prvků MeSH
• biologické modely MeSH
• jaterní oběh * fyziologie   MeSH
• játra krevní zásobení   diagnostické zobrazování   MeSH
• kontrastní látky farmakokinetika   MeSH
• lidé MeSH
• matematické pojmy MeSH
• počítačová rentgenová tomografie statistika a číselné údaje   MeSH
• počítačová simulace MeSH
• poréznost MeSH
• vylepšení rentgenového snímku metody   MeSH
• zobrazování trojrozměrné statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• Klíčová slova
• absorpční koeficienty, CT obraz,
• MeSH
• cizí tělesa * klasifikace   MeSH
• lidé MeSH
• lidské tělo * MeSH
• počítačová rentgenová tomografie * metody   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH

Cíl: Difuzní axonální poranění je traumatické postižení mozku vznikající jako následek střižného pohybu při náhlém zrychlení či zpomalení mozku výrazněji vůči zbytku těla. Za cíl jsme si dali porovnat možnosti dnešních zobrazovacích metod v diagnostice difuzního axonálního postižení (DAP). Dále jsme se snažili v retrospektivní studii zjistit senzitivitu výpočetní tomografie (CT) a magnetické rezonance (MR) v diagnostice DAP a zhodnotit korelaci nálezu na zobrazovacích metodách s tíži klinického stavu. Metodika: Vyšetření CT probíhalo na přístroji Philips Brilliance 64-řadý helikální, nativně, s provedením měkkotkáňového a kostního přepočtu. MR vyšetření bylo provedeno na přístroji Philips Achieva 1,5T s použitím hlavové cívky, nativně v T2, T1 a GRE sekvenci v rovině transverzální, FLAIR sekvence v rovině koronální či sagitální a difuzně vážená sekvence (DWI) a ADC mapy v transverzální rovině. Celkem bylo vyšetřeno 60 pacientů. Výsledky: Mezi roky 2010-2014 byl DAP popsán celkem u 60 pacientů, 38 na CT, a dalších 22 na MR. Dvacet pacientů mělo následně trvalou poruchu vědomí či zemřelo, 36 mělo trvalé následky, osm se plně uzdravilo a u šesti nevíme konečný klinický stav. Senzitivita CT je v našem souboru 63 %, specificita 97 %. Závěr: V dnešní době je zlatým standardem v diagnostice kraniotraumatu nativní CT vyšetření, které má v případě DAP v našem souboru relativně nízkou senzitivitu a vysokou specificitu. MR je vzhledem k dostupnosti i časové náročnosti vyšetření vhodnou metodou až u pacientů, u nichž nález na CT neodpovídá jejich klinickému stavu. Pacienti s diagnostikovaným DAP mají obecně špatnou prognózu, až Ms zemře nebo má trvalou poruchu vědomí a další cca Ví pacientů má trvalé následky.

Aim: Diffuse axonal injury is traumatic brain injury arising as a result of shear movement during sudden acceleration or deceleration of the brain strongly against the rest of the body. We want to compare the capabilities of todays imaging modalities in diagnostics of diffuse axonal injury (DAI). Next, we tried in retrospective study to determine the sensitivity of computed tomography (CT) and magnetic resonance (MR) in the diagnostic of DAI and to evaluate the clinical status of patients diagnosed for DAI. Method: We used 64-row helical CT (Philips Brilliance 64), we made native scans with soft-tissue and bone conversion. MR examination was performed on a Philips Achieva 1.5T machine using a head coil, natively in T2, Tl and GRE sequence in the transverse plane, FLAIR in coronal or sagittal plane and diffusion-weighted sequences (DWI) and ADC maps in the transversal plane. A total of 60 patients were examined. Results: 60 patients with DAI were examined in time period from 2010-2014, 38 with diagnoses of DAI on CT and 22 on MR. 20 patients had a subsequent permanent impairment of consciousness or died, 36 had lasting consequences, 8 fully healed and in 6 patients we do not know how they ended. Conclusion: Today native CT is the gold standard in the diagnosis of brain injury. In our group of DAI patients CT, unlike MR, had low relatively sensitivity of 63% (high specificity 97%). However, MR is not method of first choice due to its insufficient availability and time-consuming examination. MR is a useful approach for those patients whose findings on CT do not match the clinical condition. Patients diagnosed for DAP have generally a poor prognosis, Ms in our group of patients die or have permanent impairment of consciousness, and another M has long lasting consequences.

• MeSH
• difuzní axonální poranění * radiografie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie * metody   přístrojové vybavení   statistika a číselné údaje   MeSH
• počítačová rentgenová tomografie * metody   přístrojové vybavení   statistika a číselné údaje   MeSH
• poranění mozku radiografie   MeSH
• retrospektivní studie MeSH
• senzitivita a specificita * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

The article reports results from the largest international dose survey in paediatric computed tomography (CT) in 32 countries and proposes international diagnostic reference levels (DRLs) in terms of computed tomography dose index (CTDI vol) and dose length product (DLP). It also assesses whether mean or median values of individual facilities should be used. A total of 6115 individual patient data were recorded among four age groups: <1 y, >1-5 y, >5-10 y and >10-15 y. CTDIw, CTDI vol and DLP from the CT console were recorded in dedicated forms together with patient data and technical parameters. Statistical analysis was performed, and international DRLs were established at rounded 75th percentile values of distribution of median values from all CT facilities. The study presents evidence in favour of using median rather than mean of patient dose indices as the representative of typical local dose in a facility, and for establishing DRLs as third quartile of median values. International DRLs were established for paediatric CT examinations for routine head, chest and abdomen in the four age groups. DRLs for CTDI vol are similar to the reference values from other published reports, with some differences for chest and abdomen CT. Higher variations were observed between DLP values, based on a survey of whole multi-phase exams. It may be noted that other studies in literature were based on single phase only. DRLs reported in this article can be used in countries without sufficient medical physics support to identify non-optimised practice. Recommendations to improve the accuracy and importance of future surveys are provided.

• MeSH
• dávka záření MeSH
• dítě MeSH
• internacionalita MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• monitorování radiace normy   statistika a číselné údaje   MeSH
• novorozenec MeSH
• pediatrie normy   MeSH
• počítačová rentgenová tomografie normy   statistika a číselné údaje   MeSH
• předškolní dítě MeSH
• průzkumy zdravotní péče MeSH
• radiační expozice normy   statistika a číselné údaje   MeSH
• referenční hodnoty MeSH
• Check Tag
• dítě MeSH
• kojenec MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• lidé MeSH
• nádory diagnóza   epidemiologie   MeSH
• pacienti statistika a číselné údaje   MeSH
• počítačová rentgenová tomografie * statistika a číselné údaje   MeSH
• poskytování zdravotní péče statistika a číselné údaje   trendy   MeSH
• prognóza * MeSH
• registrace MeSH
• statistické modely MeSH
• statistika jako téma MeSH
• tomografie emisní počítačová * statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

The aim of this article is 3D analysis of the temporomandibular joint (TMJ) patient, who underwent surgery, during which the right TMJ was resected along with the ramus of mandible and consequently the joint was reconstructed with subtotal replacement. The main goal is to give a suitable formulation of mathematical model, which describes the changes of stresses in TMJ incurred after the surgery. The TMJ is a complex, sensitive and highly mobile joint which works bilaterally so each side influences the contralateral joint and because of this the distribution of the stresses is changed in the healthy joint as well. Detailed knowledge about function these are necessary for clinical application of temporomandibular joint prosthesis and also help us estimate the lifetime of the prosthesis a possibilities of alteration in the contra lateral joint components. The geometry for the 3D models is taken from the CT scan date and its numerical solution is based on the theory of semi-coercive unilateral contact problems in linear elasticity. This article provides medical part with case report, discretion of treatment, than the methods of mathematical modeling and his possibilities are described and finally results are reported.

• MeSH
• analýza metodou konečných prvků MeSH
• biomechanika MeSH
• cysty čelistí patologie   radiografie   chirurgie   MeSH
• lidé MeSH
• mandibula - protézy MeSH
• modely anatomické MeSH
• nemoci temporomandibulárního kloubu patologie   radiografie   chirurgie   MeSH
• počítačová rentgenová tomografie statistika a číselné údaje   MeSH
• počítačová simulace MeSH
• senioři MeSH
• temporomandibulární kloub fyziologie   patofyziologie   chirurgie   MeSH
• zobrazování trojrozměrné metody   MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• práce podpořená grantem MeSH

PURPOSE OF THE STUDY The aim of this prospective randomised study was to compare and statistically analyse two methods of condylar twist angle (CTA) measurement in total knee arthroplasty in order to assess their applicability in routine practice. MATERIAL AND METHODS The study included 238 patients with 256 sites undergoing total knee arthroplasty (TKA) in the period from January 2009 to May 2011. There were 93 men (nine with bilateral TKA) and 145 women (nine with bilateral TKA) with an average age of 69.3 years and a range of 47 to 88 years. The implants NexGen (Zimmer) and ADVANCE? Medial-Pivot Knee (Wright) were used. In each patient, CTA was measured before surgery by the radiologist on a multidetector CT SOMATOM 64 (Siemens) using the Yoshioki method. The other CTA measurement was made intra-operatively by the surgeon using our modification of the Hofmann method which involved the identification of a reference line for optimal rotational alignment of the femoral component. A STATISTICA 9.0 software package was used for statistical analysis. In addition to basic statistical data, selected data were presented in graphical forms as Box and Whisker's plots and histograms. Changes in CTA and differences between the groups were evaluated using the Wilcoxon signed-rank test. Relationships among the variables were studied using Spearman's correlation coefficient. RESULTS The statistical analysis showed that the pre-operative CTA value obtained from CT scans was, on the average, higher by 0.5 degrees than the value from intra-operative measurement, as assessed at the level of significance p = 0.001 (signed-rank test). The intra-individual variability was lower than the inter-individual one (14.4% and 30.8%, respectively). This means that both methods are suitable for CTA measurement in the knee joint replacement procedures. Spearman's correlation coefficient was 0.6, which is the value of medium strong correlation. The post-operative CTA assessed on CT scans was in the range of 0 to 2 degrees in 87.5% of the patients. Both the pre-operative and intra-operative CTA values were significantly higher in women than in men (Wilcoxon two-sample test). There was no statistical difference between the left and the right side. DISCUSSION Malrotation of the femoral component is one of the causes leading to patellar subluxation and pain in the front part of the knee. The post-operative CTA value should be zero. Optimal rotational alignment of the femoral component varies with each patient; in our study it was found in the range of 0 to 7 degrees on the basis of CTA values. We do not recommend 7 degrees of external rotation to be exceeded because of the risk associated with balancing the flexion gaps; nor do we recommend to set internal rotation of the femoral component for the risk of patellar complications. The difference of 0.5 degree found in the CTA value between the two measuring methods can be explained by individual differences in the anatomy of the medial epicondylar region, and by the use of only selected whole numbers (0, 3, 5, 7) in intra-operative measurements. This difference does not play any role in routine surgical procedures. CONCLUSIONS The statistical evaluation of the results of CTA measurement with the two methods showed that both were equally suitable for routine total knee arthroplasty. The results of intra-operative CTA measurements are comparable with those obtained on CT scans; in addition, the intra-operative method is less expensive and eliminates exposure of the patient to radiation. CT-based CTA measurements are useful in the patients with chronic problems afterTKA in whom femoral component malrotation needs to be either confirmed or ruled out.

• Klíčová slova
• CTA, condylar twist angle, Advance Medial - Pivot Knee, NexGen,
• MeSH
• chirurgie operační metody   využití   MeSH
• financování organizované MeSH
• interpretace statistických dat MeSH
• kolenní kloub chirurgie   patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• peroperační péče statistika a číselné údaje   využití   MeSH
• počítačová rentgenová tomografie statistika a číselné údaje   MeSH
• prospektivní studie MeSH
• protézy a implantáty využití   MeSH
• protézy kolene statistika a číselné údaje   využití   MeSH
• reprodukovatelnost výsledků MeSH
• rotace škodlivé účinky   MeSH
• rozsah kloubních pohybů MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• výsledek terapie MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) statistika a číselné údaje   MeSH
• zobrazování trojrozměrné MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH