Arteriography in childhood tumours

Internal geometry of arterial bifurcations

The internal geometries of 137 arterial bifurcations were measured, using enlarged angiographic pictures, to determine the position of the apex of each bifurcation in relation to the ostium of the parent artery. The measurements, relating to different parts of the cardiovascular system of man and some to that of rabbit and pig, were compared with each other and with a theoretical model of an 'optimum' arterial bifurcation. The results were found to be consistent with a position of the apex which is optimum from the point of view of local hemodynamics. In that position, the apex lies on a straight dividing streamline which divides the flow in the parent artery in the proportion required by the two branches.

Combined Modes of Imaging for Liver Hemangioma in Cancer Patients

Twenty-nine consecutive patients with single or multiple liver hemangioma were assessed with more than one mode of imaging. Static scanning with 99Tcm was done in 21, ultrasonography in 28, CT in 29 and angiography in 27. Fine-needle percutaneous biopsy was unwisely performed in 7 cases with a single but singular complication, severe peritoneal lymphorrhea. Four laparotomies and 2 laparoscopics completed the investigations. Fourteen patients had a history of primary cancer, and 3 of these had a secondary coexisting with the angioma. CT was characteristic; ultrasonography was sensitive and perhaps specific enough for small angiomas. The 2 combined plus angio-CT greatly reduce the need for hepatic angiography.

Arterial branching in various parts of the cardiovascular system

Angiographic pictures of vascular beds in various parts of the cardiovascular system were analyzed to study the geometrical structure of arterial bifurcations. The sites of arterial bifurcations were enlarged individually, and measurements were made of the branching angles and branch diameters at each site. Results from various parts of the cardiovascular system of man, and some from rabbit and pig, were compared with each other. The measurements were also compared with "optimum" values of branching angles and branch diameters which have been predicted by various theoretical studies. In general the measurements were found to give support to the theoretical premise that branching angles and branch diameters in the cardiovascular system are dictated by certain optimality principles which aim to maximize the efficiency of the system in its fluid-conducting function. In some parts of the system, however, the measured angles and diameters were found to be decidedly lower than those predicted by theory.

The clinical value of CT whole-body scanning in pediatric tumour investigation

The results of 100 consecutive CT whole-body scans in children with suspicion of a tumour and possible malignancy have been analysed. The final diagnoses were these: a tumour in 40 patients; non-tumoural lesions such as cysts, abscesses or malformations in 22; various medical conditions in 30 cases; and no abnormality in eight. The suspicion of malignancy was confirmed in 36 patients. CT proved to be an accurate method in the diagnosing and differentiation between solid or predominantly solid tumours and various non-tumoural lesions. The clinical value of CT was assessed by comparing the information from CT with those obtained by routine clinical and other radiological means. CT was positive informative in 57% of the patients and correctly excluding a tumour in 28%. CT was either non contributory or misleading in 15%. Finally, the quality of the scans were evaluated and the specific problems related to pediatric CT are discussed.