[X-ray Investigations in Intensive Care Units. Development, Organization and Methods (author's transl)]. / Röntgendiagnostik an der Intensivbehandlungsstation.

From special care following surgery and from artificial respiration of polio patients the modern and very special intensive medical care has developed. At the same time the provisional "bedside radiology" was improved to one branch of clinical radiology with special organisation and methods of investigation. Importance and urgency of radiological information are requiring close cooperation of all medical branches. Functions of these different groups have to be defined. The movable X-ray apparatus of 20 kV output is necessary for every intensive care unit. Hard beam technique for lung X-rays, scattered radiation grids and adequate positioning of the patient are important to get the same high quality are important to get the same high quality are important to get the same high quality pictures than from the radiological department.

[Optimal conventional radiodiagnosis of chronic renal failure (author's transl)]. / Optimierte konventionelle Röntgenverfahren bei chronischer Niereninsuffizienz.

Contemporary methods and risks of intravenous urography in the evaluation of chronic renal failure, are discussed. Differential diagnosis of "small" as well als of "large" kidneys is presented by analysing the contour of the organs and the configuration of the collecting systems. Illustrative cases are shown.

[The diagnostic scope of ultrasonography in renal pathology (author's transl)]. / Der Informationsumfang des Ultraschallverfahrens bei pathologischen Nierenprozessen.

The accuracy of ultrasonography in the diagnosis of different pathological renal conditions is evaluated. Correlations were established to the findings on intravenous urography and selective angiography. Ultrasonography is suitable for the determination of the exact size and site of the kidney and, therefore, should be used routinely in the follow-up of renal transplant recipients. The ability to differentiate between solid and cystic lesions is of partcular value. Moreover, perirenal changes are easily recognizable. The limits of B-mode sonography lie in the interpretation of central expanding lesions with a diameter of under 3 cm. This non-invasive method should be used selectively in the diagnosis of renal disease, whereas angiography should be limited to the classification of equivocal ultrasound findings and in the case of solid tumours.

[Endoscopy and radiological investigations of the stomach and duodenum. Alternative or complementary procedures? (author's transl)]. / Röntgendiagnostik und Endoskopie von Magen und Duodenum. Alternative oder komplementäre Verfahren?

The results of radiological and endoscopic examination in 1,030 patients were compared. In one third of cases there was some discrepancy relating to a significant diagnostic finding (malignant process, peptic ulcer, polyp, stenosis or deformity, abnormal folds, diverticula or normal findings). In analysing false negative and false positive radiological diagnoses, the patients were divided into two groups (with or without a double contrast technique). Conventional radiography proved ten to 38% less reliable than the double contrast technique for a variety of reasons. In view of the high diagnostic accuracy of modern radiological investigations of the stomach and duodenum, endoscopy and biopsy are recommended as complementary procedures. In addition to the high degree of accuracy of radiological methods for various pathological processes, endoscopy places considerable demands during investigation of the upper intestinal tract. At present radiology is used 19 times as frequently as endoscopy, suggesting that there might have to be a tenfold increase in the capacity of pathological departments if endoscopy is used more frequently.

[Differential diagnosis of liver disease by means of sonography: correlation with scintigraphy and angiography (author's transl)]. / Sonographische Differentialdiagnose pathologischer Leberprozesse: Korrelation mit Szintigraphie und Angiographie.

The value of sonography of the liver is assessed and compared with angiography and scintigraphy on the basis of case material from 102 patients, representing localized and diffuse liver processes. The diagnostic accuracy depends on the characteristic acoustic impedance differences in the examined tissue. Diffuse liver disease and processes without clearly defined acoustic borderlines may cause diagnostic difficulties and differentiation can only be attempted by additional clinical information. Defined tumours represent the main field of application. The combined use of ultrasound, scintigraphy and angiography permits a correct diagnosis to be made in nearly 90% of cases. Differential diagnosis between cystic and solid processes is possible only by ultrasound.

[Differential diagnosis of space-occupying lesions of kidneys (comparison between IVP, angiography and ultra-sound) (author's transl)]. / Zur Differentialdiagnose renaler Raumforderungen (Vergleichende Untersuchungen Zum Informationsumfang von Ausscheidungsurographie, Angiographie und Ultraschall)

On 77 IVP's it can be shown that correct assessment of the identity of space-occupying lesions of the kidneys is difficult (correct diagnosis in 39% of cystic and 10% of solid conditions). Improvement can be expected from early tomography of IVP's by improved pictures of the parenchyma, mainly with ultra-sound which separates cystic from solid conditions. Correlation of these techniques appears sufficient for cystic processes. Angiography is indicated for solid tumors and doubtful ultra-sound findings.

[Use and effectiveness of scintigraphy, sonography and angiography in circumscribed disease of the liver (author's transl)]. / Einstaz und Leistungbreite von szintigraphie, Sonographie und Angiographie bei umschriebenen Leberprozessen

The effectiveness of scintigraphy, sonography and angiography is compared in a material of 140 cases of circumscribed disease of the liver. Typical clinical starting points are defined as points of reference of the diagnostic techniques. Clinical diagnosis is very safe in cases of secondary blastoma and hepatocellular carcinoma of the liver. Since the great majority of these conditions cause space-occupying lesions of the liver, problems of radiologic diagnosis are confined to the smaller number of clinically ill-defined lesions. For the diagnosis of secondary blastomas and cystic process of all kinds, scintigraphy and sonography are not improved by angiography. Solid space-occupying lesions of unknown origin, however, can only be recognized with angiography. Histology of both benign and malignant processes will be correct in more than 90% of cases.

[Abdominal roetgen diagnosis in intensive care patients]. / Abdominale Röntgendiagnostik bei Intensivfällen

Following the discussion on special clinical issues with respect to patients in surgical and internal intensive care wards, technology and special methods used in conventional thorax and abdominal X-rays are elaborated on. The wide range of information obtained through large spectrum abdominal X-rays taken in the ventrodorsal direction with the patient lying on the left side is stressed. Small quantities of free air are visualized better in this position than in the upright one. The importance of additional X-rays of thorax and epigatrium in a seated position is accented. Subject of discussion is also the indication for visualizing by contrast medium and the selection of a contrast medium with due consideration of clinical criteria. The urgent need of an X-ray diagnosis in such a group of patients requires high standards in terms of techniques and methods used for examination--something that lies within the realm of the radiologist. Close cooperation with the attending team of physicians is a must if optimum interpretation of the X-rays is to be guaranteed.

[Angiography, scintigraphy and ultra sound in the diagnosis of splenic or hepatic disease in Hodgkin's disease (author's transl)]. / Angiographie, Szintigraphie und Ultraschall zum Nachweis von Milz- oder Leberbefall bei Morbus Hodgkin

The combined use of selective angiography, scintigraphy and ultra-sound is not reliable enough for the certain exclusion of visceral involvement in Hodgkin's disease. Since this is of importance in the planning of treatment, it confirms the recommendation made by Wagenknechts, Glatsteins and others that a diagnostic splenectomy be carried out in order to determine the presence of visceral involvement.

[Idiopathic, muscular, hypertrophic, sub-aortic stenosis]. / Die idiopathische muskuläre hypertrophe Subaortenstenose

The authors have seen 14 cases of idiopathic, hypertrophic, subaortic stenosis and they describe the pathology, the clinical and radiological diagnosis and the differential diagnosis of this condition. Their own findings are compared with those in the literature and substantial agreement is found. Some uncharacteristic clinical and radiological findings are associated with typical pressure curves in the left ventricle and marked abnormalities in the laevocardiogram. Variations in ventricular filling due to the difference in severity of the disease are discussed. The importance of a correct diagnosis is stressed, since the use of inotropic substance is this condition is contra-indicated.