Venous supply of horseshoe kidneys and normal kidneys: an angio-multislice computed tomography-based study.

BACKGROUND: Horseshoe kidney (HSK) is a common developmental anomaly which can be associated with many atypical anatomical variants of blood supply. The aim of this study was to identify the anatomical variants of renal veins supplying HSK, with particular emphasis on their relationship with the arterial system. MATERIALS AND METHODS: The analysis included 94 patients with HSK and 248 persons with normal kidneys (NK). Based on computed tomography-angiography, the number of renal arteries and veins was determined, along with the levels the arteries branched off the aorta and the veins communicated to their parental vessels. RESULTS: Four hundred and twenty-three renal arteries (4.5 per person) and 364 renal veins (3.78 per persons) were found in HSK group (p = 0.004), as compared with 598 arteries (2.41 per person) and 567 veins (2.29 per person) in the NK group (p = 0.025). Mean number of renal veins in women with HSK was higher than in men (4.11 vs. 3.72 per patient, p = 0.03). In the HSK group, the number of renal arteries correlated significantly with the number of renal veins only among men (ks = 0.35, p = 0.009). In patients with NK, significant correlations between the number of renal arteries and renal veins were found both in the whole group and among men and women. CONCLUSIONS: Horseshoe kidneys are drained by a higher number of renal veins than NK, especially in women; this also refers to accessory renal veins. The number of renal veins for HSK is less dependent on the number of corresponding arteries than these for NK.

A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification.

BACKGROUND: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. MATERIALS AND METHODS: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. RESULTS: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). CONCLUSIONS: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery.

Process of the Functional Reorganization of the Cortical Centers for Movement in GBM Patients: fMRI Study.

PURPOSE: The aim of this study was to verify whether the functional reorganization of motor cortex is associated with the increase in the size of WHO type IV glioma lesion, that is, disease duration and development, and whether surgical treatment has an impact on cerebral plasticity. METHODS: The study included 16 patients with primary tumors of the brain located at the region of central sulcus. The clinical status of patients and tumor volume was determined. Functional magnetic resonance imaging examinations were performed before and 3 months after operation. RESULTS: The activity of all cortical centers, both contralateral and ipsilateral, was observed in a group of small as well as large tumors. The intensity of activation and the number of activated clusters of small tumors were almost always higher as compared with the large tumors. The frequency of the activity of contralateral areas was similar during the first and the second examination. In the case of ipsilateral centers, the frequency of activation during the second examination was lower. Mean values of t-statistics during the first examination were higher than during the second examination. Supplementary motor area (SMAa) was the only center for which the mean values of activation intensity remained similar. CONCLUSIONS: SMAa seems to play the most important role in the processes of motor cortex plasticity in high-grade glioma patients. Surgery seems not having a significant influence on the pattern of functional reorganization of the cortical centers for movement. Identification of the individual patterns of the reorganization of motor centers plays an important role in clinical practice.

Renal artery entrapment - anatomical risk factors rating.

BACKGROUND: Cases of renal artery entrapment (RAE) by extrinsic compression have been infrequently reported in the literature. We aimed to describe RAE and elucidate anatomical factors that may be related to renal artery stenosis. MATERIALS AND METHODS: Two hundred and four patients' computed tomography scans made for various reasons in Radiology Department from 2011 to 2015 were retrospectively analysed and 7 cases of RAE were found. Authors studied the level of origin of renal arteries vs. coeliac trunk (CT), superior mesenteric artery (SMA) and vertebrae. Diameter of renal arteries, distance between main left renal artery (LRA) and right renal artery (RRA) as well as renal arterial patterns were also investigated. RESULTS: The origin of main renal arteries off the aorta was between the upper margin of L1 and lower margin of L2 vertebra, with the predominant lower 1/3 of L1 vertebra and L1 intervertebral disc. However, in patients with highest range of stenosis of renal artery the origin was most commonly located at the level of Th12 intervertebral disc and upper part of L1. Statistically significant relationships were proven between range of stenosis and level of origin of stenotic renal artery vs. vertebrae (Pearson's correlation coefficient: -0.393, p < 0.01), distance between main LRA and RRA (Pearson's correlation coefficient: 0.398, p < 0.0001), renal artery-CT distance (Pearson's correlation coefficient: -0.263, p < 0.0001), renal artery-SMA distance (Pearson's correlation coefficient: -0.149, p < 0.033). CONCLUSIONS: Analysis of RAE allowed finding anatomical factors of renal artery stenosis and classifying them regarding to their importance. Relationship of renal artery origin vs. vertebrae and distance between main LRA and RRA were proven the most important. However, distances between higher originated renal artery and CT, higher originated renal artery and SMA should also be taken into consideration.

A computed tomography study on the correlation between the morphometry of the suprascapular notch and anthropometric measurements of the scapula.

BACKGROUND: The suprascapular notch is a clinically important site because it is the main site of injury and compression of the suprascapular nerve. Its shape and size are the most important factors in the aetiopathology of suprascapular nerve neuropathy. This article reports the first computed topography (CT) study on the correlation between the diameters of the suprascapular notch and anthropometric measurements of the human scapula. MATERIALS AND METHODS: A total of 130 scans of shoulders by a helical 32-row multidetector CT scanner were retrospectively analysed. The following scapular measurements were performed: morphological length, morphological width, projection length of the scapular spine, maximal width of the scapular spine, length of the acromion, maximal length of the coracoid process, length of the superior border of the scapula, morphological height of the supraspinous fossa, length of the lateral border of the scapula, and morphological height of infraspinous fossa. The following suprascapular notch dimensions were measured: maximal depth, superior transverse diameter, middle transverse diameter. RESULTS: The maximum depth of the suprascapular notch correlates with the morphological length of the scapula, the length of the lateral border of the scapula and the morphological width of the scapula. The superior transverse diameter of the suprascapular notch correlates with the length of the superior border of the scapula and negatively with the length of the lateral border of the scapula. In addition it has been shown that the length of the superior border of the scapula correlates more closely with the superior transverse diameter of the suprascapular notch than the middle transverse diameter of the suprascapular notch. CONCLUSIONS: It could be supposed that humans with longer scapulae have deeper notches. It may be also concluded that scapulae with a wider superior border have a shallower suprascapular notch.

The influence of atherosclerotic abdominal aorta on the shape of duplicated inferior vena cava: its potential clinical implications and vascular complications.

Duplication of the inferior vena cava (IVC) is a congenital condition where there are 2 large vessels: right IVC (RIVC) and left IVC (LIVC) on both sides of the abdominal aorta. Here, we present 2 cases of duplicated inferior cava coexisting with rare morphology of left gonadal (ovarian/testicular) vein. Both were observed during multidetector 64-row computer tomography. In first case atherosclerotic, tortuous abdominal aorta models both inferior venae cavae. The shape of veins were more- (RIVC) and less-arcuate (LIVC). Two years ago, the patient had been diagnosed with pulmonary thromboembolism. In second case abdominal aortic aneurysm models both large veins. The RIVC has a highly right-arcuate shape, while the LIVC has a less left-arcade shape. Our observation would seem to be especially important, because the tortuous abdominal aorta changes the shape of both IVC, and may predispose them for thrombosis formation. The presented report precisely describes the topography and measurements of the vessels in the retroperitoneal area. The literature concerning this anomaly, potential clinical implications and vascular complications are reviewed and the possible practical aspects are discussed. A familiarity with the anatomy of the most common types of venous anomalies is crucial for all surgeons, urologists and oncologists to reduce the risk of severe haemorrhage during all abdominal procedures.

The suprascapular vein: a possible etiology for suprascapular nerve entrapment and risk of complication during procedures around the suprascapular foramen region.

INTRODUCTION: Nerve can be compressed when traveling through any osteo-fibrous tunnel. Any eventual anatomic structure limiting this passage increases the risk of neuropathy. During dissection of the shoulder region we recognized a vein travelling on the inferior border of the suprascapular notch together with the suprascapular nerve. The aim of this work was to evaluate the morphological characteristics of this vein in cadaveric material. MATERIALS AND METHODS: The suprascapular notch (SSN) region was dissected in 60 cadaveric shoulders. The course, number and diameter of nerve and vessels in the suprascapluar notch region were evaluated. Length, proximal and distal width of the superior transverse scapular ligament were measured. Photographic documentation was taken to evaluate the suprascapular nerve passage area. RESULTS: The vein identified was named as the suprascapular notch vein. It was present in 58.3% of shoulders. In 11 specimens, it was double. Its mean diameter was 1.7 mm (SD 0.7 mm) and did not correlate with the suprascapular nerve passage area. A suprascapular notch vein co-occurred more often with the anterior coracoscapular ligament (ACSL). In comparison with the SSN without the ACSL, it has a significantly greater diameter (2 mm; SD 0.7 mm vs 1.5 mm; SD 0.6 mm, respectively; P=0.021). CONCLUSIONS: The suprascapular notch vein was a common structure that did not replace the suprascapular vein. Its presence correlated with the occurrence of the ACSL and was independent of body side, STSL type and SSN type. TYPE OF STUDY: Observational anatomic study.

Prevalence of congenital coronary artery anomalies and variants in 726 consecutive patients based on 64-slice coronary computed tomography angiography.

BACKGROUND: Coronary computed tomography angiography (CCTA) is helpful in making a precise noninvasive evaluation of coronary anatomy, allowing concomitant evaluation of other cardiac structures. The aim of this study was to determine the prevalence of coronary artery variations detected by 64-slice multi detector CT. MATERIALS AND METHODS: The results of ECG-gated CCTA in 726 consecutive patients (mean age 58 years) were analysed retrospectively. The main indications for CCTA were a typical chest pain, angina pectoris, screening for coronary artery disease and determination of the patency of bypass grafts or stents. Acquisition was performed with a 64-detector CT scanner with retrospective ECG gating. Imaging results were assessed by experienced cardiovascular radiologist. RESULTS: The overall incidence of coronary artery anomalies was 1.1% (8 out of 726 participants). The most common anomaly was an anomalous origin of the circumflex artery from the right coronary sinus with a retroaortic course (4 patients,0.6%), followed by origin of right coronary artery from the left coronary sinus (2 patients, 0.3%). One patient with abnormal origin of the left main artery from the right coronary sinus (0.1%) and 1 patient with a circumflex artery origin from the proximal segment of the right coronary artery (0.1%) were observed, both with retroartic course. CONCLUSIONS: CCTA is a noninvasive imaging technique useful for the precise evaluation of variations of the coronary arteries. This study shows similar results to other reports on this subject.

Perfusion disturbances of kidney graft parenchyma evaluated with contrast-enhanced ultrasonography in the immediate period following kidney transplantation.

PURPOSE: Graft parenchyma perfusion disturbances (GPPD) in transplanted kidneys are common in the early postoperative period. Rapid and accurate diagnosis can guide proper treatment, preventing graft dysfunction. METHODS: One hundred and eighty patients, who underwent kidney transplantation (KTx), were examined in the immediate postoperative period using real-time ultrasonography (B-mode) with color and power Doppler (US-CD/PD) and B-flow ultrasound, as well as with an additional protocol of contrast-enhanced ultrasonography (CE-US). Regions of GPPD were localized and measured. The number and size of these areas were compared between the two acquisition techniques. Follow-up examinations were carried out 6 months postoperatively. RESULTS: CE-US revealed more GPPDs and showed them more precisely than the B+US-CD/PD/B-flow technique. Moreover, in the CE-US examination, ischemic foci had statistically significant higher echogenicity in comparison to normal parenchyma, were larger and better visualized (better circumscribed) than in B+US-CD/PD/B-flow. CONCLUSION: CE-US allows the visualization of GPPD caused by occlusion of small arteries. It is a noninvasive, safe, real-time method, which has many advantages over standard B+US-CD/PD/B-flow examinations, and we recommend it as a routine diagnostic procedure in the early postoperative period following KTx.

The diagnostic value of contrast-enhanced ultrasonography in the assessment of perirenal hematomas in the early post-operative period after kidney transplantation.

BACKGROUND: Routine B-mode ultrasound examination (rB-US) is a current standard for the assessment of the transplanted kidney(KTx) in the early post-operative period. The alteration of perirenal hematoma (PH) echostructure over time limits their detectability and size assessment with rB-US. The aim of this study was to evaluate the diagnostic value of contrast-enhanced ultrasound (CE-US) in diagnosing PH of KTx in the early post-operative period. METHOD: Routine B-US and CE-US of KTx, performed in 102 patients in the early post-operative period, were analyzed. CE-US was performed after intravenous administration of 2.4 mL of sulfur hexafluoride solution. The data were analyzed with respect to the occurrence and thickness of PH. RESULT: The difference in echogenicity between PH and kidney parenchyma was modest in rB-US (mean of 5.7 dB). However, in CE-US, the difference in echogenicity was significantly increased (mean of 31.4 dB). Routine B-US did not allow PH to be recognized in 18 patients. The application of CE-US results in a twofold increase in PH detection when compared with rB-US (33.3% vs. 15.7%). CONCLUSION: US-CE examination is a valuable method for detection and assessment of PH size. Compared with rB-US, this technique may substantially increase the detectability of hemorrhagic complications in the direct post-operative period.

Magnetic resonance spectroscopy in intracranial tumours of glial origin.

BACKGROUND AND PURPOSE: To determine in vivo magnetic resonance spectroscopy (MRS) characteristics of intracranial glial tumours and to assess MRS reliability in glioma grading and discrimination between different histopathological types of tumours. MATERIAL AND METHODS: Analysis of spectra of 26 patients with glioblastomas, 6 with fibrillary astrocytomas, 4 with anaplastic astrocytomas, 2 with pilocytic astrocytoma, 3 with oligodendrogliomas, 3 with anaplastic oligodendrogliomas and 17 control spectra taken from healthy hemispheres. RESULTS: All tumours' metabolite ratios, except for Cho/Cr in fibrillary astrocytomas (p = 0.06), were statistically significantly different from the control. The tumours showed decreased Naa and Cr contents and a high Cho signal. The Lac-Lip signal was high in grade III astrocytomas and glioblastomas. Reports that Cho/Cr ratio increases with glioma's grade whereas Naa/Cr decreases were not confirmed. Anaplastic astrocytomas compared to grade II astrocytomas had a statistically significantly greater mI/Cr ratio (p = 0.02). In pilocytic astrocytomas the Naa/Cr value (2.58 ± 0.39) was greater, whilst the Cho/Naa ratio was lower (2.14 ± 0.64) than in the other astrocytomas. The specific feature of oligodendrogliomas was the presence of glutamate/glutamine peak Glx. However, this peak was absent in two out of three anaplastic oligodendrogliomas. Characteristically, the latter tumours had a high Lac-Lip signal. CONCLUSIONS: MRS in vivo cannot be used as a reliable method for glioma grading. The method is useful in discrimination between WHO grade I and WHO grade II astrocytomas as well as oligodendrogliomas from other gliomas.

Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease.

Congenital anomalies of systemic veins are usually asymptomatic and found incidentally during ultrasonography, computed tomography (CT) or magnetic resonance examinations performed for other clinical indications. Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is the congenital aberration in the thoracic venous system which occurs in only 0.09%to 0.13% of patients who have congenital heart defects. In this paper, we present the extremely rare case of a 72-year-old male with PLSVC associated with an absence of RSVC, referred for coronary CT angiography. Multidetector CT angiography is a powerful tool for the detection of venous anomalies, which is essential before invasive procedures such as the implantation of pacemakers.

Differential diagnosis of intracranial meningiomas based on magnetic resonance spectroscopy.

BACKGROUND AND PURPOSE: To determine in vivo magnetic resonance spectroscopy (MRS) characteristics of intracranial meningiomas and to assess MRS reliability in meningioma grading and discrimination from tumours of similar radiological appearance, such as lymphomas, schwannomas and haemangiopericytomas. MATERIAL AND METHODS: Analysis of spectra of 14 patients with meningiomas, 6 with schwannomas, 2 with lymphomas, 2 with haemangiopericytomas and 17 control spectra taken from healthy hemispheres. RESULTS: All the patients with meningiomas had a high Cho signal (long TE). There were very low signals of Naa and Cr in the spectra of 10 patients. A reversed Ala doublet was seen only in 2 cases. Four patients had a negative Lac signal, whereas 3 had high Lac-Lip spectra. Twelve spectra showed high Cho signals (short TE). In one case the Cho signal was extremely low. All spectra displayed a very low Cr signal, but high Glx and Lac-Lip signals. Ala presence was found only in 3 patients. The mean Cho/Cr ratio (PRESS) was 5.97 (1.12 in normal brain, p < 0.05). Lac-Lip was present in all the meningiomas (STEAM). The Ala signal was seen only in 2 spectra with long TE and in 3 sequences of the short TE sequences. There were both ß/γ-Glx and α-Glx/glutathione signals in all 14 meningiomas. CONCLUSIONS: MRS is unable to discriminate low and high grade meningiomas. The method seems to be helpful in discriminating lymphomas (absent Glx signal), schwannomas (mI signal in the short TE sequences) and haemangiopericytomas (presence of mI band) from meningiomas.

Disturbances of kidney graft perfusion as indicators of acute renal vein thrombosis in contrast-enhanced ultrasonography.

INTRODUCTION: The aim of this study was to evaluate the usefulness of contrast-enhanced ultrasound (US-CE) to diagnose acute renal vein thrombosis (ARVT), acute rejection episodes (ARE), or acute tubular necrosis (ATN) in kidney grafts. MATERIALS AND METHODS: We analyzed 171 US-CE among kidney transplantation patients in the early postoperative period. Patients underwent US-CE following a standard diagnostic protocol including real-time ultrasound (B-mode) and color Doppler ultrasound with spectral flow analysis. Tissue perfusion was analyzed based upon time-intensity curves for two regions: the renal cortex and the renal pyramids. RESULTS: Of 14 patients, in whom standard ultrasound showed high resistance parameters in the renal artery, three showed ARVT and 11 had ATN or ARE, which were confirmed by biopsy. Among patients with ARVT, the US-CE showed a lack of contrast perfusion into the cortex and renal pyramids. Patients with ARE/ATN showed slower contrast inflow into the parenchyma with reduced but still present perfusion. The differences in mean signal intensity values were significant for both the cortex and the renal pyramids: cortex: -53.8±5.4 dB versus -35.0±3.5 dB (P<.05) and pyramids: -54.8±5.4 dB versus -37.0±3.5 dB (P<.05). CONCLUSION: US-CE is a noninvasive method that provides easy, reliable differentiation of ARVT from ARE/ATN.

Contrast-enhanced sonography of postbiopsy arteriovenous fistulas in kidney grafts.

PURPOSE: To assess the usefulness of contrast-enhanced ultrasonography (CE-US) in the visualization of a kidney graft following a biopsy that was complicated by an arteriovenous fistula (AVF). METHODS: Four postrenal transplant patients who had developed AVFs following graft biopsy were examined using standard US and CE-US. Additionally, follow-up examinations were conducted using CE-US, at 4-6 weeks and 10-12 weeks following fistula closure. RESULTS: The fistulas were detected using color Doppler US, Power Doppler US, and B-flow technique. Reduced parenchymal flow was only detected in one case using standard flow visualization techniques. CE-US allowed for the visualization of regions of disturbed parenchymal perfusion that were not visible in the standard examinations. At follow-up, B-mode ultrasound and standard flow examinations appeared normal. However, all contrast-enhanced images showed clearly demarcated residual regions of reduced parenchymal perfusion, in areas where the fistulas had been previously present. CONCLUSIONS: A posttraumatic AVF reduces parenchymal perfusion in the affected region. CE-US examination may help in monitoring fistulas during the active phase and following spontaneous closure.

Age effect on vascular reactivity in Type 1 diabetes.

AIM: The objective of this study was to assess the effect of age on vascular reactivity in patients with Type 1 diabetes. METHODS: Forty-five patients with Type 1 diabetes and 71 healthy control subjects, divided into three age groups (18-30, 31-45 and 46-60 years old), underwent assessment of vascular reactivity based on ultrasound examination of a brachial artery after nitric oxide donor administration. RESULTS: The vasodilative and haemodynamic effect was most pronounced in the youngest control subjects, where lumen widening of 0.51 ± 0.16 mm (13.9 ± 4.2%) and increase in early velocity of 28.4 ± 6.5 cm/s (237 ± 55%) were observed, while, in the control subjects from the middle and oldest age groups, the increase in artery diameter was 0.4 ± 0.11 and 0.22 ± 0.12 mm (9.8 ± 2.6 and 5.0 ± 2.6%), respectively. In the youngest patients with diabetes, lumen widening by 0.35 ± 0.13 mm (8.6 ± 3.4%) and increase in early diastolic velocity by 16.9 ± 5.6 cm/s (158 ± 52%) were noted (P < 0.05 vs. control subjects). In patients with diabetes from the middle and oldest age groups, the increase in artery diameter was 0.26 ± 0.06 and 0.16 ± 0.09 mm (5.5 ± 1.4 and 3.2 ± 1.8%), respectively. CONCLUSIONS: Vascular reactivity is strongly age dependent in all subjects; however, responses are delayed and occur over a longer time period in the patients with diabetes. Vasodilation test protocols should take into account the age of the subjects.

Magnetic resonance imaging of rare intracranial neoplasms--role of the in vivo 1 h spectroscopy in the radiological differential diagnostics.

BACKGROUND: The object of this study was to evaluate the usefulness of magnetic resonance (MR) spectroscopy in differentiating rare intracranial tumours in adult patients. Review of the literature on results of MR spectroscopy in these lesions is also included. MATERIAL AND METHOD: 89 patients with brain tumours were evaluated preoperatively with in vivo 1.5 T MR spectroscopy (according to eTumour study requirements). 8 of them were diagnosed as having very rare neoplasms: haemangiopericytoma (2), lymphoma (2), plexus papilloma (2), chondroma (1) and purkinjoma (1). Spectra of these tumours were compared to spectra of common brain tumours that could resemble these lesions. RESULTS: MR spectroscopy enabled discrimination between meningiomas and haemangiopericytomas, meningiomas and lymphomas, and purkinjomas or chondromas and other brain tumours. The method was unreliable in distinguishing between glioblastomas and lymphomas. CONCLUSION: The small number of patients made statistical analysis impossible. However, at present, it seems that neuroradiological diagnosis should not rely on MR spectroscopy alone.

Eyeball muscles' diameters versus volume estimated by numerical image segmentation.

PURPOSE: To determine the clinical usefulness of the numerical segmentation image technique (NSI) in estimating the volume of extraocular muscles and to compare this value to widely used measurements of single diameters of the muscles. METHODS: Forty-five patients underwent magnetic resonance examinations in 1.5-T scanner. SE T1 sequences in transversal and coronal planes were provided and data were sent to a personal computer, where the degree of exophthalmos, horizontal diameter of medial rectus muscles, and vertical diameter of inferior rectus muscles were determined on the basis of two-dimensional images. The quantity estimation of all eye muscles volumes using NSI application in three-dimensional space was carried out with use of level set segmentation algorithm. RESULTS: A strong correlation between the total eye muscle volume and degree of exophthalmos was determined. The usefulness of measuring single diameters for estimating the muscles' enlargement was confirmed. The difference between a single muscle's volume and its width also was confirmed. Estimates of muscle volume correlate with the degree of exophthalmos more accurately than measurements of single diameters. CONCLUSIONS: The NSI technique is a clinically useful application, providing objective data calculated individually for each orbit. It allows an objective estimation of the pathologic processes leading to exophthalmos and may be especially helpful in monitoring discrete changes in the muscles volume during treatment.

[Periorbital capillary hemangiomas in children--treatment and monitoring of treatment]. / Naczyniaki wlosniczkowe okologalkowe u dzieci--leczenie i monitorowanie leczenia.

PURPOSE: The purpose of the paper is to present the possibility of treatment of periorbital capillary hemangiomas in infancy. MATERIALS AND METHODS: Doppler colour ultrasonography was used as a method of diagnosis and monitoring of the treatment. The material comprised 11 patients aged from 1 month to 3 years. In 6 cases local corticosteroid injections were applied, in 3 cases surgical treatment was performed, out of which 1 additionally received steroid. RESULTS: Results of the treatment were satisfactory in all patients. No serious complications were observed. CONCLUSIONS: Basing on these cases, the authors confirmed the opinion that intralesional corticosteroid injection is the method of choice in the treatment of periorbital infantile hemangiomas. The authors indicate the usefulness of Doppler colour ultrasonography in diagnosis, demonstrating the extent of lesions and monitoring the response to therapy.