RESUMO
The recently introduced (1.1.96) new health legislation in Switzerland provides in article 26 the coverage of preventive measures. The present article discusses the actual list of preventive measures admitted to the basic health insurance package.
Assuntos
Programas Nacionais de Saúde/legislação & jurisprudência , Serviços Preventivos de Saúde/legislação & jurisprudência , Humanos , Triagem Multifásica/legislação & jurisprudência , SuíçaRESUMO
The purpose of this study was to demonstrate that dynamic MRI covering both breasts can provide sensitivity for tumor detection as well as specificity and sensitivity for differentiation of tumor malignancy. Three-dimensional gradient echo scans were used covering both breasts. Before Gd-DTPA bolus injection, two scans were obtained with different flip angles, and after injection, a dynamic series followed. Thirty-two patients were scanned according to this protocol. From these scans. In addition to enhancement, the value of T1 before injection was obtained. This was used to estimate the concentration of Gd-DTPA as well as the pharmacokinetic parameters governing its time course. Signal enhancement in three-dimensional dynamic scanning was shown to be a sensitive basis for detection of tumors. In our series, all but two mammographically suspicious lesions did enhance, and in three cases, additional enhancing lesions were found, two of which were in the contralateral breast. The parameter most suited for classification of breast lesions into benign or malignant was shown to be the pharmacokinetically defined permeability k31, which, for that test, gave a sensitivity of 92% and a specificity of 70%. Our three-dimensional dynamic MRI data are sensitive for detection of mammographically occult breast tumors and specific for classification of these as benign or malignant.
Assuntos
Neoplasias da Mama/diagnóstico , Mama/patologia , Meios de Contraste , Gadolínio , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Compostos Organometálicos , Ácido Pentético/análogos & derivados , Doenças Mamárias/diagnóstico , Feminino , Gadolínio DTPA , Humanos , Pessoa de Meia-Idade , Compostos Organometálicos/farmacocinética , Ácido Pentético/farmacocinética , Sensibilidade e EspecificidadeRESUMO
A 73-year-old female with severe sciatica suffered from an aneurysm of the left internal iliac artery. At first minimal caudographic abnormalities suggested intervertebral disc herniation and lumbar root compression but at exploratory surgery the diagnosis had to be rejected. Once the correct diagnosis was established by echography, CT-scanning and angiography surgical treatment of the aneurysm resulted in complete recovery. Because sciatic nerve lesions due to aneurysms in the pelvic region very seldom occur and may be the cause of diagnostic confusion, symptoms and treatment of these aneurysms are discussed.
