[Idiopathic pulmonary ossification]. / Untersuchungen zur idiopathischen pulmonalen Ossifikation.

OBJECTIVE: Linear and round shadows are very often revealed on chest radiographs. A rare entity most commonly appearing as branching linear shadows of calcific density involving a limited area of the lung is the so-called disseminated pulmonary ossification (DPO). Only 141 cases have been reported worldwide up to now since the first description. MATERIAL AND METHODS: A study on 490 autopsies was performed to find out the frequency of DPO. In case of DPO we compared the structures with the chest radiographs and CT of the patients. Further, we evaluate clinical communities of patients with DPO. RESULTS: From a total of 490 lungs eight were identified with DPO (1.6%). The mean age of patients with DPO was 80.2 years, the male/female ratio seven to one (mean age of all patients: 64.6 years, male/female ratio one to one). All cases were associated with hypertension followed by extreme arteriosclerosis. In 5 cases there was a proven extrapulmonary carcinoma and a renal insufficiency. In 4 cases we found diabetes mellitus. At postmortem radiographs and CT, a collection of small rounded calcific nodules and further linear shadows arranged in a branching or net-like configuration was identified. This was compared with the chest radiographs of the patients. There were no dysfunctions of lungs due to DPO. CONCLUSIONS: In chest radiographs of elderly men the differential diagnosis "DPO" should be given more importance.

Writing an expert report.

Anna was flustered. It had been three months since her patient had asked for a report about the accident. Anna had been procrastinating and now her patient was threatening to report her to the college if it wasn't ready by Monday. As Anna sat down at the computer, she did not know where to begin. Should she outline the history of the accident given by her patient or would any discrepancies between this history and her patient's version cause problems at the hearing? How much detail should be included about the assessment and the treatment? Anna felt uncomfortable expressing an opinion about her patient's prognosis, particularly since she had not assessed the patient in six months. Anna also wondered how much to charge for the report and whether she could insist upon payment before releasing the report. How did she ever get herself into this situation?

[CT-guided intervention by means of a laser marking and targeting aid]. / CT-gesteuerte Intervention mittels Lasermarkierungs- und Zielhilfe.

PURPOSE: The present study evaluates the use of a laser guidance system for CT-guided intervention. MATERIAL AND METHODS: 94 cases of diagnostic biopsies and lumbar sympathectomies (54 cases with laser guidance system and 40 without) were compared. RESULTS: Using the laser guidance system, the number of control scans decreased by 30 to 50%, and necessary corrections of needle location were reduced by a maximum of 30%. The average target deviation of the needle decreased to less than 5 mm in 50% of cases. CONCLUSION: The laser guidance system is strongly recommended in CT-guided interventions for quality assurance and higher efficiency. The advantage is especially marked if the target area is small.

Diagnostic value of 3D CT surface reconstruction in spinal fractures.

Our purpose was to evaluate the diagnostic value of three-dimensional (3 D) CT surface reconstruction in spinal fractures in comparison with axial and reformatted images. A total of 50 patients with different CT-proven spinal fractures were analysed retrospectively. Based on axial scans and reformatted images, the spinal fractures were classified according to several classifications as Magerl for the thoraco-lumbar and lower cervical spine by one radiologist. Another radiologist performed 3 D CT surface reconstructions with the aim of characterizing the different types of spinal fractures. A third radiologist classified the 3 D CT surface reconstruction according to the Magerl classification. The results of the blinded reading process were compared. It was checked to see in which type and subgroup 3 D surface reconstructions were helpful. Readers one and two obtained the same results in the classification. The 3 D surface reconstruction did not yield any additional diagnostic information concerning type A and B injuries. Indeed, the full extent of the fracture could be easier recognized with axial and reformatted images in all cases. In 10 cases of C injuries, the dislocation of parts of vertebrae could be better recognized with the help of 3 D reconstructions. A 3 D CT surface reconstruction is only useful in rotational and shear vertebral injuries (Magerl type C injury).