The tibial fracture apt to be encountered many complicationa including delayed or non-union. Many authors reported aeveral methods of early detection of the complication. Among them, it has been known that interoeseous phlebography is one of the simplest and valuable method to predict the delayed or non-union. Puranen and Kaski(1974) reported that the osteomedullography was valuable in early detection of delayed union and in deciding whether a bone graft is indicated. We performed ostemedullogram in the cases of tibial fracture since July, 1974. In this paper, we presented the caaes which showed unusual findings, and dicussed the method of evaluation of these findings. The results obtained as follows; 1. The positive Kaski signs did not always mean the completness of union of fracture. It only indicated that the union was going on. 2. Even in cases in which Kaski signs are positive, the final decision for bone graft have to depend upon the clinical and physical findings and simple roentgenogram. 3. The negative Kaski signs did not always mean the possible development of delayed or non-union. Usually it indicated only delaying of union, and the treatment should not solely depend on only the osteomedullographic findings. 4. Even in cases in which bridging callus is well formed around both fracture ends, also in cases of solidly united fracture Kaski signs were sometimes completely negative. This osteomedullography is clinically easily to apply in all cases of tibial fracture, and give us a lot of information concerning with fracture healing. We have to pay attention to the false nagative cases. In those cases we have to depend more on clinical test and simple roentgenogrm.
Bony Callus ; Fracture Healing ; Methods ; Phlebography ; Tibial Fractures ; Transplants

Epidural venography is a relatively simple and highly accurate method in the diagnosis of lumbar disc herniation. Angiographic visualization of the epidural vein has been tried and investigated by intraosseus injection of contrast agent into lumbar spinous process and intravascular injection into iliac vein since first report in 1954. Recently, lumbar epidural venography is instituted by selective catheterization of ascending lumbar vein or internal iliac vein. Lumbar epidural venography is valuable for the diagnosis of herniated lumbar disc, not demonstrated by myelography. Especially, lumbar epidural venography is more accurate than myelography in the diagnosis of L5-Sl disc herniation and in the case of extreme lateral herniation. Other advantages of epidural venography are low incidence of complication and ease of performance. Epidural venography may be recommended as an alternative rnethod rather than as adjunctive to myelography. We report 20 cases of epidural venography, compared with myelographic and operative findings.
Catheterization ; Catheters ; Diagnosis ; Iliac Vein ; Incidence ; Methods ; Myelography ; Phlebography ; Veins

There was a development of the diagnostic aids such as electromyography, discography, epidural venography, myelography, and CT in lumbar disc herniation. In 1984, Edgardo et al. described that the diagnosis of unusual extreme lateral disc herniation might be suggested by CT, but the diagnosis was made more certain with CT done after discography. Also, in 1986, Michael et al. reported,that the addition of CT to lumbar discography could help the clinician to obtain an anatomically valid diagnosis in people who, in spite of prior negative diagnosis evaluation, continue with significant clinical symptoms of low back pain and sciatica. The authors have studied 25 cases of CT after discography from July 1984 to June 1987. The results were as follows;1) CT after discography, which was a diagnostic method of direct visualization of nucleus pulposus herniation, shown same finding as previous CT in 16 cases and more accurate finding of herniated site snd size in 2 cases. 2) In one csse, the diagnosis of extreme lateral disc herniation, which was suggested by previous CT, made more certain with CT after discography. 3) There was false negative in 6 cases.
Diagnosis ; Electromyography ; Low Back Pain ; Methods ; Myelography ; Phlebography ; Sciatica

OBJECTIVETo evaluate the value of double source multidetector computed tomography (MDCT) in visualization of cardiac veins in patients with chronic heart failure.

METHODSThirty-five patients with chronic heart failure (aged 65.4 ± 8.8, 21 males and 14 females) were enrolled in the study. In Group A, MDCT and retrograde coronary venography (RCV) were performed consecutively; in Group B anterograde visualization of the coronary venous and RCV were performed.

RESULTSCoronary sinus, GCV and MCV of all individuals were identified in MDCT. LVPV was observed in 65% patients of Group A, and 66.7% patients of Group B. The correlation coefficient between MDCT and RCV was 0.944, and that between CVG and RCV was 0.42.

CONCLUSIONNon-invasive evaluation of cardiac veins with double source CT is feasible and may be used in cardiac resynchronization therapy.

Aged ; Coronary Angiography ; methods ; Female ; Humans ; Male ; Middle Aged ; Phlebography ; methods ; Tomography, Spiral Computed ; methods

Myelography is widely used fo radiological diagnosis of herniated lumbar disc. But the diagnositc accuracy isonly about 84% with range of 67 to 100% with many cases of false negative and equivocal cases. In cases of extremelateral disc herniation and short cul de sac or wide epidural space, even quite a large disc herniation cannot bedetected to myelography. But with epidural venography these defects of myelography can easily be over come. 52cases of epidural venography were performed in department of Radiology of Capital Armed Forces General Hospitalduring the 20 months from May 1979 to Dec. 1980. And the findings were compared with those of myelography andoperative results. The results are as follows; 1. Of 52 cases, satisfactory opacification was obtained in 48 cases(92.3%). 2. Single vein injection was adequate for satisfactory opacification in 40 cases (76.9%). 3. There were 2cases of retroperitoneal extravasation of contrast media, but the patient recovered without difficulty. 4. Of 24cases operated, the venographic finding was confirmed in 21 casesa (87.5%) and of the 48 cases adequatelyopacified, there were only 3 cases of confirmed diagnostic error and so the error rate is only 6.25%. 5. Abnormalfindings of myelography were exactly reproduced on epidural venography and many cases with equivocal or normalmyelographic findings were accurately diagnosed with epidural venography. 6. In cases of total block, epiduralvenography was very useful for evalutaion of the caudal portion. So lumbar epidural venography is very useful notonly as an adjunctive method to myelography, but also as the first diagnostic procedure for herniated disc, forthe procedure is simple and the diagnostic accuracy is very high.
Arm ; Diagnosis ; Diagnostic Errors ; Epidural Space ; Extravasation of Diagnostic and Therapeutic Materials ; Humans ; Intervertebral Disc Displacement ; Methods ; Myelography ; Phlebography ; Veins

OBJECTIVE: To explore the effect of direct multi-slice computed tomography venography (MSCTV) on Cockett's syndrome. METHODS: The imaging features of Cockett's syndrome diagnosed by direct MSCTV were retrospectively analyzed. The iliac vein compression tube segments were reconstructed axially. The ratio of the diameter of the lumen of pressure sections was calculated, and the boundary value was 1:3. According to the deep vein thrombosis, these data were divided into I-III types, the various therapeutic schemes were worked out, and the therapeutic effects were evaluated by the difference in diamete of lower limb before and after the treatment and 6-month follow-up. RESULTS: Thirty-five patients with Cockett's syndrome were diagnosed by MSCTV, 5 of which were Type I, characterized by local mild compression with the left common iliac vein, diameter ratio > 1/3, with distal vein dilation or without collateral pathway, and conservative treatment adopted. Nineteen were Type II, with significantly narrow lumen, obviously oppressed wall, diameter ratio ≤ 1/3, and intervention programmes adopted. Five out of the 19 adopted routine simple balloon dilatation, and the other 14 had stent implantation. Eleven were Type III, with obvious venous lumen stenosis or segmental occlusion, contrast agent missing in narrow department or contrast medium like a thin line through both ends of the tube, meanwhile companied with different degrees of thrombosis, and thrombolytic therapy and stent implantation were carried out. All 35 patients recovered after the treatment, 1 with recurrent thrombosis in the femoral vein after 6 months, while the others had no clear signs of recurrent thrombosis and re-stenosis. There was no pulmonary embolism. CONCLUSION Direct MSCTV can diagnoze the Cockett's syndrome accurately and assess the compression degree of the internal iliac vein and the lesion of vascular branches.
Adult ; Aged ; Angioplasty, Balloon ; methods ; Female ; Humans ; Iliac Vein ; diagnostic imaging ; Male ; May-Thurner Syndrome ; diagnostic imaging ; therapy ; Middle Aged ; Multidetector Computed Tomography ; methods ; Phlebography ; methods ; Stents

OBJECTIVETo optimize scan delay time of multi-slice spiral CT portal venography (MSCTP) using test bolus injection.

METHODSSixty individuals with no hepatic diseases were randomly divided into 4 groups (A, B, C and D). The time-density curves (TDC) of the portal vein (PV) were acquired by test bolus (15 ml, 5 ml/s) at the level of liver hilus. In the 4 groups, the MSCTP were delayed for 4, 6, 8 and 10 s according to the peak time of TDC, respectively. The maximum CT value of the portal vein and liver parenchyma were recorded. The maximum intensity projection (MIP) and volume rendering (VR) were employed for three-dimensional reconstruction and the image quality of the 4 groups was estimated.

RESULTSThe average peak time of healthy individuals ranged between 24 and 32 s (95% confidence interval) by means of the test bolus (15 ml). Group C (delay time of 8 s) had a much better image quality of the portal vain than the other groups, and the small branches of the portal vein (6th and 7th orders) were clearly visualized; the major portal vein branches (1st to 4th orders) were also enhanced with sharp edges. Although the hepatic vein was also observed in the portal venous phase in group D, the details of the portal vein on the hepatic edge were distinct and well defined.

CONCLUSIONAt the injection rate of 5 ml/s, the optimum scan time delayed is 8 to 10 s in normal individuals according to the peak time of the test bolus.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Phlebography ; methods ; Portal Vein ; diagnostic imaging ; Reproducibility of Results ; Time Factors ; Tomography, Spiral Computed ; methods ; Young Adult

Gross hematuria secondary to vesical varices is an unusual presentation. We report such a case recurrent gross hematuria in a male patient who had a history of bladder substitution with ileal segments that had been treated by balloon-occluded percutaneous transhepatic obliteration of vesical varices.
Balloon Occlusion/*adverse effects ; Contrast Media/diagnostic use ; Embolization, Therapeutic/*methods ; Hematuria/*etiology ; Humans ; Male ; Middle Aged ; Phlebography ; Recurrence ; Tomography, X-Ray Computed ; Varicose Veins/*complications/*therapy

Superior vena cava (SVC) obstruction is associated with the gradual development of venous collaterals. We present a rare form of systemic-to-pulmonary subpleural collateral pathway that developed in the bridging subpleural pulmonary veins in a 54-year-old woman with complete SVC obstruction. This uncommon collateral pathway represents a rare form of acquired right-to-left shunt due to previous pleural adhesions with an increased risk of stroke due to right-to-left venous shunting, which requires lifelong anticoagulation.
*Collateral Circulation/physiology ; Female ; Humans ; Middle Aged ; Multidetector Computed Tomography ; Phlebography/methods ; Pulmonary Veins/physiopathology/*radiography ; Stroke/complications ; Superior Vena Cava Syndrome/physiopathology/*radiography ; Veins/physiopathology

Internal jugular vein saccular aneurysms are rare. Surgical management is indicated when there is a risk of rupture. We recommend a hybrid procedure combining endovascular and open techniques. We report the case of a 77-year-old female patient with a saccular aneurysm of the internal jugular vein, which was excised with combined endovascular and vascular techniques.
Aged ; Aneurysm ; diagnosis ; surgery ; Angiography, Digital Subtraction ; Diagnosis, Differential ; Female ; Humans ; Jugular Veins ; diagnostic imaging ; surgery ; Phlebography ; Tomography, X-Ray Computed ; Vascular Surgical Procedures ; methods