Color Doppler sonography (CDS--spectral, color and power), harmonic imaging techniques (THI, PHI), possibility of 3D analysis of picture, usage of contrast agents, have raised the values of ultrasound as a diagnostic method to a very high level. THI--non-linear gray scale modality, is based on the processing of higher reflected frequencies, that has improved a picture resolution, which is presented with less artifacts and limiting effects of obesity and gases. Ultrasound contrast agents improve analysis of micro and macro circulation of the examined area, and with the assessment of velocity of supply in ROI (wash in), distribution and time of signal weakening (wash out), are significantly increasing diagnostic value of ultrasound. Besides the anatomical and topographic presentation of examined region (color, power), Color Doppler sonography gives us haemodynamic-functional information on vascularisation of that region, as well as on pathologic vascularisation if present. Avascular aspect of a focal pathologic lesion corresponds to a cyst or haematoma, while coloration and positive spectral curve discover that anechogenic lesions actually represents aneurysms, pseudoaneurysms or AVF. In local inflammatory lesion, abscess in an acute phase, CDS shows first increased, and then decreased central perfusion, while in a chronic phase, a pericapsular vascularisation is present. Contribution of CDS in differentiation of hepatic tumors (hemangioma, HCC and metastasis) is very significant. Central color dots along the peripheral blood vessels and the blush phenomenon are characteristics of capillary hemangioma, peritumoral vascular ring "basket" of HCC, and "detour" sign of metastasis. The central artery, RI from 0.45 to 0.60 and radial spreading characterize FNH. Hepatic adenoma is characterized by an intratumoral vein, and rarely by a vascular hallo. Further on, blood velocity in tumor defined by Color Doppler, distinguishes malignant from benign lesion, where 40 cm/s is a rough border value. Values of DPI (Doppler perfusion index) over 0.3 and tumor index over 1.0 characterize primary, and lower values characterize secondary liver malignancies. In differentiation of benign and malign tumors of kidneys, besides the aspect of vascularisation, the maximal frequency altitude in tumor artery (the limit around 2.5 kHz) is very important. However, peripheral and penetrating blood vessels are most usually seen in RCC, less often in AML and bigger oncocytomas. CDS with contrast agent is very useful in making differential diagnosis of the focal lesions with 95% specificity for some lesions.

UNLABELLED Acute appendicitis represents a leading cause of an abdominal pain in children which requires urgent surgical treatment. AIM OF THE STUDY To investigate into value of ultrasound (US) in diagnostics and differential-diagnostics of acute appendicitis in children. PATIENTS AND METHODS A prospective study during a two-year period, was conducted to analyse abdominal US findings in 95 patients, 3-16 years of age who had acute abdominal pain. In all patients we were checking for clinical symptoms of an acute abdomen: pain, nausea, vomiting, fever, frequent urination, diarrhea, duration of symptoms and count of leukocytes. US findings were compared with pathohistological results We have used Toshiba Sonolayer SAL 77 ultrasound machine with a convex 3.75 MHz probe and a linear 8 MHz probe. RESULTS In 50 patients sonographic diagnoses were confirmed by surgery .36 patients had other pathological conditions that lead to an acute abdomen. Nine findings were false-negative. The study results reveal that the US scanning enables not only reliable diagnosis of acute appendicitis, but also reliable differential-diagnosis of other pathological conditions and diseases. CONCLUSION US should be the imaging method of choice in diagnostic evaluation of little patients with acute abdominal pain. This method represents a great help in differential diagnosis not only to eliminate acute appendicitis but also to confirm accuracy of the diagnosis.

Magnetic resonance cholangiopancreatography (MRCP) is non invasive imaging technique able to provide projection images of the bile and pancreatic ducts. Using breath--hold and non-breath--hold acquisition techniques, have been employed in order to obtain MRCP images. Clinical applications of MRCP are evaluated from presenting references and from personal experience. The main indication for MRCP imaging was in evaluation of common bile duct obstruction, with aim of present the level, and its cause. The utility of conventional MR images to MRCP in the malignant lesion is already discussed. At the end, the utility of MR pancreatography in evaluation of the patients with pancreatic disease is discussed from both the literature and personal experiences. The clinical indications to perform ERCP in patients with pancreatic cancer may include palliative stent placement in patients with known non-resectable pancreatic carcinoma invading the common bile duct; obtaining tissue material in patients with atypical masses in the pancreatic head, particularly in the periampullary area; suspicion of intraductal neoplasm; difficult differential diagnosis between pancreatic cancer and chronic pancreatitis. The place for ERCP in future will be reserved for interventional procedures.

PURPOSE The aim of this study is to show the possibilities of MRI in diagnostic of the spleen affections. MATERIAL AND METHODS During a two years period, MRI of the splen alone was performed in 13 patients, while MRI of the liver was performed in 213 patients. With the liver, we examined the spleen as well. Using 1.0T Unit (Siemens Magnetom Impact) we performed next sequences: T1W SE, T2W TSE FS, PD T2W, with and without breath hold. Rutinly we used body coil. We divided all patients in two groups: 1st group--13 patients undergoing spleen examination, and 2nd group--213 patients with liver and spleen examination with retrospective analysis. RESULTS In the first group--10 patients, MRI of the spleen provided us with some new information compared with CT and US. In three patient there were no new diagnostic information. In second group, accidently showed cystic postraumatic lesions, there was trombotic aneurysm of the lienal artery. Also in the patients with liver disease spelnomegaly was found in 25. DISCUSSION According to the literature and our initial experience, MRI of the spleen is not yet in wide clinical practice because of the little difference of the relaxation time of the spleen and proton density. Introducing of the paramagnetic contrast media will provide increasing of abilities in the detection of the tumor lesion. Further development advances towards diagnostic of the lymphatic infiltration, staging of metastatic carcinoma, and differential diagnostic of splenomegaly. CONCLUSION According to our experience and literature, MRI of the spleen is not yet in wide clinical practice, for now.

UNLABELLED The aim of the study is to analyze the frequency of the congenital anomalies of the digestive tract in the period of 1993-1998. The patients and methods: Our group included 67 patients (47 males and 20 females; age range 1-12 months) suspected of digestive tract anomalies. First, all of them have been examined by pediatric surgeon. At the first place, we used the most conventional radiological procedures for digestive tract examination. They were followed by US in cases with suspicion on hypertrophic pyloric stenosis and biliary atresia (bile-duct atresia). CT and MR were performed in patients with anorectal anomalies. In cases with suspected associated anomalies of other organs, intravenous urography and chest radiography were used. RESULTS Congenital anomalies and abnormalities of the digestive tract were diagnosed in 25 patients. The most frequent anomaly was hypertrophic pyloric stenosis (n = 14), followed by invagination (n = 12) and megacolon congenitum (n = 9), all predominant in male sex. All radiological findings we confirmed at surgery (100%). CONCLUSION Conventional radiology is still extremely useful in the diagnosis of the digestive tract anomalies; also US revealed to be essential in the diagnosis of the hypertrophic pyloric stenosis and the intestinal invagination. Recognition of the associated anomalies should lead to application of the other examination techniques like CT and MR. MR might be useful in the anorectal malformations and hepatobiliary tract anomalies, but we have no experience in that field, till now.

During the war, June 1992,-August 1994, at the Institute 20 percutaneous fluid collections and abscesses drainages in the belles were done, controlled by the CT. The percutaneous drainage we started in 1984, until now we had 141 cases, 20 cases in the war time, 14 of them were wounded, while the rest was suffering from a malignant process in stomach, pancreas, kidneys. Both groups had post-operative complications after liver injuries. 7 underwent the percutaneous drainage. The length was 1-64 days, drainage contents quantity was 60-5.000 m. The drainage was successful with 14 patients, while in 5 cases we had to repeat, change the catheter place. Only with 1 patients the drainage was not done, but an aspiration. The contents were send to microbiologic analysis. It was a retro-peritoneal abscess collection. Based on our ten-years experience, we are of an opinion that the CT controlled percutaneous drainage is a very efficient, simple and acurata urgent radiology procedure. According to our experiences, nearly all cases were successful.

In the retrospective study, 210 patients with diagnosed bronchogenic carcinoma have been managed during four years period. In this group there were 23 patients with abdominal metastases; 21 with liver metastases and 2 with adrenal metastases. Abdominal metastatic lesions were diagnosed by ultrasonography and CT. With the patients with liver metastases, 4 of them had solitary lesion, and remaining 17 patients had multiple metastases. In the same group, 8 patients had planocellulary cancer, 5 microcellulary cancer, 3 had confirmed anaplastic cancer, and 5 patients were without pathohistologically confirmed findings. In one case of adrenal metastases planocellulary cancer was found, and in another case of adrenal metastases pathohistological diagnosis was unknown. The authors concluded that ultrasonography and CT were the methods of choice in diagnostics liver and adrenal glands metastases with the patients with bronchogenic carcinoma.

Percutaneous transthoracic aspiration biopsy (PTAB) is an interventional radiologic procedure for histologic confirmation or elimination of malignant nature of the lesion. The development of digital techniques (introduction of CT and US) and small gauge needles increased the interest for this method. CT scanner enables the accurate determination of the entry point of the puncture guide, precise visualisation of the needle tip and reliable analyses of complications. The type of the puncture needle is very important for establishment of the correct diagnosis. Of 163 Chiba needle punctures the cytologically representative samples were obtained in 84.7% and pathohistologically representative samples in 56%. Of complications the most common was pneumothorax found in 9.7% and alveolar hemorrhage in 9.1% cases. In this paper the method and contribution of the Chiba needles are analysed compared to the results of other authors obtained by other types of needles. Our results are satisfying with small number of complications.

The advantages of echography (EG) in the follow-up of morphologic and structural changes of cholecyst are wellknown. In this paper we tried to prove the possibilities of echography in the evaluation of cholecyst contractility as the reflection of its function. In 70 patients peroral cholegraphy (POH) and EG were performed simultaneously. In POH the congruence of contraction intensity evaluation, made visually and measured, was present in 74.3% of the cases, and EG in 71.4%. In relation to visual evaluation, the measurements in cm proved to be reliable. The evaluation of cholecyst contractility by measurements in cm was statistically congruent in POH and EG. According to the results of investigation, the measurements of cholecyst length and width in the left oblique position were more reliable. The total length was a more constant measure of cholecyst size. The contractility was satisfactory if 1/3 of total width (a) and length (b) was approximately equal to the total of width and length before (A) and after (B) stimulation. This can be expressed by the following formula: K 1/3 (a+b) A (a+b) - B (a+b). The echographic evaluation of contractility can be used as an additional procedure to cholecyst investigation and that it can replace POH completely.

CT-guided percutaneous transthoracic aspiration biopsy presenting one of interventional radiologic procedures, has enabled the sample providing for cytologic analysis. It has been frequently used with the aim of confirmation or elimination of malignant neoplastic process. The main advantages of CT over fluoroscopy are precise needle visualization, documentation of needle tip in the lesion, puncture of small, for fluoroscopy unreachable lesions, as well as the adequate presentation of eventual complications. The authors have analysed, retrospectively, 195 findings of patients, who underwent CT-guided Chiba needle percutaneous transthoracic aspiration biopsy. The finding was cytologically representative in 85.64% of cases, unrepresentative in 14.36%. Out of all complications, pneumothorax (9.74%) and perifocal hematom (9.23%) were most frequent. Contraindications, complications and safety of this very useful method in definitive diagnosing and planning of the adequate therapy have been discussed.

Since 1984, intraarterial infusion chemotherapy (IAC) has been practised at our Institute. Patients with irresectable, previously untreated abdominal neoplasms were treated with intraarterial regional chemotherapy and radiation therapy after that. The objective remission rate was 40%, and a subjective response was observed in 90% of all cases.