Radiologicka Klinika

Hradec Králové, Czech Republic

Radiologicka Klinika

Hradec Králové, Czech Republic
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Flogelova H.,Detska Klinika | Staskova L.,Detska Klinika | Michalkova K.,Radiologicka Klinika
Cesko-Slovenska Pediatrie | Year: 2017

The risk factors for recurrent urinary tract infection vary by age and thus, the diagnostic and treatment approach should vary accordingly. Whereas the main risk factor in children under 2 years of age is vesicoureteral reflux, in girls able to control their voiding (older than 3 years of age), recurrent urinary tract infection is more frequently caused by lower urinary tract dysfunction. At this age, noninvasive urodynamic testing is preferred to voiding cystourethrography. The former comprises filling in an intake and voiding diary for 2-4 days, measuring bladder wall thickness and post-void residual volume, and uroflowmetry. Based on noninvasive urodynamic testing results, daily measures and/or medication therapy are recommended.


Mihal V.,Ustav molekularni a translacni mediciny | Maly T.,1. chirurgicka klinika | Michalkova K.,Radiologicka klinika
Pediatrie pro Praxi | Year: 2016

Handlebar injuries are one of the most common causes of abdominal injuries in children. Early diagnosis and optimal care without delay may help to reduce the morbidity of injuries to the internal organs. Children with abdominal handlebar injuries should be treated with great care. We describe a young girl presented after a bicycle accident having received a sharp blow from her handlebars to just below her left costal margin. She was admitted for observation and for her primary investigation. After becoming peritonitic, her pancreatic amylase and lipase increased to 3,57 μkat/l and 16,37. Axial CT scan showed transection of the pancreas. An endoscopic retrograde cholangio-pancreatography (ERCP) confirming ductal transection. In quest of bridging the pancreatic duct and securing drainage of pancreatic juice, a pancreatic stent was placed preoperatively. Due to complete transection of the pancreas body with simultaneous interruption of the pancreatic duct, distal pancreatectomy was performed with the spleen saving. The patient recovered well and 12 weeks later, after the stent was removed, there was no evidence of pancreatic stricture.


Strelinger J.,Otorinolaryngologicke oddelenie | Klepanec A.,Radiologicka klinika | Veselkova J.,Otorinolaryngologicke oddelenie
Lekarsky Obzor | Year: 2015

Intractable posterior epistaxis represents emergency, which can attempt the life of patient. Historically, after failure of anteroposterior nasal packing, ligation of artery was done by open way. With development of endoscopic sinus surgery and interventional radiology, less invasive techniques are recommended as efficient treatment. The authors' present case of intractable posterior epistaxis successfully treated with embolization therapy and discuss actual trends of treatment. After failure of classical modalities (nasal packing, epistats) endoscopic treatment with selective intraarterial embolization as its alternative is preferred.


Zbrozkova L.B.,Radiologicka Klinika | Halek J.,Novorozenecke Oddeleni | Michalkova K.,Radiologicka Klinika | Herman M.,Radiologicka Klinika
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2017

Aim: The analysis of ultrasonographic and MRI brain findings in term neonates with hypoxicischemic encephalopathy refer red for therapeutic hypothermia. Material and methods: The study included 39 neonates (25 boys and 14 girls). In 32 cases (82%) US was done during the therapeutic hypothermia, in seven cases (18%) after it 's completition. The brain MRI was performed after the therapy in all cases. Subsequently the results from the imaging methods were analyzed. Results: The most com mon pathological US findings were low value of the resistive index (53.1% during the hypothermia, 42.9% after it's completition), the basal ganglia and thalamus injury (15.6% during the hypothermia, 28.6% after it's completition) and diffuse increased echogenicity of the brain parenchyma (12.8% during the hypothermia). The dominant findings on the brain MRI were the basal ganglia and thalami injuries (82.1%), followed by cortical and subcorticallesions (35.9%) and changes of the posterior limb of the internal capsula (30.8%). The haemor rhage occured in high percentage (35.9%). Conclusion: Pathological US brain findings in neonates with hypoxic-ischemic encephalopathy performed during the therapy and after the treatment were present in 68.7% and 57.1%, resp. MRI examinations depicted pathology in 82.1%.


Introduction: Temporal bone fractures are traditionally classified as transverse, longitudinal or mixed (according t. The direction of fracture). However, this classification has shown little association with clinical symptoms and later progressive symptomatology, and therefore a new classification system has been introduced based on High-Resolution Computed Tomography. It include. The involvement of all parts. The temporal bone (processus mastoideus, pars squamosa, pars tympanica, pars petrosa) and involvement or sparing. The otic capsule (vestibule, cochlea, semicircular canals). Methods: We carried out a retrospective analysis of 89 patients with a fracture. The temporal bone using high-resolution computed tomography scans taken i. The period from January 2003 to September 2013. We compare. The correlation betwee. The new classification of fractures. The temporal bone an. The clinical symptoms. Results: Involvement. The petrous bone was associated with a higher incidence of sensorineural hearing loss, especially in patients with fractures affectin. The otic capsule. In these cases, we found severe hearing impairments or deafness. The patients with petrous fracture affectin. The otic capsule showed a higher incidence of facial palsy. The occurrence of dizziness, tinnitus and perforation of tympanic membrane was higher in petrous fractures, especially whe. The otic capsule was involved. There were no significant differences between non-petrous and petrous fractures in terms. The occurrence of otorrhoea and hemotympanum. Conclusion: The new classification of fractures according t. The involvement of individual parts. The temporal bone has a better correlation with clinical symptoms.


This article deals with the diagnostics of axillary lymph nodes and status of core-needle biopsy in the diagnostic algorithm of breast cancer. Ultrasonography is still considered as the basic method for investigation of lymph nodes. This article describes the normal appearance of lymph nodes and their suspicious or pathological appearance. Suspect and unclear findings of lymph nodes are followed by ultrasound-guided core-needle biopsy. The technical implementation of this biopsy is simple and safe with adequate knowledge and the awareness of possible complications. In case of unclear lymph nodes, their histological verification determines the following treatment.


Kocova E.,Radiologicka Klinika | Elias P.,Radiologicka Klinika
Ceska Radiologie | Year: 2015

Incidence and prevalence of idiopathic pulmonary fibrosis are increasing. The integral part of diagnostics of idiopathic pulmonary fibrosis is high resolution computed tomography. Radiological image of idiopathic pulmonary fibrosis is usual interstitical pneumonia. On high resolution computed tomography are changes of typical usual interstitial pneumonia, possible usual interstitial pneumonia or signs which are not typical for usual interstitial pneumonia. There was made uniform scoring system which is quite simple and reproducible.


Maly R.,Subkatedra Angiologie I. Interni Kliniky | Chovanec V.,Radiologicka Klinika
Vnitrni Lekarstvi | Year: 2010

Peripheral arterial disease (PAD) is a disease characterised by narrowing and blockade of peripheral arteries, usually based on underlying obliterating atherosclerosis. According to the results of large epidemiological studies, the risk of PAD in patients with diabetes me-PADtus (DM) is fourfold higher compared to non-diabetic population. Patients with DM and PAD have a high risk of cardiovascular morbidity and mortality. Diabetes worsens the prognosis of patients with PAD; the onset of PAD in diabetics occurs at an earlier age, the course is faster than in non-diabetic patients and the disease is often diagnosed at its advanced stages. All these factors reduce the likelihood of revascularisation in DM patients with PAD. A range of factors (higher age, arterial hypertension, smoking, obesity, hyperfibrinogenaemia, insulin resistance etc.) contribute to the development of PAD in DM. Diabetes control is an independent risk factor of PAD as every 1% increase of hemoglobin A1C is associated with 28% increase of PAD. There are different clinical signs of PAD in diabetic and non-diabetic patients. In addition to the history of claudications, PAD diagnostic criteria include the presence of murmur over the large arteries, signs of chronic ischemia on the skin and distal ulcerations and gangrene. Among the imaging techniques, non-invasive investigations including Doppler pressure measurement, ankle brachial pressure index, color duplex ultrasonography, plethysmography, transcutaneous tension measurement, MR and CT angiography are preferred. Ankle brachial pressure index measurement is the easiest and the main investigation technique. The key principles of PAD treatment in diabetic patients include modification of risk factors, pharmacotherapy and revascularisation interventions aimed at improving clinical signs and prevention of cardiovascular morbidity and mortality. Antiplatelet treatment may prevent PAD progression and reduce cardiovascular events in DM patients. Early diagnosis of PAD in DM patients, rigorous prevention and aggressive management of the risk factors may significantly impact on the high incidence of amputations and decrease cardiovascular morbidity and mortality.


Mihal V.,Ustav Molekularni a Translacni Mediciny | Neklanova M.,Detska Klinika | Michalkova K.,Radiologicka Klinika
Pediatrie pro Praxi | Year: 2016

Whilst pituitary adenomas are the most common cause of a sellar mass, there is a number of other neoplastic, infection, inflammatory, developmental and vascular aetiologies that should by considered by the radiologist. Intracranial lipomas are rare developmental lesions that occur because of abnormal differentiation of embryogenic meninges. We describe and illustrate a 7-year-old boy with suprasellar lipoma associated with fever-induced convulsions in course of respiratory infection. Intracranial lipoma was demonstrated with magnetic resonance imaging.


The musculoskeletal system is one of the major regions, where changes caused by diabetes mellitus (DM) are often encountered causing severe impairment of the quality of patients' lives. These changes have therefore become an important focus of diagnostic and therapeutic procedures, with imaging methods - both plain radiography, computed tomography (CT), magnetic resonance imaging (MRI) and to a lesser extent ultrasound (US), being their cornerstones. In the article the images of musculoskeletal (MSK) manifestations of diabetes mellitus are presented, structured into changes directly caused by DM, metabolic consequences of DM, syndromes with increased coincidence with DM and septic complications. The CT, MRI and radiographic images of both initial and extensive changes are being displayed as well as evolution of the changes in a radiographic series. The concerning pathophysiologic remarks are only basic, as they are not the primary focus of radiodiagnostics. In conclusion it is stated, that imaging of the MSK system in diabetic patients is a large issue in radiologic units serving internal medicine departments, that the imaging methods should be applied specifically and that the radiologic findings influence further management of the patients in many respects, but also, that in some diagnostic questions, namely concerning septic complications of the diabetic foot, a fully reliable and unequivocal interpretation is not always possible.

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