SummaryBuckground: In recent years, the interest of cardiologists has focused increasingly on the morphologic and functional changes of the left ventricle after myocardial infarction (MI), due to their great prognostic significance for the patient.H~pothesis: The aim of this study was to evaluate changes in left ventricular morphology and function during the first 6 months following MI.Metho& In all, 61 patients (17 women, 44 men, age 36-83 years) were examined with cine magnetic resonance imaging (CMRI) 1,4, and 26 weeks after myocardial infarction. Thirty-two patients had anterior MI and 29 patients had posterior MI. According to enzyme-derived infarct weight, 15 patients had small infarcts (<20 g), 19 had intermediate-sized infarcts ( 2 W O g), and 27 patients had large infarcts (>40 g). CMRI was performed in the true short axis of the left ventricle. In each examination, left ventricular end-diastolic and end-systolic volume indices (LVEDVI, LVESVI), stroke volume index (LVSVI), ejection fraction (LVEF), and regional thickness, mass, and motility of the myocardial wall-diastolic thickness (IDdia), infarct mass (IM) and motility (MOT) of the infarct area and diastolic and systolic thickness (VDdia, VDsys), muscular mass (VM), and motility (VM0T)-were determined. In addition, patients were divided into subgroups according to New York Heart Association (NYHA) functional sldtus at baseline.Results: In the total group, LVEDVI increased from 73.9 f 23.5 ml/m2t085.4-128.1 mVm2(p<0.001)andLVESVIfrom

Cine-MRI is a reliable method for the morphological and functional examination of post-myocardial infarction.

Summary.Of 95 cases which were treated for acute pancreatitis, ten developed a "regional" suppuration. With this term, we are referring to the abscess formation, apart from the organ, appearing in the region of the subphrenic and the retroperitoneal lymphatic drainage. The percentage is relative higher than that reported in current medical literature.These ten cases will be discussed subsequent to a detailed analysis of the clinical, laboratory and X-ray findings and treatment. Abscesses were found four times primarily in the retroperitoneal and six times primarily in the subphrenical space. However, the abscess was confined to its origin only in 50o/o of the cases. No relationship between the severity of the initiating pancreatitis and that of the suppuration could be found. Diagnosis is possible by correlation of the laboratory findings to those of the clinical findings. In doubtful instances, the X-ray findings prove to be an important supplement.Treatment is surgical, although anatomical limitations restrict this procedure in the retroperitoneal space. Here the prognosis, even after application of all known treatment, is considerably poorer than those abscess formations in the subphrenical space.An acute pancreatitis may be prevented or eliminated through operative sanitation of the bile passage and the chronic ulcer of the stomach or duodenum.Zusammen/assurtg. Unter 95 Kranken mit akuter Pankreatitis entwickelten zehn ,,regionale" Eiterungen. Wir verstehen darunter Abscesse im subphrenischen und retroperitonealen Lymphabflul~gebiet, abseits des Organs. Dieser Prozentsatz ist wesentlich hSher als es den Schrifttumsmitteilungen entspricht.Nach Ausffihrungen fiber die Entstehung und Ausbreitung, welter iiber die klinische, Labor-und RSntgendiagnostik sowie die Behandlung werden eingehend die eigenen Beobachtungen abgehandelt. Bei ihnen war viermal der Absce6 primer im Retroperitoneum, sechsmal im Subphrenium aufgetreten, doch blieb er nur in der H~lfte der Fi~lle auf den Entstehungsort beschr~nkt. Eine Parallele zwischen der Schwere der ursprfinglichen Pankreatitis und der sp~teren Abscedierung ist nicht nachzuweisen. Die Erkennung ist in erster Linie klinisch mSglich, in Verbindung mit einer entsprechenden Wertung der Laborbefunde. Das RSntgenbild kann von Fall zu Fall eine wertvolle Erg~nzung darstellen.

A 32-year-old man had for about four months been suffering from discomfort in the left thorax unrelated to exertion. Coronary angiography revealed a haemangioma, 40 mm in diameter, which arose from the anterior descending branch of the left coronary artery with a connecting fistula to the main pulmonary artery. The tumour could not be demonstrated by either echocardiography or computed tomography, but magnetic resonance imaging showed an inhomogeneous structure in the basal region of the interventricular septum without increased signal intensity after injection of contrast medium. The tumour was not resected because of its small size and the minor symptoms which could not be proven as being tumour related. Repeat examinations (coronary angiography and magnetic resonance imaging) at six-month intervals are planned.

No abstract