AbstractHyoscine and drotaverine effectiveness was compared for the purposes of achieving optimum distension following insufflation in CT colonography. The in vitro effects of hyoscine and drotaverine on tone and contractility of SM preparations isolated from different areas of human colon were studied by isometric registration of contractile activity. Both medications have a relaxing effect on SM preparations and inhibit their spontaneous contractions. The drotaverine-induced effects were reliably more marked than the hyoscine-induced ones. CT colonography was performed in 70 patients who were injected with equal doses of either hyoscine (n=32) or drotaverine (n=38). The degree of drug-induced distension in both groups was determined by measuring the lumen of the colon on a 2D reconstruction. In most colon areas the width of the distended lumen was greater in the drotaverine-treated patients. We concluded that drotaverine can be used as a means to facilitate colonic distension.

Background: There is a dose-dependent relationship between chronically increased cortisol levels and the number of metabolic syndrome (MetS) components. Both cortisol and MetS are linked to various brain abnormalities. Aim: To investigate an association of MetS components and salivary cortisol levels with cortical thickness in middle-aged Bulgarian patients with MetS. Materials and methods: We examined 26 healthy volunteers (mean age 50, 16±3.1 yrs) divided into two groups depending on whether or not they were diagnosed with MetS. Salivary cortisol was sampled and tested at two time points -morning and evening. Cortical thickness measures were obtained from structural T1-images using FreeSurfer software. We performed vertex-wise analysis across entire cortex and for preselected brain regions in frontal, temporal and cingulate cortex partial correlation analysis, accounting for gender. Results: The control group consisted of 12 women; in the MetS group there were 6 men and 8 women. The whole brain analysis showed that waist circumference (WC) was negatively correlated with cortical thickness in rostro-lateral area in left frontal lobe and the right lateral orbito-frontal cortex. Morning cortisol levels, accounting for sex and WC, correlated negatively with thickness in left superior temporal area (r = −0.477, p = 0.039) and entorhinal area (r = −0.465, p = 0.045) and left mediotemporal cortex (r = −0.477, p = 0.038). Conclusion: Our pilot study confirmed that WC is associated with brain atrophic changes mainly in the frontal lobe. Our finding that cortisol levels negatively correlate with thinning of the cortex in temporal lobe should be further explored in subsequent study.

AbstractThe patients’ discomfort during CT colonography determines which method is used and its frequency of use. The discomfort is largely associated with the colon’s insufflation with gas. A system for an automatic room-air insufflation has been developed that ensures a continuous and steady air insufflation and an increase in colonic pressure and enables a relatively fast decompression. This system provides constant pressure monitoring and can alert the operator, if necessary. The degree of discomfort was evaluated for 36 patients, who were subjected to manual and automated air insufflation. The degree of the colonic distension achieved by the two methods was compared. The data analysis showed a significantly lower level of discomfort in patients with automated air insufflation. The degree of colonic distension was evaluated by comparing the diameters of similar segments of the colon, as well as by the subjective opinion of the operator. The distension with automated air insufflation was higher than that with manual air insufflation. In some cases there was a significant difference (P<0,05). In conclusion, the results show that the automatic insufflation of air at room temperature can be used to optimize CT colonography.

Purpose of this presentation is to describe etiology and pathophysiology of pneumomediastinum, pneumothorax and subcutaneous emphysema, and illustrate the imaging fittures.Materials and Methods: For a period of 5 years (2012-2017), 124 traumatic patients have undergone, examined and proved through an emergency department of the University Hospital. In each of these studies, at least two imaging methods were performed to allow even minimal injuries.Results and discussion: All of these patients have undergone, examined and proved through an Emergency and Diagnostic Imaging departments of the University Hospital. The obtained results were -in 37 patients' pneumothorax, 64-pneumomediastinum, 23 subcutaneous emphysemas. Spontaneous pneumothorax/SP/, occurs in 24 patients without underlying pulmonary disease. Conclusion:Therefore, it is possible to find amount of gas in mediastinum, pleural cavity and subcutaneous tissues in many different cases; as demonstrated, these conditions could be concurrent or isolated. Radiologist must know these conditions and, most of all, recognize the degree of severity and the onset of complications.

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