Introdução: O desenvolvimento da radiologia digital e da tomografia computadorizada de feixe cônico (TCFC) permitiu aos profissionais diferentes formas de avaliação das imagens. Entretanto, frente a materiais metálicos, é observada a formação de artefatos tanto na imagem tomográfica, quanto nas radiografias digitais após a aplicação de filtros de processamento. Objetivo: Esta pesquisa objetivou investigar a interferência provocada por materiais metálicos na avaliação da interface osso/implante em radiografias periapicais convencional e digital, e em TCFC. Materiais e Métodos: Foram inseridos implantes de titânio em 74 blocos de costelas bovina frescas. Em 37, a inserção foi em íntima relação com as paredes ósseas (Grupo Controle-GC) e nos outros 37 com um espaço de 0.125 mm (Grupo Teste-GT). As radiografias periapicais foram realizadas com filme convencional e dois sistemas digitais de placa de fósforo. As imagens volumétricas foram adquiridas em dois equipamentos de TCFC. Nos sistemas digitais as imagens foram investigadas com e sem a utilização dos filtros e, nas tomografias, com diferentes protocolos de aquisição. Três examinadores treinados e cegados realizaram a avaliação utilizando uma escala Likert de cinco pontos. Foram utilizados testes de sensibilidade, especificidade e acurácia (área sob a curva ROC) e teste de concordância de Kendall (W). Resultados: Na avaliação radiográfica (ARTIGO I), foi observada maior acurácia do exame convencional e das imagens do sistema VistaScan com filtros Caries2 e Endo e do sistema Express com filtro Sharpen3 na detecção da justaposição entre osso e implante. Na avaliação tomográfica (ARTIGO II), somente as imagens do tomógrafo i-Cat com a resolução de voxel de 0.125mm não apresentaram diferença significativa com a radiografia convencional na acurácia diagnóstica. Conclusão: Na avaliação radiográfica da justaposição entre o osso e o implante, preferência deve ser dada às radiografias convencionais ou às digitais com filtros de realce (Caries2, Endo e Sharpen3). Em caso da existência de exames de TCFC com voxel 0.125 mm, tal avaliação também pode ser realizada. / Introduction: The development of digital radiology and computed tomography cone beam (CBCT) enabled professionals different possibilities of images evaluation. However, when metallic materials are present, artifacts formation can be observed in tomographic images and in digital radiography after processing fiters. Objective: This study investigated the interference caused by metallic materials in bone/implant interface evaluation with conventional and digital periapical radiographs, and CBCT. Materials and Methods: Titanium implants were placed into 74 fresh bovine ribs. In 37, the implants were in close relation with the bone walls (Control Group-CG) and the remaining 37 ribs preparations promoted a 0.125 mm space (Test Group-GT) .The periapical radiographs were taken with conventional film and digital photostimulable phosphor plate (PSP) system of two commercial brands. The volumetric images were acquired in two CBCT equipment. The digital images were investigated with and without the use of processing filters available and the tomographic with different acquisition protocol. Three trained and blinded examiners performed the evaluation using a five points Likert scale. Sensitivity, specificity and accuracy (area under the ROC curve) tests were used and Kendall´s coefficient of concordance (W). Results: In the radiographic evaluation (Article I), there was a higher accuracy to detect the juxtaposition between bone and implant with the conventional radiography and the images of VistaScan system using the Caries2 and Endo filters, and Express system with Sharpen3 filter. In the tomographic evaluation (Article II), only the images with 0.125mm of voxel resolution from i-Cat CBCT showed no significant difference with conventional radiography in the diagnostic accuracy. Conclusion: In radiographic evaluation of juxtaposition between bone and implant preference should be given to conventional radiographs or in digital radiographs to Caries2, Endo and Sharpen3 enhancement filters. In case of the existence of CBCT exams (voxel 0.125mm), such evaluation can also be performed.

Orientador: Frab Norberto Bóscolo / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-17T23:04:36Z (GMT). No. of bitstreams: 1 Albuquerque_DanielleFrotade_D.pdf: 3639420 bytes, checksum: f2c8c2f012430b9c46964ac0f6fb9ebb (MD5) Previous issue date: 2011 / Resumo: A Tomografia Computadorizada (TC) de feixe cônico é indicada para avaliar a morfologia óssea da articulação têmporomandibular (ATM). O objetivo dessa pesquisa é avaliar diferentes protocolos de aquisição no diagnóstico de alterações ósseas da ATM através da TC de feixe cônico. A amostra foi constituída de 30 cabeças de mandíbula. Perfurações foram confeccionadas em diferentes regiões (medial, central e lateral) das superfícies das cabeças de mandíbulas, variando no tamanho, que simulam alterações ósseas na ATM. Essas mandíbulas foram submetidas à exame de TC feixe Cônico (Cone Beam i-Cat Imaging Sciences International, Hatfield, Pennsylvania, EUA) no protocolo de aquisição 1 (voxel de 0,4mm, tempo 20 segundo, FOV de 6cm, 18,45mAs e 120Kvp) e 2 (voxel 0,25mm, tempo de exposição 40 segundo, FOV 6 cm, 36,12 mAs e 120Kvp) As imagens foram formatadas, impressas em filme e avaliadas por dois examinadores. Foi aplicado a estatística de Kappa e teste de validade (especificidade e sensibilidade). Os resultados foram obtidos com a comparação entre as avaliações dos examinadores e os defeitos confeccionados. Os valores de Kappa encontrados, independente da área, no protocolo 2 (Kappa=0,241; Kappa=0,109) foram maiores que no protocolo 1 (Kappa=0,221; Kappa=0,058) para os dois examinadores, mas sem diferenças estatísticas significantes. Quando se avaliou as regiões separadamente, a maior concordância observada foi na região central, nos dois examinadores, no protocolo 1 (Kappa=0,378 e Kappa=0,270) e no protocolo 2 (Kappa=0,426 e 0,379). Concluíu-se que os protocolos avaliados podem ser usados para a observação de alterações na cabeça da mandíbula, contudo o protocolo 2 pode ser indicado para avaliação mais detalhada dos defeitos ósseos e que houve dificuldade em detectar defeitos muito pequenos, menores ou igual a 0,9mm / Abstract: Cone beam computed tomography (CT) is recommended to assess TMJ bone morphology. The aim of the present study was to evaluate different acquisition protocols of cone beam CT for the evaluation of simulated mandibular condyle bone lesions. Thirty macerated condyle were used. Spherical lesions were created in different regions (medial, central and lateral) of the condyles' surface, varying in size, which simulated bone changes in the TMJ. Condyles were submitted to cone beam computed tomography (Cone Beam i- Cat Imaging Sciences International, Hatfield, Pennsylvania, USA). The images were formatted and printed on film and subsequently evaluated by two examiners. The statistical tests used were the Kappa statistics and test validity (sensitivity and specificity). It was observed that when comparing the examiners with the gold standard, regardless of the area, the Kappa values observed for Protocol 2 (Kappa = 0.241, Kappa = 0.109) were higher than those for protocol 1 (Kappa = 0.221, Kappa = 0.058 ) for both examiners, but were not statistically different. When evaluating the individual regions, the highest agreement between both examiners was observed in the central region in protocol 1 (Kappa = 0.378 and kappa = 0.270) and protocol 2 (Kappa = 0.426 and 0.379). It can be concluded that both protocols evaluated proved to be reliable for the observation of defects in the condyle. However, protocol 2 can be recommended for further evaluation of bone defects, and very small defects, 0.9mm or smaller, were difficult to detect with this technique / Doutorado / Radiologia Odontologica / Doutor em Radiologia Odontológica

Made available in DSpace on 2014-07-29T15:07:40Z (GMT). No. of bitstreams: 1 Dissertacao Rejane G Ribeiro.pdf: 961686 bytes, checksum: ac38658942354e4c11c4b5ca7d58796c (MD5) Previous issue date: 2012-02-16 / In the last years, the interest for the study of the Brazilian fauna s animals has been increasing considerably as a result of the risk of extinction or aiming for the control of the diseases, specially the zoonoses. The Coati (Nasua nasua) is an exclusive species of South America, classified as vulnerable in some states of Brazil. In spite of its large distribution and importance, the data about its ultrasonographic anatomy was not found in the literature. The use of ultrasonographic examination in veterinary medicine is largely disseminated as a way of complementary diagnostic because it offers, as a non-invasive way, information about the organs anatomy and morphophysiology. Although ultrasonography is a largely disseminated complementary diagnostic method in the clinical routine of little animals, there are few accounts in wild animals. The aim of this study was to describe, in a comparative way, the ultrasonographic features and the topography anatomy of coatis liver, kidneys, adrenal glands, ovarian, pancreas, gastrointestinal tract, urinary vesicle, spleen and uterus, and establish reference values to measure the kidneys, urinary vesicle wall and the gastrointestinal tract, contributing in this way with scientific material to the ultrasonography learn in this species. It has been used seven adult and healthy coatis originating from the Wild Animals Selection Center WASC, in which it was realized scannings and transversal, longitudinal and coronal cuts of all the abdominal organs being studied. It was verified that the abdomen ultrasonographic examination of the coatis can be realized following the one that is advocated for the dog and for the cat. / O interesse pelo estudo de animais da fauna brasileira vem crescendo consideravelmente nos últimos anos, seja em decorrência do risco de extinção ou visando o controle de doenças, especialmente as zoonoses. O Quati (Nasua nasua) é uma espécie exclusiva da América do Sul, que está classificada como vulnerável em alguns estados do Brasil. Apesar de sua ampla distribuição e importância, dados sobre sua anatomia ultrassonográfica não foram encontrados na literatura. O emprego do exame ultrassonográfico na medicina veterinária é bastante difundido como meio de diagnóstico complementar, por fornecer de forma não invasiva informações sobre anatomia e morfofisiologia dos órgãos. Embora a ultrassonografia seja um método de diagnóstico complementar muito difundido na rotina clínica de pequenos animais, ainda são escassos os relatos em animais silvestres. O objetivo deste trabalho foi descrever, de forma comparativa, os aspectos ultrassonográficos e a anatomia topográfica do fígado, rins, glândulas adrenais, ovários, pâncreas, trato gastrintestinal, vesícula urinária, baço e útero dos quatis, e estabelecer valores de referência para as medidas de rins, parede da vesícula urinária e do trato grastintestinal, contribuindo assim, com material científico para aprendizado da ultrassonografia nesta espécie. Foram utilizados sete quatis adultos provenientes do Centro de Triagem de Animais Silvestres - CETAS, nos quais foram realizadas varreduras nos planos tranversais, sagitais e dorsais de todos os órgãos abdominais em estudo. Verificou-se que o exame ultrassonográfico do abdome dos quatis pode ser realizado seguindo o que está preconizado para o cão e o gato.

Objetivo: Avaliar as alterações cranianas e encefálicas de pacientes com encefalocele anterior e analisar fatores relevantes ao seu desenvolvimento neuropsicológico, de linguagem e na qualidade de vida. Modelo: Estudo transversal em pacientes com encefalocele anterior submetidos à avaliação multidisciplinar (craniofacial, socioeconômica, neurorradiológica, neuropsicológica e fonoaudiológica). Local: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC-USP), Bauru. Participantes: Dez pacientes com encefalocele anterior em acompanhamento com equipe de cirurgia craniofacial do HRAC-USP, submetidos à avaliação neurorradiológica (tomografia de crânio e ressonância magnética encefálica), socioeconômica, neuropsicológica, de linguagem e de qualidade de vida familiar. Resultados: Houve predomínio das encefaloceles fronto-etmoidais (70% dos pacientes), sendo malformação de corpo caloso a alteração encefálica mais encontrada (60%). Observou-se deficiência intelectual em 30%, distúrbio de linguagem em 40% e de aprendizagem em 30%. Houve correlação estatisticamente significante (p=0,045) entre diagnóstico neuropsicológico e o de linguagem. Variáveis como classe socioeconômica, nível educacional dos pais, malformações encefálicas e qualidade de vida familiar não se correlacionaram com os achados neuropsicológicos ou de linguagem. O fator II (pessimismo) do questionário de recursos e estresse simplificado predominou em 60% dos casos. Conclusões: Alterações cranianas, encefálicas, neuropsicológicas e de linguagem de pacientes com encefalocele anterior foram analisadas, havendo correlação entre o diagnóstico neuropsicológico e o de linguagem. / Objective: To evaluate cranial and brain abnormalities in patients with anterior encephalocele and to analyze relevant aspects to their neuropsychological development, language and quality of live. Model: Transversal study in patients with anterior encephalocele, who underwent a multidisciplinary team assessment (craniofacial, socioeconomic, neuroradiological, neuropsychological and language evaluations). Setting: Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo (HRAC-USP), Bauru. Participants: Ten patients with anterior encephalocele accompanied by the craniofacial surgery team of the HRAC-USP, who underwent neuroradiological (skull computed tomography and brain magnetic resonance), socioeconomic, neuropsychological, language and quality of life evaluations. Results: There was predominance of frontoethmoidal encephaloceles (70% of patients), and corpus callosum malformation was the most frequent brain abnormality (60%). Intellectual disability was observed in 30%, language disorder in 40% and learning disorder in 30%. Significant statistical correlation (p=0,045) was found between neuropsychological and language diagnoses. Variables such as socioeconomic status, parents educational level, brain abnormalities and quality of life did not correlate either to neuropsychological or language findings. Factor II (pessimism) of the short form of the questionnaire on resources and stress was predominant in 60% of the cases. Conclusions: Cranial, brain, neuropsychological and language disorders of patients with anterior encephalocele were analyzed, showing presence of correlation between the neuropsychological diagnosis and the language one.

A ultra-sonografia foi o primeiro meio diagnóstico por imagem utilizado na investigação do encéfalo, mas foi substituído pela tomografia computadorizada na década de 70 e atualmente por outros métodos como a ressonância magnética. O exame ultra-sonográfico continua sendo empregado em pacientes pediátricos e em animais jovens, cujas fontanelas permanecem abertas, servindo como janela acústica. Contudo, sua utilização em animais adultos fica restrita, em parte pela barreira proporcionada pelos ossos do crânio. Este trabalho objetivou: avaliar a possibilidade da utilização da ultra-sonografia transcraniana em cães adultos; estabelecer um paralelo com as imagens tomográficas; correlacionar as imagens sonográficas e tomográficas com a anatomia e comparar as imagens ultrasonográficas do encéfalo obtidas com e sem a interposição dos ossos do crânio. Foram utilizados dez cadáveres de cães adultos. As imagens tomográficas foram adquiridas em cortes transversais e dorsais com espessura de 5 mm e igual incremento. As imagens ultra-sonográficas foram obtidas através dos ossos temporal e porção lateral do parietal, da região frontoparietal dorsal íntegra e após craniotomia e do forame magno, em cortes transversais, dorsais e sagitais. Nesse estudo foi possível obter imagens do encéfalo dos dez cães através dos ossos temporal e parietal, evidenciando-se o tecido cerebral, os ventrículos laterais, a fissura longitudinal, alguns sulcos cerebrais, o cerebelo, o tentório do cerebelo, a região do diencéfalo e do hipocampo. A ultra-sonografia realizada através da craniotomia mostrou um bom detalhamento das estruturas anatômicas, superior ao obtido com a interposição óssea e nas imagens tomográficas. Não houve formação de imagem pelo osso frontal íntegro. Foi possível a visibilização apenas do cerebelo pela janela proporcionada pelo forame magno. As imagens tomográficas permitiram a visibilização direta do tecido cerebral, dos ventrículos laterais, do tentório ósseo do cerebelo. Muitas outras estruturas foram identificadas a partir da topografia e da sua relação com estruturas adjacentes. Concluiu-se que é possível avaliar o encéfalo de animais adultos através da ultra-sonografia utilizando como janela acústica os ossos temporal e a porção lateral do parietal. Contudo, a resolução das imagens é inferior quando comparadas àquelas realizadas com a fontanela aberta ou em craniotomias. Embora a tomografia computadorizada seja um excelente método para obter imagens seccionais, sem sobreposição de estruturas e uma maior diferenciação entre os tecidos moles, várias estruturas não são visibilizadas diretamente. Conhecer previamente a anatomia da região estudada é um pré-requisito importante para a adequada interpretação dessas imagens. / Ultrasound was the first medical technology performed for diagnostic imaging of the brain, but in the 70\'s the computed tomography became accessible, and recently, magnetic resonance imaging. Ultrasound imaging of the brain can be performed through the fontanelles in young animals. However, its using in mature dogs is restrict by the barrier presented by the bones of the skull. The purposes of this study were: evaluate of using ultrasound imaging of the brain in mature dogs; compare ultrasound with computed tomography imaging; correlate ultrasound and computed tomography features with the anatomy; compare the brain ultrasound images performed through a transosseous window with ultrasound images performed through craniotomy. Ten postmortem mature dogs were examined. Computed tomography scaning was obtained in transversal and dorsal planes, section thickness of 5mm and 5 mm intervals. Ultrasound imaging was performed through the temporal and parietal bones, dorsal frontoparietal before and after craniotomy and the foramen magnum. The images were acquired in transversal, dorsal and sagittal planes. It was possible identified intracranial structures using ultrasound imaging through the temporal and parietal bones: brain, lateral ventricles, longitudinal fissure, some brain sulci, cerebellum, diencephalon and hippocampus. Ultrasound imaging of some structures through the craniotomy showed to be superior to ultrasound imaging through transosseous and computed tomography imaging. It was not possible to visualize the brain structures in ultrasound imaging through the frontal bone. Through the foramen magnum was observed only the cerebellum. Computed tomography imaging allow to visualize the brain tissue, lateral ventricles and osseous tentorium. Many other structures were identified based on the relationship to adjacent structures and their topography. It was concluded ultrasound imaging through temporal and lateral portion of parietal bones is avaluable radiologic technique. However, the images resoluation is inferior compared to the features obtained through the fontanelles or craniotomies. Computed tomography is an excellent radiologic technique. It produces sequential sections of the brain and it capable of discerning many different soft-tissues without superposition. However, some structures couldn\'t be directly visualize. The knowledge of anatomy of the brain is essential to avoid misinterpretation of the images.

O círculo arterial do cérebro (CAC) é objeto de estudo desde os princípios da anatomia moderna e ao longo dos séculos documentado e classificado de várias maneiras. Recentemente o desenvolvimento dos métodos diagnósticos por imagem e de ultraestrutura abriram um novo leque nas possibilidades de investigação. Neste trabalho o CAC foi avaliado por meio de exames por angiotomografia computadorizada, por angiorressonância magnética, fotografias de peças anatômicas, histologia, microscopia eletrônica por varredura e por transmissão. Verificou-se na amostra que o CAC possui tendência a simetria. Os achados foram similares na comparação entre os métodos de diagnóstico por imagem, porém não demonstraram todos os achados dos espécimes anatômicos. A metodologia utilizada permitiu verificar que as camadas das paredes das diferentes artérias podem explicar parcialmente as diferenças nos achados entre os métodos de imagem e as peças anatômicas. Os dados aqui apresentados revestem-se de grande importância clínica e cirúrgica uma vez que o CAC é um elemento chave na circulação cerebral. / The Willis Polygon (WP) has been studied since the beginning of modern anatomy and documented and classified over the centuries in various ways. Recently the development of diagnostic imaging methods and ultra structure opened a new range of possibilities in the investigation. In this work the WP was assessed by computer tomography angiography examinations by magnetic resonance angiography, photographs of anatomical specimens, histology, scanning and transmission electron microscopy. It was found that the sample has a tendency to the WP symmetry. The findings were similar when comparing the methods of diagnostic imaging, but did not show all findings of anatomical specimens. The methodology has shown that the different layers of the walls of arteries may partly explain the differences in findings between imaging and anatomical parts. The data presented here are of great clinical and surgical importance, once the WP is a key element in the cerebral circulation.

Orientador: Deborah Queiroz de Freitas França / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-24T14:50:35Z (GMT). No. of bitstreams: 1 Nascimento_HelenaAguiarRibeirodo_M.pdf: 1294865 bytes, checksum: aad6a2937765cf9381c0d31a4575d026 (MD5) Previous issue date: 2014 / Resumo: O objetivo no presente estudo foi avaliar a detecção de fraturas radiculares verticais (FRVs) em radiografias convencionais (RCs) e obtidas em três sistemas digitais com diferentes condições intracanal. Foram utilizados 40 dentes humanos unirradiculares com as coroas seccionadas na junção cemento-esmalte. Em seguida, os dentes foram divididos em dois grupos com 20 dentes em cada: grupo controle sem fratura e grupo com FRV. As FRVs foram induzidas em uma máquina de ensaio universal. Após, todos os dentes foram posicionados individualmente no alvéolo de uma secção mandíbula humana seca. Foram obtidas imagens de todos os dentes de acordo com a condição intracanal: sem preenchimento, com guta-percha, com pino metálico e com pino de fibra de vidro. As imagens foram obtidas utilizando-se a técnica do paralelismo e três incidências (orto, mésio e distorradial), com filme convencional (Kodak), placas de armazenamento de fósforo (Digora Optime® e VistaScan®) e um sensor CMOS (SnapShot®). Todas as imagens foram avaliadas por cinco examinadores em uma escala de 5 pontos. Após trinta dias, 25% da amostra foi reavaliada. As reprodutibilidades intra e interexaminador foram avaliadas por meio do Teste Kappa ponderado. Foram calculados os valores de sensibilidade, especificidade, acurácia, valores preditivos positivo e negativo. A comparação das avaliações com o padrão-ouro foi obtida utilizando a área sob a curva ROC, comparadas por meio da análise de variância dois critérios com teste post-hoc de Tukey e nível de significância de 5%. As reprodutibilidades intra e interexaminador exibiram valores de moderado a substancial. Apenas a sensibilidade apresentou diferença significante entre as modalidades de imagem, com valores superiores para o SnapShot (53,3%) e VistaScan (46,0%), seguidos pela RC (41,0%) e Digora (37,5%). Ainda o sistema SnapShot (0,82) apresentou área sob a curva ROC maior que os demais (VistaScan: 0,70; Digora: 0,64; RC: 0,68) na presença do pino de fibra de vidro. Foi possível concluir que todas as modalidades de exame apresentaram um bom desempenho no diagnóstico de FRV na ausência de material intracanal e inferior na presença do pino metálico ou guta-percha. Na condição com pino de fibra de vidro, sistemas digitais com maiores resoluções devem ser preferidos / Abstract: This study aimed to evaluate the detection of vertical root fractures (VRFs) in conventional radiography (CR) and three digital systems in teeth with different intracanal condition. The sample consisted of forty single-rooted human teeth, in which the crowns were sliced at the cementoenamel junction. Then, the teeth were divided equally in two groups: control without fracture and root fracture. The VRFs were induced through a universal testing machine. After this process, all teeth were individually placed in a dry mandible. The images were obtained of all teeth according to the intracanal condition: no filling, gutta-percha, metal and fiberglass post. The images were obtained using the parallelism technique with three different horizontal angulations (ortho, mesial and distorradial) with conventional film (CF) (Kodak), two storage phosphor plates (Digora Optime® and VistaScan®) and one CMOS sensor system (SnapShot®). All images were evaluated by five examiners on a 5-point scale. After thirty days, 25% of the images were re-evaluated. The intra and interobserver reproducibility were calculated using the weighted-kappa test. Values of sensitivity, specificity, accuracy, positive and negative predictive values were calculated. The area under the ROC curve of all modalities in the presence of different intracanal materials was calculated and compared using the two-way analysis of variance (ANOVA) with post-hoc Tukey test and a significance level of 5%. The intra- and interobserver reproducibility values ranged from moderate to substantial. Only the sensitivity showed a significant difference between imaging modalities, with higher values for SnapShot (53,3%) and VistaScan (46,0%), followed by the CR (41,0%) and Digora (37,5%). Also SnapShot (0,82) had an area under the ROC curve greater than the others in the fiberglass post group (VistaScan: 0,70; Digora: 0,64; CR: 0,68). It was concluded that all imaging modalities had a good performance in the diagnosis of VRF in the absence of intracanal materials and lower in the presence of the metal post or gutta-percha. In the fiberglass post group, digital systems with higher resolution should be used / Mestrado / Radiologia Odontologica / Mestra em Radiologia Odontológica

M.Tech. / Mammography is most important in the detection of breast cancer but due to its intimate nature and the perception that it is uncomfortable and painful, many women do not optimally support mammography as a diagnostic and screening tool for breast cancer. Many factors influence the mammogram experience of patients. This research explored the preferences and perceptions of patients regarding mammographer gender and personality traits as well as student involvement in mammogram procedures. To promote positive perceptions of mammography and to ensure the availability of adequately trained mammographers to meet the future demands of the profession, the preferences and perceptions of patients and training needs of students should be carefully balanced. The study was empirical in nature and data was collected using a valid and reliable self-formulated questionnaire. The approach was quantitative and a small qualitative component added dimension to the quantitative results. A nonprobability, convenience sampling method was employed and questionnaires were distributed in radiography training centres affiliated to the University of Johannesburg. Data analysis indicated that while many women accept males in the mammography setting, most prefer female mammographers and -students. In general, women accept student presence during mammogram procedures. Personality traits that enhance effective communication and promote patient emotions such as trust, being safe and being cared for are favoured by patients. This research adhered to stipulations of the South African Patients' Rights Charter and the call of the Breast Cancer Advocacy Coalition for South African research into breast health care. The findings serve as benchmarks for patient opinions regarding mammography staff and will be of use in various fields concerning mammography, such as human resources, training and education and quality assurance of care.

Master thesis deals with creating a new design of mobile x-ray machine. Three studies of design were created on the base of processed analysis, when the best one were chosen and developed as a final design. The final design takes into account all egonomics and technical requirements and creates a machine with less technical and more favorable view for patients. Simplification and better arranged the control panels bring easier service for operators.

Abstract Biliary carcinoma, biliary fistula with occasional gallstone ileus and primary sclerosing cholangitis (PSC) are serious diseases and present specific diagnostic and therapeutic challenges. Stenting of biliary obstruction has also involved problems, but the reports are contradictory and partly limited. The aim of the present work was to evaluate and compare various imaging modalities in biliary diseases. The study also aimed to evaluate the usefulness of metallic stents in malignant biliary obstruction. The study population consisted of 210 patients with gallbladder carcinoma, bile duct carcinoma, biliary fistula, PSC or malignant biliary obstruction and eight control patients with various hepatobiliary diseases. The imaging findings of 80 patients with gallbladder carcinoma, 58 patients with bile duct carcinoma, and 16 patients with biliary fistula were reviewed. Nine patients with PSC underwent magnetic resonance cholangiography (MRC) and magnetic resonance imaging (MRI) of the liver, ultrasonography (US) of the liver and the bile ducts and endoscopic retrograde cholangiography (ERC). Eight control patients had had MRC and MRI of the liver and ERC. The medical records and radiographs of 39 patients with malignant biliary obstruction treated with percutaneously inserted metallic stents were also analysed. The stents included 48 Wallstents and seven Memotherm stents. In cases of gallbladder carcinoma, US visualised the primary tumour in 68 % and computed tomography (CT) in 57 % of the cases examined, but both methods were insufficient for accurate staging. In bile duct carcinoma, US revealed the primary tumour in 63 % and CT in 44 % of the cases examined. Both methods were sensitive in diagnosing peripheral intrahepatic cholangiocarcinoma, but inaccurate for more distal bile duct carcinoma or abdominal spread. The infiltrating type of gallbladder carcinoma and bile duct carcinoma were difficult to detect. US and CT were sensitive in revealing bile duct obstruction. The patients with biliary fistula and gallstone ileus had undergone various examinations with pathological, but not diagnostic results, and there was often a delay to diagnosis. Imaging did not reveal any of the ten spontaneous fistulas, but CT showed one of the five cases of gallstone ileus, and Gastrografin® meal revealed the single case of Bouveret's syndrome. Fistulography or cholangiography revealed all but one of the six iatrogenic fistulas. A nonvisualised or shrunken gallbladder at US should raise a suspicion of biliary enteric fistula in an appropriate clinical setting. MRC-MRI depicted the changes of PSC correctly in nine patients (radiologist 1) and in eight patients with one false positive finding (radiologist 2) in a blinded analysis. In the segmental comparison MRC missed especially bile duct dilatations. MRC was too pessimistic in the evaluation of the predictors of poor outcome. US detected features suggestive of PSC in eight patients (radiologist 3). US was unable to indicate the predictors of poor outcome. Of the patients with metallic stents in malignant biliary obstruction, 30 % had early and 66 % late complications, including stent obstructions, which occurred in 27 % of the patients at a mean of 4.4 months. The cause was mostly tumour ingrowth or overgrowth. The 25-week and 50-week patency rates were 71 % and 42 %. The patency rates of the patients with cholangiocarcinoma were significantly the lowest. There was also a tendency towards lower patency with less dilatation of the stents, an increasing number of the stents, longer strictures and hilar strictures. Many other complications were infectious. 31 % of the patients had late reinterventions.