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NEMT, Nordic Evaluation of Medical Technology, conducted a study in 1988-89 on the use and diffusion of diagnostic radiology technologies in Denmark, Finland, Iceland, Norway and Sweden, i.e. the Nordic Countries. The study analysed the responses to a questionnaire sent to all Nordic radiology departments. Our findings show a variation from about 500 to nearly 900 radiology examinations per 1000 inhabitants among the Nordic Countries. Some of the differences are explained by unique structural factors of the health care system in each country, even if they all provide comparable public health services. Other differences are explained by variations in medical practice, accessibility to new imaging modalities, and replacement policies. This paper summarizes the results of the study.

The development and innovations in Swedish radiology as reflected in Acta Radiologica during 75 years are reviewed.

Several recent reports have documented the importance of celiac and superior mesenteric angiography in finding the source of acute hemorrhage into the gastrointestinal tract or abdominal cavity. Even small bleedings are demonstrable by selective angiography (41, 42). Because the most common cause of acute abdominal bleeding is gastric or duodenal ulcer, acute upper gastrointestinal roentgen examination is the routine method of examination at the present time. This procedure often will not give any clear-cut information about the cause of the bleeding. The patient may then be operated upon, and, if the source of bleeding is not found, a “blind” gastric resection may be performed. Added to the roentgen examination, the operation is a heavy load on an already deteriorated patient. Angiography, however, may give the clinician all the information he needs, and we must now decide whether this method should be undertaken as a routine procedure in cases of acute bleeding. Thus far, there has appeared no systemati...

Angiographic examination of 7 patients with a systemic arterial supply of the lungs with malformation of the pulmonary circulation and of 2 patients with bronchopulmonary anastomoses and pulmonary atresia with ventricular septal defect illustrates the value of selective systemic angiography in such conditions, especially for demonstrating the origin and course of the anomalous arteries and their venous drainage.

The angiographic findings in 17 patients with anterior mediastinal tumors suggest that angiography has a role in the preoperative evaluation of these masses. It should be used if the diagnosis is not apparent at ordinary roentgen examination or if needle biopsy is not successful.

(1961). Angiography in Carcinoma of the Renal Pelvis. Acta Radiologica: Vol. 56, No. 2, pp. 81-93.

(1954). The Cervical Spinal Canal in Intraspinal Expansive Processes. Acta Radiologica: Vol. 42, No. 2, pp. 101-115.

Combined angiography and percutaneous transhepatic cholangiography in the evaluation of obstructive jaundice give important information about vascular and bile duct anatomy not available from one study alone. Correlation of both studies can reveal the etiology of the obstruction in detail.

Selective pancreatic angiography was performed in 21 cases of whom seven had pancreatic tumours or tumours of the hepatoduodenal ligament. A comparison was made of injection into the gastroduodenal artery (seven cases), into the common hepatic artery close to the gastroduodenal artery (seven cases), and into the common hepatic artery 1–4 cm from the gastroduodenal artery (seven cases). The best demonstration of the pancreatic arteries was obtained when the tip of the catheter was in the gastroduodenal artery. A distal position of the catheter in the common hepatic artery gave almost the same quality of pancreatic angiogram as well as additional information concerning the arterial supply of the liver.

Percutaneous catheterization is widely employed in various forms of angiography; it is not as well accepted for selective cardioangiography because an open end-hole catheter can cause severe injury within the heart. As a closed-end catheter is frequently preferable for intra-cardial contrast injections, catheter modifications have been suggested. The tip may leave the catheter through them. The catheter thus functions as a closed-end one—only a very small amount of the contrast agent emerges from the end in a retrograde direction. Types and Preparation of Catheters Polyethylene catheter material can be tapered to fit tightly around a leader if the has been occluded after its introduction into the vessel (11, 12, 16, 17), or a closed-tip catheter has been introduced percu-taneously by various means (3, 6, 10, 11). To make use of the advantageous percutaneous technic, a modification of the commonly used polyethylene (PE) catheter was made. This catheter has the distal end tapered and drawn out 3 to 5 cm. Bo...

During a two year period percutaneous cardiac catheterization under local anesthesia was performed on the venous side in 89 children and on the arterial side in 73. In children under 1 year of age venous percutaneous catheterization failed more often than did arterial percutaneous catheterization. In children above this age percutaneous catheterization was nearly always successful. A specially designed catheter for percutaneous angiocardiography was used.

After all clinical methods, including ordinary roentgen diagnostic procedures, have been attempted, the source of gastrointestinal bleeding remains unexplained in many patients. As many as 20 per cent of massive hemorrhages are undiagnosed (8). The cause of chronic or intermittent bleeding is even more difficult to detect. In this latter group of patients, the source, though undetected at barium examination, may be revealed by selective angiography. Thus, cases of unexpected tumor (3), angioma (10), arteriovenous fistula (18), and varices (1) have been diagnosed. At the Roentgendiagnostic Department, University Hospital of Lund, 24 patients with previously undiagnosed melena have been examined with selective celiac and superior mesenteric angiography. These examinations have been reviewed to assess the usefulness of the method in these patients, who present difficult diagnostic problems. Materials and Methods The patients in this series were chosen according to the following criteria: (a) two or more posi...

We report on 2 patients with cystic-appearing lesions in the renal hilus that were detected on urography. In 1 case an ultrasound study confirmed a cystic mass but an arteriogram revealed a renal artery aneurysm. The arteriogram before the contemplated puncture of the renal hilar mass prevented an inadvertent puncture. The information about the arterial anatomy helped preoperative planning, which resulted in successful repair of the aneurysm by microdissection and auto-transplantation.

A case of lateral displacement of the lower pole of the right kidney caused by an interposing ascending colon is presented. An interposition of this kind is rare and does not cause any gastrointestinal symptoms but is of differential diagnostic importance. In this case computed tomography was a simple noninvasive procedure for correct diagnosis.

Eighty-six consecutive pancreatic angiographies were reviewed prospectively. Ater more than one year 79 of them were "blindly" and independently reviewed by three radiologists. The results concerning accuracy, value three radiologists. The results concerning accuracy, value of superselective technique at malignancy and prediction of extirpability at malignancy were compared. The accuracy was similar, i.e. at malignancy 92 and 86 per cent (mean), respectively, as the prediction of extirpability 88 and 80 per cent (mean), respectively. The value of superselective technique differed considerably, 55 and 14 per cent (mean), respectively, and this is discussed. Pancreatic angiography in relation to CT, ultrasound and ERCP is discussed and considered to be of value late in the diagnostic program.

The effect of epinephrine on celiac and superior mesenteric angiography has been studied in 65 patients. Evaluation has been made of changes in arterial detail, transit time of contrast material, capillary accumulation, venous opacification and of the diagnostic usefulness of the drug in the various lesions encountered. Epinephrine caused the most marked constriction and increase in transit time in the splenic artery. An actual decrease in transit time of the contrast material was seen in the bowel arteries. The pancreatic vessels were not constricted, except in the presence of chronic pancreatitis. The duodenal arteries also showed increased filling following the drug. In general, capillary accumulation was diminished except in the duodenum, and veins were not seen as well except in the superior mesenteric distribution. In general, primary and secondary tumors were demonstrated better after epinephrine if they were vascular and if the contrast material reached the vascular bed of the tumor. Carcinomas of the stomach were not seen as well because of marked constriction of the gastric vessels. Inflammatory lesions showed increased constriction following the drug, with the exception of lesions of the duodenum. Collateral vessels were not affected by the drug. The usefulness of this technique for physiologic investigations is discussed.

Angiography was performed before and after construction of end-to-side portacaval shunts in 10 cirrhotic patients. In comparison to preoperative angiograms, postoperative studies demonstrated: 1. Increased diameter of the hepatic artery and its branches; 2. Increased incidence of collateral circulation from the superior mesenteric artery; 3. Decreased size of the liver; 4. Increased or unchanged size of the splenic artery; 5. Decreased size of the spleen. Arterioportal flow was seen in about two-thirds of patients. In two patients, orthograde flow was present in the hepatic limb of the portal vein, indicating parahilar arterioportal communications. Parahilar collateral vessels were actually demonstrated in one case, and may represent markedly dilated vasa vasorum of the portal vein. In some other patients, retrograde flow was present in the portal vein indicating peripheral arterioportal communications. After end-to-side portacaval shunts were performed in three dogs, arterioportal communications were demonstrated centrally or peripherally.

1. The angiographic features of 5 cases of pheochromocytoma localized by retrograde femoral aortography are described.2. Hypertensive crises attributable solely to the procedure were not encountered in these 5 cases.3. To our knowledge, 42 cases (including the 5 in this paper) of pheochromocytoma have been studied by translumbar or retrograde femoral aortography since 1958 with 6 hypertensive crises and no fatalities.4. Retrograde femoral aortography is relatively safe and is an effective method for the preoperative diagnosis and localization of pheochromocytoma.5. Retroperitoneal pneumography should be reserved for the occasional suspected pheochromocytoma in which aortography does not demonstrate or adequately outline the tumor.