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Rak dojke najčešća je zloćudna novotvorina u žena u Republici Hrvatskoj. Osnovne radiološke pretrage u dijagnostici bolesti dojke jesu mamografija, ultrazvuk i magnetska rezonancija. U radu su prikazane radiološke smjernice za radiološku dijagnostičku i intervencijsku obradu bolesti dojke i praćenje bolesnica oboljelih od raka dojke u Republici Hrvatskoj. Razrađen je algoritam radiološke obrade kod simptomatskih bolesnica, trudnica i dojilja, bolesnica prosječnog i povećanog rizika za razvoj karcinoma dojke, te kod bolesnica s radiološkim nalazom upalnih promjena (mastitisa)., Breast carcinoma is the most common neoplasm in the female population of Croatia. The main imaging breast diagnostic modalities are mammography, ultrasound, and magnetic resonance. This paper reviews radiological guidelines for breast diagnostic and interventional procedures, and monitoring of breast cancer patients in the Republic of Croatia. An algorithm for radiological assessment is presented for symptomatic patients, pregnant and lactating women, patients with average and increased risk of developing breast cancer, and patients with radiological findings of mastitis.

Background/introduction Description of activity and work performed Conclusion and recommendations Personal/organisational information References, Background/introduction: With very few dedicated children's healthcare institutions in Croatia placed mainly in big cities, children are very often imaged in adult radiology departments. As there is no subspecialisation in paediatric radiology in Croatia, children might be...

Aims and objectives Methods and materials Results Conclusion Personal information References, Aims and objectives: Breast cancer (BC) is the most prevalent cancer in the world with the incidence of 1.67 million in 2012. It is the most common cancer site with 26 % of all cancer sites in females. BC is also a major public health problem in Croatia with increasing...

Background/introduction Description of activity and work performed Conclusion and recommendations Personal/organisational information References, Background/introduction: As required by new EU BSS directive, diagnostic reference levels for radiodiagnostic examinations and interventional radiology procedures, where appropriate, shall be established, regularly reviewed and used for the purpose of optimisation [1]. This...

CILJ RADA: Cilj ovoga rada je utvrditi udovoljavaju li prostorije u kojima se očitavaju snimke, kao i monitori koji se koriste u radiološkoj dijagnostici propisanim uvjetima kao i međunarodnim preporukama. MATERIJALI I METODE: Ispitivanje je provedeno u dva klinička bolnička centra i dvije kliničke bolnice. Ambijentalno osvjetljenje u prostorijama u kojima se očitavaju snimke mjereno je lux- metrom. Opća provjera monitora te provjera kalibracijske krivulje i jednoličnosti osvijetljenja monitora koji se koriste za očitavanje snimki ispitani su korištenjem fotometra i AAPM uzoraka oznake TG18-QC, TG18- LN12, TG18-UNL10 te TG18-UNL80. Uz analizu izmjerenih vrijednosti prethodno spomenutih parametara, provedena je i analiza veličine monitora koji se koriste, veličine piksela, matrice piksela i pozadinskog osvjetljenja, kao i obuhvaćenost ispitivanja monitora bolničkim programom osiguranja kvalitete. REZULTATI: Ispitivanjem je utvrđeno da se za očitavanje snimki koriste i monitori koji ne pripadaju kategoriji dijagnostičkih monitora od kojih većinu nije moguće kalibrirati. Utvrđeno je i korištenje nekalibriranih dijagnostičkih monitora. U nekim se slučajevima upareni koriste monitori različitih proizvođača. Monitori uglavnom nisu obuhvaćeni programom osiguranja kvalitete. Ambijentalno osvjetljenje također nije u svim slučajevima udovoljavalo propisanim uvjetima, posebice u slučaju korištenja prostorija s prozorima. ZAKLJUČAK: Razina svijesti o potrebi provedbe provjere kvalitete monitora koji se koriste u dijagnostičkoj radiologiji u zdravstvenim ustanovama koje su sudjelovale u istraživanju na niskoj je razini što rezultira uvjetima očitavanja snimki koje bi odgovarajućim korektivnim radnjama trebalo uskladiti s propisanim uvjetima i međunarodnim preporukama.

Mammography is the most important diagnostic method for the early detection of breast cancer. The objective of mammography examination is to obtain accurate diagnostic information while keeping the dose as low as possible what is achieved by comprehensive quality assurance program. During past 8 years several quality audits of mammography systems were performed in Croatia ; primarily aimed to the centres included in the national breast screening program. At that time most of mammography units were film/screen (FS) based and therefore developing process deficiencies were frequently found. Quality assurance/quality control (QA/QC) program was missing in most of the surveyed centres. In the last few years there was a significant increase of digital systems due to its better efficiency in image archiving and absence of developing process problems. In this work image quality and dose of different types of mammography systems were compared. Siemens Mammomat 3000 using FS and computer radiography (CR) systems at University hospital of Osijek and full field digital (FFD) GE Seno Essential at hospital Vukovar were compared. All components of the FS system are under strict QA/QC program and used routinely for screening. CR AGFA DR-M system have special mammography program and uses screen with pixels size of 50 microns, but is not used for screening at the moment. Patient dose assessment was performed in terms of average glandular dose (AGD), and image quality was assessed using phantoms to estimate high and low contrast resolution, contrast and image quality score. Phantom images acquired on digital systems were analyzed on mammography dedicated workstation with 2x5MP monitors, non diagnostic PC monitor (1.3MP), and dryprinted film with 1:1 and 1:2 print ratio to validate earlier identified clinical practices. Patients’ doses were well below proposed limits for all systems, and FFD unit showed significantly lower AGD for thicker breasts. Image quality was always degraded in digital systems when non diagnostic monitor was used or image is printed, especially when printed decreased in size. Despite that, digital systems always showed equal or better detection of simulated low contrast lesions than FS system. High contrast resolution was superior at FS system due to limitations in pixel size of digital units, but when resolution was estimated using low contrast resolution pattern, FFD system with diagnostic monitor was comparable to the FS system. FFD and CR systems show the highest and the lowest phantom image scores, respectively. Our results showed that improved contrast resolution of FFD mammography despite reduced spatial resolution allows superior or equal phantom object detection compared to FS mammography. The clinical use of digital mammography (FFD or CR) may generally improve image quality with equal or lower breast doses, but all advantages could be diminished with inappropriate use of digital techniques or if QA/QC is missing.

Cilj je procijentii prediktivnu vrijednost BIRADS deskriptora u razlikovanju malignih od benignih solidnih tvorbi u dojci. Rad je izvršen na 163 ispitanice.Pojedini BIRADS ultrazvučni deskriptori, najviše oblik tvorbe, rubovi i paralelna orijentacija, a naročitu ukupna BIRADS ocjena pokazali su visoku prediktivnu vrijednost u razlikovanju malignih i benignih lezija. Uporaba BIRADS klasifikacije može smanjiti broj invazivnih dijagnostičkih pretraga (core biopsije)

The radiologist’s objective is to obtain accurate diagnostic information from mammography while keeping radiation dose to the breast acceptable. Image quality and patient doses in mammography depend on large number of factors such as film speed and contrast, film processing, tube voltage, breast size and composition, and automatic exposure control. Also, image viewing conditions can considerably influence overall diagnostic accuracy of mammography, especially its sensitivity. Due to number of steps involved in this process, the potential for mistakes increases. Reproducible high-quality images with reasonably low radiation doses are, in general, assured by comprehensive quality assurance / quality control (QA/QC) program and this is demanded by the Croatian radiation protection law. The national audit of mammography equipment performance, image quality and dose in Croatia was done recently. Results showed large variations in image quality and patient doses and revealed the need to continuously monitor and optimize mammography techniques. Survey pointed out that main problem in the Croatia is the lack of written QA/QC procedures. Consequently, equipment performance, image quality and dose are unstable and activities to improve image quality or to reduce the dose are not evidence based. At the University hospital of Osijek mammography QA/QC programme, based on EC (European Commission) guidelines, was implemented during the year of 2007. After we did the corrective actions based on measured data and image quality assessment, technical parameters are now within acceptable levels given by EC guidelines. Image quality is improved significantly and rate of rejected images is much less than before implementation of programme.

Mamografija je najvažnija dijagnostička metoda za rano otkrivanje tumora dojke. Cilj radiologa je imati najbolju moguću dijagnostičku informaciju uz prihvatljivu dozu zračenja za bolesnika. Kvaliteta slike i doza zračenja ovisi o velikom broju čimbenika kao što su brzina i kontrast filma, razvijanje filma, napon i automatska kontrola ekspozicije mamografskog uređaja, te veličina i gustoća dojke. Uz to, uvjeti gledanja slike mogu značajno utjecati na točnost mamografske informacije. Obzirom na veliki broj čimbenika koji su važni za dobru dijagnostičku informaciju postoji velika mogućnost pogreške. Ponovljive mamografske slike visoke kvalitete, uz razumno malu dozu zračenja, osiguravaju se sveobuhvatnim programom osiguranja kvalitete. Nedavno je u Hrvatskoj provedeno istraživanje tehničkih karakteristika opreme, doza bolesnika, kvalitete slike i postojanja programa osiguranja kvalitete. Zaključak istraživanja je da je mamografska dijagnostika u Hrvatskoj u pravilu neadekvatna i nestabilna, te je potrebno uvesti program osiguranja kvalitete na državnoj razini. Takav program propisan je i Zakonom o zaštiti od zračenja Republike Hrvatske (NN 64/06, NN 125/06). U Kliničkoj bolnici Osijek program osiguranja kvalitete mamografske dijagnostike, temeljen na preporukama Europske Komisije (EC), uveden je 2007. godine. Prema mjerenjima tehničkih značajki te ocjenama kvalitete slike prema EC kriteriju za kvalitetu slike, učinjeno je niz zahvata na uređajima i načinu rada. Kvaliteta slike je značajno unaprijeđena, a mjerenja tehničkih značajki i održavanje istih unutar tolerancije dane preporukama EC osiguravaju stabilnost kvalitete slike. To se očituje i smanjenjem udjela slika koje se moraju ponavljati zbog loše kvalitete.

Prikazana je bolesnica sa spororastućim tumorom kraniocervikalnog prijelaza. Bolesnica je u dobi od 46 godina. Tegobe počinju 6 mjeseci prije prijma otežanim izmokravanjem, osjećajem trnjenja u potiljku, postupno nastupajućim bolom u vratu sa širenjem u lijevo rame, osjećajem ukočenosti i zatezanja u lijevoj polovici prsnog koša i lijevoj ruci te trnjenjem u šakama. Kasnije se javlja i slabost u lijevoj ruci, a nekoliko dana prije prijma i u nogama, više u lijevoj. Tegobe su se pogoršale nakon provedene fizikalne terapije. U neurološkom statusu pri prijmu nađeni su znakovi spastične tetrapareze, više izraženo na lijevim ekstremitetima te urinarna retencija. Nađena je atrofija mišića lijeve šake i znakovi ispada senzibiliteta ispod razine C2 kralješka. MR glave pokazuje znakove okrugle tumorske tvorbe u razini C1 kralješka odnosno kraniocervikalnog prijelaza s bazom na prednjoj stijenci spinalnog kanala, promjera 2, 5 cm, koja zauzima veći dio kraniocervikalnog prijelaza s jakim kompresivnim učinkom na medulu spinalis i medulu oblongatu, a koja po svojim karakteristikama odgovara meningeomu. CT angiografija, koja osim ranije verificirane tumorkse tvorbe, pokazuje i očuvani lumen i zadovoljavajući prikaz vertebralnih arterija koje obilaze oko već spomenute ekspanzivne tvorbe u visini okcipitalnog formaena što potvrđuje spori rast tumora. Bolesnica je operirana trinaesti dan po prijemu, a po provedenoj rehabilitaciji je bez neurološkog deficita. PHD nalaz pokazao je da se radi o meningeomu. Ovja primjer ppokazuje velike mogućnosti adaptacije i "plastičnosti" moždanog tkiva na kompresiju.

Breast imaging primary goal is to find and target malignant lesions as small as possible. The smaller tha lesion, the greater is the curability and survival rate. In this small-numbered research we are trying to distinguish pros and cons regarding the small lesions core needle biopsy.

It is natural to ask ourselves to what extent can machines be used in humanitarian demining, having in mind the issues of costs, performance and unnecessary life loss. The answer is of paramount importance as well. This article covers the contribution of machine demining in the Republic of Croatia. After the war around 10% of Croatia’ s surface area was declared mine-polluted teritory. In the year 2005. the percentage of machine demining in Croatia amounted to a very high 85% of treated area, while there were no casulties. This points out that there is only a very small percentage of the mine suspected areas where machines could not have been used. These areas were not suitable for machine demining (rocky areas, soil of low bearing characteristics such as marsh land, forest areas etc.). Machines have contributed to higher performance, improved safety and quality of work as well as lower price of demining. This is the result of understanding their role and development for the actual demining conditions. According to the diversity of the ground clearing tasks, machines are designed in several categories: light, medium and heavy. In most cases machines with flails perform demining better than machines with a tiller. Especially light and medium flails have advantages in very demanding intersected regions, in easier access to the areas, in forests and around demolished houses. Based on the theory of soil treating, effects of mine explosions on the safety of humans and on machine performance, the original machine models are designed, allowing feasible technical solutions. Also, machine testing criteria, operator’ s safety, field clearance, efficiency, cross country capability are defined according to CWA standard.

Objective of this paper is to review drug- induced movement disorders (D-IMD) treated patients on Department of Neurology in University Hospital Osijek. We reviewed patients treated during 10 years period (from 1992 to 2002). Analysed group consisted of 14 patients. Reasons for hospitalisation were swallowing problems in 6 patients, neuroleptic malignant syndrome (NMS) in 3 patients, stroke in 2 patients, bolus choking in 2 patients, and speech disturbance in 1 patient. Working diagnosis for most of our patients was neurological disease, yet only later D-IMD diagnosis was established excluding primary neurological disease, or as associated disease to basic neurological disorder. Nine patients have diagnosed as Parkinson syndrome, 3 patients as NMS, and 4 as orolingual dyskinesia, either autonomously, or in combination with Parkinson syndrome. D-IMD was most frequently caused by neuroleptics. Thus the small number of patients hospitalised regarding this syndrome on Department of Neurology.

The present the first case of surgically treated patient with intractible seizure in University Hospital Osijek. Amygdalohippocampectomy is a well known surgical procedure for seizure control. Thirty procent of epilepsy is medical resistent. Some of patients with partial complex seizure have to use three or more antiseizure drugs. Even that seizure can be only partially controled. Multidrug treatment have long lasting side effects. Surgical procedure as last treatment option in drug resistent seizure. Amygdalohippocampectomy is treatment of choice for a patient with hippocampal sclerosis. A 19- year-old man has started to suffer from partial complex sizure in his age 3. Seizures have had partially controled by multidrug medication (Phemiton, Tegretol, Topamax). Surgical treatment has planned. He underwent surgery for right sided amygdalohippocampectomy via right sided frontotemporal craniotomy. Right temporal apex, nucleus amygdaloideus and hipocampal formation have been removed. Quality of life is significantly improved.