The American journal of roentgenology, radium therapy, and nuclear medicine最新文献

Five patients with acute megacolon with varied types of progressive muscular dystrophy are presented. Dysfunction of smooth muscle among patients with muscular dystrophy is reviewed. The extra gastrointestinal roentgen features are summarized. Recognition of the diffuse smooth muscular involvement among patients with muscular dystrophy is stressed for proper diagnosis and patient management.

The medullary rays are well-defined anatomic structures consisting of bundles of renal tubules which form in the renal cortex and continue through the renal medulla as the medullary striations. These structures are occasionally visualized during excretory urography in abnormal physiologic states characterized by tubular stasis and hyperconcentration of contrast material. Under these conditions, fine striations are visualized which correspond in position and orientation to these structures. The work of others has shown that in tubular stasis, contrast material is hyperconcentrated in the tubules. On microradiography in normal and obstructed kidneys, the highest concentrations of contrast material are seen in the lumen of collecting ducts. Lastly, retrograde injection of contrast material into the medullary rays produces a roentgen image similar to our illustrated cases.

Superior mesenteric arteriography can often demonstrate actively bleeding marginal ulcers. Five cases diagnosed by angiography are reported. Pitressin infusions of the superior mesenteric artery stopped bleeding permanently in two cases, transiently in two cases, and was not attempted in one case. Pitressin infusions of the superior mesenteric artery should be attempted before surgery is performed for bleeding marginal ulcers.

Paralleled clinical studies of radioisotopic imaging or tumor metastases in the bone were undertaken with Tc99m pyrophosphate, Ga67 citrate, and Tc99m sulfur colloid. All three were capable of anticipating the bone roentgenograms. A critical analysis suggested that positive delineation with Ga67 citrate would sometimes be superior to the others. This deserves further investigation. Clinically the combined use of Tc99m pyrophosphate with Ga67 for the chest areas and extremties or with Tc99m colloid for the pelvic and abdominal areas would be more frutiful in early detection and exact localization of bone metastases.

Two patients are reported with the clinical and roentgenographic findings of the Weissenbacher-Zweymuller syndrome. The features are neonatal micrognathia (Pierre Robin syndrome), rhizomelic chondrodysplasia with dumbbell shaped femur and humeri. The bone changes tend to regress and there is normal growth on serial studies. A third case seemed at birth to show similar roentgenographic changes but was dwarfed; serial observations revealed him to be a case of the Kniest syndrome with micrognathia as an added feature. The term "micrognathic dwarfism" suggested by Maroteaux is probably best aboided since it will inevitably include a variety of conditions, only some of which are associated with dwarfism.

Intracranial hemangiopericytomas are tumors which angiographically and histologically can mimic other vascular intracranial masses. The term angioblastic meningioma has been applied to this tumor and to other vascular tumors. However, hemangiopericytomas have a unique biological behavior and prognosis as they tend to recur or metastasize and are insensitive to radiation. Hence, the importance of their specific recognition is emphasized. This is a report of the roentgenologic and pathologic fidings in five cases of histologically verified intracranial hemangiopericytomas. The angiographic findings common to these tumors include a myriad of tiny irregular feeding vessels springing from a main trunk, an intense fluffy type of stain, lack of early veins, and prolonged tumor circulation time. The major arterial supply is from the internal carotid or vertebral circulation rather than from external (meningeal) vessels. Differentiation from other vascular tumors particularly supratentorial hemangioblastoma, glioblastoma multiforme, as well as from vascular meningothelial meningioma is important from both the angiographic and histologic aspects.

Reconstruction of the esophagus has been used for more than half a century. Benign as well as malignant diseases are treated in this manner. Viscera used for reconstruction are: colon, jejunum, and stomach. The different modalities of surgical intervention have been briefly summarized. Complications have been enumerated with the major ones stressed in more detail. The exact nature of surgical procedure should be known before attempting to evaluate roentgenologically a reconstructed esophagus. Preoperative roentgen evaluations, including barium study and angiography, are indicated for better postoperative results. Postoperative roentgen studies are needed to detect most of the postoperative complications.

Microradioscopic study of metacarpals in 24 osteomalacic and 34 osteoporotic patients revealed excessive intracortical resorption (striations) in approximately 60 percent of patients suffering from osteomalacia, but in none of the osteoporotics. Phalangeal periosteal resorption was found less frequently in osteomalacia than metacarpal striations, and was absent in osteoporotics. On the other hand, quantitative evaluation of cortical thickness, percent cortical area, bone mineral mass, and density did not show any clear differences between the two study groups. It is concluded that the differential diagnosis between osteomalacia and osteoporosis may be considerably improved by microradioscopy of hand bones.

The dural branches from the cavernous portion of the internal carotid consists of the meningophypopseal trunk, the inferior cavernous, and the capsular arteries. These vessels have extensive anastomoses in and around the sellar area. These arteries are not usually demonstrated angiographically; therefore, when they are enlarged, a pathological lesion should be suspected. There are numerous lesions other than meningiomas associated with hypertrophy of these dural branches and the corresponding vessels involved depends on the anatomic location of the associated lesion.

Congenital subglottic stenosis, which is life-threatening to the infant, can be diagnosed by the correlation of the clinical and the roentgenologic findings. The main clinical sign is the persistence of stridor from birth. The indicative roentgenologic finding is a symmetrical narrowing of the subglottic segment which is constant in form and length during the various phases of the respiratory cycle. Two cases are presented, one confirmed by postmortem examination and the other by endoscopy. The etiology of this condition and the differential diagnosis are discussed.