Acta radiologica: diagnosis最新文献

Cerebral CT scannings were performed in 19 homosexual men with the acquired immunodeficiency syndrome (AIDS). Nearly half of them (9 patients) had cortical atrophy. Three patients with toxoplasmosis had cerebral pathology, in two of them with ring enhancement while the third had an ill-defined nonspecific lesion with slight heterogeneous enhancement without ring formation. Two patients with multifocal leucoencephalopathy and non-Hodgkin's lymphoma, respectively, presented non-enhancing, low attenuating lesions at CT.

Two hundred and forty-five temporal bone specimens were examined radiographically. Subsequently the topographic relationship between the jugular fossa and surrounding structures was evaluated in plastic casts of the specimens. Fifty-eight casts showed a high jugular fossa and in 17 a jugular bulb diverticulum was found. A diverticulum is regarded as an anomaly of the high jugular bulb and presumably has a potential for expansion. Most frequently a diverticulum was directed medially into the space between the internal acoustic meatus, the vestibular aqueduct and the posterior cranial fossa. Seven diverticula reached the level of the internal acoustic meatus. Encroachment upon the vestibular aqueduct was seen in 4 casts and both the internal acoustic meatus and the cochlear aqueduct were very close to the diverticulum. A few diverticula were directed postero-laterally close to the facial canal and the stapedius muscle. The investigation was supplemented with a selected clinical material of radiographs of temporal bones with high fossae. The results corresponded to those of the experimental investigation. The jugular bulb diverticulum is a relatively common feature and should be regarded as an anomaly with a potential to give rise to clinical symptoms consequent to its intrusion upon surrounding structures.

Pharyngeal function and gastroesophageal reflux were compared in 84 dysphagic patients examined clinically and radiologically. Cricopharyngeal muscle incoordination, assessed cineradiographically, was revealed in 5 of 41 patients (12%) without and 17 of 43 patients (40%) with gastroesophageal reflux assessed clinically (p less than 0.05). Thus, there was a positive correlation between dysfunction of the cricopharyngeal muscle and gastroesophageal reflux. There was no correlation with other types of pharyngeal dysfunction. Our results support the assumption of a positive relationship between gastroesophageal reflux and pharyngeal function in terms of cricopharyngeal dysfunction. The pathogenesis of this relation was, however, not revealed.

A patient with fever and abdominal pain was examined with ultrasonography and CT. The two methods demonstrated an isolated perirenal mass but the exact nature of it could not be established. Ultrasonographically guided coarse needle biopsy and the following histopathologic examination of the biopsy core demonstrated a malignant lymphoma.

To increase our understanding of the complex topographic relations between temporal bone structures and to facilitate the interpretation of their radiographic images, two techniques were developed. Plastic moulding of temporal bone specimens using polyester resin and silicone rubber substances providing detailed information and a three-dimensional survey of the structures. Carefully macerated temporal bone specimens are filled with plastic material under vacuum and the bone is then dissolved. The preparations, freed from irrelevant structures and embellished, allow metric evaluation of the different structures and their topographic relations. Automatic serial cryomicrotomy of fresh, deep-frozen temporal bones, using a commercial sledge-cryomicrotome. Photography of the cut surfaces of the specimen, usually at distance of 0.25 to 0.50 mm, allows natural-colour reproduction of minute detail, e.g. the melanin cell area in the cochlea, the smallest vessels on the ossicular surfaces, and the origin of the cochlear aqueduct at the basal turn of the cochlea. By correlating the photographs with images from the corresponding tomographic planes accurate information is obtained for interpretation of the radiographic images. A combination of the two techniques facilitates a detailed study and is a valuable aid in the teaching of temporal bone anatomy.

A new set of angles measured on standard axial CT images of the hip joint is defined. The angles provide information on the support of the femoral head from the anterior and the posterior part of the acetabulum. These angles have been measured in 82 adult hips, and correlated to a set of established parameters commonly measured at conventional roentgenography and on CT images of the hip joint. The defined angles may prove to be valuable in the total appreciation of hip joint function and stability.

Two patients with tumours in the pituitary gland and the liver, respectively, were studied with MRI. Regions of different transverse relaxation times were found in the tumours. Subtraction of images recorded with different echo times demonstrated the tumour regions better than the original images although these were recorded with 2 repetition times and double and multiple echo sequences. Subtraction techniques may thus aid diagnosis in MRI.

An investigation for biliary tract calculi and food-stimulated gastro-oesophageal reflux was carried out in 37 patients with duodenal diverticula demonstrated by barium examination. Sixty per cent of the diverticula were located in the descending part of the duodenum. Biliary tract calculi were demonstrated in 38 per cent and food-stimulated gastro-oesophageal reflux in 81 per cent of the patients. The detection of a duodenal diverticulum should result in a supplementary investigation for gallstones and gastro-oesophageal reflux and its sequelae.

The recent development of improved commercial radiofrequency coils and multiecho, multislice software for low field strength magnetic resonance systems has markedly increased the clinical utility of magnetic resonance imaging (MRI) of the pelvis at low field strengths. An evaluation of 70 patients with a variety of pelvic lesions and 14 normal volunteers who were studied using 0.15 T resistive magnet scanner revealed that anatomic structures and a variety of mass lesions could be clearly depicted in transaxial, sagittal and coronal planes using this updated system. Accurate characterization of lesions was possible in many instances using T2 weighted multiecho scans with echo time (TE) ranging from 30 ms to 120 ms (45 ms-180 ms using a reduced bandwidth technique). T1 weighted multislice scans demonstrated anatomic structures to best advantage and calculation of T1 and T2 relaxation times frequently facilitated more accurate differential diagnosis, particularly in the case of ovarian lesions.

Coronary angiography in patients with angina pectoris and wide-spread atherosclerosis imposes special technical problems. In two patients with unaccessible femoral and brachial arteries and one with bilateral occlusion of the femoral arteries selective left and right coronary angiography was performed by translumbar insertion of catheters using a modified catheter replacement technique. The technique is simple and no complications were observed.