The Journal of computed tomography最新文献

Hemorrhage in a pituitary adenoma is a rare occurrence. Before computed tomography became the primary imaging modality for the sella, hemorrhage in pituitary adenoma was always diagnosed during operations or at autopsy. A patient with subacute hemorrhage in a nonfunctioning chromophobe pituitary adenoma with computed tomography findings is reported. The clinical presentation was unlike a pituitary apoplexy.

Mediastinal adenopathy and endobronchial metastases are sometimes the only radiological manifestation of metastatic disease from extrathoracic neoplasms. We report on four patients in whom hilar and paratracheal adenopathy (n = 3) and endobronchial involvement (n = 1) were the only intrathoracic manifestations of metastatic renal cell carcinoma. Three of the patients had nephrectomies 9 months to 4 years before the appearance of intrathoracic disease; another patient presented with medastinal disease as the initial manifestation of renal cell carcinoma. If a patient with a history of renal cell carcinoma develops pulmonary hilar adenopathy, metastatic disease should be suspected and appropriate diagnostic measures should be taken.

Computed tomography scans were performed on two patients who presented with clinical rhabdomyolysis and acute renal failure secondary to myoglobinuria. Localized muscle swelling with patchy focal areas of low attenuation were demonstrated. Computed tomography may be helpful to clarify the nature and extent of the muscle injury in the appropriate medical setting.

A case of mediastinal thymic cyst evaluated by computed tomography and magnetic resonance imaging is presented. The anterior mediastinal mass was well-demarcated and measured 10 Hounsfield units on the computed tomographic scan. The lesion showed intermediate signal intensity on T1-weighting and became hyperintense on T2-weighted images. These computed tomography and magnetic resonance imaging features suggested a cystic structure, which proved to be a benign thymic cyst on pathologic examination.

Lobar attentuation difference of liver on computed tomography was seen in a case of portal pyemia complicating perforated appendicitis. Left portal vein thrombus was detected first by ultrasound and subsequently confirmed by computed tomography. The left lobe of the liver showed greater contrast enhancement during the dynamic computed tomography study. The possible cause of this lobar attenuation difference is discussed.

Skeletal metastases from colorectal carcinoma are unusual and osteoblastic metastases are quite rare. Three cases are described in which an isolated recurrence of a previous colorectal carcinoma occurred within the pelvic bones, without evidence of skeletal metastases elsewhere so that local spread via portocaval anastomoses in the pelvis is postulated. In all three cases, proliferative calcification and new bone formation occurred within an expansile, destructive lesion, suggesting the occurrence of a synergistic effect between the underlying bone and a malignant neoplasm which has a propensity to calcify.

We report a case of renal sinus non-Hodgkin's lymphoma without contiguous adenopathy. Magnetic resonance and computed tomography images of this rare tumor were correlated with a pathologic specimen. On computed tomography the renal sinus lymphoma was evaluated as a well circumscribed, low-density mass owing to the mixture of the lymphomatous cells and fat tissues. Magnetic resonance showed the replacement of the renal sinus fat tissues with a spoke-like solid mass. The renal artery and vein were also evaluated thoroughly and were without tumor thrombosis.

The computed tomography findings of 10 patients with neutropenic colitis are described and illustrated. Seven of these patients had leukemia, one had lymphocytic lymphoma, and two had systemic lupus erythematosus. All patients had colon wall thickening which was either isodense with the normal bowel tissue or showed areas of intramural low density. Air in the thickened bowel wall was seen in six patients. These computed tomography findings in neutropenic patients with fever, abdominal pain, and diarrhea should suggest the diagnosis in most instances, resulting in prompt treatment of this usually life-threatening entity.

Computed tomography has become a prime method of examination after trauma. We report a case of traumatic leukoencephalopathy detected with highfield strength, heavily T₂-weighted magnetic resonance imaging in a patient with minimal computed tomography findings.

Two patients with presumed intraventricular neuroepithelial cysts are reported. Their characteristic features on magnetic resonance imaging are described, and the importance of demonstrating the cysts' walls is underscored.