The Journal of computed tomography最新文献

Two patients with unusual central nervous system sarcoid were investigated using computed tomography and magnetic resonance imaging, as well as other x-ray studies. A patient with intramedullary involvement of the spinal cord as well as nerve root involvement was examined. Follow-up examination after treatment with steroids showed a return to normal.

The second patient had optic nerve involvement as well as two intracranial parenchymal lesions and granulomatous arachnoiditis. In this patient magnetic resonance imaging offered no advantages over computed tomography in the orbit but was significantly more accurate intracranially.

Ependymomas are common types of tumors occurring within the brain and usually derive from the ependymal lining, especially of the ventricles. Ependymomas also occur, usually within the spinal canal, as primary intramedullary lesions or as late “drop” metastases from intracranial ependymomas. Extradural ependymomas are rare. They could occur as intraspinal or extraspinal lesions. We hereby report a case of an extradural (intraspinal) lesion with extraspinal extension, the extraspinal lesion being presacral in position, which presented with urinary and colonic symptoms. The lesions were secondary ependymoma subsequent to an intracranial ependymoma previously treated by combined surgery, radiotherapy, and chemotherapy 4 years earlier. The extradural and extraspinal site of the secondary lesion as well as its mode of presentation are noteworthy.

This report is a review of the findings of computed tomography and angiography of eight supratentorial gliomas with dural invasion. Computed tomography revealed localized increases in the thickness of ring enhancements at the sites of dural invasion in four cases, which was attributed to increased blood supplies by the meningeal vessels. Angiographically, feeders from the meningeal vessels entered the tumors mostly through relatively broad areas of tumor-dura attachment. A sunburst type of neovascularity from a meningeal artery was seen in only one case. In most such cases the differential diagnosis from meningioma was possible by the computed tomographic and angiographic findings. Selective external carotid angiography was the most important examination for diagnosing dural invasion by gliomas.

Demonstration of an air-fluid level in the body wall on a computed tomography examination usually suggests the presence of an abscess or a postoperative fluid collection. However, the small amount of air that frequently is injected during intravenous contrast administration may result in a similar computed tomography appearance.

Primary involvement of the uterine cervix is a rare presentation of extranodal lymphoma. The clinical and computed tomography findings are described in four patients ranging from 23 to 74 years of age. All presented with vaginal bleeding. Computed tomography findings were similar to those of other primary pelvic neoplasms, with diffuse uterine enlargement and lobular contour alteration often mimicking fibroids. Lymphadenopathy was not observed in comparison to secondary lymphoma of the female genitalia. All patients had excisional biopsies. One patient had an initial TAH and BSO. Histology was varied with one case of large cell lymphoma, one of diffuse histiocytic, one of unclassifiable poorly differentiated lymphoma, and one of nodular poorly differentiated lymphocytic lymphoma that was finally classified as granulocytic sarcoma. Disease extent could be assessed by computed tomography and aided treatment planning. In conclusion, computed tomography was found to be useful in the evaluation of uterine lymphoma. Although the findings are not specific, the local tumor extent can be evaluated at the same time as other sites of potential involvement.

Mucous secretions filling the bronchial tree may be identified on computed tomography (CT) as low-density, treelike branching structures within consolidated or collapsed lungs similar to air bronchograms. These mucous bronchograms may occur from mucoid impaction of the bronchi distal to an obstructing lesion of the bronchus, most notably bronchogenic carcinoma, and from conditions that cause impaired mucociliary transport. In most cases, thin-section CT (5 mm) will demonstrate the presence or absence of an obstructing tumor involving the bronchus and will allow a correct assessment as to the cause of the mucous bronchograms; however, on occasion mucus within the central bronchi may result in a false-positive CT diagnosis of obstructing tumor. The demonstration of mucous bronchograms within a thoracic mass indicates that the mass is consolidated or collapsed pulmonary tissue and allows distinction from pleural disease.

The unusual computed tomographic appearances of a hepatic hemangioma in a neonate are reported. The liver was replaced by cystlike spaces that enhanced with contrast. These blood-filled spaces were responsible for the cardiac failure that improved following ligation of the hepatic artery.

We report a case of bilateral renal vein and inferior vena cava thrombosis in a patient with membranous glomerulonephritis. To the best of our knowledge, this is the first case demonstrated by magnetic resonance imaging.

We describe a case of acute alcoholic myopathy evaluated by computed tomography. Computed tomography showed a low-density, delimited area in the semimembranous muscle and edema of the subcutaneous cell tissue, permitting determination of the extent of the disease and its localization for purposes of biopsy and fasciotomy of the affected muscle.