Computerized radiology : official journal of the Computerized Tomography Society最新文献

Involvement of the central nervous system (CNS) in patients with histiocytosis-X manifesting secondary hormonal change is well known clinically. Proof of involvement of the most common CNS focus, the hypothalamus., is also seen in autopsy cases on occasion. However, premortem radiographic evidence of hypothalamic infiltration is unusual. Presented is a case report and a brief literature review of such cases.

A retrospective analysis of the computer tomographic scans (CT) in 68 patients with juvenile hemiplegia was clone. There was predominance of males (60%) over females, as well as left-sided lesions (57%). The CT findings were normal in 15% with atrophic changes in 34%, low attenuation areas of fluid density in 46% and 2.9% (two cases) with tumours. Typical areas of infarction following vascular injuries could be identifieD in 15% of cases. Six out of 8 calcifications were associated with tuberculoma of the brain. It is noted that cystic changes are the end-results of most infarctions, infections and other diseases within the brain. Therefore. CT as a diagnostic tool is efficacious in determining the anatomical site of lesion, but incapable of elucidating the aetiological basis of such a lesion.

We discuss the clinical and CT features of certain metabolic brain disorders which cause specific CT abnormalities. These disorders may be divided into those which affect the gray matter, white matter or a combination of both gray and white matter regions. In metabolic disorders which affect the gray matter, there is ventricular enlargement with basal cistern and cortical sulcal space enlargement. In metabolic disorders which affect the white matter, there are symmetrical hypodensities seen throughout the white matter region.

A 73-year-old male was found to have multiple subpleural pulmonary nodules, predominately of the upper lobes, on CT. Some contained calcifications. Lymphadenopathy was absent. The importance of CT in suggesting the diagnosis of nodular pulmonary amyloidosis is discussed.

CT is an important modality for imaging mediastinal masses, and certain CT attenuation features (fat, calcium, or water attenuation, contrast enhancement) are well known to suggest specific diagnoses. In a series of 132 consecutive patients with tissue-proven mediastinal masses, these specific CT features were present in only 16. We evaluated the ability of CT to differentiate soft tissue mediastinal masses based on morphology and distribution of disease. Metastatic disease and lymphoma accounted for 69% of masses in this series, and CT could not generally differentiate them. However, CT was helpful in differential diagnosis in certain settings. CT demonstration of multiple mediastinal masses when conventional radiographs showed a single mass generally excluded diagnoses such as thymoma and teratoma. CT demonstration of a single middle mediastinal mass, frequently missed by conventional radiography, made metastatic disease a much more likely diagnosis than lymphoma. Finally, CT demonstration of certain ancillary findings strongly favored a diagnosis of lymphoma (axillary adenopathy) or metastatic disease (solitary pulmonary mass, focal liver lesions, bone lesions).

A case of intracranial tuberculosis due to Mycobacterium bovis is presented. Computed tomography (CT) identified multiple enhancing lesions which by biopsy proved to be intracranial tuberculomas. The CT appearance, epidemiology and bacteriology as well as pharmacotherapy of this uncommon entity are discussed.

Forty-two patients out of 300 who had undergone bilateral stereotactic cingulotomies were studied by means of computerized tomography (CT). The appearance showed bilateral encephalomalacia, measuring on the average 5 × 7 mm², located in the cingulate gyrus. These induced lesions had attenuation values similar to cerebrospinal fluid and did not enhance with contrast. CT is a useful technique for initial evaluation, management, and follow up of these patients.