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

At the sites of previously documented lung metastases from bladder carcinoma, computed tomography identified lung cavities that were virtually imperceptible by plain radiographs. Such thin-walled cavities, which developed following chemotherapy, have not been previously described in patients with bladder carcinoma.

Traumatic arteriovcnous fistulas involving the superior mesenteric artery are rare. Diagnosis is most commonly made shortly after the injury. Symptoms, when present, are usually related to intestinal ischemia. Angiography has been the conventional modality used in diagnosing arteriovcnous fistulas. We report a patient with a superior mesenteric artery to left renal vein fistula who presented in overt heart failure five years after a gun shot wound. The fistula was evaluated with magnetic resonance imaging.

Seventeen patients with breast cancer had CT evidence of intracranial metastatic lesions. Sixteen patients showed neurological abnormalities on examination; one patient had no abnormalities on clinical examination. CT showed evidence of basal parasellar lesions (3 cases), orbital lesions (2 cases), or cerebral hemispheric (intracerebral or subdural) lesions (11 cases). In one case, diffuse meningeal and cortical nodular enhancement was consistent with diagnosis of carcinomatous meningitis. Ten had solitary and seven had multiple lesions. CT showed evidence of bone lesions in 8 cases and there were accompanying parasellar (3 cases), orbital (2 cases), and subdural lesions (3 cases). The intracerebral lesions(s) had an iso- or hypodense appearance on plain scan; there was peripheral rim or nodular enhancement on post-contrast scan.

Hypoplasia of the carotid arteries is a rare congenital anomaly which when clinically symptomatic presents as cerebral ischemia or hemorrhage. Patients with this anomaly commonly have associated variations of the circle of Willis, an increased incidence of intracranial aneurysms and extensive networks of collateral vessels to accomodate the diminished carotid flow. Carotid artery hypoplasia should not be confused with other conditions which may have a similar appearance such as arterial dissection, vasculitis, and tubular fibromuscular hyperplasia.

A patient with a rare combination of cerebral venous angioma and a varix is reported. Only two such cases have been previously reported in the literature. The importance of being aware of the association of two such vascular malformations in the same patient is underscored.

An unusual case of superinfected thrombosis of the portal and superior mesenteric veins is presented. Thrombus and gas within the portal system were accurately detected by CT. A necrotic segment of distal small bowel was believed to be responsible for the findings. Prompt recognition of this rare entity and rapid initiation of adequate therapy may aid in improving the outcome of this usually fatal condition.

Two cases of surgically proven myxopapollary ependymomas of filum terminale are reported. In both, myelography and metrizamide-enhanced computed tomographic (CT) scans were performed. An intramedullary tumor in the lower thoracic spine, soft-tissue masses in the neural foramina and enlarged bony spinal canal in the lower thoracic and upper lumbar spine were noted in one case and, in the other, an intradural extramedullary tumor at T12-L1 level. Both patients had normal cranial CT scans, and both presented with similar symptoms—low back pain and weakness and paresthesia of leg or legs for up to 3 years' duration. Myelography and metrizamide-enhanced CT scans were performed in order to evaluate disc disease in one patient and spinal stenosis in the other. Ependymoma was an incidental finding, which was then removed by surgical resection. Pathology confirmed the diagnosis.