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Computed tomography of abdomen in staging and clinical management of lymphoma
Adult polycystic kidney disease: ultrasonographic and computed tomographic appearance Lawson, TL, McClennan BL, Shirkhoda A, JCU 6:297-302, 1978 Sixteen patients with adult polycystic kidney disease (PKD) were studied by gray scale B mode ultrasonography. The nephrosonographic appearance of adult PKD is a spectrum ranging from kidneys of normal size to enlarged kidneys with multiple variable-sized cysts. Strong focal cortical echoes were present in patients with only small cysts in the renal cortex. Hepatic cysts, which appeared as sharply marginated anechoic regions within the liver parenchyma, were detected by ultrasound in 50°70 of our patients. Hepatic and renal cysts appeared on computed tomograms as sharply defined, ovoid areas of low attenuation. There was good diagnostic correlation between ultrasonography and computed tomography. Ultrasound and computed tomography are accurate methods for diagnosis of adult PKD; however, the ability to diagnose quickly and noninvasively both renal involvement and associated extrarenal involvement makes ultrasound the procedure of choice for diagnosis, screening, and followup. Author's Abstract
Correlation between liver scintigraphy and computed tomography in the detection of liver metastases Frtihling J, Osteaux M, Eur J Nucl Med 3:169, 1978 Parallel scintigraphic and computed tomographic (CT-scan) examinations of the liver were carried out during the same observation period in 55 cancer patients in whom the liver status could be microscopically and macroscopically documented with regard to presence or absence of metastases. Scintigraphy was realized by means of 198Au or 99mTc-colloid using a rectilinear scanner or a gamma-camera; CT-scan images of the liver were obtained by a standard commercial instrument before and after injection of a contrast product. The liver was found to be normal in 38 out of the 55 observed patients and a metastatic involvement was seen in 17 cases. In 45 out of 55 cases, there was concordance between the results obtained by the two investigation methods and discordance in 10 cases. The sensitivity is 97% for the scintigraphy, 94°70 for the CT scan, and 100°70 for the common negative results. The specificity can be established as 64°70 for the scintigraphy, 65% for the CT scan, and 74070 for common positive findings. It seems therefore that Abstracts 240
these two techniques present the same efficiency in the detection of liver metastases and that the results obtained are only partly complementary. Author's Abstract
Postoperative CT changes Ruggiero G, Sabattini L, Neuroradiology 16:266, 1978 An analysis is made of 36 cases of severe postoperative changes, some of which are undoubtedly of iatrogenic origin. CT has considerably improved the possibilities of postoperative control. By this means it is easy to check the result of the operation. Moreover the neuroradiologist can verify the quality (indication and technique) of the work of his surgical colleagues in the same way that the neurosurgeon can verify the neuroradiologist's work in the operating theater. This will result in a better knowledge of each other and, even more important, in better care of the patient. Author's Abstract
Computed tomography of abdomen in staging and clinical management of lymphoma Best J J, Blackledge G, Forbes WS, Todd ID, Eddleston B, Crowther D, Isherwood I, Br Med J 2: 1675, 1978 During July 1976 to December 1977, 150 patients with Hodgkin's disease and 138 with non-Hodgkin's lymphoma were examined by computed tomography (CT). In 45 cases, 50 repeat examinations were conducted. Concurrent laparotomy and lymphography were performed on 68 and 56 patients, respectively. The overall incidence of false-positive CT examinations as confirmed by laparotomy was 7.4°70. In 18 patients with non-Hodgkin's lymphoma in the abdomen there was good correlation between the two techniques. Of the 50 patients with Hodgkin's disease who underwent laparotomy, 17 had splenic disease and 14 minimally enlarged lymph nodes in 20 areas; CT, however, detected only four diseased spleens and five minimally enlarged lymph nodes. Nevertheless, CT often detected enlarged lymph nodes missed by lymphography and was 23°70 more efficient than lymphography in detecting unsuspected disease. CT also detected unsuspected disease in patients with relapse of lymphoma. CT may replace other non-invasive investigations of abdominal disease in patients with lymphoma and give a reliable guide to prognosis. It
does not, however, eliminate the need for laparotomy in staging Hodgkin's disease. Author's Abstract
Computed tomography of the pancreas: the use of intravenous contrast to define the dorsal surface of the pancreas Steele JR, Sones P J, Comput Tomogr 2:303-307, 1978 After a non-selective review of 80 abdominal CT examinations, it was found that the use of intravenous contrast markedly improves the recognition of the superior mesenteric vein and the splenic vein. These veins lie adjacent to the posterior surface of the pancreas. When the pancreas is poorly seen due to inadequate retroperitoneal fat, when pancreatic size is borderline, or when pancreatic ductal obstruction is suspected on scans prior to intravenous contrast administration, the use of contrast may resolve the uncertainty. Author's Abstract
Cranial computed tomography in the diagnosis of systemic lupus erythematosus Gonzalez-Scarano F, Lisak RP, Bilaniuk LT, Zimmerman RA, Atkins PC, Zweiman B, Ann Neurol 5: 158, 1979 The cranial computed tomograms of 29 patients with systemic lupus erythematosus (SLE) were reviewed. Twenty-two patients had a clinical course consistent with central nervous system involvement. Of these, 20 had abnormal CT studies during the course of their CNS symptoms. The most common finding was sulcal enlargement, either with or without ventricular enlargement, and it was prominent in patients with either psychosis or dementia. Infarcts and intracranial hemorrhages were seen as well. Seven CT studies were obtained in SLE patients without a clear diagnosis of CNS involvement. Only one of these was abnormal. Author's Abstract
Computed tomography of the prostate Van Engelshoven JM, Kreel L, J Comput Assist Tomogr 3:45, 1979 The conventional anatomy of the prostate is reviewed and the computed tomography (CT) anatomy de-
scribed and illustrated. The results of 55 "normal" cases were analyzed for size and relationship to the symphysis pubis, retropubic space, and bladder, as shown on CT sections correlating the features with age and possible urinary symptoms. Attention is also drawn to the differences between phleboliths and prostatic calcification. Computed tomography is an effective method of demonstrating the prostate and surrounding structures and of assessing prostatic enlargement. Author's Abstract
Pelvic lipomatosis: diagnosis by computerized tomography scan Crawford ED, Dumbadze I, Katz DL, Vester JW, Am J Med 65:1021, 1978 Pelvic lipomatosis is a rare, relatively self-limiting disease characterized by the overgrowth of unencapsuluted lipomatous tissue within the pelvis. The diagnosis is suggested, but not substantiated, by the striking roentgenographic changes noted on barium enema and intravenous pyelogram. Previously, Pelvic laparotomy with tissue diagnosis was essential for documenting the disease. We report three cases in which computerized tomography was utilized as a safe, noninvasive, and accurate method of diagnosis. The role played by partial venous obstruction is discussed in addition to rectal bleeding as a mode of presentation. Author's Abstract
A clinical evaluation of isotope scanning, ultrasonography and computed tomography in pancreatic disease Braganza JM, Fawcitt RA, Forbes WS, Isherwood I, Russell JG, Prescott M, Testa H J, Torrance HB, Howat HT, Clin Radiol 29:639, 1978 In a prospective study of 46 patients with suspected pancreatic disease the provisional diagnoses arrived at independently by isotope scanning (IS), ultrasonography (USS) and computed tomography (CT) have been compared. In the control group, IS and CT were associated with a higher false positive rate than USS; the isotope scan was abnormal in most patients with proven chronic pancreatitis and cancer. The results from USS and CT were similar when structural changes were present. USS was superior in diagnosing pancreatic carcinoma and was a convenient means to follow the progression of acute pancreatitis to final resolution or the development of a pseudocyst. CT Abstracts 241
Correlation between liver scintigraphy and computed tomography in the detection of liver metastases Frtihling J, Osteaux M, Eur J Nucl Med 3:169, 1978 Parallel scintigraphic and computed tomographic (CT-scan) examinations of the liver were carried out during the same observation period in 55 cancer patients in whom the liver status could be microscopically and macroscopically documented with regard to presence or absence of metastases. Scintigraphy was realized by means of 198Au or 99mTc-colloid using a rectilinear scanner or a gamma-camera; CT-scan images of the liver were obtained by a standard commercial instrument before and after injection of a contrast product. The liver was found to be normal in 38 out of the 55 observed patients and a metastatic involvement was seen in 17 cases. In 45 out of 55 cases, there was concordance between the results obtained by the two investigation methods and discordance in 10 cases. The sensitivity is 97% for the scintigraphy, 94°70 for the CT scan, and 100°70 for the common negative results. The specificity can be established as 64°70 for the scintigraphy, 65% for the CT scan, and 74070 for common positive findings. It seems therefore that Abstracts 240
these two techniques present the same efficiency in the detection of liver metastases and that the results obtained are only partly complementary. Author's Abstract
Postoperative CT changes Ruggiero G, Sabattini L, Neuroradiology 16:266, 1978 An analysis is made of 36 cases of severe postoperative changes, some of which are undoubtedly of iatrogenic origin. CT has considerably improved the possibilities of postoperative control. By this means it is easy to check the result of the operation. Moreover the neuroradiologist can verify the quality (indication and technique) of the work of his surgical colleagues in the same way that the neurosurgeon can verify the neuroradiologist's work in the operating theater. This will result in a better knowledge of each other and, even more important, in better care of the patient. Author's Abstract
Computed tomography of abdomen in staging and clinical management of lymphoma Best J J, Blackledge G, Forbes WS, Todd ID, Eddleston B, Crowther D, Isherwood I, Br Med J 2: 1675, 1978 During July 1976 to December 1977, 150 patients with Hodgkin's disease and 138 with non-Hodgkin's lymphoma were examined by computed tomography (CT). In 45 cases, 50 repeat examinations were conducted. Concurrent laparotomy and lymphography were performed on 68 and 56 patients, respectively. The overall incidence of false-positive CT examinations as confirmed by laparotomy was 7.4°70. In 18 patients with non-Hodgkin's lymphoma in the abdomen there was good correlation between the two techniques. Of the 50 patients with Hodgkin's disease who underwent laparotomy, 17 had splenic disease and 14 minimally enlarged lymph nodes in 20 areas; CT, however, detected only four diseased spleens and five minimally enlarged lymph nodes. Nevertheless, CT often detected enlarged lymph nodes missed by lymphography and was 23°70 more efficient than lymphography in detecting unsuspected disease. CT also detected unsuspected disease in patients with relapse of lymphoma. CT may replace other non-invasive investigations of abdominal disease in patients with lymphoma and give a reliable guide to prognosis. It
does not, however, eliminate the need for laparotomy in staging Hodgkin's disease. Author's Abstract
Computed tomography of the pancreas: the use of intravenous contrast to define the dorsal surface of the pancreas Steele JR, Sones P J, Comput Tomogr 2:303-307, 1978 After a non-selective review of 80 abdominal CT examinations, it was found that the use of intravenous contrast markedly improves the recognition of the superior mesenteric vein and the splenic vein. These veins lie adjacent to the posterior surface of the pancreas. When the pancreas is poorly seen due to inadequate retroperitoneal fat, when pancreatic size is borderline, or when pancreatic ductal obstruction is suspected on scans prior to intravenous contrast administration, the use of contrast may resolve the uncertainty. Author's Abstract
Cranial computed tomography in the diagnosis of systemic lupus erythematosus Gonzalez-Scarano F, Lisak RP, Bilaniuk LT, Zimmerman RA, Atkins PC, Zweiman B, Ann Neurol 5: 158, 1979 The cranial computed tomograms of 29 patients with systemic lupus erythematosus (SLE) were reviewed. Twenty-two patients had a clinical course consistent with central nervous system involvement. Of these, 20 had abnormal CT studies during the course of their CNS symptoms. The most common finding was sulcal enlargement, either with or without ventricular enlargement, and it was prominent in patients with either psychosis or dementia. Infarcts and intracranial hemorrhages were seen as well. Seven CT studies were obtained in SLE patients without a clear diagnosis of CNS involvement. Only one of these was abnormal. Author's Abstract
Computed tomography of the prostate Van Engelshoven JM, Kreel L, J Comput Assist Tomogr 3:45, 1979 The conventional anatomy of the prostate is reviewed and the computed tomography (CT) anatomy de-
scribed and illustrated. The results of 55 "normal" cases were analyzed for size and relationship to the symphysis pubis, retropubic space, and bladder, as shown on CT sections correlating the features with age and possible urinary symptoms. Attention is also drawn to the differences between phleboliths and prostatic calcification. Computed tomography is an effective method of demonstrating the prostate and surrounding structures and of assessing prostatic enlargement. Author's Abstract
Pelvic lipomatosis: diagnosis by computerized tomography scan Crawford ED, Dumbadze I, Katz DL, Vester JW, Am J Med 65:1021, 1978 Pelvic lipomatosis is a rare, relatively self-limiting disease characterized by the overgrowth of unencapsuluted lipomatous tissue within the pelvis. The diagnosis is suggested, but not substantiated, by the striking roentgenographic changes noted on barium enema and intravenous pyelogram. Previously, Pelvic laparotomy with tissue diagnosis was essential for documenting the disease. We report three cases in which computerized tomography was utilized as a safe, noninvasive, and accurate method of diagnosis. The role played by partial venous obstruction is discussed in addition to rectal bleeding as a mode of presentation. Author's Abstract
A clinical evaluation of isotope scanning, ultrasonography and computed tomography in pancreatic disease Braganza JM, Fawcitt RA, Forbes WS, Isherwood I, Russell JG, Prescott M, Testa H J, Torrance HB, Howat HT, Clin Radiol 29:639, 1978 In a prospective study of 46 patients with suspected pancreatic disease the provisional diagnoses arrived at independently by isotope scanning (IS), ultrasonography (USS) and computed tomography (CT) have been compared. In the control group, IS and CT were associated with a higher false positive rate than USS; the isotope scan was abnormal in most patients with proven chronic pancreatitis and cancer. The results from USS and CT were similar when structural changes were present. USS was superior in diagnosing pancreatic carcinoma and was a convenient means to follow the progression of acute pancreatitis to final resolution or the development of a pseudocyst. CT Abstracts 241