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Computed tomography of acoustic neuroma
overlap is present and the CT numbers we not. in themselves. enough to separate the two. Stephen 1. Schobel, M.D. Medicn! University of South Carolina CORl ed lo aphy in Lhe ~~a~~Qai~, and SlSfj ~~~~~1 of a~~~~~~a~ lymphcma Schaner EG. Head GL, Dopp. man JL, Young UC (National Cancer Institute, National Institutes of Health, Beihesda, Maryland) Comput Assist Tomoqr 1:17C-180, April 1977 -rbe authors compare the results uf bipedal lympbography and computed tomography io the staging of abdominal lgmphoma (23 cases). When compnred wiih computed tomography. lymphogram underestimated the volume of perhortic nodal mass (11123). superior extent of node1 involvement (13123) and f&d to demonstrate involvement in the renal hilum (10123) in the merentary (3/23). in the ~steriormediastinum~l123~,therplenichilumandihe roleen (2 23) and in heoatic nareenchvma (l/23). In two ca%r, lymph nodes were morphologically abnormal on lymphography. but normal in size ond were not detected by computed tomography. CT is nrexntlv not able to detect subtle ch;ineer in archkturc~of unenlarged lymph nodes. bit it ~I!ow better delineation of the extent of nodal enlargement wttholrt dep%oding upon nwial function. The autho * feel that it will be valuablle in both staging and radiaticn therapy planning.
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Goldwin fiadlology
RL, Hellzman ER, 124:235. July 1977
Proto
AV.
The authors assessthe efncacy of cnmputed tomog raphy (CT) scsnning of the mediastinum and cone. late CT tomograms with ymss body sections fmm the same cadaver. MediRstinal vn~culrw structures were idcntilicd is a high percentage of cnsw, IS were oxmy normal mediastinnl organs. Tbe left subclavian artery was identifsd in th: wgion of the apea in 88% of cases, the wending aorta in two. thirds of cases and Ihe z,ortic mot in 82% of cases. The right pulmonary artery in its position haween the superior rena srld the cave nnd right mainstem bronchus ~6s identitied in 21% of icases. and is possibly useful as B new method of evaluating pulmonary arter:al hypertension. The esophagus was virunlized in pmt in twwthirds of the cases. Vahular calciticntions were quite easily identified. Some indications for CT of the mediastinum include: 1) evaluation of lesions partially 01 questionsbly hidden by the mediastinum; 2) evaluation of th: tissue density of lcsions by determination of their attenuation coefficient; 3) identification of the mediastinum when widened by fatty infiltration or pvwninent great veesols; 4) evaluation of the mediastinum which is abnormal 07 questionably abnarmnl on standard rsdioxraphs; 5) awluation of tumor extent and loca!izatian or waluiltion of mcdiastinal l:,mph node enlargement. Robert C. McReynclds, M.D. Ocbsner Clink
Stephen 1. Scbnbe,. M.D. Mcdlcal University of South Carolina Benign Repelic tumofs snd cysta in wonwn us4ng oral contr&wptive agmtr: ComfnMd tomography 18 B dlagnartic ald Havrllls TA. Papa RG. bllidi RJ, Haaga JR (Clevslend Clinic, Clewland, Ohio) Cleve. land 44:41-47, SprinQ 1s 77 The authors report two c8se.x en,: hepalic cyst a”(: one adeaoma of the liver demcmtrrwd by computed tomOgraphy and proven by :iurgery in women taking oral contraceptives. The cyst bad B Cl’ oom. bet of 0 and failed to enhmxr with iotrsveoous contra%“. The ndaoms wr indirl:in@k~ble from surrosndlng hepatic parenchyma both before and atlv cootra%t infusion and ~8s visible only as bullour enlargement of thz liver. Stcphco 1. Scbabel. M.D. Medical University of South C~rotins
Compuled Potnography 01 acouc~lc new. ems Davla P:R, Parker SW, Nnw PFJ, Aoberson GH, Taveras JM. Ojemann RJ, Weiss AD (Maaaactwaaitos General Hospital md Harvard Medical School) fladiology 124:81-86, July 1977 A retrospective review of 49 crises of curgicnlly prow acoustic ne~~romas WBI carried out with ape&l reference to correfation with pwperative computed tomography (CT) ncnns, including contrast enhancement (CB). Eighty percent ot the patients had I poritivc CT scan following CE. With only one exception. the size of the &ions estimated at surgery was greater fhan that recorded on the Cl scan. the increw! timging from 0.5 to 2.0 cm. Of the casesshowing no CE, none had poritive plain L’T scans. All of the Else negative scans were proven a! surgery to bc asrristed with terionr less than 2 cm
Mickael 1. Helm. M.D. Ochmer Clkdc
~l~on+lsi~ d inurscranisl sbtxzwdu Shaw MDM, Ru!i?.ell JP, (Institure of Neurological Southern General Hospital, Sciences, Glasgow) J New01 Neurosurg Psychiatry 40~214-223, fdamh 1977 Cwwuted +amogr;,phy (CT) xu,s c,f 60 pn+ients uitk intracrmia. infection were reviewed. Comnuted
uitk J. false ;;eg;&e rsle of about 1%. Surrounding .I” intrscrnrrial abscess ir an arra of hyperemia whit defiled halo of increased densq during CT scan with contrast enkancemcnt. In well developedal~~cewx. this halo may be present before con+ms+\:nkanecmen+.If enhangmen+ doer not OECIII. end pan icularly if any ventricular distortion ;I preset:. further investigations nre required. i.v.. brain scan EEG. angiograpky, and possibly kurr hnle erplnrhtion. However. despite the hi&b degrx of accuracy in dk~gnosir. the mortality rate from infracrPnisl abxess remains anchnnged.
1appears ai aclearly
a* i~t~~~. Pm% Gild B N Jr. Koo AH, NlcDonald CJ (Santa Clara Valley Medical Center, Department of RadIology, San Jose, Callfornla) Radiology 124:108112, July 1977 Six patients with intrscmnial ~~~~*~~ were studied with computed tomography. with and without con. trant material. The initial ap~arance I bra1 hemomhrgc. Tke prewncc cf I) an atypical clinical setting or bleeding rite. 2) motrart enksncement early in the clinical eMLrse or 3) multiple lesions were found to be important difSxen+iating factors in the caonsiderat’hm af metastatic diseaseas a possible cause of intraccrcbnl hemmrbege. Diagnostic accuracy cnn be improved by an iafusioo wan when intracercbral hemorrkagt;is ruggested. T. hi. Dir, bf.D. Ockrner Clinic
JacquesA. de IS Bwxonne. M.D. ~OrhsnerClinic
Diagnostic wxeracy of ccrrbral englqj. raphy and computrrlzed cranial lomq raptly Strasberg 2, Mclot MJ, Kapur P, Tuttle RJ (McMasler Ilnlwr8ity Medlcal School. and Dopartme~la of Radiology, St. Joseph’s Hoaplta, HamIlton, and Hamilton General Hospital) Can Med ASSOC J llg(l0): May 21, lS77 In an uttempt to compote the relative cllicacy of mmpa+c;ized crwicd tomography (CT) wifh cerebral angiography. 64 paients were sludicd via both modalities and the rwlts cumpured. Overall diagnostic ~ccuwy was similar (81% for nngiogrnpky nnd 84% for CT). but each modality proved its supwiorlt)’ in pnrticular types of problems. CT denmnnlrnted ntropky and ventricular dilatation particularly well. and w.w the only modality
computrr lomo(lnphj F~rrwBreohner T, Winter J, Anesth Anr:lg (Clew) 56(3):344347, May-June 1977 Cerebral computer tomagrapky. II rwmtly intru. duced ncurorndiolqic procedure. involves tomy raphic x.rays of borimontalbrain zactiwr. Al:hau$h rn”~t adults underga tkc procedure without anestherln, children and unnmpcratiwa adults mug+ be given geneal awrthesin for nbsdutf knmobllity. Of 83 trmadurca under nencnl ansstherir. IO
.
.
.
.
Goldwin fiadlology
RL, Hellzman ER, 124:235. July 1977
Proto
AV.
The authors assessthe efncacy of cnmputed tomog raphy (CT) scsnning of the mediastinum and cone. late CT tomograms with ymss body sections fmm the same cadaver. MediRstinal vn~culrw structures were idcntilicd is a high percentage of cnsw, IS were oxmy normal mediastinnl organs. Tbe left subclavian artery was identifsd in th: wgion of the apea in 88% of cases, the wending aorta in two. thirds of cases and Ihe z,ortic mot in 82% of cases. The right pulmonary artery in its position haween the superior rena srld the cave nnd right mainstem bronchus ~6s identitied in 21% of icases. and is possibly useful as B new method of evaluating pulmonary arter:al hypertension. The esophagus was virunlized in pmt in twwthirds of the cases. Vahular calciticntions were quite easily identified. Some indications for CT of the mediastinum include: 1) evaluation of lesions partially 01 questionsbly hidden by the mediastinum; 2) evaluation of th: tissue density of lcsions by determination of their attenuation coefficient; 3) identification of the mediastinum when widened by fatty infiltration or pvwninent great veesols; 4) evaluation of the mediastinum which is abnormal 07 questionably abnarmnl on standard rsdioxraphs; 5) awluation of tumor extent and loca!izatian or waluiltion of mcdiastinal l:,mph node enlargement. Robert C. McReynclds, M.D. Ocbsner Clink
Stephen 1. Scbnbe,. M.D. Mcdlcal University of South Carolina Benign Repelic tumofs snd cysta in wonwn us4ng oral contr&wptive agmtr: ComfnMd tomography 18 B dlagnartic ald Havrllls TA. Papa RG. bllidi RJ, Haaga JR (Clevslend Clinic, Clewland, Ohio) Cleve. land 44:41-47, SprinQ 1s 77 The authors report two c8se.x en,: hepalic cyst a”(: one adeaoma of the liver demcmtrrwd by computed tomOgraphy and proven by :iurgery in women taking oral contraceptives. The cyst bad B Cl’ oom. bet of 0 and failed to enhmxr with iotrsveoous contra%“. The ndaoms wr indirl:in@k~ble from surrosndlng hepatic parenchyma both before and atlv cootra%t infusion and ~8s visible only as bullour enlargement of thz liver. Stcphco 1. Scbabel. M.D. Medical University of South C~rotins
Compuled Potnography 01 acouc~lc new. ems Davla P:R, Parker SW, Nnw PFJ, Aoberson GH, Taveras JM. Ojemann RJ, Weiss AD (Maaaactwaaitos General Hospital md Harvard Medical School) fladiology 124:81-86, July 1977 A retrospective review of 49 crises of curgicnlly prow acoustic ne~~romas WBI carried out with ape&l reference to correfation with pwperative computed tomography (CT) ncnns, including contrast enhancement (CB). Eighty percent ot the patients had I poritivc CT scan following CE. With only one exception. the size of the &ions estimated at surgery was greater fhan that recorded on the Cl scan. the increw! timging from 0.5 to 2.0 cm. Of the casesshowing no CE, none had poritive plain L’T scans. All of the Else negative scans were proven a! surgery to bc asrristed with terionr less than 2 cm
Mickael 1. Helm. M.D. Ochmer Clkdc
~l~on+lsi~ d inurscranisl sbtxzwdu Shaw MDM, Ru!i?.ell JP, (Institure of Neurological Southern General Hospital, Sciences, Glasgow) J New01 Neurosurg Psychiatry 40~214-223, fdamh 1977 Cwwuted +amogr;,phy (CT) xu,s c,f 60 pn+ients uitk intracrmia. infection were reviewed. Comnuted
uitk J. false ;;eg;&e rsle of about 1%. Surrounding .I” intrscrnrrial abscess ir an arra of hyperemia whit defiled halo of increased densq during CT scan with contrast enkancemcnt. In well developedal~~cewx. this halo may be present before con+ms+\:nkanecmen+.If enhangmen+ doer not OECIII. end pan icularly if any ventricular distortion ;I preset:. further investigations nre required. i.v.. brain scan EEG. angiograpky, and possibly kurr hnle erplnrhtion. However. despite the hi&b degrx of accuracy in dk~gnosir. the mortality rate from infracrPnisl abxess remains anchnnged.
1appears ai aclearly
a* i~t~~~. Pm% Gild B N Jr. Koo AH, NlcDonald CJ (Santa Clara Valley Medical Center, Department of RadIology, San Jose, Callfornla) Radiology 124:108112, July 1977 Six patients with intrscmnial ~~~~*~~ were studied with computed tomography. with and without con. trant material. The initial ap~arance I bra1 hemomhrgc. Tke prewncc cf I) an atypical clinical setting or bleeding rite. 2) motrart enksncement early in the clinical eMLrse or 3) multiple lesions were found to be important difSxen+iating factors in the caonsiderat’hm af metastatic diseaseas a possible cause of intraccrcbnl hemmrbege. Diagnostic accuracy cnn be improved by an iafusioo wan when intracercbral hemorrkagt;is ruggested. T. hi. Dir, bf.D. Ockrner Clinic
JacquesA. de IS Bwxonne. M.D. ~OrhsnerClinic
Diagnostic wxeracy of ccrrbral englqj. raphy and computrrlzed cranial lomq raptly Strasberg 2, Mclot MJ, Kapur P, Tuttle RJ (McMasler Ilnlwr8ity Medlcal School. and Dopartme~la of Radiology, St. Joseph’s Hoaplta, HamIlton, and Hamilton General Hospital) Can Med ASSOC J llg(l0): May 21, lS77 In an uttempt to compote the relative cllicacy of mmpa+c;ized crwicd tomography (CT) wifh cerebral angiography. 64 paients were sludicd via both modalities and the rwlts cumpured. Overall diagnostic ~ccuwy was similar (81% for nngiogrnpky nnd 84% for CT). but each modality proved its supwiorlt)’ in pnrticular types of problems. CT denmnnlrnted ntropky and ventricular dilatation particularly well. and w.w the only modality
computrr lomo(lnphj F~rrwBreohner T, Winter J, Anesth Anr:lg (Clew) 56(3):344347, May-June 1977 Cerebral computer tomagrapky. II rwmtly intru. duced ncurorndiolqic procedure. involves tomy raphic x.rays of borimontalbrain zactiwr. Al:hau$h rn”~t adults underga tkc procedure without anestherln, children and unnmpcratiwa adults mug+ be given geneal awrthesin for nbsdutf knmobllity. Of 83 trmadurca under nencnl ansstherir. IO