Serial angiotomography in supratentorial tumors

Serial angiotomography is a selective investigative method which contributes to exact differential diagnosis and localization of the tumor. With the localization near the midline of the supratentorial tumors it can occasionally be the only arteriographical method which will bring a definite result. With basal processes the relationship of the tumor to the bones and dura can be demonstrated more accurately. In addition angiotomography brings new haemodynamic aspects with regard to the circulation time and intensity of the tumor stain of glioblastoma.     

Delineation of pituitary adenomas by angiotomography

Summary The supra sellar extension of even small sized pituitary adenomas can be delineated with accuracy by angiotomography. This technique avoids the discomfort of pneumoencephalography in many patients. Angiotomography is also useful for the differential diagnosis of empty sellae.Presented at the Annual Meeting of the French Society of Neuroradiology. Montpellier, May 1975.     

Computed angiotomography of unruptured cerebral aneurysms

Twenty-seven unruptured cerebral aneurysms in 25 patients were detected by computed angiotomography. A comparison of the computed angiotomographic features in common aneurysm sites with plain CT and conventional arteriography was carried out. An isodense, round cisternal defect and a calcification or high-density mass in the basal cisterns on plain CT are important findings suggestive of unruptured aneurysms larger than 7 mm in diameter. The identification of the aneurysm, as well as of the afferent and efferent arteries on computed angiotomography is essential for the direct diagnosis of smaller unruptured aneurysms related to the circle of Willis. This is possible in a number of cases when the aneurysms are relatively large. It appears that the aneurysm size must be larger than 3 mm in diameter to permit its recognition on the basis of angiotomography and the avoidance of false-positive findings.     

Demonstration of cystic brain tumors by angiotomography

Cysts in cerebral tumours, as small as 1 cm in diameter, have been demonstrated by angiotomography with the sections made in the frontal plane. Two signs suggest a cystic lesion; a geometrically round, vessel-like outline in either the arterial or venous phase, resulting from a cystic cavity under pressure, and, during the parenchymatous phase, a radiolucent area having a radiological contrast identical to the non-injected hemisphere.     

Fast overlapping scans in cerebral computed angiotomography

Three to four overlapping cerebral CT scans were obtained after the injection of a single bolus of contrast medium. The rapid sequential dynamic scanning was carried out with table increments, while there was peak iodine density in the carotid artery. The demonstration of cerebral vessel lesions (aneurysms, moyamoya disease, arteriovenous malformations, arterial narrowing, etc.) is easier and safer with this method as compared with the conventional multiple injection technique.     

Clinical experience with iopamidol for myelography

Within 20 months 145 ascending thoracocervical myelographies and 155 lumbar myelographies with the nonionic water-soluble contrast medium iopamidol were performed. The iodine concentration given was 250 mg I/ml or 200 mg I/ml respectively. The total iodine never exceeded 2.5 g (8-10 ml). Image quality was assessed in terms of diagnostic value having experience of more than 1,000 myelographies using metrizamide. Picture quality was similar to metrizamide of equal iodine concentration. In 35 patients electroencephalography (EEG) was recorded before and after myelography with iopamidol 250. No changes that could be referred to the contrast medium were seen. There were no adverse reactions to lumbar myelography other than those following the lumbar puncture. In thoracocervical myelography mild and transient side effects occurred in 41 (28.3%). The most common were headache (41 cases), nausea (12), radicular pain (10), and dizziness (five). General seizures and psychopathologic symptoms were not observed.     

Clinical experience with technetium 99m teboroxime

Technetium 99m teboroxime is a boronic acid adduct of technetium dioxime complex, a neutral lipophilic technetium-containing myocardial perfusion imaging agent with high myocardial extraction, rapid myocardial washout, and entero-hepatic excretion. Early "redistribution" occurs, and, based on preliminary animal data, appears to be due to differential washout alone since there is no reuptake of teboroxime into the heart; however, for practical purposes two injections of tracer, at stress and at rest, are used clinically. Due to the high photon flux of technetium, diagnostic images can be acquired in the narrow time window between the end of blood clearance and peak hepatic uptake. To begin an acquisition within 2 minutes of tracer injection, the patient must be moved rapidly from the treadmill to a camera that is set and ready to count. A complete set of planar images can be completed in less than 5 minutes. Optimal single photon emission computed tomography (SPECT) imaging requires a continuously counting single detector camera or a three-headed camera to complete acquisition in less than 10 minutes. The image quality is comparable to thallium 201 and the imaging time is a fraction of the time required to complete SPECT thallium scans. Both left ventricular function (ejection fraction) and planar imaging can be performed in less than 4 minutes, without moving the patient from the treadmill, using the Sim-400 (Scinticor, Milwaukee, WI), a portable high count-rate, multicrystal scintillation camera. Because teboroxime maintains high myocardial extraction at high myocardial flow, it may be uniquely suited to be used in combination with pharmacological stress, which does not require patient movement between stress and imaging. Work is in progress to further refine and optimize imaging protocols using teboroxime.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical experience with multihance in CNS imaging

The use of Gd-BOPTA as a contrast agent for morphological and functional MR imaging allows improved detection and delineation of CNS lesions compared with conventional gadolinium agents. This not only leads to more confident diagnoses being made, but also results in a substantially improved differential diagnostic process. The higher relaxivity of Gd-BOPTA helps to optimize functional MR imaging studies, for example, perfusion MR imaging and dynamic MR angiographic protocols.