Ultrasonography of the diaphragmatic crura.

The diaphragmatic crura are being recognized with increasing frequency on routine sonograms. In a study of 100 random patients the right crus was seen in parasagittal scans in 50% of patients and in transverse scans in approximately 90%. The left crus was not specifically identified on parasagittal scans, but was visible in about 50% of patients on transverse scans. Longitudinal coronal approaches can significantly improve visualization of the crura.     

Computed tomographic demonstration of aortic transection at the diaphragmatic hiatus

A rare case of dissection of the descending aorta at the level of the diaphragmatic hiatus is presented.     

Computed tomographic evaluation of the breast.

Experience with a dedicated breast CT scanner (General Electric CT/M) using a contrast medium enhancement technique indicates that CT is superior to mammography, thermography, or physical examination for diagnosing both benign and malignant mammary disease especially in dense, thick, or fibrocystic breasts. CT is capable of diagnosing totally unsuspected early miniature carcinomas. It can identify and differentiate potential precancerous lesions from benign fibrocystic disease, and is the diagnostic tool of choice for evaluating and following severe fibrocystic disease. CT evaluation also affords definitive diagnostic help in instances where the mammographic, thermographic, and/or physical examinations are inconclusive. It can influence immediate surgical intervention or mitigate against an unnecessary biopsy. The study not only demonstrates morphologic changes in the breast but also accurately depicts an altered iodine pool in mammary tissues.     

Computed tomographic evaluation of non-metallic middle-ear prostheses

Non-metallic middle-ear prostheses, including a plastipore total ossicular replacement prosthesis (TORP) and partial ossicular replacement prosthesis (PORP), a Teflon loop stapes piston, and a Ceravital PORP were used to reconstruct the ossicular chain in formalin fixed cadaver temporal bones. The temporal bones were examined using high resolution, thin-section computed tomographic techniques identical to those used for patient studies. The detail and resolution of the images were comparable with those obtained on standard patient exams. The temporal bones were evaluated to determine the appearance of the prostheses in normal and abnormal positions within the middle ear. The radiologist examined the images without fore-knowledge of the position of the prostheses and was able to accurately identify both normal and abnormal positions. With the proper technique an accurate evaluation of non-metallic middle-ear prostheses is possible by high-resolution computed tomography.     

Computed tomographic evaluation of intrathoracic thyroid malignancy

As only a few cases of intrathoracic thyroid malignancy with computed tomographic (CT) examination have been described, we reviewed the CT examinations of three patients with primary and five patients with recurrent thyroid malignancy involving the thorax. Irregular border of the thyroid mass, extension of tumor mass into mediastinal fat or chest wall, or lymphadenopathy suggested the malignant nature of the primary tumor. CT examination in recurrent disease demonstrated mediastinal, hilar and retrocrural adenopathy, compression of major vessels with collateral flow, pulmonary and bony metastases. CT was of value both in identifying the extent of disease and documenting response to treatment.     

Computed tomographic evaluation of aortic aneurysms.

Applications of computed tomography are being extended from the brain to other body parts. This report describes CT scanning of abdominal and thoracic aortic aneurysms in 30 patients. CT shows greatest promise in abdominal aortic scanning, where reliable identification of the aorta can be achieved even in the absence of enlargement or calcification. However, current limitations prevent visualization of internal detail such as intimal plaques or mural thrombi. Technical advances are described which should have an important bearing on this.     

Computed tomographic evaluation of the early phase of adrenoleukodystrophy

Summary An unusual case of giant aneurysmal dilatation of torcula in a 2 1/2-year-old boy with multiple intracranial venous sinus occlusions is described.     

Computed tomographic evaluation of the retrocrural prevertebral space.

Abdominal computed tomography (CT) scans of 151 patients were reviewed for the presence of discrete structures between the vertebra and the diaphragmatic crura. A distinct retrocrural structure larger than 6 mm in diameter was present in 39 patients. In 112 patients the retrocrural space contained discrete structures smaller than 6 mm or showed no definable structures. Of the 39 patients with retrocrural structures larger than 6 mm in diameter, 37 had clinical and other CT evidence as well as biopsy or lymphangiographic evidence of middle to upper abdominal paraaortic adenopathy. Only three of the 112 patients exhibiting retrocrural structures smaller than 6 mm had such evidence of associated retroperitoneal adenopathy. These three were found to have enlarged nodes, but in the lower rather than the middle or upper abdomen. It is concluded that discrete retrocrural structures larger than 6 mm represent enlarged lymph nodes. Smaller retrocrural structures represent azygous veins or normal lymphatic structures.     

Computed tomographic evaluation of advanced gastric cancer]

Pre-operative CT of 75 gastric cancer lesions in 74 patients were evaluated for CT diagnosis of N-factor, n-factor and pancreatic invasion. 1. Sensitivity of CT diagnosis of N-factor was depended upon the size of the lymph node; Group A, where all nodular density within the fat plane of anatomical lymph node location were called abnormal, revealed 73.8% sensitivity. Sensitivity of group B was 69.8%, group C was 60.4% and group D was 28.6%. Pre-education of operators did not significantly affect the sensitivity. 2. CT detected No. 3, 7, 8, 9, 12, 14, and 16 in higher sensitivity, and No. 2, 4, 5 and 15 in lower sensitivity as N-factor. 3. Overall CT sensitivity of n-factor diagnosis was 48.5% and specificity was 95.6% and accuracy was 88.5%. No. 3, 7 and 8 showed higher sensitivity and specificity, but low sensitivity and specificity were noted at No. 1 and 4. 4. Pancreatic invasion was evaluated objectively from ROC, and sensitivity was 80.0% and 73.3% with and without operative findings, respectively.     

Computed tomographic evaluation of blunt abdominal trauma.

Given the magnitude of the problem of blunt abdominal trauma, we have the opportunity, through abdominal CT, of making a great impact on the health care of many patients. Through the efforts of early investigators and with continued refinements, great progress has been made in developing CT as an accurate, reliable emergency modality. With meticulous technique and careful interpretation, even subtle visceral, bowel, and mesenteric injuries can be detected. Close monitoring by an experienced tomographer and a good working relationship with referring clinicians can lead to prompt and appropriate clinical decisions.     

Computed tomographic evaluation of hydronephrosis in uterine carcinoma

By using computer tomography (CT) hydronephrosis was discovered in 13 cases (18 sides) of previously treated uterine carcinoma. Local tumor recurrence was found to be responsible in six cases, para-aorta nodal masses in three cases and intrapelvic nodal masses in two others. One case was considered to be due to vesicoureteral reflux resulting from radiation cystitis. It was difficult to distinguish increased fibrous tissue as radiation sequelae from tumor infiltration. A variety of causes of hydronephrosis in uterine carcinoma can be clarified by CT.     

Computed tomographic evaluation of primary osseous malignant neoplasms

A total of 128 patients with pathologically confirmed primary osseous malignant lesions was examined by computed tomography (CT). In each case, the CT findings were compared with those from the standard radiographs, tomograms, and isotope bone scans as well as with the clinical findings, in regard to tumor detection, diagnosis, and extent. Even though CT demonstrated all lesions, 96% were seen on radiographs, with only 4% of tumors identified solely by CT. In 7% of cases, CT provided unique diagnostic information not obtainable by other means. In 77% of cases, CT gave a better indication of tumor location, extent, and relationships than did any of the other methods. After treatment, CT was efficacious in the detection or ruling out of recurrences and in patient follow-up after chemotherapy or radiation therapy.