Computed tomographic features of intraperitoneal fat-containing lesions: pictorial essay.

Abdominal CT, which is a common imaging modality performed for a variety of clinical indications, provides an important tool in the diagnosis and evaluation of various lesions with fatty components affecting the peritoneal cavity and its contents.     

Computed tomographic features of esthesioneuroblastoma

Summary Esthesioneuroblastomas are uncommon neoplasms of the superior nasal cavity originating from olfactory epithelium. High resolution CT features of this neoplasm have not been well studied. Nine cases of esthesioneuroblastoma were reviewed to evaluate findings on high resolution CT. Homogeneous soft tissue masses with relatively uniform enhancement centered in the superior nasal cavity are characteristic. Bony erosion is frequent and usually accompanied by molding of bone. Staging, determined by extension and critical for treatment decisions, is well evaluated by CT.     

Computed tomographic features of mandibular osteochondroma

Osteochondroma of the mandibular condyle is fairly rare. We describe a case of this lesion in a 52-year-old woman who presented with symptoms of temporomandibular joint dysfunction. Although a panoramic radiograph demonstrated the bony exostosis, a pre-operative CT examination showed the relationship of the tumour to the condyle and also depicted soft-tissue changes secondary to the growth.     

Computed tomographic features of round atelectasis

Computed tomography (CT) of the chest is often variable in the evaluation of pulmonary masses. Our case demonstrated characteristic findings on CT that aided in the diagnosis of round atelectasis.     

Computed tomographic features of renal tuberculosis

Computed tomograms (CT) in twenty cases of renal tuberculosis (TB) were reviewed in comparison with intravenous urograms. CT findings were calyectasis, low parenchymal density, parenchymal retraction, and calcification. The main CT feature of renal TB was the simultaneous appearance of these findings in combination. Three of these findings were seen in two-thirds of the cases in the present series. Total renal volume was grossly normal in 10 of 24 affected kidneys and decreased in only seven. Global enlargement of the affected kidney occurred when calyceal dilatation surpassed parenchymal retraction. In our series, affected kidneys tended not to be small in size when renal TB was active. Non-functioning kidneys depicted by intravenous urography were successfully evaluated by CT.     

Computed tomographic features in ovarian bleeding

CT scans of eight patients with ovarian bleeding (7 idiopathic and 1 secondary to bleeding tendency) were reviewed. CT showed intrapelvic hemorrhage in all cases, and ruptured ovary was identified in 6 cases. High density area in or around the ovary, seen in 2 cases, suggested the site of bleeding. In 4 cases the ovary was observed as a low density area. Ovarian bleeding is a common disorder, and should be considered as a differential diagnosis of intrapelvic hemorrhage in females.     

Computed tomographic features of primary brain lymphoma

Head computed tomographic (CT) examinations of 14 patients with primary brain lymphoma were reviewed to assess the CT features of the presenting and subsequent lesions. Presenting lesions were single in 62% and multiple in 38%. Lesions tended to be iso- or hyperdense and homogeneously enhancing. They were commonly located in the deep hemispheric regions, corpus callosum, and posterior fossa. Despite these characteristic patterns, the diagnosis of lymphoma was initially considered in just three patients. Follow-up CT showed good initial response to radiotherapy in 10 patients although mortality was high and posttherapy changes were frequent. Consideration of primary brain lymphoma by radiologists is important, as needle biopsy and radiotherapy may be preferred to a surgical resection.     

Computed tomographic assessment of intraperitoneal fluid distribution prior to intraperitoneal chemotherapy for ovarian cancer.

Intraperitoneal chemotherapy (IPCT) is under evaluation in patients with ovarian cancer. Computed tomographic peritoneography (CTP) prior to IPCT establishes the distribution of the infusate, which if complete, demonstrates the patient's suitability for this method of treatment. We report our method of CTP and describe the intraperitoneal fluid distribution and complications encountered in 28 patients with advanced ovarian carcinoma being considered for IPCT.     

Computed tomographic appearances of treated metastatic testicular tumours

Recent therapeutic advances have considerably improved survival rates in patients with testicular tumours. Computed tomography (CT) permits accurate staging and follow-up monitoring of these patients, and it is important, therefore, to be familiar with the evolution of abnormalities on CT after treatment. This study was undertaken to evaluate these appearances and consider their impact on management. Eighty-three patients with metastatic testicular neoplasms had serial CT scans as part of their management. The average age was 34 years (range 19-66 years) with a mean follow-up period of 30 months (range 3-97 months). Seventy-three patients had nodal disease at some stage: 44% reverted to normal on treatment, with no recurrence, while 30% regressed but did not clear completely. Thirty-six patients had lung lesions: although most responded to treatment persistent abnormality was observed in 39% of cases. Nine patients had extranodal disease. A variable response to treatment is reflected by CT findings that contribute to the development of a follow-up strategy whereby successful therapy may be recognised and residual or recurrent disease confirmed.     

F-18 FDG PET-CT findings of intraperitoneal carbon particles-induced granulomas mimicking peritoneal carcinomatosis

F-18 FDG PET-CT is a useful modality for monitoring residual or recurrent tumors after surgical resection. We report on 3 patients with intraperitoneal charcoal-induced granulomas mimicking peritoneal carcinomatosis on PET-CT images. Two of them underwent a radical gastrectomy because of advanced gastric cancer, and the other underwent a hemicolectomy because of sigmoid colon cancer. All 3 patients had a history of intraperitoneal chemotherapy using mitomycin C bound to activated carbon particles during surgery. Follow-up PET-CT studies demonstrated increased FDG uptake mimicking peritoneal carcinomatosis on PET images alone. However, the accompanying noncontrast CT showed variously shaped hyperdense nodules in the dependent positions of the peritoneal cavity, including the paracolic gutter and rectovesical space, indicating charcoal-induced granulomas rather than peritoneal carcinomatosis.     

Computed tomographic features of Legionella pneumophila pneumonia in 38 cases

PURPOSE: To characterize the imaging features of Legionella pneumophila pneumonia (LPP). SUBJECTS AND METHODS: Imaging findings of computed tomography (CT) in 38 cases of microbiologically or serologically determined LPP were analyzed and compared with those of 35 cases of Streptococcus pneumoniae pneumonia. RESULTS: In cases with LPP, abnormal opacities were distributed in a single lobe in 5 cases, in multiple lobes unilaterally in 10 cases, and multifocally and bilaterally in 23 cases. All cases showed consolidation and/or ground glass opacity in lung fields. Sharply demarcated peribronchovascular foci of consolidation intermingled with ground glass opacity were noted in 24 cases (24 of 38, 63%), whereas imaging features were seen in only 3 cases (3 of 35, 9%) of Streptococcus pneumoniae pneumonia. These CT patterns have nothing to do with clinical features such as age, sex, severity of disease, and time between onset of disease and CT examination. CONCLUSIONS: Imaging features of LPP on CT include bilateral and unilateral single and multifocal consolidation and ground opacity. Sharply demarcated peribronchovascular foci of consolidation intermingled with ground glass opacity seem to be one of the most frequent CT appearances of LPP.     

Computed tomography with intraperitoneal contrast medium for localization of peritoneal dialysis leaks

Dialysate leakage into subcutaneous tissues occurs not uncommonly in patients on continuous ambulatory peritoneal dialysis. When the leakage site cannot be localized clinically, CT with intraperitoneal contrast medium administration may localize the site. We report our experience with three cases in which this technique did localize the leakage site and thereby determined the type of surgical correction.     

Computed tomographic features of afferent loop syndrome: pictorial essay.

ALS, a rare condition, is often difficult to diagnose clinically but has a characteristic CT appearance as a U-shaped, fluid-filled tubular structure crossing the midline between the abdominal aorta and the superior mesenteric artery. Radiologists should be familiar with this rare entity, as awareness of its pathognomonic CT features will aid in establishing the correct diagnosis as well as in offering a tentative etiology as a guide for treatment.     

Computed tomographic features of pulmonary septic emboli: comparison of causative microorganisms

OBJECTIVE: To describe and compare the computed tomographic (CT) findings of pulmonary septic emboli in causative microorganisms. METHODS: The CT findings of 16 patients (8 men and 8 women; age range, 17 to 80 years; mean, 53.1 years) with documented pulmonary septic emboli were retrospectively reviewed by 2 radiologists; their decisions on the findings were reached by consensus. Statistical analysis was performed using the t test and the chi test. RESULTS: A total of 197 peripheral nodules were seen in 6 gram-positive (n = 88) and 10 gram-negative (n = 109) septic pulmonary emboli patients, respectively. The sizes of the nodules (15.94 mm; range, 3-46 mm) in gram-positive septic emboli were larger than those (12.29 mm; range, 4-44 mm) in gram-negative septic emboli (P = 0.006). Cavitation (n = 30 [34%] vs n = 23 [21%]; P = 0.041) and air bronchogram (n = 12 [14%] vs n = 4 [4%]; P = 0.008) within the nodules were more commonly seen in gram-positive septic emboli. A ground-glass attenuation halo around a nodule (n = 69 [63%] vs n = 32 [36%]; P = 0.000) and feeding vessel signs (n = 56 [51%] vs n = 25 [28%]; P = 0.001) were more commonly seen in gram-negative septic emboli. Wedge-shaped peripheral lesions abutting the pleura were seen in 4 gram-positive (67%) and in 1 gram-negative (10%) septic emboli patients, respectively (P = 0.047). CONCLUSIONS: The detailed CT characteristics of peripheral nodules in pulmonary septic emboli may be able to differentiate the causative microorganisms and to provide additional information regarding treatment plans in patients with sepsis.     

Computed tomographic imaging features of sudden cardiac arrest and impending cardiogenic shock

We intend to describe the imaging findings of sudden cardiac arrest occurring during computed tomographic (CT) examination and also of impending cardiogenic shock in 4 patients. Despite rare reports of acute cardiac arrest occurring during or shortly after CT scan, CT features are quite characteristic. Familiarity with CT findings of these patients is essential for accurate interpretation of images, immediate initiation of resuscitation, as well as informing clinical physician in these conditions.