Computed tomography and magnetic resonance imaging in cystic fibrosis lung disease

Computed tomography (CT) is the current "gold standard" for assessment of lung morphology and is so far the most reliable imaging modality for monitoring cystic fibrosis (CF) lung disease. CT has a much higher radiation exposure than chest x-ray. The cumulative radiation dose for life-long repeated CT scans has limited its use for CF patients as their life expectancy increases. Clearly, no dose would be preferable over low dose when the same or more relevant information can be obtained. Magnetic resonance imaging (MRI) is comparable to CT with regard to the detection of most morphological changes in the CF lung. It is thought to be less sensitive to detect small airway disease. At the same time, MRI is superior to CT when it comes to the assessment of functional changes such as altered pulmonary perfusion. The recommendation is to further reduce radiation dose related to the use of CT and to use MRI in the follow-up of morphological changes where possible.     

Computed tomography of cystic neck masses

Computed tomography (CT) of the neck has been primarily applied to the assessment of malignant disease with few reports describing its utility in benign conditions. The authors report 13 cases of cystic neck masses evaluated by CT. Pathological conditions included brachial cleft cyst, laryngocele, thyroglossal duct cyst, cavernous lymphangioma, necrotic lymphadenopathy, and asymmetric jugular veins. Computed tomography was helpful in correctly predicting the etiology by determining the exact location of these masses in relation to the normal anatomic structures in the neck.     

Computed tomography of retroperitoneal cystic lymphangiomas

The CT features of retroperitoneal lymphangiomas are unilocular or multilocular cysts in the retroperitoneum and slightly and uniformly thickened wall that enhances following contrast medium administration. Three cases are reported.     

Computed tomography of folded lung

Computed tomography (CT) scans of 22 examples of folded lung in nine patients were reviewed. The most important CT criteria of folded lung are the presence of vessels and bronchi running in a smooth curvilinear fashion towards a peripheral mass with an ill defined central edge associated with pleural thickening. These features were seen in all 22 examples. The lesions are frequently multiple (eight out of nine patients). When these features are present the diagnosis can be made without recourse to biopsy or thoracotomy. Enhancement with intravenous contrast medium is unnecessary and does not provide any extra useful information. Various other previously described criteria such as air bronchograms are not necessary for the diagnosis.     

Computed tomography in chest diseases

The evaluation of mediastinum, lngs, and chest wall diseases can simutaneously be accomplished by computed tomography (CT). A wide range of congenital, inflammatory and neoplastic disorders seen at our institution are presented to show the additional information available by CT as opposed to conventional films. CT has the advantage of being able to detect minor differences in attenuation and its noninvasive.     

Computed tomography manifestations of peritoneal diseases

The peritoneal cavity is a potential space that is divided by the peritoneal reflections into various complex subspaces. It can be involved in many disease processes including developmental, inflammatory, neoplastic and traumatic conditions. Computed tomography is highly sensitive and consistent in detecting peritoneal pathology. This pictorial essay aims to emphasize and illustrate the CT features of the spectrum of peritoneal diseases.     

Computed tomography of cavernous sinus diseases

Summary We retrospectively analyzed CT scans of 21 cavernous sinus lesions in an attempt to discover CT findings helpful to the differential diagnosis. With the integration of various CT observations it was possible to categorize the lesions into inflammatory, vascular, benign neoplastic and malignant metastatic lesions with few exceptions. Four of 5 cases of septic cavernous sinus thrombophlebitis revealed unilateral or bilateral multiple irregular filling defects in the enhancing cavernous sinus with or without orbital inflammatory change. Four of 5 cases of carotid-cavernous fistula demonstrated unilateral or bilateral diffuse bulging and homogeneous enhancement of the cavernous sinus with obliteration of normal low densities of cranial nerves and gasserian ganglion. Dilatation and tortuosity of superior ophthalmic vein were also associated. Four of 5 cases of benign neoplastic lesion showed well-circumscribed enhancing masses confined to the cavernous sinus with pressure erosion or hyperostosis of adjacent bone. Five of 6 cases of malignant metastatic lesion showed changes suggesting malignancy such as destruction of adjacent bone or associated manifestations of intracranial spread. As compared with the axial scan, coronal scans proved to be more sensitive in detection of subtle cavernous sinus expansion, and superior in evaluation of intracavernous neural structures, relationships with the pituitary gland and changes in the skull base. Axial scans, however, were superior in detection of associated orbital and intracranial abnormalities. Scans in both projections are needed in the evaluation of most cavernous sinus diseases.     

囊性肾恶性肿瘤的CT诊断

目的 :探讨囊性肾恶性肿瘤的CT表现与临床病理基础 ,提高对囊性肾恶性肿瘤的认识。方法 :对经手术病理证实的 2 2 7例肾恶性肿瘤中 2 5例囊性肾恶性肿瘤的CT图像进行回顾分析。结果 :2 5例囊性肾恶性肿瘤中肾盂移行细胞癌 8例 ,肾细胞癌 16例 ,肾胚胎癌 1例。本组 2 5例囊性肾恶性肿瘤的壁均显示较厚 (厚于 3 .0mm) ,且厚薄不均 ,占 10 0 %。囊变区有不规则的分隔或囊内有实性成分 2 0例 ,占 80 %。增强后囊壁、囊内分隔及实性成分均有强化。囊变区内CT值较单纯性肾囊肿高 ,P <0 .0 1。结论 :囊性肾恶性肿瘤的CT表现有一定特征性 ,了解这些特征有利于正确诊断     

Computed tomography of “cystic” intramedullary lesions

Summary Using an EMI 5005 scanner with high resolution option, 75% of syrinxes were shown as low density cavities. Most spinal cord tumours caused isodense swellings, but 41% contained low density zones and cystic elements were demonstrated in 76% of these at surgery or by puncture of the spinal cord; a few (11%) of the isodense tumours were cystic. The differential diagnosis of low density intramedullary lesions is discussed.     

Computed tomography screening for lung cancer

1. Screening with low-dose computed tomography reduces mortality from lung cancer in high-risk patients. 2. Lung cancer screening with chest radiography alone or in combination with sputum analysis is currently not recommended. 3. The feasibility and impact of screening in patients with a low or moderate risk for primary lung cancer are currently not known. 4. A standardized framework for testing and management in a multidisciplinary fashion is necessary to provide lung cancer screening. 5. The National Comprehensive Cancer Network and the American Lung Association have recently issued guidelines for lung cancer screening with computed tomography in high-risk patients.     

Computed tomography in opportunistic lung infections

Chest radiography in two teenage boys, one with Wiscott-Aldrich's syndrome and one with acute lymphatic leucemia in remission showed increased interstitial pattern. In both computed tomography (CT) of the lungs showed heavy interstitial pneumonia, rather different in appearance but in both cases equal to the CT findings in opportunistic lung infections known from immunoincompetent patients with for instance pneumocystis carinii and/or cytomegalo virus infections. In both patients the CT findings led to lung biopsy establishing the etiologic agent.     

Computed tomography of benign cystic teratoma of the omentum

Benign cystic teratoma of the omentum is a rare gynecologic condition. No cases have been diagnosed preoperatively; six cases have been reported in association with an ovarian teratoma. We report a seventh case in which ultrasound and CT were used preoperatively.     

Computed tomography of cystic lymphangioma in a wandering spleen

A large cystic lymphangioma in a wandering spleen was discovered by chance in a young woman, 2 months after she delivered her first child. The clinical finding was that of a pelvic mass, which at CT was found to be a wandering spleen, containing multiple cystic lesions. The diagnosis of cystic lymphangioma was made at the pathological examination of the specimen after splenectomy. The association of cystic lymphangioma in a wandering spleen has not been reported previously.