Computed tomography of long-bone osteosarcoma.

Six cases of osteosarcoma, including medullary, parosteal, periosteal, and intracortical types, were studied by computed tomography (CT). In selected cases, CT provided additional preoperative information as to osseous size and soft-tissue extent. CT helped determine intramedullary involvement and specific sites of cortical destruction and thereby helped to plan the surgical approach to biopsy and the definitive excision.     

Computed tomography of parosteal osteosarcoma

Twelve patients with parosteal osteosarcomas were evaluated by computed tomography (CT). CT accurately defined the extent of the tumors for purposes of surgical planning, although tumor bone often could not be distinguished from thickened host bone. Nine tumors invaded the medullary cavity, a feature that implies a poorer prognosis when the tumor also contains high-grade areas. Six CT studies accurately detected the medullary invasion, but three did not. Lucent areas within dense tumors contained either benign tissue or high- or low-grade tumor; CT did not differentiate among these different tissues. CT also did not reveal small satellite nodules of tumor beyond the main tumor mass.     

Computed tomography of primary renal osteosarcoma

Primary renal osteosarcoma, a rare malignancy, was diagnosed preoperatively based on its unusual imaging features. The CT demonstration of a peripherally located renal mass containing ossification suggests the diagnosis of renal osteosarcoma. This diagnosis is clinically significant due to the poor prognosis of patients with this tumor even when surgically resectable.     

Computed tomography of parosteal osteosarcoma of the rib

The computed tomography findings in a case of radically resected parosteal osteosarcoma of the rib are reported. Computed tomography disclosed a huge ossifying mass with lobulated structure, ossifying rim, linear lucent zone between tumor and cortex, destruction of the affected rib cortex, and intramedullary involvement. These findings are specific to advanced parosteal osteosarcoma.     

Computed tomography in the evaluation of 41 cases of Ewing's sarcoma

Computed tomography (CT) has already proved extremely effective both in cerebral and abdominal pathology. Several recent publications describing first heterogeneous series [1, 2, 7, 11–17], then studies of a single type of lesion [3–6, 8] have illustrated its usefulness in the study of bone lesions. This report deals with 41 cases of Ewing's sarcoma studied by CT at the Institut Gustave Roussy from October 1977 to July 1981, and tries to show both the limitations and indications of this technique for the diagnosis, treatment, and follow-up of Ewing's sarcoma as well as in the diagnosis of any eventual recurrence.     

Computed tomography in the evaluation of patients with bilateral retinoblastomas.

Six patients with histologically proven retinoblastomas were examined by computed tomography, two at the time of initial diagnosis and four from 2 to 30 years following treatment, which consisted of radiation therapy alone or with surgery. The spectrum of computed tomographic findings includes: calcified retinal tumor, intracranial subarachnoid spread of tumor, radiation-induced tumors (papillary adenocarcinoma and undifferentiated sarcoma) in the field of prior radiation, and second, primary central nervous system tumor, a pineoblastoma.     

Computed tomography of osteosarcoma after intraarterial chemotherapy

The response to intraarterial cis-diamminedichloroplatinum II (CDP) chemotherapy was evaluated by computed tomography (CT) in 33 patients with pathologically proved osteosarcoma of the long or flat bones. Twenty-one of the 33 patients had a CT scan before chemotherapy was started. In the other 12 patients, a CT scan was obtained after at least two courses of treatment, and additional studies were performed during the course of therapy. In those patients responding to treatment, the posttherapy scan revealed a remarkable decrease or complete disappearance of the associated soft-tissue mass and clear reestablishment of the fat planes between the muscle bundles that had been obscured. There was sharp definition of the peripheral margins of the calcified healing neoplasm, and the calcification in the healing tumor could be differentiated easily from that of the original bone neoplasm. The findings of CT were compared with those of conventional studies and pathologic results. CT was more accurate than conventional studies in detecting healing process and diagnosis of remission.     

Computed tomography of the heart: Initial experience

Computed tomography (CT) provides non-invasive diagnosis of cardiac lesions by direct demonstration of the myocardium and the individual cavities of the heart. The potential role of CT scanning in the detection and quantitation of acute myocardial infarction has been previously investigated in experimental animals. Initial experience in assessing 10 patients admitted with recent infarction on biochemical and electrocardiographic evidence is reported. Intravenous infusion of iodinated contrast agents produced contrast enhancement either of the rim or diffusely through the myocardium in the area of infarct, as sited electrocardiographically. Patients with coronary artery bypass grafts and hypertrophic cardiomyopathy have also been studied by this method. Cardiac CT with intravenous administration of contrast may have an important role in the future in assessment and follow-up of ischaemic heart disease.     

Computed tomography in the evaluation of subdural hematomas.

Computed tomographic (CT) scans used in the diagnosis and management of subdural hematomas were analyzed with respect to their contribution to angiography and surgery. There has been a progressive increase in the use of CT in evaluating post-traumatic and postoperative subdural hematomas at the Mayo Clinic. At present, 40% of all patients undergo operation on the basis of the CT findings alone. False-positive diagnoses revealed at surgery have decreased to less than 4%. Erroneous negative interpretations have involved 10% of all patients whose diagnosis was subdural hematoma. Criteria for the interpretation of scans have been established.     

Computed tomography: evaluation of the posterior third ventricle.

The normal computed tomography (CT) appearances of the posterior third ventricle and related structures are presented. Seventy-six patients with lesions directly involving this ventricle were studied by CT, and results of other neuroradiological procedures evaluated. Primary tumors, metastases, hematomas, infarcts, and cysts may be reliably distinguished by CT, particularly if contrast enhancement is utilized. Size and density resolution limit the direct visualization of the aqueduct of Sylvius; stenosis however may be inferred. Small infarcts may be difficult to demonstrate by the use of CT scans without contrast enhancement, yet be shown by isotope scans.     

Computed tomography in the evaluation of hepatocellular carcinoma.

Computed tomography (CT) was used to evaluate 47 cases of hepatocellular carcinoma: it was definite in 37, equivocal in 5 and negative in 5 cases. No specific patterns of CT images were recognized. Pre- and postcontrast scans were necessary because several tumors could only be detected on one or the other scan. CT may reveal the exact extent of tumor and show additional tumors in case of multiple lesions. However, false negative results are possible in isodense or very small tumors.     

Computed tomography in the evaluation of abdominal trauma.

Four patients with blunt abdominal trauma underwent computed tomography (CT) as part of their diagnostic evaluation. In each case CT accurately demonstrated the pathology and the extent of injury. The results suggest that routine use of CT scanning may be an effective screening modality in the traumatized patient. It is perhaps more specific than radioisotope scanning and may eventually reduce the need for invasive techniques such as angiography.     

Computed tomography in the evaluation of diverticulitis

Computed tomography (CT) was performed in 43 cases of colonic diverticulitis and compared with the contrast-enema examination (CE) in 37 patients. Findings on CT included inflammation of the pericolic fat in 98% of cases, diverticula in 84%, thickening of the colon wall in 70%, a pericolic abscess in 35%, peritonitis in 16%, a fistula in 14%, colon obstruction in 12%, and intramural sinus tracts in 9%. Secondary findings included a distant abscess in 12% and ureteral obstruction in 7%. In addition to detecting ureteral and bladder involvement and distant abscess formation, CT was preferable for demonstrating the extent of pericolic inflammation, which was underestimated with CE in 41% of patients. Differential diagnosis of the CT findings is discussed. The authors indicate that CT should be the initial procedure in patients with suspected diverticulitis, particularly when CE is contraindicated.     

Computed tomography in the evaluation of benign asbestos-related disorders.

High-resolution CT is more sensitive than chest radiography and conventional CT in the detection and assessment of benign asbestos-related pleural and parenchymal diseases. The HRCT features of asbestosis correlate with clinical and functional restriction. The specificity of HRCT findings of asbestosis needs further evaluation. Given its low cost and availability, chest radiography remains the mainstay of imaging in benign asbestos-related diseases. CT (conventional or high-resolution) is not recommended as a universal screening test in asbestos-exposed workers. It has a useful role in identifying and quantitating pulmonary fibrosis distinct from emphysema and pleural disease, in distinguishing pleural disease from normal extrapleural soft tissues, and in clarifying the confusing chest radiograph or conflicting pulmonary function data. CT is useful in excluding a mass that may be obscured by extensive pleural and parenchymal fibrosis and is helpful in the follow-up of benign fibrotic masses or in the direction of their biopsy.     

Computed tomography in the evaluation of a pelvic tumor.

A case of a pelvic tumor evaluated preoperatively by computed tomography (CT) is reported. Conventional radiology suggested pelvic lipomatosis, but CT revealed a solid tumor without fat deposits.     

Computed body tomography in children: evaluation of 45 patients.

Computed tomographic (CT) body scans from a series of 45 infants and children were reviewed for the indications leading to the examinations, for technical quality of the images, and for diagnostic value of CT scanning. Useful diagnostic information was obtained in 30 of the 39 cases with technically satisfactory images. Individual case reports of CT examinations including findings from other imaging studies demonstrate how CT can interface with other methods to yield additional diagnostic information. Methods of patient preparation and suggested indications for CT body scan examinations of children are presented.     

Computed tomography in the evaluation of the suspected carcinomatous prostate.

Twenty-six patients with physical findings suspicious for prostatic cancer were examined by contrast-enhanced computed tomography (CT) of the prostate region prior to prostatic biopsy of resection. Twelve had benign hypertrophy and/or prostatitis and fourteen had adenocarcinoma. Prostatic contour, density, seminal vesicle "angle," extraprostatic soft tissue "mass," and the pelvic fat planes were evaluated. A nodular prostatic contour was found only in patients with adenocarcinoma of the prostate, indicating a role for CT in the diagnosis of this disease. Two patients with benign prostatic disease had extraprostatic soft tissue "masses" identical to those seen in six patients with adenocarcinoma of the prostate, suggesting limited usefulness of CT in staging patients with known tumor.