Computed tomography in adrenal tumors.

Computed tomography (CT) was used to evaluate 26 patients with a variety of adrenal lesions. Surgical proof was available in 22 patients and clinical confirmation with a variety of other studies in the other four patients. Nine patients ahd aldosterone-producing adrenal adenomas and CT correctly identified seven. Four patients had cortisol-producing adenomas and five patients had cortisol-producing carcinomas; CT identified each of these tumors. Prominent but normal shaped glands were seen in each of the four patients with adrenal hyperplasia. Adrenal metastases from malignant melanoma in two patients were identified. Only one of two pheochromocytomas in two patients could be seen on CT. CT is a noninvasive method of localizing adrenal tumors and may be helpful in distinguishing adenomas from adrenal hyperplasia.     

Computed tomography of lower extremity tumors.

Fifty cases of lower extremity tumors examined with computed tomography were reviewed. Of the 50 cases, 41 had gross pathologic correlation, either by enbloc resection (26) or by amputation (15). Important information regarding size, location, definition, and anatomic relation of tumors to vital structures (neural, vascular, and osseous) may be ascertained by this means with great accuracy. Localization of vessels by intravenous infusion of contrast material during the scan, or after arteriography with intraarterial contrast infusion, is found to enhance such evaluation. This information is particularly important where the feasibility of en-bloc resection is being evaluated.     

Computed tomography of tumors of the pineal region.

Eight pathologically proven cases of pineal region tumors examined by computed tomography (CT) were found upon reviewing 11,000 consecutive CT studies at the Massachusetts General Hospital. The CT scan findings of the eight cases are described and related to a pathological classification of pineal tumors.     

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 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 of ureteral tumors

Ten patients with one or more ureteral tumors were examined with CT. The tumor was clearly recognizable as a soft tissue mass (average density 46 HU) filling the ureter in nine of the patients. In five of these patients the tumor was not detected by urography. Tumors less than 5 mm in diameter were missed on CT in one patient. Although most ureteral tumors are detectable with urography and retrograde pyelography, CT can be a valuable diagnostic tool. Computed tomography is particularly advantageous in patients with nonfunctioning kidneys and in those in whom retrograde pyelography is unsuccessful.     

Computed tomography of chondrogenic tumors

The computed tomography (CT) morphology of chondrogenic tumors and the utility of CT in their diagnostic work-up is presented on the basis of 19 cases. CT provided unique informations regarding definition of tumor extent and tumor relationship to adjacent structures particularly in the axial skeleton. CT has diminished the indications for angiography in chondrogenic tumors.     

Computed tomography of Krukenberg tumors

Computed tomography (CT) of three patients with Krukenberg tumor was reviewed retrospectively. CT showed large, lobulated, multicystic masses with soft-tissue components, indistinguishable from primary ovarian carcinoma. Indeed, CT and sonography of all three patients were initially interpreted as primary ovarian carcinoma. The ovary is a frequent site of metastases, particularly from colon carcinoma. These can be quite large, yet diagnosis is seldom made preoperatively. Much has been written about metastatic ovarian tumor, but this is the first report in the radiologic literature about their CT features. The authors emphasize the importance of recognizing the ovary as a frequent site of metastases and the proper approach to this problem. In patients with a history of colon or gastric carcinoma, the mixed cystic and solid ovarian mass on CT should be regarded as metastatic tumor until proven otherwise. A careful search for gastrointestinal tract signs or symptoms should be done in any patient with a pelvic tumor. When CT is done for evaluation of ovarian tumor, the stomach and colon should be carefully evaluated, and the ovaries routinely examined in the preoperative CT staging of gastric or colon carcinoma.     

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 gastrointestinal stromal tumors

The aim of this study was to define the imaging characteristics of primary and recurrent gastrointestinal stromal tumors (GIST) in computed tomography with respect to the tumor size. Computed tomography was performed in 35 patients with histologically confirmed gastrointestinal stromal tumors and analyzed retrospectively by two experienced and independent radiologist. The following morphologic tumor characteristics of primary (n=20) and (n=16) recurrent tumors were evaluated according to tumor size, shape, homogeneity, density compared with liver, contrast enhancement, presence of calcifications, ulcerations, fistula or distant metastases and the anatomical relationship to the intestinal wall, and the infiltration of adjacent visceral organs. Small GIST (<5 cm) showed a sharp tumor margin with homogeneous density and structure on unenhanced and contrast-enhanced images, and were characterized by an intraluminal tumor growth. Intermediate sized GIST (>5–10 cm) demonstrated an irregular shape, inhomogeneous density on unenhanced and contrast-enhanced images, a combined intra- and extraluminal tumor growth with aggressive findings, and infiltration of adjacent organs in 9 primary diagnosed and 2 recurrent tumors. Large GIST (>10 cm), which were observed in 8 primary tumors and 11 recurrent tumors, showed an irregular margin with inhomogeneous density and aggressive findings, and were characterized by signs of malignancy such as distant and peritoneal metastases. Small recurrent tumors had a similar appearance as compared with large primary tumors. Computed tomography gives additional information with respect to the relationship of gastrointestinal stromal tumor to the gastrointestinal wall and surrounding organs, and it detects distant metastasis. Primary and recurrent GIST demonstrate characteristic CT imaging features which are related to tumor size. Aggressive findings and signs of malignancy are found in larger tumors and in recurrent disease. Computed tomography is useful in detection and characterization of primary and recurrent tumors with regard to tumor growth pattern, tumor size, and varied appearances of gastrointestinal stromal tumors, and indirectly gives hints regarding dignity and therefore prognostic outcome.     

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.     

腮腺肿瘤的CT诊断

本文回顾性分析了14例经病理证实的腮腺肿瘤CT表现,并与病理对照进行研究,旨在探讨CT对腮腺良、恶性肿瘤的诊断及鉴别诊断价值。1材料与方法1.1一般资料14例腮腺肿瘤中,男9例,女5例,年龄35~78岁。主要临床症状为腮腺区无痛性肿块,咽部异物感,体检质软或稍硬,有结节感。病程最长者30年,所有病例经手术及病理证实。1.2检查方法使用TCT-300或Esprit Phus螺旋CT扫描机,层距层厚各5mm,以病变为中心扫描,取常规卧位,采用Reid线,即眶下缘至外耳道连线,平行向下扫至下颌角,层厚及层间隔为5mm,全部均采用CT平扫及增强扫描。4例加冠状位扫描。增…     

Computed tomography of monkey brain tumors

Thirty-five Japanese monkeys were inoculated intracerebrally with chick embryo fibroblasts that were producing Schmidt-Ruppin strain of Rous sarcoma virus. Tumors were induced in 54.3% (19/35). Computed tomography detected tumors in 10 symptomatic animals with an average latency of 32.6 (15-43) days. At autopsy, the brains were sectioned into 5 mm slices, coplanar to the CT image. Various CT features of high- and low-density area correlated well with the histopathological findings, such as tumor, hemorrhage, necrosis, and peritumoral edema. Contrast-enhanced CT detected 10 tumors greater than 4 mm in diameter, and there was +/- 2 mm potential error in determining tumor size. Follow-up CT revealed growth of tumors in four animals and stabilization of tumor in two animals. Large brain size, 90-110 g in adult monkeys, and availability of induced tumors offer an excellent brain tumor model for CT studies.