Computed tomography of isodense subdural hematomas.

Eight cases of isodense subdural hematomas were evaluated by computed tomography (CT). CT demonstrated varying degrees of compression of a lateral ventricle, shift of the midline structures and, in some cases, obliteration of the subarachnoid sulci on the side of the lesion. Contrast enhancement was helpful in one case and demonstrated medial displacement of enhanced cortical margins away from the inner table of the skull. Two of the eight patients had no clear history of trauma.     

Computed tomography of isoattenuating subdural hematomas.

CT scans of 87 patients with subdural hematoma were compared to those of 393 patients with midline shift caused by other intracranial lesions with regard to attenuation changes in the lesion and the character of the ventricular deformity. Isoattenuating was exhibited by 25% of the subdural hematomas and 5% of the other lesions. In 70 to 80% of the isoattenuating hematomas, the diagnosis could be made on the basis of the characteristic ventricular deformity. Other diagnostic procedures are not necessary in these cases.     

Diagnosis of isodense subdural hematomas by computed tomography.

Subdural hematomas, whose absorption values approximate those of adjacent brain, are not visualized in routine computed tomography. Two clues indicating the presence of such "isodense" subdural hematomas are: (1) unilateral effacement of cerebral sulci on the convexities, and (2) midline shift or mass effect on the ventricles in the absence of abnormal areas of diminished or increased density in the brain. Nine cases were detected on pre- and postcontrast studies in 2,500 CT scans of the brain over a 10 month period. Delayed CT scanning 4-6 hr after intravenous contrast injection showed enhancement of the subdural hematoma in three of seven cases.     

Computed tomography characteristics of intermesenteric hematomas

Abdominal bleeding may accumulate in the peritoneal cavity, retroperitoneal compartments, intraabdominal organs such as liver or bowel wall, or, rarely, in the intestinal mesentery. During the past 3 years we have encountered four cases of isolated mesenteric hematomas that were demonstrated on abdominal computed tomography examination. In this report, we present the clinical and computed tomography findings of intermesenteric hematomas with review of the pertinent mesenteric anatomy, and add four more cases to the two cases reported in two earlier reports.     

Computerized tomography in chronic subdural hematomas (effusions) of infancy

Summary During the past 2 years six infants were seen at University of Wisconsin Hospitals (UWH) with subdural hematomas (effusions). This communication describes the abnormalities found on computerized tomographic (CT) evaluation of the six infants.     

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.     

Chronic subdural hematomas

Summary Surgery was undertaken on 32 chronic subdural hematomas in a series of 28 patients who had preoperatively undergone delayed contrast-enhanced computed tomography (DCECT). Timedensity curves on DCECT and iodine concentrations of subdural specimens revealed that chronic subdural hematomas, regardless of density, were significantly enhanced by the entrance of intravascular contrast medium into the interior of hematomas. The ingress of intravascular contrast medium into the interior of the hematomas was chemically proven and might result from a complex transcapillary shift.     

Computed tomography of intracerebral hematomas. I. Transmission CT observations on hematoma resolution.

Changes in the size and density of intracerebral hematomas were investigated by analyzing the sequential CT studies of 40 patients. Intracerebral hematomas decrease in density by an average of 0.7 EMI units per day. The dense portion of the hematoma decreases in size by an average of 0.65 mm per day. Mass effect does not decrease in proportion to the decrease in size of the dense portion of the hematoma but is delayed. The only instances of increasing mass effect occurred in patients undergoing surgical evacuation of the hematoma and in those who sustained trauma. Posthematoma residua include decreased parenchymal density, focal atrophy, and ventricular enlargement.     

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 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 of cranial subdural and epidural hematomas: variation of attenuation related to time and clinical events such as rebleeding

Forty-one cases of subdural and nine of epidural hematomas were studied with regard to attenuation and the time between trauma and computed tomography scanning. The attenuation of the hematomas showed a consistent decrease with time during the first 4 weeks. High attenuation of chronic subdural hematomas is explained by a sudden or continuous rebleeding. No correlation was found between the attenuation of the hematoma and the attenuation of venous blood from the same patient.