Pneumomediastinum and pneumopericardium due to malignant subcarinal lymphadenopathy: CT demonstration

A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection on the right and cervical irradiation (60 Gy). Two months after therapy he presented with dysphagia and hemoptysis. Admission chest X-ray revealed a pneumopericardium. It was caused by a bronchomediastinal fistula due to necrotic metastatic lymph nodes as shown by CT, which also revealed a concomitant pneumomediastinum. The patient died 10 days later from pneumonia. The CT findings were confirmed at autopsy. We conclude that malignant mediastinal lymphadenopathy is a potential cause of pneumopericardium and pneumomediastinum. Received 2 February 1996; Revision received 21 June 1996; Accepted 16 August 1996     

CT demonstration of interlobar fissure calcification due to asbestos exposure

This is the second report of calcification of the major fissure in asbestos-related pleural disease and the first in which CT was necessary to visualize its presence. This case illustrates that CT may have an additional important use in the radiologic evaluation of individuals who have had asbestos exposure.     

CT demonstration of hyperdense cerebral vasculature due to bromide therapy

An increase in the effective atomic number of blood is among the factors allowing or influencing the visualization of the major cerebral vessels on noncontrast CT. Bromine (atomic number, 50) attenuates 70 keV X-rays significantly and was responsible for a striking enhancement of the major cerebral vessels on the noncontrast CT in a child being treated for epilepsy. Although oral bromides are only occasionally used in the treatment of epilepsy, their use causes an increase in blood density and thus bromides need to be considered along with other etiologies (reviewed) that allow visualization of the major cerebral vessels on noncontrast CT.     

CT demonstration of gastropancreatic fistula due to penetrating gastric ulcer

We report a patient with gas in the pancreatic duct due to a gastropancreatic fistula resulting from gastric ulcer. No mass or pseudocyst was demonstrated. This entity should be considered when patients with gas in the pancreas are encountered.     

CT demonstration of high attenuation pleural-parenchymal lesions due to amiodarone therapy

We report a case in which CT demonstrated high attenuation pleural-parenchymal lesions (142-175 HU) and increased liver density (96.7 HU) in a patient on long-term amiodarone therapy.     

Diffuse pneumocephalus due to Clostridium septicum cerebritis in haemolytic uraemic syndrome: CT demonstration

Summary The computed tomography finding of diffuse pneumocephalus due to infection by gas-forming organisms is very unusual. We report such a case due to secondary infection byClostridium septicum in a child with diarrhoea-associated haemolytic uraemic syndrome.     

Perfusion changes of hepatic parenchyma due to infectious hepatobiliary disease: demonstration by perfusion CT.

We present two cases, in which perfusion CT demonstrated diffusely increased arterial and decreased portal perfusion of the liver parenchyma around liver abscess and infectious bilomas. These cases suggested that perfusion CT may be useful for a quantitative analysis of perfusion changes in infectious hepatobiliary diseases with good anatomical detail.     

CT demonstration of brain infarcts due to deep venous thrombosis in systemic lupus erythematosus

Rapid development of low density bilateral lesions in the brain due to deep venous thrombosis in Systemic Lupus Erythematosis is described. To the best of our knowledge, this type of symmetry, distribution and appearance of brain infarcts in CT due to deep venous thrombosis has not been reported previously.     

CT demonstration of massive cerebral air embolism from pulmonary barotrauma due to cardiopulmonary resuscitation

A 77-year-old man with loss of consciousness, circulatory collapse, and apnea caused by myocardial infarction underwent cardiopulmonary resuscitation with intratracheal intubation and manual bag ventilation. Computed tomography of the head demonstrated massive air embolism in the entire cerebral circulation. The patient was diagnosed as brain dead the next day. Demonstration of massive cerebral air embolism on head CT is presented.     

支气管扩张大咯血的急诊介入栓塞治疗

目的：探讨90例支气管扩张大咯血患者的动脉造影表现及急诊介入栓塞治疗的疗效。方法对90例支气管扩张大咯血的患者行急诊动脉造影检查,明确出血部位后,选用不同的栓塞剂栓塞出血动脉,对动脉造影的表现及治疗结果进行回顾性总结及评价。结果90例患者共找到135支出血动脉,全部成功栓塞治疗。栓塞术后随访12个月,8例患者复发咯血,6例采用肺叶切除手术后出血停止。2例患者死于结核菌合并曲霉菌感染所致的并发症。栓塞治疗的总有效率91．11％（82／90）。栓塞术后无严重并发症出现。结论急诊动脉栓塞治疗支气管扩张大咯血是一种安全、有效的治疗手段。合理选择和使用栓塞剂及彻底全面栓塞出血动脉是治疗成功的关键。     

Clivus fracture: CT demonstration

A transverse fracture of the clivus through the region of the fused sphenooccipital synchondrosis involving the carotid canals was studied by CT. The patient also had bilateral temporal bone fractures with otorrhea and a carotid cavernous fistula. The literature related to clivus fractures is reviewed.     

Elastofibroma dorsi: CT demonstration

Elastofibroma dorsi is a pseudotumorous connective tissue mass that characteristically arises between the chest wall and the inferior angle of the scapula. Its long axis is typically craniocaudal. Two patients are illustrated, each presenting with a fixed subscapular mass. Computed tomography showed each mass as elongated, incompletely marginated, and of soft tissue density deep to the inferior angle of a scapula. The latissimus dorsi and an underlying layer of fat were posterolaterally elevated inferior to the tip of the scapula. After incisional biopsy excluded sarcoma, each mass was locally excised.     

婴儿期迟发性维生素K缺乏致颅内出血的CT表现

目的探讨婴儿期迟发性维生素K缺乏性颅内出血的CT影像特点。方法选择临床确诊为迟发性维生素K缺乏性颅内出血的23例患儿的头颅CT资料进行回顾性分析。结果蛛网膜下腔出血8例,脑实质出血10例,硬膜下出血5例,脑室内出血3例,其中60%为多部位出血,脑梗死1例。结论结合临床特点,CT检查不仅可以明确具体的出血部位,还可以辅助作出出血的病因诊断。     

CT demonstration of pulmonary embolism due to the rupture of a giant hepatic hydatid disease

Hydatid disease can be seen anywhere in the body and presents with a variety of clinical symptoms and imaging features according to its location. In this article, computed tomography features of a giant hepatic hydatid cyst extending into the right atrium and causing pulmonary embolism are presented.     

CT of airways disease and bronchiectasis

High-resolution CT is accepted as an accurate noninvasive means of diagnosing bronchiectasis. A wide spectrum of abnormalities may be identified at HRCT in patients with airway disease, including various distinctive patterns of bronchiectasis in specific clinical settings, such as ABPA, MAC infection, AIDS, and CF. Characteristic CT findings occasionally suggest a specific diagnosis that may not have been under clinical consideration. HRCT also provides significant clinical use in assessing the degree and extent of airway disease, and allows noninvasive monitoring of disease progression, regression, or response to therapy.