Rhabdomyolysis: computed tomography findings

Computed tomography scans were performed on two patients who presented with clinical rhabdomyolysis and acute renal failure secondary to myoglobinuria. Localized muscle swelling with patchy focal areas of low attenuation were demonstrated. Computed tomography may be helpful to clarify the nature and extent of the muscle injury in the appropriate medical setting.     

Cytomegalovirus pneumonia: computed tomography findings

Cytomegalovirus (CMV) is a frequent pathogen of the respiratory tract in immunosuppressed patients. The diagnosis of CMV pneumonia frequently requires bronchopulmonary lavage or lung biopsy because the findings on chest radiographs are nonspecific. In only three cases of pure CMV pneumonia has the computed tomography (CT) appearance been described. In this study CT scans and chest radiographs of eight patients with CMV pneumonia were evaluated to determine if a characteristic CT appearance exists. The studies were evaluated for the type, severity and distribution of parenchymal abnormality. The most common CT finding was the presence of mixed alveolar and interstitial disease (seven patients); alveolar disease predominated in five of the seven patients, equal amounts of alveolar and interstitial disease were noted in one and interstitial disease predominated in the remaining patient. Air-space disease alone was present on CT examination of the eighth patient. In no case was there interstitial disease alone. Although mixed alveolar and interstitial disease was the most frequently encountered pattern, the variety of appearances suggests that the CT findings of CMV pneumonia are nonspecific.     

Paratracheal air cysts using low-dose screening chest computed tomography: clinical significance and imaging findings

Purpose  

The aim of this study was to evaluate the prevalence and clinical relevance of paratracheal air cysts in a general population who underwent low-dose computed tomography (LDCT).     

Primary peritoneal neuroblastoma: computed tomography findings

Primary peritoneal tumors are rare neoplasms. The computed tomography findings in an adult patient with a primary peritoneal neuroblastoma are described. Discussion of these uncommon neoplasms and this unusual presentation of neuroblastoma forms the basis of this report.     

Ground-glass opacity: High-resolution computed tomography and 64-multi-slice computed tomography findings comparison

Objective

Comparative evaluation of ground-glass opacity using conventional high-resolution computed tomography technique and volumetric computed tomography by 64-row multi-slice scanner, verifying advantage of volumetric acquisition and post-processing technique allowed by 64-row CT scanner.

Methods

Thirty-four patients, in which was assessed ground-glass opacity pattern by previous high-resolution computed tomography during a clinical-radiological follow-up for their lung disease, were studied by means of 64-row multi-slice computed tomography. Comparative evaluation of image quality was done by both CT modalities.

Results

It was reported good inter-observer agreement (k value 0.78-0.90) in detection of ground-glass opacity with high-resolution computed tomography technique and volumetric Computed Tomography acquisition with moderate increasing of intra-observer agreement (k value 0.46) using volumetric computed tomography than high-resolution computed tomography.

Conclusions

In our experience, volumetric computed tomography with 64-row scanner shows good accuracy in detection of ground-glass opacity, providing a better spatial and temporal resolution and advanced post-processing technique than high-resolution computed tomography.     

The computed tomographic findings of popliteal cysts

The computed tomographic (CT) findings of two popliteal cysts are presented, and the correlated anatomico-pathologic changes are discussed. The characteristic findings include thin, well-defined cyst wall, fluid density contents, central septum or septi, and medial popliteal location with mediocaudal extension. These findings, however, may vary due to herniation or rupture of the synovial membrane, gelatinous cyst contents, or metaplastic change of the cyst wall. Differential diagnoses include liposarcoma, popliteal aneurysm or hematoma, thrombophlebitis, xanthoma, fibrosarcoma, or other soft tissue tumors.     

Metrizamide-enhanced computed tomography of intracranial arachnoid cysts

Between July 1981 and August 1983 the authors studied 21 patients with intracranial arachnoid cysts using metrizamide-enhanced CT. With this method we are able to determine the degree of communication between the cysts and the surrounding subarachnoid space as well as to assess the evolving character of some of these lesions. This information will allow a more rational choice of surgical treatment.     

Acute mediastinitis: spectrum of computed tomography findings

The objective of this study was to describe CT findings and to determine the diagnostic value of CT in diagnosis of acute mediastinitis. CT findings were retrospectively studied in 40 patients with suspected acute mediastinitis, including 28 postoperative patients, five with acute descending necrotizing mediastinitis (ADNM), and seven with suspected post-traumatic perforation of the esophagus. Findings included increased attenuation of mediastinal fat (100%), localized mediastinal fluid collections (55%), free gas bubbles in the mediastinum (57.5%), mediastinal lymph nodes (35%), pericardial effusions (27.5%), pleural effusions (85%), lung infiltrates (35%), sternal dehiscence (40%), and pleuromediastinal fistula (2.5%). The sensitivity and specificity of CT in postoperative patients in the first 17 days was 100% and 33% respectively, and after day 17, 100% and 90%. In patients with ADNM sensitivity was 100% while in patients with suspected esophageal perforation sensitivity and specificity were 100%. CT is a highly sensitive technique for the detection of mediastinitis of various causes. For the postoperative patients there is clear time dependence for CT interpretation and accuracy. In patients with suspected ADNM, and traumatic esophageal perforation CT is highly specific early after clinical presentation.     

CT薄层扫描对于周围型小肺癌的诊断价值

目的 研究周围型小肺癌于CT薄层扫描的表现，并确定提示其诊断的某些继发征象之发生率。方法 48例可疑周围型小肺癌患均经CT薄层（2-3mm)扫描，并预期地分析了其CT征象。结果 48例周围型小肺癌中，细支气管肺泡癌24例，腺癌11例，鳞癌6例，小细胞癌5例，以及未发分化癌2例。周围型小肺癌的主要CT征象有：深分叶征见于43例（90%），边缘毛刺征36例（75%），空泡征27例（56%）。胸膜凹陷征38例（79%），以及血管集束征33例（69%）。结论 在周围型小肺癌诊断中，CT征象起着重要作用。尤其薄层扫描能够更加清晰地显示上述诸征象，因而能够提高小肺癌的确诊率。     

Pharyngitis of infectious mononucleosis: computed tomography findings

Two women presented with sore throat and fever. Their symptoms were not alleviated by antibiotics. Cervical computed tomography (CT) with contrast enhancement demonstrated enlargement of predominant posterior cervical lymph nodes and streaky heterogeneous tonsils with interspersed low attenuation. They were diagnosed as having infectious mononucleosis by their laboratory data. Thus, when radiologists encounter these CT findings of pharyngitis that is not alleviated by antibiotic therapy, infectious mononucleosis should be considered in the differential diagnosis.     

Diagnosis of sacral perineural cysts by computed tomography

Three cases of sacral perineural cysts associated with chronic low-back pain are described with their myelography, computed tomography, and plain film findings. Significant findings include multiple cystic dilatations of lumbosacral nerve root sheaths, enlargement of the sacral foramina by masses isodense with cerebrospinal fluid, and asymmetric epidural fat distribution. Recognition of these findings on unenhanced computed tomography scans should preclude further evaluation by myelography and intrathecal metrizamide (Amipaque) computed tomography. These cysts are usually not the primary cause of back and leg pain.     

Granulomatous enterocolitis: findings by ultrasonography and computed tomography

Granulomatous enterocolitis was evaluated in 51 patients by ultrasonography, and in 14 of those patients also by computed tomography (CT). The features of granulomatous enterocolitis include abscesses in various locations and bowel loops that are matted and inflamed, dilated due to obstruction, or have thickened walls. Although the diagnostic findings of ultrasound and CT examinations are not as specific as those of barium-enhanced radiographic examinations, they are helpful in the clinical management of patients. Serial ultrasound examinations are ideal to demonstrate progression or regression of the inflamed bowel-loops and abscesses. Real-time scanning is important in the differentiation of fluid-filled or matted and inflamed bowel-loops from abscesses. However, manual scanning is usually better for the delineation of the abdominal wall and complicated retroperitoneal abscesses.     

Hepatocellular-cholangiocarcinoma: helical computed tomography findings in 30 patients

OBJECTIVE: To report the helical multiphasic computed tomography (CT) findings in 30 patients with hepatocellular-cholangiocarcinoma. METHOD: We evaluated age, gender, tumor risk factors, serum tumor markers, symptoms, and tumor morphology and enhancement on helical multiphasic CT in 30 patients. RESULTS: Twenty-six of 30 patients (86%) were men. Patients had an age range of 27-78 years (mean = 58 years). Abdominal signs or symptoms were present in 21 of 30 patients, and 25 of 30 (83%) had chronic liver disease. Helical CT demonstrated a well-defined tumor in all patients with signs of malignancy such as hepatic hypervascularity (63%), biliary obstruction (17%), satellite lesions (40%), and lymphadenopathy (27%). Portions of the tumor were hyperattenuated on arterial-phase imaging and hypoattenuated on all other phases, whereas other portions showed delayed persistent enhancement, sometimes (27%) with hepatic capsular retraction, findings that have been reported to be characteristic of hepatocellular carcinoma and cholangiocarcinoma, respectively. CONCLUSION: The diagnosis of hepatocellular-cholangiocarcinoma should be considered when a hepatic tumor has CT features of both hepatocellular carcinoma and cholangiocarcinoma. Radiologists should be aware of this tumor type so that the biopsy is performed properly to allow sufficient tissue sampling.     

Rhabdomyolysis: magnetic resonance imaging and computed tomography findings

OBJECTIVE: Our purpose was to describe the magnetic resonance (MR) imaging and computed tomography (CT) findings in patients with rhabdomyolysis. METHODS: The medical records and imaging studies of 10 patients (5 males, 5 females; age range, 14-60 years; mean age, 28.3 years) with rhabdomyolysis were retrospectively reviewed. Magnetic resonance imaging was available in 9 patients and CT in 2 patients. RESULTS: Two distinct imaging types of rhabdomyolysis were observed. For type 1 rhabdomyolysis (n = 2), the affected muscles revealed homogeneously isointense to hyperintense on T1-weighted, homogeneously hyperintense on T2-weighted and short-tau inversion recovery (STIR) images, and homogeneously enhanced on contrast-enhanced MR images. For type 2 rhabdomyolysis (n = 8), the affected muscles revealed homogeneously or heterogeneously isointense to hyperintense on T1-weighted images, heterogeneously hyperintense on T2-weighted and STIR images, heterogeneously hypodense on CT images, and rim enhanced on contrast-enhanced MR and CT images with the presence of a specific presentation, named as the "stipple sign." CONCLUSIONS: Rhabdomyolysis is a clinical and biochemical syndrome comprising 2 distinct imaging types. Homogeneous signal changes and enhancement in the affected muscles advocate type 1 rhabdomyolysis. The stipple sign is helpful in demonstrating the areas of myonecrosis in type 2 rhabdomyolysis and, together with clinical and laboratory presentations, in reaching the correct diagnosis.     

Renal replacement lipomatosis: ultrasonography and computed tomography findings

Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. The diagnosis is difficult to establish with conventional radiographic methods. Although ultrasonography may show highly suggestive findings, computed tomography seems to be the most accurate method for demonstrating the distinctive features of replacement lipomatosis. Ultrasonographic and computed tomographic features in three cases of replacement lipomatosis of the kidney are reported. Received: 19 October 1998; Revision received: 8 December 1998; Accepted: 6 January 1999     

Median arcuate ligament syndrome: multidetector computed tomography findings

OBJECTIVE: We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament. MATERIALS AND METHODS: Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiographies were used for interpretation. RESULTS: Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing. CONCLUSIONS: The MDCT exanimation with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.     

Abdominal complications of chemotherapy: findings at computed tomography

Modern chemotherapy may result in an array of complications that can produce computed tomography (CT) findings in the hepatobiliary, gastrointestinal and urinary systems. This article describes the CT findings that may be seen in abdominal complications of contemporary chemotherapy. Knowledge of the varying CT appearances that can be encountered may facilitate both diagnosis and management in such cases.