Detection of subcutaneous metastases by computed tomography.

Subcutaneous fat provides excellent contrast for water density tissue. Five patients with subcutaneous metastases visualized on computed tomography (CT) scans are presented. In some cases, CT proved to be the optimal diagnostic modality for visualizing these lesions and documenting their response to therapy.     

Inflammatory aneurysm of aorta: development documented by computed tomography

Aortic aneurysmal disease appears to be the central focus of the inflammatory process resulting in inflammatory aneurysm formation. Some authors believe that inflammatory aortic aneurysm disease is a distinct clinicopathologic entity; however, others have included it with retroperitoneal fibrosis. The histologic features of inflammatory aneurysm suggest an immunologic basis for the lesion, with the atherosclerotic aorta as a possible source of the allergen.     

Pulmonary nodules studied by computed tomography

The authors analyzed 177 pulmonary nodules using thin-section computed tomography (CT), calculating the representative CT number (RCT#) from a computer printout. None of the 96 malignant nodules had an RCT# greater than 151 H. Of the 81 benign nodules, 14 were shown to be calcified by conventional radiography and had an RCT# ranging from 763 and 1,023 H. Thirty had an RCT# greater than 200 H; this included 24 which showed no calcification on conventional tomograms. The remaining 37 benign nodules had an RCT# less than 200 H; 6 of them were hamartomas, including 2 which were diagnosed as such due to their fat content.     

Aggressive fibromatosis in childhood computed tomographic findings in three patients

Three children with aggressive fibromatosis are presented and the value of computed tomography in defining the extent of the lesions and for follow-up and treatment planning is discussed. Aggressive fibromatosis is a nonmetastizing fibrous lesion with a propensity for local invasion and recurrence after surgery. The lesions usually have a poorly defined margin on computed tomography and the attenuation coefficient is less than that of muscle with poor enhancement following intravenous administration of contrast material.     

螺旋CT与X线平片在诊断髋关节创伤中的应用分析

目的：对比分析螺旋CT与X平片对髋关节创伤的影像诊断，探讨其临床运用价值。方法：84例髋关节创伤病例进行X线平片和CT检查，全部病例作CT二维重建，部分病例作三维重建，比较两种检查方法对髋臼骨折，股骨头及股骨颈骨折，关节腔内外游离碎骨片，髋关节脱位，关节囊积血，积液及关节周围软组织损伤的诊断效能。结果：CT在髋臼骨折的分型诊断，发现股骨头撕脱性骨折和显示关节腔内外游离骨片等方面优于X线平片，CT还可显示髋关节创伤后伴发的关节囊及周围软组织损伤的形态变化。平片的整体形态显示能力优于CT，且具有经济实惠，简单快捷的特点。结论：CT是全面评估髋关节创伤的必要检查手段。其总体诊断效能优于X平片。二者在髋关节创伤中联合应用，可相互补充，进一步提高诊断准确率。     

Pulmonary hydatidosis. Contribution of x-ray computed tomography

33 patients with pulmonary hydatidosis were followed by CT scan imaging. 53 hydatid cysts were found in 31 of them. The remaining two were cases of metastatic hydatidosis, the primary affection was cardiac located with multiple small bilateral cysts. The observed cysts were single in 27 cases and multiple in 4, totalizing 26 cysts. Among the 27 single cysts, 15 were found to be complicated while 8 cysts were complicated among the four cases of multiple hydatidosis. This paper gives the most important signs observed by CT scan imaging in 33 cases examined during 6 months in the Central Service of Radiology Avicenne CHU, Rabat.     

Use of additives to contrast media to improve imaging in plain film and computed tomography urography

RATIONALE AND OBJECTIVES: To investigate the effects of additives to iodinated radiograph contrast agents on image quality in plain film and CT urography. MATERIALS AND METHODS: Urea (52 mg/mL), iloprost (10, 20, 50, and 100 ng/mL), nifedipine (0.02 mg/mL), papaverine (0.625 mg/mL) and sodium nitroprusside (0.05 microg/mL) were added to commercial iopromide (300 mg/mL) and iotrolan preparations (280 mg/mL) and plain film urograms were obtained at different time points after contrast injection in rabbits and dogs at iodine doses of 300 or 600 mg/kg body weight. The experiments were repeated in rabbits using CT imaging and iopromide or iotrolan plus urea (52 mg/mL) or iloprost (20 ng/mL) and iodine doses of 50 mg/kg body weight. RESULTS: Urea and iloprost at low concentrations (10 and 20 ng/mL) increased image quality both in plain film and in CT urography. Iloprost at high concentrations (50 and 100 ng/mL), nifedipine, papaverine and sodium nitroprusside decreased image quality. An increase in image quality was accompanied by faster renal elimination of the contrast agent. CONCLUSION: Image quality in plain film and CT urography might be improved by additives to the contrast medium. More data, particularly on dose-response relationships are needed.     

Cystosarcoma phylloides: calcified pulmonary metastases detected by computed tomography

We report the appearance of calcifications on computed tomography (CT) images of pulmonary metastases from a rare breast tumor, malignant cystosarcoma phylloides. Histologic examination of the pulmonary masses revealed malignant spindle cells with osteoid and cartilage components in the cellular stroma. This appearance has not been described previously.     

Diagnosis of posttraumatic pericardial tamponade by plain film and computed tomography and control of bleeding by embolotherapy of the left inferior phrenic artery

A 21-year-old male developed pericardial tamponade in a delayed fashion after blunt chest trauma. Tamponade was not suspected clinically and was first seen on computed tomography of the abdomen. Plain films of the chest revealed distortion of the path of a Swan-Ganz catheter due to the ventricular compression. After drainage, left inferior phrenic artery embolization was performed to treat the persistent hemothorax.     

Increased F-18 FDG uptake on positron emission tomography/computed tomography imaging caused by plantar fibromatosis

We detail the history and evaluation of a 68-year-old man who had head-to-toe PET/CT scanning that showed a focal area of increased FDG uptake in the left medial foot. This was thought to be recurrence of his melanoma. The patient was asymptomatic. He had a history of malignant melanoma of the right ear, which was removed in 2001. On biopsy, the foot lesion was diagnosed as plantar fibromatosis. Plantar fibromatosis is a benign fibroblastic condition, which can be indistinguishable from malignancy in head-to-toe PET/CT scans. Awareness of their potential appearance on PET and PET/CT will aid in the appropriate staging of oncology patients.     

Cerebral damage following ventricular shunt for infantile hydrocephalus evaluated by computed tomography

Summary The results of a late CT control of infantile hydrocephalus is reported with an analysis of effects of the catheter on the cerebral tissue in the immediate and late postoperative course. The most frequent finding is blood in the ventricle and/or subependymal or intraparenchymal along the catheter or near its tip.     

Aggressive fibromatosis of the neck: MR findings.

We present a case of aggressive fibromatosis of the scalene and longus colli muscles with surgically proved secondary involvement of the brachial plexus and carotid sheath in a 29-year-old woman in whom MR imaging failed to show involvement of the carotid sheath. The well-defined lesion was isointense on T1-weighted images and hyperintense on T2-weighted images relative to adjacent normal muscle and enhanced brightly.     

Unidentified liver metastases at ultrasonography or computed tomography

Sixty-six patients with hepatic metastases, examined by ultrasonography (US) and computed tomography (CT) with an interval of a few days between the two examinations, showed discrepancies between the US and CT findings. The US and CT images were compared lesion by lesion, and the reasons why a metastasis was missed at US or CT were analysed. Lesions larger than 3 cm in diameter could be detected at technically successful examinations with both methods. The unreliable imaging regions with US were the ventrocranial aspect of the right lobe, the caudate lobe, and in obese patients the dorsal part of the right lobe. With CT, the caudal aspect of the left lobe, the area surrounding the gallbladder, and portions beneath the ribs were most unreliably imaged. Sometimes, at either US or CT, the image characteristics of the metastasis were too similar to those of the normal parenchyma to be differentiated.     

Pulmonary lymphangioleiomyomatosis. Radiologic aspects and the diagnostic role of computed tomography

Lymphangioleiomyomatosis (LAM) is an uncommon disease affecting women of reproductive capacity. It is characterized by non-neoplastic proliferation of smooth muscle in the lungs and, occasionally, in lymph nodes and in the thoracic duct. The patients present with dyspnea, chylous pleural effusion, pnx, and hemoptysis. The authors evaluated 4 patients with biopsy-proven LAM, by means of CT. In all cases, CT revealed small well-defined cystic air spaces with smooth and thin walls, scattered in the lungs. CT was very useful because it was more sensitive and specific than conventional radiography. The CT appearance of LAM distinctly differed from that of other diseases than can produce cystic air spaces in the lungs, such as UIP, eosinophilic granuloma, centri-acinar emphysema, and bronchiectasis. Our experience confirms the clinical usefulness of CT in diagnosing LAM.     

Pulmonary artery diameters measured by multidetector-row computed tomography in healthy adults

Background: The range of the diameters of pulmonary arteries (PA) is not fully shown in the current literature. Contrast-enhanced computed tomography (CT) of the thorax might be used for measuring diameters of the PA.

Purpose: To determine the diameters of PAs in subjects with normal PA pressure by using thoracic CT.

Material and Methods: 126 subjects aged between 19 and 46 years, having normal thoracic CTs (5-mm slice thickness) and normal PA pressures (≤25 mmHg, determined by echocardiography), were included in the study. The diameters of the main, right, and left PAs were measured by using multidetector CT.

Results: The main PA diameters of all the subjects showed a normal distribution, and the mean was 24.0±2.8 mm. The main PA diameters in male and female subjects also showed a normal distribution. The difference between the sexes for the main PA diameters was not significant (P = 0.08). There were correlations between main PA diameter and body-mass index (BMI) (R = 0.41, P = 0.001) and weight (R = 0.34, P = 0.001). However, there was no significant correlation between main PA diameter and height (R = 0.05, P = 0.6).

Conclusion: This study suggests that diameters of the main PA and its main branches show a normal distribution in subjects having normal PA pressures. Based on our findings, the upper limits of the main, right, and left PA diameters are 29.5 mm, 19.8 mm, and 22.1 mm, respectively, in healthy adults.