Failure of gated SPECT and echocardiography to detect large apical aneurysm secondary to hyperdynamic left ventricular wall at the aneurysm neck

We present a patient with a history of coronary artery disease and exertional angina after an acute anterior myocardial infarction. Angiography and ventriculography revealed multivessel coronary artery disease and a large apical aneurysm. Echocardiography and gated SPECT studies were performed for further evaluation of ischemia and assessment of left ventricular function. Gated SPECT and echocardiography failed to detect a large apical aneurysm due to a hyperdynamic left ventricular wall at the neck of the aneurysm. This case demonstrates the importance of using multiple imaging modalities in the evaluation of ventricular function in the setting of coronary artery disease.     

Ejection fraction by combined inverse Fourier analysis and second-derivative technique: Correlation with isocontour method

Summary In order to measure ejection fractions (EFs) from nuclear ventriculograms, we devised a semi-automated edge-detection technique based on a combination of inverse Fourier analysis and second-derivative techniques. Initial clinical studies showed that, for the left ventricle, our method gives EF values statistically identical with those obtained using a conventional isocontour technique. For the right ventricle, however, the values obtained using the two methods were somewhat more at variance. Despite requiring a longer processing time, the results obtained with our method are reproducible because less operator intervention is necessary.     

Radiographic studies of the ventricles in syringomyelia

Summary Radiographic investigations of 171 patients with communicating syringomyelia have been reviewed. Hydrocephalus was found in onethird of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occlusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment.     

CT脑室造影对脑室型囊尾蚴病的诊断价值

目的评价CT脑室造影的方法及价值,为手术摘除囊尾蚴提供理论依据。方法回顾性分析30例经手术病理证实的脑室内囊尾蚴病的CT脑室造影表现。通过脑室引流管注入2ml非离子造影剂行CT扫描。结果四脑室充盈缺损20例,三脑室3例,侧脑室7例。合并脑实质型13例,合并脑膜型7例。结论CT脑室造影方法简单,安全,实用,是CT、MRI重要的补充检查手段。     

Spontaneous rupture of the third ventricle in obstructive hydrocephalus: A radiographic diagnosis

Summary Two cases of posterior fossa tumours with spontaneous rupture of the third ventricle are presented. In the first case there was dramatic relief of symptoms of raised intracranial tension. Rupture of the supra-pineal recess was demonstrated by Conray ventriculography in both cases.     

Trans-reservoiral ventriculography (TRV)

Summary We report here the usefulness of ventriculography by means of percutaneous injection of a recently developed water-soluble contrast medium of great safety through a shunt flushing reservoir; the method is called trans-reservoiral ventriculography (TRV), and is presented here in twelve clinical cases.The TRV is especially useful in observing the course of brain tumour after either surgical or non-surgical treatment.     

Belastungsuntersuchung bei langjährigem Typ-I-Diabetes mit der Radionuklidventrikulographie

Summary Left ventricular function was assessed by means of radionuclide ventriculography in 42 patients with long-standing (13±5 yrs) insulin-dependent diabetes mellitus and in eleven healthy age matched control subjects. Only diabetics were included in the study without diabetes related cardiac risk factors such as hypertension and CAD in order to evaluate diabetes specific changes of cardiac function. No differences were seen between diabetics and controls concerning heart rate and functional parameters of left ventricle in systole and diastole. The rapid filling period was not prolonged. According to our radionuclide data there is no evidence of diabetes related impairment of ventricular function in young patients with long-standing type-1-diabetes mellitus.

     

Angiographic and echocardiographic observations in surgical patients with atrial myxoma

In a series of 18 patients with atrial myxoma (16 left, 2 right) the tumors were consistently identified by right ventriculography and generally visualized by left ventriculography in patients with left atrial myxoma examined owing to concomitant mitral insufficiency caused by tumor invasion at the site of mitral valve closure. Echocardiography was suited to early diagnosis of suggested tumor. Pseudoaneurysms in the cerebral and coronary arteries, apparently caused by myxomatous emboli with weakening of vessel lumen, were noted in several patients; therefore, selective coronary and cerebral arteriography should be performed preoperatively in patients with symptoms of thromboembolism. We stress that echocardiography should be performed routinely after surgery to disclose recurrences, while arteriographic control studies should be added in cases with vascular anomalies seen peeoperatively.     

New catheter for retrograde left heart catheterization in aortic stenosis

Left heart catheterization in patients with aortic stenosis continues to be a difficult procedure to perform. A new catheter is described with three shapes that adjust to fit the width of the ascending aorta and which may be directed straight into the aortic orifice. Results of the catheterization of 120 patients with aortic and combined mitral valve diseases are presented. The proposed catheter should make such examinations simpler and safer and thereby obviate the need for transseptal catheterization.     

A stereotaxic method based on ventricular radiography in the cat (with special reference to the stereotaxic topography of the substantia Nigra)

Summary A method based on an intracerebral coordinate system and contrast ventriculography was developed for Stereotaxic surgery in the cat. The intercommissural (CA-CP) line was used as the principal reference because its length showed little variability in animals within a wide weight range. The Stereotaxic coordinates of the substantia nigra (SN) in relation to the CA-CP line and the midline were evaluated in serial sections. Stereotaxic operations with the use of ventricular radiography were performed in different parts of the SN in 18 cats. Histological verification showed that the selected target regions within the SN were very accurately reached in all animals operated with this method. The precision of the Stereotaxic method based on the intracerebral coordinate system compared to the Horsley-Clarke method is discussed.Offprint requests to: Dr. I.A. Ilinsky (address see above)