Search PubMed⌕ Search

Biomedical subjects

C F Lanzieri

Publications and source records attributed to C F Lanzieri.

At least 37 records · Page 2Linked to original sources
PubMed1992

Complementary use of computed tomography and magnetic resonance imaging in assessing skull base lesions.

Twenty-six patients underwent computed tomography (CT) and magnetic resonance imaging (MRI) of skull base lesions at the Cleveland Clinic Foundation. CT provided improved bone detail, documenting invasion of the lamina papyracea, orbital floor, fovea ethmoidalis, cribriform plate, pterygoid plates, hard palate, and skull base. MRI defined invasion of the orbit, dura, brain, and cavernous sinus. Improved soft-tissue-tumor interface was evident on MRI. MRI was superior to CT in determining carotid artery involvement. MRI distinguished between tumor and retained secretions in the paranasal sinuses. Combining radiographic tumor staging reliably predicted surgical findings; however, MRI consistently yielded sufficient diagnostic information and the additional expense of performing two imaging procedures may not be justified.

Angiography, Digital Subtraction↗
PubMed1991

Use of gadolinium-enhanced MR imaging for differentiating mucoceles from neoplasms in the paranasal sinuses.

The purpose of this study was to determine whether additional clinically useful information could be obtained from gadolinium-enhanced magnetic resonance (MR) imaging compared with the information obtained from nonenhanced MR imaging and computed tomography (CT). Therefore, the authors selected 41 patients, whose results at CT examinations demonstrated a variety of pathologic conditions of the paranasal sinuses, to undergo MR imaging both with and without the use of gadopentetate dimeglumine for contrast enhancement. In 22 of 35 cases of neoplasms and mucoceles occurring separately, the lesions were correctly differentiated by established MR signal criteria alone. However, 32 of these 35 cases were accurately differentiated when gadolinium-enhanced MR images were obtained. Six cases demonstrated co-existing neoplasm and mucocele: Gadolinium-enhanced MR enabled correct differentiation of five of these lesions, while unenhanced MR enabled correct differentiation of three. On the basis of these results, the authors conclude that the use of gadopentetate dimeglumine for contrast enhancement at MR imaging is useful for differentiating mucoceles from neoplasms in the sinonasal tract.

Contrast Media↗
PubMed1990

Magnetic resonance imaging of the nasopharynx.

Imaging of the upper aerodigestive tract, mainly the nasopharynx and oropharynx, has always challenged the radiologist. It is clear that MRI has a leading role in the diagnosis and treatment planning of patients with diseases of the head and neck. This is especially true in the nasopharynx. Although improvements have been made in x-ray diagnosis through the years, subtle diagnoses have been difficult to make because of the variations in airway contour and the superimposition of areas of interest. CT allowed the deep soft tissue planes to be evaluated and provides a complement to the physical examination of the nasopharynx, oral pharynx, and skull base. MRI possesses many advantages over other imaging modalities. The ability to differentiate between inflammatory and neoplastic diseases is extremely important for tumor staging and patient management. At the present time it is not possible to predict the histology of a nasopharyngeal tumor, but the ability to differentiate between various histologic types would be of obvious importance. More experience is needed before this bridge can be crossed.

Carcinoma, Squamous Cell↗
PubMed1989

Three-dimensional surface rendering of nasal anatomy from computed tomographic data.

This article investigates the potential of using three-dimensional surface-rendered computed tomographic reconstructions for demonstrating normal and pathologic intranasal anatomy. Three-dimensional surface renderings of the intranasal structures were generated in 38 patients from coronal high-resolution computed tomographic images. Because of the complex anatomy, three-dimensional images were believed to be useful for surgical planning. There may be a correlation between the appearance of the uncinate process and severity of inflammatory sinus disease.

Humans↗
PubMed1989

MR imaging characteristics of tuberculous spondylitis vs vertebral osteomyelitis.

Retrospective evaluation was made of four patients with tuberculous spondylitis who had been studied by MR with T1- and T2-weighted images in the sagittal plane and spin-density-weighted images in the axial plane. Evaluation was made of the distribution of abnormal signals within the body and posterior elements of the vertebrae, the intervertebral disk, and the associated paraspinal and epidural areas. In two of the cases, three-level involvement was seen with noninvolvement of intervening disks; metastases were misdiagnosed. One patient had anterior/inferior erosion of the vertebral body without visualization of the disk. The last patient had the more typical MR characteristics of intervertebral disk infection. Plain film examination showed only degenerative changes in three of the four cases. MR revealed more extensive involvement than the plain films did. Involvement of the posterior element and posterior vertebral body was prominent in three of the four cases. This is a significant finding since these patients are more likely to have neurologic symptoms and require laminectomy. Follow-up examinations in two cases showed increased signal on T1-weighted images, suggesting infiltration of hemopoietic marrow with fat, as has been described for degenerative osteoarthritis. The anatomy of the microcirculation of the vertebral body is related to the patterns of vertebral osteomyelitis, and discrepancies can be seen between the findings in our cases and the MR criteria previously noted for pyogenic vertebral osteomyelitis. The MR findings in our patients generally were more typical of neoplasm than of infection. These findings may reflect the characteristics of the tuberculous organism relative to the age-dependent pattern of vertebral microcirculation. Correct diagnosis of tuberculous spondylitis in young to middle-aged adults requires correlation of MR and clinical findings.

Adolescent↗
PubMed1987

The preoperative venogram in planning extended craniectomies.

A technique of extended craniectomy sometimes allows removal of large central or transtentorial mass lesions at a single operative sitting because it affords better exposure and control of normal structures. While seeking to avoid multiple craniotomies, this method requires permanent ligation of the transverse venous sinus. Unless there is adequate collateral venous drainage from the ipsilateral hemisphere, the patient is at risk for venous infarction in the post-craniectomy period. The purpose of this study is to propose a method of establishing the presence of collateral venous drainage preoperatively. Each carotid artery is injected with the head in a neutral position and with the head turned to the side ipsilateral to the carotid artery injection in an attempt to divert the venous flow. Fifty patients were examined using this method; seven were being evaluated for possible craniectomies. The technique identified nine patients with potential venous collaterals (20%). They would otherwise have been considered nonoperable: two of the six patients eventually operated upon (33%) fell into this category. In general, the operative procedure may be safe more often on the left than the right (45%) vs (20%). Particular attention must be given to the pattern of venous drainage from the posterior temporal lobe to avoid isolation of the venous drainage from this area.

Adult↗
PubMed1986

Differentiation of large suprasellar masses by evaluation of the superior margin.

Differentiation of suprasellar masses by computed tomography criteria depends on intrasellar extension, patterns of calcification and enhancement, associated bony reaction, and cystic changes. In the case of a homogeneously enhancing suprasellar mass that does not exhibit any of these differentiating findings, separating a suprasellar meningioma from a large suprasellar pituitary adenoma has been quite difficult. We reviewed the computed tomography findings of 42 such tumors. There were 19 meningiomas and 23 pituitary adenomas chosen that had few or none of the commonly applied findings used in differentiation. Evaluation of the superior contour of these masses seems a reliable sign to use in this situation. A single upward convex curve correlated with a meningioma in 15 of 19 cases (78%), whereas a multiple upward convex curve correlated with a pituitary adenoma in 19 of 23 cases (82%). Although some pitfalls were encountered when employing this sign--such as pseudolobulations caused by the adjoining cavernous sinus, dural, or vascular structures--it nonetheless led to the correct diagnosis in approximately 80% of cases.

Adenoma↗
PubMed1986

Cystic adult medulloblastomas.

The computed tomography scans of four patients who had a medulloblastoma are reviewed. In all the cases, atypical findings were present--specifically, cystic or lucent areas within the tumor. The importance of this uncommon finding associated with adult medulloblastoma is discussed.

Adolescent↗
PubMed1986

The postcraniectomy site: CT appearance.

The hospital records and computed tomographic (CT) scans of 124 postcraniectomy patients were reviewed. The normal CT appearance of the operative site was defined and referred to as the "meningogaleal complex" (MGC). The CT characteristics of postoperative infections, intraaxial tumor recurrences, extraaxial tumor recurrences, and the various forms of postoperative cerebrospinal fluid collections were identified and differentiated by comparison with the normal scans. Specifically, when compared with the "postoperative baseline" anatomy, smooth thickening of the MGC often indicated postoperative infection (six cases), while nodular thickening heralded recurrent extraaxial tumor (eight cases). Recurrent intraaxial tumor adjacent to the craniectomy site caused no change in the MGC itself. A knowledge of the normal postoperative appearance of the MGC as well as good communication with the neurosurgeon can allow earlier detection of postoperative complications.

Adult↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients.

The unique anatomy of the ethmoid sinuses makes it difficult to interpret "soft-tissue clouding," especially on plain films. The clinical significance of isolated or generalized soft-tissue disease within ethmoid cells is unclear, and the patterns of bone erosion or remodeling must be relied on in establishing a specific differential diagnosis. Of 400 patients studied, 186 had inflammatory disease and 214 had tumors. Squamous cell carcinomas, metastases, and a few aggressive sarcomas were found almost exclusively to have bone destruction, while 94% of the remaining neoplasms were characterized by cavity remodeling. Further differentiation was sometimes possible because of the pattern and degree of tumor enhancement. Of the neoplasms, only the minor salivary gland lesions and neuromas had nonhomogeneous enhancement. Malignant lesions cannot be diagnosed with computed tomography (CT) unless bone destruction is present. Similarly, although the significance of persistent, benign-appearing soft-tissue disease during chemotherapy is unclear, tumor must always be suspected, even after many months of a stable CT appearance.

Diagnosis, Differential↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part II. Postoperative findings.

Clinical, pathologic, and computed tomographic (CT) findings were reviewed in 400 patients with ethmoid sinus disease, including 272 who had undergone surgery. The postoperative appearance of ethmoid sinuses on CT scans is a highly neglected subject in radiologic literature. The unique ethmoid anatomy permits a variety of surgical approaches, and radiologists must be familiar with the postoperative appearances if they are to recognize the effects of prior surgery and detect, when possible, the recurrence of disease. It is often difficult to evaluate the clinical significance of soft-tissue disease, despite good clinical correlation.

Ethmoid Sinus↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part III. Craniofacial resection.

Of 400 patients with ethmoid sinus disease, 18 had undergone craniofacial resection. This operation is an aggressive surgical procedure directed at total en bloc extirpation of tumors that extend through the floor of the anterior cranial fossa. Recent advances in surgical technique have made it the procedure of choice for sinonasal tumors that extend through the cribriform plate, fovea ethmoidalis, and orbital roof. Specifically, this operation has had excellent results in patients with esthesioneuroblastomas. Radiologists must be aware of the possible pitfalls in interpreting the postoperative computed tomographic scans and the findings that suggest tumor recurrence.

Carcinoma↗
PubMed1985

Chondrosarcoma of the spine: an unusual radiographic presentation.

Chondrosarcoma is a primary malignant tumor arising rarely in the axial skeleton. It usually presents as a destructive lesion with diffuse mottled calcification. We report three patients with chondrosarcoma of the spine. Each patient was evaluated by conventional radiographic technique, computed tomography, and myelography. All of them show radiographically a purely destructive process of the body and in one case the body and lamina. This pattern remains to be documented in the radiologic literature.

Adult↗
PubMed1985

Radiology of large transincisural masses.

A large, potentially resectable mass that crosses the tentorial incisura may present unique problems for the neurosurgeon. Fifteen patients with large transincisural extraaxial masses were reviewed. The computed tomography and angiography findings are discussed. The importance of altering the clinician to the presence of a transincisural mass and accompanying computed tomography and angiography findings are emphasized.

Brain Neoplasms↗