Biomedical subjects
Publications and source records attributed to C Ozdoba.
A device for computed tomography (CT)-guided percutaneous punctures that is not affixed to the patient and can be used even when the gantry is tilted was developed and tested. In initial patient examinations, the device was accurate within 1.0 mm of the predetermined target point. Experience so far has involved retrobulbar anesthesia and puncture of intervertebral disk space.
Pre-treatment CT examinations of 333 patients with squamous carcinomas in the head and neck region have been analysed. Two hundred and six patients had lymph-node metastases and lymph-node staging was ascertained. The criteria for metastatic involvement were lymph node size greater than 15 mm. and changes in structure (inhomogeneity, central hypodensity and ring enhancement). CT had a sensitivity of 93% and accuracy of 89%. This was better than palpation (sensitivity 64%, accuracy 72%). CT can be regarded as a reliable basis for treatment planning.
42 CT and MR examinations of orofacial tumours have been analysed and their value has been compared. In 78% of cases MR was superior to CT in delineating the tumour borders. T1-weighted and gradient echo sequences after intravenous gadolinium injection were particularly useful. Nevertheless, T-staging based on clinical and CT findings was altered in only two cases (5%) by MR. MR should, at present, be used in those cases where small tumours can not be demonstrated by CT, or where metal artifacts obscure the region of interest.
Ten healthy volunteers and sixty-four patients with various abnormalities of the hypopharynx and larynx were examined by CT in different functional stages in order to study the normal anatomy and the diagnostic value of CT. CT images during quiet respiration are best for showing small glottic carcinomas. To demonstrate, or exclude, fixation of the vocal cords, it is important to obtain images during "E" phonation. Images during "E" phonation, or during Valsalva's manoeuvre, are essential for demonstrating small carcinomas of the hypopharynx and should be obtained in these cases. These images are also helpful in studying functional abnormalities from paralyses of the recurrent laryngeal nerve, trauma of the larynx and laryngoceles. Images during "E" phonation should therefore be obtained in addition to those during quiet respiration as part of the standard examination of the hypopharynx and larynx.
The clinical role of contrast-enhanced CT for pre-operative T-staging of oro-facial tumours was evaluated in 174 patients. During stages T1 and T2, clinical examination is 90% accurate and has a significantly higher sensitivity than CT, with an accuracy of only 53%. The clinical diagnosis of T1 and T2 is, however, made with undue frequency; CT makes it possible to obtain correct staging. Combination of CT and clinical examination can improve correct staging from 46% to 81%. During stages T3 and T4. CT has sensitivity of 91% and is markedly superior to clinical examination, with a sensitivity of 34%. Combined clinical and CT examination improves the predictive value from 52% to 92%. Combination of clinical and CT staging, when the higher stage is accepted as being correct, has a sensitivity and reliability of over 90%. It can be used as a firm basis for treatment planning, judging the prognosis and the effects of treatment.
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Of 114 patients with Hodgkin's disease reviewed, 13 (11%) had bone involvement. The typical osseous lesion in Hodgkin's disease is a secondary manifestation in the axial skeleton. The lesions are mainly lytic; there is no relation between the site of the affection and the character of the lesion. Of 261 patients with non-Hodgkin lymphoma, 19 (7.3%) had bone involvement. Non-Hodgkin lymphoma very rarely affects the bone primarily; these lesions are lytic. Involvement of the appendicular skeleton is reported to by typical; this cannot be confirmed by our study. Most secondary osseous lesions in non-Hodgkin lymphoma are found in the cranium, the spine and the sternum; this pattern of distribution as well as the mainly lytic appearance can be considered typical.
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A simple technique using stereotactic needle placement for retrobulbar anesthesia is reported. The method utilizes a CT-guided stereotactic device that permits precise intraconal injection of local anesthetics; in addition, the risk of injury to muscles, vessels, eyeglobe, or optic nerve is substantially reduced.
OBJECTIVE: Optic nerve glioma is a common finding in patients with neurofibromatosis type 1 (NF-1). Although dural ectasia of the optic nerve is encountered rarely, it has to be considered in the differential diagnosis. MATERIALS AND METHODS: Three patients affected by NF-1 were examined sequentially by CT and MRI. RESULTS: Computed tomography demonstrated nonprogressing enlargement of the anterior optic pathways. Magnetic resonance imaging displayed widening of the perioptic dural sheath without any suggestion of tumor. CONCLUSION: These findings are compatible with meningocele or dural ectasia of the optic nerve sheath. This entity represents a differential diagnosis to optic glioma in patients with NF-1.
OBJECTIVE: To present the CT and MR findings of two patients with maxillofacial intraosseous arteriovenous malformations (AVMs) before and after endovascular therapy. MATERIALS AND METHODS: Two young girls suffering from AVMs in the maxilla and mandibula with spontaneous bleeding in the oral cavity were examined by CT and MR on a 1.5 T GE unit before and after selective endovascular embolization. RESULTS: Computed tomography using a high-resolution algorithm and two-dimensional reconstructions demonstrated the morphology of the bony lesions as well as the regrowth of the bone after successful embolization. Magnetic resonance was the best imaging technique to show vessel structures and the accompanying soft tissue changes. Angiography showed the exact angioarchitecture of the AVM and was essential for therapy planning. CONCLUSION: Because selective endovascular embolization of maxillofacial AVMs is gaining in importance, CT and MRI are, therefore, essential for diagnosis and therapy planning as well as for follow-up imaging.
Perilymphatic fistulas of the inner ear constitute abnormal leaks of perilymphatic fluid into the middle ear or mastoid air cell system and represent a rare cause of otorrhea. We report the case of a 5-month-old child presenting with sudden otorrhea. High resolution CT cisternography showed a malformation of the middle ear and a passage of contrast-enhanced CSF into the tympanic cavity through the left oval window. Surgery confirmed a tear of the tympanic membrane as well as a stapes malformation with aplasia of the crura and an associated perilymphatic fistula through a defect in the stapes footplate. The fistula was closed with adipose tissue from the ear lobe.
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