Three years ago, at the VIIth International Congress of Radiology in Otorhinolaryngology, held in Copenhagen, the early impressive results of computer-assisted tomography (CAT) in otorhinolaryngology were presented. Since considerable technologic and diagnostic progress of CAT has taken place in the meantime, questions about the increase in CAT's value and the expansion of its limits are appropriate now. Computed and, in some cases, conventional tomograms of facial lesions are used in the discussion of these questions. There is no doubt of CAT's advance within the last few years; there are, however, limits of CAT to be emphasized: (a) coronal CAT might be uncomfortable (especially if the gantry cannot be tilted), unsuccessful (e.g., in cases of neck stiffness), and even dangerous (when head injury is combined with trauma to the cervical spine); (b) enhancement is often not useful (except when intracranial tumor invasion is suspected); (c) specific diagnosis, based on CAT findings only, is impossible in most cases; (d) the radiation dose, which increases with improvement in the quality of the image, must be considered in each case; and (e) CAT does not replace conventional x-ray techniques, least of all polytomography.

Aged↗

PubMedDate not supplied

Demonstration, importance, and origin of renal varices.

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Adult↗

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Extra-CNS metastases of glioblastoma: CT and MR studies.

The case of a 29-year-old man with glioblastoma and multiple metastases outside the CNS is presented. Cervical lymph node involvement was ascertained with CT and magnetic resonance (MR), and numerous bone metastases were detected with skeletal scintigraphy. The extent of the cervical tumor and its relationship to the carotid artery could be better assessed with MR than with CT. The patient died despite repeat operations, radiotherapy, and intraarterial systemic chemotherapy. The importance of radiological screening for detecting glioblastoma metastases in patients with long survival is discussed.

Adult↗

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Spontaneous subarachnoid hemorrhage with negative angiography: CT findings.

Computed tomography of 31 patients with spontaneous subarachnoid hemorrhage (SAH) but negative angiography was evaluated to find out whether the pattern of SAH as seen in CT offers indications for a possible reexamination with angiography. Based on the distribution and the amount of SAH, classification into three groups was possible: (a) 18 cases, normal CT (but blood in the CSF, gained by lumbar puncture) or SAH in the basal cisterns only; repeat angiography was negative in all these cases; (b) nine cases, SAH in the basal cisterns as well as in one or both Sylvian fissures; in addition, small amounts of blood in the interhemispheric fissure and/or in the sulci; repeat angiography revealed an aneurysm in one of these cases; (c) four cases, large quantities of blood in all subarachnoid spaces; in all but one of these cases a vascular lesion was visualized with repeat angiography or verified at autopsy. In conclusion, repeat angiography is mandatory in cases with SAH patterns that can be classified into group b or c, whereas it can be omitted in patients with small amounts of blood confined to the basal cisterns.

Cerebral Angiography↗