[Computed tomography of chest wall abscess].
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Biomedical subjects
Publications and source records attributed to J Arisawa.
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We have studied real-time sonograms of 11 surgically proven benign mediastinal teratomas. Eight cystic teratomas were sonographically visualized as various kinds of masses: four complex, two solid, and two cystic. The echo patterns of cystic teratomas were determined by the serous or nonserous nature of the cysts. In the presence of serous fluid, the tumor was visualized as a cystic mass. If, on the other hand, the cyst of the tumor was nonserous or was sebaceous, it appeared as a solid or complex tumor. The remaining three solid teratomas, which had some small cysts, appeared as complex tumors.
A parathyroid cyst was evaluated by sonography and computed tomography (CT) in a patient with hyperparathyroidism. Sonography demonstrated a cystic lesion near the left lower pole of the thyroid, extending into the anterior mediastinum. On CT, the parathyroid cyst had a slightly high attenuation (30 H), with a smooth wall demonstrated after intravenous administration of contrast material. Fine-needle aspiration biopsy of the cyst showed elevated parathyroid hormone (PTH) level. The lesion probably represents cystic degeneration of an adenoma.
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We recently encountered a tracheal schwannoma presenting as a polypoid mass. Computed tomography (CT) was very effective in evaluation of the size, shape and site of this rare tumour. Furthermore, CT images in the prone position made it easy to exclude tumour extension into the mediastinum.
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Fifteen patients with primary intrathoracic neurogenic tumours were evaluated using computed tomography (CT) scans. Schwannomas were demonstrated as homogeneous or slightly inhomogeneous densities on plain CT images; 4 of 5 schwannomas showed rim enhancement with some enhancement in the central portion of the tumour on post-enhancement CT images. Neurofibromas and ganglioneuromas were visualized as homogeneous densities on plain CT images. Three of 5 ganglioneuromas revealed homogeneous contrast enhancement of post-contrast CT images. A ganglioneuroblastoma and 2 neuroblastomas manifested slightly inhomogeneous tumour density on plain CT images. The inhomogeneity of the tumours was accentuated on contrast enhancement CT images.
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Nine consecutive patients with ventricular septal defect (VSD) and pulmonary atresia associated with large aortopulmonary collateral arteries underwent primary repair with simultaneous ligation of these collateral arteries. The patients ranged from 1 year to 20 years old (average, 8.0 years). The average number of large aortopulmonary collateral arteries was 1.9 per patient. Arborization abnormality was found in 5 patients. The aortopulmonary collateral arteries were reached solely through a median sternotomy, with dissection of the posterior pericardium or anterior mediastinal pleura before or after the initiation of cardiopulmonary bypass. The immediate postoperative peak pressure ratio between the right and left ventricles was higher in patients with an arborization abnormality, but all ratios ranged from 0.60 to 0.87. There was 1 operative death. Postoperative transcatheter embolization for a residual large aortopulmonary collateral artery was required in 1 patient and pulmonary infarction of mild degree developed with spontaneous recovery in another. These results indicate the usefulness and safety of simultaneous ligation of large aortopulmonary collateral arteries through median sternotomy, even with an associated arborization abnormality.
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