Akiko Shigeta

Anomalous left brachiocephalic vein: CT findings.

Eight cases of anomalous position of the left brachiocephalic vein were demonstrated by CT. Six coursed downward lateral to and below the aortic arch to enter the superior vena cava (SVC). Two cases were double left brachiocephalic veins. The superior branch was in the normal position, but the inferior vessel coursed below the aortic arch. Most of these subaortic left brachiocephalic veins enter the SVC at the same level or caudal to the azygous arch. Only two cases were associated with congenital heart disease. This anomalously positioned vessel is asymptomatic but must be distinguished from the pulmonary artery and persistent left SVC, especially when open heart surgery for cardiac malformations is being considered.

Head and neck reconstruction with pectoralis major myocutaneous flap: CT evaluation.

Sixty-one CT scans in 20 patients who had undergone head and neck reconstructive surgery using a pectoralis major myocutaneous (PM-MC) flap were retrospectively evaluated to assess the usefulness of Ct in the follow-up of these patients. The normal CT findings in patients with PM-MC flaps are described. Of 13 cases with tumor recurrence, CT examination correctly detected recurrent masses in all cases, including 3 in which there was no clinical sign of recurrence. Postoperative masses mimicking tumor recurrence included deformed breast tissue, hematomas, lymphoceles, and abscesses. Computed tomography was of great value in the detection of tumor recurrence, but careful interpretation is required because a postoperative complication or anatomic alteration may lead to the erroneous diagnosis of tumor recurrence.

Long follow-up study in patients with prior myocarditis by radionuclide methods

SummaryTen patients with previous myocarditis were evaluated to determine cardiac conditions by Tl-201 myocardial perfusion imaging and stress radionuclide ventriculography during the follow-up of 18–102 (average 56) months; the results were compared with those from ten sex-and age-matched controls. Exercise capacity by supine bicycle ergometer was reduced in patients with myocarditis. Their resting left ventricular ejection fraction (LVEF) was 57.5%±3.9%, similar to that of controls. LVEF response to stress in myocarditis was abnormal with an increment of end-systolic volume, while in the controls LVEF increased significantly during stress. Seven of the eight patients with an abnormal ejection fraction response had constant Tl-201 perfusion defects.This study indicates that latent left ventricular dysfunction is present in patients with prior myocarditis and that nuclear study is useful for long-term follow-up.