Cg Dedrick

Transbrachial hepatic arterial chemotherapy using an implanted infusion pump

Two patients with hepatic metastases from colonic cancer were treated with hepatic arterial FUDR using an innovative drug infusion system. The two patients reported underwent transbrachial hepatic artery catheterization with a 5 French polyethylene catheter. This catheter was amputated just distal to its exit from the brachial artery and attached to a totally implantable, percutaneously refillable drug infusion pump placed in the infraclavicular position. The patients received FUDR at flow rates of 3–4 ml/day. The pumps were refilled weekly by percutaneous injection. One patient was treated for seven weeks, and another for ten weeks without technical difficulties. This innovative approach offers marked improvement in comfort and convenience for patients who are candidates for long-term hepatic artery chemotherapy, and avoids the morbidity of laparotomy for direct hepatic arterial catheterization.

Computed tomography of the tracheal bronchus.

Surgicalracheal bronchus is an uncommon anomaly in which an ectopic bronchus arises from the trachea above the carina. It occurs on the right side and two types are described: “supernumerary,” which is associated with a normal trifurcating right upper lobe bronchus, and “displaced,” in which instance the ectopic bronchus supplies the apical segment of the upper lobe. The CT appearance of this anomaly is described in two cases. Findings include identification of a bronchus arising from the trachea in a section more cephalad than the carina and the presence of only two segmental bronchi arising from the anatomic right upper lobe bronchus when the anomaly is of the “displaced” type. Thin axial sections and coronal imaging display the tracheal broanchus to best advantage.

Dynamic incremental computed tomography of the pulmonary hila using a flow-rate injector.

Dynamic incremental CT of the pulmonary hila using a flow-rate injector is a safe, reliable, and reproducible technique. The technique described allows confident distinction of hilar masses from hilar vessels, while limiting the total amount of contrast medium used and eliminating radiation exposure to the radiologist.

Pseudometastases secondary to film static artifact.

Low density areas in the liver on computed tomography (CT) may be produced by cysts, abscesses, or tumors. A case is reported in which film static resulted in multiple focal low density areas in the liver in a patient with lymphoma. This potential pitfall in CT interpretation can be avoided by taking proper measures to avoid film artifacts and by reviewing all cases on the cathode ray tube (CRT) display as well as the hard copy film.