Eugene V. Leslie

Postmortem radiology of head neck injuries in fatal traffic accidents.

A series of 146 victims of fatal traffic accidents were subjected to postmortem radiographic examination prior to medicolegal autopsy. A total of 42% were found to have radiographically demonstrable head injuries ranging from relatively simple linear skull fractures to massive skull damage. Free intracranial or intravascular air was demonstrated in more than 60%. A total of 21% had demonstrable neck injuries, most of which were localized to a single level at the craniocervical junction or the upper two cervical vertebrae. Flexion and extension studies of this area are of major importance in demonstrating the injury and locating potentially occult lesions for the forensic pathologist.

The radiology of cerebrospinal fluid shunts and their complications

Abstract The three commonly used types of cerebrospinal fluid shunts are ventriculo-cisternal, ventriculo-atrial, and ventriculo-peritoneal shunts. These consist of catheters, valves, flushing devices and reservoirs. The radiographic features of several shunt systems are described. The radiographically recognizable complications of cerebrospinal fluid shunts are cranial, cardiovascular, and abdominal. The cranial complications include displacement and disconnection of the ventricular catheter. Cardiovascular changes include retraction of catheters, embolism and thrombosis of vessels and, rarely, damage to the cardiac wall. Migration of catheters out of or into the abdominal cavity and occasional volvulus or bowel perforation represent the possible abdominal complications. All of these complications ultimately lead to cessation of function of the shunt.

Efficacy of computed tomography of the abdomen--early results.

Our experience with 153 CT scans of the abdomen and pelvis over the first eight months of availability at our institution has been analyzed. The efficacy in terms of contribution to the diagnosis in each patient was assessed and accuracy determined. CT was found to have made a significant contribution to the diagnosis in patients with diseases of the pancreas, aorta, retroperitoneal structures, and in cases of abdominal and pelvic masses and abcesses. It has been somewhat less helpful in evaluation of liver and renal diseases. Overall, CT scanning appears to be a significant new diagnostic modality in the evaluation of patients with abdominal and pelvic diseases.

False Positive Dynamic Imaging of the Cerebral Circulation Due to a Congenital Anomaly

False positive dynamic imaging of the cerebral circulation simulating vascular occlusive disease resulted from a clinically insignificant congenital variation in several patients at our institutions. The anomaly consisted of the asymmetrical caliber of the internal carotid and proximal anterior cerebral arteries. The 1 mm difference in the diameter of the internal carotid arteries was sufficient to be appreciated on dynamic imaging. The frequency of this anomaly was found to be 5% in a series of 200 bilateral carotid angiograms.

Abnormal renal uptake in indium-111-chloride scanning.

A patient with severe alcoholic liver disease, in whom there was almost complete suppression of function of the reticuloendothelial system of the liver as noted on a 99Tc-SC scan is discussed. Obstructive biliary disease was suggested on 131l-rose bengal imaging. The depressed RES function was confirmed on 111In-chloride scan, showing abnormal uptake in the kidneys which could be secondary to inflammatory infiltration in the renal parenchyma from urinary tract infection with gamma enterococci.