Harold V. Posniak

Effect of an inelastic aortic synthetic vascular graft on exercise hemodynamics

This study compared aortic input impedance characteristics between patients with aortic interposition Dacron grafts placed for traumatic aortic injury and normal age-matched control subjects. All subjects were examined at rest and after treadmill exercise. Magnetic resonance imaging was conducted to rule out anatomic (stenosis) effects. Exercise increased characteristic impedance (ie, reduced aortic distensibility) by 29% and decreased total systemic arterial compliance by 21% in the patient group, whereas the normal control group showed insignificant change in these variables after exercise. Peripheral pressure wave reflection was reduced substantially with exercise (27%) in the control group, with much less reduction observed in the patient group. These abnormal vascular hemodynamics were associated with significantly high cardiac energetic costs in the patient group. A plausible explanation for the observed differences lies in the exaggerated vascular impedance mismatch between compliant aorta and inelastic graft, when cardiac output increases dramatically.

Computed tomography in traumatic defects of the diaphragm

Two patients with traumatic diaphragmatic defects visible on computed tomography are presented. The diagnosis was delayed for several years in both patients. The diagnosis of these acquired diaphragmatic defects is often difficult. Computed tomography can lead to earlier diagnosis by demonstrating the defect in some patients when radiographic studies are not diagnostic.

Benign mediastinal cysts: pointed appearance on CT.

A case of bronchogenic cyst and two cases of pericardial cysts are presented. Our report illustrates the diagnostic utility of a pointed contour and the dependence of contour on position on CT in establishing the cystic nature of mediastinal mass.

Diaphragmatic endometriosis : CT and MR findings

A case of endometrioma presenting as a diaphragmatic mass in a 36-year-old woman is described. The computed tomographic (CT) and magnetic resonance (MR) findings of the lesion at this rare site of involvement are illustrated, and the pertinent literature is briefly reviewed.

Computed tomography diagnosis of partial anomalous pulmonary venous drainage

A case of the rarely occurring partial anomalous pulmonary venous drainage of the right upper lobe into the azygos arch is presented. Computed tomography (CT) clearly demonstrated the abnormal vessel coursing through the right upper lobe and draining into the azygos arch.

Pancreatic plasmacytomas in a patient with multiple myeloma: CT and ultrasound findings

Extramedullary plasmacytomas are an unusual manifestation of multiple myeloma. They occur most frequently in tissues or organs rich in reticuloendothelial cells. Pancreatic plasmacytomas are rare, with only a few case reports in the literature. We present the ultrasound (US) and computed tomographic (CT) findings of two pancreatic plasmacytomas in a patient with multiple myeloma

Coexistent adenocarcinoma and microcystic adenoma of the pancreas

A case with coexistent pancreatic adenocarcinoma and microcystic adenoma is presented. These diagnoses were suspected on the basis of their computed tomography (CT) appearances and confirmed with CT-guided fine-needle aspiration.

Computed tomography of partial unilateral agenesis of the pectoralis muscles.

The most common congenitally absent muscles are the pectoralis major and minor. Absence is usually incomplete. This anomaly is often one component of a syndrome associated with other hand (Poland syndrome) and thoracic anomalies. Computed tomography can identify partial absence of the pectoralis muscle and exactly define the altered anatomy. A patient with myasthenia gravis and isolated partial agenesis of the pectoralis muscle is presented.

Computed tomography of posterior pararenal and properitoneal metastases

Identification of the retroperitoneal fascial planes with modern computed tomographic scanners allows for precise localization of pathologic processes in the individual compartments of the retroperitoneum. Metastatic disease to the posterior pararenal space or properitoneal space in 6 patients is reported. Two patients had diffuse histiocytic lymphoma and 4 had metastatic melanoma.

Inferior mesenteric artery branch avulsion from blunt trauma—CT findings case report

Mesenteric arterial injuries are uncommon following blunt abdominal trauma. We describe the computed tomography (CT) findings of a patient with avulsion of a branch of the inferior mesenteric artery following a low-speed motor vehicle accident.