Rina Tadmor

Early MR demonstration of spinal metastases in patients with normal radiographs and CT and radionuclide bone scans.

Forty patients with known primary tumor and progressive back pain, suspected of having spinal metastatic disease, underwent magnetic resonance (MR) examinations of the thoracic and lumbosacral spine. Conventional radiographs and CT scans of the spine were all normal. The radionuclide bone scans were equivocal. In 21 patients focal or diffuse vertebral MR abnormalities were detected. In nine patients the lesions were hypointense on T1 sequence, and the same lesions were demonstrated poorly or not at all on T2 and proton density sequences. In eight other patients the bone marrow metastases presented with strong signal intensity on T2 and were poorly or not at all demonstrated on T1 and proton density sequences. In three patients with multiple myeloma, the signal intensity pattern of the vertebrae was diffusely heterogeneous, with alternating small foci of strong and weak signals (a mosaic-like pattern). Following the MR studies, needle biopsy confirmed the malignancy in the 21 patients who had shown abnormalities. No correlation between the type of primary tumor and the signal intensity of the vertebral metastases was shown. Possibly the mosaic pattern shown in three of the multiple myeloma patients represents a special case.

Orbital Fracture Evaluation by Coronal Computed Tomography

Coronal computed tomography produces orbital scans in a plane that is analogous to Caldwell-view x-ray films. Coronal computed tomography permits simultaneous visualization of the orbital walls and the orbital soft tissues, including all extraocular muscles. Using coronal computed tomography, we studied a series of patients with radiographically proven orbital floor fractures. We studied in detail three of these patients, one with a linear orbital floor fracture, one with a depressed orbital floor fracture, and one with a severely comminuted orbital floor. In two patients, coronal computed tomography showed inferior rectus muscle entrapment, which was confirmed at the time of surgery. In each patient, some bone fragments could be seen more discreetly on coronal computed tomography than on conventional polytomes. Coronal computed tomography may be used to help confirm extraocular muscle entrapment in patients with orbital floor fractures. Coronal computed tomography can also be used to examine patients with possible intraorbital foreign bodies, unexplained reduction of vision, or severely displaced bone fragments.

Computed Tomography of the Orbit with Special Emphasis on Coronal Sections: Part I. Normal Anatomy

Visualization of orbital soft tissue structures by computed tomography in direct coronal and axial studies is extremely useful in diagnosis. Direct enlargement viewing of scans has disclosed minute anatomical details. This study reviews some of our experiences in the investigation of a variety of lesions within the orbit and attempts, in particular, to illustrate the value of direct coronal studies.

Computed tomography in primary malignant lymphoma of the brain.

Primary malignant lymphoma of the brain is a rare lesion characterized clinically by varied nonspecific neurologic deficits and usually a rapid fulminant deterioration and death. This course may be altered by radiotherapy, and early diagnosis assumes major importance. Laboratory tests. EEG. radionuclide scans, angiography, and pneumoencephalography may not show definite abnormality in the early stages. This report concerns four cases in which good correlation between the location of the brain lesion and the abnormality on computed tomography scan was demonstrated.

Computed Tomographic Evaluation of Traumatic Spinal Injuries

A full radiological evaluation of patients who sustained traumatic injuries to the spine may be difficult to obtain due to the danger associated with manipulation. Computed tomography offers a new modality for simple and accurate evaluation; valuable information may be gained without the use of invasive methods.

Computed tomography in metrizamide cisternography--importance of coronal and axial views.

Computed tomographic scans were performed in 34 patients following lumbar introduction of metrizamide. Imaging of the cranial spaces was obtained with horizontal and inclined (25°) as well as coronal planes. Mass lesions within and encroaching upon the cisternal spaces were demonstrated, and the ventricular system was shown with varying degrees of opacification. Coronal and semicoronal views facilitated the localization of parasellar and incisural mass lesions.

Computed Tomography of the Orbit with Special Emphasis on Coronal Sections

Computed tomography (CT) of the orbit is capable of demonstrating soft tissue structures not visualized yet by any other radiological modality. The possibility of obtaining direct coronal slices has added a new dimension to the study. Direct enlargement viewing on the display console reveals many anatomical details. For better evaluation of pathological findings, an accurate anatomical knowledge is required. The purpose of this study is to report on the normal anatomy of the orbital soft tissues made visible by CT. with emphasis on the coronal views.

Computed tomography of the skull and facial structures: Preliminary evaluation of direct coronal sections

Skull and facial structures may be evaluated on computed tomography (CT), as well as the brain. A valuable new dimension to the study has been added with the feasibility of obtaining direct coronal sections using a wide gantry aperture. The patho-anatomical details of bone and soft tissues including the orbit and paranasal sinuses are well demonstrated. Direct viewing on a display console of an enlarged quadrant of the scan is of prime importance in diagnosing fine changes involving the thin facial bones.

Malignant Tumors of the Sinuses Radiologic Evaluation, Including CT Scanning, with Clinical and Pathologic Correlation

This study is based on experience with 100 patients. The clinical and pathologic features of carcinoma of the sinuses are analyzed. The various radiologic modalities are described and evaluated with respect to diagnosis and treatment.

Computerized Tomography for Evaluation of Fractures and Foreign Bodies of the Orbit

Orbital trauma may injure soft tissues, damage the facial bones, and imbed foreign bodies. Injury may also occur to structures adjacent to the orbits, leading to cerebrospinal fluid leaks, carotid-cavernous sinus fistulas, and damage to the brain, nasolacrimal pathways, or paranasal sinuses (Smith et al., 1976; Grove, 1977). Because of the difficulty in determining the extent of soft tissue injuries in patients with orbital fractures, and in localizing intraorbital foreign bodies, computerized tomography has been used to aid in the management of patients with mid-facial injuries (Grove, 1977; Grove et al., 1974, 1977; Momose et al., 1975; Kollarits et al., 1977).