Robert Seigel

Computed tomographic and angiographic demonstration of gastroduodenal artery pseudoaneurysm in a pancreatic pseudocyst.

The complementary use of computed tomography and angiography in two patients with bleeding gastroduodenal artery pseudoaneurysm associated with pancreatic pseudocyst is presented.

Variation of position of the kidneys and diaphragm in patients undergoing repeated suspension of respiration.

The position of the upper poles of the kidneys in relation to the 12th thoracic vertebra was evaluated on each of three nephrograms of 32 cooperative patients undergoing excretory urography during evaluation for hypertension. Mean change in kidney position relative to vertebral position between nephrograms varied from a mean 4.9 mm on films taken during inspiration to 7.7 mm on films obtained in expiration. Diaphragmatic positional changes could be evaluated in 12 patients: mean change in diaphragmatic position between nephrogram exposures was 8.0 mm. Considerable variation in diaphragm position does occur during successive breath-holding attempts for cross-sectional imaging.

Intraspinal, extradural ependymoma.

Extradural ependymoma is a rare tumor arising most commonly in the soft tissues of the presacral area, less commonly in the soft tissues of the sacrococcygeal region dorsal to the sacrum, and rarely in the extradural portion of the spinal canal. The differential diagnosis varies with the location, but the natural history of the tumor is the same. If the tumor is not completely excised at surgery, it may recur. Distant metastases have been reported. A case of an extradural ependymoma arising within the spinal canal is reported with myelographic and computed tomographic findings at diagnosis and after therapy.

The posterior pararenal space: an escape route for retrocrural masses.

In two patients with retrocrural tumors, dissection of the tumors selectively into the posterior pararenal space was observed by computed tomography. Cadaver studies confirmed the presence of potential communications between the retrocrural space and the extrapleural space of the thorax or the posterior pararenal space of the abdomen.

Localization of the head of the pancreas using the junction of the left renal vein and the inferior vena cava.

The junction of the left renal vein with the inferior vena cava is visualized on most computed tomography studies of the abdomen. This junction is a useful guide in localizing the pancreatic head, just as the superior mesenteric artery is used to localize the body of the pancreas.

A simple method of localizing the level of computed tomography cross sectioning.

Before computed tomography (CT) scanning, a preliminary radiograph of the area of interest is obtained with a Bell-Thompson ruler on the table top parallel to the spine. This allows precise localization of the level of CT sectioning in relation to the vertebral column.

Lack of visualization of the portal venous tree in cirrhosis of the liver: a computed tomography finding with possible diagnostic significance.

During computed tomography (CT) scanning of the liver, the inferior vena cava can be identified as a separate structure of lesser density adjacent to the caudate lobe in two-thirds of patients without known hepatocellular disease. In patients with alcoholic (portal) cirrhosis of moderate to severe degree, intrahepatic portal veins may not be identified on CT scans, even though their inferior vena cavas can be definitely distinguished from the caudate lobe. Portal cirrhosis causes distortion and obliteration of the portal triads, which is presumably reflected by lack of visualization of intrahepatic portal veins during CT scanning.

Visualization of the longitudinal fold of the duodenum by computed tomography.

The longitudinal fold of the duodenum can be visualized by computed tomography (CT). Visualization of the fold helps localize the hepatopancreatic duct entrance into the duodenum. Many pathological processes of the head of the pancreas such as pancreatitis or malignancy can produce swelling involving the longitudinal fold, which can be visualized by CT.

Rapid Sequence Display of Computed Tomographic Images: An Aid in the Diagnosis of Pulmonary Metastases

A technique is described for expediting the comparison of adjacent CT sections when examining the lungs.

LEUKOENCEPHALOPATHY IN OCULOCRANIOSOMATIC NEUROMUSCULAR DISEASE WITH RAGGED-RED FIBERS (MITOCHONDRIAL ABNORMALITIES): DEMONSTRATION BY COMPUTERIZED TOMOGRAPHY

In a group of 13 patients affected by oculocraniosomatic neuromuscular disease with mitochondrial abnormalities and ragged-red fibers, a major, diffuse leukoencephalopathic process was recognized by computerized tomography (CT) in three cases. Clinically, these three patients were the most severely affected. The areas involved by the leukoencephalopathic process did not show enhancement after contrast medium injection. In several of the remaining ten cases, various forms and grades of CSF cavity dilation were encountered. Four of the 13 patients had very high CSF protein levels, three had CT-demonstrated leukoencephalopathy, and the fourth had substantial sulcal dilation. The CT findings in this group of patients corresponded well to the previously reported histopathological observations and indicated the clinical usefulness of CT in identifying brain involvement in this syndrome.