Biomedical subjects
Publications and source records attributed to A A Franchetto.
Aortic transection is a frequently fatal traumatic injury. Patients who survive the initial event require rapid diagnosis and treatment. To this end, enhanced CT of the chest has been used to detect both mediastinal hematoma and direct vessel injury [1-6]. This essay shows the CT features associated with aortic transection, particularly the direct signs.
We report two unusual cases of intracranial meningioma with extracranial metastases to bone. The diagnosis was made by fine needle aspiration biopsy in both cases and confirmed by open biopsy in one. The lungs were spared in both. A review of the literature is included.
The authors report a case of hyperacute spinal epidural hematoma, an uncommon condition, imaged by both magnetic resonance imaging and computed tomography. The relative specificity of these two imaging methods for this abnormality is discussed, and recommendations for emergent imaging in this setting are given.
BACKGROUND AND PURPOSE: The aim of this study was to determine the potential value of carotid artery calcification observed on plain radiographs in patients referred for carotid angiogram in the diagnosis of carotid artery stenosis. METHODS: One hundred sixty consecutive patients with suspected carotid artery stenosis underwent both plain radiographs of the carotid arteries and digital subtraction angiography of the same vessels. In addition, 108 of these patients also had duplex ultrasound of the same vascular area. The clinical usefulness of the carotid artery calcification was assessed by calculating the likelihood ratios for different test results against results of angiography and duplex ultrasound. RESULTS: There is a statistically significant association between the degrees of calcification and carotid disease as demonstrated by angiography (P = .0001), although positive correlations of the degrees of stenosis and calcification was only fair (Spearman correlation coefficient r = .4). The sensitivity of carotid calcification in detecting clinically significant stenosis assuming any calcification is abnormal was 89% with a specificity of 46%. The likelihood ratios for 50% stenosis by angiography varied from 0.24 (no calcification) to 3.41 (level III) and for 50% stenosis by duplex ultrasound varied from 0.21 (no calcification) to more than 5.87 (level III). Assessments of the degree of calcification based on plain radiographs had excellent reproducibility (all intraclass correlation coefficients were greater than .9). CONCLUSIONS: In this population with a high prevalence of carotid artery disease, there is an association between the presence of carotid calcification and atheromatous disease. If subsequent studies were to show this to apply in the general population, this could be of value in identifying asymptomatic patients at increased risk.
Biliary cystadenomas and cystadenocarcinomas are rare. They arise in the liver or, less frequently, from the bile ducts. The characteristic appearance of these lesions in computed tomography and ultrasonography scans, as observed in a 26-year-old woman, is described. The features are similar to those of hydatid disease, and without travel history and the results of stool cultures and serologic tests differentiation may be impossible. Other considerations in the differential diagnosis are also discussed. Surgery is always indicated, because benign and malignant tumours in this area cannot be differentiated radiologically.
In this study we reviewed 23 postoperative magnetic resonance (MR) imaging examinations of patients with pituitary macroadenomas to determine if intravenous contrast is of value in this setting. The addition of contrast enhanced images to noncontrast T1-weighted images changed the radiologist's assessment in 4/5 early postoperative examinations and in 0/18 late postoperative examinations. Intravenous contrast is of value in distinguishing residual tumor from packing material on early postoperative MR examinations but is less useful in later postoperative examinations.