[Subarachnoid hemorrhage imaging].
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Biomedical subjects
Publications and source records attributed to A Racle.
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The authors report about one case of giant-cell tumor of the cricoid bone (osteoclastoma, myeloplaxic tumor). The diagnosis is difficult as the clinical and radiological symptoms are not specific. A detailed iconography sums up the clinicopathological characteristics of this tumor. The authors emphasize the necessity to perform wide exeresis surgery through total laryngectomy.
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The authors have studied by CT brain infarcts of different ages in 16 patients, two of whom were also examined by MRI. The early and CT signs of wallerian degeneration of the descending tracts within the brain stem are described. Three cases of crossed cerebellar atrophy are reported; in one of them, the cerebral lesion had been present for less than 8 years. The physiopathology of pontine hemiatrophy and crossed cerebellar atrophy is discussed.
Nineteen patients with histologically proved tumor thrombi of the inferior vena cava (IVC) secondary to abdominal neoplasms were studied with the use of ultrasonography (US) and computed tomography (CT). The primary neoplasms were renal cell carcinoma (13 cases), adrenal tumors (two cases), retroperitoneal tumors (two cases), and hepatic tumors (two cases). A positive diagnosis of tumor thrombus was achieved by both methods. The cranial extent of the tumor thrombus was better demonstrated by US studies, which showed echogenic endoluminal material within an enlarged IVC with a bulging anterior wall. On CT scans the tumor thrombus usually appeared as an endoluminal filling defect surrounded by a rim of contrast material. Tumor thrombus was better outlined by CT, particularly when it extended beyond the limits of the IVC wall, as in the retroperitoneal tumors. Neither method could accurately be used to predict IVC wall infiltration when the tumor thrombus remained within the confines of the IVC, nor could either method differentiate tumor from nontumor thrombi. US and CT are complementary in the preoperative assessment of tumor thrombus, and their use obviates the need for venacavography in many cases.
In about 10% of lymphopathies with extensive retroperitoneal adenopathies, adenopathies are also encountered within the hepatoduodenal ligament. When large, such adenopathies, which surround the portal vein, hepatic artery, and bile duct, give rise to a particular ultrasound pattern: the "rosebud pattern."
We evaluated the ability of dynamic CT scanning to accurately demonstrate the laterosellar extradural venous spaces. Careful examination of 680 consecutive patients with this technique has permitted us to describe four main venous groups: the veins of the lateral wall (present in 98% of cases), the vein of the inferolateral group located beneath cranial nerve VI (present in 92% of cases), the medial vein located between the internal carotid artery and the pituitary gland (present in 20-30% of cases), and the vein of the carotid sulcus located between the intracavernous internal carotid artery and the lateral wall of the sphenoid bone (present in 65% of cases). The vein of the carotid sulcus is absent only when the internal carotid artery lies close to the sphenoid bone. In 12 patients with suspected cavernous sinus invasion, dynamic CT scanning demonstrated obliteration of the vein of the carotid sulcus. In five patients with huge tumors of the temporal region, dynamic CT scanning of the cavernous sinus permitted demonstration of normal laterosellar extradural venous spaces, thus permitting exclusion of intracavernous sinus invasion. We believe dynamic CT is the imaging technique best suited for studying the laterosellar extradural venous spaces. Its spatial resolution and dynamic capacity make it superior to MR, and it should be the first procedure when invasion of the cavernous sinus by a pituitary tumor is suspected.