Biomedical subjects
Publications and source records attributed to H V Posniak.
Myelomatous involvement of the uterine cervix is rare and, to our knowledge, has not been reported previously in the radiologic literature. This report describes the computed tomographic (CT) findings and reviews differential diagnostic considerations.
Magnetic resonance (MR) imaging is a valuable technique for noninvasive evaluation of the female pelvic region. This article presents the normal anatomy and abnormalities of the female pelvis. MR imaging may be more useful than clinical evaluation or other imaging modalities in diagnosing or staging developmental anomalies, leiomyomas, adenomyosis, endometrial or cervical carcinoma, vaginal neoplasms, ovarian cysts, endometriosis, teratomas, polycystic ovaries, or other ovarian masses. It could potentially replace laparoscopy as a more useful tool in the diagnosis of uterine anomalies. MR imaging is generally capable of helping determine whether a pelvic mass is uterine or adnexal in origin and may be used to characterize some adnexal masses. In some cases, MR imaging is used to differentiate recurrent disease from posttreatment fibrosis, which aids in treatment planning.
High-resolution real time ultrasound of the scrotum, including gray-scale and color Doppler sonography is presented. The normal anatomy of the scrotum with sonographic correlation is reviewed. The sonographic features of scrotal pathology, including congenital, neoplastic, inflammatory, and traumatic conditions are presented.
Congenital and acquired abnormalities may alter the anatomy, size, or position of the azygos system. Computed tomography is often able to depict these abnormalities and in many cases indicate the cause. In this article, the normal anatomy of the azygos system is discussed and examples of congenital and acquired abnormalities are presented.
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.
Thirteen patients with clinical stages I and II endometrial carcinoma were examined with magnetic resonance (MR) imaging before surgery. Depth of invasion and stage of disease were assessed, and the results were compared with those from MR images of the surgical specimens and pathologic findings. Staging with MR imaging was accurate in 11 of 13 patients (85%). Our results agree with previous reports that MR imaging is an accurate, noninvasive method of assessing depth of myometrial invasion and cervical involvement. We anticipate that MR imaging will have an increasing role in treatment of patients with endometrial carcinoma.
Aneurysms of the thoracic aorta are most often the result of arteriosclerotic disease. Other causes include degeneration of the medial layer of the aortic wall, either idiopathically or due to genetic disorders such as Marfan syndrome; aortic dissection; trauma; syphilis and other bacterial infection; noninfective aortitis; and congenital anomaly. We review normal anatomy of the aorta and discuss our technique and interpretation of computed tomography (CT) in the evaluation of the thoracic aorta. We illustrate the CT appearance of different types of aortic aneurysms as well as discuss the use of CT for assessing complications of aneurysms, for postoperative follow-up, and in the differentiation of aortic aneurysm from a paraaortic mass.
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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.
Computed tomography is an established modality for the evaluation of the pericardium. It is used to evaluate complicated pericardial effusions, pericardial thickening, calcific pericarditis, pericardial cysts, postoperative changes and primary and metastatic neoplasms of the pericardium. Magnetic resonance imaging is being used with increasing frequency in the evaluation of pericardial disease. It offers advantages over computed tomography, including a potential for tissue characterization, absence of ionizing radiation or need for intravenous contrast medium, and the ability to scan in any plane. Disadvantages include greater cost, longer examination times and the inability to identify calcification positively.
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.
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A 24-year-old woman with a two-year history of hypertension was hospitalized for coma and quadriplegia secondary to pontine hemorrhage. A seven-year history of intermittent severe headaches, diaphoresis, and anxiety together with persistent severe hypertension led to the diagnosis of pheochromocytoma. This unusual but devastating manifestation of pheochromocytoma illustrates the importance of excluding remedial forms of hypertension in young patients before initiating antihypertensive therapy.
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.
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.
A case of primary cardiac lymphoma initially diagnosed by routine cytologic examination of pericardial fluid is presented. In a 64-year-old woman woman who originally presented with chest pain and heart block, the initial clinical impression was ischemic heart disease. However, coronary angiography failed to reveal significant disease. An echocardiogram demonstrated pericardial fluid, which was drained. A small amount was sent for cytologic examination, and the diagnosis of malignant lymphoma, large cell type, was made. Subsequent radiologic examinations revealed an intracardiac mass involving the atrioventricular canal; surgical biopsy confirmed the diagnosis of a large cell lymphoma. While primary malignant lymphoma of the heart is rare, this case highlights the efficacy of routine cytologic examination of an effusion fluid (often drained therapeutically) in establishing the correct diagnosis.