Evaluating the clinical efficacy of diagnostic imaging procedures.
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Biomedical subjects
Publications and source records attributed to M R Sage.
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Cryptococcosis presenting as an intrabronchial mass is not a recognized cause of complete lung collapse. This case report illustrates this extremely rare manifestation of pulmonary cryptococcosis, which mimicked primary pulmonary carcinoma clinically, radiologically and bronchoscopically.
A case of a rare intracerebral tumour, namely a ganglioglioma, is reported to illustrate the CT and MRI features. The finding of focal thinning of the inner skull vault in association with an adjacent intracerebral mass lesion can aid in the diagnosis of intracerebral ganglioglioma.
Cervical spondylolysis is a rare condition, characterised by the presence of a corticated cleft between the superior and inferior articular facets of the articular mass (1). This defect involves the cervical equivalent of the pars interarticularis of the lumbar spine. Associated dysplastic changes are present, suggesting that the lesion is congenital (1 and 2). This case report describes bilateral spondylolysis and associated dysplasia of C6 in an 18 year old female. The importance of this lesion lies in its differentiation from the more serious articular mass fracture or dislocation (1).
A case of an enterogenous cyst of the cervical spinal canal in an 18 year old man is presented, high-lighting the radiological findings. A brief overview is given of these rare cysts, together with their clinical and radiological features and associations.
This case report describes an unusual congenital anomaly of the craniovertebral junction in a 14 year old male. Cervical radiographs showed the bony anomaly, while thin slice CT (with 2-D and 3-D reformations), MR imaging, and angiography were particularly useful in accurately assessing the bony, soft tissue and vascular anatomy, prior to and following surgery.
A case of tenth and twelfth nerve compression secondary to a bony exostosis of the first cervical vertebra is described. This uncommon phenomenon serves to outline the importance of imaging the course of a cranial nerve when no intracranial abnormality is demonstrable on CT or MRI. The radiologic features of spinal osteochondromas are reviewed.
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This study was performed to assess the relative contributions of contrast medium osmolality and chemotoxicity to contrast-induced blood-brain barrier (BBB) damage. Experimental carotid angiography was carried out in rabbits with mannitol at an osmolality of 714 mOsm/kg, with the nonionic, monomeric contrast media iohexol and ioversol at similar osmolalities, and with the nonionic, dimeric contrast media iodixanol and iotrolan at osmolalities less than half that of the mannitol. The amount of damage caused by the procedure was assessed by determining the amount of intracerebral extravasation of intravascularly injected technetium-99m-pertechnetate. Mannitol caused no detectable BBB damage, but all four contrast media caused BBB damage that was significantly more severe than that caused by mannitol. The BBB damage caused by carotid angiography with iohexol, ioversol, iodixanol, and iotrolan was not attributable to their osmolalities, but due to some other physical and/or chemical effects of these media on the BBB.
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The rare occurrence of an encephalocoele through a defect in the tegmen of the petrous bone is reported. The case illustrates the association of this abnormality with recurrent meningitis and the importance of imaging in defining the nature and site of the lesion prior to surgery.
The administration of oestrogens is known to cause an increased risk of thrombosis in the cerebral arterial circulation. It has also been associated with cerebral venous thrombosis in patients on the contraceptive pill. We describe a case of cerebral venous thrombosis in a woman on post-menopausal hormonal therapy and discuss this with reference to the current literature.
Previous investigations in this laboratory have confirmed the observation of facial muscle twitching during intracarotid injections of nonionic contrast media (CM) in rabbits. The reaction appears to be a locally mediated effect. To further investigate this reaction, cortical electroencephalogram (EEG) and facial electromyogram (EMG) recordings were made from rabbits receiving selective internal carotid artery (ICA) and external carotid artery (ECA) injections of CM. The effects of iopromide and iohexol were compared with and without the addition of sodium (Na) and calcium (Ca) ions at different concentrations. External carotid injections of iopromide also were performed in some animals paralyzed with D-tubocurarine to exclude the possibility that the reaction is due to an effect on peripheral nerves. The addition of between 5 and 20 mM Ca ions to both CM prevented the reaction but while the addition of Na ions (up to 150 mM) to iopromide had some preventative effect, it did not totally abolish the reaction. In those animals paralyzed with D-tubocurarine, the reaction to iopromide, as observed and recorded by EMG, was the same as that occurring in nonparalyzed animals. This finding is consistent with this reaction being independent of the peripheral nervous system.