Biomedical subjects
Publications and source records attributed to R S Dossetor.
Two cases of lipoma of the spinal cord are presented. CT gives a specific diagnosis in this condition without any contrast being given. It is important to make a preoperative diagnosis, as in lipoma of the spinal cord biopsy is dangerous and frequently makes the patient worse. CT is also valuable as the length of the required decompression laminectomy can be assessed.
Two cases are presented in which metrizamide refluxed into the lateral ventricles after vomiting, the contrast having been brought in intrathecally by lumbar route for CT-scanning of the basal cisterns. It is suggested the intrathoracic and intraabdominal pressures transority achieved in vomiting are transmitted to the spinal canal through the vertebral venous plexus. This results in a pressure which is transmitted through the C.S.F. to the posterior fossa, and from there, for anatomical reasons, to the ventricular system. Transitory dilatation of the ventricles results in aspiration fluid from the fourth ventricle, and hence reversal of normal flow in the aqueduct of Sylvius.
A simple method for identifying the scanning level in computed tomography (CT) of the spine is described. The method involves exposing a lead lattice grid on a conventional X-ray film and taking a conventional spine film with aluminum markers on the patient's back. The film showing the grid and the markers on the patient's spine is used to localize the CT scans taken with the aluminum markers still on the patient's back.
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A case of choroid plexus papilloma is presented which was extensively investigated. The location of the pedicle of this tumor was not demonstrated by conventional CT, ventriculography of ventriculoscopy. Coronal CT sections, however, clearly showed the pedicle and its location. Dilatation of the cisterns and sulci suggested that there was overproduction of cerebrospinal fluid.
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A simple new formula for relating changes in renal length to changes in renal volume is derived. It is not assumed that the kidney is any given shape, but it is assumed that a kidney does not change its shape when it enlarges. It is shown that the fractional change in renal volume equals three times the fractional change in renal length plus three times the fractional change in renal length squared. Examples of applications of the formula using figures for changes in renal length, published elsewhere in the literature, are given for renal hypertrophy in both childhood and adult life and for volume changes during excretion urography.
Compensatory renal enlargement was assessed in 19 adult patients who either had a nephrectomy (17 cases) or developed a functionless kidney following obstruction (two cases). Hypertrophy of the healthy kidney was assessed by comparing renal size on urography before and after removal or destruction of the diseased kidney. Compensatory renal enlargement was demonstrated in 40 per cent of the patients, including two patients in their sixties. The average increase in length was 3 per cent and the maximum increase in length was 9 per cent. Therefore compensatory enlargement does occur in adult life, but is much less than that occurring in childhood. The presence of a hypertrophied adult kidney over 17 cm in length usually indicates that the contralateral renal disease was present in childhood.
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