[The cholesterol granuloma of the frontal sinus. Its radiological morphology and differential diagnostic aspects].
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Biomedical subjects
Publications and source records attributed to W Zaunbauer.
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Twenty-four patients with dissecting aortic aneurysms have been examined by CT and possible causes of mistaken diagnosis are discussed. Failure to diagnose a dissection by CT may be due to atypical localisation and thrombosis of the aortic dissection; dissections of small volume, particularly in the ascending aorta; failure to demonstrate an intimal flap and inadequate contrast enhancement. A false positive diagnosis may be due to fibrotic, inflammatory or neoplastic periaortic changes, aneurysm of the sinus of Valsalva, or artifacts.
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The computed tomographic findings in nine female patients with acute pyelonephritis were reviewed. The major impact of CT was the demonstration of renal enlargement, abnormal contour, perirenal inflammatory extension and, on contrast-enhanced scans, abnormal nephrograms and impaired renal function. It was concluded that CT can provide specific information about the nature and extent of the inflammatory process, thus complementing intravenous urography so that appropriate therapy may be selected. Follow-up studies can be helpful in monitoring the progress of a patient.
The CT appearances of malignant tumours of the paranasal sinuses are illustrated on the basis of 15 patients, and the differential diagnosis discussed. Malignant soft tissue tumours in the paranasal sinuses are characterised on CT by their non-homogeneous structure; they may destroy the bony margins of the sinus and infiltrate neighbouring regions in certain preferred directions, and they may enhance following the administration of contrast. Precise definition of the malignant tumour by CT permits their exact staging, may help to determine therapy and is valuable for serial observation. It remains to be seen, however, whether the improved radiological diagnosis results in improved prognosis of malignant tumours of the paranasal sinuses.
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Radiodiagnostically relevant normal values and variations for measurements of the cervical region, the arithmetical average and the standard deviation were determined from adequate computer tomograms on 60 healthy women and men, aged 20 to 83 years. The sagittal diameter of the prevertebral soft tissue and the lumina of the upper respiratory tract were evaluated at exactly defined levels between the hyoid bone and the incisura jugularis stuni. The thickness of the aryepiglottic folds, the maximal sagittal and transverse diameters of the thyroid gland and the calibre of the great cervical vessels were defined. To assess information about laryngeal function in computerized tomography, measurements of distances between the cervical spine and anatomical fixed points of the larynx and hypopharynx were made as well as of the degree of vocal cord movement during normal respiration and phonation.
The clinical and roentgenographic findings in two patients with posterior fossa extra-axial cysts are presented, a detailed analysis of the angiographic findings of this congenital retrocerebellar leptomeningeal malformations reported and their differential diagnosis discussed.
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Biliary excretion of iotroxamat (ITX) and ioglycamide (IGL) in cholecystectomized dogs fitted with a Thomas duodenal cannula is compatible with saturation kinetics exhibiting maximal excretory velocities of 2.23 +/- SD 0.18 and 1.22 +/- 0.19 mumol/min/kg, respectively. While biliary excretion of ITX obeyed classical Michaelis Menten kinetics, the data obtained with IGL suggested a more complex process. The choleretic effects of both contrast agents (23.6 +/- SD 2.29 and 25.8 +/- 2.21 microliter of excreted substance) were comparable. On the basis of these results and in view of the similar toxicity of the two contrast agents in animals, it may be expected that ITX will have advantages over IGL for intravenous cholangiography.
The radiological features of congenital choledochal cysts are discussed with reference to three cases seen by the authors. The diagnostic problems are mentioned, and use of scintigraphy and ultrasound tomography at an early stage is recommended in order to define more clearly the indications for invasive radiological methods.
The radiological morphology of indirect rupture of the diaphragm is described; this may be followed by transdiaphragmatic prolapse of viscera, possibly complicated by strangulation or incarceration. The differential diagnosis is discussed with reference to fifteen cases seen by the author(s).
The radiological appearances of fibro-epithelial polyps of the ureter are demonstrated by four cases and the differential diagnosis is discussed. These mesenchymal tumors are characterised by their variable position and change in shape during the course of a retrograde pyelogram; they appear as smooth intraluminal filling defects with a narrow base and occasionally a racemose pattern. In general, they do not cause ureteric obstruction--and are more common on the left and in the proximal ureter.
Percutaneous biopsy of the pancreas with a fine needle aimed by ultrasound was carried out on 26 patients with sonographically proven carcinoma of the pancreas. The accuracy of this method was correlated with other radiological techniques. Needle biopsy of the pancreas proved an informative and economical procedure, since the sonographic demonstration of a pancreatic mass otherwise requires additional radiological and endoscopic investigations.
The results of a percutaneous radiotherapy of 136 patients with bladder carcinomas who were treated between 1966 and 1972 are presented in a retrospective study. Before the beginning of the treatment, the diagnosis of these patients had been verified by a lympho-cavo-urography. 21% of the patients had a pathological lymphogram and 40% a pathological urogram. The survival time of patients with normal and those with pathological lympho-cavo-urography showed a difference which was statistically significant (p less than 0.001). There was no patient with inhibited urinary defluxion and demonstrated lymph node metastases who lived longer than 21 months after the treatment. Exclusive percutaneous radiotherapy and primary total cystectomy cannot be considered as curative therapeutic methods. If metastases in the lymph nodes of the regio iliaca communis and paraaortal are demonstrated by lymphography, the prognosis is unfavourable and only palliative methods are justified.
Transcatheter therapeutic arterial embolization with Spongostan was performed in 10 patients with inoperable malignant tumors of the urinary tract. It resulted in prompt and to some extent permanent relief and/or reduction of local tumor symptoms. Despite frequent transient side effects following occlusion, no permanent or serious complications have been directly attributable to the embolization.