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Positional shift of intraventricular blood clots demonstrated by computed tomography.

Computed tomography with the patient in the prone position was employed to obtain information in a case of intraventricular hematoma secondary to arteriovenous maliformation. A gravitational shift in the position of the intraventricular blood clots was demonstrated by a scan obtained with the patient in the brow-down position. Consideration is given to the possible use of the "prone EMI scan" for other intracranial problems of differential diagnosis.

Adolescent

Quantification of bone mineralization using computed tomography.

Computed tomography was used to find a sensitive parameter for bone mineralization. A precision scanning instrument was constructed for determination of the mineral distribution in sections of the forearm. The quality of the reconstructed images allows separate quantification of compact and spongy bone even when gamma rays are used. Computer simulation and measured of models and macerated human bones showed that under clinical conditions it is possible to quantify spongy bone density within an accuracy of +/-2%.

Adolescent

Demonstration of purulent bacterial intracranial infections by computed tomography.

Computed tomography is shown to be an important modality in both diagnosis and management of cerebral infections. Representative findings from CT scans of patients with purulent bacterial infection of the meninges, cerebrum, ventricles, and adjacent structures are presented. Material is taken from 2,645 CT scans done in a 1 year period at the Hospital of the University of Pennsylvania. It is hoped that the use of CT will lead to a decrease of morbidity and mortality in entities such as brain abscess and subdural empyema.

Adolescent

Evaluation of sellar and parasellar masses by computed tomography.

Computed tomography is the method of choice for initial evaluation of patients with potential suprasellar masses. In our experience, CT has proved completely reliable for detecting or ruling out the presence of a suprasellar mass, the direction and degree of parasellar extension, and the presence of any calcific or cystic component of the lesion. When multiple cut CT has been negative, further diagnostic studies have proved unrewarding. When CT has been positive, additional studies have been required in some cases to rule out aneurysm prior to craniotomy.

Adenoma

Comparison of whole lung tomography and computed tomography for detecting pulmonary nodules.

Detecting pulmonary metastasis is important when planning surgical therapy, radiotherapy, or chemotherapy in patients with known malignancy. A series of 91 patients was studied by both whole lung tomography and computed tomography (CT) of the lungs. More pulmonary nodules were detected with CT than with whole lung tomography in 32 (35%) of the patients. Of the 91 patients in the study, 31 had resection of some or all of the pulmonary nodules. In 27 patients, the nodules were primary or metastatic malignant lesions. Bilateral pulmonary nodules were detected with CT in 13 patients when whole lung tomography had demonstrated nodules in only one lung. CT has replaced whole lung tomography as the method preferred by the authors for detecting pulmonary nodules in selected patients at risk to develop pulmonary metastasis.

Adolescent

Effective atomic number and electron density as measured with a computed tomography scanner: computation and correlation with brain tumor histology.

The mathematical basis and methodology for determining the effective atomic number and electron density of a tissue are presented. Cranial computed tomography (CT) scanning is performed at two different energy levels, both with and without contrast enhancement. The histology of 15 brain tumors has been correlated with the effective atomic number and electron density of the tumor, with parameters of the linear attenuation coefficient, and with statistical values of the CT numbers. The most useful value in separating gliomas from meningiomas from metastases appears to be the percentage change of effective atomic number following contrast enhancement.

Absorptiometry, Photon

Orbital trauma evaluation by computed tomography.

Computed tomographic scans are useful for the evaluation of orbital trauma because they provide visualization of fractures, soft tissue damage, and embedded foreign bodies. Six cases are presented to demonstrate the usefulness of these studies in the evaluation of patients with a variety of injuries. By using both coronal and axial computed tomographic scans, orbital details can be studied with three-dimensional accuracy.

Female

Stop-action cardiac computed tomography.

Computed tomographic (CT) cardiac imaging in vivo has been hampered by motion of the heart during its cardiac cycle. A technique of post data-acquisition correlation of the angular projection data using the electrocardiogram as a reference signal is described. This method produced seven "stop action" images of the heart and resulted in delineating morphological detail not recognizable on the conventional CT scan.

Electrocardiography

Orbital fracture evaluation by coronal computed tomography.

Coronal computed tomography produces orbital scans in a plane that is analogous to Caldwell-view x-ray films. Coronal computed tomography permits simultaneous visualization of the orbital walls and the orbital soft tissues, including all extraocular muscles. Using coronal computed tomography, we studied a series of patients with radiographically proven orbital floor fractures. We studied in detail three of these patients, one with a linear orbital floor fracture, one with a depressed orbital floor fracture, and one with a severely comminuted orbital floor. In two patients, coronal computed tomography showed inferior rectus muscle entrapment, which was confirmed at the time of surgery. In each patient, some bone fragments could be seen more discreetly on coronal computed tomography than on conventional polytomes. Coronal computed tomography may be used to help confirm extraocular muscle entrapment in patients with orbital floor fractures. Coronal computed tomography can also be used to examine patients with possible intraorbital foreign bodies, unexplained reduction of vision, or severely displaced bone fragments.

Adult

[Abdominal computer tomography].

In computer tomography of the abdomen the amount of diagnostic information obtained depends on the organ system examined and correlates with the topographical anatomy. The information gained by this non-invasive method results from the demonstration of contour alteration and from inherent density differences. Although at this point in time, while the process of evaluation is still in progress, it is too early to formulate definitive guidelines on the indications for computer tomography of the abdomen, we suggest, on the basis of experience hitherto, that computer tomography of the adrenals and the pancreas is better than the previously known image-producing diagnostic methods. The overall diagnostic value of computer tomography of the liver and spleen, depending on the pathology in question, is apparently at least equal to sonography, nuclear medicine and angiography. Computer tomography of the gastrointestinal tract and the kidneys, when compared to other diagnostic radiographic and sonographic investigations, at present adds little information, and for this reason has limited application in these systems. In contrast to this is the highly instructive computer tomographic examination of the extrarenal retroperitoneal space.

Abdomen

Steroids and apparent cerebral atrophy on computed tomography scans.

Computed tomography scans of 15 long-term steroid users showed varying degrees of apparent cerebral atrophy, not expected at their ages (8 to 40 years). Most were suffering from autoimmune diseases. There appeared to be some correlation between dosage and degree of apparent atrophy. There was surprisingly little clinical evidence of cerebral dysfunction associated with this apparent atrophy. In two of the cases, the appearance of the brain improved following decrease or cessation of steroid use. Speculations are made on possible causes.

Adolescent

Lissencephaly (agyria) on computed tomography.

Unusual computed tomographic findings were observed in two infants with similar clinical pictures including delay in developmental milestones, seizures, decerebrated posture, and microcephaly. Computed tomography revealed small brain with widened subarachnoid space, smooth surface of the brain, uniformly enlarged ventricles, wide sylvian cisterns, and lack of insular opercularization. These findings coincide with pathologic features of lissencephaly (agyria), a rare congenital anomaly of the brain due to interruption of neuronal migration.

Brain