Diagnosis of retroperitoneal hemorrhage by serial computed tomography.

A case of retroperitoneal hematoma is presented in which the characteristic density changes of the hematoma as seen on serial computed tomography permitted an accurate preoperative diagnosis.

Congenital renal arteriovenous malformation: ultrasonic appearance.

We report a case in which a congenital renal arteriovenous fistula was detected using gray scale ultrasonography and arteriographically confirmed. This abnormality should be considered when renal ultrasonography reveals anechoic structures located centrally or peripherally within the kidney in association with an enlarged renal vein.

Diagnosis of hydronephrosis: comparison of radionuclide scanning and sonography.

Diagnostic sonographic and radioisotope scanning techniques have been shown to be useful in the diagnosis of obstructive uropathy. The accuracy of both methods was compared and sonography was found to provide the more accurate data (sensitivity, 90%; specificity, 98%; accuracy, 97%). Sonography provides excellent anatomic information and enables one to grade the degree of dilatation. Renal radionuclide studies were less sensitive in detecting obstruction, particularly in the presence of chronic renal disease, but offered additional information regarding relative renal blood flow, total effective renal plasma flow, and interval change in renal parenchymal function.

Computed tomography in the diagnosis of aortic aneurysm dissection or traumatic injury.

Thirty patients thought to have an atherosclerotic thoracic aneurysm or chronic aortic dissection were evaluated by computed tomography (CT) and the findings compared with those from conventional radiography, thoracic aortography, and surgery. In all cases, CT defined the lesion and correlated well with angiography. Staging of atherosclerotic aneurysms was possible, and CT also demonstrated the relationship between true and false lumina in aortic dissections; however, aortography was often necessary to differentiate a dissection from an aneurysm or for staging. The relative value of CT and aortography is discussed.

Descending venography: a method of evaluating lower extremity venous valvular function.

Recently developed surgical techniques for the correction of lower extremity venous insufficiency have renewed interest in venous valvular functions. To assess the value of descending venography in the evaluation of venous valvular incompetence, this technique was compared with bidirectional Doppler ultrasound and ascending venography in the examination of 32 patients with clinical signs of chronic venous insufficiency. Twelve of these patients underwent surgery to valvular incompetence, and all underwent descending venography and Doppler ultrasound examinations postoperatively. Descending venography proved to be an effective, accurate method of diagnosing venous valvular incompetence of the saphenofemoral system.

Computed vs. conventional tomography in evaluation of primary and secondary pulmonary neoplasms.

One hundred patients, ultimately proved to have chest malignancies, were evaluated prospectively with conventional chest tomography and computed tomography. In 58 patients with primary malignancies, conventional tomograms were more useful in evaluation of the hilus than CT scans. The mediastinum was better assessed by CT. Thus, evaluation of the presence of neoplasia is better accomplished by conventional examination, while extent of disease is best assessed by CT. Thoracotomy for curative resection was not attempted (in the latter cases of this series) based on CT findings of mediastinal involvement. In 42 patients with metastases to the chest, CT scans of the lung parenchyma were more sensitive than whole lung tomography but had little additional impact on patient treatment. Nevertheless, in 18 patients the results of CT or whole lung tomography directly affected patient therapy.