Comparison of sonography and computed tomography in the study of orbital space-occupying lesions.

Seventy cases of space-occupying lesions in the eyeball and 140 extraocular masses in the orbit were explored by both sonography and compute tomography (CT). The merits of each method were demonstrated relative to defining the location, extension, and nature of the lesion. In adults with ocular masses, sonography is usually sufficient. For retinoblastoma, CT is usually necessary to rule out an extraocular extension. When an orbital process is involved, greater diagnostic accuracy can be achieved if the two methods are combined.

Computed tomography in 75 clinical cases of syringomyelia.

Seventy-five patients with a clinical diagnosis of syringomyelia were examined by computed tomography after intrathecal injection of metrizamide. A central cavity was demonstrated in 67 patients. Tilting the patient head down did not increase the rate of cavity opacification. This evidence favors transneural migration of metrizamide into the cavity. The spinal cord was measurably enlarged in only a minority of the patients. In some, the cavity appeared to have clefts or wall defects. These results are discussed according to the etiopathogenic theories advanced by Gardner, Aboulker, and Williams.

Intraocular pressure in normal llamas (Lama glama) and alpacas (Lama pacos).

OBJECTIVE: To determine the mean intraocular pressure in llamas (Lama glama) and alpacas (Lama pacos) using applanation tonometry.Animals studied: Ten llamas and 10 alpacas.Procedures: Intraocular pressure (IOP) was measured with a Tono-Pentrade mark XL (Mentor Ophthalmics, Inc., Norwell, MA, USA). Three values, with 5% variance, were recorded for each eye. Least-squares means were determined for IOP for each eye of llamas and alpacas. Controlling for age, differences between left and right eye were analyzed using ANOVA. Two age groups were established, less than 5 years and greater than 5 years. The effect of age on IOP within each group was analyzed by linear regression. Probability values of less than 0.05 were considered significant. RESULTS: Comparison of mean IOP between right (n = 20) and left eyes (n = 20), independent of species type, showed no differences in IOPs for llamas and alpacas. Mean IOP declined with increasing age in llamas and alpacas. Mean IOPs for 20 eyes in 10 llamas was 16.96 +/- 3.51 mmHg. Mean IOP for 20 eyes in 10 alpacas was 16.14 +/- 3.74 mmHg. Mean IOP for all eyes (n = 40), independent of species, was 16.55 +/- 3.55 mmHg. The range of IOP in normal llamas and alpacas within 2 SD (95% of the population) was 14.89+/-18.21 mmHg. CONCLUSIONS: There was no significant difference in IOP between alpacas and llamas. Mean IOP in both species decreased with increased age.

Analysis of aqueous humor obtained from normal eyes of llamas and alpacas.

OBJECTIVE: To evaluate composition of aqueous humor obtained from normal eyes of llamas (Lama glama) and alpacas (Lama pacos). SAMPLE POPULATION: Aqueous humor obtained from 10 male llamas and 10 male alpacas. PROCEDURE: All animals had normal eyes, as determined by ocular examination. Aqueous humor samples were obtained via paracentesis of the anterior chamber of animals that were heavily sedated. Chemical analysis included measurement of concentrations of sodium, potassium, magnesium, chloride, bicarbonate, phosphorus, and glucose as well as osmolality and pH. RESULTS: With the exception of potassium concentrations, values for aqueous humor composition did not differ significantly between llamas and alpacas. Mean +/- SD values for llamas and alpacas, respectively, were: sodium, 154.7 +/- 2.1 and 152.7 +/- 2.1 mEq/L; potassium, 5.3 +/- 0.4 and 4.6 +/- 0.4 mEq/L; magnesium, 1.8 +/- 0.1 and 1.7 +/- 0.1 mg/dl; chloride, 130.0 +/- 1.6 and 127.0 +/- 3.3 mEq/L; bicarbonate, 19.2 +/- 1.5 and 20.2 +/- 2.3 mEq/L; phosphorous, 2.7 +/- 0.3 and 2.5 +/- 0.4 mg/dl; glucose, 80.3 +/- 3.9 and 80.8 +/- 7.3 mg/dl; total protein, 29.0 +/- 8.6 and 31.5 +/- 10.1 mg/dl; and osmolality, 305.8 +/- 11.8 and 306.2 +/- 4.9 mOsm. The pH ranged from 7.5 to 8.0 for both species. Potassium concentrations were significantly higher in llamas than alpacas. CONCLUSIONS AND CLINICAL RELEVANCE: Except for potassium, composition of aqueous humor did not differ significantly between llamas and alpacas. Aqueous humor composition of llamas and alpacas is similar to that of other species that have been examined.

[Value of computer assisted tomography in the exploration of the sellar and supra sellar structures (author's transl)]. / Apport de la tomodensitométrie a l'exploration de la région sellaire et supra-sellaire.

The results obtained in 145 cases of space-occupying lesions in the sellar and suprasellar structures, after exploration with computer assisted tomography, were used to assess the technical and diagnostic value of this procedure. Precise details of the localization and extent of the lesion can be obtained, but not the nature of the lesion in many cases.

[Oculomotor lesions and myeloma: a case with a CT scan study (author's transl)]. / Les atteintes oculo-motrices au cours des myélomes. A propos d'un cas étudié par tomodensitométrie.

A 62 year-old woman presented with a unilateral, incomplete ophthalmoplegia, and pain in the territory of the ophthalmic branch of the trigeminal nerve. She had an IgG gamma 2-lambda 2 type myeloma. Opacification by phlebography of the cavernous sinus on the affected side was not possible, neither through the ophthalmic vein nor through the anastomotic coronal veins. This suggested invasion of the sella turcica. Combined radiotherapy and chemotherapy led to rapid and almost total recovery. The lesion recurred 15 months later. Then there was a bilateral oculomotor palsy involving both external recti, and exophthalmos. CT Scan demonstrated a marked increase in size of the external recti. Special features in this case were the oculomotor paralysis and its occurrence as the initial sign of the disease, and its secondary localization in the orbits with bilateral muscle lesions.

[Computed tomography in multiple sclerosis]. / La tomodensitométrie dans la sclérose en plaques.

Sixty patients with multiple sclerosis were examined by computed tomography using an Acute 200 Pfizer apparatus (matrix: 256 X 256; sections: 8 mm thick). In 48 cases iodine contrast medium was injected prior to examination, and in 6 cases the examination was repeated after several months. Abnormal C.T. readings were found in three quarters of the patients; increased image density in 10 patients, reduced density in 10 other cases; isolated cerebral atrophy in 26 patients, associated in 10 other cases with increased or reduced density of the image. Increased densities were seen mainly during acute episodes, then tended to isodensities or low densities. Though these different images are not specific, their association, the absence of mass effect and the absence of correlation between their location and the clinical signs, are elements in favor of the diagnosis of multiple sclerosis. Regions of increased density probably represent active foci of demyelinization and their investigation could be of value during long-term follow-up of these patients.

[Scannography apport in syringomyelic study. 40 syringolyelic cases (author's transl)]. / Apport de la scannographie a l'étude des syringomyélies. 40 cas de syringomyélie de l'adulte.

Forty patients with a syringomyelic syndrome were studied by means of scannography of the cervical spine and cervico-occipital joint before and after intrathecal injection of metrizamide. metrizamide transit, and more particularly the opacification of the syringomyelic cyst by metrizamide were assessed by delayed passages. This study demonstrates the value of this technique both from the morphological and dynamic point of view.

[Lobar holoprosencephaly associated with heterotopic gray matter. A case disclosed in adulthood by epilepsy]. / Holoprosencéphalie lobaire associée à des hétérotopies de substance grise. Un cas révélé à l'âge adulte par une épilepsie.

A case of lobar holoprosencephaly associated with heterotopias of the grey matter is reported. The patient was a young woman whose cerebral malformation was revealed by epileptic seizures at the age of 22. There was no intellectual deficit. Computerized tomography and, chiefly, magnetic resonance imaging, enabled the study of the malformation.

[Echotomography of the carotid bifurcation (author's transl)]. / Examen de la bifurcation carotidienne par échotomographie.

Echotomography examinations of carotid bifurcation were conducted in 19 patients, with a real-time apparatus (71 crystals, 7 MHz). Serial transversal sections plus two or more longitudinal sections enabled identification by Echo-B of the three carotid arteries, and thus the bifurcation, in 37 instances. Arteriography was performed in 11 patients (21 carotid arteries). Correlation between Echo-B and arteriographic findings was good in 10 cases (including 1 case of occlusion and 2 of stenosis). There were 3 false negatives but no false positives. Echo-B did not detect the bifurcation on either side in one patient. The method is non-invasive, painless, and can be repeated without risk. It enables the detection of stenotic and occlusive lesions with a certain degree of reliability. It is also of value for demonstrating the presence of atheromatous plaques, and to some extent, irregularities in the arterial wall or variations of its diameter. It allows new perspectives for long-term following of patients after medical or surgical treatment.

[Wilson's disease. X-ray CT and MRI aspects of the brain in a case before treatment]. / Maladie de Wilson. Aspects TDM et IRM de l'encéphale d'un cas avant traitement.

Wilson disease is an autosomal recessive disorder of copper metabolism. The case of a young girl is reported here, with CT and MRI data before any treatment. The unusual MR presentation on T2 weighted sequences is studied, and compared with those described in patients under treatment.

[Role of imaging in the diagnosis of coma]. / Place de l'imagerie dans le diagnostic des comas.

Imaging has become one of the main methods to diagnose and monitor coma. CT is the technique of choice in the exploration of traumatic coma or spontaneous intracerebral haemorrhage, but MRI is better than CT to explore comas of ischaemic, infective, tumoral or toxic origin, as it provides earlier and more precise images.