Detection of cerebral artery fenestrations by computed tomography angiography.

BACKGROUND AND PURPOSE: Cerebral artery fenestrations (CAF) are rare congenital variations usually diagnosed by digital subtraction angiography (DSA). The aim of this study was to examine the frequency of occurrence of fenestrations in cerebral arteries and their coexistence with cerebral aneurysms in computed tomography angiography (CTA). MATERIAL AND METHODS: All reports of cerebral CTA (1140) performed in one institution from March 2005 to December 2007 were analysed. We found 40 patients with single fenestrations of the intracranial arteries. All 40 examinations were retrospectively reviewed for location of vascular malformations and presence of aneurysms or subarachnoid haemorrhage (SAH). Medical histories of those patients were then analysed for evidence of SAH and referral reasons for CTA. RESULTS: Forty fenestrated arteries were found in CTA: 18 basilar arteries (45%), 16 anterior cerebral arteries (40%), 4 anterior communicating arteries (10%) and one middle cerebral artery (2.5%). Only one vertebral artery fenestration was found due to the technique of the examination. Six patients (15%) with fenestrated arteries had a total of 8 aneurysms, although only one aneurysm was ipsilateral to the fenestration. In 8 cases of SAH, two were with no evidence of vascular malformation. The coexistence of CAF and aneurysms in CTA amounted to 15% (6/40), but the incidence of ipsilateral aneurysm was only 2.5% (1/40) and it affected the anterior cerebral artery. CONCLUSIONS: Basilar artery fenestration is the most frequent observed fenestration in CTA, followed by anterior cerebral artery and anterior communicating artery fenestrations. Coexistence of fenestration and aneurysm is uncommon in CTA examination.

Extracolonic findings at CT colonography - additional advantage of the method.

BACKGROUND: In virtual colonoscopy (VC) we are capable to assess all organs located between a diaphragm and pelvic bottom. This report provides a breakdown of extracolonic pathological findings in VC performed in standard indications. MATERIAL/METHODS: We reviewed 71 consecutive VC (29 men and 42 women) performed using double-slice scanner General Electric High Speed NX/I Pro. Pathological findings were presented in a tabular form illustrated by sample images. RESULTS: Extracolonic findings were found in 53 cases (74.6%), and were equally frequent in subgroups with pathological colon and free from colon lesions. Renal cysts occurred most often. In 15 cases the extracolonic pathologies were clinically important, most of them tumors. CONCLUSIONS: VC is found to be a very useful tool in the detection and evaluation of extracolonic pathologies.

Stereotactic methods in interdisciplinary diagnosis and treatment of posterior fossa tumours.

For over 2 years, we have had access to latest generation apparatus and software for planning and stereotactic treatment as well as for x-rays treatment. Until now, we have carried out over 100 procedures. These included 52 stereotactic biopsies of neoplasms, some of them located within the structures of the posterior fossa. In this report, we have discussed the possibilities and effectiveness of diagnosis and treatment of tumours located in different structures, including posterior cave. In the study, we used stereotactic methods. We have described biopsies of the following tumours: cerebellar hemisphere tumour (diagnosed as "metastatic atypic planoepitheliale carcinoma" in a patient with coexisting orbit lymphoma), a bifocal lesion (located in cerebellar hemisphere and cerebellar peduncle, diagnosed as pilocytic astrocytoma of WHO malignancy grade II/III), and lesion (located in the pons, diagnosed as pilocytic astrocytoma WHO grade II).

[Endoscopic ventriculostomy of the third ventricle in adults. Own experience]. / Wentrikulostomia endoskopowa komory III u doroslych. Doswiadczenia wlasne.

Only few reports can be found on endoscopic third ventriculostomy (ETV) in the Polish literature, and the majority of other reports concern paediatric or mixed population. This has induced the authors to report their experience with ETV in adults, reporting the results and discussing the usefulness and effectiveness of this procedure, causes of complications and failure. ETV was carried out in 20 patients aged over 18 years in a two-year period, beginning in 1999. In 13 cases (64%) the cause was external compression of CSF system by tumour leading to hydrocephalus. In 3 cases aqueduct stenosis was producing hydrocephalus, in 3 cases arachnoid cyst, perisellar or situated in posterior part of the third ventricle, was the cause, and in one case colloidal cyst of the third ventricle. The outcome were analysed according to clinical and radiological criteria finding that the ETV was successful in 90% of cases by clinical criteria, and in 88% by radiological criteria. Only unimportant clinical complications were reported without major consequences. It is concluded that ETV is a very useful method for hydrocephalus treatment in adults, especially if caused by blockade of CSF pathways by tumour or arachnoid cysts in the vicinity of the third ventricle.

[Progressive myositis ossificans--case report]. / Postepujace kostniejace zapalenie miesni--opis przypadku.

Myositis Ossificans Progressiva (MOP) is a rare hereditary condition with ectopic ossifying. This case report demonstrates clinical picture of MOP and possibilities of diagnosis.

[Myositis ossifications progressiva]. / Postepujace kostniejace zapalenie miesni.

Myositis ossificans progressiva (MOP) is a rare hereditary connective tissue disorder. Skeletal abnormalities and progressive ectopic ossifications are features of this condition. Diagnosis is often delayed because of heterogenous picture of MOP. Treatment is unknown, so MOP leads to prolonged disability.

[Virtual colonography in CT and MRI examinations]. / Wirtualna kolonoskopia w badaniach TK i MR.

The paper presents new ways of visualizing internal structures of the large intestine. Use of spiral computed tomography (CT) or magnetic resonance imaging (MRI) combined with appropriate software leads to imaging that can be compared with colonoscopy or double contrast enema. The authors discuss patients' preparation, methods for CT and MRI variants, indications, advantages and costs.