CT evaluation of patients during treatment of advanced non-small cell lung carcinoma.

Twenty-one patients with Stage III non-small cell bronchogenic carcinoma were studied by chest radiograph and computed tomography (CT) before and after chemotherapy. In three patients (14%), the prechemotherapy CT showed measurable disease not seen on chest radiograph. Postchemotherapy CT scans showed additional measurable disease not seen on chest x-ray films in nine of 56 (16%) follow-up exams. This represented additional disease in seven of the 21 patients (33%). The CT findings resulted in a significant change in therapy in six of the 21 patients (29%).

Pelvic haematocele in ruptured ectopic pregnancy simulating uterine enlargement.

Rupture of an ectopic pregnancy may result in the formation of a pelvic haematocele. Four cases are presented in which the haematocele appeared as a solid or complex mass of coarse echoes on ultrasound examination and was indistinguishable from the uterus. Because of this, the sonographic examination suggested enlargement and inhomogeneity of the uterus. Differential diagnosis is discussed.

Cryptic cause of renal malrotation.

An intravenous urogram in a child with left adrenal neuroblastoma and bone metastases deomonstrated malrotation of the left kidney but no visible mass. A bone scan showed uptake of 99mTc by the tumor which suggested the diagnosis, confirmed by an abdominal echogram.

Sonographic determination of fetal gender before 25 weeks gestation.

Sonographic determination of fetal gender was attempted prospectively in 121 consecutive routine obstetric scans between 10 and 25 weeks gestation. There were two sets of twins in this group, so a total of 123 fetuses was studied. Birth records were subsequently available in 113 of these fetuses at which time conclusive data regarding the fetal gender could be analyzed. Of these 113 fetuses, a sonographic determination of fetal gender was made in 53 (47%). There were three errors in this group of 53 (error rate 6%) and all of these incorrect determinations were male fetuses thought to be females in utero by sonography. There were no errors in those called male by sonography in utero. The male-female mix demonstrated a higher number of males in the group in whom sonographic determination was possible. There was a lower number of males than females in the group in whom the gender of the fetus could not be detected by sonography. A significantly higher number of males (60) than females (53) was present in the study population for no apparent reason.

The radiographic anatomy of surgical extracranial-intracranial anastomoses.

Microvascular surgical techniques have been developed that allow anastomosis between extracranial arteries and cortical branches of intracranial arteries distal to a stenotic, occluded, or diseased arterial segment. Indications for this procedure other than cerebrovascular occlusive disease are discussed. The radiographic anatomy of the various surgical bypasses is described.

Periaortic fluid aspiration for recognition of infected graft: preliminary report.

Diagnostic aspiration of a periaortic fluid collection was performed four times on three patients suspected of aortic graft infection. One aspiration was positive for Staphylococcus epidermidis and the others were sterile. The results of aspiration were critical in determining if radical surgical treatment should be performed. CT guidance is well suited for this type of aspiration because it results in accurate needle placement without inadvertent puncture of bowel or the graft.

Liver injury and complications in the postoperative trauma patient: CT evaluation.

Twenty-eight patients with surgically documented and classified hepatic injury were studied by computed tomography (CT) in the postoperative period. CT demonstrated no abnormalities in 12 of these patients, most of whom had sustained simple lacerations of the liver. Of the 16 patients with abnormal scans, perihepatic fluid collections were present in six, five of whom had simple lacerations at surgery. The other 10 patients had CT evidence of parenchymal abnormalities, and all of these had sustained major hepatic injuries. CT is useful in depicting the postoperative anatomy, and in many cases demonstrates the nature and extent of damage; the likelihood of finding an abnormality varies with the severity of the injury, even though repair has been attempted. The frequent problem of postoperative sepsis is also amenable to CT evaluation, but the changes demonstrated are often nonspecific and the possibility of residual hepatic injury has to be considered. Finally, CT can document healing of parenchymal injury.