CT and MR imaging of partial anomalous pulmonary venous return to the azygos vein.

Partial anomalous pulmonary venous return to the azygos vein is very unusual, occurring in 0.02% of autopsy examinations. We report the CT, magnetic resonance, and angiographic findings in a 67-year-old man with partial anomalous venous return to the azygos vein.

Ascending aorta complications of cardiac surgery: CT evaluation.

Dissecting aortic aneurysms and pseudoaneurysms of the ascending aorta can occur secondary to clamping of the ascending aorta, incision of the great vessels, or secondary to aortic cannulation for cardiopulmonary bypass. Contrast-enhanced CT offers an excellent means of distinguishing between aortic pathology and other causes of mediastinal widening following cardiac surgery. Five cases are reported in which iatrogenic vascular lesions were identified on CT as the cause of postoperative mediastinal widening.

Automatic implantable cardioverter-defibrillator: radiographic appearance.

The automatic implantable cardioverter-defibrillator is used in patients with ventricular tachyarrhythmias resistant to medical or surgical therapy. The device, which has a unique radiographic appearance, senses ventricular tachycardia or fibrillation and automatically delivers a cardioverting or/defibrillating electric shock.

Amiodarone-induced pulmonary toxicity.

Amiodarone hydrochloride, an investigational drug used to suppress ventricular arrhythmias, may cause pulmonary toxicity with associated radiographic abnormalities. Two patients are presented who illustrate the variability of these abnormalities. One of these patients died of respiratory failure while the other recovered after amiodarone was stopped and corticosteroid therapy was started.

Echocardiographic assessment of cardiac chamber size and left ventricular function in aerobically trained athletes.

We compared the echocardiographic assessment of left ventricular function in 20 aerobically trained male athletes (VO2 max 61 ml/kg/min) with 20 control subjects of similar age and size (VO2 max 37 ml/kg/min). On average, the left ventricle was larger in athletes and the extent of myocardial contraction (fractional shortening) was reduced. In nine athletes, fractional shortening was less than our laboratory lower limit of normal (26%) and in four athletes the left ventricle was enlarged and fractional shortening was reduced. However, the peak rate of circumferential shortening was not reduced in athletes. We concluded that athletes have normal myocardial contractility but some have a reduced extent of myocardial contraction which could be mistaken for the effects of myocardial disease.

Abdominal computed radiography: evaluation of low-constrast lesions.

Computed radiography has proved useful as a localization device for computed tomography. In an attempt to evaluate computed radiography as a primary diagnostic device, 16 patients were evaluated with various degrees of gallbladder opacification following standard oral cholecystograms, and 15 patients were evaluated with renal masses, identified on standard excretory urography. Subjective evaluation of computed radiographs as compared to the standard radiographs demonstrated no diagnostic advantage to computed radiography. The poor spatial resolution of the computed radiographs was not overcome by the improvement in contrast resolution.

Colonic polyp detection: role of roentgenography and colonoscopy.

In order to determine the relative yields of colonoscopic and radiologic examinations of the colon, the following guidelines are suggested: (a) prospective data collection; (b) a standard, effective colon cleansing regimen; (c) colonoscopic and radiologic examiners of comparable expertise; (d) examiners should be unaware of each other's findings; (e) a suitable method for demonstrating false-negative findings and for resolving conflicting findings between the two examinations; and (f) indexing of the study findings as to lesion size, lesion location, quality of colon cleansing, and examiner's level of confidence. The two examinations should be used as complementary diagnostic procedures.

Cardiac localization of 99mTc-(Sn)-pyrophosphate following irradiation of the chest.

Of 70 consecutive cancer patients referred from radiotherapy for bone scans, 32% showed cardiac uptake of 99mTc-(Sn)-pyrophosphate; only 9% of a control group showed this uptake. Of those with prior left hemithorax irradiation, 60% showed cardiac uptake; only 12% of those with irradiation elsewhere showed this phenomenon (p less than .01). The patients who had no increased uptake tended to have shorter irradiation-to-scan time intervals (less than 10 months) than those who did show increased uptake (mean of 22 months).

An evaluation of colon cleansing regimens.

To study the efficacy of colon cleansing regimens, 500 hospital outpatients were randomly assigned to one of four regimens. Two featured castor oil followed by phosphate enema and two used magnesium citrate and bisacodyl. For the 349 patients who completed all components of the regimens, quality of the subsequent barium enema examination was scored by three radiologists in a blind manner. Regimens featuring magnesium citrate and bisacodyl were found to be significantly superior to those featuring castor oil. Calcium bisdiocytl sulfosuccinate did not improve the quality of colon cleansing but appeared to decrease the incidence of abdominal cramping in patients receiving magnesium citrate and bisacodyl. It is hoped that the investigative approach used in this study may serve as a model for future testing of colon cleansing regimens.