Superior diaphragmatic lymph nodes: CT assessment.

The normal CT appearance of the superior diaphragmatic (also called cardiophrenic angle or pericardial) lymph node group was assessed in 39 adult patients who were free of diseases known to involve lymph nodes. In 15 patients there were 27 ovoid opacities, corresponding to known lymph node sites, namely in the anterior portion of the diaphragm; all except one opacity measured less than 5 mm in diameter. Superior diaphragmatic lymph nodes greater than or equal to 6 mm in diameter were observed in 30 of 190 patients with diseases known to be associated with lymphadenopathy.

Neck neoplasms: MR imaging. Part II. Posttreatment evaluation.

Thirty-three patients who had undergone prior surgery and/or radiation therapy for malignant neoplasms of the neck were studied with magnetic resonance (MR) imaging. Twenty-seven of these patients were also evaluated with computed tomography (CT). Ten patients were healthy posttreatment volunteers, and 23 had documented tumor recurrence.

Neck neoplasms: MR imaging. Part I. Initial evaluation.

Untreated neoplasms of the neck (tumors of the oropharynx, supraglottic area, carotid body, and thyroid, in addition to malignant lymphadenopathy) were evaluated in 23 patients with magnetic resonance (MR) imaging. The results were compared with computed tomographic (CT) scans in 20 patients. Contrast between tumor and fat was best on relatively T1-weighted images (500/30-35 [TR msec/TE msec]), whereas separation of tumor and muscle was best with relatively T2-weighted pulse sequences (1,500/90).

Thoracic wall involvement by Hodgkin disease and non-Hodgkin lymphoma: CT evaluation.

Thoracic computed tomographic (CT) scans of 250 patients with newly diagnosed or recurrent lymphoma revealed thoracic wall involvement in 24 patients (11 with Hodgkin disease, 13 with non-Hodgkin lymphoma). Thoracic wall involvement occurred without contiguous mediastinal or parenchymal involvement in 17 patients. Of these, 13 patients had masses beneath the pectoralis muscles or within the breast, and four had masses arising from the ribs.

Pleural and chest wall invasion in bronchogenic carcinoma: CT evaluation.

CT scans of 47 patients who had peripheral bronchogenic carcinoma contiguous to the pleural surface and who had undergone thoracotomy were retrospectively reviewed. The CT features of the primary neoplasm that were analyzed included the angle and amount of contact with the adjacent pleural surface, associated pleural thickening, fat plane between the tumor and chest wall, rib destruction, and chest wall mass. CT was of limited predictive value in separating those patients who had parietal pleural/chest wall involvement from those who did not.

MRI and CT of the mediastinum: comparisons, controversies, and pitfalls.

The evolving roles of MR and CT in mediastinal imaging are of keen interest to both the radiologist and the clinician. This article has illustrated the usefulness of both CT and MRI in evaluating the mediastinum. The potential pitfalls and limitations of each modality have been reiterated to help gain a perspective for further application of these technologies.

Radiologic evaluation of the mediastinum.

New imaging techniques have had a major impact on radiologic evaluation of the mediastinum. Computed tomography has led the way in defining internal anatomy noninvasively. Ultrasound plays a small but well-defined role in the evaluation of certain mediastinal masses.

Computer-assisted instruction in radiology.

We developed an interactive computer system to support various educational uses. The system allowed numerous instructors to create lessons or tests in a flexible, personalized fashion. As a pilot project, the system was used to develop and administer a computer-driven final examination in a didactic radiology course for second-year medical students.

The superior sinus of the pericardium: CT appearance.

On computed tomography, a mass-like density is often observed, just posterior to the ascending aorta, that occasionally has been mistaken for mediastinal lymph node enlargement. Cadaver studies confirmed this retroaortic structure to be an extension of the pericardial cavity, the superior sinus. Current anatomic texts sometimes depict this space without description.

Normal thoracic aortic diameters by computed tomography.

Although computed tomography (CT) has played an important role in evaluation of the thoracic aorta, no standards for aortic dimensions exist. To establish the range of normal variation of aortic diameters, a retrospective study of 102 chest CT studies in adults without clinical evidence of hypertension, diabetes, cardiovascular disease, or renal disease was performed. The coronal aortic diameter was measured at three levels: just beneath the aortic arch, just above the aortic valve, and at the level of the diaphragm.

Utility of CT in detecting postpneumonectomy carcinoma recurrence.

After pneumonectomy for bronchogenic carcinoma, detection of recurrent disease in the ipsilateral hemithorax or mediastinum is often difficult. The authors discuss the utility of CT in the evaluation of 18 postpneumonectomy patients who had developed new clinical symptoms. In six patients without documented tumor recurrence, CT demonstrated a normal postpneumonectomy appearance.

Extralaryngeal causes of vocal cord paralysis: CT evaluation.

Computed tomography (CT) was used in 33 patients to evaluate possible extralaryngeal causes of vocal cord paralysis (22 left, 11 right). Neoplasm in the lower neck or upper mediastinum (lung, esophagus, thyroid, breast, lymphoma) was found to be the predominant cause (27/33). A negative CT examination correlated with a neuropathic (e.

CT of fibrosing mediastinitis: findings and their utility.

The computed tomographic (CT) manifestations of fibrosing mediastinitis were assessed in seven patients with pathologically proven disease. Computed tomography had been done to evaluate further a mediastinal or hilar mass seen on the conventional chest radiograph or to define extent of disease preoperatively. Findings included a mediastinal or hilar mass (7/7), calcifications of the central mass or in associated lymph nodes (6/7), tracheobronchial narrowing (5/7), and pulmonary infiltrates (4/7).

Computed tomography of laryngoceles.

Six patients with laryngoceles, two internal and four of the mixed type, were studied with CT. Uncomplicated laryngoceles appear on CT as air-filled structures lying in the paralaryngeal space (internal), lateral neck (external), or in both locations (mixed). Obstruction of the neck of the laryngocele by either tumor or chronic inflammation can result in a fluid-filled structure, producing on CT a well circumscribed mass of either near water or soft-tissue density, depending on its composition.

High CT attenuation values of a benign pulmonary nodule.

Computed tomography (CT) is thought to be a reliable predictor of the benignancy of pulmonary nodules when high attenuation values can be demonstrated. However, the cause of increased attenuation has not been proven. A pulmonary nodule evaluated initially by CT and subsequently followed for 4 years has developed central calcification by conventional tomography.

High resolution computed tomography in the staging of carcinoma of the larynx.

The normal anatomy of the larynx as displayed on computed tomography is illustrated. Pathological alterations in patients with carcinoma of the larynx are depicted and discussed. Computed tomography (CT) is recommended as the initial radiological procedure when additional diagnostic information is required to supplement the findings of laryngoscopy.

Traumatic fissural hemonpneumothorax.

A case of interlobar air-fluid collections following nonpenetrating chest trauma is presented. Radiographic features which suggest the diagnosis of traumatic fissural hemopneumothorax are discussed.

Lung carcinoma associated with bullous lung disease in young men.

Over a 6 year period, three cases of pulmonary carcinoma in young men with severe bullous lung disease were seen at Washington University Medical Center. The patients did not have a long cigarette-smoking exposure. It would seem that patients with severe bullous lung disease are at a higher risk for the development of pulmonary neoplasm than the general population.

Computed tomography and 67Ga citrate radionuclide imaging for evaluating suspected abdominal abscess.

A retrospective analysis of the results of 67Ga citrate radionuclide imaging and computed tomography (CT) in 45 patients with suspected abdominal abscess was conducted to determine the mertis of each method. Both techniques were highly sensitive in detecting abdominal abscesses, and often provided complementary and supplementary diagnostic information; their combined use many times offset the limitations of each method used alone. Guidelines are suggested that permit rapid evaluation, while limiting diagnostic errors, when using 67Ga citrate radionuclide imaging and CT in the presence or absence of localizing symptoms and signs.

Oat cell carcinoma manifesting as a bronchocele.

Three cases of oat cell carcinoma appearing as a bronchocele on the chest radiograph are described. A bronchocele as the major radiologic manifestation of oat cell carcinoma has not been emphasized previously. Such a bronchocele may be filled with neoplastic cells rather than only inspissated mucus.

Evaluation of abdominal abscess with computed tomography.

Computed tomography (CT) is valuable in providing a specific diagnosis of abdominal abscess and in determining its site and extent. Computed tomography is also capable of excluding an abscess with a high degree of certainty. In 31 of 34 patients with proven abdominal abscess, CT suggested the correct diagnosis and accurately defined the extent of involvement.