Spiral computed tomography in the diagnosis of limb osteomyelitis

The results of radiation studies in 121 patients of different age (4 to 75 years) examined for limb osteomyelitis are analyzed. All the patients underwent routine X-ray study and computed tomography (CT), 26 patients had X-ray fistulography; 8, linear tomography; 10, CT fistulography; 6, scintigraphy, and 15, ultrasound study. Acute hematogenous osteomyelitis (AHO), chronic hematogenous osteomyelitis (CHO), and atypical (here Garre's sclerosing osteomyelitis and Brodie's abscess) osteomyelitis were ascertained in 10.6, 26.4, and 10.1% of cases, respectively. Posttraumatic osteomyelitis was diagnosed in almost 50% of the patients. CT defined the phase of chronic limb osteomyelitis. Spiral CT has proven to be the most effective technique for diagnosing limb osteomyelitis as compared with routine X-ray study: the accuracy of X-ray study was 81.8%, its sensitivity, 84.9%, and specificity, 60.0% and those of computed tomography were 96.7, 99.1, and 80.0%, respectively.     

Spiral computed tomography in the diagnosis of limb osteomyelitis

The results of radiation studies in 121 patients of different age (4 to 75 years) examined for limb osteomyelitis are analyzed. All the patients underwent routine X-ray study and computed tomography (CT), 26 patients had X-ray fistulography; 8, linear tomography; 10, CT fistulography; 6, scintigraphy, and 15, ultrasound study. Acute hematogenous osteomyelitis (AHO), chronic hematogenous osteomyelitis (CHO), and atypical (here Garre's sclerosing osteomyelitis and Brodie's abscess) osteomyelitis were ascertained in 10.6, 26.4, and 10.1% of cases, respectively. Posttraumatic osteomyelitis was diagnosed in almost 50% of the patients. CT defined the phase of chronic limb osteomyelitis. Spiral CT has proven to be the most effective technique for diagnosing limb osteomyelitis as compared with routine X-ray study: the accuracy of X-ray study was 81.8%, its sensitivity, 84.9%, and specificity, 60.0% and those of computed tomography were 96.7, 99.1, and 80.0%, respectively.     

Spiral computed tomographic angiography in the diagnosis of vertebral artery occlusive lesions

The study was undertaken to evaluate the efficiency of spiral computed tomographic angiography (SCTA) in the diagnosis of vertebral artery (VA) occlusive lesions in 23 patients with vertebrobasilar insufficiency, by using this technique (CT-LIGHTspeed 16, HAS CT/i (CGE). Manual and semiautomatic calculations using in the estimation of the degree of VA stenosis revealed critical (70% or more) stenoses in 14% of the study group patients, moderate (30-69%) stenoses in 38%, and mild (30% or less). In 90% of cases, plaques were located in the ostium of VA or in the segments of clavicular arteries in the immediate proximity to the ostium. The obtained results of SCTG have indicated that the technique is of great informative value in the diagnosis of stenotic lesions: its sensitivity, specificity, and precision in <50% stenosis were 93, 86, and 82%, respectively; and these in >50% stenoses were 94, 88, and 86%.     

Spiral computed tomography in the diagnosis of ankle and foot injuries

The data on 187 patients with traumatic lesions of the ankle joint and foot were used to analyze the capacities of computed tomography (CT) in the diagnosis of this pathology. The efficiency of CT versus X-ray study was evaluated. Specific guidelines are given to make spital CT. CT is shown to be of the most informative value in the diagnosis of lesions of the tibial plateau, undisplaced fractures of the internal malleolus, small marginal comminuted fractures, and lesions of the distal tibiofibular syndesmosis. There is evidence for that CT plays a dominant role in the diagnosis of lesions of the talus and calcaneus. Emphasis is laid on the great value of secondary multi- and three-dimensional image reconstructions.     

Spiral computed tomography in the diagnosis of gunshot wounds of the abdomen and pelvis

Spiral computed tomography (SCT) in combination with SCT angiography with the rapidity and low-invasiveness of the study yields necessary information and minimizes the number of diagnostic measures in severely wounded patients, by substantially reducing the preoperative period of their examination. The assessment of findings, the processing of data, and the construction of additional repairs do not require the presence of the patient and may be made in later periods. If required, repeated studies make it possible to evaluate the time course of postoperative changes, to identify complications of wound disease at the right time, and to optimize surgical treatment policy. Thus, SCT for fighting gunshot abdominal injury may significantly amplify and, in many cases, substantiate for the existing radiation diagnostic techniques.     

Spiral computed tomography in the diagnosis of the abdomen gunshot wounds and their complications

The results of studies by spiral computed tomography (SCT) in 62 patients with abdominal wounds were analyzed at the Main Military Clinical Hospital of Internal Forces, Ministry of Internal Affairs of Russia. The main contingent of the wounded included active servicemen who had been wounded in the areas of local conflicts, military men. The studies were conducted on days 2 to 15 of their receiving a wound. The potentialities of the technique in evaluating damages to abdominal organs, retroabdominal space, bony structures, in assessing the topography of foreign bodies are described. SCT was compared with classical X-ray and ultrasound studies, laparocentesis which are traditionally used in the diagnosis of gunshot injury. In the authors' opinion, SCT has become the method of choice in the diagnosis of gunshot injury to the abdomen and its complications today.     

Multislice spiral computed tomography in the diagnosis of osteomyelitis

This paper deals with the results of a radiation study in 34 patients with the clinical manifestations of maxillofacial osteomyelitides. It describes the radiation semiotics of changes occurring in the bone and its surrounding soft tissues of the maxillofacial region in different phases of osteomyelitis. Comparative analysis of orthopantograms and images obtained by multislice spiral computed tomography revealed the benefits of the latter in detecting soft tissue changes and subtle bone alterations.     

Potentialities of computed tomography in the diagnosis of hiatal hernia

An analysis of the results of 98 studies has demonstrated the potentialities of X-ray computed tomography in the diagnosis of hiatal hernia (HH), provided the X-ray computed tomography (XCT) semiotics of HH. It has found that XCT may directly visualize and objectively evaluate anatomic structures, such as diagraphmatic crus and esophageal foremen. It has emphasized that when XCT of abdominal and thoracic organs is performed, it is necessary to include the areas of diagragmatic curs and esophageal foramen into the list of anatomic structures binding for visual assessment and characterization, which in combination with other studies will assist in the early diagnosis of hiatal hernia and eventually expand the potentialities of XCT to a greater extent.     

Procedure for spiral computed tomography in the diagnosis of tooth impaction

The paper presents a procedure for spiral computed tomography that may be used if there are some difficulties in the diagnosis of impaction of different teeth. Examples art used to show the capacities of specified diagnosis in solving the problems and difficulties in surgical or orthodontic treatment.     

The computed tomographic semiotics of inflammatory diseases of the adnexa uteri

The authors sum up the results of CT and clinical investigation of 46 women with inflammatory diseases of the uterine appendages: salpingo-oophoritis, pyosalpinx, pyoovarium, and 2 types of tuboovarian abscesses. They have shown CT potentialities in differential diagnosis of inflammations of the uterine appendages with cysts and true ovarian tumors on the basis of routine investigation and an iv contrast study of intensified images. Retrospective analysis of the most typical diagnostic errors is given.     

Magnetic resonance tomography, computed tomography and ultrasonic diagnosis of hemangiomas of the liver

The paper is concerned with the potentialities of modern radiation methods in the diagnosis of liver hemangiomas. USI, CT, angiography and MR-tomography (MRT) were used for investigation of 64 patients with liver hemangiomas. The diagnostic potentialities and the role of each of the above methods in the diagnostic algorithm in liver hemangiomas were studied. The results of the investigation have shown that MRT possesses a higher informative value than USI and CT in the diagnosis of liver hemangiomas and can even replace angiography in the verification of diagnosis.     

Volumetric dynamic computed tomography angiography in the topical diagnosis of sporadic insulinomas

The authors analyzed the data of contrast-enhanced multislice spiral computed tomography (MSCT) angiography versus those of volumetric dynamic computed tomography, percutaneous and endoscopic ultrasonography, selective angiography, and arterial stimulation blood sampling in the diagnosis of sporadic insulinomas depending on the size and site of the tumor. Forty-five patients (25 women and 20 men) aged 20 to 55 years (mean age, 43.4 +/- 2.8 years) with characteristic clinical symptoms and Whipple's triad, were examined. These were found to have 45 sporadic insulinomas that were located in the head and isthmus (n = 13 (28.9%)), body (n = 19 (42.2%)), and tail (n = 13 (28.9%)). The insulinomas measured 4.0 to 10.0 mm (mean size, 6.5 +/- 2.1 mm) (n = 9), 11.0 to 20.0 mm (mean size, 13.2 +/- 2.5 mm) (n = 23), and 21.0 to 25.0 mm (mean size, 22.6 +/- 2.8 mm) (n = 13). Volumetric dynamic CT angiography increases detection rates for tumors less than 1.0 cm in size to 77.8%. It enabled insulinomas to be localized in 82.2% of cases.     

Computed tomography in the diagnosis of degenerative diseases of the spine

CT and roentgenography were used for the investigation of 78 patients with the radicular syndrome. The state of the intervertebral disks, intervertebral joints and cerebrospinal canal in degenerative vertebral diseases was assessed. CT permits the detection of hernia, protrusion of the intervertebral disks, deformity of the intervertebral joints, and the narrowing of the cerebrospinal canal as a result of degenerative changes, as well as establishing the cause of the affection of neural structures in the cerebrospinal canal, radicular holes. CT possesses some advantages over roentgenography in the diagnosis of degenerative vertebral diseases and can be recommended as the principal method together with roentgenography for investigation of patients with lumbar pains.     

Computed tomography in the diagnosis of diffuse diseases of the liver

Methods of CT, echotomography and scintigraphy of the liver were used to investigate 95 patients with diffuse liver diseases (fatty dystrophy, hepatitis, cirrhosis, hemosiderosis and amyloidosis). CT changes in these diseases were described. A high efficacy of CT was established in the detection of diffuse liver lesions and portal hypertension permitting one to give up in some cases invasive puncture biopsy of the organ.     

Noncontrast computed tomography in the diagnosis of tumors of the major salivary glands

Non-contrast computed tomography (CT) of the major salivary glands was made in 127 patients, which revealed 95 space-occupying lesions (88 intraglandular and 7 extraglandular ones). Pleomorphic tumors of the parotid glands are solitary, round, high-density (29.6 +/- 4.2 HU) masses with well-defined, smooth margins. Salivary cysts were characterized by the presence of a dense capsule; the density of cyst contents was 8.0 +/- 2.0 HU. Salivary lipomas had a characteristic tomographic pattern due to the presence of adipose tissue; the lipoma density was -108.3 +/- 7.8 HU. Malignant parotid tumors were characterized by the presence of higher-density masses with irregular shapes and ill-defined, indistinct margins. Benign submandibular gland tumors had no well-defined margins that separated the tumor from the gland; the density of a tumor matched that of the parenchyma; the mean tumor size was 3.6 +/- 1.3 cm; there was an increase in the sizes of the gland as compared to those of the contralateral gland, as well as a displacement of the adjacent soft tissues. Malignant submandibular gland neoplasms tumors were characterized by the presence of inhomogenous lower-density masses with irregular shapes. Enlarged paraglandular lymph nodes were observed. The sensitivity, specificity, and accuracy of native CT in diagnosing space-occupying lesions of the salivary glands were 97.6, 96.4, and 97.6%, respectively.     

Potentialities of new radiation technologies (ultrasonography, computed tomography, magnetic resonance imaging) in the diagnosis of endocrine diseases

In the paper providing the data available in the literature and many years' experience gained by the Department of the Moscow Regional Clinical Research Institute, the authors describe the potentialities of the currently available radiation techniques in the diagnosis of surgical endocrine diseases. The incidence of various organ dysfunctions is presented. The authors also consider the introscopic symptoms of various endocrinopathies and outline the common specific features of the ultrasound, computed tomographic, and magnetic resonance imaging pattern of individual masses (including adipose tissue cysts and tumors). Emphasis is laid on the leading role of ultrasonography (USG) in the diagnosis of thyroid and parathyroid diseases and on the priorities of computed tomography (CT) and magnetic resonance imaging (MRI) in visualIzing the abnormal thymus, mediastinally ectopic glands, and pituitary tumors. The capacities of each technique in the diagnosis of endocrine space lesions of the pancreas and adrenals are defined. The increase in the frequency of endocrine abnormalities accidentally identified at USG, CT, and MRI, which is noted in the paper, fosters the development of new trends in endocrinology and points to the need for screening surveys (particularly patients who live in poor environmental areas).