Potentialities of temporal bone computed tomography in the identification of causes of hypoacusis of postinflammatory genesis

Temporal bone computed tomography (CT) was used to examine 64 patients with impaired hearing due to inflammatory diseases of the middle year. In 21 patients, the pathological process was bilateral. A total of 85 series of temporal bone CT scans were analyzed. The patients' age ranged from 2 to 66 years. CT verified adhesive otitis media in 62 cases, otosclerosis in 7, local malformation of the auditory ossicles and/or the labyrinthine fenestrae in 11. No CT changes were revealed in 5 cases. The CT symptoms of adhesive otitis media were identified. These included soft tissue bands and/or soft tissue-density portions that fix the auditory ossicles or block the niches of the labyrinthine fenestrae (31 temporal bones); sclerosis or ossification of the ligaments and tendons of the middle ear (7 temporal bones); calcification foci in the tympanic cavity (9 cases); osteosclerotic changes in the epitympanus (2 cases); cicatricial changes in the tympanic membrane (24 cases); destructive changes in the auditory ossicles (19 temporal bones). There has been evidence that CT may be used for the differential diagnosis of adhesive otitis media from otosclerosis and congenital malformations of the structures of the middle ear.     

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.     

Potentialities of spiral computed tomography in the diagnosis and treatment of traumatic injuries of the midface

The paper summarizes the results of examination of 169 patients referred to the surgeon in the period from 1 till 47 days after medial facial (MF) trauma by using spiral computed tomography (SCT) and the method of laser stereolitography (LSLG). The actual aspects of diagnosis and treatment are marked; the methods for the analysis of injuries of soft tissue structures and adjacent areas while orbit trauma are developed together with the methods for determination of degree of enophthalmos. Also discussed are the possibilities of SCT and LSLG in visualization of MF injuries and planning patient treatment.     

Potentialities of temporal bone CT in the diagnosis of chronic purulent otitis media and its complications

Temporal bone CT was used to examine a group of 87 patients with chronic purulent otitis media (103 temporal bones). The patients' age ranged from 2 to 74 years. A scheme was developed and proposed to evaluate the temporal bone by CT. The CT signs of chronic purulent otitis media uncomplicated by cholesteatoma and those of cholesteatomic purulent otitis were identified. The CT symptomatology of chronic purulent otitis includes: sclerotic changes in the bone tissue of the mastoid process, impaired pneumatization of the cavities of the middle ear, including the tympanic cavity, destructive changes in auditory ossicles, carious changes in the walls of the cavities of the middle ear. The CT semiotics of cholesteatoma depends on its site and spread into the temporal bone and includes as follows: deformation of the epitympanum due to soft tissue mass-induced destruction of the lateral wall; the dilated entrance into the antrum; the presence of a cavity with the sclerosed walls in the antromastoid area; carious changes in the auditory ossicles; the displacement of a chain of ossicles medially or laterally in relation to the initial site of cholesteatoma. CT reflects carious changes in the walls of the cavities of the middle ear, including the roof and labyrinthine wall of the tympanum, which allows labyrinthine fistula and intracranial cholesteatomic complications. The study of the temporal bone by the proposed scheme may reveal anomalies and the specific features of its structure: the presentation of the sigmoid sinus, the high elevation of the bulb of the jugular vein, diverticulum of the latter, the low standing of the bottom of the ACH.     

Potentialities of ultrasound and computed tomography in the diagnosis of metastases of lung cancer in the mediastinal lymph nodes]

The results of routine roentgenotomography, CT and USI in the diagnosis of intrathoracic metastases of lung cancer were compared in 69 patients (central type--52, peripheral--17). These results were compared with operative findings in 45 patients. The sensitivity of USI in the diagnosis of enlarged paravasal lymph nodes exceeded that of roentgenotomography and was slightly inferior to CT. CT was informative for all mediastinal lymph nodes whereas tomography and USI were informative in certain areas only. The authors recommend to combine the use of routine and ultrasound tomography to assess the spreading of lung cancer to the mediastinum. The information obtained increases the accuracy of staging and specifying a process, slightly yielding CT results.     

The intermediate nerve and its place in the system of cranial nerves

The intermediate nerve (IN) in embryogenesis of man, cat and white rat is formed similarly. From the common with the VIII cranial nerve anlage the geniculum node, the vestibular and cochlear ganglia are emerged. A separated root of the IN connects the geniculum node with the nuclei, situating in the CNS. From the geniculum node main branches of the IN get off: the greater petrosal nerve and the cord of the tympanum, its fibers in the temporal bone canal run in the facial nerve trunk. In the periphery the IN branches unite with other cranial nerves, make connections with branches of vegetative (parasympathetic) ganglia and plexuses. They spread along a large territory, forming a system of parasympathetic innervation in the area of the head and ensuring with specific nervous apparatuses the gustatory organ. It is expedient to select the IN into an independent cranial nerve and confirm it the number of the regular pair.     

New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy

To evaluate ultrasonographic (US) cross-sectional areas (CSAs) of peripheral nerves, indexes of the differences between CSAs at the same point (∆CSAs) and between tunnel (T) and pre-tunnel (PT) ulnar CSAs (∆TPTs) in leprosy patients (LPs) and healthy volunteers (HVs). Seventy-seven LPs and 49 HVs underwent bilateral US at PT and T ulnar points, as well as along the median (M) and common fibular (CF) nerves, to calculate the CSAs, ∆CSAs and ∆TPTs. The CSA values in HVs were lower than those in LPs (p < 0.0001) at the PT (5.67/9.78 mm²⁾ and T (6.50/10.94 mm²⁾ points, as well as at the M (5.85/8.48 mm²⁾ and CF (8.17/14.14 mm²⁾ nerves. The optimum CSA- receiver operating characteristic (ROC) points and sensitivities/specificities were, respectively, 6.85 mm² and 68-85% for the PT point, 7.35 mm² and 71-78% for the T point, 6.75 mm² and 62-75% for the M nerve and 9.55 mm² and 81-72% for the CF nerve. The ∆CSAs of the LPs were greater than those of the HVs at the PT point (4.02/0.85; p = 0.007), T point (3.71/0.98; p = 0.0005) and CF nerve (2.93/1.14; p = 0.015), with no difference found for the M nerve (1.41/0.95; p = 0.17). The optimum ∆CSA-ROC points, sensitivities, specificities and p-values were, respectively, 1.35, 49%, 80% and 0.003 at the PT point, 1.55, 55-85% and 0.0006 at the T point, 0.70, 58-50% and 0.73 for the M nerve and 1.25, 54-67% and 0.022 for the CF nerve. The ∆TPT in the LPs was greater than that in the HVs (4.43/1.44; p <0.0001). The optimum ∆TPT-ROC point was 2.65 (90% sensitivity/41% specificity, p < 0.0001). The ROC analysis of CSAs showed the highest specificity and sensitivity at the PT point and CF nerve, respectively. The PT and T ∆CSAs had high specificities (> 80%) and ∆TPT had the highest specificity (> 90%). New sonographic peripheral nerve measurements (∆CSAs and ∆TPT) provide an important methodological improvement in the detection of leprosy neuropathy.     

Evaluation of temporal bone computed tomography and paranasal sinuses magnetic resonance images in acromegalic patients

OBJECTIVE: Acromegaly is a rare disease, which symptoms are caused by excess secretion of a growth hormone (GH) from the anterior pituitary benign tumor - adenoma. Authors present an evaluation of computed tomography (CT) and magnetic resonance (MR) images of temporal bone and paranasal sinuses of patients with acromegaly. CONCLUSIONS: 1. In all patients with acromegaly, morphological changes in paranasal sinuses were shown. They were mostly pronounced within the maxillary sinuses including the mucosa thickening up to 6 mm and encysted fluid occurrence. 2. CT of temporal bone did not reveal structural changes of internal and median ear. 3. There is a need for further studies on hearing impairment in patients with acromegaly.     

High-resolution computed tomography for the comparative study of fossil and extant bone

Special methods have been developed to use computed tomography (CT) for 3-dimensional imaging of both fossil and extant bones. Most commercial CT scanners cannot display the internal structure of fossils because the very high density is beyond the upper limits of the normal CT number scale (Hounsfield scale) of the scanners. X-ray projections from CT scans of fossils were modified by scaling the data to provide an expanded CT number scale, allowing the internal structure of highly fossilized objects to be visualized. These images were compared with state-of-the-art, high-resolution CT images of extant bone. Special image reformatting software was used to provide qualitative and quantitative 3-dimensional imaging. The recent rapid advances in CT technology have made this imaging modality the procedure of choice in much of diagnostic radiology. Use of this tool in paleoanthropology has been limited in the past by restricted access to scanners. However, new developments in CT will make this technique available to many researchers in the near future.     

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).     

Potentialities of MRI in the differential diagnosis of peripheral lung cancer and inflammatory changes

The paper analyzes the authors' own data of chest magnetic resonance imaging (MRI) in 62 patients with verified peripheral lung cancer and different inflammatory changes (round pneumonic focuses, abscesses, etc.). The MRI signs of peripheral lung cancer are systematized. The additional capacities of contrast enhancement are analyzed. The MRI semiotics of different inflammatory changes has been developed. The differential diagnostic criteria for recognizing peripheral lung cancer and inflammatory changes have been also elaborated.     

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.     

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.