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 temporal bone computed tomography in the study of the facial nerve and in the diagnosis of peripheral pareses of thr 7th pair of cranial nerves

Computed tomography (CT) was used to examine 200 patients (400 temporal bones) aged 3 to 74 years who had no signs of facial nerve lesion and 28 patients who had clinical manifestations of peripheral paresis of the facial nerve of varying genesis. Multipositional CT of the temporal bone is the most informative mode of visualization of the fallopian canal which is embodied on tomographic scans in 100% of cases irrespective of the age of a patient. CT data indicate that the formation of the facial nerve canal brings to completion by the age of 6 years. The following causes of n. facialis paresis were identified: facial neuroma; sarcoma of the temporal bone sarcoma; dehiscence of the canal wall in otitis media acuta; destruction of the tympanic wall of the canal in otitis nedia chronica, fractures of the temporal bone, anomalies of the fallopian canal in temporal bone malformations; stenosis of the canal in fibrous dysplasia. The detected alterations of the n. facialis canal permits further policy of management of a patient to be defined.     

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.     

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.     

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).     

Mechanical strength of tibial trabecular bone evaluated by X-ray computed tomography

The prospects for the use of quantitative computed tomography (QCT) for evaluation of mechanical properties of tibial trabecular bone were investigated. Computed tomography (CT) data from the proximal tibial epi- and metaphysis of six human cadaver knees were correlated with mechanical data obtained from compression tests and penetration strength measurements. In addition CT and intraoperative penetration data were compared in 20 patients. If spatial agreement between CT and mechanical measurement sites is optimized, close correlations are found between the relative linear attenuation coefficient determined by CT and the ultimate strength (r = 0.84), the yield strength (r = 0.85), the elastic modulus (r = 0.78), the ultimate energy absorption (r = 0.83), the yield energy absorption (r = 0.81), and the penetration strength (r = 0.82). It is concluded that these correlations are sufficient to make QCT a valuable tool for non-invasive evaluation of the spatial distribution of bone properties in several clinical applications.     

Three-dimensional computed tomography of the mummy Wenuhotep

Computed tomography allows cross-sectional imaging of anthropological as well as clinical subjects. Recently, technical innovations have made three-dimensional reconstruction of these images feasible. We performed two-dimensional and three-dimensional computed tomography of a Late Period Egyptian mummy to reexamine findings seen on previous radiographic studies and to evaluate the usefulness of these techniques in paleopathology. Two-dimensional images provided excellent anatomic detail. There was graphic depiction of the mummification process that corroborated information previously obtained from Egyptological studies. Three-dimensional reconstruction provided images of facial features as if the mummy had been unwrapped. Three-dimensional computed tomography is a useful method of nondestructively evaluating paleopathological remains, and it may yield information not obtainable by any other means.     

X-ray quantitative computed tomography: the relations to physical properties of proximal tibial trabecular bone specimens

Cylindrical bone specimens from the proximal epiphysis of ten normal human proximal tibiae were randomly assigned to a destructive axial compression test-series (N = 94) or to a protocol of standardized mechanical conditioning followed by non-destructive repeated testing to 0.6% strain and a final destructive test (N = 121). Specimen X-ray quantitative computed tomography (QCT) obtained at different scanning energies (100, 120 and 140 kVp) yielded closely related results (r = 1.00). Accordingly, predictions of physically measured densities or mechanical properties were not improved by using more than one scanning energy. QCT and physically measured densities were intimately related (QCT at 140 kVp to apparent density using linear regression: r = 0.94, and to apparent ash density: r = 0.95) and did not differ significantly in their ability to predict the mechanical properties, thus favouring the more easily implemented QCT for routine work. Evaluation of the relation of apparent density to Young's modulus and ultimate strength suggested that a power law regression model is preferable to a linear model, although linear model prediction of mechanical properties does not have significantly worse accuracy within the narrow density range investigated. The effect of conditioning on the behaviour of bone specimens subjected to destructive compression tests was to increase the stiffness and strength by approximately 50 and 20% respectively.     

Preoperative computed tomography of temporal bones and its use in selecting patients with sensorineural deafness for cochlear implantation

Cochlear implantation (CI) involves the insertion of electrode systems in the inner ear in order to restore hearing in patients with sensorineural deafness. Positive CI results are closely related with careful selection of candidates. Preoperative computed tomography (CT) and its results are decisive in this selection. Temporal bone CT was made in 40 patients aged 1 to 57 years who had sensorineural deafness. The following changes were detected: malformations of the inner ear, the inner auditory canal, meningititis-induced cochlear obliteration, post-traumatic temporal bone changes, local auditory ossicle malformation, inflammatory middle ear changes, the high position of the jugular vein bulb, and its diverticula. Temporal bone CT plays an important role in selecting candidates for CI and circumvents potential difficulties and complications at CI.     

Potentialities of computed tomography and ultrasound in diagnosis of hormonally active adrenal diseases: results of comparison CT and US with operative adn histological data

The data given in the paper suggest that X-ray computed tomography (CT) is highly effective in detecting all types of hormonally active adrenal abnormalities. CT used in hormonally active adrenal diseases yielded data on major quantitative and qualitative (primarily densitometric) criteria that could be used in assessing the images of the adrenal area in these patients. Ultrasound study (USS) made at the first stage of topical diagnostic searches was of informative value in detecting adrenal tumor lesions, the technique being highly sensitive in the diagnosis of adrenal pheochromocytomas and adenocarcinomas, but less informative in the detection of hormonally active adrenocortical adenomas (aldesterone-producing ones in particular) than CT. The diagnosis of various adrenocortical hyperplasies and the differentiation of hyperplastic and tumor forms of hypercorticoidism are a prerogative of CT that substantially supplements USS findings in such cases.     

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.