Metrizamide Computed Tomographic Cisternography for the Diagnosis of Occult Lesions of the Hypothalamic-Hypophyseal Axis in Children

Neurosurgery ◽  
1981 ◽  
Vol 8 (5) ◽  
pp. 531-541 ◽  
Author(s):  
Dachling Pang ◽  
Arthur E. Rosenbaum ◽  
James E. Wilberger ◽  
James P. Gutai
Keyword(s):  
Computed Tomography ◽  
Diagnostic Yield ◽  
Empty Sella ◽  
Functional Disorders ◽  
Ct Cisternography ◽  
Empty Sella Syndrome ◽  
Computed Tomographic ◽  
Suprasellar Cistern ◽  
Enhanced Computed Tomography ◽  
Metrizamide Ct Cisternography

Abstract In children, hypothalamic-hypophyseal syndromes such as diabetes insipidus, precocious puberty, growth retardation, and panhypopituitarism can be due either to structural lesions or to functional disorders of the cerebral endocrine complex. When clinical and endocrinological parameters fail to distinguish between these etiologies, neuroradiographical diagnosis becomes extremely important. Although conventional intravenously enhanced computed tomography (IVCT) is satisfactory for the diagnosis of lesions larger than 1 cm, metrizamide CT cisternography (MCTC) greatly improves the diagnostic yield for smaller juxtapituitary masses in the suprasellar cistern, clearly defines their sizes and relationships with contiguous structures, and definitively confirms the diagnosis of empty sella syndrome. Six patients with endocrinopathies and normal or ambiguous IVCT findings are presented to illustrate how MCTC can influence their management and outcome without the patient discomfort and technical complexity associated with pneumoencephalography.

Communicating Triventricular Hydrocephalus and Its Treatment with a Lumboperitoneal Shunt

Neurosurgery ◽  
1985 ◽  
Vol 16 (4) ◽  
pp. 557-561
Author(s):  
Nobuhiko Aoki ◽  
Hiroshi Mizutani
Keyword(s):  
Computed Tomography ◽  
Aqueductal Stenosis ◽  
Ct Cisternography ◽  
Computed Tomographic ◽  
Lateral Ventricles ◽  
Lumboperitoneal Shunt ◽  
Spinal Subarachnoid Space ◽  
Metrizamide Ct Cisternography ◽  
4Th Ventricle ◽  
Triventricular Hydrocephalus

Abstract With computed tomography, triventricular hydrocephalus shows enlargement of the 3rd and both lateral ventricles with a nearly normal size 4th ventricle. Triventricular hydrocephalus has been described as noncommunicating because of aqueductal stenosis or obstruction. The authors, however, have encountered three patients whose computed tomographic (CT) images were those of triventricular hydrocephalus despite a patent aqueduct. This condition may be suitably referred to as communicating triventricular hydrocephalus because in all cases metrizamide CT cisternography demonstrated the communication between the spinal subarachnoid space and both lateral ventricles. The authors discuss its treatment with a lumboperitoneal shunt.

Diagnostic yield of computed tomography in the evaluation of unilateral vocal fold palsy

2021 ◽  
pp. 1-4
Author(s):  
H S Chew ◽  
J C G Goh ◽  
D Y A Tham
Keyword(s):  
Computed Tomography ◽  
Vocal Fold ◽  
Diagnostic Yield ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Vocal Fold Paralysis ◽  
Initial Assessment ◽  
Contrast Enhanced ◽  
Vocal Fold Palsy ◽  
Enhanced Computed Tomography

Abstract Background There is a paucity of Asian-based data regarding the diagnostic yield of computed tomography imaging in the initial assessment of idiopathic unilateral vocal fold palsy. Objectives To investigate the diagnostic yield of computed tomography in idiopathic unilateral vocal fold palsy cases in an Asian tertiary hospital, and to determine the causative pathologies and positive predictive factors. Method A retrospective chart review was conducted of patients (between 2010 and 2018) with a clinical diagnosis of idiopathic unilateral vocal fold palsy who underwent contrast-enhanced computed tomography of the neck and chest at Tan Tock Seng Hospital, Singapore. Results The overall computed tomography diagnostic yield was 21 per cent, with malignancy accounting for 63.6 per cent of diagnoses. Degree of vocal fold weakness was the only significant predictor of positive computed tomography findings (11.5 per cent in vocal fold paresis vs 29.1 per cent in vocal fold paralysis, p = 0.025). None of the patients with negative computed tomography findings went on to develop disease after a mean follow up of 14.3 months. Conclusion Computed tomography is a useful initial investigation for idiopathic unilateral vocal fold palsy, particularly in cases with vocal fold paralysis.

Predicting Stroke Risk in Pediatric Moyamoya Disease with Xenon-enhanced Computed Tomography

Neurosurgery ◽  
2004 ◽  
Vol 55 (2) ◽  
pp. 327-333 ◽  
Author(s):  
David J. McAuley ◽  
Ken Poskitt ◽  
Paul Steinbok
Keyword(s):  
Computed Tomography ◽  
Moyamoya Disease ◽  
Stroke Risk ◽  
Tissue Perfusion ◽  
Computed Tomographic ◽  
Before And After ◽  
Xenon Computed Tomography ◽  
Enhanced Computed Tomography ◽  
Acetazolamide Challenge

Abstract OBJECTIVE: To determine whether estimates of regional cerebral blood flow (rCBF) using xenon computed tomography (XeCT) in children with moyamoya disease can predict stroke risk before and after treatment. METHOD: Seven patients with moyamoya disease underwent 22 serial Xe computed tomographic scans. Estimates of rCBF were obtained at three computed tomographic levels by use of a 5-minute inhalation of 28% Xe. Acetazolamide challenge was performed in eight scans. For comparison of abnormal vessel distribution and areas of infarction, 17 intra-arterial digital subtraction angiograms, 47 computed tomographic scans, and 15 magnetic resonance imaging scans were available. Follow-up exceeded 36 months in all patients. Mean follow-up for the interventional group was 65.2 months (n =5; range, 37–109 mo) and 38 months for the nonoperative patients (n =2; 36 and 40 mo). RESULTS: Of six Xe computed tomographic scans obtained at diagnosis, four revealed regions of oligemia, augmented vertebrobasilar flow, and regions of carotid steal after acetazolamide. In the delay between diagnosis and treatment, three patients had strokes in ischemic areas identified by XeCT. Of the 10 posttreatment scans obtained from 4 patients, 2 revealed improved tissue perfusion with angiography confirming successful encephaloduroangiomyosynangiosis. In 2 others, XeCT performed 6 months posttreatment revealed improved perfusion without angiographic change, and angiography at 1 year revealed failed encephaloduroangiomyosynangiosis and new native collaterals. None of the patients with improved rCBF had new strokes. Eleven of 14 Xe computed tomographic scans were obtained within 30 days of angiography. Comparison of these studies demonstrates that regions of oligemia were confined to areas associated with vessel stenosis and little neovascularity or collateral pathways. CONCLUSION: XeCT, particularly with acetazolamide challenge, objectively quantifies rCBF. Our preliminary data suggest that it may permit assessment of stroke risk in children with moyamoya disease and may predict surgical outcome earlier than angiography.

Changes in computed tomographic findings in microprolactinomas before and after bromocriptine

1985 ◽  
Vol 110 (3) ◽  
pp. 308-312 ◽  
Author(s):  
R. Demura ◽  
O. Kubo ◽  
H. Demura ◽  
K. Shizume ◽  
K. Kitamura
Keyword(s):  
Computed Tomography ◽  
Empty Sella ◽  
Ct Scans ◽  
Plasma Prolactin ◽  
Computed Tomographic ◽  
Enhanced Ct ◽  
Before And After

Abstract. Computed tomography (CT) of the pituitary before and after bromocriptine treatment were performed in 10 patients with microprolactinoma. Intra-pituitary low densities were demonstrated in 7 out of the 10 patients before bromocriptine. Low densities shrank in size and increased in density after normalization of the plasma prolactin (Prl) level following bromocriptine. At the same time, various degrees of empty sella were demonstrated in these patients and in 2 out of the 3 without noticeable changes before treatment. It was concluded that enhanced CT scans, especially sagittal reconstruction images, were very informative for the diagnosis of microprolactinoma and that bromocriptine reduced the size of the microprolactinoma and often led to empty sella.

Intrasellar cyst masquerading as empty sella syndrome: history repeating itself

2019 ◽  
Author(s):  
Thomas Wright ◽  
Steven Tao ◽  
Joseph Harding ◽  
Sarah Chatharoo ◽  
Pankaj Chaturvedi ◽  
...  
Keyword(s):  
Empty Sella ◽  
Empty Sella Syndrome

A Giant Coronary Sinus Aneurysm with Secondary Vena Cava Aneurysms

2016 ◽  
Vol 19 (1) ◽  
pp. 028
Author(s):  
Shengjun Wu ◽  
Peng Teng ◽  
Yiming Ni ◽  
Renyuan Li
Keyword(s):  
Computed Tomography ◽  
Heart Transplantation ◽  
Coronary Sinus ◽  
Unusual Case ◽  
Superior Vena ◽  
Vena Cava ◽  
Final Diagnosis ◽  
Rare Entity ◽  
First Case ◽  
Enhanced Computed Tomography

Coronary sinus aneurysm (CSA) is an extremely rare entity. Herein, we present an unusual case of an 18-year-old symptomatic female patient with a giant CSA. Secondary vena cava aneurysms were also manifested. The final diagnosis was confirmed by enhanced computed tomography (CT) and cardiac catheterization. As far as we know, it is the first case that such a giant CSA coexists with secondary vena cava aneurysms. Considering the complexity of postoperative reconstruction, we believe that heart transplantation may be the optimal way for treatment. The patient received anticoagulant due to the superior vena cava (SVC) thrombosis while waiting for a donor.

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