Radioisotope cisternographic evaluation of hydrocephalus: Comparison with CT, MRI, and clinical findings

To evaluate the clinical usefulness of radionuclide(RI) cisternography in patients with hydrocephalus, we retrospectively analyzed RI cisternographic findings of 47 patients by using our classification which was modified from Baum's. and correlated them with CT(n=37) or MRI(n=10) findings and clinical outcome in selected patients with hydrocephalus(n=37). Modified RI cisternographic patterns of 37 patients were type I in three cases(8%), type II in seven(18%), type III-A in six(16%), no case of type III-B, type IV-A in 12(32%), and type IV-B in nine(24%). RI cisternography enabled to differentiate communicating hydrocephalus(27 cases, 73%) from noncommunicating hydrocephalus (10 cases, 27%). There was marked clinical improvement in 17 patients(46%), slight improvement in 11 patients(30%), and no improvement in nine patients(24%). The clinical outcome of patients with RI cisternographic type IV-B was worse than that of other types. CT and MRI could neither predict the clinical outcome nor differentiate type IV-B from Type IV-A(p>.05). Ventricular size index (VSI( was significantly higher in patients with type IV than that with other types(p<.001). RI cisternographic patterns of communicating hydrocephalus were relatively correlated with clinical outcome (r=-0.53, P=.001), VIS(r=0.59, p=.001), and dilatation of fourth ventricle(r=0.41, p<.05). We suggest that our modified classification of RI cisternographic patterns can provide more strict physiological assessment of the CSF dynamics and RI cisternography may be still useful to differentiate communicating hydrocephalus from noncommunicating hydrocephalus and to predict the clinical outcome in conjunction with CT/MR findings and clinical presentation.

Computed tomography of stomach cancer: water as an oral contrast agent

No abstract available.

Dyke-Davidoff-Masson Syndrome Associated with Occlusion of Internal Carotid Artery

No abstract available.

Treatment of Traumatic Carotid-cavernous Fistula Using Debrun's Latex Detachable Balloon

A case of traumatic carotid-cavernous fistula treated by using Debrun's latex detachable balloon catheter is reported. The patient was a 28 year old man, who had complaints of headache, proptosis and chemosis of left eye 3 weeks after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow type. Following complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detachable balloon. Immediately after occlusion of the fistula the clinical symptoms were markedly improved.

Atrioventricular septal defects: angiographic analysis of 31 cases

No abstract available.

Computed Tomography of Juvenile Nasopharyngeal Angiofibroma

It is well-knwon that computed tomography (CT) is useful in detecting accurately the location, extent, erosion and relationshlp of angiofibroma to surrounding structures such as pterygopalatine fossa, It is well-known that computed tomography (CT) is useful in detecting accurately the location, extent, erosion and relatiohship of angiofibroma to surrounding structures such as pterygopalatine fossa, sphenoid slnus, and etc. CT of 20 patients with juvenile angiofibroma, which were examined for 5 years from Feburary, 1979 to May. 1984 at Department of Radiology, Seoul National University Hospital, were retrospectively analized. The results were as follows: 1. AII 20 patients of juvenile angiofibroma had tumors in nasopharynx and posterior nasal cavity showing homogeneously dense.enhancing soft tissue mass on CT. There was extension of the tumor from nasopharyhx and posterior nas.al cavity into Pílranasal sinus (60%, 12/20), pterygopalatine fossa (55%, 11/20), infratemporal fossa (30%, 6/20), posterior orbit (10%, 2/20) and cranial cavity (15%, 3/20). 2. Angiography usually adds Iittle diagnostic information, but is still needed to identify the precise source of blood supply to the tumor, and to perform the pre-operative embolization. The use of CT has deferred angiography until just before surgery, permitting embolization at optimal time. 3. CT is almost always necessary to reveal accurately the full extent of the tumor, especially intracranial space in the axial and coronal planes with contrast enhancement. CT is useful both in diagnosis as a guide to angiography and in planning the adequate thereapy of juvenile angiogibroma.

Radiological evaluation of double-outlet right ventricle: an analysis of cinecardioangiography in 44 cases

Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completelyfrom the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; andusually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases ofdouble-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department ofRadiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to thesegmental combinations, the height of conus the relationship of great arteries, the location of ventricular septaldefects, and associated anomalies. The resuslts were as follows; 1. Among 44 cases, 36 cases had normal cardiacposition, 4 cases had dextrocardia with situs inversus, 2 cases had dextrocardia with situs solitus, 1 case hadlevocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were[S.D.D] in 36 cases, [I.L.L] in 3 cases, [I.D.D] in 2 cases, [S.D.L], [S.L.L] and [A,D,D] in 1 case respectively.3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lowerthan pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2cases. 4. The relation of the great arteries were normal in 15 cases, side-by side in 13 cases, dextromalpositionin 13 cases, and levomal position in 3 cases. 5, The position of the ventricular septal defects with respect tothe origins of the great arteries is subaortic (type A & type B) in 23 cases, subpulmonary (type C) in 13 cases,double committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations arepulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C,left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery in 4, interrupted IVC in 1,obstructive VSD in 2, ASD in 4, PDA in 4, right aortic arch with levocardia in 5, and ectopic spleen withmesocardia in 1 case. 7. Biplane cinecardioangiogram must be performed in both ventricles to define the VSD andits relationship to the great arteries, and, if necessary, should also be performed in the aorta to rule outcoarctation and coronary artery abnormalities, and in the pulmonary artery to visiualize pulmonary venous returnand mitral valve. Angiography is of crucial importance in differentiating double-outlet right ventricle fromtetralogy of Fallot and complete transposition of the great arteries.