Communicating hydrocephalus as a complication of eosinophilic meningoencephalitis.

The authors reported an adult patient with communicating hydrocephalus in eosinophilic meningoencephalitis. He presented with localized peritonitis and then developed eosinophilic meningoencephalitis. Angiostrongylus cantonensis was the causative agent. This was confirmed by the positive serology test. His consciousness did not recover after supportive treatment. The MRI of the brain showed diffuse enlargement of the ventricular system two weeks after the diagnosis was made. The parameters for hydrocephalus were measured and were compatible with the Gyldensted's criteria.

Predictive CT features in ruptured abdominal aortic aneurysm.

OBJECTIVE: To evaluate the CT findings including size of aneurysm, hyperattenuation crescent sign and focal discontinuity of mural calcification to predict the risk of ruptured aneurysm. MATERIAL AND METHOD: Records of 27 patients, who underwent Multislices Computed Tomography (MDCT) and required operative repair of abdominal aortic aneurysm from July 2000 to July 2003 were retrospectively reviewed Two radiologists evaluated the images by consensus, analyzing the aneurysm size, hyperattenuation crescent sign, and focal discontinuity of mural calcification. RESULTS: The authors found that the mean maximum AP diameters of the aneurysm in the ruptured and nonruptured group were 6.95 cm and 5.50 cm, respectively. All patients in the ruptured group had an aneurysm size of more than 5.0 cm. The hyperattenuation crescent sign and focal discontinuity of mural calcification had a high specificity for predicting ruptured aneurysm, 95% and 100%, respectively. There was statistical significant difference between the ruptured aneurysm and non-ruptured groups in the patients who had maximum aneurysm size more than 5 cm with positive hyperattenuation crescent sign (p < 0.041). CONCLUSION: A maximum size of aneurysm greater than 5 cm with positive hyperattenuation crescent sign is a suggestive sign to predict ruptured aneurysm.

Comparison of high-resolution computed tomography with pulmonary function testing in symptomatic smokers.

PURPOSE: To compare high-resolution computed tomography (HRCT) of lungs with pulmonary function in smokers diagnosed with emphysema. MATERIAL AND METHOD: The authors retrospectively reviewed 17 patients with a history of smoking and dyspnea, who underwent HRCT of the lungs and pulmonary function testing. HRCT scores were determined and compared to pulmonary function (FEV1, FEV1/FVC, and DLCO). RESULTS: The HRCT of all 17 patients (17/17; 100%) were typical of centrilobular emphysema; with a mean score of 12.88+/-9.18 (range, 4 to 34). Decreased FEV1 (<80% predicted) was found in 8 patients (47%), decreased FEV1/FVC (<70% predicted) in 13 patients (76%) and decreased DLCO (<80% predicted) in 3 patients (18%). The severity of emphysema revealed by HRCT was inversely correlated with the pulmonary function test: DLCO (r=-0.842, p=0.000) and FEV1 (r=-0.597, p= 0.011), but not FEV1/FVC (r=-0.400, p=0.112). CONCLUSION: HRCT allows detection of emphysema in symptomatic smokers even when pulmonary function appears to be normal. The greater the involvement of emphysema revealed by the HRCT, the poorer the pulmonary function. The authors, therefore, conclude that HRCT is the most sensitive modality for diagnosing early emphysema in smokers with dyspnea.