Dynamic CT in the evaluation of physiologic status of renal transplants.

Dynamic computed tomographic scans were performed in 23 patients to evaluate perfusion and function of renal transplants. Using corticomedullary junction and corticoarterial junction attenuation/time curve analysis, we were able to differentiate normal renal transplants from those undergoing rejection. Corticomedullary junction time was used to assess function and was significant in distinguishing normal renal transplants from those with rejection (p less than 0.001). Similarly, corticoarterial junction time was used to assess perfusion and had a significance of p less than 0.05. The study demonstrates the ability of computed tomography to yield excellent physiologic information.

Differentiation of tumor from syringohydromyelia: intraoperative neurosonography of the spinal cord.

Real-time ultrasonography was useful in differentiating tumor from syringohydromyelia as the cause of cervical cord widening in four patients. Those with syringohydromyelia had a smooth, regular, cystic space located symmetrically in the spinal cord. Tumor appeared as an echogenic, hypoechoic, or cystic expansile lesion that both narrowed the subarachnoid space and obliterated the spinal canal. When intraoperative sonography detects cystic lesions of the spinal cord, careful search for the presence of these signs is necessary to exclude tumor. Intraoperative spinal cord ultrasonography is simple and rapid, and it provides the surgeon with valuable information not readily available previously.

Utilization of temporary muscle paralysis to eliminate CT motion artifact in the critically ill patient.

The intubated, critically ill patient often cannot suspend respiration long enough to eliminate severe computed tomographic (CT) motion artifact, even with current generation CT scanners. High quality, motion-free CT images were safely and easily obtained in two such patients using pancuronium bromide (Pavulon) to achieve muscle paralysis.