Double contrast technique in the proximal stomach.

The double contrast technique is of particular value in the proximal stomach, where one is able to detect ulcers and masses not recognized on a conventional upper gastrointestinal series. Pseudotumors which may occur in the fundus with the conventional barium technique are readily resolved. When a lesion in the proximal stomach is suspected by conventional radiography, immediate use of double contrast radiography may confirm or better delineate the lesion. Double contrast examination of the proximal stomach may thus be used as a primary or immediate secondary procedure to increase radiologic accuracy.

Intracranial meningioma presenting as a mass in the neck.

A meningioma demonstrating unusual anatomical and clinical manifestations is described. This intracranial tumor originated in the petrous region and extended into the neck, the patient remaining neurologically asymptomatic for nearly 2 years. The radiological features of this tumor as well as a review of the pertinent literature are presented.

Esophageal carcinoma: a survey of populations at risk.

Carcinoma of the esophagus is found more commonly in association with head and neck tumors, lye stricture, achalasia, and Barrett esophagus than in the general population. Our experience with these associated entities in a population of 680 patients with carcinoma of the esophagus is reviewed. Carcinoma of the esophagus has traditionally had a very poor prognosis which continues to the present. Routine periodic use of double contrast esophagography is advocated to screen populations containing these associated high-risk entities. This may ultimately increase survival through diagnosis of earlier stages of carcinoma of the esophagus.

Lymphoid follicular pattern of the colon in adults.

The clinical and radiographic findings of the colonic lymphoid follicular pattern in 37 adults aged 20-79 years were evaluated. An incidence of 13% was found on review of 100 consecutive double-contrast barium enemas. Usually, the presence of multiple 1-3 mm diam, uniform-size nodules is sufficiently characteristic to make a presumptive diagnosis on these radiographic criteria. The nodules are often not visible endoscopically. The clinical data suggest that that the lymphoid follicular pattern is usually of no clinical significance in adults. In most patients, its radiologic pattern can be distinguished from entities such as familial polyposis and early Crohn's disease, thus sparing the patient unnecessary further diagnostic evaluation.

CT contrast enhancement in cerebral infarction.

Computed tomography was used to study 100 patients with ischemic cerebral infarcts. All cases were documented by autopsy, radionuclide imaging, cerebral angiography, or clinical course. Vascular distribution of infarcts was varied and included infarcts of cerebral hemispheres, basal ganglia, and cerebellum. Distinct patterns of enhancement are seen following administration of intravenous contrast material: predominantly peripheral, central, homogeneous, or heterogeneous. Enhancement of the infarcted area usually occurs 1-4 weeks after the onset of clinical symptoms, but was seen as early as the first day or as late as several months after the onset of symptoms. Infarcts showing contrast enhancement may or may not revert to a nonenhanced pattern on follow-up examination for several months. Lesions demonstrating contrast enhancement in cerebrovascular disease may at times be indistinguishable from tumor. Contrast enhancement was the only manifestation of infarction in some instances, and an infarcted area may be completely missed if a postcontrast examination is not performed.