Computerized tomography with and without intraperitoneal contrast for determination of intraabdominal fluid distribution and diagnosis of complications in peritoneal dialysis patients.

Seven computed tomography scans and 19 computed tomograph peritoneography (CTP) studies performed in 20 peritoneal dialysis patients were analyzed retrospectively as to their diagnostic usefulness in peritoneal dialysis related complications. Computed tomographic peritoneography was found to be superior to computed tomography scans in localizing small leak sites. In seven of nine patients with clinically diagnosed dialysate leakage, computed tomographic peritoneography supported the clinical diagnosis and localized the leak site in six patients. All patients with a conspicuous leak site and/or with leaks through hernias had to have surgical treatment. Computed tomographic peritoneography failed to reveal a leak or identify a fluid tract in patients with intermittent, small leaks. Those leaks responded easily to a dialysis regimen with diminished intraabdominal pressure. Normal intraperitoneal fluid distribution was based on 17 studies after intraperitoneal infusion of 2,000 ml of peritoneal dialysis solution in patients without intraabdominal organomegaly and/or any clinical suspicion of fluid maldistribution, with average peritoneal transport characteristics. As appraised in the supine position, approximate fluid contents in the intraperitoneal spaces were pelvis, 30-55%; paracolic gutter, 15-30%; perisplenic and perihepatic, 10-20% each, and lesser sac, 1-3%. Severe fluid maldistribution on computed tomography peritoneography, particularly a small fluid volume in the pelvic space, is a poor prognostic sign as to the feasibility of peritoneal dialysis; neither of our two patients with no fluid in the pelvic space could be maintained on peritoneal dialysis, while patients with no fluid in the lesser sac, perihepatic and perisplenic spaces could be maintained on peritoneal dialysis. No fluid was seen in the peritoneal cavity after drainage in the vertical position.(ABSTRACT TRUNCATED AT 250 WORDS)

Nonpalpable occult testis tumor.

We present a case study of a patient with seminoma who had normal testicles on palpation. Testicular ultrasound is the technique of choice to locate occult nonpalpable testis lesions. We recommend its use in the search for the source of any retroperitoneal mass of undetermined origin.

Hereditary multiple exostoses and cervical cord compression: CT and MR studies.

Hereditary multiple exostoses usually involve the long bones, but occasionally the spine. When the spine is involved, serious neurologic deficits may occur. We report a case of a 12-year-old girl with an exostosis in the cervical spine (C5), which caused a spastic quadriplegia.

Computed tomography in the diagnosis and follow-up of American Burkitt's lymphoma.

CT scans of Burkitt's lymphoma in 8 American patients are presented. Computed tomography was the major diagnostic imaging modality in 4, and the abdomen was the most commonly involved site in our patients. CT was found to be the method of choice for diagnostic purposes and for assessing the size of abdominal masses. Furthermore, because of the relative effectiveness of modern chemotherapeutic agents in treatment of this type of lymphoma, CT did and can play a unique role in follow-up of these cases during therapy.

Esophageal hemangioma: diagnosis with computed tomography and radionuclide angiography.

Esophageal hemangioma is a benign tumor that may cause dysphagia and upper gastrointestinal bleeding. Invasive measures such as endoscopic biopsy and surgical excision have been required for diagnosis in most reported cases. We have reported a case focusing on the use of two noninvasive techniques, contrast CT and radionuclide angiography, in the diagnosis of esophageal hemangioma.

Intraosseous hemophilic pseudotumor of the orbit.

Intraosseous hemophilic pseudotumor involving the orbit has not been described previously. A 14-year-old white male presented with a rapidly progressive, expansile right orbital mass consisting of hematoma contained within bony cortex. Computerized tomography revealed findings consistent with intraosseous hemophilic pseudotumor. The patient responded to conservative therapy of factor VIII replacement.

Computed tomography and intracranial aspergillosis.

A case of aspergillosis of the central nervous system with multiple granulomas examined by computed tomography is reported. The findings are those of chronic mass lesions with and without calcium deposits. An associated cystic configuration probably is not specific for aspergillomas.

Towards computer analysis of pulmonary infiltration.

A feasibility study is described to provide quantitative texture measures to distinguish between normal lung, alveolar infiltrates and interstitial infiltrates. Advanced computer imaging technology and decision making processes were applied to distinguish between these textural patterns. The results, based on computer extracted quantitative measures, show an excellent separation of the three classes considered with 95% accuracy in the training phase and 90% accuracy in the testing phase.

General purpose digital display system for computed tomography images.

The authors describe a microprocessor-based digital image display system utilizing a solid-state image memory with a high quality television-type monitor for display of computed tomography images. It is an alternative to a commercially available display system, and offers the potential for research in digital image display. It is now under clinical evaluation. Image input to the stand-alone display system is via 9-track magnetic tape common to almost all CT machines, and it may be programmed to accept digital tapes from any type of CT machine and display them in a common format.

Missouri Automated Radiology System: a dynamic, interactive diagnostic and management system for radiant images.

Missouri Automated Radiology System has functioned in full support of the Department of Radiology for more than 7 years. For the past 5 years, MARS has functioned as a minicomputer system on a DEC (Digital Equipment Corporation) PDP-15 computer. While continuing to effectively support the department, in daily use by 20 staff and 15 resident physicians, MARS has continued to function in a research and development mode. With the continuous development of new applications, MARS is now essential to the function of the department and has again proven the point that physicians and computers can function symbiotically in the medical environment.