The radiological diagnosis of cerebral venous angioma: cerebral angiography and computed tomography.

The angiographic and CT findings in seven cases of cerebral venous angioma are presented and analyzed. Two cases were also examined with dynamic CT. The radiological literature on the subject is reviewed and a new classification of cerebral venous angioma based on its pattern of drainage is proposed. It is concluded that with the use of thin slices and coronal cuts both the angioma and its pattern of venous drainage can be identified on CT in a high proportion of cases. In addition, with dynamic CT the specificity of CT in diagnosing cerebral venous angioma may further increase.

[Ultrasound-controlled fine needle puncture of gastrointestinal tumors with continuous view]. / Die ultraschallgesteuerte Feinnadelpunktion gastrointestinaler Tumoren unter permanenter Sicht.

On account of its principle, ultrasound tomography cannot be recommended as a screening method for intestinal tumors; nevertheless, it may sometimes demonstrate larger tumors not producing typical signs. These neoplasms show a characteristic pattern ("cockade phenomenon"). In the region of the antrum they appear occasionally as a rigid thickening of the gastric wall. The nature of such an expansive lesion may be evaluated quickly and safely by a fine-needle puncture performed under sonographic control. No complications have been observed so far.

The current state of the radiological diagnosis of acoustic neuroma.

Thin, overlapping section, contrast-enhanced, axial and coronal CT, with additional high-resolution (HR) treatment of the sections through the internal auditory canal, was performed on 31 patients clinically suspected of acoustic neuroma. With this technique 13 acoustic neuromas protruding more than 10 mm and eight acoustic neuromas protruding between 2 and 10 mm outside the internal auditory canal were unequivocally diagnosed. O2CT cisternography was performed on ten patients. An intracanalicular neuroma was diagnosed in three cases with this technique, also a small extracanalicular neuroma in one case, and an acoustic neuroma was definitely excluded in six cases. It is concluded that O2CT cisternograhy is the diagnostic procedure of choice for the detection of purely intracanalicular neuromas and the definite exclusion of acoustic neuroma. HR CT proved superior to polytomography for the evaluation of the internal auditory canal and should be performed in every case suspected of acoustic neuroma. A protocol for the radiological investigation of patients suspected of acoustic neuroma is given.

Intramural pseudodiverticulosis of the esophagus: report of seven cases and literature review.

Seven cases of esophageal intramural pseudodiverticulosis (EIPD) are presented and compared with 46 cases previously reported. EIPD is mainly a disease of older age with a 3:2 predominance of male patients. The radiologic appearance of EIPD shows great variation in localization and severity of visible changes. Radiologic examination is far more sensitive than endoscopy in diagnosing EIPD. The most effective therapy for EIPD is dilatation of strictures, leading to amelioration or disappearance of symptoms in over 90% of cases. Visible pseudodiverticula may persist after therapy, even in symptom-free patients.

[Experience with sonographically controlled fine-needle punctures with permanent visual control (author's transl)]. / Erfahrungen mit der ultraschallgezielten Feinnadelpunktion unter permanenter Sichtkontrolle.

With our new biopsy-device it is now possible to perform fine-needle punctures of lesions in the abdomen, thoracic cage, cervical region and extremities under continuous visual control. This intervention can easily be done with low risk for the patient and can be repeated whenever necessary. It has proven its advantages for amniocentesis as well, especially in cases with a low amount of amniotic fluid. Moreover, our new device allows the combination of sonographical and radiological interventions, for example of the kidneys.

[Correlation the laevocardiogram and plain chest films in the presence of myocardial insufficiency (author's transl)]. / Die Korrelation zwischen Lävokardiogramm und Nativthoraxröntgenbild bei der Herzmuskelinsuffizienz.

A correlation was attempted in 106 patients with myocardial insufficiency between linear and volume parameters of the laevocardiogram and the corresponding parameters on plain chest films, as well as between pressure measurements and the degree of pulmonary congestion. Measurements on the plain radiograph provide only limited information on the function of the myocardium and the severity of myocardial lesion respectively. Nevertheless, they are of some value during the course of the disease.

Computed tomography of acoustic neuromas with emphasis on small tumor detectability.

The results of CT analysis of 41 acoustic neuromas are presented. Large and medium-sized tumors are easily detected: our results are comparable to the reported findings of other authors. The detectability of small acoustic neuromas is considerably improved by the application of newer-generation CT apparatus and the use of specific scanning parameters, including extremely thin overlapping slices, low scan speed, high gantry tilt, short time between contrast agent application and tumor scanning, and computer-assisted magnification of the posterior fossa.

[Possibilities and limits of xeroradiography. A statement (author's transl)]. / Möglichkeiten und Grenzen der Xeroradiographie. Eine Bilanz.

Xeroradiography has proved to be of particular use for the examination of soft tissues. Due to great latitude and edge enhancement effect alterations of the splanchnocranium, the breast and the juxtaosseous soft tissues are especially well recognizable. Also for examination of larynx and trachea as well as certain soft tissues in the region of the neck this method is advantageous and proves its facilities to demonstrate diseases of the lungs and hilar region. On the contrary, alterations of the vertebral column, the basis of the skull and the abdomen cannot be examined by means of xeroradiography because of not justified radiation dosage. Xeroradiography offers no advantage for arthrography, angiography and examination of bones and skeletal parts of joints.

[Abeurysm of the septum membranaceum]. / Das Aneurysma des Septum membranaceum.

Between 1968 and 1977 5000 angiocardiographies revealed an aneurysm of the membranous septum (AMS) in 20 patients. In 11 patients the AMS was accompanied by a usually minor ventricular septal defect, in 4 by aortic valve disease, in 3 by coronary heart disease and in the remainder by some other rare heart disease. The diagnosis of AMS was established by angiocardiography, but in 3 patients it was detected by echocardiography. In one case a sepsis lenta with cerebral embolization was observed.

[Radiological diagnosis of the narrow lumbar spinal canal syndrome (author's transl)]. / Radiologische Diagnose des engen lumbalen Spinalkanals

31 myelograms of patients with the syndrome of lumbar spinal canal constriction were analysed. Two forms can be distinguished - a primary form with hypoplasia of the lumbar section of the spinal canal, and a secondary form with circumscribed constriction through olisthy or spondylosis deformans. The characteristics symptoms of the primary form (n = 21) are: difficult lumbar puncture, the ascent of the contrast medium in the thoracic section of the vertebral canal, multiple protrusions of the intervertebral discs, reduced sagittal diameter of the dural area which is marked by additional signs of spondylosis. In this connection, the alterations were so characteristic that it was possible to diagnose the condition even before the operation. The myelogram with water-soluble contrast-medium is considered to be markedly superior to other methods of radiological examination.

[Abdominal plain films in mesenterial infarct]. / Das Abdomenleerbild bei Mesenterialinfarkt

86 plain films of the abdomen from 63 patients with acute mesenteric infarction were compared with plain films of 90 patients with acute abdomen of different origin. The airless abdomen, the increased thickness of the gut wall and the hairpin sign proved tbe nonspecific, but more pronounced and more frequent in mesenteric infarction. Gas in the gut wall and in the portal vein system was found only in mesenteric infarction. All 6 patients with gas in the portal veins died. The airless abdomen in a patient with severe abdominal pain is a surprising finding and points to the possibility of mesenteric infarction.