[Thrombosis of the upper thoracic inflow vessel. Spiral CT and 3-D reconstruction]. / Thrombose der oberen thorakalen Einstrombahn. Spiral-CT and 3-D-Rekonstruktion.

Spiral-CT-Depiction and 3D-Reconstruction: A patient complaining of upper thoracic inlet syndrome after thyroidectomy underwent contrast-enhanced spiral-CT. Coronal reconstructions and three-dimensional reconstructions were used to generate phlebographic images of the thoracic inlet veins thrombosis. The diagnosis of thrombosis was confirmed by phlebography.

[Improved imaging of mandibular cysts using dental-CT]. / Verbesserung der Darstellung von Unterkieferzysten mittels Dental-CT.

The purpose of this study was to evaluate orthopantomography and a newly developed CT software package (Dental-CT) in the preoperative assessment of mandibular cysts. In this study 16 cysts in 13 patients were examined radiographically by orthopantomography and dental-CT to reformat the axial scans into truly cross-sectional views perpendicular to the anatomical axis of the jaw. The obtained images were compared for visualisation of the alveolar canal, the mandibular anatomy and the cortical involvement. Dental-CT proved superior for establishing a correct radiographic diagnosis and was rated significantly (p < 0.001) higher with regard to examined points. Dental-CT has to be considered the method of choice in the preoperative evaluation of mandibular cysts providing detailed anatomical information needed for the further management. Radiation exposure remains within an acceptable range.

Videoendoscopic procedures in thoracic surgery: technical aspects and report of removal of a mediastinal cyst.

Current videoendoscopic technology and percutaneous techniques of exposure and dissection have been successfully applied to abdominal surgery with favorable results. Application of this technology to our practice of thoracic surgery is the basis of this report. Video-assisted thoracic surgery was performed in 36 patients for the following indications: Raynaud's syndrome, undefined pulmonary nodule, persisting spontaneous pneumothorax, T1 bronchial carcinoma, and mediastinal cyst. Videoendoscopic surgical procedures were accomplished using double-lumen endotracheal anaesthesia and a percutaneous stapling device. Procedures performed using this technique include thoracic sympathectomy, wedge or keel excision, blebectomy, lung apex stapling, parietal pleurectomy, and dissection of the mediastinal cyst. Median operating time was 45 min (range, 15 to 90 min). Tissue diagnosis was obtained in all patients. Median diameter of excised nodules was 10 mm (range, 7 to 70 mm). There were no operative deaths. The single complication was a prolonged air leak. This new method of thoracic surgery appears to benefit the patients. For us it proved a secure way to perform thoracic surgery. Our case of removal of a benign cyst in the posterior mediastinum shows that video-assisted thoracic surgery has expanding applications in the field of general thoracic surgery.

Videoendoscopic removal of a mediastinal cyst.

A 41-year-old woman was admitted to the hospital for obstetric surgery. A preoperative chest x-ray film showed a mediastinal mass. After examinations with echocardiography, computed tomography, and magnetic resonance imaging, we removed a cyst that was 2.7 x 3.5 cm in size by thoracoscopic means. The patient left the hospital 3 days after the operation.

Lumbar myelography with three-dimensional MR imaging.

A strongly T2*-weighted, three-dimensional (3D) PSIF (time-reversed FISP [fast imaging with steady-state precession]) gradient-echo magnetic resonance (MR) sequence, with postprocessing of the 3D data set with a maximum-intensity projection (MIP) algorithm, produced x-ray myelography-equivalent images. The method was tested in 10 healthy volunteers to optimize sequence parameters and was evaluated in 30 patients with proven lumbar disk disease. MIP myelograms, unlike two-dimensional MR images, could not show the pathologic disks themselves but clearly demonstrated the effect on the thecal sac, giving a clear overall view of its geometry and dimensions, especially when displayed in a cine loop. All 28 medial and mediolateral disk herniations could be visualized, whereas only three of eight intraforminal disk herniations were seen on MR myelograms.