Gravid uterine dehiscence: MR findings.

Gravid uterine rupture can be a difficult diagnosis, both clinically and radiologically. Ultrasound has been successful in detection of some indirect signs of uterine rupture but thus far has shown little success in demonstrating the myometrial defect. We present the MR findings in a case of gravid uterine dehiscence in which the actual uterine wall defect was well demonstrated. Gross pathologic correlation is provided.

Pseudothrombosis of the right ovarian vein. Pitfall of abdominal spiral CT.

We present the computed tomography (CT) findings of pseudothrombosis of the right ovarian vein. In two young multiparous women, pseudothrombosis was detected on early-phase spiral CT scans by the presence of retrograde flow of contrast medium down the left ovarian veins. Asymmetry of density seen in the ovarian veins in the early phase of spiral CT scanning related to reflux in the left ovarian vein should not be mistaken for right ovarian vein thrombosis.

Fibrolamellar hepatocellular carcinoma: MR appearance mimicking focal nodular hyperplasia.

We report the MR findings of a case of fibrolamellar hepatocellular carcinoma that fulfilled MR criteria proposed as diagnostic of focal nodular hyperplasia. Because confusion of fibrolamellar carcinoma with focal nodular hyperplasia could result in a missed opportunity for cure, pathologic assessment remains necessary in cases demonstrating these MR findings that do not show radiotracer uptake on 99mTc-sulfur colloid scintigraphy.

Cavernous hemangioma of the adrenal gland: MR findings.

Adrenal hemangioma is considered a rare tumor and is pathologically similar to hemangiomas found elsewhere in the body. Magnetic resonance imaging (MRI) findings thought to be highly suggestive of this neoplasm are presented. Correlation with pathologic findings in this case, as well as imaging and pathologic findings in other reported cases, is provided.

Diffuse lung calcifications following fat emboli and adult respiratory distress syndromes: CT findings.

We present a case of diffuse lung calcifications that developed following fat emboli and adult respiratory distress syndrome. Computed tomography (CT) showed the majority of the calcifications to be within branches of the pulmonary arteries. High-resolution CT findings helped to characterize associated lung parenchymal changes.

Emergence of mature teratoma following treatment of sacrococcygeal endodermal sinus tumor: CT and MR imaging with pathological correlation.

We report a case of pseudoretroconversion in which, clinically and pathologically, it appeared that an endodermal sinus tumor retroconverted to mature teratoma. An 8-month-old white female infant with a sacrococcygeal tumor, diagnosed by biopsy as endodermal sinus tumor (yolk sac tumor), was treated with chemotherapy. The residual tumor after treatment was mature teratoma confirmed by imaging and by pathological examination. We present the computerized tomography (CT) and magnetic resonance imaging (MRI) findings with pathological correlation.

Intrarenal aneurysm associated with "Ask-Upmark kidney": imaging pitfalls and limitations.

The imaging of a case of intrarenal aneurysm with associated "Ask-Upmark kidney" is presented. Pitfalls and limitations encountered with imaging in this case are discussed. Magnetic resonance imaging (MRI) proved to be the best imaging modality for visualization and characterization of the mass lesions present.

Esophageal foreign body after smoking crack cocaine.

Injuries from cocaine abuse are often seen and have been reported more often with the introduction of crack cocaine. Burns of the upper aerodigestive tract have been reported but no reports of esophageal obstruction have been located. We report ingestion of a foreign body from smoking crack cocaine and our management. A review of other possible aspiration and ingestion injuries is included.

Evaluation of alimentary tract foreign body: clinical and imaging review of 100 consecutive cases.

We investigated the cases of 100 consecutive patients with alimentary tract foreign bodies for clinical findings and use of imaging and compared our findings with those of other reported series. Most of our patients were children, and the alimentary tract foreign body was metal in most cases. There was no undue morbidity or mortality related to either conservative or interventional treatment. Imaging was useful in diagnosis and management of cases. Use of computed tomography and magnetic resonance imaging in evaluation of alimentary tract foreign bodies is discussed.

Computed tomography in the management of blunt thoracic trauma.

Computed tomographic (CT) scanning has proved to be valuable in evaluating the head and abdomen of victims of blunt trauma; CT scans of the thorax often are obtained on patients with blunt torso trauma, but their value for this purpose is unclear. We conducted a prospective study to evaluate the role of chest CT scanning in thoracic trauma. Hemodynamically stable patients at least 18 years old with an estimated Abbreviated Injury Scale--Thorax score of 2 or greater underwent a contrast-enhanced CT scan of the chest, usually in conjunction with CT scans of the head, abdomen, or both. Thirteen patients were dead on arrival, 14 required emergency surgical procedures, and 13 were too unstable to undergo chest CT scan. Thirty-three patients were not included because they refused to participate or the protocol was not followed. Forty-six men (69%) and 21 women with a mean age of 42.7 years completed the study. Sixty-one were injured in motor vehicle crashes, four were injured in falls, and one each was injured by assault and by crushing forces. Injury Severity Scores ranged from 4 to 45, with a mean of 20.5. Four patients died (6%), three from head injury and one from multiple organ dysfunction. Chest roentgenography (CXR) was superior to CT scanning in identifying rib fractures, but CT scanning was more sensitive than CXR for pneumothorax, fluid collections, and infiltrates (p < 0.001); CT scanning also was more specific for aortic injury. Despite this quantitative superiority, the abnormalities missed by CXR but identified by CT scanning infrequently led to a change in management.(ABSTRACT TRUNCATED AT 250 WORDS)

Thrombosis of the IVC and azygous continuation of IVC by bronchogenic cancer: CT and MRI appearance.

The authors describe the computed tomography (CT) and magnetic resonance imaging (MRI) findings in a patient with thrombosis of the inferior vena cava (IVC) and azygous continuation of the IVC caused by bronchogenic carcinoma. CT has been touted as the modality of choice for mediastinal evaluation. MRI is presently considered to be the initial modality of choice for mediastinal vessel evaluation. MRI is noninvasive, there is no radiation dose to the patient, multiplanar imaging can be done, and there is no need for iodinated contrast material. The satisfactory evaluation of an individual patient may require the use of MRI and CT in a complementary fashion.

Metastatic pineoblastoma via a ventriculoperitoneal shunt: CT demonstration.

We report the CT findings in a patient with pineoblastoma metastatic to the peritoneum via a VP shunt. A large, soft tissue tumor mass was revealed in the pelvis with associated peritoneal seeding and ascites. The initial intracranial tumor biopsy and later biopsy of metastatic peritoneal tumor demonstrated identical tissue diagnostic for pineoblastoma. Patients with intracranial malignant neoplasms and VP shunts will be followed during or after treatment with MRI brain scans. Periodic CT abdomen scans should be obtained to detect potential peritoneal metastases early to allow more effective treatment.

Severe hypertension associated with an intrarenal aneurysm.

A 26-year-old woman with regularly documented normal blood pressure had sudden onset of severe hypertension. Investigation revealed an intrarenal artery aneurysm involving the upper pole of the left kidney, as well as elevated levels of both renin and aldosterone. With ACE inhibitor therapy, blood pressure promptly returned to normal, and subsequent surgical removal of the upper pole of the involved kidney has resulted in normal blood pressure for 9 months of follow-up. Although uncommon, intrarenal aneurysms may lead to severe renal vascular hypertension that is relieved by surgery. This definitive procedure may not take place if one is not aware of the excellent response to ACE inhibitors in this situation.

CT of crack cocaine ingestion.

The imaging findings of a crack cocaine "body stuffer" are presented along with findings from in vitro experimentation with crack cocaine. It has been shown previously that contrast enhanced radiographic examinations can often outline the vessel in which ingested cocaine is contained; our work demonstrates that the crack cocaine itself may be visualized with CT performed without intravenous or oral contrast material. Due to the cost of CT, however, it is indicated only when clinically warranted to guide treatment. Positive identification of ingested crack cocaine by CT might prove helpful for both medical and legal indications.

Inferior vena cava interruption with renal vein collar continuation: CT and MRI appearance.

The CT and MRI appearance of an inferior vena cava (IVC) interruption with renal venous collar continuation is presented. CT and MRI identify and define venous anomalies without the need for invasive angiography. Knowledge of an anomalous IVC is important to the vascular and transplant surgeon as well as to the interventional radiologist.

Use of CT in metastatic adrenal gland tumor.

The autopsy findings and CT scans on patients with adrenal metastatic tumor over a six year period were analyzed. No pattern on CT was felt to be specific for metastatic tumor to the adrenal glands. Bilateral adrenal metastatic disease was found more common than unilateral disease by CT and by autopsy. All patients with adrenal metastatic disease had metastatic disease elsewhere. CT showed the other metastatic disease in approximately 90% of the cases. All our patients with follow-up scans showed change in the size of the tumor. CT remains the modality of choice for evaluation of the adrenal glands.