Radiology

Rohlfing, Barbara M.; White, Eric A.; Webb, W. Richard; Goodman, Philip C.

doi: 10.1148/128.2.289pmid: 663232

Enlargement of hilar and mediastinal lymph nodes commonly accompanies a lung abcess. Of 27 patients with lung abscesses, 14 had hilar or mediastinal adenopathy or both. The problem resolved promptly with clearing of the abcesses and was absent on clinical and radiographic follow-up. Index terms Lungs, abscess, 60 .216 Lungs, cavitation, 60.282 Lungs, diseases Mediastinum (Mediastinum, lymphadenitis, 60.282) Copyrighted 1978 by the Radiological Society of North America, Inc.

Vix, Vernon A.

doi: 10.1148/128.2.295pmid: 663233

Calcifications within the lung may produce symptoms when they erode surrounding tissue and move. Lithoptysis, hemoptysis, or symptoms related to bronchial obstructions may occur. Under these circumstances, careful attention should be paid to evidence of movement of a calcific focus and its relationship to the bronchi. Six examples are described. Tomography and bronchography are useful. Histoplasma organisms can be demonstrated in most broncholiths in an endemic area. In other areas this entity is becoming unusual, probably because of the declining incidence of tuberculosis. Not all hilar or parenchymal calcifications are innocuous. Index terms Bronchi, abnormalities Bronchi, obstruction (Lung, calcification, 60 .810) Lungs, calcification (Trachea, bronchi, broncholith, 671.811)

Bonilla-Santiago, Jaime; Fill, William L.

doi: 10.1148/128.2.301pmid: 663234

Aspiration of sand and other foreign material is often discovered at autopsy in victims of drowning, but is not commonly seen radiographically. Two such cases are described, one of drowning and one of near drowning. In each case, the sand was radiopaque because of its calcium carbonate content and created a “sand bronchogram,” i.e., sand in the tracheobronchial tree. With early recognition, successful bronchoscopic removal of the aspirated sand is possible. Index terms Bronchi, obstruction Bronchoscopy Drowning Foreign bodies, in air and food passages (Lung, near drowning, 60.7115) (Trachea, bronchi, opaque foreign body, 6 71.461)

Gohel, Vijay K.; Edell, Steven L.; Laufer, Igor; Rhodes, W. H.

doi: 10.1148/128.2.303pmid: 663235

Fine transverse folds can be seen by double contrast technique in the human esophagus which are similar to those seen regularly in the feline esophagus. These folds are transient in nature and possibly represent contraction of the muscularis mucosae. This fold pattern can be seen in patients with gastroesophageal reflux and in those with no symptoms of esophageal disease. The marginal serration should not be mistaken for diffuse ulceration on barium filled views of the esophagus. Distortion or interruption of the normal fold pattern can be seen in patients with superficial ulceration due to reflux esophagitis or other invasive mucosal lesions. Although the pathophysiologic significance of this phenomenon is uncertain, the demonstration and recognition of these folds allows for better definition of mucosal surface abnormalities. Index terms Esophagus, mucosa Esophagus, diseases Esophagus, radiography (Esophagus, normal variant, 71.130 (Esophagus, anatomical detail, 71.920 (Esophagus, special contrast medium exam, 71. 1232)

Carsen, Gregory M.; Casarella, William J.; Spiegel, Richard M.

doi: 10.1148/128.2.309pmid: 307258

Five patients with Mallory-Weiss tears of the esophagus and massive uncontrolled upper gastrointestinal bleeding were treated by Gelfoam embolization of the left gastric artery. Four of the five required no further therapy. In one case permanent hemostasis was not achieved due to extension of the tear to branches of the inferior phrenic artery. Since Mallory-Weiss tears are usually self-healing, embolization is potentially the primary treatment modality. Surgery can be reserved for treatment of transmural perforation or recurrent bleeding. Index terms Embolization, therapeutic, 9.129 Esophagus, cardioesophageal junction Gastrointestinal tract, hemorrhage, 95.710 (Esophagus, Mallory-Weiss syndrome, 71.713)

Peterson, Gary H.; Miller, Roscoe E.

doi: 10.1148/128.2.315pmid: 663236

In a crossover study of more than 300 double contrast colon examinations, including 2,200 radiographs, many common and some uncommon views were taken and compared. An optimal series of “routine” films and the order in which they should be taken are presented. This will produce a complete colon examination in the most efficient way. Some technical considerations are presented which proved necessary to produce a superb examination. This new routine represents a reduction in the number of films advocated by Welin and Miller in earlier publications. The findings are compatible with both air contrast and full column techniques. Index terms Barium-enema examination, technique Colon, radiography (Colon, air contrast examination, 75.1282) (Colon, routine examination, 75.1281)

Goldstein, Steven J.; Crooks, David J. Mackenzie

doi: 10.1148/128.2.321pmid: 663237

Two new cases of Behçet's disease with colitis are presented and the radiographic features described. The changes in the colon resemble Crohn's disease more closely than ulcerative colitis but show some features which are distinct from both. One patient had perforation of a cecal ulcer and severe bleeding, stressing the serious nature of this form of colitis. Index terms Behçet's disease Colitis, granulomatous Intestines, diseases (Colon, other colitis, 75.269; Small intestine and colon, other enteritis or colitis, 78. 269) Intestines, hemorrhage

Goldman, Martin L.; Gonzalez, Antonio C.; Galambos, John T.; Gordon, Ira J.; Oen, Khee-Tiang

doi: 10.1148/128.2.325pmid: 307259

The transjugular technique facilitates various diagnostic and therapeutic procedures in the liver. Even in patients with defective hemostasis, severe ascites, or marked obesity, liver biopsy or cholangiography can be performed with relative safety. It also provides an alternative route for entry into the portal system. Index terms Cholangiography, technique, 7 6. 1226 (Liver, biliary system, other special technique, 76. 1229) Liver, biopsy Veins, jugular

Ring, Ernest J.; Oleaga, Juan A.; Freiman, David B.; Husted, James W.; Lunderquist, Anders

doi: 10.1148/128.2.333pmid: 663238

Percutaneous transhepatic catheterization of the biliary tree was performed in 23 patients. In 21 the catheter was advanced past an obstructing lesion into the distal common bile duct and duodenum to establish antegrade biliary drainage. The catheter was left permanently in place as a form of endoprosthesis in 5 patients. Index terms Bile ducts, obstruction Catheters and catheterization Cholangiography, technique (Liver, biliary system, percutaneous cholangiography, 76.1226)

Banner, Marc P.; Hassler, Randy

doi: 10.1148/128.2.339pmid: 663239

Vasoseminal vesiculography was performed on 69 asymptomatic men. Considerable variability in the appearance of the normal adult seminal tract was seen. On the left, the normal seminal vesicle averaged 4.6 cm long, 2.0 cm wide, and 0.6 cm in luminal diameter; on the right, it averaged 5.0 cm long, 2.0 cm wide, and 0.6 cm in luminal diameter. The normal ejaculatory duct averaged 16.0 mm long and 1.5 mm wide on the left and the same on the right. Criteria for normality are presented and the radiographic techniques reviewed. Index terms (Male genitalia, epididymography, seminal vesiculography, 84.1287) (Male genitalia, normal variant, 84. 130) (Seminal vesicle, anatomical detail, 845. 130) (Seminal vesicle, normal variant, 845. 130) Seminal vesicles