The Journal of computed tomography
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Case Reports
Fibrobullous disease of the upper lobes: an extraskeletal manifestation of ankylosing spondylitis.
Fibrobullous disease of the upper lobes of the lungs is a rare extraskeletal manifestation of ankylosing spondylitis, occurring in 1.3% of patients with ankylosing spondylitis. We present a patient with this disease, and discuss this pulmonary manifestation. Because the radiographic appearance of the chest in this disease resembles that in tuberculosis, many patients are misdiagnosed and treated for tuberculosis despite negative bacteriology. Computed tomography is useful in delineating the extent of pleural thickening, bullous changes, volume loss, parenchymal fibrosis, and bronchiectasis, as well as identifying or excluding an intracavitary pulmonary mycetoma.
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Comparative Study
The diagnostic significance of posttraumatic sphenoid sinus effusions: correlation with head computed tomography.
In review of 1544 patients with both head computed tomography (CT) examinations and skull radiographs, 150 patients were found to have a history of acute head trauma. Twenty-nine of these patients had sphenoid sinus effusions. ⋯ Of the patients with sphenoid effusions, 31% (9/29) had intracerebral hematomas, 24% (7/29) had extracerebral hematomas, 13% (4/29) had pneumocephalus, and 13% (4/29) had cerebral edema. We conclude that the presence of posttraumatic sphenoid sinus effusion on the skull radiograph is a sensitive sign for intracranial damage and serves as an emergent indication for head CT.
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A solitary pulmonary nodule was shown by dynamic computed tomography to be vascular, to be enhanced during the pulmonary venous phase, and to be in continuity with the left inferior pulmonary vein. The diagnosis of pulmonary varix was confirmed by pulmonary angiography, an invasive procedure that can be avoided in the future.
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A report of the demonstration of an asymptomatic intracardiac osteogenic sarcoma metastasis by computed tomography. This metastasis was successfully excised along with associated pulmonary metastases. Intensive chemotherapy and aggressive surgical excision of metastatic osteosarcoma lesions have resulted n 40%-60% long-term survival in these patients.