Investigations of the incidence and the extent of the asymptomatic early stages of extracranial arterial disease (EAD) have been restricted for methodical reasons. Direct Continuous Wave-Doppler examination has given highly accurate results in the location and correct estimation of the degree of EAD both for the carotid (97%) and the vertebral arteries (90%), as shown from a detailed comparison with carotid (n = 604) and vertebral (n = 426) angiograms. Compared with this degree of reliability, the validity of normal auscultation for the diagnosis of EAD is shown to be poor: if bruits are taken as the only signs of associated EAD in patients with systemic atherosclerosis, only 27.6% in a group of 123 patients would have been correctly diagnosed. This parallels the number of false-positives (22.6%) in patients with normal results. The frequency and degree of EAD was studied by the use of direct Doppler examination in 2009 neurologically asymptomatic patients admitted either with severe vascular (n = 375) or coronary atherosclerosis (n = 262) or with high-risk factors (n = 1370). The frequency was significantly higher (32.8%) in patients with peripheral vascular disease than in those with coronary artery disease (6.8%) and in risk-factor patients (5.9%). The combination and degree of vessel involvement are presented in detail and their possible prognostic significance discussed.
The CT patterns of 295 glioblastomas examined with pre- and postcontrast scans using an EMI scanner Mark I (Matrix 160/160) have been reviewed and compared with the CT appearances of other brain tumors, metastases and abscesses. There is a great variety of CT patterns with glioblastomas. However, a garland-shaped CT appearance, representing a subgroup of ring-shaped lesions, seems to be most typical for glioblastomas since it was observed in 19% of ring-shaped glioblastomas but in only one out of 172 metastases and in no case of an astrocytoma grade II or an abscess in our series. The initial CT diagnosis, based on the CT finding, the patient's history and the clinical data, was correct in 69.8% of the glioblastomas, 41 recurrent glioblastomas included. In 12% of the cases the presence of a glioblastoma was within differential diagnosis. These results lead to the conclusion that in many cases additional diagnostic methods, such as serial scintigraphy and/or cerebral angiography, are required for a reliable differential diagnosis.
Computed tomography (CT) has given us a new method for examining the orbit and its contents. The technique of examination is described, and the indications for the application of computed tomography in ophthalmology are considered: suspected orbital tumors, unilateral exophthalmos, pareses of the ocular muscles, traumatic lesions and malformations in the region of the orbit. The findings in 210 cases of orbital lesions examined in this study are reported and the differential diagnosis is discussed. Considerable improvement and greater accuracy in diagnosis have been achieved in the field of ophthalmology by using computed tomography. Early tumor visualization is possible without risk or discomfort to the patient.
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