In order to determine the prevalence and severity of hepatic osteodystrophy by noninvasive means we compared 115 consecutive ambulant patients with histologically proven chronic liver disease to 113 age and sex matched control subjects. Methods used included the assessment offracture prevalence rates, spinal radiography, and measurements of bone mineral density in the spine and the forearm. Spinal and peripheral fractures were more prevalent in the patients than in the control subjects (p<003 and p<001 respectively).

The accuracy of duplex studies compared with angiography in the assessment of extracranial vascular disease depends on the method of angiographic determination of carotid stenosis. Vascular laboratories should validate the duplex criteria they use against a standard method of angiographic assessment of carotid artery stenosis, with special reference to the recently reported studies noting the significance of a stenosis greater than 70% in patients with symptoms.

Cholesterol granuloma and cholesteatoma are the two most common destructive lesions of the petrous apex. Arachnoid cyst is less common. These three expansile lesions are often indistinguishable on clinical grounds. Cholesterol granulomas can be treated effectively through internal drainage into the mastoid cavity or middle ear. Cholesteatomas, however, are managed by more aggressive and complicated removal, which often mandates the sacrifice of hearing. Symptomatic arachnoid cysts are amenable to simple surgical drainage. Therefore, accurate preoperative recognition on computed tomography (CT) and magnetic resonance imaging (MRI) is important in planning proper treatment. Thirteen cases of destructive lesions of the petrous apex are analyzed. The authors' experience illustrates that the "typical" CT and MRI radiographic features are diagnostic in some cases, but not in all. In this study the pathologic findings have been correlated with the radiologic features on both MRI and CT.

Acoustic neuromata (AN) account for nearly 90 per cent of internal auditory canal (IAC) and cerebello-pontine angle (CPA) tumours. The second most common tumour is meningioma. Rare lesions include primary cholesteatoma, facial neuroma, lipoma, angioma and various cysts.Two cases of IAC tumour are presented, one of hamartoma in which smooth muscle was prominent and the other of lymphangioma. Of interest are the specific clinical and radiological features associated with these lesions.

After injection of Gd-EOB-DTPA, T1 and T2 were determined on a clinical MR scanner (1.5 T) in the liver and kidneys of sacrificed but intact guinea pigs with normal and obstructed biliary systems and in bile, urine, and blood collected postmortem. Tissue [Gd] was determined by radioassay of 153Gd and relaxivities (R1 and R2; units of s(-1) x mmol(-1) x kg) of Gd-EOB-DTPA calculated. Compared with R1 in 2% agarose gel (4.49 +/- 0.03), in normal animals R1 was increased in liver (9.3 +/- 0.5), similar in kidney cortex (4.1 +/- 0.5), but reduced in kidney medulla (2.5 +/- 0.4) and papilla (2.7 +/- 0.4). Chronic biliary obstruction did not change R1 in liver (9.7 +/- 4.3) but reduced R1 further in kidney tissues (1.0-0.4). In normal animals, R2 values of all tissues (9.5-18.4) were greater than R2 in gel (5.72 +/- 0.12). Biliary obstruction possibly elevated R2 in liver (40.1 +/- 63.5), severely depressed R2 in kidney cortex (-4.2 +/- 6.2) and medulla (-2.3 +/- 5.4), and reduced R2 in papilla (5.4 +/- 4.6). Obstruction had little effect on R1 and R2 in bile and urine. Water content, macromolecular binding, microviscosity, compartmentalization, and susceptibility effects can readily account for the R1 and R2 observed in liver and kidney. Negative R2 could be a result of several factors, including reduced endogenous magnetic field gradients due to "susceptibility matching" as [Gd] increased, changes in tissue T2 with period of ligation, or a physiological effect of EOB-DTPA. These results show that disease can alter both R1 and R2 from their values in normal tissues.