Four cases of congenital seminal vesicle anomalies were evaluated using computed tomography. Abnormalities ranged from complete absence of the seminal vesicle to solid and cystic enlargement. Three cases had ipsilateral renal agenesis. Seminal vesicle lesions are uncommon, but may be detected more commonly in the future with increased use of computed tomography, and should be considered when evaluating males with pelvic masses.
Twenty five patients with manifestations of cerebrovascular ischemic disease were evaluated with high resolution computed tomography of the neck, following intravenous infusion of a contrast agent. Computed tomography images of extracranial carotid arteries revealed atherosclerotic plaque formations and their complications: stenosis, occlusion, ulceration, calcification and mural lucent defects. Histologic analysis of 15 endarterectomy specimens obtained from symptomatic patients who had computed tomography images of discrete lucent defects in carotid plaques demonstrated subintimal hemorrhage of varying age in 13, focal necrosis in 1 and excessive subintimal thickening in 1. It is concluded that lucent images observed in computed tomography of extracranial carotid arteries represent vascular wall lesions within carotid plaques suggestive of subintimal hemorrhage, focal necrosis and/or excessive subintimal thickening. Computed tomography of the extracranial carotid arteries is a relatively non-invasive method that permits the diagnosis of plaque hemorrhages in symptomatic and asymptomatic carotid arteries.
Dynamic, rapid sequence, axial computed tomography (CT) was employed to evaluate the extracranial common and internal carotid arteries in 17 patients with clinical histories suggesting recent or remote ischemia in the territory supplied by the internal carotid artery. The CT findings were correlated with arteriographic observations and with gross and histologic evaluations of endarterectomy specimens. Areas of arterial wall thickening were evaluated on CT scans with regard to both degree of thickening and radiographic density (attenuation). The degree of vessel wall thickening secondary to atheromatous plaque demonstrated on CT scans corresponded closely to the severity of luminal compromise seen on arteriograms. Isodense or mildly hypodense focal mural thickening noted on CT scans of seven endarterectomy specimens proved to be primarily fibrotic (simple) atheromatous plaque on gross and histologic examination. Areas of markedly lucent focal mural thickening on CT scans of 11 specimens all demonstrated varying amounts of subintimal hemorrhage within loosely arranged and rather acellular (complex) atheromatous plaques on pathologic examination. While arteriography provides information regarding the status of the arterial lumen, CT offers the potential of accurate characterization of pathologic changes in the wall of the extracranial carotid arteries in patients with symptoms of cerebral ischemia.
Axial computed tomographic (CT) scans after intravenous contrast infusion were used to image the cervical carotid arteries of patients with cerebral ischemic symptoms. Standard transfemoral cervical carotid and cerebral angiography was the principal diagnostic modality used in all patients studied. The angiographic results were compared to the CT images and to the gross and microscopic endarterectomy pathological specimens, when available. Examples of the various types of abnormalities that can be visualized using CT scans are presented. The CT scan was useful for determining the presence of degenerative atheromatous changes including carotid artery calcification, subintimal hemorrhage, carotid occlusion, carotid segmental occlusion, and carotid pseudoocclusion, as well as carotid artery dissection. The scans were particularly useful for identification of atheromatous carotid artery disease when the carotid angiogram appeared nearly normal and for identifying the cause of postoperative carotid stenosis. CT scanning allows visualization of the carotid artery wall and lumen rather than just the lumen and, consequently, can sometimes add helpful information about the pathological processes affecting this artery.
It is important for the radiologist to understand the embryologic basis ofgenitourinary tract anomalies in order to recognize and assess correctly their radiologic manifestations.
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