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Computed tomography (CT) was used to guide percutaneous fine-needle biopsy in 150 cases of difficult thoracic lesions; in 76 cases, nondiagnostic bronchoscopy (n = 62) and fluoroscopic biopsy (n = 14) had previously been performed. CT was indicated for guidance when the pulmonary or pleural lesions were small (0.3-2.5 cm); in a juxta-vascular location, either hilar or mediastinal; not seen or poorly visualized on conventional radiographs; or considered inaccessible. A diagnosis was made in 124 of 150 cases (82.7%) (107 of 124 malignant and 17 of 26 benign lesions), including 86 of 107 lung nodules (80.4%), 28 of 31 mediastinal lesions (90.3%), and ten of 12 pleural masses (83.3%). Complications included pneumothorax (n = 64), hemoptysis (n = 5), hemothorax (n = 2), and pericarditis (n = 1). The high rate of pneumothorax, its treatment, and advantages of its immediate radiologic management are discussed. Use of CT guidance considerably expands the scope of thoracic lesions amenable to percutaneous biopsy.

The discovery of isotopic anomalies in the calcium- and aluminum-rich inclusions of the Allende meteorite has improved our knowledge of the origin of the solar system. Inability to find more inclusions without destroying the meteorite has hampered further study. By using a fourth-generation computed tomographic scanner with modifications to the software only, the interior of heterogeneous materials such as Allende can be nondestructively probed. The regions of material with high and low atomic numbers are displayed quickly. The object can then be cut to obtain for analysis just the areas of interest.

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Previous observers have noted features of the radiographic appearance of cystic fibrosis in adults which differ from those in children, such as predominant involvement of the upper lobes [3] and lack of hypeninflation in a substantial proportion of cases [4]. This report presents observations on the radiographs of 50 adults with cystic fibrosis, describing the characteristic early and late mani festations of the disease, the findings indicative of airways disease, and the relation between these findings and the underlying pathology. Materialsand MethodsThe study populationconsisted of 50 patients with cystic fibrosis, documentedby repeated sweat test chloride > 60 mg/dl in a sample of at least 100 mg sweat, who had attended the University of California Medical Center since 1970 and had attained at least age17 yearsatthe timeoflast followup.Excludedwasoneradiographicallynormalpatient whocommittedsuicideat age 21.Routineradiographsmadeat full inspirationwerestudiedretrospectively. Initialgrading of abnormalitieswas by consensusbetweentwo of us (P. E. and P. J. F.), but as more materialwas added,the classificationwas revisedand films were regradedby one (P. J. F.). Subsequentlyall films were regraded by him and discrepanciesexamined by case review. The semiquantitative description of findings was based on the most recent available film in each case, except in one patient with a terminal pneumonia. Serial observations weremadeto determinethe progressionof findings:24 caseshad 1â€"¿ 4 yearsof followup,