The groin region is subdivided into two distinct anatomic areas: the inguinal canal and the femoral triangle. A series of cross-sectional imaging cases illustrate that a good understanding of the local anatomic characteristics of the groin allows confident characterization of groin pathologic conditions. Such conditions can be classified into five major groups: congenital abnormalities, noncongenital hernias, vascular conditions, infectious or inflammatory processes, and neoplasms. Congenital entities include hernias, cysts, undescended testis, and retractile testes. Ultrasound (US) is useful in depicting these conditions. In the second group, noncongenital hernias, US allows visualization of bowel loops in peristalsis within the hernia. Herniography, computed tomography (CT), and magnetic resonance (MR) imaging are also helpful in diagnosis. Among vascular conditions, false aneurysms may be detected from the turbulent flow through the tract at Doppler US. The characteristic venous flow of varicoceles is best diagnosed with US during the Valsalva maneuver. Infectious or inflammatory conditions include, among others, hematomas, which appear hyperattenuating at CT and have variable appearances, depending on the age of the blood products, at MR imaging. The origins of neoplasms may be assessed at CT and MR imaging, although appearances of solid tumors are relatively nonspecific.
Increased iron deposition is described in four children following severe ischemic-anoxic insult and subsequent resuscitation. All cases demonstrated on T2-weighted magnetic resonance images areas of hypointensity in the basal ganglia, thalami, and white matter that were attributed to iron deposition. Associated areas of hyperintensity were also seen in the periventricular and subcortical white matter, and these were attributed to gliosis. In one case calcium deposition was also present within the areas of hypointensity. These findings suggest that after anoxic-ischemic damage, normal axonal transportation of brain iron can no longer occur. This may lead to increased accumulation of iron centrally at the sites of iron uptake in the basal ganglia and in the white matter. Additional iron deposition may occur more rapidly due to direct injury by lipid peroxidation degradation products catalyzed by iron.
Recent research revealed impaired processing of both nonliteral meaning and affective prosody in adults with agenesis of the corpus callosum (ACC) and normal intelligence. Since normal children have incomplete myelination of the corpus callosum, it was hypothesized that paralanguage deficits in children with ACC would be less apparent relative to their peers. The Familiar and Novel Language Comprehension Test (FANL-C) and Prosody Test were given to 18 children with ACC and normal intelligence and 17 controls matched for age (7-13 years), education, and IQ (83-122). When controlling for age, children with ACC were significantly poorer in comprehension of the precise meaning of both literal and nonliteral items on the FANL-C. Adults with ACC had previously been shown to have difficulty only on nonliteral items. The effect size for nonliteral comprehension in children with ACC was smaller than that seen in adults. There was only a trend for the child ACC group to perform worse on the recognition of affective prosody. Thus, while deficits in paralinguistic processing were apparent, children with ACC were not as clearly different from age peers as adults, and were equally deficient at comprehending literal and nonliteral expressions. The differences in results between adults and children with ACC are thought to reflect incomplete callosal development in normal children, and the importance of the corpus callosum in the early stages of the development of the ability to process literal language.
Ten healthy subjects and 44 patients with diseases of the tongue or oropharynx were studied with magnetic resonance (MR) imaging. Axial, coronal, and sagittal images with a thickness of 4 mm were obtained with a pixel size of 0.75 X 0.75 mm on a 256 matrix. Nineteen of the patients underwent computed tomography (CT). Nine of those patients later had surgery, and the specimens were obtained for organ sectioning. These three studies as well as clinical history and physical examination findings were correlated. MR imaging was equal to or better than CT in those patients having both examinations. However, neither CT nor MR allowed recognition of histologic features or detection of microscopic spread of disease. Direct coronal and sagittal imaging planes on MR imaging allowed visualization of intrinsic tongue musculature, not possible with CT; this was important in recognizing subtle tumor extension. For these reasons, MR is the imaging method of choice for studying diseases of the tongue and oropharynx.
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