Faculty Bibliography

Cytomegalovirus is one of the more common opportunistic organisms implicated in the development of esophagitis in patients with AIDS. A review of the radiographic features of 16 proved cases of cytomegalovirus esophagitis showed a spectrum of abnormalities related to the severity of the inflammatory process. Seven patients had a mild form of esophagitis with segmental involvement characterized by granular mucosa, superficial erosions, and poorly defined, shallow ulcerations. Nine patients had more severe esophagitis with solitary or multiple deep ulcers and a background of normal mucosa. The deep ulcerations were oval in shape and varied in size. Some projected intraluminally and had a thin rim of radiolucency at the base. Short-term follow-up examinations showed progression of the disease in four patients, no change in one patient, and regression without specific therapy in one patient. Although these radiographic features are highly suggestive of cytomegalovirus esophagitis, the diagnosis requires histologic confirmation

The CT findings of 38 consecutive patients with acute appendicitis are analyzed, described, and illustrated. CT showed intraabdominal disease in 92% of patients and made a specific diagnosis of appendicitis in 79% of cases. The most common CT findings were pericecal inflammation (68%), abscess (55%), calcified appendicolith (23%), and an abnormal appendix (18%). CT had a sensitivity similar to that of contrast enema examinations, but it correlated much better with the surgical findings in detecting the precise nature, extent, and location of the disease process. Normal CT does not exclude appendicitis, since mild forms without periappendiceal disease may escape detection

Air insufflation of the colon as an adjunct to pelvic CT examinations was performed in 49 patients for evaluation of a known or suspected pelvic mass or in follow-up of treated pelvic tumors. This safe, simple method of colonic visualization clearly outlines the rectosigmoid colon and permits a reliable assessment of the mucosa, wall thickness, and extrinsic abnormalities, thereby improving diagnostic accuracy in staging pelvic malignancy and evaluating pelvic pathology

Forty-seven patients with sacroiliac joint abnormalities were examined with computed tomography and conventional complex-motion tomography. Twenty-nine patients had spondyloarthritis. Of the 29, complex-motion tomography detected bone erosions in 16 patients, whereas computed tomography revealed erosions in nine. Computed tomography was more sensitive in detection of joint narrowing, joint widening, osteosclerosis, and intraarticular bony ankylosis. In the remaining 13 patients, computed tomography was the modality of choice in detection of paraarticular soft tissue pathology, such as abscess or tumor, and in detection of the lesions involving the sacral canal and neural foramina

Computed tomographic examinations in 75 normal individuals are analyzed to define the cross-sectional anatomy of the diaphragm. Anatomic relationships among the inferoposterior portions of the lungs, the pleura, and the hemidiaphragms are clarified. The posterior pleural recess, an important potential space, is described and illustrated. The relationships of the crura, arcuate ligaments, and the hemidiaphragms are discussed as well. Awareness of these anatomic relationships forms an important basis in analyzing peridiaphragmatic fluid collections