The computed tomographic appearances of 22 biopsy-proved supratentorial ependymomas were analyzed. Supratentorial ependymomas were usually intraparenchymal, larger than 4 cm, and cystic. Contrast enhancement was moderate to intense, with homogeneous or ring-enhancement patterns commonly seen. Intratumoral calcification was present in one-third of the cases, while hydrocephalus and peritumoral edema were seen in 50%. Intratumoral hemorrhage was not a characteristic of the lesion. In contrast to cellular ependymomas, malignant ependymomas and ependymoblastomas demonstrate higher attenuation prior to administration of contrast material, more intense enhancement, lower frequency of calcification within the tumor, and less distinct margination.

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To facilitate catheter entrance into the stomach during percutaneous gastrostomy, we sutured a balloon to a nasogastric tube and inflated the balloon in the stomach. The balloon provides support and firmness for the compliant stomach, and prevents the gastric wall from being pushed away by incoming needles and catheters. The balloon frequently becomes palpable in the left upper quadrant and offers a good target fluoroscopically or sonographically. Trocar catheters were easier to insert when the target balloon technique was used, and trocar puncture shortened procedure time. The technique initially was developed in the laboratory and then tested in cadavers. Presently it is used with patients. To date, no specific complications have occurred with this procedure.