Forty-two patients with laryngeal carcinomas were examined with computed tomography (CT) and magnetic resonance (MR) imaging. The accuracy of both CT and MR imaging in the depiction of cartilage invasion was evaluated in 16 patients by comparing findings at CT and MR with pathologic findings. Calcified cartilage that has been invaded by cancer is frequently seen on CT scans as having an intact contour. Tumor approaching nonossified cartilage may simulate cartilage invasion. On T1-weighted MR images, invaded marrow of ossified cartilage is of intermediate signal intensity, allowing it to be differentiated from normal bone marrow. On proton-density images, tumor is of increased signal intensity, which allows it to be differentiated from nonossified cartilage. In our experience, the specificities of CT and MR imaging were approximately equal (91% and 88%, respectively), but CT had a considerably lower sensitivity than MR (46% vs. 89%). Gross movement artifacts, which resulted in nondiagnostic images, occurred in 16% of the MR examinations. MR imaging is recommended as the modality of choice in the diagnosis of cartilage invasion.

A case of neurocutaneous melanosis developing a leptomeningeal melanoma is described in a ten year old girl in whom an intraspinal lipoma had been resected seven years earlier. Standard and CT myelographic findings are described and the complementary role of Gadolinium-enhanced MRI is discussed. The literature is reviewed and the association of a lipoma and neurocutaneous melanosis has not been encountered.

Debate about the lesion site in the Miller Fisher syndrome is still going on. We studied a patient with features of the Miller Fisher syndrome in whom arguments for both central and peripheral nervous system dysfunction were found.

The authors report on five cases of septic sinus thrombosis occurring as early complications and/or long-term complications of infections in the head and neck region. The necessity for early diagnosis of this condition by high-resolution CT scanning is emphasized, as it provides a reliable diagnostic tool to evaluate this serious intracranial disease at a relatively early stage, provided an intravenous contrast medium is used. Although MRI represents an interesting new technique in the assessment of intracranial pathology, it cannot be routinely carried out during the acute phase of this condition due to metal life-support systems near the patient.

Computed tomography permits reliable demonstration of the spinal canal and its contents. Measurements of the sagittal diameter of the bony canal do not take into consideration size, shape and state of intraspinal soft tissue structures, i.e. the thecal sac and its own contents, epidural fat and blood circulation pattern. Three particularly illustrative cases were selected in which obvious epidural venous engorgement was visualized in association with spinal stenosis. The authors think that epidural venous stasis occurring in segmental spinal stenosis is a CT sign of clinically significant narrowing of the neural canal. Accurate recognition of the type of lumbar stenosis together with epidural blood flow alterations permits a better understanding of the existing lesions. Thus, a more precise and specific surgical approach is possible.