No abstract

A total of 116 consecutive obstetric ultrasound examinations were reviewed. An anechoic area was observed at the placental-endometrial junctionin all 54 fundal placentas, 51 of the 52 posterior placentas, and 9 of the 36 anterior placentas. Detail was enhanced by use of a focused transducer with digital gray-scale equipment, and visualization of anterior placentas was improved by placing a water bath between the transducer and the skin surface. The anechoic area was seen beginning in the twelfth week of gestation and corresponds best to the dilated vessels of the decidua basalis.

High-resolution 2-mm thick sequential CT scans of 23 patients with primary laryngeal carcinoma were reviewed to judge the value of CT in early tumor detection and the ability of CT to establish tumor extent reliably, particularly early cartilage invasion. False-negative results were likely when superficial lesions were confined to the true vocal cord mucosa. False-positive examinations occurred with vocal cord polyps and with acute and chronic granulomatous reaction of the vocal cords. In tumors large enough to be imaged, there were no false negatives. False-positive results for clearly identified tumors were related to the interpretation of tumor on CT where only edema was present at surgery. Both early and gross cartilage invasion were well correlated with surgically resected specimen sections. Early cartilage involvement by tumor can be detected by the development of a fenestrated chondral margin. Other benign expansive cartilage processes, such as occur with chondromas, have calcified cartilage fragment distributions that are out of proportion to any soft-tissue mass present.

The diagnostic value of plain film metrizamide myelography (PFMM) was compared with computed tomographic metrizamide myelography (CTMM) in a study of 106 individuals who had undergone high-resolution computed tomographic scanning of the spine. CTMM provided more significant information than PFMM in 42 of 106 cases (40%), but showed no advantage over PFMM in 63 of 106 cases (59%). In 19 of the 42 cases (45%), PFMM was useful in directing the CT analysis to the appropriate region of pathology. In one patient, PFMM revealed a mobile herniated disc that had not been visualized with CTMM. In 30 of 106 cases in which plain CT scans of the spine were also obtained, the addition of intrathecal metrizamide demonstrated additional pathology in ten individuals. In general, CTMM was useful in the delineation of a variety of pathologic entities, especially neoplasms and congenital abnormalities. Low-dose CTMM (3 ml of a 150 ml/mg concentration) was performed as an outpatient procedure and found to be a useful adjunct to plain CT in two patients. A schema for the radiological evaluation of pathology of the spine is presented.

A mammography screening program for breast cancer carried out in Sacramento by the University of California Davis School of Medicine, Davis, was canceled because of negative public reaction to sensationalized reports in the lay press on the potential carcinogenic risks of the radiation exposure, along with passivity on the part of the medical community in defending the procedure and the program. Disappointment in this occurrence spurred us to explore physician's knowledge of and attitudes toward breast cancer and mammography. The results confirmed our suspicions that a significant number of physicians lack accurate knowledge of breast cancer and of the extremely high benefit-to-risk ratio of mammography as a means of early detection.