[en] Computerized tomography of the trunc of the body, which has required a certain time to mature, has now become about as important as computerized tomography of the brain. The aim of the symposium on computerized tomography held in Graz in October 1978, and of this book published as a result of it, has been to point out the position currently occupied by computerized tomography in radiology and clinic and to discuss its value in the most different spheres of application. The enourmous pace at which computerized tomography has developed further in the last two years shows how important it is to make an updated assessment of the value of a new investigation procedure. This will enable also the colleagues who are not working in this special field to recognize what this method can do and what its limitations are. 50 contributions. (orig./AJ)

[en] Until now cerebral blood volume estimations have been made using dye dilution methods, by labelling the red cells with Cr⁵¹, Tc⁹⁹, or I¹³¹, or using radiofluorescence or from regional cerebral blood flow. A new method of measurement of rCBV will be described which employs contrast medium and computer tomography. A scan before the intravenous introduction of contrast medium is subtracted from the scan following, using a second computer. At the same time during the scans measurements are made of the contrast medium level in the blood, the haematocrit and the capillary PCO₂ tension. From the subtraction picture which represents the density change in the vascular compartment due to the contrast medium, and knowing the plasma contrast medium level, the regional plasma volume can be calculated. Hence, taking the haematorcrit into account, the regional blood volume can be estimated. The greatest advantage of the subtraction method of measuring rCBV is that it is non-invasive. Also the three dimensional information is better and the definition more exact than in other methods making possible estimations of rCBV in definite anatomical areas so that for the first time CBV can be assessed in the basal ganglion. In addition changes in rCBV with hyperventilation can be measured. (orig./VJ)

[en] The typical computer tomographic signs of ischaemic cerebral infarct are discussed on the basis of 631 cases. Infarcts have three typical stages. Stage I, one week, fresh infarct with signs of oedema (space-occupying lesion with an unsharp margin, slightly reduced density, lack of contrast uptake). Stage II, second to fourth week, reduction in the oedema. Frequently very marked contrast enhancement of the cortex and basal nuclei. Stage III, later than four weeks. Development of malacic cysts, with further reduction in density and size. Development of homolateral atrophy. The computer tomographic diagnosis of cerebral infarcts during Stage I is often very difficult. Distinction from infiltrating tumour is often possible only after further observation. The diagnosis of cerebral infarcts in stages II and III is possible in most cases. Haemorrhagic cerebral infarcts do not follow a temporal pattern as accurately as anaemic infarcts. They show circular increase in contrast of slowly diminishing size. The increased contrast persits considerably longer and is clearly distinguished from that in an anaemic cerebral infarct. (orig.)

No abstract available

[en] Idiopathic Parkinson's disease (PD) is the most common neuro degenerative disorder. An important step in diagnosing the disease has been achieved with the development of the cocaine derivative [¹²³I] β-CIT for single photon emission computed tomography (SPECT). The aim of this study was to demonstrate the disease progression by repeated measuring presynaptic dopamine transporter density and relating it to clinical data. The presynaptic dopamine, transporter density of 15 PD patients was measured two times with a mean interval of 15 months. All patients were clinically assessed at the time of the experiments according to the classification scheme of Hoehn and Yahr. 11 healthy volunteers were used as a control group. [¹²³I] β-CIT was injected intravenously and measured with a triple-headed camera twenty hours later. The pictures were evaluated semi quantitatively by using the ratio of specific to non-displaceable binding. Presynaptic dopamine transporter density differed significantly between controls and PD patients. A significant correlation between imaging data and clinical stages (H/Y I 27 %, H/Y II -40 %, H/Y III 58 %) was observed for the patient group in the initial experiment. The subsequent decrease of dopamine transporter binding depended on the initial clinical stage (H/Y I -6.81 %; H/Y II -6.05 %; H/Y III -1.25 %) of the patients, and regression analysis revealed that. 91.4 % of the variance of the second measurement were predicted by the initial measurement. No correlations were found for age, gender and disease progression. All patients were treated with L-DOPA and those given a higher dose showed a more rapid decrease of dopamine transporter density. This result could be interpreted as an indication for in vivo neurotoxicity of high concentrations of L-DOPA. We conclude that combining [¹²³I] β-CIT with SPECT imaging is not only a powerful tool for diagnosing PD patients, but may also be used to demonstrate neuro degeneration in vivo. (author)

[en] 208 patients with epilepsy were investigated by computertomography (Emil Scanner CT 1010 and CT 5005). In 173 patients with generalised epilepsy 87 had a normal scan, 51 revealed a definitive diagnosis and 37 showed generalised atrophy. Of the 35 patients with partial seizures a definitive diagnosis was possible in 22; representing a higher proportion than the group with generalised seizures. A definitive diagnosis from the CT Scan was significantly more common in both patients with generalised and partial seizures when pathological neurological findings were also present. Symptomatic epilepsy was only significantly commoner in Dementia patients with generalised seizures. A significantly higher proportion of patients over 30 years old demonstrated a symptomatic epilepsy than those under 30 yaers of age. (orig.)

[en] 88 patients in primary subarachnoidal haemorrhage are evaluated with CT and partly with cerebral angiography. The CT shows the successions of the haemorrhage and ischemia, and partly the existence of aneurysms. For preoperative clarification, angiography is necessary. (orig.)

[en] 135 patients were examined by CT who had been clinically diagnosed as multiple sclerosis cases. The average disease period was 4.5 years. Atrophy was seen in 40.7% and normal findings in 48.9% of the patients. Hypodense lesions were found in 22.2% of the cases, 28.4% of the hypodense foci being of periventricular location. Normal findings became less frequent, the longer the disease period, whereas the incidence of atrophy increased. In 23.3% of the patients with defined lesions a contrast enhancement was seen after contrast medium application. This contrast behaviour was found exclusively during the acute phase of the disease. With increasing disease period there was no increase in the incidence of hypodense lesions. (orig.)

[en] Regional cerebral blood volume (rCBV) was measured in 14 patients with normal CT scans. An EMI CT 1010 scanner was used in combination with a computer subtraction technique. The mean CBV in the cortex was 5.0 ml/100 ml of tissue and 2.2 in the white matter. Regional differences were not significant and no difference was found between the right and left hemispheres. (author)

[en] It is seen at the results presented that in a high percentage of the patients suffering from posttraumatic epilepsia whom we examined pathological computertomographical and EEG-findings had to be compiled at the time of the examination. There was a discrepancy between this and the neurological findings, but in 80% of the cases, the pathological computer-tomographical and the EEG-findings were correspondent. These findings coincide with the results obtained by other examiners (Scollo-Lavizzari et al. 1976; Wessely et al. 1978). In our cases, the cause for the pathological findings consisted in covered craniocerebral traumata; in only 18% of the patients severe injuries such as durapenetrating traumata and sub- or epidural bleedings respectively were existent. In the case of computer-tomography, however, especially if the examination takes place only in the chronic stage, years after the trauma, problems occur in the causal classification of various lesion patterns. The typical focus of contusion - especially in connection with a one-sided ventricle extraction and expansion - can be easily classified ethiologically (Lanksch et al. 1978), as was the case in 38 of our patients. A hypodense region in the cerebral medulla or an atrophy afflicting the ventricle regularly cannot be placed in a traumatic etiology because of the individual computer-tomographical finding; under certain circumstances, however, an atrophy can be observed coming into existence on the development of an oedema to a defect in the substance by slow demacation can be seen. (orig.)