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A tumor originating in a lobus v. azygos is very seldom. We report here on a patient with a poorly differentiated adenocarcinoma of the lobus v. azygos which exhibits a very aggressive growth. Depending on the tumor localization, the metastasis is typical and can be recognized by computertomography (CT). In spite of the large number of treatment strategies, the prognosis is poor.

A patient with a carcinoma of the oral cavity, pleural empyema, persisting seropneumothorax, and suspected bronchopleural fistula underwent computed tomography for further evaluation. Volume acquisition using the spiral technique was the prerequisite for three-dimensional reconstruction, which was done by minimum intensity-projection and seed-based "volume of interest" segmentation. The diagnosis "bronchopleural fistula", which was displayed in its entire course, was confirmed.

Conventional radiological methods in the diagnosis of esophageal carcinoma include esophagography as well as chest radiography, the latter revealing pathological findings in advanced cases. Esophagography may be used for early diagnosis, tumor staging and for follow-up examinations after irradiation and/or surgery. In particular early tumor diagnosis requires a double contrast technique with an optimal mucosal coating and distension of the esophagus. The esophagogram reveals indirect signs related to the staging from the localization and length of the tumor and from ulcerations and fistulas. In the diagnosis of recurrent tumor after surgery, esophagography is not the primary diagnostic tool. After irradiation therapy, however, it can detect intramurally growing remaining or recurrent tumor.

Chronic pulmonary berylliosis presents both in computed tomography, including high resolution techniques, and in plain radiographs of the chest with unspecific results: subpleural micronodular changes, thickening of interlobular septa, occurrence of intralobular septa, traction bronchiectasis, and honeycombing. Conspicuous in high resolution expiratory scans are density inhomogeneities which are interpreted as expiratory obstructions in small airways with ventilation-perfusion mismatches that accompany respiratory partial insufficiency. A differentiation from other pneumoconioses or other interstitial pulmonary diseases is not possible. The significance of CT lies in the exact documentation of the localization and extent of the lesions and in evaluation.

The use of tailored acquisition spiral CT protocols together with standardized contrast medium injections result in a detailed visualization of the pulmonary arteries. Since spiral CT is a quick and noninvasive imaging modality, it is especially suited for severely ill patients suspected to be suffering from acute pulmonary embolism. In contrast to perfusion scintigraphy, spiral CT will directly visualize the emboli, and should be performed if scintigraphy is not conclusive before the patient is referred to angiography. In cases of chronic pulmonary embolism spiral CT will directly visualize thromboemboli, consecutive wall thickening, pulmonary infarctions, and relative hyperperfusion as well as signs of pulmonary arterial hypertension and right heart failure. Acquisition protocols, diagnostic criteria, and clinical value of spiral CT are presented.

Computed tomography (CT) is widely recognized as a part of the routine preoperative staging in patients with esophageal carcinoma. Applying a tailored technique, CT criteria of transmural growth and infiltration of adjacent structures are highly accurate for estimating resectability. The size-based assessment of mediastinal and abdominal lymph nodes is usually reported with low sensitivity and specificity. Spiral technology (spiral CT) increases image quality by a reduction of artifacts due to respiratory motion or cardiac pulsation, higher anatomic detail, and peak vascular opacification throughout the entire examination. Thus, an improvement of diagnostic accuracy in the staging of esophageal carcinoma can be expected. Its targeted application and a comparison with the conventional technique are presented.

The updated minimally invasive surgical methods used in chronic sinusitis require accurate and anatomically detailed preoperative diagnostics. Conventional x-rays cannot satisfy these increasing diagnostic requirement, since this method images a complex three-dimensional anatomy and pathology by means of a two-dimensional summation take. Both CT and MRI have a high resolution of contrast and site and assure visualization that is free from superimpositions. Both methods, however, differ from one another in respect to principles of technique and in characteristics; in this regard, the imaging of bone by MRI is always hypointense, which is a major drawback. Hence, for clarifying the identification of chronic sinusitides, in the diagnosis of suspected chronic sinusitis, CT is the method of choice. Besides the typical presentation of normal anatomy and anatomical variations, pathological findings are demonstrated.

Galeazzi's fracture represents the rather rare association of a fracture of the radial shaft with disruption of the distal radio-ulnar joint (13). The assessment of 19 galeazzi's fractures revealed the typical displacement of the distal radial fragment with a concomitant contraction in 7 and a lateral dislocation to the ulnar and/or volar side in 7 cases. The characteristic dorsal and/or lateral dislocation of the ulna following the disruption of the distal radio-ulnar joint was seen in 16 patients. Besides this dislocation additional radiographic signs of the rupture of the capsule and ligaments were a widening of the joint space of the distal radio-ulnar articulation shown on the ap-projection in 10, a pathological shortening of the radius or ulnae in 7 and the avulsion of the ulnar styloid process in 10 patients.

The confirmation of the diagnosis of intralobar pulmonary sequestration usually requires angiographic demonstration of the systemic arterial supply, and venous drainage. Magnetic resonance angiography (MR angiography) is a new, non-invasive imaging modality for examinations of the vasculature. In this report we describe its successful application in intralobar pulmonary sequestration demonstrating the feeding systemic artery, including its intrapulmonary branching, and the type of the venous return.