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An anomalous position of the petrous portion of the right internal carotid artery was originally diagnosed as a glomus jugulare tumor. Carotid arteriography established the correct diagnosis. The computed tomographic findings of this anomaly are reported.

Some pseudotumours and pitfalls in computer tomography of the abdomen and the head are demonstrated. In abdominal CT the patient preparation is discussed.

A patient with a large renal cyst that became infected, after puncture, is reported. A very high LDH of the aspirate was highly suggestive of infection. CT showed air bubbles, a thick wall with little contrast enhancement, and low density content. CT alone cannot differentiate an infected cyst from an abscess necrotic tumor.

Unlabelled: Two hundred and thirteen patients with hypertension and renal artery stenosis were treated with percutaneous transluminal renal angioplasty (PTRA). The angiographic appearance was typical of atherosclerosis in 134 patients and of fibromuscular dysplasia (FMD) in 52 patients, and could not reliably be classified in one of these groups in 27. In these patients 272 renal artery stenoses were treated. In 81% of these patients the PTRA was technically successful. The antihypertensive result in this group of 210 patients was positive (cure or improvement) in 80%. The life-table results after 5 years show cure or improvement in the atherosclerotic group (n = 35) in 80.27%, in the FMD group (n = 20) in 88.83% and in the unclassified group (n = 10) in 74.27%. One patient died from a mesenteric thrombosis and one from a myocardial infarction which both occurred within a few days after PTRA. Accordingly, the mortality was less than 1%., In Conclusion: PTRA appears to be a good treatment of renovascular hypertension caused by atherosclerosis or FMD, with good long-term antihypertensive effects.

To determine whether the varicocele results from collateral circulation partially replacing an obstructed left renal vein, we developed a scintigraphic technique that provides not only information about the velocity of retrograde flow in the testicular veins but also quantitative information about the size of the varicocele. The reliability of this method was assessed by comparison with the results of phlebography and the clinical diagnosis in 104 patients. Furthermore, the diameter of the left testicular vein was determined on the phlebogram. Good correlation was found among the velocity of the retrograde flow in the left testicular vein, the size of the varicocele and the diameter of the left testicular vein.

Left renal vein compression occurring mainly with the patient in the upright position, and being less severe or absent in the supine position, was considered to be the main cause of varicoceles. We show that left renal vein compression is, indeed, more severe with the patient in the upright than in the supine position and that it produces a left renocaval pressure gradient that is responsible for the retrograde blood flow in the left testicular vein. This pressure gradient, which was determined in the supine and semierect positions in 34 patients, increased from a mean of 3.8 mm. Hg in the supine position to a mean of 7.8 mm. Hg in the semierect position. On the basis of the assumption that the renocaval pressure gradient measured with the patient in the semierect position determines the presence and velocity of a retrograde flow in the left testicular vein, as shown by the dynamic portion of the varicocele scintigram (see part I), these variables were analyzed and the correlation coefficient proved to be good. Therefore, we conclude that the varicocele occurs when the left testicular vein lacks valves or there is a renogonadal bypass, and the severity of the left renal vein compression in the (semi) upright position determines the velocity of the retrograde flow in the left testicular vein and the size of the varicocele.

A collection of pseudomasses and pitfalls in abdominal ultrasound are reviewed. This article discusses the way in which to avoid misinterpretation in these cases. Some anatomical variations and accidental configurations are mentioned.

Percutaneous transluminal laser recanalization was attempted in 21 patients with occluded superficial femoral arteries and 'life style limiting claudication'. Primary success was achieved in 20 (95%) of these total occlusions. In 7/21 no laser energy was required. At one month only 1 patient had claudication and the mean Doppler ankle/arm systolic pressure ratio had increased by 0.36 +/- 0.19 (p less than 0.001) at rest and 0.47 +/- 0.34 (p less than 0.001) after exercise. Complications directly attributable to the procedure were: perforation (1), peripheral embolic episodes (2), haematoma (1), transient vasospasm (2). All complications could be treated non-surgically. These preliminary data suggest that laser recanalization of relatively short occlusions of the superficial femoral artery, followed by balloon dilatation, may be accomplished with satisfactory acute and short-term results, but not without risk.