[Computerized tomography of the child's thorax. Clinical use]

The authors describe the use of Computed Tomography for the evaluation of pediatric patients, with a variety of chest diseases. Indications and technical factors are described according to the experience of the examinations done in the first 100 children studied in the Radiology Department of the Santa Maria Hospital.

Radiation therapy in the unresectable cavernous hemangioma of the liver

Hemangioma is the most common benign neoplasm of the liver, for which a 'wait and see' policy has been advised when it is small or without symptoms. Surgery is the treatment of choice of these tumors when marked symptomatology is present. However, some of these lesions cannot be excised due to their size, multiplicity, location or medical conditions. In these patients, radiotherapy has been reported to give good results with minor morbidity, suspending the tumor growth and decreasing the symptomatology. Seven symptomatic patients were treated with radiotherapy with a dose of 15-30 Gray in 15-22 fractions. Improvement of the quality of life was observed in all patients and the regression of the tumor volume was confirmed by computed tomography in five, with a follow-up ranging from 40 to 67 months.

[Neuroradiology in the physiopathologic diagnosis of subarachnoid hemorrhage--cerebral aneurysm]

The clinical importance of the cerebral aneurismatic lesion in well known. In Portugal we still do not have reliable statistics regarding the occurrence of the subarachnoid hemorrhage, however we can make a comparison through Kassel's and Drake's studies where they refer that annually 28,000 North-Americans suffer from subarachnoid hemorrhage attributed to the rupture of the cerebral aneurysm. This is a clinical situation that needs to be analyzed, more so because if it is not diagnosed and treated in time, it can cause a high level of morbidity and mortality. From 1984 to 1990, the authors studied 208 clinical cases of in-patients at the Santa Maria Hospital who had been diagnosed as having subarachnoid hemorrhage-cerebral aneurysm. They analyzed 172 cranium-encephalic Tomographies and 190 cerebral Angiographies. They found levels that overlapped the series already published with respect to the location of the lesion, dimensions and age groups involved. They tried to relate the presence aneurysm in the willis arterial circle with the occurrence of locoregional anatomic variants that were detected in 51% of the patients with aneurysm of the anterior communicating artery and in 33% of the cases in the posterior communicating artery. The high occurrence of serious forms of tomodensitrometric presentation should also be emphasized. As a matter of fact, 42.6% of the patients studied were grouped in degree IV of the Fisher Scale. This result translates the effort that is still required towards an early clinical and imaging diagnosis of warning hemorrhage to avoid or prevent a catastrophic hemorrhage recurrence.

[Complete interruption of the aortic arch in adults]

We describe a case of total interruption of the aortic arch (Steidele Complex) that survived without surgical operation and reached adulthood. The patient first presented with stroke. The diagnosis was made by cardiac catheterization. The presence of fixed pulmonary arterial hypertension excluded the possibility of surgical correction.

[Effectiveness of radiotherapy in non-resectable cavernous hemangioma of the liver]

In the management of the unresectable cavernous hemangioma of the liver, the Radiotherapy has an important role. This paper reports the experience of Radiotherapy department of Hospital Santa Maria. The authors review retrospectively the literature concerning techniques, results and complications of this therapy and analyse other possible attitudes in treatment of these lesions.