Equivocal mammographic findings. A pictorial essay.
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Biomedical subjects
Publications and source records attributed to A F Govoni.
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We evaluated the image quality of mammograms made by using a new dual-screen, dual-emulsion film combination (Kodak Min-R Fast screen, T-Mat Mll film) that permits reduction of radiation exposure by approximately 50% when compared with a standard single-screen, single-emulsion film system (Kodak Min-R screen, OM-1 film). This new film has been improved when compared with earlier T-Mat M film, including the introduction of an inert dye to reduce light crossover to essentially 0%. Mammogram pairs made with the dual-emulsion film combination and the standard single-emulsion film combination were obtained in 50 patients otherwise undergoing routine mammography. The image pairs were randomized and evaluated by three radiologists who used a three-point scale (better, same, or worse). Each pair was evaluated with regard to parenchymal contrast, sharpness, and latitude, as well as the number and sharpness of calcifications (n = 19) and sharpness of masses (n = 12) when present. All three observers found the dual-emulsion film combination to be better than or the same as the standard with regard to parenchymal sharpness (94-100%), the number and sharpness of calcifications (98-100%), and sharpness of masses (100%). Two observers found the dual-emulsion film combination to be significantly worse (p less than .05) than the standard with respect to parenchymal contrast (72%, 86%), and all three observers rated it significantly worse for film latitude (14 to 42%). Our results suggest that this new dual-emulsion film combination that allows mammography to be performed with less radiation exposure can be used without loss of image quality.
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Three patients with the acquired immunodeficiency syndrome had biliary obstruction resulting from benign strictures of the biliary tract. Stenosis of the distal common bile duct with differing degrees of irregularity of the smaller intrahepatic and extrahepatic ducts was seen in association with either cryptosporidial or cytomegaloviral infection of the biliary tree. We review cytomegaloviral and cryptosporidial infections of the biliary system, as well as possible relationships with idiopathic primary sclerosing cholangitis. Stenotic biliary tract disease appears to be yet another complication of the acquired immunodeficiency syndrome.
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The radiological anatomy of the respiratory diaphragm is defined and its relationship with the contents of the thoracic and the abdominal cavity is reviewed with particular attention to the anatomo-topographic position of the gastroesophageal hiatus.
Further report on the importance of routine "water test" in the demonstration of an unsuspected gastroesophageal reflux and possible associated reflux esophagitis. Analysis based on 24,106 consecutive and unselected gastrointestinal tract examinations and description of the technique.
Ischemic colitis following conservative management of sigmoid volvulus is documented in four cases. Repeat barium enema studies in these patients showed characteristic "thumbprinting", transverse ridging, and mucosal ulcerations within a segment or the entire length of the sigmoid, lasting up to 7 days after nonoperative decompression. The development, extent, and severity of the ischemic changes seem to correlate with the degree of volvulus, blockage of venous and arterial circulation in the sigmoid mesocolon, and increased intraluminal pressure.