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Biomedical subjects

B G Coleman

Publications and source records attributed to B G Coleman.

At least 37 records · Page 2Linked to original sources
PubMed1989

Hepatic and biliary tract abnormalities in patients with AIDS. Sonographic-pathologic correlation.

A retrospective evaluation of hepatobiliary sonograms in 22 patients with AIDS was performed and the sonographic abnormalities were correlated with pathologic findings in 10 patients. Hepatic parenchymal abnormalities noted on ultrasound include a hyperechoic parenchymal echo pattern in 45.5%, hepatomegaly in 41%, and focal masses in 9% of patients. Etiologies for the diffuse hyperechoic pattern based on pathologic correlation in eight cases were hepatic steatosis and granulomatous hepatitis. Biliary tract abnormalities identified included gallbladder wall thickening in 55% of patients, dilated gallbladder in 18%, biliary sludge in 23%, and gallstones in 5% of patients. Extrahepatic ductal dilation was seen in 23% of patients, but the intrahepatic ducts were dilated in only 5% of patients. Possible etiologies for biliary tract abnormalities suggested by pathologic correlation in five patients and literature review were cytomegalovirus and cryptosporidial infection, although constitutional factors may have played a role. Hepatobiliary ultrasound is, therefore, an effective screening tool for directing further diagnostic and therapeutic procedures in AIDS patients presenting with clinical evidence of hepatobiliary dysfunction.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Hyperdense pelvic and inguinal lymph nodes.

This small series reports on the computed tomography appearance of hyperdense iliac, inguinal, and femoral lymph nodes in four cases of lymphoma and one case each of ovarian and breast carcinoma. The mean attenuation value of the lymph nodes was 93.8 Hounsfield units (HU), compared to 61 HU for adjacent muscle and 110.7 HU for blood vessels. A relatively homogeneous enhancement pattern was noted, which could not be directly related to hypervascularity, inflammation, or previous treatment with drugs or radiation.

Adult↗
PubMed1988

Radiographically negative avascular necrosis: detection with MR imaging.

To correlate the morphologic appearance on magnetic resonance (MR) images of radiographically negative avascular necrosis (AVN) of the femoral head with that on computed tomographic (CT) and radionuclide scans, the radiographic and clinical records of 24 patients were reviewed retrospectively. In 18 patients the MR signal intensity features were monitored by means of serial imaging. All MR studies included T1-weighted (short repetition time [TR], short echo delay time [TE] ) imaging and T2-weighted imaging (long TR, long TE). Thirty-one hips were determined with MR to be involved by AVN; 27 were staged on the basis of signal intensity characteristics within the low-intensity rim. Core decompression was performed on 18 hips. Afterward, progression of disease occurred in only one hip. Fourteen of the 16 asymptomatic patients (88%) had early-stage focal lesions. CT scans were obtained in 15 patients and radionuclide scans in 21. Ten hips at radionuclide imaging and five at CT appeared normal when MR results were distinctly abnormal. MR can depict early radiographically negative AVN in asymptomatic individuals. At this early stage, the lesions in this series appear to be nonprogressive after treatment.

Adult↗
PubMed1988

Transvaginal and transabdominal sonography: prospective comparison.

Transvaginal (TV) and transabdominal (TA) sonography were compared in a prospective study. A total of 230 examinations (126 pelvic, 104 pregnancy) were performed on 215 patients, ranging in age from 14 to 80 years. The improved anatomic detail on TV scans yielded new information in 138 (60%) examinations and better visualization of pelvic structures in 51 (22%) examinations. There was no important difference in diagnostic information provided by the two imaging modalities in 36 (16%) cases, and TV images were worse in five (2%). The clinical diagnosis was altered on the basis of TV sonographic findings in 54 (24%) cases and confirmed with certainty in 166 (72%). Diagnostic problems posed by TA scanning were not resolved by TV scanning in ten (4%) instances. Statistical analysis indicated that TV scanning was significantly better than TA scanning in the visualization of gestational sac contents (P less than .005), detection of fetal heart motion (P less than .001), and evaluation of the endometrial canal in the retroverted or retroflexed uterus (P less than .001). TV scanning was significantly better than TA scanning in visualization of the ovaries in patients with uterine leiomyomas (P less than .005) but not significantly better in peri- and postmenopausal patients (P greater than .05).

Adult↗
PubMed1988

Renal allografts: prospective analysis of Doppler sonography.

Fifty-six consecutively transplanted renal allografts were prospectively evaluated with serial Doppler sonographic examinations. Thirty-eight episodes of transplant rejection in 32 patients (63% proved pathologically) and 24 episodes of acute tubular necrosis (ATN) in 24 patients were encountered. The Doppler spectral waveform was characterized by means of the pulsatility index (PI), systolic/diastolic ratio (SDR), diastolic/systolic ratio (SDR), diastolic/systolic ratio (DSR), and resistive index (RI). Accuracy was optimized with use of top normal values as follows: PI = 1.8, SDR = 4.0, DSR = 0.25, RI = 0.75. There were no significant differences in the indices for those patients undergoing rejection versus those with ATN. The sensitivity for predicting transplant rejection was adversely affected by the history of either ATN or a previous rejection episode in the same allograft. Comparison with concurrent radionuclide examinations revealed similar sensitivities for rejection with scintigraphy and sonography. Differentiation of ATN from rejection was more reliable with scintigraphy than with sonography.

Acute Kidney Injury↗
PubMed1987

Ultrasonic anatomy of hepatic veins.

Whereas the portal veins and hepatic arteries supply the right and left lobes of the liver, the hepatic veins pass along the boundaries between the lobes and segments. Their positions can therefore be used to identify liver segments and allow a precise description of the position of focal lesions. In 104 subjects without liver pathology, the hepatic veins were demonstrated in 101 and followed the classical pattern in 87. Absent and accessory veins were encountered.

Hepatic Veins↗
PubMed1987

Kidney changes after extracorporeal shock wave lithotripsy: CT evaluation.

Computed tomography (CT) was performed in 50 patients before and after extracorporeal shock wave lithotripsy (ESWL) to determine the effects of ESWL on the kidney and perinephric tissues. Bilateral treatments were performed in three patients. Post-ESWL scans demonstrated subcapsular hematomas in eight (15%) patients (two large, six small, none symptomatic) and intrarenal hematomas in two (4%) patients. In three (6%) patients small subcapsular fluid collections of uncertain cause were seen. Treated kidneys showed a statistically significant mean increase in size (9%) after ESWL, as measured at the axial level of the major stone fragment. Perinephric soft-tissue stranding and fascial thickening were seen in 37 (70%) of 53 treated renal fossae, with the changes ranging from mild to severe. The authors conclude that while most patients undergoing ESWL will show some posttreatment abnormality on CT scans, the procedure appears to be associated with a low frequency of serious renal trauma.

Adult↗
PubMed1987

Adnexal masses: MR imaging observations at 1.5 T, with US and CT correlation.

To assess the role of 1.5-T magnetic resonance (MR) imaging in evaluation of the adnexa, 43 consecutive examinations that revealed 61 adnexal masses were retrospectively reviewed. T1- and T2-weighted images in coronal, axial, and/or sagittal planes were included. Available ultrasound (US) (n = 30) and/or computed tomographic (CT) (n = 9) scans were then correlated with the MR images. On T2-weighted images at least part of all adnexal masses was of higher signal intensity than surrounding muscle and adipose tissue, and therefore the adnexal masses were best seen with these sequences. T1-weighted imaging improved tissue characterization by revealing signal characteristics of fat in teratomas and characteristics of blood in endometriomas or hemorrhagic cysts, pelvic inflammatory disease, ovarian carcinomas, serous cystadenomas, and teratomas. MR imaging provided additional information or increased diagnostic confidence in 25 of 30 patients who underwent US or CT. MR imaging is a promising problem-solving modality after US in the study of adnexal abnormalities.

Adenoma↗
PubMed1987

Effects of maternal hydration on fetal renal pyelectasis.

Fetal renal pyelectasis is a frequent finding on routine obstetrical sonography. The cause of this pelvocalyceal dilatation is often not apparent, although urinary tract obstruction is the most important condition to be excluded. One of the many hypothetical explanations for minimal fetal renal pyelectasis suggests that aggressive maternal hydration before sonography leads to fetal diuresis with resultant pelvocalyceal dilatation. In this study, 20 pregnant volunteers underwent sonography after 10-12 hours of dehydration, after which 1,000 ml of fluid was administered and repeat sonography was performed. Despite a significant increase in the state of maternal hydration as determined by a decrease in urine specific gravity, there was no significant change in the degree of fetal renal pyelectasis before and after hydration. Therefore, pelvocalyceal dilatation identified prenatally should not be attributed to maternal hydration.

Drinking↗
PubMed1987

Leiomyomas in pregnancy: sonographic study.

With ultrasound monitoring, analysis of the behavior of uterine leiomyomas (fibroids) and their impact on the course of pregnancy was undertaken in a group of 113 patients. Fibroid size changes were analyzed on the basis of trimesters. In the second trimester, smaller fibroids increased in size, whereas larger fibroids decreased in size. In the third trimester, a decrease in size was documented regardless of initial size. The most common patterns of echotexture were hypoechoic, heterogeneous, and echogenic rim. The development of a heterogeneous pattern or anechoic/cystic spaces on a follow-up study was accompanied in seven of ten patients by severe abdominal pain, compared with 12 cases of abdominal pain in 103 patients without such echotexture changes. Although the number of patients was small, the development of these patterns apparently indicates significant degeneration of the fibroid. Fibroids located in the lower uterine segment were accompanied by a higher frequency of cesarean section and retained placenta. Fibroids located in the uterine corpus were more frequently associated with early abortions. Multiple fibroids were accompanied by a higher frequency of malpresentation and premature contractions compared with cases with one or two fibroids.

Adult↗
PubMed1987

Twin gestations: monitoring of complications and anomalies with US.

An evaluation of 227 consecutive twin gestations was undertaken to assess the role of ultrasound (US) in the diagnosis of major obstetric complications and congenital anomalies. US accurately depicted the growth and development of fetuses in 65 patients with underlying maternal disorders that produced additional risks to the pregnancy. Complications such as malpresentations (104 cases), polyhydramnios (15 cases), oligohydramnios (five cases), and uterine myomas (seven of 11 cases) were demonstrated prenatally with US. Fetal anomalies included anencephaly (two cases), hydrocephalus (two cases), conjoined twins (three cases), twin-twin transfusion syndrome (five cases), and acardiac monsters (two cases). Demise of one twin in 20 gestations and demise of both twins in 18 gestations (overall mortality of 17%) were correctly identified with US. These 38 gestations included intrauterine demise in 12, spontaneous abortion in 13, and neonatal deaths in 13. Therefore, when multiple gestations are suspected clinically, serial real-time US scans should be obtained beginning in the first trimester.

Adolescent↗
PubMed1987

CT evaluation of gracilis myocutaneous vaginal reconstruction after pelvic exenteration.

After pelvic exenteration for cancer, the gracilis muscles, skin, and subcutaneous fat from the inner aspect of both thighs may be raised as a pedicle flap and tunneled under the skin into the pelvic space to create a neovagina. We reviewed nine pelvic CT examinations in six patients to evaluate the CT appearance of this procedure and its complications. Five patients are alive and without complications. One patient died 6 months after surgery and had a small-bowel fistula to the neovagina. Normal CT findings included air in the vaginal canal in six of nine examinations, gracilis muscle atrophy in two patients who had early and late CT studies, and early separation of the anterior and posterior approximation of the flaps in one patient. Abnormal findings were seen in two patients: one had an abscess near the vaginal apex that was drained per vagina; the other had extraluminal air in the retropubic and subcutaneous fatty tissues due to a small-bowel fistula into the vagina.

Adult↗
PubMed1986

Cystic renal mass evaluation: real-time versus static imaging.

Fifty consecutive cystic renal masses in 43 patients were evaluated by both static scanning and real-time scanning techniques. Various parameters were evaluated and compared to ascertain whether the strict static scan cystic criteria were always present in comparable real-time evaluations. Four (8%) of the 50 masses were not classic cysts on real-time examinations, although the criteria were present on the static scans. Two had minimal acoustic enhancement and two had low-intensity internal echoes. Possible reasons for this difference were detailed and discussed. The potential problems in this observation were enumerated. Based on these observations, in certain cases when a cystic renal mass demonstrates poor acoustic enhancement or low-level internal echoes in real-time examination, static scanning may be helpful and may obviate the need for further studies.

Diagnosis, Differential↗
PubMed1986

Computed tomography in the diagnosis of renal pseudotumors.

If the initial evaluation of the urinary tract raises the possibility of renal mass, one must decide what study or studies to perform to confirm or deny its presence. Radionuclide imaging has been the study of choice in this situation. Six cases are presented in which computed tomography definitively demonstrated that a suspicious renal mass represented normal renal parenchyma. Comparison with other renal imaging modalities is discussed.

Adult↗
PubMed1986

Concurrent duplication and azygos continuation of the inferior vena cava.

Duplication of the inferior vena cava and azygos continuation of the inferior vena cava arise from separate embryologic anlage. The former arises from persistence of both supracardinal veins and the latter from arrested development of the right subcardinal vein. Individually these entities are uncommon, but their occurrence together in one patient is exceedingly rare. A patient with both these anomalies of the venous system concurrently is described. This combination has been reported only once before in the radiologic literature.

Azygos Vein↗
PubMed1986

Twin and singleton growth patterns compared using US.

Sonography has been used widely in the evaluation of singleton fetal growth. Twin gestations, however, have received less careful attention. In a statistical study of 103 twin pregnancies, the growth patterns of twin biparietal diameter (BPD), fetal femur length (FFL), and abdominal circumference (AC) were compared with those of singletons. The results of the study revealed a decrease in twin BPD growth after 31 to 32 weeks of gestation relative to singletons. Twin AC growth rate decreases after 32-33 weeks of gestation relative to singletons, but the twin FFL growth pattern does not deviate from that of singletons throughout gestation. Because of the significant difference in growth patterns of BPD and AC between twins and singletons in our population, new growth charts for twin BPD and AC are proposed.

Adolescent↗