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Biomedical subjects

B G Coleman

Publications and source records attributed to B G Coleman.

At least 55 records · Page 3Linked to original sources

Gastrointestinal tract focal mass lesions: role of CT and barium evaluations.

Fifty-eight patients with focal mass lesions involving the gastrointestinal tract were studied retrospectively. The diagnostic value of CT scans was seen by assessing the barium studies alone, then by combined review of radiographs and CT scans. Patient management decision making was similarly evaluated. CT scanning aided in diagnosis of the focal masses in 17 patients (29%), changing the differential diagnosis in eight (14%) and increasing diagnostic confidence significantly in nine (16%). In 21 (36%) additional cases, the diagnosis did not change, but CT scanning improved the understanding of disease extent. In the remaining 20 cases (34%), CT scanning did not help diagnostically. CT scanning altered patient management decisions in 19 of the 58 patients (33%). CT study was most helpful in cases of benign extrinsic cystic disease, lymphoma, and smooth-muscle tumors and less helpful for adenocarcinomas of the bowel. The value of the CT data increased as one moved from mucosal lesions to submucosal or extrinsic lesions.

Adenocarcinoma↗

Ectopic embryo detection using real-time sonography.

An analysis of the sonograms of 60 patients with a surgically confirmed diagnosis of ectopic pregnancy was performed. In 36 examinations, both real-time and static images were compared, and real-time was judged superior in 22 based on a correlation between the original report and surgical pathology. The appearance of the endometrial canal and the adnexa was characterized in a total of 65 scans. The endometrial canal appearance was variable, with the most common finding being a linear echo (39%). The adnexal changes were less diverse, with an adnexal ring suggestive of an extrauterine gestational sac identified in 60%. In 10 cases, the adnexal ring contained a distinct fetus with a measurable crown-rump length, and cardiac activity was evident in six. Our results indicate that real-time ultrasound coupled with serum beta-hCG RIA should be the procedure of choice when ectopic pregnancy is suspected.

Adnexa Uteri↗

Computed tomography findings in clinically normal and abnormal thyroid patients.

Fifty normal volunteers had unenhanced thyroid computed tomography scans. A range of normal computed tomography densities and volumes was established for each age group. Pre- and postcontrast scans were done on 47 abnormal patients with hemorrhagic cysts, multinodular goiter, thyroiditis, papillary carcinoma, and benign adenomas. The computed tomography characteristics of each of the pathologic groups was noted for both the abnormal areas and the uninvolved part of the gland. Preliminary observations of the computed tomography characteristics of each abnormality are discussed.

Adenoma↗

New observations of soft tissue sarcomas with contrast medium-enhanced computed tomography.

Computed tomography examinations were performed on 74 patients who presented to the Children's Hospital of Philadelphia and the Hospital of the University of Pennsylvania with a known or suspected diagnosis of primary or secondary soft tissue sarcoma. Focal masses were detected on computed tomography study in 59 patients. These masses were classified into three broad categories: centrally necrotic masses with a large predominantly liquefactive center and higher density periphery (29); multilocular, septated masses with distinct linear bands or striations (21); and miscellaneous masses (9). The miscellaneous category included six inhomogeneous and three homogeneous masses. The apparent density differences within these sarcomas were best appreciated on dynamic postcontrast scans. The computed tomography appearance of these sarcomas may be explained by the pathologic findings of cystic degeneration, extensive necrosis, central cavitation, focal hemorrhage, and myxoid changes.

Adolescent↗

Routine fetal genitourinary tract screening.

To evaluate routine fetal genitourinary tract obstetrical ultrasound screening, and to determine what size renal pelvis is indicative of significant renal disease, we reviewed 4,832 examinations, which had been performed over 2 years, of 3,530 consecutive obstetrical patients. Any fetus that had a renal pelvis greater than 5 mm or a definable cystic area was identified for follow-up. The fetuses of 39 patients (1.1%) who underwent 112 examinations fulfilled these criteria and constitute the basis of this report. A variety of examination criteria were recorded and analyzed in relationship to the follow-up, which ranged from 2-3 days to 21 months. The fetuses of the 39 patients were grouped into three categories: those with renal pelves between 5 and 9 mm in size; those with renal pelves larger than 10 mm; and those with cystic abnormalities. Those with renal pelves larger than 10 mm had either an obstructing lesion or exceptional extrarenal pelves. The clinical and pathologic aspects of these three groups are detailed, discussed, and analyzed. Criteria for significant fetal renal hydronephrosis and aspects of a loculated appearance are given.

Dilatation, Pathologic↗

Sonographic evaluation of bile duct size during pregnancy.

Real-time sonography was used to examine the biliary tracts of 103 pregnant women. Common hepatic duct size, degree of right hydronephrosis, and presence of gallstones were noted. There were three important observations: (1) The top normal size of the common hepatic duct was 5 mm; (2) no correlation was found between common hepatic duct size and stage of pregnancy or degree of right hydronephrosis; and (3) gallstones were incidentally noted in 3.9% of patients.

Bile Duct Diseases↗

Ultrasonography of the upper genitourinary tract.

Ultrasonography is now well established as an accurate, noninvasive means of evaluating the genitourinary tract in patients of all age groups. Ease, speed, and portability of real-time have made ultra-sonography one of the most readily accessible imaging procedures. Most authorities concede that it is best utilized as a complement to other imaging modalities. This article describes and illustrates the many pathologic processes involving the upper genitourinary tract that can be accurately diagnosed utilizing real-time ultrasonography.

Carcinoma, Renal Cell↗

Case report: computed tomography in the diagnosis of Yersinia infection in a patient with thalassemia major.

Yersinia enterocolitica is becoming increasingly recognized as a source of abscess formation in patients with numerous underlying disease entities, most notably hepatic and hematologic disorders. Patients ranging in age from infancy to adulthood can become infected with this worldwide pathogen, which seems to be relatively rare in the United States. We present the appearance of a Yersinia abscess on computed tomography in the hope that an increased awareness of this infection will result in earlier diagnosis and improved therapeutic management.

Abscess↗

Computed tomography in soft tissue calcification layering.

Soft tissue calcification occurs in a variety of disorders. When it is associated with an abnormal calcium phosphorous product, it may present as large, periarticular masses that demonstrate layering on horizontal beam radiographs or computed tomography (CT). Previous reports have shown this phenomenon in idiopathic tumoral calcinosis. We report two patients with metastatic calcification of different etiologies: one patient with tumoral calcinosis and one with secondary hyperparathyroidism complicating chronic renal failure. Both showed layering on CT. The pathology of this phenomenon as well as therapeutic implications are discussed.

Adult↗

CT features of endobronchial granular cell myoblastoma.

The CT features of endobronchial granular cell myoblastoma are reported in an acknowledged heavy smoker without pulmonary complaints. Computed tomography confirmed the intraluminal location of the mass, demonstrated associated atelectasis, and detected the lack of adenopathy or invasion into the mediastinum, thus contributing significantly to surgical planning.

Bronchial Neoplasms↗

Contrast medium pooling in cystic renal carcinoma: CT findings.

This case report describes a serendipitously diagnosed renal carcinoma in a transplant donor. Computed tomography was instrumental in establishing the true nature of this mass based on its ability to demonstrate pooling of contrast material and staining of discrete septae on dynamic postcontrast scans.

Carcinoma, Renal Cell↗

Thyroid imaging: comparison of high-resolution real-time ultrasound and computed tomography.

High-resolution real-time ultrasound (US) and computed tomography (CT) were compared in 48 patients with a clinical diagnosis of thyroid abnormality and also correlated with biopsy or surgery. The modalities were considered comparable in 38 cases (79%), while CT was superior in 5 and US in 5. CT illustrated substernal extension of a goiter, demonstrated a 5-mm nodule not seen in US, showed 2 cases of thyroiditis better than US, and diagnosed a suspected thyroid mass as a lipoma anterior to the thyroid. US detected 4 nodules not seen on CT and resolved contiguous nodules that appeared to be a single nodule on CT. Both techniques lacked histopathological specificity. CT appears to be advantageous in detecting substernal thyroid extension and confirming thyroiditis, while the ability of US to detect small nodules makes it the procedure of choice in evaluating suspected intrinsic thyroid abnormalities.

Adolescent↗

Hyperdense renal masses: a computed tomographic dilemma.

High-density renal masses are atypical lesions that represent a diagnostic dilemma for computed tomography (CT). The differential diagnosis includes mainly complicated benign cysts and malignant neoplasms. This report analyzes the CT findings in 17 cases of discrete, sharply marginated masses that initially exceeded the density of the uninvolved renal parenchyma, averaging 50 H or more. The subsequently proven pathologic entities responsible for these high attenuation values included primary malignancies in six patients, one of whom also had multiple retention cysts containing highly proteinaceous, gelatinous material; a hemorrhagic cysts with an associated desmoplastic, fibrotic reaction in one patient; and single or multiple hemorrhagic cysts in four patients. No histologic proof was obtained in six patients, three with neoplastic disease and one mentally retarded youth who underwent renal aspiration without sufficient material obtained for analysis. Two patients with presumed hemorrhagic cysts have had serial CT scans without interval change in 8-12 months. An approach to the therapeutic management of affected patients is described.

Angiography↗

Mediastinal computed tomography in myasthenia gravis.

Thirty-six of 119 patients with myasthenia gravis examined by computed tomography for possible thymic mass had a thymectomy. The computed tomographic findings were compared to the findings of chest x-ray and linear tomography and then correlated with the surgical histopathologic results. Computed tomography detected all cases of thymoma or thymic enlargement due to hyperplasia. Chest x-ray correctly demonstrated 50% of thymomas present while linear tomography demonstrated 88%. Computed tomography was not able to distinguish between enlargement due to thymoma or hyperplasia unless calcification was present. The role of computed tomography is detailed and discussed in relationship to the other diagnostic modalities.

Adolescent↗

Gray-scale sonographic assessment of pancreatitis in children.

A total of 144 gray-scale sonograms were obtained in 110 children to evaluate the pancreas. The entire gland was adequately visualized in just over 86% of cases. The size, contour, echo pattern, and echo intensity were assessed. Either diffuse or focal enlargement of the pancreas was the most consistent finding in the 25 children with pancreatitis. In contrast to previous reports, decreased echo intensity was not a reliable indicator of inflammation. Numerous complications were detected on the 54 sonograms of these 25 patients. These complications included pseudocysts, lesser sac fluid collections, ascites, biliary obstruction, and hemorrhage. It is recommended that ultrasound be the initial imaging procedure in the evaluation of children with suspected pancreatic disease, and that it be used in conjunction with clinical and biochemical data.

Acute Disease↗