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Biomedical subjects

C M Tempany

Publications and source records attributed to C M Tempany.

At least 55 records · Page 3Linked to original sources
PubMed1995

Second trimester uterine atony imitating ectopic pregnancy: magnetic resonance diagnosis.

When an obstetrical patient was referred for inability to auscultate fetal heart tones at 18 weeks' gestation, ultrasound identified a single living fetus in the maternal right upper quadrant. Magnetic resonance imaging (MRI) ruled out a suspected uterine ectopic pregnancy and avoided laparotomy. The patient experienced an uncomplicated term delivery. MRI is a useful adjunct to ultrasound for mid-trimester pregnancy localization when the differential diagnosis includes uterine eccyesis.

Adult↗
PubMed1994

Staging of prostate cancer: results of Radiology Diagnostic Oncology Group project comparison of three MR imaging techniques.

PURPOSE: To assess accuracy of three different magnetic resonance (MR) imaging techniques, including the endorectal coil, in staging prostate cancer. MATERIALS AND METHODS: MR imaging was performed in 213 patients with prostate cancer with a conventional body coil, with fat suppression and a body coil, and with an endorectal coil. Radiologists identified tumor invasion into periprostatic tissues, neurovascular bundles, and seminal vesicles. Each technique was evaluated separately, and in a subset of 74 patients the three techniques were evaluated together. Images obtained with the two body-coil techniques were read in combination with images obtained with the endorectal coil (combination A) and alone (combination B). RESULTS: Overall accuracy for conventional body-coil, fat-suppressed body-coil, and endorectal-coil MR was 61%, 64%, and 54%, respectively. Overall group accuracy for combinations A and B was 57% and 61%. Considerable interreader variability was found for combination A. CONCLUSION: No technique was highly accurate for staging early prostate cancer. Individual radiologists did achieve a high degree of staging accuracy with the endorectal-coil and body-coil combination.

Humans↗
PubMed1993

The influence of finasteride on the volume of the peripheral and periurethral zones of the prostate in men with benign prostatic hyperplasia.

To determine the influence of androgen deprivation induced by the potent 5 alpha-reductase inhibitor finasteride on the volume of the zones of the prostate, 20 symptomatic men with established BPH were randomized to one of three groups: placebo, finasteride 1 mg, and finasteride 5 mg/day. The volume of the entire prostate gland, periurethral zone, and peripheral zone and the seminal vesicles were determined by three dimensional reconstructions of magnetic resonance contoured images of the prostate. There was no significant difference between the results achieved with 1 and 5 mg of finasteride per day; thus the results in these two groups were combined. In the placebo group there was no significant change in the volume of any structure. Following treatment for 1 year with finasteride there was a significant (P < 0.02) 17% decrease in total gland size (11.5 +/- 3.2 cc). Similarly, there was a significant (P < 0.02) 17% decrease in total gland size (11.5 +/- 3.2 cc). Similarly, there was a significant (P < 0.03) decrease in the size of the periurethral zone of the prostate (6.2 +/- 3 cc). Although there was also a decrease in the size of the peripheral zone of the prostate (2.8 +/- 1.2 cc) this did not reach statistical significance. There was no significant change in the volume of the seminal vesicles. These findings indicate for the first time that androgen deprivation induces a significant decrease in the size of the periurethral zone of the prostate in men with established BPH.

5-alpha Reductase Inhibitors↗
PubMed1993

Prospective comparison of T2-weighted fast spin-echo, with and without fat suppression, and conventional spin-echo pulse sequences in the upper abdomen.

PURPOSE: To evaluate use of fast spin-echo (FSE) magnetic resonance imaging with and without fat suppression in the liver and upper abdomen. MATERIALS AND METHODS: Conventional spin-echo (SE) T2-weighted, FSE T2-weighted, and fat-suppressed FSE T2-weighted images from 37 patients strongly suspected to have focal hepatic lesions were evaluated. RESULTS: Quantitative analysis demonstrated that fat-suppressed FSE imaging had the highest lesion-liver contrast-to-noise ratio; conventional SE imaging, the lowest. In a qualitative analysis, FSE imaging was preferred. In a rank order analysis, FSE imaging was preferred 83% of the time and fat-suppressed FSE imaging 17% of the time as regards overall image quality; fat-suppressed FSE imaging was preferred 64% of the time, FSE imaging 23% of the time, and conventional SE imaging 13% of the time as regards signal abnormality detection. CONCLUSION: FSE imaging with and without fat suppression is a potentially useful pulse sequence for evaluating the upper abdomen.

Abdomen↗
PubMed1992

MR imaging of the female pelvic region.

Magnetic resonance (MR) imaging is a valuable technique for noninvasive evaluation of the female pelvic region. This article presents the normal anatomy and abnormalities of the female pelvis. MR imaging may be more useful than clinical evaluation or other imaging modalities in diagnosing or staging developmental anomalies, leiomyomas, adenomyosis, endometrial or cervical carcinoma, vaginal neoplasms, ovarian cysts, endometriosis, teratomas, polycystic ovaries, or other ovarian masses. It could potentially replace laparoscopy as a more useful tool in the diagnosis of uterine anomalies. MR imaging is generally capable of helping determine whether a pelvic mass is uterine or adnexal in origin and may be used to characterize some adnexal masses. In some cases, MR imaging is used to differentiate recurrent disease from posttreatment fibrosis, which aids in treatment planning.

Female↗
PubMed1992

Needle-tip localization during CT-guided abdominal biopsy: comparison of conventional and spiral CT.

OBJECTIVE: This study was performed to determine whether the time required for needle-tip localization during biopsy of the abdomen would be reduced if continuous-volume data acquisition, also known as spiral CT, were used for guidance instead of conventional CT. SUBJECTS AND METHODS: Forty patients had biopsies of an abdominal mass; half underwent needle-tip localizations with conventional CT and half with spiral CT. The times required to localize the needle for 104 needle passes were calculated; scanning and reconstruction times were included, and the radiologist's technique and procedural difficulties were deliberately excluded. The mean needle localization times with conventional and spiral CT were compared for the upper abdominal and pelvic regions by using the two-tailed unpaired Student's t-test. RESULTS: The mean time (+/- SE) for spiral CT was 35 +/- 2 sec compared with 105 +/- 18 sec for conventional CT (p < .001). When analyzed by region, times with spiral CT were shorter in both the upper abdomen (means, 37 sec for spiral CT vs 150 sec for conventional CT, p < .001) and pelvis (means, 25 sec for spiral CT vs 74 sec for conventional CT, p = .038); the magnitude of the improvement was greater in the upper abdomen. CONCLUSION: The time required to find the needle tip during guided biopsy of an abdominal mass is reduced with spiral CT compared with conventional CT. This improvement is partly a result of the ability to eliminate respiratory misregistration with spiral CT, which is not possible with conventional multisectional CT; hence the greater advantage in upper abdominal biopsy.

Abdominal Neoplasms↗
PubMed1991

Pulmonary Aspergillus chest wall involvement in chronic granulomatous disease: CT and MRI findings.

Pulmonary Aspergillus infection in patients with chronic granulomatous disease tends to involve the chest wall and consequently carries a high mortality rate. We report the findings of computed tomography (CT) and magnetic resonance imaging (MRI) in three such cases. One patient underwent both CT and MRI, one, CT only, and one, MRI only. In all three, both CT and MRI demonstrated pulmonary consolidations with direct extension to the adjacent chest wall. In both patients who were examined by CT, scans revealed permeative osteolytic changes of adjacent rib or spine compatible with osteomyelitis. In both patients who were examined by MRI, adjacent chest wall involvement was depicted on T1-weighted images and showed increased signal intensity on T2-weighted images. In one of these patients, the chest wall lesion was well defined on T2-weighted images, an appearance compatible with abscess. Epidural extension was demonstrated on MRI in the other patient, who later developed paraparesis. We suggest that CT and MRI have a complementary role in evaluating chest wall invasion by pulmonary Aspergillus infection in chronic granulomatous disease.

Adolescent↗
PubMed1991

Nonpalpable prostate cancer: detection with MR imaging.

The pathologic specimens and magnetic resonance (MR) images of 53 patients with clinically palpable prostate cancer confined to one lobe were studied to evaluate the ability of MR imaging to depict clinically nonpalpable prostate cancer. All patients had undergone imaging with a 1.5-T imager with T1- and T2-weighted sequences in both axial and sagittal planes before undergoing radical retropubic prostatectomy. At pathologic examination, only the palpable tumor was present in 30 of the 53 patients (57%), and 33 unsuspected tumors were present in an area distinct from the palpable tumor in 23 of the patients (43%). MR imaging successfully depicted 51 palpable tumors for a sensitivity of 96% and 19 of the 33 unsuspected tumors for a sensitivity of 58%. The sensitivity of MR imaging in the detection of nonpalpable, posteriorly located tumors was greater than for those located anteriorly (85% vs 15%). MR imaging was false-positive for nonpalpable tumor in 17 of 30 patients for a specificity of 43%. On the basis of these data, MR imaging has greater sensitivity in the depiction of posteriorly located cancer and is limited by a high false-positive rate in the depiction of nonpalpable tumors.

False Positive Reactions↗
PubMed1991

Invasion of the neurovascular bundle by prostate cancer: evaluation with MR imaging.

Preservation of the neurovascular bundle (NVB) and potency without compromising tumor control are current objectives of radical retropubic prostatectomy as treatment for prostate cancer, but preoperative determination of whether cancer has invaded the NVB can be difficult. The use of conventional body-coil magnetic resonance (MR) imaging to make this preoperative determination was evaluated in 50 patients with biopsy-proved cancer. All patients underwent radical retropubic prostatectomy after MR imaging. MR imaging, surgical, and pathologic data were correlated relative to tumor location and volume, Gleason grade, presence of capsular penetration, and depth of NVB invasion. The sensitivity of MR imaging for invasion was 68%, specificity was 59%, and overall accuracy was 64%. Results of this study indicate that MR imaging can help identify the NVB and predict invasion of the NVB by tumor, but the usefulness of the technique is limited by the lack of spatial resolution associated with use of the whole-body coil.

Erectile Dysfunction↗
PubMed1991

Aortic dissection: atypical patterns seen at MR imaging.

Aortic dissection is typically manifested by an intimal flap separating true and false lumens. Atypical patterns lacking an intimal flap can occur, however, and are less well recognized. In this study, the authors review their experience with atypical patterns at magnetic resonance (MR) imaging. They evaluated the T1-weighted and gradient-echo MR images of the entire aorta in 64 patients with aortic dissection. In nine patients (14%) aortic wall thickening was the only sign of dissection in the thorax. In three of these cases, an intimal flap was found in the abdominal aorta; the other six patients had no flap in any region of the aorta, and this led to false-negative angiographic results in three cases. Aortic wall thickening as an atypical sign of dissection was seen more frequently in acute (29%) than in chronic (7%) dissection and was seen in only patients without Marfan syndrome. Two patients with atypical acute dissection at initial examination developed a clearly identifiable intimal flap at follow-up. Aortic wall thickening may represent the only sign of aortic dissection. In some cases, imaging the entire aorta can enable recognition of dissection in atypical cases.

Acute Disease↗
PubMed1990

Clinical magnetic resonance imaging of the vascular system.

Magnetic resonance imaging is extremely well suited to the diagnostic evaluation of the cardiovascular system. Over the past few years, more effective pulse sequences for imaging the heart and blood vessels have been developed, and although clinical use of cardiac MRI remains limited the use of MR angiographic techniques to evaluate major blood vessels is one of the fastest growing clinical applications of MRI today. The article reviews the current indications for vascular MRI with emphasis on those that are increasingly accepted by referring clinicians.

Carcinoma, Renal Cell↗
PubMedDate not supplied

Superparamagnetic iron oxide hepatic MR imaging: efficacy and safety using conventional and fast spin-echo pulse sequences.

The purpose of this study was to evaluate the technical efficacy and safety of iv ferumoxides (Feridex), a superparamagnetic iron oxide contrast agent for detection of hepatic lesions using conventional spin-echo and fast spin-echo MR images. Precontrast and postcontrast MR studies were performed on 25 patients with suspected focal hepatic lesions. Conventional T1- and T2-weighted MR images, as well as fast spin-echo and fat suppressed fast spin-echo MR images, were evaluated. Quantitative assessment of the contrast agent was performed obtaining region of interest measurements of the liver, spleen, and selected hepatic lesions. The pulse sequences were also evaluated subjectively for overall image quality and a subjective assessment of lesion detection. The use of a superparamagnetic iron oxide contrast agent led to a decrease in hepatic signal intensity on all pulse sequences. Lesion-to-liver contrast increased 41.1%, 36.5%, and 32.0% on the conventional T2, fast spin-echo, and fat suppressed fast spin echo pulse sequences, respectively. Lesion-to-liver contrast decreased on the T1-weighted postcontrast pulse sequence by 23.8%. Despite improvement in lesion-to-liver contrast, radiologists subjectively preferred the precontrast sequences because of overall better image quality. At a dose of 10 mumol/kg, ferumoxides favorably impacts lesion-to-liver contrast, and may be useful in hepatic imaging, more with conventional T2-weighted spin-echo pulse sequences than with T2-weighted fast spin-echo pulse sequence.

Chi-Square Distribution↗
PubMedDate not supplied

Thrombophlebitic retroperitoneal collateral veins mimicking lymphadenopathy: MR and CT appearance.

The authors report the magnetic resonance (MR) and computed tomography (CT) features of what is believed to be thrombophlebitis of the left cava of a duplicated IVC, which mimicked lymphadenopathy, and prompted both a CT-guided needle aspiration biopsy and surgical exploration. Knowledge that retroperitoneal vascular anomalies can mimick lymphadenopathy, both clinically and radiographically, may help obviate further testing and intervention.

Adult↗
PubMedDate not supplied

MR hysterography using axial long TR imaging with three-dimensional projections of the uterus.

A rapid screening technique for the presentation of uterine cavity anatomy obtained with MR is described. MR hysterographic (MRHG) images were generated and evaluated for uterine cavity abnormalities. Six patients referred for MRI evaluation of the uterus for infertility had an MRI using a pelvic phased array coil with axial 3 mm interleaved fast spin echo images (TR 9000 ms, TE 288 ms with fat saturation) processed using maximum intensity projection algorithms to construct MRHG images. Using the conventional MR sequence as the gold standard the MRHG images were evaluated by two reviewers and accuracy calculated. MRHG took less than 3 min, demonstrated the correct diagnosis in all with a quality score of diagnostic to optimal, and with excellent interobserver agreement (kappa 0.9).

Adult↗
PubMedDate not supplied

Biliary cystadenoma with intratumoral bleeding: radiologic-pathologic correlation.

We report a case of a 35-year-old woman with a mucinous biliary cystadenoma of the liver. The patient presented with the acute onset of upper abdominal pain and jaundice, symptoms caused by bleeding into the cystadenoma. Findings of a variety of imaging modalities including ultrasound, CT angiography, MR imaging, and endoscopic retrograde cholangiopancreatography are correlated and verified by pathological studies performed on the material obtained surgically.

Adult↗