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D F Bliss

Publications and source records attributed to D F Bliss.

10 recordsLinked to original sources

Skeletal 3-D CT: advantages of volume rendering over surface rendering.

Both surface rendering and volume rendering have been extensively applied to CT data for 3-D visualization of skeletal pathology. The review illustrates potential limitations of each technique by directly comparing 3-D images of bone pathology created using volume rendering and surface rendering. Surface rendering show gross 3-D relationships most effectively, but suffer from more stairstep artifacts and fail to effectively display lesions hidden behind overlying bone or located beneath the bone cortex. Volume-rendering algorithms effectively show subcortical lesions, minimally displaced fractures, and hidden areas of interest with few artifacts. Volume algorithms show 3-D relationships with varying degrees of success depending on the degree of surface shading and opacity. While surface rendering creates more three-dimensionally realistic images of the bone surface, it may be of limited clinical utility due to numerous artifacts and the inability to show subcortical pathology. Volume rendering is a flexible 3-D technique that effectively displays a variety of skeletal pathology with few artifacts.

Algorithms↗

Spiral CT during arterial portography: technique and applications.

Spiral computed tomography during arterial portography (CTAP) combines rapid scanning with selective imaging during the portal phase of enhancement of the liver, resulting in an effective method for evaluation of liver neoplasms prior to partial hepatic resection. Compared with dynamic incremental CTAP, spiral CTAP results in improved quality of three-dimensional and multiplanar reconstructions, facilitating presurgical planning. Accurate volumetric analysis of the tumor can be performed, and subsegmental tumor localization is facilitated by the high levels of hepatic and portal venous enhancement. Additional advantages of spiral CTAP include small reconstruction intervals for improved lesion detection. However, the specificity of spiral CTAP is low because both benign and malignant tumors appear as hypoattenuating perfusion defects. In addition, both focal and geographic nontumorous perfusion defects may be seen more frequently with spiral CTAP than with dynamic CTAP. Knowledge of common diagnostic pitfalls is necessary for accurate interpretation of spiral CTAP images.

Adult↗

Three-dimensional spiral CT during arterial portography: comparison of three rendering techniques.

The three most common techniques for three-dimensional reconstruction are surface rendering, maximum-intensity projection (MIP), and volume rendering. Surface-rendering algorithms model objects as collections of geometric primitives that are displayed with surface shading. The MIP algorithm renders an image by selecting the voxel with the maximum intensity signal along a line extended from the viewer's eye through the data volume. Volume-rendering algorithms sum the weighted contributions of all voxels along the line. Each technique has advantages and shortcomings that must be considered during selection of one for a specific clinical problem and during interpretation of the resulting images. With surface rendering, sharp-edged, clear three-dimensional reconstruction can be completed on modest computer systems; however, overlapping structures cannot be visualized and artifacts are a problem. MIP is computationally a fast technique, but it does not allow depiction of overlapping structures, and its images are three-dimensionally ambiguous unless depth cues are provided. Both surface rendering and MIP use less than 10% of the image data. In contrast, volume rendering uses nearly all of the data, allows demonstration of overlapping structures, and engenders few artifacts, but it requires substantially more computer power than the other techniques.

Algorithms↗

CT of the esophagus: spectrum of disease with emphasis on esophageal carcinoma.

The esophagus is involved by a wide range of pathologic processes that can be detected, defined, and staged with computed tomography (CT). These processes include esophageal carcinoma; benign esophageal tumors; inflammatory and infectious diseases; miscellaneous conditions such as Barrett esophagus, achalasia, and varices; and trauma and perforation. CT is usually performed to clarify findings seen with other imaging modalities or to stage a pathologic condition; however, it may be the primary imaging modality in some cases. Because of the critical location of the esophagus, it can be involved secondarily by other disease processes or as part of a systemic process. By being aware of the appearances of the various entities that affect the esophagus, the radiologist can play an important role in detecting and staging esophageal disease. Although the role of CT in the evaluation of esophageal disease has been controversial, recent developments such as spiral CT have the potential to renew interest in this application.

Adult↗

Splenic involvement in pancreatitis: spectrum of CT findings.

The pancreas is located deep within the retroperitoneum in the anterior pararenal space. The distal portion of the pancreatic tail extends along the course of the splenic artery and vein (Fig. 1) and enters the splenic hilum contained within the splenorenal ligament. Because of these anatomic relationships, the spleen and splenic vessels may be involved by pancreatitis. Although rare (frequency, 1-5%), splenic involvement by pancreatitis includes intrasplenic pseudocyst, abscess, hemorrhage, infarction, splenic rupture, and vascular injury. Because these complications can be life-threatening, the extent and course of the disease are closely monitored with CT to determine whether and when aggressive intervention is necessary to avoid catastrophic clinical outcomes. The purpose of this essay is to illustrate the spectrum of CT findings in cases of pancreatitis with splenic involvement.

Humans↗

Imaging of intrahepatic cholangiocarcinoma: 1. Peripheral cholangiocarcinoma.

Cholangiocarcinoma is the second most common primary hepatic malignant tumor after hepatocellular carcinoma, accounting for 5-30% of all primary hepatic malignant tumors [1]. Intrahepatic cholangiocarcinomas can be classified as peripheral cholangiocarcinoma, which originates from an interlobular biliary duct, or as hilar cholangiocarcinoma, which originates from a main hepatic duct or from the bifurcation of the common hepatic duct. Intrahepatic cholangiocarcinomas account for only about half of cholangiocarcinomas, and this pictorial essay focuses only on the peripheral form of the disease. Clinically, therapeutically, and radiologically, these two types of cholangiocarcinomas differ. Features suggestive of the diagnosis of peripheral cholangiocarcinoma can be shown by sonography, CT, and MR imaging. Cholangiography and angiography have a limited role in evaluating this neoplasm that manifests as a focal mass. This essay reviews the appearances of peripheral cholangiocarcinoma and discusses the various imaging techniques that can be used to evaluate this unusual tumor that is often resectable and potentially curable.

Adult↗

Imaging of intrahepatic cholangiocarcinoma: 2. Hilar cholangiocarcinoma.

Hilar cholangiocarcinoma (also called Klatskin's tumor) is more common than peripheral cholangiocarcinoma. Sonography, CT, MR imaging, angiography, and cholangiography can suggest the diagnosis, but the major issue of imaging with this tumor is to determine whether the tumor is resectable. The anatomic location of hilar cholangiocarcinoma makes resection difficult, so that surgical exploration of patients with this condition should be undertaken only when preoperative evaluation has shown a potential for curative resection. Preoperative assessment of resectability of hilar cholangiocarcinoma is often extensive, requiring several types of imaging. This pictorial essay reviews the imaging features of hilar cholangiocarcinoma. The role of imaging in the preoperative planning, with specific emphasis on staging extent of disease, including hepatic and vascular involvement, is discussed and illustrated.

Adult↗

The dorsal mesocardium and development of the pulmonary veins in human embryos.

Pulmonary vein development was studied using serial histologic sections of normal human embryos of Carnegie stages 11 to 15. Three-dimensional models were created in the program Swivel 3D on a Macintosh IIfx computer. The position of the mesocardium was found to be an important factor in the placement of the vein. Since the vein grows through a gap in the myoepicardium of the dorsal atrial wall created by the mesocardium, the vein can only grow where the mesocardium is positioned. Displacement of the initially median pulmonary vein ostium into the left atrium appeared to be caused by the formation of the left valve of the sinus venosus. This latter structure displaces the mesocardium to the left from stage 14 and later, carrying the vein to the left as well. The subsequent development of several pulmonary veins from the original single pulmonary vein occurred later, as the apex of the heart rotated to the left and brought the left atrium into a dorsal midline position. The study shows that correct placement of the pulmonary vein in the left atrium is the consequence of the successful execution of a sequence of developmental events in cardiogenesis.

Crown-Rump Length↗

Surgical segmental anatomy of the liver: demonstration with spiral CT during arterial portography and multiplanar reconstruction.

A major role of imaging in the evaluation of hepatic tumors is to assist surgeons in the preoperative determination of the feasibility of hepatic resection. Although the segmental location of tumors is not the sole criterion for determining resectability, such knowledge is useful for preoperative planning of the type of resection. This essay illustrates the surgical segmental and subsegmental anatomy of the liver as shown by spiral CT during arterial portography (CTAP) with multiplanar reformation.

Hepatectomy↗