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Biomedical subjects

D F Caroline

Publications and source records attributed to D F Caroline.

At least 37 records · Page 2Linked to original sources
PubMed1988

Relative merits of MRI, transrectal endosonography and CT in diagnosis and staging of carcinoma of prostate.

Magnetic resonance imaging (MRI) and transrectal sonography of 27 patients with biopsy-proved carcinoma of the prostate were performed to compare the sensitivity of these modalities to each other for diagnosis and to computed tomography (CT) for staging. Sonography was superior to MRI for the detection of intraglandular carcinoma and capsular disruption. MRI was superior to both sonography and CT for evaluating seminal vesicle invasion, and slightly better than CT for detecting lymphadenopathy.

Carcinoma↗
PubMed1988

Esophageal disruption: evaluation with iohexol esophagography.

Twenty-six patients with possible esophageal disruption who were also at risk for aspiration or direct communication of the esophagus with the tracheobronchial tree were examined with iohexol esophagography. Fifteen patients had normal studies confirmed by findings at a barium examination performed immediately after. In 11 patients abnormalities were diagnosed on the basis of iohexol esophagograms; the abnormalities included extraluminal extravasation of contrast material (n = 7), aspiration (n = 1), esophageal stricture with intramural diverticulosis (n = 1), edema of the gastroesophageal junction (n = 1), and epiphrenic diverticulum (n = 1). Eight of these patients were immediately reexamined with barium esophagography, which yielded no additional information. Low-osmolality, water-soluble contrast agents are a safe alternative for patients in whom barium esophagography poses a risk of mediastinitis and esophagography with diatrizoate meglumine and diatrizoate sodium (Gastrografin) poses a risk of pulmonary edema.

Adult↗
PubMed1988

Urachal carcinoma: CT findings.

The computed tomographic (CT) appearance of urachal carcinoma in ten patients was studied and compared with the pathologic findings. Magnetic resonance images were available in one case. All tumors were mucinous adenocarcinomas; four were solid, three were cystic, and three were mixed. The tumor had a characteristic location along the expected midline course of the urachus directly behind the anterior abdominal wall. The main tumor mass was supravesical in eight patients. Seven tumors contained calcification. CT correctly depicted bladder wall involvement and supravesical extent of tumor in all cases. CT provided incorrect information about invasion of the perivesical fat in three patients and about bladder mucosal invasion in two patients.

Adenocarcinoma, Mucinous↗
PubMed1988

Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography.

High-resolution CT (HRCT) has the ability to demonstrate both asbestos-related pleural disease and parenchymal abnormalities consistent with asbestosis. The role of CT in the diagnosis of asbestosis can be defined by comparing it with radiography. We evaluated 60 men who had a history of occupational exposure to asbestos and whose outside chest radiographs were considered abnormal. Chest radiographs (inside films) and HRCT were performed in all patients at our institution and were interpreted independently by experienced radiologists. Outside film results were compiled from the submitted reports. The final conclusion regarding the interpretation of the radiologic examinations was determined by consensus when disagreements existed. Positive predictive values (the likelihood that a positive report is correct) for pleural disease were: outside films 56%, inside films 79%, HRCT 100%. The positive predictive values for parenchymal disease were: outside films 51%, inside films 83%, HRCT 100%. The addition of HRCT to chest radiography is most useful in eliminating false-positive diagnoses of asbestos-related pleural disease caused by subpleural fat and false-positive diagnoses of parenchymal asbestosis in patients with extensive plaques or emphysema obscuring lung detail. The interpretation of chest radiographs in patients exposed to asbestos is often extremely difficult and subjective, and we recommend that positive findings (except calcified plaques) be confirmed with HRCT.

Asbestos↗
PubMed1988

Endoscopic laser therapy for carcinoma involving the esophagus: the value of pretreatment computed tomography.

Computed tomographic (CT) scans of the esophagus were performed on 15 patients with carcinoma of the esophagus or gastroesophageal junction prior to endoscopic laser therapy (ELT). The scans were evaluated for proximity to adjacent structures, symmetry, and luminal deviation, to help the endoscopist plan the route for therapy. A total of 50 procedures were performed without any serious complications. Pretreatment CT scans are a useful adjunct to ELT for carcinomas of the esophagus.

Adult↗
PubMed1987

Enterobronchial fistula.

An unusual case of a fistula originating from the jejunum and crossing the diaphragm to involve the pleura and bronchial tree is presented. The presence of the fistula was first suggested on a computed tomographic examination of the chest. An upper gastrointestinal series verified the origin of the fistula.

Barium Sulfate↗
PubMed1987

Pancreatitis presenting as pleural effusions: computed tomography demonstration of pleural space extension of pancreatitis exudate.

Reported are two cases of acute pancreatitis that presented as large pleural effusions in which the route of communication of the pancreatic fossa with the chest was demonstrated on computed tomography. The bloody effusions were right-sided in one case and bilateral in the other. Pleuropulmonary complications of pancreatitis and possible mechanisms for pulmonary involvement are presented.

Acute Disease↗
PubMed1987

Magnetic resonance imaging in young adults with cystic fibrosis.

It is difficult to distinguish between atelectasis, mucoid impaction, and peribronchial inflammation on chest roentgenograms (CXR) in patients with cystic fibrosis (CF). Differentiation between hilar adenopathy and prominent pulmonary vessels is also sometimes difficult. We studied 16 young adults with CF using both magnetic resonance imaging (MRI) and CXR to evaluate the usefulness of MRI in this clinical context. The same patients were studied with abdominal ultrasound and MRI for evaluation of the pancreas, gallbladder, liver, and spleen. The MRI was superior to CXR in detecting hilar and mediastinal adenopathy and in differentiating nodes from prominent vessels. It was useful in the evaluation of bronchiectasis. The CXR was superior for assessing infiltrates, hyperinflation, sternal bowing, volume loss, and hilar retraction. The MRI was only slightly better than sonography in depicting fatty infiltration of the pancreas. The modalities were equally effective in detecting hepatosplenomegaly and signs of portal hypertension. Gallbladder evaluation was far superior with sonography.

Adolescent↗
PubMed1987

Hepatic cavernous hemangioma: diagnosis with 99mTc-labeled red cells and single-photon emission CT.

During the performance of high-resolution real-time abdominal sonography, small echogenic hepatic masses are frequently discovered. A second imaging test to confirm the suspected diagnosis of hemangioma is often required. Planar labeled red-cell imaging will often not detect hemangiomas smaller than 3 cm. We studied 14 patients with labeled red-cell scintigraphy and single-photon emission CT (SPECT). Six hemangiomas were diagnosed by SPECT that would have been missed by planar imaging alone. All six were smaller than 2.5 cm. With the addition of SPECT, labeled red-cell scintigraphy has specificity and sensitivity that make it at least as reliable as dynamic CT for the noninvasive diagnosis of hepatic cavernous hemangioma.

Erythrocytes↗
PubMed1987

Hepatic infarcts: new observations by CT and sonography.

Until recently hepatic infarcts were rarely diagnosed before autopsy and were nearly always fatal. Four cases of hepatic infarcts, three of them nonfatal, were diagnosed and followed by CT (three cases), sonography (two cases), arteriography (two cases), and sulfur colloid liver-spleen scan (one case). In three patients with multiple subsegmental hepatic infarcts, most of the lesions were round or oval and centrally located. Only a minority of the lesions were wedge-shaped and peripheral. The early lesion appears hypoechoic on sonography, and CT shows a poorly demarcated low-density region. Later, lesions become confluent with more distinct margins. Bile lakes are a late sequela of large infarcts. Gas formation within sterile infarcts is newly described in two cases. Hepatic infarcts have a variable appearance on CT and sonography and are not reliably distinguished from other lesions such as abscess or necrotic neoplasm.

Adult↗
PubMed1987

CMV colitis mimicking Crohn's disease in a patient with acquired immune deficiency syndrome (AIDS).

The spectrum of gastrointestinal tract infections observed in patients with acquired immune deficiency syndrome (AIDS) has been widening rapidly. Patients with cytomegaloviral (CMV infection of the colon have been described predominantly as having cecal disease or a superficial colitis. We report a patient with scattered deep colonic ulcerations, mimicking Crohn's disease and representing another appearance of CMV colitis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Colitis: radiographic features and differentiation of idiopathic inflammatory bowel disease.

It is important clinically to be able to differentiate ulcerative colitis from Crohn's colitis because they differ considerably in the nature of complications and prognoses. Radiographically, it is possible to render a specific diagnosis in the vast majority of cases using criteria described in this article. The problem of the underlying process in inflammatory bowel disease in elderly patients and indeterminate colitis is also discussed.

Aged↗
PubMed1986

Scar sign of renal oncocytoma: magnetic resonance imaging appearance and lack of specificity.

This case report illustrates the magnetic resonance imaging (MRI) appearance of a typically asymptomatic renal oncocytoma as a homogeneous mass of medium signal with a stellate central region of decreased signal, representing the central scar. The MRI was correlated with computed tomography (CT), ultrasound (US), and gross pathologic appearance. The appearance of a central scar is not specific for oncocytoma and does not exclude renal cell carcinoma, as illustrated by a second case.

Adenoma↗
PubMed1986

Impact of magnetic resonance on staging of renal carcinoma.

Computerized tomography (CT), ultrasound, and angiography have been used for staging renal cell carcinoma. CT has proven to be the most reliable and sensitive of these techniques. Magnetic resonance (MR) has emerged recently as a viable alternative imaging modality. Five patients with renal cell carcinoma and suspected caval involvement were evaluated by CT, ultrasound, and MR. Caval extension and the differentiation of intra-versus retrocaval tumor was seen with greater clarity on MR scans; perinephric extension was seen equally well with both modalities. The primary tumor itself was better defined with CT. In patients with equivocal findings regarding the renal veins or inferior vena cava, MR is a valuable adjunct in preoperative evaluation. In patients at high risk for contrast administration, MR is the staging modality of choice.

Adult↗