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Biomedical subjects

D H Stephens

Publications and source records attributed to D H Stephens.

At least 55 records · Page 3Linked to original sources
PubMed1984

CT of extracranial hemorrhage and hematomas.

Computed tomography was used to examine 100 patients with extracranial hemorrhage. Of these patients, 29 had serial scans that allowed for the study of evolutionary changes. Operation, anticoagulation, and trauma were the prime etiologic factors. The most frequent sites included the retroperitoneum (27%), body wall or extremities (24%), peritoneal cavity (19%), and subcapsular (16%) and intraparenchymal (7%) locations. The computed tomographic features were carefully studied and documented. Age-related features included contrast-material extravasation, inhomogeneity, hematocrit effect, attenuation changes, lucent halo, pseudocapsule development, decreased size with time, peripheral calcification, and fascial plane thickening. Some of these features are indicative of hemorrhage but others are nonspecific. This report discusses all these findings and their usefulness in diagnosis and patient care.

Adolescent↗
PubMed1984

CT features of nonfunctioning islet cell carcinoma.

To determine the computed tomographic (CT) characteristics of nonfunctioning islet cell carcinoma of the pancreas, the CT scans of 27 patients with that disease were reviewed. The pancreatic tumor was identified as a mass in 26 patients (96%). Demonstrated masses were 3-24 cm in diameter. Eight of the tumors (31%) were larger than 10 cm. Six tumors (22%) contained calcification. Of the 25 tumors evaluated with contrast enhancement, 20 became partially or diffusely hyperdense relative to nearby normal pancreatic tissue. Hepatic metastases were identified in 15 patients (56%), regional lymphadenopathy in 10 (37%), atrophy of the gland proximal to the tumor in six (22%), dilatation of the biliary ducts in five (19%), and dilatation of the pancreatic duct in four (15%). The CT appearances of the nonfunctioning islet cell tumors were compared with those of 100 ordinary (ductal) pancreatic adenocarcinomas. Although the two types of tumors were sometimes indistinguishable, features found to be more characteristic of islet cell carcinoma included a pancreatic mass of unusually large size, calcification within the tumor, and contrast enhancement of either the primary tumor or hepatic metastases. Involvement of the celiac axis or proximal superior mesenteric artery was limited to ductal carcinoma.

Adenoma, Islet Cell↗
PubMed1984

Ultrasonography and computed tomography in focal fatty liver. Report of two cases with special emphasis on changing appearances over time.

The features of focal fatty infiltration of the liver are described in 2 patients. In 1 patient, hepatic malignancy was initially suspected, and the true nature of the lesion was not appreciated until months later. The nondiagnostic features on ultrasonography and the characteristic features on computed tomography are described. Additional diagnostic information was obtained by guided liver biopsy and from repeat computed tomography months later, when partial or total resolution of the lesions was observed.

Adult↗
PubMed1983

Computed tomography and peritoneoscopy for detection of liver metastases: review of Mayo Clinic experience.

The effectiveness of computed tomography (CT) and peritoneoscopy in detecting liver metastasis was studied by review of 97 cases in which both of these procedures and also biopsy or autopsy were performed. Tissue examinations disclosed hepatic lesions in 45 cases. The sensitivity of CT and peritoneoscopy was 89 and 62%, respectively; and their specificity 94 and 96%. In 35% of biopsy-proven cases, CT detected lesions not visible at peritoneoscopy; and in 7% peritoneoscopy revealed lesions not shown by CT. The difference resulted from the more frequent occurrence of liver metastases in locations more suitable for CT detection. The results suggest that CT should be tried before peritoneoscopy (other considerations being equal), and that CT guidance for biopsy deserves more frequent use. The reliability of negative CT or peritoneoscopy findings remains uncertain, since autopsy has been obtained in only 3 of the 52 negative cases.

Adolescent↗
PubMed1983

Pheochromocytoma: value of computed tomography.

A review of 60 histologically proved pheochromocytomas confirmed the value of computed tomography (CT) in the evaluation of this tumor. CT was found to be an accurate means of locating the tumor in 52 patients presenting for the first time and 8 patients with evidence of recurrence.

Adolescent↗
PubMed1981

Computed tomography and angiography of cavernous hemangiomas of the liver.

Cavernous hemangioma is the most common benign tumor of the liver. Eighteen patients were studied by both computed tomography (CT) and angiography. The angiographic features were classic, consisting of normal hepatic arteries, no tumor vessels, and densely stained blood-filled spaces producing a "cotton-wool" appearance. Before contrast infusion, CT scans showed roughly spherical, well-demarcated low-density masses; afterward there was a peripheral zone of enhancement which varied in thickness and sometimes had a corrugated inner margin, though the center remained low in density and the overall size of the lesion did not change. The authors feel that the CT findings are characteristic and that in some cases angiography is unnecessary.

Angiography↗
PubMed1981

Double-contrast radiography: colonic inflammatory disease.

Double-contrast examination and proctosigmoidoscopy were performed in 240 patients with ulcerative colitis and 60 patients with granulomatous colitis. Both examinations were evaluated for accuracy of detection of disease, accuracy of classification of disease, and the ability of one examination to add information not gained by the other. Endoscopy was more sensitive than double-contrast examination in detection of disease of the distal colon and rectum in 18% of cases of ulcerative colitis and 17% of cases of granulomatous colitis. Double-contrast examination was more specific than proctosigmoidoscopy in differentiation of disease in cases of ulcerative colitis; endoscopy incorrectly classified 11% of cases as granulomatous colitis, and double-contrast examination misclassified only one case (less than 1%). Neither examination misclassified a case of granulomatous colitis as ulcerative colitis. Finally, double-contrast examination demonstrated disease proximal to the range of the proctosigmoidoscope of a greater severity than that seen endoscopically in 24% of patients with ulcerative colitis and 70% of patients with granulomatous colitis. Radiographic variations in disease presentation occasionally caused difficulty in classification. Double-contrast examination and proctosigmoidoscopy are complementary, and both should be used in evaluating patients with inflammatory disease of the colon.

Barium Sulfate↗
PubMed1981

Lipomatous tumors of the abdominal cavity: CT appearance and pathologic correlation.

Twenty patients with pathologically confirmed extraparenchymal intraabdominal lipomatous tumors, including two lipomas, two cases of diffuse infiltrating lipomatosis, and 16 liposarcomas, were examined by computed tomography (CT). The CT appearance of these tumors closely correlated with their gross and microscopic pathologic anatomy. Distinctive CT features differentiated simple lipomas from diffuse infiltrating lipomatosis and from liposarcomas. The densities of these tumors, including the variable densities of liposarcomas, were explained by their tissue composition. Lipomas, diffuse infiltrating lipomatosis, and lipogenic liposarcomas were predominantly of fat density, whereas myxoid liposarcomas were of a higher range of densities. Liposarcomas often contained more than one type of tumor tissue, resulting in masses of distinctly different densities coexisting within the same tumor. CT accurately depicted the presence, location, and size of the tumors and provided information about their relation to adjacent structures.

Abdominal Neoplasms↗
PubMed1981

Computed tomography in duodenal rupture due to blunt abdominal trauma.

Computed tomography (CT) has become a useful procedure in the evaluation of abdominal trauma, since it is able to detect abnormalities in contour or tissue density of the major abdominal and retroperitoneal organs and spaces. Cases have been reported demonstrating the usefulness of CT in evaluating splenic, renal, and hepatic hematomas, retroperitoneal hemorrhage, spinal injuries, and traumatic diaphragmatic hernia. We describe a patient with traumatic rupture of the duodenum in whom CT played a key role in the diagnosis.

Adult↗
PubMed1980

Computed tomography of the abdomen in evaluation of patients with fever of unknown origin.

Applying Petersdorf's classic criteria for fever of unknown origin (FUO), 75 of 6,654 CT scans were reviewed to evaluate the diagnostic effectiveness of abdominal CT. Twenty-three (29%) of these 78 scans had positive CT findings and 8 (10%) had positive but nonspecific findings. Abdominal exploration or biopsy was carried out in 20 of these 31 patients. In addition, 10 cases with negative CT results were explored. In no case was any gross anatomic abnormality found in these negative cases.

Abdomen↗
PubMed1980

Upper abdominal abscess: a continuing and deadly problem.

Subphrenic and other upper abdominal abscesses continue to be associated with high mortality, even in today's era of broad spectrum antibiotics and sophisticated surgical techniques. Most cases represent complications of intraabdominal surgery. Because the clinical presentation is often subtle and nonspecific, the radiologist plays a paramount role in early diagnosis. Conventional radiography remains an effective method in the initial detection of upper abdominal abscesses. In this study, radiographs were reviewed in 82 patients. In retrospect, plain films revealed extraluminal gas or soft-tissue mass due to abscess in 58 patients (71%). Of these, the abscess was accurately reported initially in 42 patients, but it was initially missed in 16 patients. Conventional gastrointestinal contrast studies, which were underutilized, proved extremely accurate in demonstrating abnormality, especially in the left upper abdomen. Computed tomography, gallium scanning, and ultrasound were effective confirmatory procedures in many cases.

Abscess↗
PubMed1980

Enlarged accessory spleens: CT appearance in postsplenectomy patients.

An unexplained abdominal mass discovered on CT examinations of a postsplenectomy patient may represent a hypertrophied residual accessory spleen. Six such patients were found to have left upper quadrant masses on CT examinations that were subsequently proved to be enlarged accessory spleens. The CT appearance is that of discrete, solitary, rounded masses of uniform soft-tissue density in the left upper quadrant. Diameters of the masses were 3.5-5.0 cm. The splenic nature of such a mass can be confirmed by appropriate radionuclide imaging.

Adolescent↗
PubMed1978

Chenotherapy for gallstone dissolution. I. Efficacy and safety.

Clinical experience with chenodeoxycholic acid therapy for dissolving gallstones is reported, with particular attention to determinants of response. Of 12 patients receiving 15 mg/kg/day or more, ten responded (83%); only 15 of 40 patients (38%) receiving less than 15 mg/kg/day responded. Large solitary stones and stones in gallbladders that visualized poorly after oral cholecystography had a lower response rate. Radiopaque stones did not respond in 18 patients. Five of ten patients with stones in the common bile duct responded. Small, dose-related elevations in SGOT were the only biochemical abnormality observed. Liver biopsy specimens showed no notable abnormality. Diarrhea was an infrequent problem. Stones recurred in three of 15 patients during six to 48 months of observation without treatment. Chenodeoxycholic acid, when given in adequate dosage, continues to appear promising as medical therapy for asymptomatic radiolucent gallstones in radiologically visualizing gallbladders.

Chenodeoxycholic Acid↗