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Biomedical subjects

D Schellinger

Publications and source records attributed to D Schellinger.

At least 73 records · Page 4Linked to original sources
PubMed1977

Computerized axial tomography in clinical pediatrics.

Computerized axial tomography (CAT), a noninvasive radiologie method, provides a new dimension in screening and diagnosis of intracranial pathology. Evaluation of 725 scans in infants and children demonstrates that CAT may be performed with negligible risk, although sedation and restraint are essential to the successful performance of studies in children under 6 years of age. CAT is the preferred initial diagnostic method in suspected hydrocephalls and is accurate in the detection and precise localization of brain tumors. The management of hydrocephalus and brain tumors has been significantly altered by the availability of CAT. Few invasive neuroradiologic procedures are required and pneumography is especially curtailed. Serial scanning is the best available method of monitoring ventricular alterations in hydrocephalus, tumor size during radiotherapy or chemotherapy, and postoperative recurrence of benign neoplasms. Complex intracranial anomalies are detectable with computerized tomography, but complete definition of pathology often requires angiography and air studies. Limited clinical experience in detecting neonatal intraventricular hemorrhage suggests that CAT will be a valuable tool for futlre investigations of that problem.

Adolescent↗
PubMed1976

Computerized tomography and benign intracranial hypertension.

Benign intracranial hypertension (BIH) is a recognized syndrome of unknown origin that conventionally has been diagnosed by excluding an underlying space-occupying lesion using invasive contrast procedures. Computerized tomography (CT) scanning of the head is a safe, accurate method of defining intracranial structures that were previously only discernible by invasive studies. Seven patients with headaches, papilledema, normal mental status, normal brain scan, and normal electroencephalogram had normal CT scans of the head. Patients suspected of BIH can be spared invasive contrast procedures if the CT scan of the head is normal.

Adult↗
PubMed1976

Computerised axial tomography for diagnosis of pancreatic cancer.

Computerised axial tomography demonstrated the presence of a mass lesion in the pancreas in 9 (64%) of 14 patients with histologically confirmed pancreatic cancer. Since this was a retrospective analysis, the percentage of false positive and negative results using this technique is not as yet known. The technique appears accurate in detecting abnormal pancreatic masses of 10 cm in diameter or more, however, for masses less than 10 cm in diameter the yield at present is only 33%. With further technical refinement to increase resolution, the automatic computerised transverse axial scan should prove to be an invaluable procedure for the detection of pancreatic carcinoma, in designing radiation therapy ports, and in providing objective information regarding response of therapy and progression of disease.

Adenocarcinoma↗
PubMed1976

An analysis of the first one thousand cerebral ACTA scans.

The first 1000 ACTA Scans of the brain are analyzed. ACTA Scanning is ideal for evaluating the ventricular system and other CSF containing spaces. High density lesions, such as intracerebral hematomas are depicted with great consistency. The method is less reliable for detecting subdural hematomas. For brain tumor screening, intravenously applied contrast agents are mandatory, so that tumors with subtle density changes can be identified more positively.

Brain Neoplasms↗
PubMed1976

Computed tomography of spinal cord after lumbar intrathecal introduction of metrizamide (computer-assisted myelography).

Computed tomography (CT) of the thoracic and cervical spine was carried out after lumbar intrathecal introduction of a water-soluble radiographic contrast medium (metrizamide). By choice, no head-down position of the patient was used to facilitate craniad movement of the contrast medium; rather, advantage was taken of the normal CSF flow. This technique, referred to as computer-assisted myelography (CAM), permits the demonstration of the metrizamide-containing subarachnoidal spaces surrounding the thoracic and cervical cord. Some examples of the diagnostic possibilities of the method are discussed.

Computers↗
PubMed1976

Computed tomographic evaluation of aortic aneurysms.

Applications of computed tomography are being extended from the brain to other body parts. This report describes CT scanning of abdominal and thoracic aortic aneurysms in 30 patients. CT shows greatest promise in abdominal aortic scanning, where reliable identification of the aorta can be achieved even in the absence of enlargement or calcification. However, current limitations prevent visualization of internal detail such as intimal plaques or mural thrombi. Technical advances are described which should have an important bearing on this.

Aorta, Abdominal↗
PubMed1975

Computerized axial tomography in syringomyelia.

The ACTA-scanner, a device for computerized axial tomography, permits cross-sectional radiographic study of the entire human body, including the spine. In the ACTA-scan, the spinal cord appears as a roundish formation surrounded by the less dense subarachnoidal cerebrospinal fluid. The spines of 18 patients with verified (nine cases) or suspected (nine cases) syringomyelia were studied by ACTA-scanning. In seven of the verified and in four of the nonverified cases, some evidence of cord cavitation was shown. The cystic part of a cervical-cord ependymoma was also demonstrated. ACTA-scanning is an easily performed, noninvasive, innocuous procedure. This technic, which complements other radiographic methods of evaluating the spinal cord, is particularly suitable for screening and follow-up study of patients with syringomyelia. The easily accomplished recognition of a possible associated hydrocephalus is an added advantage of ACTA-scanning.

Brain Diseases↗
PubMed1975

Early clinical experience with the ACTA scanner.

An alternative method of computed tomography has been devised employing a new instrument, the ACTA scanner. This is a total-body scanner which permits study of virtually all body parts, since a water medium is not employed. Early clinical experience with this new method is discussed, and normal and pathological scans are presented.

Brain Diseases↗
PubMedDate not supplied

Non-invasive evaluation of thoracic aneurysms.

Sixty-six patients with possible abnormalities of the thoracic aorta were examined by CT and the data compared with standard chest radiographs, angiography and, in most, with the surgical findings. Using contrast enhancement computed tomography was able to evaluate and differentiate between a tortuous aorta, an atherosclerotic aneurysm, and aortic dissection and extra-aortic masses. Distinguishing pathological features are discussed. In aortic dissections angiography may be necessary to delineate the site of the intimal tear. Long term follow-up of aortic dissections, especially Type III, is best done by CT. Aneurysmal rupture or leakage, as well as extension into the abdominal aorta, can easily be ascertained by this method.

Aged↗
PubMedDate not supplied

Ventricular shapes, distortions, and deformities: mirrors of past cerebral insults. A study based on early sonographic follow-up studies.

Ventricular distortions and deformities often represent the endpoint of neuropathologic reactions that evolve early in life. Once fully developed, they may offer no clues as to preceding etiologic agents or pathogenesis. Serial sonography in the neonatal period of 14 patients with periventricular leukomalacia provided documentation of the evolution of certain ventricular patterns. When recognized early, these ventricular changes have prognostic significance because periventricular leukomalacia can produce serious neurologic sequelae. If found later in childhood, periventricular leukomalacia can be suggested as the original pathology. Ventricular deformities can be generalized (12 patients) or focal (11 patients); the various types of distortions are seen frequently in combination. The generalized form of ventricular expansion consisted of uniform expansion of the parieto-occipital components (hydroporencephaly), following extensive periventricular white matter necrosis. Hydroporencephaly is a new form of ex vacuo hydrocephalus in the pediatric age group. Focal changes are caused by more localized white matter cavitations with ventricularization of ensuing porencephalic cysts. These changes result in a footprint-shaped ventricular pattern (10 patients) or in frontal/occipital (polar) ventricular pointing (4 patients). White matter necrosis in other areas may lead to ventricles with bumpy contours (5 patients).

Brain Damage, Chronic↗
PubMedDate not supplied

PACS clinical experience at Georgetown University.

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for three-and-a-half years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for two-and-a-half years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Computer Systems↗
PubMedDate not supplied

Meningeal Gd-DTPA enhancement in patients with malignancies.

Nineteen patients with malignant diseases and pathologically enhancing meninges were studied by pre- and postcontrast (Gd-diethylene-triamine pentaacetic acid) magnetic resonance (MR) scans. Two patterns of enhancement were recognized: the dural (14 patients) and the leptomeningeal (mainly pial) (5 patients). Positive cytology was found in only 3 of the 14 patients with dural enhancement (21%), whereas in the remaining 11 patients we noted either nonspecific CSF findings such as elevated protein, high white blood cell count, and low glucose or entirely normal CSF. Four patients (80%) in the group with leptomeningeal enhancement showed positive cytology and one had normal CSF analysis. We conclude that meningeal enhancement as seen on MR imaging is a nonspecific finding and correlates well with positive cytology only when the more rare form of leptomeningeal enhancement is encountered.

Adult↗
PubMedDate not supplied

Functional MRI of human olfaction.

PURPOSE: Our goal was to use functional MRI (fMRI) to measure brain activation in response to olfactory stimuli. METHOD: fMRI brain scans were obtained in 17 normal subjects (9 men, 8 women) using-multislice FLASH MRI in response to three olfactory stimuli (pyridine, menthone, amyl acetate) in three coronal brain sections selected from anterior to posterior temporal brain regions. Activation images were derived using correlation analysis, and ratios of areas of brain activated to total brain areas were calculated. RESULTS: Activation was present in each section in all subjects. Subjective estimation of vapor intensity followed relative vapor pressure of stimuli presented (pyridine > amyl acetate > menthone) and were similar for both men and women. However, brain activation did not follow subjective responsiveness order but rather pyridine > menthone > amyl acetate, a pattern demonstrated by both men and women. Brain activation in women was consistently lower than in men for all vapors in all brain sections, although regions of activation did not differ. Activation occurred in regions previously recognized as associated with olfactory stimulation, including orbitofrontal and entorhinal cortex; however, extensive regions within frontal cortex including cingulate gyrus were also activated. Brain regions activated to odors considered pleasant or unpleasant did not differ. CONCLUSION: The techniques used in this study demonstrated that brain activation to olfactory stimuli could be measured quantitatively such that differences between groups of subjects (in this case men and women) could be compared. Although localization of brain activation was not the major thrust of this study, activation to olfactory stimuli was found not only in brain regions previously associated with processing of olfactory information but also in several other areas of frontal cortex, in cingulate gyrus, and in several components of the limbic system. This is the first study in which activation in human brain parenchyma of normal humans to olfactory stimuli has been quantitated by fMRI.

Adult↗