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Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 253 records · Page 14Linked to original sources
PubMed1991

CT and anatomic study of postcatheterization hematomas.

The appearance of hematomas resulting from transfemoral catheterization as depicted with computed tomography (CT) has been infrequently reported. The authors devised a system for classifying the CT appearance of such iatrogenic hematomas that is based on the anatomic location and route of bleeding. There are four different types of hematomas: retroperitoneal, intraperitoneal, groin and thigh, and abdominal wall. Bleeding spreads along the fascial planes, and the type of hematoma probably depends on whether the bleeding is confined to the femoral sheath or spreads into the femoral triangle. Recognition of the different types is essential as they may have different clinical implications.

Abdominal Muscles↗
PubMed1991

Retroperitoneal and pelvic CT of patients with AIDS: primary and secondary involvement of the genitourinary tract.

Although genitourinary tract disorders are common in acquired immunodeficiency syndrome (AIDS), little attention has been paid to their manifestations on computed tomographic (CT) scans. The authors reviewed the CT scans of 86 patients infected with the human immunodeficiency virus for CT manifestations of primary or secondary involvement of the genitourinary tract. Genitourinary tract abnormalities identified in the 86 patients included nephromegaly in 34 (40%), hilar adenopathy in 30 (35%), bladder wall thickening in 19 (22%), medullary hyperattenuation in 12 (14%), renal calcifications in seven (8%), adnexal masses in five (6%), hydronephrosis in four (5%), pyelonephritis in three (3%), renal abscesses in three (3%), and solid renal masses in three (3%). Although these abnormalities are seen on CT scans in many other diseases, in the AIDS patient they often indicate the presence of an AIDS-related renal disease or involvement of the genitourinary tract by an AIDS-related neoplasm or infection.

AIDS-Associated Nephropathy↗
PubMed1991

Complications of radiation therapy: CT evaluation.

Radiation therapy is an important technique for treating cancer. In the evaluation of the results of radiation therapy with computed tomography (CT), radiation-induced injuries to normal tissues are often detected. Common complications include pneumonitis, calcified lymph nodes, gastric ulceration, enteritis, hepatitis, cystitis, nephritis, osteitis, and insufficiency fractures. Rare complications include spontaneous pneumothorax, thymic cysts, vascular calcifications, and osseous sarcomas. Radiation-induced injury can usually be diagnosed from characteristic CT appearances and knowledge of the radiation port, radiation dose, and time interval since therapy. CT findings that cannot be explained on the basis of radiation therapy or that are suggestive of recurrent disease must be further evaluated.

Adult↗
PubMed1991

CT of lymphoma: spectrum of disease.

Computed tomography (CT) is the study of choice for the detection and staging of Hodgkin and non-Hodgkin lymphoma. CT enables accurate measurement of both tumor extent and volume and provides information that can be used to plan an appropriate therapeutic regimen as well as follow patient response to therapy. This article presents a systematic review of the common and uncommon appearances of lymphoma in the chest and abdomen. Potential pitfalls and limitations of CT in staging and follow-up are also addressed.

Hodgkin Disease↗
PubMed1991

CT of posterior mediastinal masses.

This article presents an algorithmic approach to the evaluation of posterior mediastinal masses seen with computed tomography (CT). CT remains the study of choice, since it not only can be used to help confirm the presence of these masses, but it also helps define the (a) location and extent of the lesion, (b) adjacent organ involvement, or (c) vascular involvement. Causes of posterior mediastinal masses include esophageal lesions, congenital or acquired vascular lesions, foregut cysts, intrathoracic goiters, mediastinal pseudocysts, fat-containing tumors, adenopathy, neurogenic tumors, infectious spondylitis, and vertebral tumors. From the CT appearance of the lesion, one can often distinguish among the various masses and identify their origin and cause. This information enables patient triage and therapy to be expedited and, in most cases of posterior mediastinal masses, allows a correct diagnosis to be made solely on the basis of the CT examination.

Blood Vessels↗
PubMed1991

Gastric antral vascular ectasia ("watermelon stomach"): radiologic findings.

Radiologic findings in a patient with gastric antral vascular ectasia are described on computed tomographic scans, upper gastrointestinal series, and specimen radiographs. Findings include prominent, scalloped antral folds radiating to the pylorus and thickening of the gastric antrum. Pathognomonic red vascular folds, likened to stripes on a watermelon, can be seen endoscopically.

Aged↗
PubMed1991

Sacral foramina: view at CT.

Conventional transaxial computed tomography (CT) is superior to plain radiography in depicting the sacrum. Because of the shape and orientation of the sacrum, CT provides oblique views of the structures of interest. With easily reproducible landmarks and standard transaxial CT data, orthogonal image sets can be produced that provide a true en face orientation matching the obliquity of the sacrum. This allows optimal visualization of the paired foramina and of the sacroiliac joints for better assessment of trauma, tumor, or inflammatory disease.

Humans↗
PubMed1991

Diffuse esophageal leiomyomatosis in a patient with Alport syndrome: CT demonstration.

In a patient with progressive dysphagia, postprandial vomiting, and a history of Alport syndrome, barium and manometric studies had been interpreted as consistent with achalasia, but a subsequent computed tomographic (CT) scan of the thorax was suggestive of a lower esophageal intramural mass. Multiple leiomyomas of the esophagus were later proved at thoracotomy. Differences between adult and pediatric leiomyomas and the association of leiomyomas with Alport syndrome are discussed.

Adolescent↗
PubMed1991

Crohn disease in the pediatric patient: CT evaluation.

Computed tomographic (CT) scans and medical records of 25 children (age range, 10-18 years) with pathologically proved Crohn disease were reviewed to better define the role of CT in the management of pediatric patients with Crohn disease. CT findings included small bowel thickening (range, 5-10 mm) (n = 20), colonic wall thickening (range, 6-15 mm) (n = 15), and small bowel dilation (n = 5). Mesenteric abnormalities such as adenopathy and focal fatty proliferation were seen in 11 to 18 patients, respectively. Extraluminal complications were easily identified with CT. Abscesses were noted in seven patients, inflammatory masses in four, and perirectal or perineal inflammation in 10. Fistulas were detected in four patients. The authors conclude that CT should be the initial imaging study performed in children with known Crohn disease and a changing pattern of clinical symptoms.

Abscess↗
PubMed1991

Helicobacter pylori gastritis mimicking gastric carcinoma at CT evaluation.

The abdominal computed tomographic (CT) scans from 61 patients with biopsy-proved Helicobacter (formerly Campylobacter) pylori gastritis were retrospectively reviewed. The CT scans were interpreted on the basis of the original report of the findings at CT examination and without knowledge of the results of biopsy. Of 19 patients (31%) with gastric abnormalities at CT, 14 (74%) had inflammatory changes initially reported as suspicious for gastric malignancy; malignancy was entertained as the primary diagnosis in four of those patients. In five of the 19 abnormal cases (26%), the diagnosis with CT was gastritis. The two major patterns of severe H pylori infection identified were (a) circumferential antral wall thickening and (b) thickening of the posterior gastric wall along the greater curvature, with or without evidence of ulceration. Thickening averaged 1.5-2.0 cm in cases suspicious for malignancy. The majority of abnormalities involved the gastric antrum (68%). No cases demonstrated significant adenopathy, obliteration of fat planes, or invasion of adjacent organs.

Adult↗
PubMed1991

Pseudomembranous colitis: CT evaluation of 26 cases.

Pseudomembranous colitis (PMC) is an infectious colitis usually occurring as a complication of antibiotic use. The computed tomographic (CT) appearances of 26 patients with PMC were reviewed. Twenty-three patients demonstrated an abnormal bowel wall, with an average wall thickness of 14.7 mm (range, 3-32 mm); in three patients, bowel wall thickness was normal. Contrast material trapped between thickened folds corresponded to the broad transverse bands described on plain radiographs. Pancolonic involvement was seen in 13 cases, while seven patients had right-sided involvement only; three patients had bowel wall thickening limited to the rectosigmoid only. Although the CT appearance of PMC is not highly specific, the diagnosis may be suggested in the proper clinical setting.

Adolescent↗
PubMed1991

Lymphoma of the lung: CT findings in 31 patients.

Lymphomatous involvement of the lungs is often a difficult clinical and radiologic diagnosis to make, yet is often critical in determining treatment. To better define the CT appearance of pulmonary lymphoma, we undertook a retrospective review of 31 patients with recurrent or secondary non-Hodgkin lymphoma or Hodgkin disease and lung parenchymal involvement on CT scans. Diagnoses were confirmed either by lung biopsy or by disease regression or progression with appropriate therapy. The CT scans were evaluated for the following findings: (1) nodules less than 1 cm, (2) a mass or masslike consolidation greater than 1 cm with or without cavitations or bronchograms, (3) alveolar or interstitial infiltrates, (4) masses of pleural origin, (5) peribronchial or perivascular thickening with or without atelectasis, (6) pleural effusions, and (7) hilar or mediastinal lymphadenopathy. The most common CT finding was a mass or masslike consolidation larger than 1 cm, seen in 21 (68%) of the 31 patients. The second most common finding was nodules less than 1 cm (19 patients). Sixty-eight percent of patients had three or more of the CT abnormalities. Lymphoma involving the lung parenchyma causes a variety of CT findings, the most common being a mass or masslike consolidation. Two-thirds of patients have more than one type of CT finding simultaneously.

Adult↗
PubMed1991

Computed tomographic evaluation of gallstone calcification for biliary lithotripsy.

As the Food and Drug Administration trials for biliary lithotripsy in the United States near completion, future criteria for patient eligibility remain to be defined. Gallstone calcification greater than 3-mm partial rim on plain film (KUB) or oral cholecystogram (OCG) has excluded patients thus far, since early results of gallstone clearance (lithotripsy plus chemodissolution) were suboptimal with calcified stones. To evaluate the usefulness of these criteria for gallstone fragmentation, computed tomographic (CT) scans were performed on 20 patients immediately prior to lithotripsy to evaluate gallstone density and 24 hours after lithotripsy to observe the CT appearance of fragmentation. The adequacy of fragmentation was determined by pre- and post-lithotripsy sonography. This report constitutes the results of these investigations.

Calcinosis↗
PubMed1991

Upper urinary tract infection: the current role of CT, ultrasound, and MRI.

This article reviewed some of the fundamental concepts in renal inflammatory disease. The difficulties in present terminology were reviewed and our approach discussed. The pathological underpinning of the acute-subacute infections were contrasted with those seen in the granulomatous diseases. The importance of CT in separating emphysematous pyelonephritis from emphysematous pyelitis and perinephric emphysema was stressed. Although ultrasound has been used in the past and is still of value in select situations, we prefer CT for assessment of renal infection. CT examinations show whether the disease is focal or diffuse, whether air is present, whether there is perinephric or pararenal extension, whether an abscess is present, and when the ideal time is for intervention. In severe renal infection in the adult, CT has shown the development of renal scars, perinephric extension, and the spontaneous drainage of Staphylococcus abscesses into nearby calyces.

Bacterial Infections↗