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Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 487 records · Page 27Linked to original sources
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Multidimensional interactive display of CT and MRI data.

This paper presents a technique for the multiplanar display and manipulation of standard CT and MRI data. Using this interactive tool one can display axial, coronal, and sagittal plane from standard CT or MRI data sets, as well as selecting arbitrary oblique planes. This system uses a bi-cubic interpolation technique to produce high quality reformatted images. The tool allows interactive roaming of the CT or MRI data volume and facilitates communication between the radiologist and the referring physician.

Algorithms↗
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Distribution of metastases in breast carcinoma: CT evaluation of the abdomen.

To determine the frequency and distribution of extrahepatic and extraskeletal metastases in patients with breast carcinoma, the abdominal CT scans of 260 consecutive patients were systematically evaluated. Extrahepatic and extraskeletal metastases were demonstrated in 26 patients (10%). Confirmation of findings was made by biopsy, autopsy, or by demonstration of progression or regression of disease. Twelve patients (4.6%) demonstrated metastases to the stomach, eleven of whom presented with a linitis plastica pattern. Retroperitoneal and/or mesenteric adenopathy was noted in 10 patients (3.8%), of whom three demonstrated associated hydronephrosis and one demonstrated associated biliary obstruction. Ascites was seen in 14 (5.4%) and peritoneal carcinomatosis in 7 (2.6%). Genitourinary involvement included metastases to the kidney (one case), ureter (one), and uterus (one). Direct invasion of the diaphragm by adjacent pleural metastases (two cases) as well as a soft tissue metastasis (one case) was also demonstrated. Metastases to the ovaries, adrenals, or pancreas could not be identified. Although lesions to the liver and skeleton account for the largest group of metastases from breast carcinoma seen in the abdomen, one should be aware of the potential for other locations of metastatic disease.

Abdominal Neoplasms↗
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Nonfunctional paraganglioma of the liver.

Paragangliomas occurring in the liver are rare. We report a patient with a history of nonfunctional paragangliomas in the head and neck who developed liver metastases years later. We discuss findings on cross-sectional imaging modalities, including magnetic resonance imaging (MRI), which demonstrate the hypervascular nature of the liver masses.

Adult↗
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Detection of internal mammary lymph node enlargement: comparison of CT scans and conventional roentgenograms.

Sixty-two patients with breast cancer had thoracic computed tomography (CT) scans and conventional chest radiographic (CXR) examinations separated by an average of 29 days. CT served as the gold standard showing 13 cases with enlarged internal mammary nodes 0.4 to 7 cm in diameter. Original CXR interpretations were available. Additionally, these films were reinterpreted, without knowledge of the CT results, with special attention to the retrosternal region on the lateral film including the use of a bright light and comparison to prior lateral views. Original CXR interpretations detected only one (7 cm) enlarged node. Sensitivity was 8% and specificity 100%. Reinterpretation of the CXRs, without knowledge of the CT results, with special attention to the retrosternal region yielded five true positive and seven false positive determinations for a sensitivity of 38% and specificity of 86%. No enlarged node under 2.5 cm in diameter was detected on CXR. Sensitivity of CXR can be considerably improved by careful evaluation of the retrosternal space, but at the cost of considerable increase in false positive examinations. CT is necessary to achieve reasonable sensitivity and specificity in the detection of internal mammary lymphadenopathy.

Breast↗
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Giant pseudoaneurysm of the hepatic artery--CT demonstration. Case report.

Noninvasive imaging studies, particularly computed tomography (CT), are the first step in evaluation of patients with suspected hepatic trauma. Iatrogenic injury, accounting for up to one-third of cases, may commonly result in hepatic artery pseudoaneurysm formation. We present a case in which a giant hepatic artery pseudoaneurysm was misinterpreted as an intrahepatic hematoma on sequential CT scans due to the failure to employ dynamic contrast-enhanced scan techniques.

Aneurysm↗
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Inflammatory breast cancer: CT evaluation.

Eleven patients with inflammatory breast carcinoma were examined by computed tomography (CT) prior to treatment with radiation and chemotherapy. Determination was made of skin thickening of the affected breast, presence of diffuse breast tumor infiltration or mass, calcification, adenopathy; and metastases. All affected breasts demonstrated increased skin thickness relative to the nonaffected breast, ranging from 0.7 cm-3 cm. Each could further be characterized as having diffuse infiltration of the breast tissue (5), a focal mass lesion (4), or a combination of mass with associated infiltration (2). Two of the breast masses showed diffuse calcification. Only one patient had disease confined to breast tissue at the time of study. Nine patients presented with adenopathy; 7 axillary, 3 internal mammary, 2 supraclavicular, and 1 hilar. Bilateral adenopathy was noted in two patients. Distant metastases to lung, bone, or stomach were observed in 7 of 11 patients. Distant metastases and degree of adenopathy was not related to skin thickness, degree of tumor infiltration, or presence of a defined mass. Inflammatory breast cancer presents with a spectrum of computed tomography appearances. Computed tomography aids in the assessment of local disease, adenopathy, and distant metastases.

Axilla↗
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High resolution computed tomography of inflation-fixed lungs: pathologic-radiologic correlation of pulmonary lesions in patients with leukemia, lymphoma, or other hematopoietic proliferative disorders.

The accuracy of high resolution computed tomography (HRCT) in the diagnosis of pulmonary lesions arising in patients with leukemia, lymphoma, or other hematopoietic proliferative disorders was evaluated in postmortem lung specimens from 35 patients with one of these neoplasms. Lungs were obtained from autopsied patients and prepared in a manner that allowed for direct pathologic-radiologic correlation. Eighty-eight pulmonary lesions with one of five radiographic patterns were identified in these 35 lungs. The gross, histologic, and radiographic changes were examined and the radiologic and pathologic diagnoses for each lesion were compared. A diffuse alveolar pattern on HRCT was primarily the result of pneumonia or intraalveolar hemorrhage, while irregular focal densities were produced by foci of hemorrhage, infarcts, lymphoma, and fungal infections. HRCT of the lung from a patient with pulmonary histiocytosis X showed a wedge-shaped subpleural density in association with a "crab-like" interstitial pattern, which was histologically shown to be an infarct with interstitial enlargement by infiltration of histiocytosis X. Air bronchograms were seen in two settings. In patients with necrotizing pneumonia, air bronchograms were associated with bronchiectasis. In contrast, air bronchograms seen in a patient with a bronchocentric lymphoproliferative disorder showed a pattern of bronchial constriction. These results suggest that HRCT may play an important role in the evaluation of pulmonary lesions in patients with leukemia, lymphoma, or other hematopoietic malignancies.

Adolescent↗
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Cervical fracture in ankylosing spondylitis: value of multidimensional imaging.

Ankylosing spondylitis creates a rigid spinal column that cannot easily accommodate to altered or increased forces. Fractures or fracture-subluxation may be seen following apparently trivial injury. Assessment of the lower cervical and cervicothoracic spine can be limited in the kyphotic, ankylosed spine. However, reformatted computed tomography (CT) data can be manipulated to provide true orthogonal (sagittal, coronal) planar images of the obliqued spine, and can be used to provide a three-dimensional overview of anatomy prior to treatment. One such case is presented.

Aged↗
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Tumoral calcinosis causing bone erosion in a renal dialysis patient.

Tumoral calcinosis is a rare disorder manifest by large calcific periarticular masses. Associated bone destruction has been described previously only once. The radiographic and computed tomographic (CT) findings of bone erosion in a case of tumoral calcinosis in a renal dialysis patient are presented. Although the presence of bone destruction may suggest a neoplasm, it does not exclude the diagnosis of tumoral calcinosis.

Aged↗
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Splenic abscess as a complication of septic yersinia: CT evaluation.

Yersinia enterocolitica (YE) frequently causes gastrointestinal illness, but is rarely a cause of systemic infection. The complications of septic YE include a wide variety of extraintestinal manifestations, with a 34-50% mortality rate. We present a patient with septic YE complicated by a splenic abscess. The clinical presentation was nonspecific, and the diagnosis of splenic abscess was made by computed tomography (CT). Because of the nonspecific clinical presentation and the wide range of extraintestinal manifestations of septic YE, CT can prove helpful in the diagnosis and management of these patients.

Abscess↗
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Acute pulmonary hemorrhage. CT evaluation.

The computed tomography (CT) scans and chest radiograph of seven patients with bronchoscopic or pathologically proven cases of pulmonary hemorrhage were reviewed to determine the appearance and value of each modality. CT revealed the presence and location in all cases while chest radiographs were falsely negative in two cases. The CT pattern was always an alveolar pattern while the pattern was more variable on chest radiographs. By providing better pattern definition than the chest radiographs, CT is the study of choice in detecting the presence of a suspected pulmonary hemorrhage.

Acute Disease↗
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Mesenteric panniculitis presenting as a multilocular cystic mesenteric mass: CT and MR evaluation.

Mesenteric panniculitis is a non-neoplastic, inflammatory process affecting the adipose tissue of the mesentery in adults with slight male predilection. Typical computed tomography (CT) or magnetic resonance imaging (MRI) findings are of either diffuse mesenteric infiltration or nodular mesenteric masses. We encountered a case of mesenteric panniculitis in a 26-year-old woman with the left upper quadrant pain and fullness, in which CT and MRI disclosed a large, ill-defined, multilocular cystic mesenteric mass. After surgery, the diagnosis of mesenteric panniculitis was made. The cystic components were dilated lymphatics due to lymphatic and venous obstruction by the mesenteric panniculitis.

Adult↗
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Angioleiomyoma involving the sciatic nerve--CT demonstration. Case report.

An angioleiomyoma adjacent to the sciatic nerve was responsible for an 11-year history of pain and dysfunction in the sciatic nerve distribution, which required numerous therapeutic procedures and intermittent use of narcotic analgesics. Diagnosis was finally made when results of a sciatic nerve block suggested possible mechanical compression of the nerve and computed tomography examination of the pelvis was extended further caudal than usual, demonstrating the tumor adjacent to the sciatic nerve near the ischial tuberosity. Only one previous case of nerve dysfunction due to impingement by an angioleiomyoma has been reported.

Adult↗