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Biomedical subjects

E R Heitzman

Publications and source records attributed to E R Heitzman.

At least 37 records · Page 2Linked to original sources
PubMed1986

The role of computed tomography in the diagnosis and management of lung cancer. An overview.

Computed tomography (CT) is now established as the principal radiographic adjunct to plain film examination in the diagnosis and management of lung cancer. It should be used in the evaluation of every pulmonary nodule to determine whether the nodule is solitary and whether mediastinal metastases are present and to evaluate the mass by assessing its density. In general, nodules with Hounsfield numbers greater than +175 can be presumed to be calcified and, hence, benign. CT is of great value in determining the extent of lung cancer and at present the best imaging modality for evaluating mediastinal lymph nodes. Spread of tumor to mediastinal nodes is evaluated on the basis of node size. Nodes less than 1.0 cm in diameter are considered normal, 1.0-1.5 cm suspicious for tumor, and greater than 1.5 cm have a high probability of being malignant. Node size, however, is dependent on location in the mediastinum and whether infection is present in the lung. Size criteria alone should not be used to deny surgery.

Adrenal Gland Neoplasms↗
PubMed1982

Pathways of tumor spread through the lung: radiologic correlations with anatomy and pathology.

The pathways of tumor spread through the lung are described and their significance for radiographic interpretation is illustrated. A key to understanding the spread of bronchogenic carcinoma is the realization that although the normal flow of lymph in the pulmonary lymphatics is centripetal, lymphatic obstruction can cause reversal of flow. As a result, tumor cells are commonly carried centrifugally to the periphery in lymphatics or the connective tissue around them, and remote pleural involvement, secondary parenchymal masses, or satellite nodules may develop. Failure to appreciate peripheral spread of tumor has negative consequences for tumor staging, surgery, and radiotherapy. In the absence of hilar node involvement causing obstruction, long line shadows more than 0.5 inch (1.25 cm) in length proximal to a peripheral mass very infrequently represent tumor.

Bronchi↗
PubMed1982

Radiographic anatomy of the interlobar fissures: a study of 100 specimens.

A review of the anatomy of the interlobar fissures is based on a detailed study of 100 fixed and inflated lung specimens (50 right and 50 left lungs). The upper part of the fissural surface of the right lower lobe almost always faces in a slightly lateral direction and is usually concave; the lower part typically faces laterally but is usually convex. The upper part of the left major fissure also almost always faces laterally and is concave; but unlike the right side, the lower part usually faces medially and is convex. The minor fissure is typically oriented so that the anterior part is lower than the posterior part and the lateral margin is lower than the medial margin. Incompleteness of the fissures (fusion between lobes) is common; this study revealed a 70% incidence of fusion across the upper right major fissure, 47% across the lower right major fissure, 40% across the upper left major fissure, 46% across the lower left major fissure, and 94% across the minor fissure. The fissural complex is a term used to describe the variable anatomic relation of the major and minor fissures. Some comments are offered concerning fissural anatomy relative to collateral air drift, the visualization and position of interlobar fissures on chest radiographs, and the appearance of inferior interlobar fluid on the lateral radiograph.

Humans↗
PubMed1980

Density patterns in the normal lung as determined by computed tomography.

Lung density patterns in a group of randomly selected, normal individuals were determined by computed tomography, using two methods: one measuring the density of the peripheral lung (parenchyma), and the other determining the density of the whole lung field. The effects of body position and respiratory phase, as well as patient age were assessed. The potential use for this information in clinical settings and in physiological investigation is suggested.

Age Factors↗
PubMed1979

Transmission computed tomographic diagnosis of experimentally produced acute pulmonary vascular occlusion in the dog.

Acute experimental pulmonary arterial occlusions were produced in 5 dogs. The chest was subsequently imaged with computed tomography (CT), 99mTc-MAA scintigraphy, and plain radiography. Gamma images revealed all 6 lesions, and plain radiographs were uniformly negative. Enhanced CT scans demonstrated 3 of 5 lesions, and unenhanced scans revealed 1 of 6. CT findings were variable.

Animals↗
PubMed1979

Transmission computed tomography, Tc-99m MAA scintigraphy, and plain chest radiography after experimentally produced acute pulmonary arterial occulusion in the dog.

We have occluded segmental and subsegmental pulmonary arteries in the dog with Swan-Ganz balloon catheters or i.v. injection of autologous clot, and have studied the chest with transmission computed tomography (TCT), Tc-99m-MAA gamma imaging, and plain radiographs. The arterial occlusions were between 1 and 5 hr old at the time of imaging. Radiographs revealed no lesions. Tc-99m MAA scanns revealed ten of 11 lesions. When a TCT image was made before i.v. injection of Renografin-60, two of 11 lesions were identified; after Renografin the score was four out of ten. The appearance of lesions on TCT was highly variable. Tc-99m-MAA gamma imaging, therefore, is far more accurate than TCT in the identification of small experimentally produced acute pulmonary arterial occlusions in the dog, and our study fails to suggest a secure place for TCT in the diagnosis of small, acute human pulmonary emboli. The commonly-held assumption that postembolic lung is oligemic is questioned.

Animals↗
PubMed1978

Computed tomography of the lung.

Preliminary work has shown that normal lungs have predictable CT patterns and density ranges. In emphysema, there are irregular zones of extremely low density as well as an overall low mean density. CT appears to have considerable potential for early detection of pulmonary emphysema and characterization of the degree of involvement. CT can also be useful in the study of physiological phenomena such as regional blood flow.

Adolescent↗