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Biomedical subjects

G A Gooding

Publications and source records attributed to G A Gooding.

At least 73 records · Page 4Linked to original sources
PubMed1985

Parathyroid aspiration biopsy under ultrasound guidance in the postoperative hyperparathyroid patient.

A 10-MHz high-resolution dedicated small parts scanner and a static 5-MHz digital scanner were used in the ultrasound (US) examination of 11 patients with hyperparathyroidism who had previously undergone surgery of the parathyroid (eight patients) or thyroid (three patients) gland. Using US localization, aspiration biopsies were performed successfully in nine patients: parathyroid disease was confirmed in seven patients and thyroid lesions in two. Inadequate aspirate was obtained in one patient; in another patient a biopsy was done successfully under CT guidance following a negative US examination. The authors conclude that high-resolution US is an effective tool for guiding the aspiration biopsy of nonpalpable parathyroid tumors in patients who have had neck surgery. They suggest modifications of the US equipment that would simplify the localization procedure.

Adenoma↗
PubMed1985

Scrotal calculi: sonographic detection.

Scrotal calculi are freely moving concretions that lie in the space between the tunicae lining the scrotum and the testicles. They are believed to originate either as fibrinous deposits in the tunica vaginalis testis or as remnants of the appendix testis or appendix epididymidis that have undergone torsion and become freely movable. A sector real-time scanner with a 7.5-MHz transducer and a small-parts scanner with a 10-MHz transducer were used to visualize scrotal calculi in two patients. The ultrasonic appearance is described along with the surgical findings, and the pathogenesis of this benign process is discussed.

Aged↗
PubMed1985

Sonography of axillofemoral and femorofemoral subcutaneous arterial bypass grafts.

Axillofemoral and femorofemoral grafts in 12 patients were examined on 22 occasions with linear-array and digital static scanners with 5-MHz transducers and a 10-MHz high-resolution real-time instrument. Real-time instruments that produce a linear image, particularly high-resolution small-parts units, are the most appropriate to define the incorporation of the prosthesis, its pulsatility, and the nature of the perigraft bed. Early after implantation, these grafts have small perigraft fluid collections in the surgically created tunnels. These collections disappear spontaneously as the graft is incorporated into the tissues. However, discrete and persistent perigraft fluid collections are abnormal. Such collections were noted in five patients. One proved to be abscess and four were seromas. Graft occlusions (four patients) and an anastomotic aneurysm (one patient) were also readily diagnosed on sonography.

Aged↗
PubMed1985

Intraoperative sonography of perisplenic pseudocysts.

Three patients with pseudocysts of the pancreas affecting the spleen were examined with intraoperative sonography, which demarcated the fluid collections either within the pancreas (two cases), in the splenic hilum (one case), encapsulating the spleen (one case), or along the lateral aspect of the spleen (one case). This method was useful in defining the location of the cysts, distinguishing one from another, determining the relation of the cyst to adjacent organs, and assessing the adequacy of the surgical drainage.

Adult↗
PubMed1985

Heel pad thickness: determination by high-resolution ultrasonography.

Heel pad thickness classically is increased in acromegaly and can also be noted in long-term Dilantin therapy. A high-resolution 10-MHz dedicated superficial small parts real-time scanner was used to evaluate heel pad thickness without the use of radiation and without the magnification inherent in the standard procedure, a lateral radiograph of the foot. Fifty-four patients were studied, and it was determined in 10 controls that heel pad thickness averaged 16.6 mm. In 38 diabetics without ulcers of the feet, the heel pad was 17.8 mm. A single treated acromegalic had a heel pad thickness of 21 mm. Ultrasonography offers an effective alternative to radiography in the measurement of heel pad thickness.

Acromegaly↗
PubMed1985

The predictive value of physical examinations for ascites.

To determine the predictive value of physical signs for ascites, we compared the results of physical examination with those of abdominal sonography in 90 men in hospital with liver disease. The positive predictive values of shifting dullness and prominent fluid waves were low (51% and 73%). We divided the patients into two groups: those with prolonged prothrombin times (72% prevalence of ascites by sonogram), and those with normal prothrombin times (15% prevalence). In patients with prolonged prothrombin times, a prominent fluid wave had a very high positive predictive value for ascites (96%). Many patients with prolonged prothrombin times had ascites despite negative physical signs. In contrast, in those with normal prothrombin times, both shifting dullness and prominent fluid waves were usually falsely positive. Patients with normal prothrombin times and no shifting dullness rarely (2%) had ascites. The predictive value of physical signs for ascites depends on the prevalence of ascites in groups of patients that are examined. The prothrombin time is a useful index for identifying inpatients with a high or low prevalence of ascites and the predictive value of physical signs is enhanced by interpreting them in combination with a patient's prothrombin time.

Ascites↗
PubMed1985

Localization studies in patients with persistent or recurrent hyperparathyroidism.

Preoperative localization studies are essential for patients who have undergone previous parathyroid operations. This is because the remaining parathyroid glands are more difficult to identify at operation because of increased scarring with loss of normal tissue planes and because the remaining abnormal parathyroid tissue is more likely to be situated in an ectopic position. This investigation concerns the accuracy of preoperative localization studies in 36 consecutive patients. All patients had symptoms and clinical and laboratory data diagnostic of primary (31 patients) or secondary (five patients) hyperparathyroidism. Ultrasonography was performed in all 36 patients; 18 (50%) were positive, 14 (39%) were negative, and four (11%) were false positive examinations. Eight of the negative study results occurred in patients with abnormal parathyroid glands situated in the mediastinum. Computerized tomography (CT) was performed in 25 patients. There was an equal number of positive (11; 44%) and negative (11; 44%) studies with three (12%) false positive test results. CT was helpful in identifying substernal lesions and other abnormal parathyroid glands situated in ectopic positions. Thallium chloride 201-technetium 99m pertechnetate scans were used in 22 patients. There was an equal number of positive (eight; 36%) and negative (eight; 36%) studies. Six patients (27%) had false positive scans. One or more of these noninvasive tests was positive in 27 of the 36 patients (75%). Highly selective venous catheterization for the measurement of immunoreactive parathyroid hormone concentrations localized the elusive parathyroid tumor in 12 of the 16 patients (75%) overall and in six of the nine patients (66%) whose tumors were not identified by other studies. One patient had both a false positive ultrasound and thallium chloride 201-technetium 99m pertechnetate scan. Preoperative localization studies were therefore very helpful for locating hyperfunctioning parathyroid glands in patients with recurrent or persistent hyperparathyroidism, and 75% of the tumors were identified by noninvasive studies. Seventy-five percent of the tumors not identified by noninvasive studies were localized by selective venous catheterization. Most tumors not identified by noninvasive studies were mediastinal or ectopic in position.

Adult↗
PubMed1984

Magnetic resonance imaging of the neck. Part I: Normal anatomy.

Magnetic resonance (MR) images of the neck were obtained in 24 patients using a specially designed radio-frequency coil, standard and high-resolution imaging techniques, and a variety of spin echo and inversion recovery pulse sequences. Cervical vascular structures were more easily identified with MR than with CT because of the inherent contrast of flowing blood. The laryngeal skeleton, paralaryngeal tissues, trachea, thyroid, esophagus, and muscles were identified in all cases by MR using morphologic criteria comparable with CT criteria. The spatial resolution of high-resolution MR was slightly inferior to high-resolution CT. However, streak artifacts due to motion and x-ray beam hardening often limited CT, but did not affect MR. Anatomic resolution was best using high-resolution spin echo images obtained with TR = 2.0 seconds and TE = 28 msec because this imaging technique offered excellent contrast between normal tissues and had the highest signal-to-noise ratio. With further improvements in spatial resolution MR is likely to become an important technique for imaging the neck.

Adolescent↗
PubMed1984

Magnetic resonance imaging of the neck. Part II: Pathologic findings.

Magnetic resonance (MR) images of the neck were obtained in 14 patients with thyroid, parathyroid, lymph node, or laryngeal lesions. Tumors and lymph nodes were more easily differentiated from muscle and blood vessels with MR than with CT because of the superior soft tissue contrast of MR. Tissue characterization allowed MR differentiation of thyroid nodules, thyroid cysts, and parathyroid tumors from normal thyroid tissue; however, nonspecifically increased T1 and T2 relaxation times overlapped for a variety of neoplastic and inflammatory conditions. Thyroid cyst fluid had the greatest water content and longest T1 and T2 times of all tissues studied. Parathyroid hyperplasia could not be differentiated from parathyroid adenoma; however, parathyroid tumors had slightly longer T1 and T2 times than thyroid nodules or lymph nodes. With further experience, MR tissue characterization may become a useful technique for evaluating neck masses.

Adolescent↗
PubMed1984

Iliofemoral venous thrombosis: real-time ultrasound diagnosis, normal criteria, and clinical application.

We determined the response of the common femoral vein to respiratory maneuvers using high resolution real-time ultrasound in 10 normal subjects, and we evaluated this modality in the diagnosis of iliofemoral venous thrombosis in 36 patients. We developed diagnostic criteria for assessment of the venous system and have confirmed them with phlebography or pathologic findings. An increase in venous diameter of 50-200% on performance of the Valsalva maneuver, with a prompt return to the original configuration, was always associated with a normal iliofemoral venous system. Two patterns of occlusion of the femoral venous system were found: an enlarged circular femoral vein that did not increase in size on deep inspiration or performance of the Valsalva maneuver, and difficulty or inability to detect the common femoral vein. A dampened response, i.e., a 10-50% diameter increase on performance of the Valsalva maneuver, was associated with deep vein thrombosis in four of six patients. The false positive rate of 8% was due to gross congestive cardiac failure in one patient. This technique is simple to perform, relatively inexpensive, expeditious, and has proved useful in confirming or denying the presence of iliofemoral venous thrombosis.

Adult↗
PubMed1984

High-resolution sonography of scrotal contents in asymptomatic subjects.

Forty male volunteers with no known intrascrotal pathology by history and physical examination were scanned with a 10-MHz dedicated superficial-parts scanner. Sonographic features of intrascrotal anatomy were reviewed. The testes appeared homogeneous in texture and occasionally contained cysts (8%). The echogenic head of the epididymis, although variable in size and shape, was consistently imaged. Epididymal cystic structures (29%) and calcifications (3%) were occasionally seen. The amount of peritesticular fluid, presence of variococeles , and range of scrotal skin thickness were also noted. An understanding of intrascrotal anatomy in asymptomatic subjects can provide a baseline for the evaluation of the symptomatic scrotum.

Adult↗
PubMed1984

Sonographic detection of ascites in liver disease.

In a prospective study of 132 men suspected to have liver disease, ultrasound defined ascites in 62. Patients with minimal ascites were most likely to have subtle fluid collections around the liver. When this minimal ascites was confined superior to the liver, real-time sector units were unable to detect it with medium-focus transducers. A right lateral decubitus position (right side down) for detection of small amounts of fluid was superfluous.

Ascites↗
PubMed1983

Intraoperative real-time ultrasound in the localization of intracranial neoplasms.

Intraoperative ultrasound imaging in the localization of intracranial lesions in eight patients is described. This technique is effective in tumor location, and it can be used throughout surgery to monitor the extent of tumor resection. The ability to locate precisely a deeply situated intracranial lesion intraoperatively can reduce the risk of damage to normal tissue, assist in determining the extent of tumor resection, and reduce the time of surgery. Intraoperative ultrasound holds great promise, but if it is to be used to its fullest extent, further modifications of transducers must be developed.

Astrocytoma↗
PubMed1983

The status of women radiologists: membership on editorial boards and participation in upper echelons of radiologic societies.

A study was undertaken to determine the role of women radiologists in organized radiology on a national level. Statistics relating to age and sex distribution of radiologists, editorial representation of women radiologists, and membership of women radiologists in upper echelons of radiologic societies were analyzed. In relation to their numbers, women radiologists were found to be under-represented in all categories studied; some possible contributing factors are noted. Greater participation of women radiologists should be supported and encouraged.

Adult↗