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Biomedical subjects

G L Melson

Publications and source records attributed to G L Melson.

At least 37 records · Page 2Linked to original sources
PubMed1985

Sonographic detection of rotator cuff tears.

Thirty-nine consecutive patients referred for shoulder arthrography underwent shoulder sonography to determine the ability of sonography to detect rotator cuff tears. Fifteen patients had arthrographically proven rotator cuff tears. Of these, 14 were detected by sonography, for a sensitivity of 93%. The three sonographic criteria indicative of rotator cuff tear were (1) discontinuity in the normal homogeneous echogenicity of the rotator cuff; (2) replacement of the normal homogeneous echogenicity by a central echogenic band; and (3) nonvisualization of the cuff. Twenty patients had normal sonographic examinations, 19 of which were normal by arthrography. Therefore, the predictive value of a negative sonogram was 95%. On the basis of these findings, sonography can provide a noninvasive means of screening patients with suspected rotator cuff tears.

Adult↗
PubMed1984

Diagnostic evaluation of adult polycystic kidney disease in childhood.

Since adult polycystic kidney disease, an autosomal-dominant disease, results in renal failure in at least 50% of affected patients, its detection before childbearing age is desirable. To evaluate this capability and the preferred screening technique, 28 members of two generations of an affected kindred were studied. Sonograms, excretory urograms with nephrotomograms, and clinical laboratory evaluation were compared. Five of six studied members of the older generation had cysts demonstrated by both sonograms and excretory urograms with nephrotomograms. Eleven of 22 members of the younger generation were affected, the youngest being 5 years old. In this group, excretory urograms with nephrotomograms were a slightly more sensitive detector, especially in the younger patients. However, sonography provided sufficient sensitivity in the older child, and, because of its noninvasive nature, was the preferred screening technique. The clinical laboratory evaluation was of little diagnostic aid in children with adult-type polycystic disease.

Adolescent↗
PubMed1984

Papillary renal cell carcinoma: CT and sonographic evaluation.

The CT, sonographic, and pathologic appearances of 13 surgically confirmed cases of papillary renal cell carcinoma were reviewed. CT-pathologic correlation was available in all 13 cases. Sonography was performed in eight patients (10 distinct renal masses). CT features closely correlated with the previously established clinicopathologic and angiographic appearances. Papillary renal cell carcinoma demonstrated low stage at presentation in most cases (10 of 13 had stage I or II), had a high frequency of calcification (seven), and had less enhancement (diminished vascularity) than typical hypernephroma on CT scans. No consistent sonographic pattern existed; one of 10 masses was hyperechoic, five were hypoechoic, and four were isoechoic compared with normal kidney cortex. On the basis of these observations, a prospective CT diagnosis of papillary renal cell carcinoma can be confidently made in many circumstances. This is particularly important when renal-sparing surgery is a clinical consideration.

Adult↗
PubMed1982

A prospective comparison of the evaluation of biliary obstruction using computed tomography and ultrasonography.

A total of 103 consecutive patients with suspected biliary obstruction were studied using both computed tomography (CT) and ultrasound (US) to evaluate the relative accuracy of the methods. In 47 patients with confirmed obstruction, CT and US were comparable accurate in differentiating obstruction from nonobstruction. The precise level of obstruction was identified by CT in 88% and by US in 60%; the cause of obstruction was accurately predicted by CT in 70% and by US in 38%. Both methods detected useful additional information, such as cholelithiasis or retroperitoneal adenopathy. The authors use US as a screening examination; if there is doubt about the level and cause of sonographically demonstrated obstruction, CT has proved to be an accurate means of further evaluation.

Aged↗
PubMed1982

Sonographic detection of occult testicular neoplasms.

Testicular sonograms were performed in four patients with pathologically proven metastatic neoplasms but a normal physical examination of the scrotum. An abnormal echo texture was seen in all cases: focal hypoechoic nodule (about 1 cm) in two, diffusely hypoechoic in one, and mixed diffuse/focal abnormality in one. Correct sonographic identification of the abnormal testis facilitates surgical removal and precludes unnecessary excision of the contralateral normal testes. The authors recommended testicular sonography to be used as a routine procedure in all patients with such a clinical presentation.

Adenocarcinoma↗
PubMed1982

Hemorrhagic periventricular leukomalacia: diagnosis by real time ultrasound and correlation with autopsy findings.

Hemorrhage into areas of periventricular leukomalacia may occur and range in size from microscopic to massive. Hitherto, the definitive diagnosis has been made only at autopsy. A case is described in which the diagnosis of hemorrhagic periventricular leukomalacia was made antemortem by real-time ultrasound scanning and confirmed at autopsy. Periventricular/intraventricular hemorrhage, a more common hemorrhagic lesion, may extend into periventricular with matter in a location ventral and medial to hemorrhagic periventricular leukomalacia. Real-time ultrasound scanning is a safe and reliable means of defining the topography of these two hemorrhagic lesions and, thereby, of suggesting the correct diagnosis.

Brain↗
PubMed1981

Relative value of computed tomography and ultrasonography in the assessment of renal angiomyolipoma.

Imaging studies on six patients with known angiomyolipomas were reviewed to determine the contribution of each imaging modality to the preoperative diagnosis. A spectrum of clinical presentations from asymptomatic patients with tuberous sclerosis to acutely ill patients with flank pain and hypotension was included. Findings varied from multiple, small, bilateral intrarenal masses to single larger masses with extrarenal components. Computed tomography (CT) identified fat containing masses in all cases. Ultrasound showed hyperechoic masses in all four cases in which it was utilized. In addition, CT allowed diagnosis of associated hematomas and additional angiomyolipomas not seen on other studies. Ultrasound provided a noninvasive follow-up method without the use of ionizing radiation.

Adult↗
PubMed1981

Can real-time ultrasonography replace static B-scanning in the diagnosis of renal obstruction?

Two hundred consecutive patients were evaluated for renal obstruction using both static B-scanning and high resolution real-time scanning. The overall diagnostic accuracy was 93% for the static B-scanner and 94% for the real-time unit, with a false positive diagnostic rate of 8% for each. Because of its greater flexibility and shorter scanning time, real-time can replace static B-scanning in the diagnosis of renal obstruction. It has also become the preferred method of guidance for interventional uroradiological procedures. The pitfalls of real-time scanning in evaluating renal obstruction are also discussed.

False Negative Reactions↗
PubMed1980

Cholecystosonography: accuracy, pitfalls and unusual findings.

Gray scale cholecystosonograms in 200 patients were reviewed. The findings in 133 of the patients were proved correct at surgery or autopsy. The overall accuracy for the detection of gallstones was 92 percent, with a false-negative rate of 4 percent. A false-positive diagnosis of cholelithiasis was made in three patients, two of whom proved to have extensive cholesterolosis. Causes of false-negative studies were the presence of a single small calculus, obseity and a large distended gallbladder. Ultrasound was specific but insensitive in the detection of a thickened gallbladder wall. The significance of a nonvisualized gallbladder by ultrasound and the role of ultrasound in the diagnosis of gallbladder disease are discussed.

Adolescent↗
PubMed1980

Limitations of the post-lymphangiogram plain abdominal radiograph as an indicator of recurrent lymphoma: comparison to computed tomography.

A comparison was made between post-lymphangiogram abdominal radiographs and computed tomographic (CT) scans in 18 lymphoma patients. When radiographs were obtained more than one year after the original lymphangiogram, only a small percentage of the patients had adequate contrast medium remaining in the lymph nodes for a definitive diagnosis. In three cases with apparently adequate residual contrast material, the radiograph did not provide accurate information on the presence or extent of recurrent lymphoma. The authors conclude that CT is the preferred method for the initial staging of patients with lymphoma, as well as for follow-up studies after one year.

Adult↗
PubMed1980

Acute focal bacterial nephritis: emphasis on gray scale sonography and computed tomography.

The radiologic findings of acute focal bacterial nephritis in 13 patients are described. These include (1) focal swelling or mass on excretory urogram; (2) solid mass, often with echo amplitude lower than adjacent normal renal cortex on sonography; and (3) a poorly marginated, low density mass that exhibits patchy and inhomogeneous enhancement after intravenous contrast medium on computed tomographic scans. Serial sonograms are used to monitor the response of these patients to antibiotic therapy. The respective roles of sonography and computed tomography in the diagnosis and management of these patients are discussed.

Adult↗
PubMed1979

The roles of Gallium-67 scintigraphy, ultrasonography, and computed tomography in the detection of abdominal abscesses.

The evaluation of patients with suspected abdominal abscesses begins with a history and careful physical examination. Gallium-67 (67Ga) scintigraphy, ultrasonography (US), and computed tomography (CT) are utilized only after other routine investigations have failed to localize the abscess. All three modalities are reliable for the detection of abdominal abscesses. The decision regarding which of these three diagnostic tests to use in a particular patient rests upon clinical considerations. If the patient has acute localizing signs and symptoms, 67Ga should not be used initially. In this type of patient, rapid diagnosis is best provided by either US or CT. Further radiologic investigation may be terminated if the CT or US findings are characteristic of an abscess. A 67Ga scan should be performed in a patient with acute localizing signs and symptoms if the initial CT or US is negative. In a patient with nonlocalizing signs and symptoms, 67Ga imaging should be employed as the first procedure since the entire body is easily surveyed. If the 67Ga images are abnormal, then CT or US should be utilized for further lesion characterization. This diagnostic approach will optimize the rapidity of patient evaluation and will minimize diagnostic errors.

Abdomen↗