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Biomedical subjects

G Morillo

Publications and source records attributed to G Morillo.

At least 19 recordsLinked to original sources
PubMed1996

Genitourinary tract gas: imaging evaluation.

Gas-forming infections of the genitourinary tract may manifest as life-threatening conditions, often requiring aggressive medical and surgical management. Accurate interpretation of the radiologic studies is essential for early and accurate diagnosis of gas within the renal parenchyma or collecting system, bladder, uterus, and scrotum. Three distinct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess. Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introduced by means of instrumentation. Uterine gas usually indicates an underlying infection or a neoplasm. Gas in the scrotum is most commonly due to an infectious process or bowel herniation into the scrotal sac. Before institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tract. Plain radiography, including tomography, and ultrasonography are useful screening modalities. Although in some cases urography, barium enema studies, and other contrast material-enhanced studies enable a diagnosis to be made, in many patients computed tomography is the definitive diagnostic technique.

Adult↗
PubMed1994

Radioimmunodetection of colorectal carcinoma using technetium-99m-labeled Fab' fragments of the IMMU-4 anti-carcinoembryonic antigen monoclonal antibody.

BACKGROUND: Radioimmunodetection of cancer using monoclonal antibody fragments offers certain potential advantages over that with whole monoclonal antibodies, including the ability to image early (i.e., to provide images at an early time after injection of the radioantibody) while minimizing the incidence of human anti-mouse antibody response. This paper reports a prospective trial comparing radioimmunodetection with IMMU-4 (a murine anti-CEA monoclonal antibody) 99mTc-labeled Fab' fragments to conventional imaging in 35 colorectal cancer patients. METHODS: All patients were investigated by conventional diagnostic methods (CDM) within 4 weeks of radioimmunodetection. Surgical corroboration of findings was obtained in 26 patients (15 with evidence of disease on CDM [CDM+] and 11 with abnormal serum CEA [CDM-] as the only evidence for recurrence). After 1 mg IMMU-4 99mTc-Fab' was injected (19.3 mCi on average), patients underwent planar/SPECT radioimmunodetection 2-5 hours later and planar radioimmunodetection 18-24 hours later. Three patients underwent a second radioimmunodetection study 16, 20 and 23 months after the first. RESULTS: Radioimmunodetection was superior to CDM, accurately predicting disease distribution in six nonsurgical and ten CDM+ surgical patients, and was complementary to computed tomography in two nonsurgical and two CDM+ surgical patients. Radioimmunodetection would have directed or changed management decisions in 6 of the 15 (40%) CDM+ surgical patients. Radioimmunodetection correctly identified all recurrent tumor in 8 of 11 CDM- surgical patients and was negative in one patient with cirrhosis and no recurrence, representing a potential clinical benefit of 82%. Analyzed on a regional basis, radioimmunodetection was found to be superior to CDM in extrahepatic abdomen and pelvis imaging and was complementary to (although not as accurate as) CDM in the liver. Human anti-mouse antibody did not develop in any of the patients, including three who were injected twice. CONCLUSIONS: IMMU-4 99mTc-Fab' radioimmunodetection shows promise as a clinically useful diagnostic tool in patients with colorectal cancer, detecting disease often missed by conventional imaging. IMMU-4 99mTc-Fab' may prove useful for serial radioimmunodetection studies, because human anti-mouse antibody response does not appear to be a problem with this radioimmunoconjugate. It also has the advantage of permitting same-day imaging.

Animals↗
PubMed1991

Imaging of intra- and extraabdominal desmoid tumors.

Desmoid tumors are characterized by proliferation of fibroblastic cells that arise from the fascia or aponeurosis of muscle. They are most commonly found in the abdomen of adults, arising from the anterior abdominal wall, mesentery, or retroperitoneum. At sonography, desmoids have variable echogenicity, with smooth, well-defined margins. On contrast-enhanced computed tomographic scans, the tumors are generally high attenuation (relative to muscle) and have either ill- or well-defined margins. At magnetic resonance imaging, desmoids have low signal intensity relative to muscle on T1-weighted images and variable signal intensity on T2-weighted images. There are no specific imaging features to distinguish desmoid tumors from other solid masses. The diagnosis of desmoid tumor should be considered in patients with an abdominal mass, a history of abdominal surgery or injury, or Gardner syndrome.

Abdominal Neoplasms↗
PubMed1989

The CT appearance of cystic masses of the liver.

The authors here discuss twelve discrete pathologic entities that they found, in a review of over 500 abdominal CT scans, caused the appearance of a cystic lesion in the liver. The CT characteristics of the various lesions are illustrated, differential points in the patients' histories are noted, and gross and microscopic pathology specimens are correlated with the CT appearances to explain the CT findings. Lesions considered include: simple (bile duct) cyst, adult polycystic kidney disease, Caroli disease, pyogenic abscess, echinococcal cyst, amebic abscess, metastasis, biliary cystadenoma and cystadenocarcinoma, hepatocellular carcinoma, cholangiocarcinoma, biloma, and extrapancreatic pseudocyst.

Carcinoma, Hepatocellular↗
PubMed1987

Hemangioma of the liver: heterogeneous appearance on T2-weighted images.

We reviewed the gross photographs of 19 patients with hemangioma of the liver. On cut sections, all 19 tumors were inhomogeneous. In 17 cases (89%) there were areas of predominantly central fibrosis. Lobulations were present in 10 cases (53%). Areas of thrombosis (nine cases), calcification (four cases), and hemorrhage (four cases) were also present. We also reviewed 15 hemangiomas of the liver in 12 patients studied by MR imaging. Gross photographs and MR scans were available in three hemangiomas, thus allowing direct radiologic-pathologic correlation. Twelve (80%) of the hemangiomas were inhomogeneous on T2-weighted images and three (20%) were homogeneous. Other characteristics were sharp margins in all 15 cases (100%), lobulations in 11 cases (73%), peripheral location in 10 cases (67%), and internal septations in four cases (27%). We concluded that (1) hemangiomas of the liver are frequently inhomogeneous on cut sections; (2) heterogeneity in T2 images is commonly seen and should not exclude hemangioma; and (3) other signs, such as sharp margins, lobulated contour, and peripheral location, may be helpful in the MR diagnosis of hemangioma of the liver.

Hemangioma↗
PubMed1986

Renal cell carcinoma complicating long-term dialysis: computed tomography-guided aspiration cytology.

The diagnosis of renal cell carcinoma was established by computed tomography-guided aspiration in two small solid lesions occurring in end-stage kidneys. This represents a safe means of providing more specific information about the various lesions that specific information about the various lesions that frequently develop in chronic hemodialysis patients: complex cysts, adenoma, and renal cell carcinoma. The proposed conservative approach of simple observation of these lesions may be altered if a precise diagnosis is obtained. Computed tomography is considered the most reliable imaging modality for evaluation and guided aspiration.

Adult↗
PubMed1986

Review of computed tomography findings in thrombosis of the major abdominal venous pathways.

Computed tomography is commonly the first diagnostic modality to detect venous thrombosis. The relatively constant location and anatomic relations of the major abdominal veins allow for their proper recognition and differentiation from other tubular structures. Whether the occlusion is secondary to blood clot or tumor extension, the vessels demonstrate a characteristic appearance. The presence of adjacent tumor mass is the single most important factor to differentiate the two types of thrombi. Invaluable aid is provided by computed tomography in the management of this clinical situation. Uncommonly, the diagnosis remains unclear and venography must be done. Selected examples of major abdominal venous thrombosis are presented.

Abdomen↗
PubMed1981

The sonographically solid appearing benign cystic teratoma.

The sonographic appearance of 6 solid benign cystic teratomas (in 5 patients) was reviewed. Three of these tumors were difficult to identify due to the presence of acoustical shadowing obscuring the posterior portions of the tumors. This appearance was mistaken ultrasonically for bowel gas. The tumors were diagnosed by abdominal radiographs showing calcifications, teeth and/or radiolucency due to fat. With the presence of a clinically palpable pelvic mass in a young woman, and an apparently normal sonogram, an abdominal radiograph should be considered to look for evidence of a benign cystic teratoma.

Adolescent↗
PubMed1980

Gallium-67 radionuclide imaging in acute pyelonephritis.

The symptoms and clinical course of patients with acute pyelonephritis are variable; likewise, urinalysis, blood cultures, and excretory urography may be normal or equivocal. The ability of gallium-67 to accumulate in areas of active inflammation was useful in the diagnosis of acute pyelonephritis in 12 cases. A multiplane tomographic scanner was used for imaging four of these patients. Initial experience with this scanner is also discussed.

Acute Disease↗
PubMed1980

Mediastinal adenopathy in myeloma.

Radiographic detection of intrathoracic lymphadenopathy in multiple myleoma is uncommon, but may occur late in the course of the disease. Rarely, it may present a diagnostic problem and needle aspiration biopsy may be necessary for definitive diagnosis.

Diagnosis, Differential↗
PubMed1979

Pathologic vascularity of renal angiomyolipoma: cast corrosion and angiographic study.

Angiomyolipomas of the kidney at times have been preoperatively identified by the interlobar or interlobular artery eneurysms in the early vascular phase of renal arteriograms. A case report is presented in which a plastic cast corrosion technique was used postnephrectomy to demonstrate the presence of aneurysms identified angiographically prior to surgery. Portions of a cast corrosion model of a hypernephroma are also exhibited to compare and contrast pathologic vascular features of both types of tumors.

Adult↗
PubMed1979

The role of computed tomography in the diagnosis of renal and perirenal abscesses.

Computed tomography was done on 4 patients suspected of having an intrarenal or perirenal abscess based on clinical grounds and an abnormal excretory urogram. Intrarenal abscesses with perinephric extension were demonstrated in 3 patients and a solitary perinephric abscess was demonstrated in 1. Computed tomography is a valuable tool in the diagnostic study of suspected intrarenal and perirenal abscesses because not only can the primary abscess be shown but also its possible extrarenal extension.

Abscess↗
PubMed1979

Retrocaval ureter: report of 8 cases and the surgical management.

We present 8 cases of retrocaval ureter, one of which concerns a unique periureteral venous ring formed by the persistence of the right posterior cardinal vein along with a normal vena cava. Current radiographic concepts are reviewed and the importance of inferior venacavography in the preoperative evaluation for correction of the retrocaval ureter is emphasized.

Adolescent↗
PubMed1979

The differential diagnosis of the unilateral small kidney.

Although it is frequently possible to determine the cause of an unilateral small kidney, there are cases where the renal damage is so advanced, or the interference to growth and maturation so extensive, that the etiology cannot be established. High-dose urography with tomography during the nephrographic phase are required for a confident diagnosis. Ureteral compression should be used to improve calyceal visualization. This technique can be adapted for children. Complementary diagnostic procedures are often needed, both in adults and in children. We cannot emphasize enough the need for clinical correlation and comparision with previous examinations.

Adult↗