Search PubMedSearch

Biomedical subjects

G R Cherryman

Publications and source records attributed to G R Cherryman.

At least 19 recordsLinked to original sources

The role of computed tomography in the investigation of recurrent axillary disease in patients with carcinoma of the breast.

Carcinoma of the breast commonly recurs in the axilla. A nodal mass may be palpable and computed tomography (CT) is frequently requested in order to differentiate recurrent tumour from the longer term effects of surgery and radiotherapy. We have reviewed the CT scans of 35 such patients referred consecutively to our CT unit. CT only detected the presence of recurrent tumour in one patient in whom a mass could not be palpated. This patient had a previously irradiated 'wooden' axilla making clinical examination impossible. CT failed to diagnose recurrence in two patients; one with disease in normal sized nodes and the other with axillary vein thrombosis. We conclude that CT of the axilla only appears to be of value when the axilla is impossible to palpate due to previous treatment. The key to the diagnosis of axillary tumour recurrence is careful palpation supplemented by aspiration cytology of any mass. When no mass is evident on clinical examination, CT is unlikely to demonstrate disease.

Axilla

Cutaneous neuro-endocrine (Merkel cell) carcinoma.

Two cases of neuro-endocrine (Merkel cell) tumours of the skin are reported. There was evidence of distant relapse in both patients who eventually succumbed to the disease. The wide range of clinical and radiological manifestations of this rare tumour are discussed and the literature reviewed.

Aged

Magnetic resonance imaging in suspected metastatic spinal cord compression.

This study describes high field magnetic resonance imaging (MRI), in 55 patients with suspected metastatic spinal cord compression. MRI, principally using T1-weighted sagittal surface coil images, showed evidence of cord compression in 29 patients, and intramedullary masses in three patients. MRI clearly showed the site, nature and extent of the cord compression and gave useful additional information about the presence of bone marrow metastases and paravertebral soft-tissue masses. Comparison with conventional myelography was possible in 21 patients and MRI was superior or equivalent to myelography in 18 patients and inferior in three patients. MRI is the method of choice for the investigation of patients with suspected metastatic spinal cord compression.

Adolescent

Bladder cancer: staging with CT and MR imaging.

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in 30 patients with histologically proved bladder cancer. MR imaging was accurate in depicting the presence or absence of extravesical spread in 22 patients (accuracy, 73%; sensitivity, 82%; specificity, 62%), and CT was accurate in 24 patients (accuracy, 80%; sensitivity, 94%; specificity, 62%). The MR examinations of two patients were of undiagnostic quality and therefore considered to be technical failures. Each technique resulted in five false-positive and one false-negative examination for the diagnosis of extravesical tumor spread. In 28 patients the integrity of the bladder wall was assessed with MR imaging. In 22 patients the bladder wall was disrupted, and 18 of these patients had deep muscle invasion. In six patients the bladder wall was intact, and none of these patients had evidence of deep muscle invasion at pathologic examination. In this study MR imaging was slightly inferior to CT in the delineation of invasive tumors beyond the bladder wall. However, if one excludes from analysis the two patients with undiagnostic studies, there is no significant difference in accuracy between the two techniques.

Adult

Magnetic resonance imaging in recurrent carcinoma of the cervix.

Twenty patients with suspected recurrent cervical carcinoma were evaluated with computed tomography (CT) and high-field magnetic resonance imaging (MRI). Histological verification of the imaging findings were available in all cases. Computed tomography and MRI were equally effective in making the diagnosis of disease recurrence. The extent of vaginal recurrence and involvement of pelvic floor muscles was better shown on MRI than on CT.

Carcinoma, Squamous Cell

The value of thoracic computed tomography in the detection of recurrent Hodgkin's disease.

Fifty chest radiographs and concurrent thoracic computed tomography (CT) scans obtained in a total of 44 patients with 50 separate episodes of suspected recurrent Hodgkin's disease were reviewed. Recurrent disease was present in 18 episodes, involving the mediastinum in 12, the lung parenchyma in five and both mediastinum and lung parenchyma in one. In four episodes, mediastinal recurrence was demonstrated on both the chest radiograph and CT scan. In a further two cases, the chest radiograph appeared normal but CT detected recurrence in the mediastinum. In 20 cases, the mediastinal appearances on chest radiography were suspicious but not diagnostic of recurrence, usually because of previous radiotherapy resulting in residual mediastinal widening. Computed tomography diagnosed recurrent disease which was subsequently proven in seven of these cases. Recurrent disease was suggested by CT in a further case, subsequently shown to be radiation fibrosis. Of the 12 remaining chest radiographs in which the mediastinal assessment was indeterminate, CT was true negative for recurrent disease in 10 cases and was also indeterminate in two. Recurrent disease in the lung parenchyma was demonstrated on the chest radiograph and CT scan on five occasions. There was one incident in which the chest radiograph was normal but CT detected recurrent parenchymal disease. The appearances of the lung parenchyma were indeterminate for recurrent disease on three chest radiographs but CT was helpful in only one case in which radiation change alone was diagnosed. In eight cases the diagnosis of recurrent disease by CT resulted in a decision to initiate treatment. Computed tomography is of value in detecting relapse in patients with suspected recurrent Hodgkin's disease when the chest radiograph is inconclusive, and may enable differentiation of radiation change from recurrent disease in the mediastinum.

Adult

Fast magnetic resonance imaging of intracerebral metastatic disease.

The appearance of intracerebral metastases imaged with a multi-slice fast imaging sequence (FLASH) is described. Images were obtained using a Siemens 2.0 T Magnetom operating at 1.5 T. Results of the FLASH imaging sequence at different values of repetition time, different values of "flip angle" and different numbers of acquisitions are described both qualitatively and quantitatively. At low flip angles, both tumour and oedema appear brighter than surrounding white matter. Increasing the flip angle tends to make oedema brighter than both tumour and white matter and increasing the flip angle still further makes tumour and oedema darker than white matter. A major limitation of this technique is that the low flip angle images, in particular, suffer from low signal-to-noise ratios. High flip angle FLASH images have higher signal-to-noise ratios but show similar contrast behaviour to T1-weighted spin-echo images and are likely to be no better as a screening sequence for intracerebral metastases. All the FLASH sequences showed a sensitivity to changes in magnetic susceptibility. This made small intratumoral haemorrhages and basal ganglia "calcification" easier to detect than on spin-echo images but also caused susceptibility artefacts in images around the base of the skull.

Brain

Imaging techniques.

Explore the source record for details and available documents.

Carcinoma, Hepatocellular

Nuclear magnetic resonance imaging and single photon emission tomography with radio-iodine labelled compounds in the diagnosis of dementia.

White matter lesions and T1 changes were identified using NMR and then compared between groups of patients suffering from dementia of the Alzheimer type (DAT), Multiple infarct dementia (MID) and normal controls. All DAT and MID patients were also imaged with a gamma camera using 123Iodo-n-isopropyl-amphetamine, a radiopharmaceutical whose uptake in the brain follows the regional blood flow. While NMR was not able to differentiate between DAT and MID, 19 out of 21 DAT patients compared to four out of 18 MID patients showed bilateral parietal lesions on IMP scans.

Adult

Nuclear magnetic resonance brain imaging in chronic schizophrenia.

Patients with chronic schizophrenia were examined by nuclear magnetic resonance imaging of the brain. Subgroups of the syndrome with high positive or high negative symptom scores and ventricular dilatation were compared with each other and with normal controls in respect of regional spin lattice relaxation time (T1) changes. Significant differences were not observed between the schizophrenic subgroups and controls but there were significant differences between the subgroups themselves. The presence of tardive dyskinesia was associated with increased T1 of the basal ganglia. The significance of these results is discussed in relation to findings using other techniques.

Adult

A comparison of T1 measurements at 1.7 and 3.4 MHz in the diagnosis of prostatic carcinoma.

To compare the specificity of T1 measurement for the diagnosis of prostatic carcinoma in vivo, two groups of patients with clinically enlarged prostate glands have been imaged. One group comprising 25 patients was imaged at 1.7 MHz the other comprising 51 patients at 3.4 MHz. T1 measurements together with the gross anatomical appearances of the prostate gland were observed and compared with the clinical and histologic diagnoses. At 1.7 MHz it was found that the T1 measurement of carcinoma of the prostate and benign hypertrophy of the prostate fell into two distinct ranges with no overlap between the two conditions. Three false-positive diagnoses of carcinoma were made in patients with prostatitis where the T1 values fell in the upper part of the carcinoma range. T1 measurement in the group studied at 3.4 MHz demonstrated no specific value for either condition and diagnosis of malignancy had to be made from the morphologic appearances of the gland. Morphologically benign hypertrophy appeared homogeneous while carcinoma appeared heterogeneous with small areas of increased T1 in the malignant part of the gland.

False Positive Reactions

The nuclear magnetic resonance appearances of neuroblastoma.

In addition to being a non-ionising method of imaging, nuclear magnetic resonance has the ability to demonstrate the body organ using different radio pulse sequences in order to highlight different tissues. Neuroblastomas are best demonstrated using proton spin lattice relaxation time (T1) weighted images such as inversion recovery or calculated T1, rather than proton density. The ability to produce sections in the sagittal and coronal as well as the axial plane allows for accurate tumour localisation and management planning. The appearances of primary neuroblastoma and metastatic spread to bone are described in three cases of neuroblastoma.

Adolescent

Nuclear magnetic resonance in adrenoleukodystrophy: report of a case.

The nuclear magnetic resonance images obtained in a case of adrenoleukodystrophy are presented. The areas of demyelination are clearly seen. The T1 values of the affected areas are not specific and coincide with those previously recorded in the lesions of multiple sclerosis or cerebrovascular disease. A diagnosis of adrenoleukodystrophy should be considered in younger male patients presenting with behavioural disturbances, especially when these are associated with abnormalities of vision or gait. There may be no clinical evidence of the associated adrenocortical insufficiency.

Adrenal Glands

Nuclear magnetic resonance tomography of the orbit at 3.4 MHz.

The significantly different signals from the various structures within the orbit suggest that NMR tomography will prove to be a valuable method for the diagnosis of both ocular and orbital disease. The resolution of the technique is initially illustrated by the demonstration of the signal patterns from the normal globe and orbit. The characteristic features of some pathological conditions, including vitreous haemorrhage and retinal detachment, are then shown. The value and limitations of the technique in differentiating conditions such as choroidal haemorrhage from malignant melanoma, and intra-orbital lymphoma from pseudo-tumour, are illustrated and discussed. The absence of artefact from bone, synthetic lens implants and non-ferromagnetic metallic foreign bodies is stressed.

Clinical Trials as Topic