Biomedical subjects
Publications and source records attributed to J A Becker.
Newer techniques have supplanted the urogram as the preferred procedure for evaluation of several renal infections. When imaging is indicated in acute pyelonephritis, sonography should be performed first. In focal pyelonephritis, sonography and/or computed tomography are preferred. These techniques are also generally required for elucidation of renal abscess and pyonephrosis.
Sonography can replace urography in the search for a duplication anomaly of the collecting system. As a screening procedure, sonography is more cost effective and does not require ionizing radiation or an intravascular injection.
Sonography of 8 patients with renal tuberculosis is reported and collated with 3 additional cases reported in the literature. The patterns of hydronephrosis versus granuloma formation are presented and the differential diagnoses at sonography reviewed.
One hundred patients underwent excretory urography and a comparison was made of ten-minute, well-collimated images that were obtained with both par-speed and rare-earth screens, the latter being 6.5 times faster than the par-speed calcium tungstate screens. Radiation dose was greatly reduced with the rare-earth screens. There were fewer inferior examinations, even though fine detail was imaged poorly, and there was a slightly increased quantum mottle, which was only a minor problem at this low 65 kVp. Since quantum mottle increases with kVp, however, our results are not applicable to higher kVp examinations. Despite reduced detail and increased mottle, the overall image quality obtained with the rare-earth screen was superior to the image quality obtained with the par-speed screen.
Presacral hemorrhage commonly accompanies fractures of the posterior pelvic ring. The source of this bleeding is the fractured cancellous bone and supporting ligamentous structures of the sacrum and sacroiliac joint. The radiologic appearance is of granular and punctate contrast accumulations due to extravasation from the iliolumbar and lateral sacral branches of the hypogastric artery. This bleeding can be controlled by small particle embolotherapy provided care is taken not to bypass the posterior division of the hypogastric artery.
Eighteen patients undergoing bench surgery and autotransplantation are reported. The major indications for this procedure are renovascular hypertension and neoplasms affecting either both kidneys or a solitary kidney. The least satisfactory results were obtained when calculus disease was present.
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Transitory and occasionally irreversible renal failure secondary to parenterally administered iodinated contrast material is now well documented. Diabetes and pre-existing renal insufficiency are the two most important risk factors. Intravascular contrast examinations should be avoided whenever possible in high-risk patients, particularly diabetics with creatinine levels of 5 dl./ml. or higher. Alternative methods for the etiologic evaluation of renal failure or hematuria are suggested.
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Quality Circles, a type of "international process consultation," can be of great assistance in dealing with conflicts, employee turnover and low productivity in radiology departments. Radiology administrators need to know how to implement Quality Circles in their departments and realize its associated benefits. Quality Circles could establish the needed psychological interdependence among radiographers as well as other staff in the hospital.
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Pancreatic pseudocysts are notorious for their extension beyond the normal confines of the pancreatic bed. Their inferior extension has been known to involve kidney and ureter. However, involvement of the bladder and rectum is unique although understandable on anatomic grounds. We report an enormous pseudocyst with extension deep into the pelvis to displace both rectum and bladder.
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Five patients with renal cell carcinoma were noted at angiography to have vascular hepatic lesions which resembled metastatic renal cell carcinoma but which proved to be benign hepatic hemangiomas. The angiographic differentiation between small hemangiomas and metastatic vascular neoplasms of the liver can be difficult; angiographic characteristics may not be definitive. Surgery to remove the renal tumor should not be deferred solely on the basis of vascular hepatic lesions found at angiography.
A reciprocating Bucky design for serial film changers is described. It is simple to construct. Inexpensive, and enhances radiograph resolution by eliminating grid lines.
Eight cases of wandering spleen demonstrate that this rare entity has a characteristic constellation of findings which, though nonspecific, are highly suggestive of the diagnosis. Angiography or isotopic imaging specific for the spleen confirms the diagnosis. Asymptomatic patients may be carefully observed, with the institution of splenectomy should signs of torsion develop.