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Biomedical subjects

J D Godwin

Publications and source records attributed to J D Godwin.

At least 55 records · Page 3Linked to original sources
PubMed1990

Bronchopulmonary sequestration: CT assessment.

Computed tomographic (CT) scans of 24 bronchopulmonary sequestrations in 23 patients were reviewed. Seventeen sequestrations were diagnosed at surgery, three at angiography, and four on the basis of radiographic or CT findings combined with appropriate history. Sixteen sequestrations were intralobar, and eight were extralobar; 21 were posterobasal. Seventeen occurred on the left side and seven on the right. Anomalous systemic arterial supply was demonstrated by CT in 16 sequestrations. In the others, a systemic artery was not shown, presumably because of unfavorable orientation or small size of the vessel. The lung abnormalities shown by CT were classified into three types: A = cysts containing air or fluid (n = 8), or soft-tissue masses (n = 2); B = emphysematous lung surrounding cysts, and/or soft-tissue nodules (n = 13); and C = lung hypervascularity (n = 2). In only three cases did the chest radiograph show the emphysematous lung tissue. Such emphysematous lung has rarely before been reported as a CT finding, and lung hypervascularity has not, to the authors' knowledge, been reported. The authors conclude that CT can be helpful in the diagnosis and evaluation of bronchopulmonary sequestration. Characteristic manifestations are (a) a complex lesion containing solid or fluid components combined with emphysematous lung or (b) any basal lesion supplied by a systemic artery.

Adolescent↗
PubMed1990

CT appearance of the retroaortic anastomoses of the azygos system.

The terminations of the hemiazygos and accessory hemiazygos veins can be mistaken for normal or enlarged posterior mediastinal lymph nodes on CT scans of the chest. These terminations are termed the retroaortic anastomoses by anatomists. We studied the CT appearances of these veins on scans of one cadaver and seven patients. We found that the retroaortic anastomoses usually were clearly recognizable because of their continuity with the hemiazygos or accessory hemiazygos vein. However, it is sometimes possible to mistake these vessels for lymph nodes, especially when only short segments of the vessel are visible on a CT image or when the vessel is not clearly opacified by contrast material. Familiarity with the CT appearances of the hemiazygos and azygous veins can prevent their being mistaken for normal or enlarged lymph nodes.

Azygos Vein↗
PubMed1989

Adult respiratory distress syndrome from overdose of tricyclic antidepressants.

Adult respiratory distress syndrome (ARDS) from overdose of tricyclic antidepressants (TCA) has been reported but is not well known. During a 1-year period, 81 patients with serious overdose from tranquilizers and other psychotropic drugs were examined. TCA alone induced overdose in 30 patients or were combined with other drugs in 26 patients. Twenty-five (31%) patients had overdose from drugs other than TCA. Chest radiography revealed that 30 (54%) patients with TCA overdose and six (24%) patients with non-TCA overdose had abnormalities. Clinical and radiographic findings consistent with ARDS were noted in five (9%) patients with TCA overdose and none of the patients with non-TCA overdose. Five patients with TCA overdose and one (4%) patient with non-TCA overdose had interstitial edema that never progressed to ARDS. TCA should be added to the list of drugs associated with the development of ARDS.

Antidepressive Agents, Tricyclic↗
PubMed1989

Left azygos lobe.

Left azygos lobe is much rarer than right azygos lobe, but cases have been reported. Computed tomography proved more reliable than plain radiography in the diagnosis of left azygos lobe in a 10-year-old girl.

Azygos Vein↗
PubMed1989

Pulmonary histiocytosis X: comparison of radiographic and CT findings.

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.

Adult↗
PubMed1988

Pulmonary alveolar proteinosis: CT findings.

In pulmonary alveolar proteinosis (PAP), a proteinaceous material accumulates in the alveolar air spaces, causing hypoxemia, restrictive lung disease, and dramatic abnormalities on chest radiographs. Complications are unusual, but of the ones that do occur, infection, particularly with Nocardia asteroides, and fibrosis are the most common. Few computed tomographic (CT) studies of this condition have been reported. The CT scans of nine patients with PAP were reviewed. Varying combinations of air-space and interstitial patterns were seen. The CT appearance of air-space disease ranged from ill-defined nodules to patchy consolidation to large regions of confluence. Air-space consolidation was sometimes sharply demarcated from surrounding normal lung tissue, which created a geographic pattern. Despite the predominance of air-space patterns, air bronchograms were not a prominent feature. CT showed the interstitial component of disease and the extent of disease more clearly than did plain radiography. In two cases, CT demonstrated focal pneumonia that was not visible on the radiographs.

Adolescent↗
PubMed1988

The role of computed tomography scanning in the initial assessment and the follow-up of malignant pleural mesothelioma.

Between October 1983 and April 1987, 20 patients with malignant mesothelioma underwent computed tomography scans of the chest and upper abdomen to evaluate the extent of disease before treatment. Twelve of these 20 patients deemed to have some potential for long-term survival had scans performed every 3 months after operation to help detect recurrent disease. Anatomic correlation of computed tomography scan findings was available in all 20 patients. The limitations of computed tomography in initial evaluation were its difficulties in assessing (1) chest wall involvement (nine patients), (2) mediastinal lymph nodes (four patients), (3) transdiaphragmatic extension of tumor (four patients), and (4) peritoneal studding and solid organ metastases less than 2 mm in size (one patient). Computed tomography was helpful in detecting recurrent disease in the 12 patients having long-term follow-up. In six of eight cases with histologically proved recurrence, computed tomography detected tumors from 1 to 8 months before the onset of signs or symptoms. Although computed tomography is known to provide far more information about the extent of disease than plain radiographs, it remains an imperfect tool for the staging of disease in patients with malignant mesothelioma. Despite its limitations, computed tomography is probably the most accurate way to provide follow-up for patients during treatment.

Follow-Up Studies↗
PubMed1987

Thoracic cardiovascular trauma.

Trauma is the third leading cause of death in the United States and the leading cause for persons under 40 years of age; chest trauma accounts for more than 25% of these deaths. Rates of trauma to the chest--both blunt and penetrating--are rising because of the continuing development of high-speed transportation and because of increasing inner-city violence combined with ready availability of handguns. But treatment has improved; even injury to the heart is no longer considered invariably lethal. This review describes the spectrum of injuries to the pericardium, heart, aorta, and thoracic arteries and veins, exclusive of iatrogenic trauma and high-velocity gun shot injuries caused by military weapons. The role of imaging is described.

Aorta↗
PubMed1987

Cartilaginous variant of congenital adenomatoid malformation of the lung.

We report the occurrence of an unusual variant of congenital adenomatoid malformation (CAM) of the lung in a 16-year-old male. Abundant cartilage in the walls of malformed bronchioles, an extremely rare finding in CAM, distinguishes this lesion from the usual forms. We present the roentgenographic, computed tomographic, and pathologic features of this lesion as well as its embryologic implications. In addition, two similar cases are reviewed, one of which has been briefly discussed in a previous publication. Cartilaginous CAM should be distinguished from another lesion with abundant cartilage, the so-called pulmonary hamartoma.

Adolescent↗
PubMed1987

The radiographic distinction between pericardial and myocardial calcifications.

Calcification overlying the left side of the heart on a chest radiograph may involve either the pericardium or, alternatively, the myocardium in association with a left ventricular aneurysm. Distinction between these two conditions can be of great clinical significance. To identify distinguishing features, we reviewed the radiographs and medical records of 29 patients: 14 had proven calcific pericarditis and 15 had proven calcified left ventricular aneurysm. Pericardial calcification was found primarily over the right-sided cardiac chambers (14 of 14 patients) and in the atrioventricular grooves (11 of 14), infrequently over the base of the left ventricle (five of 14), and rarely over the apex of the left ventricle (two of 14). When the left ventricle was involved, there was always more extensive calcification elsewhere in the pericardium. Myocardial calcification occurred predominantly in the apex of the left ventricle (13 of 15 patients), although it was rarely confined to the posterior wall of the left ventricle (two of 15). By noting characteristic sites of calcium deposition, pericardial calcification can be effectively distinguished from myocardial calcification. Isolated calcification in the region of the left ventricular apex, therefore, strongly suggests left ventricular aneurysm.

Adolescent↗
PubMed1987

CT of the lungs.

Explore the source record for details and available documents.

Bronchiectasis↗
PubMed1986

Role of chest CT in non-Hodgkin lymphoma.

A retrospective study of 48 patients with non-Hodgkin lymphoma (NHL) who underwent 54 computed tomographic (CT) examinations of the chest evaluated the role of chest CT in the management of this disease. Of 18 cases in which chest radiographs were not indicative of NHL, CT scans showed abnormalities consistent with NHL in five (28%). Of 11 cases where radiographs were questionable, CT confirmed NHL in five (45%) and excluded it in six (55%). Of 25 cases where radiographs were consistent with NHL, CT confirmed the findings in 23 (92%) and added information in all 25. Chest CT affected management in eight of 25 treated and five of 19 untreated patients. It appears to be useful in untreated patients with stage I or II NHL but no definite radiographic abnormalities, or with abnormal radiographs but no extrathoracic spread, and in treated patients with questionable radiographs. CT is not helpful in untreated patients with stage III or IV NHL or treated patients with normal radiographs.

Adolescent↗
PubMed1986

Scimitar syndrome: four new cases examined with CT.

Four new cases of scimitar syndrome illustrate the complex derangement of the right lung architecture. Computed tomography (CT) helped in demonstrating the hyparterial relationship of the right bronchus to the pulmonary artery, the course and termination of the scimitar vein, the mediastinal shift, unusual fissures, and abnormal lobation and bronchial distribution. The CT findings confirm that the retrosternal opacity and indistinct right heart border are results of the mediastinal shift. One case had features resembling, but clearly distinguishable from, the horseshoe lung syndrome.

Adult↗
PubMed1986

Centrilobular emphysema: CT-pathologic correlation.

Over a 5-year period, 25 patients who had undergone chest computed tomography (CT) died and were autopsied. Their lungs were fixed in the inflated state and were assessed for the presence and severity of centrilobular emphysema (CLE). Three radiologists independently evaluated the CT scans for nonperipheral low-attenuation areas, peripheral low-attenuation areas, pulmonary vascular pruning, pulmonary vascular distortion, and pulmonary density gradient. The CT criterion that best correlated with the presence and severity of CLE was the nonperipheral low-attenuation area. With this CT criterion, lung destruction was correctly identified in 13 of 15 cases. The absence of this criterion resulted in correct identification of eight of ten normal lungs. These preliminary data suggest that CLE can be reliably identified and quantified with current CT scanners.

Emphysema↗