Biomedical subjects
J E Husband
Publications and source records attributed to J E Husband.
Magnetic resonance behaviour of lipiodol.
Lipiodol is a frequently used contrast agent for lymphangiography and more recently has been used in the investigation of hepatoma. We describe the magnetic resonance characteristics of lipiodol using a Siemens 1.5 T Magnetom with reference to the appearance and behaviour of lipiodol in abdominal lymphadenopathy. The characteristics described differ from previously published reports.
Contrast enhancing lymph nodes in bladder cancer: a potential pitfall on CT.
We report three cases of bladder cancer in which contrast enhanced computed tomography (CT) demonstrated minimally enlarged lymph nodes. These showed uniform uptake of contrast medium to a similar degree as adjacent venous structures, making the distinction between vessels and lymph nodes difficult. Magnetic resonance imaging (MRI) examination resolved the problem in two of the three patients.
Intra-abdominal panniculitis can mimic recurrent stomach carcinoma.
Carcinoma of the stomach is increasingly treated with chemotherapy. We describe two cases of intra-abdominal panniculitis in patients after laparotomy and chemotherapy for stomach carcinoma. Intra-abdominal panniculitis can result in mass lesions in the mesentery and omentum. The diagnosis should be considered in patients who have undergone chemotherapy for stomach carcinoma and who develop abdominal masses.
Magnetic resonance imaging in oncology.
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Multiple myeloma: appearance at MR imaging.
Magnetic resonance (MR) imaging examinations of the lumbar spine and clinical and laboratory findings in 32 patients with multiple myeloma were reviewed. On T1-weighted images, signal intensity (SI) of the vertebrae approximated that of muscle in 14 cases and was intermediate (between the SIs of muscle and fat) in 18. Definite foci of decreased SI were seen in eight cases (25%), and foci of increased SI, representing fatty infiltration, were seen in 12 (38%). On T2-weighted images, SI approximated that of muscle in 17 cases and was intermediate in 15. Definite foci of increased SI were seen in 17 (53%). Of 38 vertebral compression fractures (including 18 in nine additional patients), foci of abnormal SI consistent with tumor on either T1- or T2-weighted images were seen in 19 cases (50%). There was no correlation between MR imaging findings and laboratory or bone marrow findings. Foci of presumed tumor were better or exclusively shown on T2-weighted images in 11 of 17 patients (65%) with identifiable focal disease. Other suggestions of multiple myeloma on T1-weighted images may be the absence of fatty replacement or a generalized decrease in SI.
Ewing sarcoma: MR imaging of chemotherapy-induced changes with histologic correlation.
In a study group of 18 consecutive patients with Ewing sarcoma proved by means of biopsy, the signal intensity characteristics of tumor on magnetic resonance (MR) images were assessed before and after chemotherapy. Sixteen patients underwent MR imaging at 1.5 T before chemotherapy; all 18 patients underwent MR imaging at 1.5 T within 10 days after chemotherapy. Standard spin-echo sequences were used with T1 and T2 weighting in all patients. The primary tumor was visualized in all 16 patients who underwent MR imaging before chemotherapy. Histologic correlation, obtained in 14 patients, showed that areas of high T2-weighted signal intensity on MR images obtained after chemotherapy may represent tumor necrosis, cystic hemorrhagic areas, and fibroblastic repair tissue. In 10 patients (71%), microscopic clusters of viable tumor cells were depicted in areas of both low and high signal intensity after treatment. It is concluded that MR imaging is unreliable for exclusion of active disease, although a pattern of change in signal intensity is qualitative evidence of chemotherapeutic effect.
The role of computed tomography in the management of testicular teratoma.
CT scans of the lungs, mediastinum and abdomen have been performed in 65 patients with malignant teratoma between August 1977 and June 1978. CT is superior to conventional radiology in detecting pulmonary metastases and mediastinal lymphadenopathy. It is a valuable technique for defining the full extent of para-aortic nodal disease and provides more information than lymphography alone. In this series sequential CT scans have been used to monitor treatment response to detect relapse and to assess operability of demonstrable residual disease.
The role of computed tomography in the staging of bladder cancer.
Computed tomography of the pelvis has been performed in 60 patients with epithelial bladder tumours. The CT findings have been compared with the clinical staging (T-stage), lymphography (N-stage) and wherever possible the surgical staging (P-stage). Although the intraluminal tumour was visualised in a high proportion of examinations, the greatest value of CT is in the accurate delineation of the extravesical extension of the growth. This is likely to be the primary role of CT in the staging of bladder cancer. Difficulties in detecting invasion of contiguous organs, particularly the prostate, and the failure to demonstrate nodal involvement within the pelvis were noted. The technique has clear advantages over more invasive investigations and the additional information provided over and above clinical staging is seen as a major advance in the assessment of these tumours.
Computed tomography--a new technique in radiology.
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Scanning: which technique?
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CT scanning and the surgery of metastatic teratoma of the testis: a preliminary report.
Accurate definition of metastases in para-aortic lymph nodes and lungs is essential in planning treatment for patients with testicular teratoma. The addition of CT scanning to routine investigation of these patients has given additional sensitivity in detection and localisation of metastases. The extent of para-aortic metastases could be clearly defined, even when bulk replacement of nodes prevented definition by lymphography. This information was used in planning the best surgical approach for para-aortic lymphadenectomy, which was done as part of combined treatment of large volume metastases.
Computerized tomography in the localization of abdominal malignancy.
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The B-scan ultrasonic appearances of gas in the biliary tree.
Gas in the biliary tree has a striking but not unique ultrasonic appearance consisting of acoustic shadows trailing behind well-defined discrete high amplitude echoes deep within the liver parenchyma, and may be mimicked by intrahepatic gall stones and calcified tumours and granulomas. It interferes with assessment of liver structure, and renders ultrasound B-scan unreliable for the detection of liver metastases. Computed tomography remains unaffected by biliary gas.
Comparison of ultrasound and computer-assisted tomography in pancreatic diagnosis.
In a series of patients suspected of having pancreatic disease both ultrasound and computerized tomography (CT) were performed. The diagnosis has been confirmed in 50 patients. Computerized tomography visualized the pancreas in all 50 (100%) whereas ultrasound was successful in 40 patients (80%). The ultrasound failures were due to bowel gas anterior to the pancreas. The overall diagnostic accuracy was 84% for computerized tomography and 64% for ultrasound; however, in those cases where ultrasound successfully detected the pancreas the diagnostic accuracy was 80%.
[Comparative evaluation of computerized tomography/magnetic resonance (1.5 T) in the detection of brain metastasis].
Forty-four patients with small cell carcinoma of the bronchus underwent CT and MR studies of the brain to detect cerebral metastases. All patients were studied with contrast-enhanced CT scans, short (T1-weighted) and long (T2-weighted), spin-echo (SE) and FLASH 90 degrees MR sequences. Gd-DTPA enhanced SE-T1 and FLASH 90 degrees sequences were also obtained. A quantitative comparison of the results was carried out to assess the sensitivity of the different techniques in the detection of brain metastases according to lesion diameter. Metastases were identified in 19/44 patients (43%). All techniques detected the lesions greater than 2 cm; of the metastases less than 2 cm, 63/124 (51%) were detected only by Gd-DTPA SE-T1 and FLASH sequences and 11 more (9%) only by Gd-DTPA SE-T1 scans. All the lesions identified on enhanced CT scans or on T2-weighted images were easily detected by Gd-DTPA scans. CT sensitivity was higher than that of pre-contrast SE-T1 and FLASH studies and only slightly lower than that of T2-weighted images. As for lesions less than 2 cm, Gd-DTPA T1-weighted sequences had the highest detection rate (124 lesions) versus Gd-DTPA FLASH 90 degrees scans (113 lesions) and precontrast T1-weighted scans (45 lesions). When comparing Gd-DTPA SE-T1 and FLASH 90 degrees sequences in the detection of lesions less than 1 cm, we observed that the latter missed 9% of metastases, mainly due to a high rate of magnetic susceptibility artifacts and to lower contrast resolution. Therefore, Gd-DTPA SE-T1 images still remain the most accurate technique in the assessment of cerebral metastases.