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Biomedical subjects

J G Murray

Publications and source records attributed to J G Murray.

At least 55 records · Page 3Linked to original sources
PubMed1994

Percutaneous aspiration thromboembolectomy: a preliminary experience.

Percutaneous aspiration thromboembolectomy (PAT) is a radiological alternative to surgical embolectomy or thrombolysis in the treatment of acute arterial thromboembolic disease. We report our experience in eight patients aged 63-83 years (mean 71 years). Indications were graft thrombosis (1) or emboli from atrial fibrillation (3), abdominal aneurysm (2) or proximal angioplasty (2). PAT was performed at 10 arterial sites; common iliac (1), profunda femoris (1), superficial femoral (2), femoro-popliteal graft (1), popliteal (2) and arteries of the trifurcation (3). PAT was used as an adjunct to thrombolysis or angioplasty in five patients and as the sole procedure in three patients. It was successful in six patients (seven sites) with mean ABI rising from 0.4 pre- to 0.8 post-procedure. Two of the failures required amputations. One of these was a completely thrombosed dacron femoro-popliteal graft with poor run-off, and the second case had a failed surgical embolectomy prior to amputation. There were no major complications, and no mortality on follow-up at 1 month. PAT is a useful adjunct to thrombolysis and balloon angioplasty in the radiological treatment of acute thromboembolic disease. In patients in whom thrombolysis is contraindicated, it offers an alternative to surgical embolectomy.

Aged↗
PubMed1994

Digital subtraction in contrast-enhanced MR imaging of the postoperative lumbar spine.

OBJECTIVE: The objective of this study was to evaluate the routine use of digital image subtraction as an adjunct to standard MR sequences in patients with failed lumbar spine surgery. MATERIALS AND METHODS: Unenhanced and contrast-enhanced T1-weighted MR images of 112 consecutive patients with failed back surgery were reviewed, and corresponding axial images at the level of previous surgery were digitally subtracted by using standard software. The technique was successful in 96 patients and was abandoned in 16 owing to patient motion. Two radiologists independently assessed the subtracted images for areas of enhancement not seen on T1-weighted images, and suggested a diagnosis based on a combination of the findings on standard and subtracted images. This diagnosis was compared with the original MR diagnosis, and surgical findings were sought in cases of conflict. RESULTS: Enhancement was best seen on the subtracted images in muscle fascial planes (100%), anterior epidural fibrosis (55%), spinal canal fat (31%), posterior epidural fibrosis (27%), types I and II marrow change (24%), and facet joints (17%). Subtraction improved the homogeneity of contrast enhancement, thereby improving the visualization of nerve roots lying in scar tissue (16%), and better defined the extent of epidural fibrosis, particularly when the fibrosis was contiguous with fat. The subtracted image increased diagnostic confidence in 25% of cases, but altered final diagnosis in only two patients. CONCLUSION: Although digital subtraction revealed areas of enhancement not seen on standard spin-echo MR images, it rarely altered final diagnosis and does not appear to be useful for routine imaging of patients with failed lumbar spine surgery. It might, however, be useful for increasing diagnostic confidence or as a problem-solving technique in selected patients.

Adult↗
PubMed1993

The American Thoracic Society lymph node map: a CT demonstration.

It is now a decade since the American Thoracic Society (ATS) lymph node map was first described. Recently it has been upgraded to include supraclavicular and superior diaphragmatic lymph nodes. By standardising terminology the map aids in the provision of a more valid data base to evaluate diagnostic techniques and therapeutic protocols. Despite these potential benefits the map has failed to gain widespread use amongst European radiologists. This essay illustrates the relationship of the nodal stations to normal anatomy utilizing calcified nodes on CT scans. The ease with which the map can be applied to cross-sectional anatomy is emphasized. It is hoped that the images will act as a teaching aid to promote greater acceptance and use of the ATS map. The relationship of the nodal stations to the new American Joint Classification of disease extent is also outlined.

Biopsy↗
PubMed1992

Assessment of mammographic film processor performance in a hospital and mobile screening unit.

In contrast to the majority of mammographic breast screening programmes, film processing at this centre occurs on site in both hospital and mobile trailer units. Initial (1989) quality control (QC) sensitometric tests revealed a large variation in film processor performance in the mobile unit. The clinical significance of these variations was assessed and acceptance limits for processor performance determined. Abnormal mammograms were used as reference material and copied using high definition 35 mm film over a range of exposure settings. The copies were than matched with QC film density variation from the mobile unit. All films were subsequently ranked for spatial and contrast resolution. Optimal values for processing time of 2 min (equivalent to film transit time 3 min and developer time 46 s) and temperature of 36 degrees C were obtained. The widespread anomaly of reporting film transit time as processing time is highlighted. Use of mammogram copies as a means of measuring the influence of film processor variation is advocated. Careful monitoring of the mobile unit film processor performance has produced stable quality comparable with the hospital based unit. The advantages of on site film processing are outlined. The addition of a sensitometric step wedge to all mammography film stock as a means of assessing image quality is recommended.

Breast Neoplasms↗
PubMed1992

Imaging of the mediastinum and hila.

This review covers the papers that we believe represent the most interesting and innovative developments in hilar and mediastinal imaging over the past year. One of the most exciting of these is the expanded role for sonography in imaging extracardiac mediastinal pathology. A number of reports highlight its use in directing mediastinal biopsy, for tissue characterization, and for staging lymphoma. The comparative merits of CT and MR imaging in staging bronchogenic carcinoma have been further clarified. The past year has also seen further attempts to characterize tumor versus postobstructive pneumonitis or collapse using MR imaging and CT. Other useful clinical work includes the documentation of signs distinguishing paramediastinal lung masses from primary mediastinal pathology. References are also made to clinically relevant aspects of MR scanning and advances in imaging of the airway, particularly cine and high-resolution CT of the trachea.

Diagnosis, Differential↗
PubMed1987

Revised post-mortem inspection procedures for cattle and pigs slaughtered at Australian abattoirs.

Revised procedures for the post-mortem inspection of cattle and pigs at Australian abattoirs were developed as minimum national requirements. Comparative trials of current and revised procedures were conducted at 3 and 4 Australian abattoirs for pigs and cattle respectively. Residual pathological changes after inspection and removal of lesions from heads, carcases or viscera were recorded by an evaluation team with the data used to determine relative effectiveness. For cattle, there was no significant difference between current and revised procedures. Although it had been proposed to eliminate routine incision of cervical lymph nodes for pigs, it was found necessary to retain this procedure. The data also revealed a significant variation in detection of pathology between abattoirs for both species. Parasitic conditions accounted for the greatest proportion of undetected lesions in both species for both current and revised procedures. These comprised mainly fascioliasis in cattle and ascariasis in pigs. The former was associated with the study being conducted in eastern Australia. Chronic interstitial nephritis was also a common undetected lesion, reinforcing the need for intensified inspection of kidneys. However, such residual pathology was considered to be of only limited significance to human health. The revised procedures and findings are discussed in the context of animal and human health and of the importance of the meat industry to Australian exports. Some attention has been given to specific conditions likely to be affected by the proposals including tuberculosis, bovine cysticercosis, fascioliasis, porcine arthritis and salmonellosis. The role of meat inspection in monitoring for specific diseases is discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Abattoirs↗