"Delta sign" in bone scan interpretation--a cautionary note.
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Biomedical subjects
Publications and source records attributed to J V Hunter.
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Digital subtraction angiography is able to provide simultaneous information on renal structure and function. Thirteen normal patients were investigated. Parametric analysis was performed and a set of normal ranges was established for T-1/2 max, T-max, and renal-artery-to-renal-vein peak-to-peak transit time. Cases are presented to show that the technique is capable of identifying the normal kidney and differentiating it from abnormalities of intrarenal perfusion based on the detailed analysis of the vascular nephrogram.
Digital subtraction angiography following an injection of iodinated contrast material can regularly produce good quality images. In addition to the conventional anatomical information, the timed sequence of digital images also contains useful temporal information which hitherto has been largely ignored. A simple method of image processing is described which utilises this timing information and presents it as a colour-coded set of functional images. Three parameters MAX, T-MAX and T-1/2 MAX are extracted from time-density curves, analogous to the time-activity curves of Nuclear Medicine, on a pixel-by-pixel basis. These parameters are used as a measure of overall organ perfusion, blood transit time between different vascular compartments, and as an indication of the initial delivery of contrast material to an organ. They have found use in the analysis of myocardial perfusion, before and after pharmacological intervention, and in the examination of the cerebral and renal circulations. The potential advantages of this technique derive from its superior spatial, temporal and contrast resolution.
Evidence of anaerobic infection was sought in 83 patients with pulmonary disease with anaerobic culture and gas liquid chromatography (GLC) of mucopurulent sputum, or pleural fluid where appropriate. Saliva samples from nine healthy controls and 14 patients with cystic fibrosis were examined by the same methods to assess anaerobic content. Clinically significant anaerobic pleuropulmonary infection was not found in our patients with bronchitis, bronchiectasis and cystic fibrosis and occurred in only some of our patients with empyema and lung abscess. GLC of pleural fluid (empyema) or sputum (lung abscess) was helpful in identifying these cases, when a strongly positive reading was obtained. The gas liquid chromatogram was negative or only weakly positive in those patients where the presence of anaerobes was clinically insignificant, most probably resulting from contamination of the sputum samples by saliva. Results were rapidly available and the need for transtracheal aspiration to obtain specimens of bronchial secretion uncontaminated by mouth flora was avoided. The semiquantitative GLC would therefore appear to be a useful method for investigating specimens from patients with suspected anaerobic pleuropulmonary infection.
Pulmonary digital subtraction angiography offers a further method of distinguishing vascular from avascular lesions in the lung. The computerised (digitised) recording allows versatility of data manipulation and post-processing and is of particular value in identifying a vascular component in complex lung masses. In the five cases described, digital subtraction angiography provided useful information; in three, it was the definitive diagnostic procedure.
The radiological diagnosis of rickets is mainly based on the widened appearance of actively developing epiphyseal growth plates. In the adolescent with rickets the secondary iliac and ischial ossification centres may be abnormally wide when most other epiphyses have fused. The appearance of the iliac crest is of use both in helping to make the diagnosis and in monitoring the results of treatment.
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Explore the source record for details and available documents.