Papillary necrosis causing hydronephrosis in the renal allograft. Sonographic findings.
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Biomedical subjects
Publications and source records attributed to L G Shapeero.
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An ultrafast, cine-CT scanner was used to demonstrate the differential mobility of the lateral and medial femoral condyles on their respective tibial plateaus in cadaver knees and to show the kinematic type of motion of the knee joint. Current imaging techniques cannot accomplish this because they do not perform combined quantitative, tomographic, and dynamic studies. Accordingly, this preliminary report presents the data from cine-CT scans of 12 normal intact adult cadaver knees. Scans were obtained at the rate of 14 or 17 per second at 50 or 100 ms exposures through midsagittal planes of the medial and lateral condyles and intercondylar notch. The cine-CT scans were displayed on a CRT and analyzed as closed-loop movies and as isolated images. Each cadaver femoral condyle demonstrated a different combined rolling and gliding motion. Preliminary results on the cadaver knee suggest the lateral femoral condyle moved 2.3 times further on the tibial plateau than its medial counterpart. The percentage of rolling for the lateral condyle was 43%-49%; the percentage of gliding was 51%-57%, with a ratio of rolling to gliding of 1:1.2. The percentage of rolling for the medial condyle was 16%-26%; the percentage of gliding 74%-84% with a ratio of rolling to gliding of 1:3.8. The femoral condyles, tibia, and cruciate ligaments acted as a crossed four-bar linkage in concordance with kinematic theory. The applicability of the cadaver knee results to patient dynamics and diagnosis cannot be determined from this study and awaits further investigations on the in vivo knee. However, ultrafast cine-CT demonstrated the complex knee motion in the cadaver knee joint.
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The potential of magnetic resonance (MR) imaging in the detection of endometrial carcinoma and in the assessment of its extent was evaluated prospectively in 51 patients clinically suspected of having the disease. MR imaging findings were compared with the results of surgical-pathologic staging and lymph node sampling following hysterectomy. Histologic findings showed 45 patients to have endometrial carcinoma, three to have no residual tumor after dilatation and curettage, and three to have adenomatous hyperplasia of the endometrium. MR imaging demonstrated an endometrial abnormality in 43 of the 51 patients (84%). Endometrial carcinoma could not be differentiated from adenomatous hyperplasia or blood clots. Therefore, MR imaging was not specific for tumor detection, and histologic diagnosis remains essential. The overall accuracy of MR imaging in staging endometrial carcinoma was 92%; its overall accuracy in demonstrating the depth of myometrial invasion was 82%. Demonstration of lymphadenopathy and adnexal or peritoneal metastases by MR imaging was suboptimal.
Three cases of lymph nodes in the neck and mediastinum that enhance on postcontrast computed tomography are discussed. Correlation with the histology demonstrated that all three lymph nodes contained vascular neoplasms.
Mycosis fungoides is a malignant lymphoma of the skin that causes intense erythema, plaques, edema, and induration. The primary computed tomographic findings of mycosis fungoides, i.e., skin thickening, tumorous infiltration, edema of the soft tissues, and lymphadenopathy, are presented in two patients.
To evaluate the efficacy of transrectal real-time gray-scale sonographic voiding cystourethrography in patients with neuromuscular dysfunction of the bladder, 32 men suspected of having neuromuscular dysfunction each underwent sonographic and radiographic voiding cystourethrography and urodynamic studies. The benefits accruing from the sonographic study included: (1) patients received no radiation; (2) it was as diagnostic as, and sometimes more diagnostic than, the radiographic study; (3) drug effects were easily studied; (4) accurate measurements of urethral length could be obtained; and (5) prostate diseases that might affect these patients were visible, such as benign prostatic hyperplasia, prostatic carcinoma; and prostatic calculi. In addition, sonography made one new observation possible: The seminal vesicles were enlarged in 10 patients receiving the alpha-adrenergic blocker, phenoxybenzamine. This enlargement may cause sterility.
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The authors present three cases of histologically proved synovial sarcoma. CT is useful in assessing erosive or destructive changes in bone, and in demonstrating calcifications. MR characteristics are nonspecific; calcifications within these tumors can be missed on MR. MR can help to assess tumor extension, vascular invasion, and hemorrhage within the tumor.
PURPOSE: To compare magnetic resonance angiography (MRA) with duplex Doppler ultrasound (US) and x-ray angiography (XRA) in the evaluation of the carotid bifurcation. METHODS: The carotid arteries of 61 patients were studied using MRA, US, or XRA; 31 of the patients underwent all three examinations. MRA included both 2D and 3D time-of-flight sequences. Internal and external carotid artery origins were graded normal, mild, moderate, severe, or critical stenosis, or complete occlusion by each of the three studies. RESULTS: Spearman rank correlations of both internal and external carotid artery grades were 0.85 (MRA and XRA), 0.69 (MRA and US), and 0.73 (XRA and US). For internal carotid artery origins only, the correlations were 0.94 (MRA and XRA), 0.85 (MRA and US), and 0.82 (XRA and US). Of discrepancies in internal carotid artery interpretation greater than one grade, seven resulted from US error, three from MRA error, and one from XRA error. A 2-cm partially thrombosed aneurysm detected by US and MRA was missed by XRA. Of 16 possible ulcers on XRA, 11 were noted by MRA, none by US. CONCLUSIONS: MRA and XRA are similar in assessment of carotid bifurcation stenosis. MRA, like US, permits direct visualization of plaque. This preliminary study suggests that MRA may be used to clarify equivocal findings of US, or replace XRA in presurgical planning.