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Biomedical subjects

M C Hill

Publications and source records attributed to M C Hill.

At least 37 records · Page 2Linked to original sources
PubMed1986

Serous carcinoma of the ovary: CT identification of metastatic calcified implants.

The metastasis along peritoneal surfaces of serous cystadenocarcinoma, the most common ovarian malignancy, occurs early and is present in most patients at the time of clinical diagnosis. In many patients, however, computed tomography (CT) is unable to demonstrate peritoneal metastases because of their small size and similarly has been unable to demonstrate metastases in normal sized lymph nodes. Serous cystadenocarcinoma contains histologic calcification in approximately 30% of cases; thus, CT scans were retrospectively reviewed in 15 patients with pathologically proved stage III or IV disease to detect calcified peritoneal metastases. Six patients had calcified peritoneal implants, five of which had perihepatic calcifications. One of the five also had calcified lymphatic metastases, some of which were in normal sized nodes. In three of these five, the examination was otherwise normal. Search for these calcifications should improve the sensitivity of CT in diagnosing metastases from ovarian carcinoma.

Calcinosis↗
PubMed1986

The sonographic evaluation of fetal anomalies in oligohydramnios between 16 and 30 weeks gestation.

The sonograms of all patients with oligohydramnios between 16 and 30 weeks gestation seen over a 4-year period were reviewed to determine (1) whether sonographically detectable fetal anomalies were present, and (2) when these anomalies were present, how this information was used in maternal fetal management. Cases of ruptured membranes and fetal demise were excluded from the study. Sixteen patients with severe oligohydramnios were identified. On postmortem examination, nine had urinary tract anomalies, one had evidence of a chronic intrauterine infection, and four had no anomalies. There were only two neonatal survivors: one had no anomalies while the other had posterior urethral valves. These findings confirm that second trimester oligohydramnios has a poor prognosis and is often associated with anomalies of the urinary tract. Sonography aids in the clinical management of such patients.

Amniotic Fluid↗
PubMed1986

The spectrum of sonographic findings in pancreatic carcinoma.

The ultrasound studies of 59 patients with cancer of the pancreas were reviewed and the findings grouped into two categories: intrapancreatic, which included the appearance of the primary tumor and the pancreatic duct; and extrapancreatic, which included biliary obstruction, hepatic metastases, regional lymph node involvement, ascites, spleen enlargement and invasion, and alteration of the upper abdominal veins. Pancreatic duct dilatation was more evident with smaller tumors of the pancreatic head, while inferior vena cava compression was found not to be a constant finding even with large tumors of the head of the pancreas. Tumor extension to regional lymph nodes was difficult to detect and consequently underestimated. Nonvisualization, occlusion with or without collaterals, and displacement or deformity of the major branches of the portal venous system were detectable sonographically. The liver metastases of pancreatic carcinoma tended to be small and hypoechoic. This is a different pattern from that typically described for other gastrointestinal adenocarcinomas and, in particular, markedly different and distinguishable from the metastatic pattern seen with malignant pancreatic islet cell tumors. The significance of the intra- and extrapancreatic changes seen sonographically in cancer of the pancreas by ultrasound is discussed in relationship to clinical staging and prognosis.

Adenocarcinoma↗
PubMed1985

Intraperitoneal hepatocellular carcinomatosis.

The sonographic and computed tomographic features of liver involvement with hepatocellular carcinoma are well known. The extrahepatic manifestations of hepatocellular carcinoma are not uncommon, but have received little attention in the radiologic literature. We present a case in which intraperitoneal carcinomatosis and portal vein thrombosis were the dominant findings on sonography and computed tomography.

Aged↗
PubMed1985

Sonography vs. excretory urography in acute flank pain.

A prospective study compared the diagnostic accuracy of sonography and excretory urography in determining the cause of acute flank pain in 61 patients. Forty-one patients had urinary tract stone disease. Of these, five had nonobstructing renal stones and 36 had obstructing stones. A correct diagnosis was made by urography in 85% and by sonography in 66%. Small stones at the ureterovesical junction were more accurately diagnosed by sonography (79%) than by urography (68%). In all the patients where sonography failed to detect the offending stone, the stone was calcified and evident on the plain radiographs. There were no false-positive diagnoses in the patients clinically judged to have passed a renal stone (nine patients) or whose pain was arising outside of the urinary tract (five patients). Neither sonography (17%) nor urography (50%) was accurate in diagnosing acute pyelonephritis in the six patients with this diagnosis. Although sonography is not as accurate overall as urography in acute flank pain, it is a viable alternative in those with recurrent renal colic due to stone disease and in the pregnant patient.

Abdomen↗
PubMed1985

Ultrasonography in portal hypertension.

High resolution real time ultrasound is a non-invasive method of evaluating patients with suspected portal hypertension. The portosystemic collateral most frequently identified is the dilated coronary vein and its associated gastro-oesophageal varices. Other collaterals that can be seen include: gastrorenal, splenorenal, paraduodenal, periportal, pelvic and retroperitoneal varices along with a recanalized umbilical vein and ductus venosus. Using duplex doppler ultrasound, the rate and direction of portal blood flow can be ascertained. Sonography is better than barium studies in assessing whether gastro-oesophageal varices are present, however, it is not as sensitive as endoscopy, laparoscopy or portography.

Collateral Circulation↗
PubMed1983

Abdominal aspiration biopsies. Sonographic v computed tomographic guidance.

One hundred eighty-four diagnostic aspirations performed on 169 patients were reviewed (1) to define the decision process regarding which guidance method (sonography v computed tomography) should be used on any given patient, and (2) to determine, once a guidance method was chosen, its accuracy and complication rate. Sonographic guidance (84%) proved to be an effective method for obtaining a correct diagnosis in 98% (110/112) of cystic masses and 79% (34/43) of solid masses. Computed tomography (16%) was used when sonography could not identify the mass or when the mass was small, deeply located, and often solid. Computed tomographic guidance provided a correct diagnosis in 100% (13/13) of cystic masses and 81% (13/16) of solid masses.

Abdomen↗
PubMed1983

Limitation of pulsatility index as a diagnostic tool in the newborn.

Pulsatile flow in the anterior cerebral arteries was studied and pulsatility index (PI) calculated by 3 observers in 10 newborn infants in order to establish the reproducibility of a noninvasive Doppler technique. No significant differences were noted among the observers and the estimated error of observation was 0.073. Subsequently, 14 healthy preterm infants were studied daily by a single observer in an attempt to establish a normal range of PI for prematures in the first 5 days of life. The babies were concomitantly studied with serial ultrasound examinations to rule out intracranial hemorrhage. The study revealed good interobserver reliability but wide variation of PI in normal, healthy premature infants with values falling within abnormal ranges previously described in asphyxiated infants or those with intraventricular hemorrhage (IVH). Caution is advised in using the PI to predict outcome.

Cerebral Arteries↗
PubMed1983

The role of percutaneous aspiration in the diagnosis of pancreatic abscess.

Percutaneous aspiration should be performed on pancreatic/peripancreatic fluid collections when an abscess is suspected. Thirty-one percutaneous aspirations were performed on 21 such patients and seven (33%) proved to have an abscess. A Gram stain after the aspiration is important, as it can make an immediate diagnosis of an abscess. By helping make an early diagnosis, percutaneous aspiration might reduce the high mortality rate associated with a pancreatic abscess while avoiding surgery in those who have sterile fluid collections. Two complications (6%) occurred: superinfection of a pseudocyst and a hemoperitoneum.

Abscess↗
PubMed1982

Acute pancreatitis: clinical vs. CT findings.

In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptoms. This was especially true of phlegmonous pancreatitis, where the CT findings could persist for months.

Abscess↗
PubMed1981

The clinical significance of acute pancreatic hemorrhage.

Computed tomography (CT) has the ability to demonstrate acute hemorrhage both within the pancreatic parenchyma and the adjacent retroperitoneal spaces. It was found that during the acute phase of pancreatic hemorrhage (about 1-7 days) the CT number of hemorrhage is significantly greater than that of the gland. At the present time the true incidence of pancreatic hemorrhage and the relation of the CT demonstration of hemorrhage to the clinical entity of hemorrhagic pancreatitis is unclear. The CT, laboratory, and clinical findings in eight patients with acute pancreatitis were analyzed to help answer these questions. This limited experience suggests pancreatic hemorrhage is more frequent than hemorrhagic pancreatitis as currently defined clinically.

Acute Disease↗
PubMed1981

Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography.

A prospective study using sonography and computed tomography (CT) was performed on 102 patients consecutively identified as having acute pancreatitis to see which method provided the most information. Each examination was graded for visualization of the pancreas, extent of disease, and the detection of complications. CT was found to be of significantly greater value than sonography due to the high percentage (38%) of nondiagnostic studies with the latter method. Of the 102 patients, 70% had abnormal CT studies, including 18% with extrapancreatic phlegmons, 10% with pseudocysts, 5% with acute hemorrhage, and 3% with pancreatic abscesses.

Acute Disease↗
PubMed1981

Sonography of hypertensive portal venous system: correlation with arterial portography.

Sixteen patients with portal hypertension and bleeding from gastroesophageal varices were studied prospectively by sonography and arterial portography. Sonography was able to demonstrate anechoic venous structures in characteristic sites in the upper abdomen corresponding with portosystemic collateral veins seen with arterial portography. Of four patients with sonographic visualization of a dilated umbilical vein, three were seen with angiography. Two patients had periportal collateral veins seen with both methods. Of 10 patients with retrograde opacification of the left gastric vein, nine were seen with sonography. Although all 16 patients had endoscopic proof of gastroesophageal varices, only 12 were demonstrated by angiography. Of these 12 patients, 10 had sonographic visualization of varices alone the gastroesophageal junction and lesser curvature of the stomach. One patient with opacification of a gastrorenal communication also had left upper quadrant venous abnormalities at sonography. Sonography is useful in the noninvasive identification of portosystemic collateral vessels in patients with portal hypertension.

Adult↗
PubMed1981

The sonographically solid appearing benign cystic teratoma.

The sonographic appearance of 6 solid benign cystic teratomas (in 5 patients) was reviewed. Three of these tumors were difficult to identify due to the presence of acoustical shadowing obscuring the posterior portions of the tumors. This appearance was mistaken ultrasonically for bowel gas. The tumors were diagnosed by abdominal radiographs showing calcifications, teeth and/or radiolucency due to fat. With the presence of a clinically palpable pelvic mass in a young woman, and an apparently normal sonogram, an abdominal radiograph should be considered to look for evidence of a benign cystic teratoma.

Adolescent↗
PubMed1980

Retroperitoneal processes involving the psoas demonstrated by computed tomography.

Twenty-five patients were found to have retroperitoneal pathology involving the psoas muscle including nine patients with inflammatory lesions, three with hematomas, seven with adenopathy, one patient with leukemic infiltration of the psoas, and five with retroperitoneal tumors. Computed tomography (CT) offers a unique method to investigate pathological processes that affect the psoas. In addition, the abdominal films on 24 of the patients were analyzed to correlate the value of radiography with that of CT. Computed tomography confirms the belief that the mere presence of a retroperitoneal mass will not necessarily obliterate the psoas.

Abscess↗
PubMed1980

Sonography of the renal arteries: left lateral decubitus position.

Despite the routine visualization of many of the major branches of the abdominal aorta using current state of the art sonography equipment, the renal arteries are still infrequently seen in normal patients and are rarely seen in patients with abdominal aortic aneurysms. Longitudinal scanning in the left lateral decubitus position will frequently visualize the origin of the renal arteries from the aorta and/or the right renal artery as it crosses under the inferior vena cava. Using this technique the renal arteries in 16 of 20 patients were visualized. The experience with this technique so far is limited to three patients with aortic aneurysm. In two, the relation of the aneurysm to the renal arteries could be delineated.

Aorta, Abdominal↗