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M N Wakabayashi

Publications and source records attributed to M N Wakabayashi.

4 recordsLinked to original sources

Magnification views of mammography decrease biopsy rates.

Mammography is a valuable tool for screening and has increased early detection of breast cancer. Magnification views are commonly used to further elucidate suspicious changes seen on routine mammograms. The effect of magnification views and their utility have not been studied regarding the influence on treatment strategies. All patients who had magnification views performed along with their mammogram at Tulane University Medical Center over a one-year period were included. Patient charts were reviewed for mammogram readings, recommendations, and any biopsy results. The original mammograms without the magnification views were given to a physician who was blinded to the final results of the magnification views for a recommendation of whether or not to biopsy the lesion. These recommendations were compared with the results with actual recommendations. Magnification views were performed on 127 patients. After the additional magnification views were taken 27 per cent (34 of 127) of patients had biopsies performed. Biopsy results revealed benign findings in 71 per cent and nonbenign findings (lobular carcinoma in situ, ductal carcinoma in situ, or carcinoma) in 29 per cent. On the basis of the recommendations without magnification views 64 per cent of patients would have had biopsies performed. Magnification views decreased the biopsy rates by 58 per cent (P < 0.001; chi2 tests). Magnification views can help decrease the number of biopsies performed for suspicious small areas on mammograms. Their judicious use can help decrease unnecessary procedures, patient anxiety, and cost. Magnification views are useful to help surgeons and radiologists best screen for breast cancer.

Biopsy↗

Esophageal varices: evaluation with transabdominal US.

PURPOSE: To prospectively evaluate the clinical usefulness of transabdominal ultrasound (US) in the detection of esophageal varices. MATERIALS AND METHODS: Transabdominal US was performed in 47 patients (30 men, 17 women; age range, 18-75 years) with liver cirrhosis or idiopathic portal hypertension. The intraabdominal esophagus was demonstrated satisfactorily, and the findings were correlated with the presence of esophageal varices at endoscopy and angiography. The thickness of the anterior wall of the intraabdominal esophagus was measured and the irregularity of the wall surface documented. Blood flow signal in the esophageal wall also was evaluated with color Doppler and pulsed Doppler examinations. RESULTS: The mean thickness of the esophageal wall was 5.7 mm +/- 1.7 (standard deviation) in patients with esophageal varices and 3.6 mm +/- 0.96 in patients without varices. This difference was statistically significant (P < .001). Varices also caused irregular wall surfaces. Another specific finding was hepatofugal venous flow within the esophageal wall at Doppler examination. When an esophageal wall thickness of at least 5 mm or an irregular wall surface was used as a diagnostic criterion for esophageal varices, the sensitivity, specificity, and accuracy were 93%, 82%, and 89%, respectively. CONCLUSION: Transabdominal US can play a role in screening for esophageal varices. The intraabdominal esophagus should be observed during standard abdominal US in patients with chronic liver disease.

Adult↗