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P Vock

Publications and source records attributed to P Vock.

132 records · Page 8Linked to original sources

Hydrostatic pulmonary edema. An analysis of lung density changes by computed tomography.

The computed tomographic (CT) appearance of pulmonary edema induced by elevated left atrial (LA) pressure was examined. Dogs, in the prone position, were scanned during suspended ventilation at functional residual capacity. A surgically implanted LA balloon was inflated to elevate LA pressure for 30 to 140 minutes to a mean pressure of 29.8 mm Hg. Lung water, measured gravimetrically, averaged 14.7 ml/kg body weight compared with 5.7 ml/kg in nonedema control dogs. Lung density in dogs with edema was 69.5% higher than base-line density, while in the control group final lung density was only 4% higher than base line. Analysis of regional density indicated that there were greater increases in density in more central and dependent (ventral) zones of the lung and relatively smaller increases in nondependent (dorsal) peripheral zones. These results are in contrast to the previously reported pattern of density change seen with oleic acid injury in which density increases were primarily in peripheral zones of the lung.

Animals↗

Morphology of oleic acid-induced lung injury. Observations from computed tomography, specimen radiography, and histology.

Previously, we reported that oleic acid infusion in dogs produced a patchy and predominantly peripheral increase in lung density. The present study examines in more detail the morphology of the early stages of development of the oleic acid lesion using computed tomography (CT), specimen radiography, and conventional histology. Dogs were sacrificed 10, 30, 60, and 240 minutes after infusion of oleic acid (.05 ml/kg). After freezing in dry-ice, the thorax was scanned and cut into 1-cm thick sections. Frozen sections were then contact radiographed and sampled for histology. Within 10 minutes of infusion, subtle increases in peripheral lung density were visible on the contact radiographs. Patchy areas of peripheral density, resembling secondary lobules, were especially prominent 60 and 240 minutes after infusion. These lesions were often clearly associated with the distal bronchovascular structures. Histologic signs of edema were present in all animals sacrificed 30 or more minutes after receiving oleic acid. These correlative studies provide additional insight into the early subgross development of oleic acid-induced injury by showing the relationship between the developing edema and the bronchovascular structure of the lung.

Animals↗

Two- and three-dimensional phase contrast MR angiography of the abdomen.

Protocols for two- and three-dimensional phase contrast magnetic resonance angiography of the major vessels in the abdomen were developed and demonstrated in healthy volunteers. Phase contrast imaging provides excellent suppression of stationary tissue signal and can be used to quantify the speed and direction of flow in a given vessel. The two-dimensional protocols provide rapid breath-held images, which proved useful for anatomical localization. The three-dimensional studies required longer acquisition times but provided superior image quality. Artifacts from bowel and respiratory motion were not significant with either protocol. Vasculature detected includes the renal, splenic, hepatic, and mesenteric systems as well as the aorta and inferior vena cava.

Abdomen↗

Long-term changes induced by high-dose irradiation of the head and neck region: imaging findings.

High-dose irradiation is an effective treatment for tumors in the head and neck. Radiation-induced complications are uncommon but may result in chronic, progressive symptoms months or years after therapy. In 19 (1%) of 1,950 patients who underwent successful high-dose irradiation of head and neck tumors over a 5-year period, delayed radiation-induced changes were documented with imaging. These changes can be categorized as soft-tissue, bone, and cartilage necrosis; fibrosis leading to functional disorders; arteriopathy; central nervous system reactions, delayed myelopathy, and cranial nerve palsies; and the development of meningiomas. Radiologic features of radiation-induced soft-tissue, bone, and cartilage necrosis include inflammatory swelling adjacent to the area of involvement; deep gas-containing ulcerations; sclerotic appearance of the involved cartilages; fragmentation and sloughing of necrotic bone or cartilage; and abscess and fistula formation. Masticator muscle fibrosis appears as an area of diffusely increased signal intensity on T2-weighted images and of enhancement on postcontrast T1-weighted images. Radiation arteriopathy may manifest as occlusion, subocclusive sclerotic or atheromatous plaque, localized mural thrombus, aneurysm, or, rarely, spontaneous rupture. In central nervous system reactions, imaging findings include demyelination foci in the white matter, focal radiation necrosis, and severe brain atrophy. Radiation-induced meningiomas display the same imaging features as non-radiation-induced meningiomas at computed tomography, magnetic resonance imaging, and angiography, although follow-up examinations may reveal their more aggressive biologic behavior. Knowledge of the radiologic appearance of radiation-induced changes may prevent misinterpretations and facilitate treatment.

Aged↗

The Rocky liver: radiologic-pathologic correlation of calcified hepatic masses.

Although relatively uncommon in daily clinical practice, calcification may be found in inflammatory hepatic lesions and in benign and malignant liver neoplasms. The most common source of calcified hepatic lesions is inflammatory conditions such as granulomatous diseases (e.g., tuberculosis). The calcification typically involves the entire lesion and appears as a dense mass that can produce artifacts on computed tomographic (CT) scans. Echinococcus cysts have curvilinear or ring calcification. Hemangiomas, especially large ones, may contain large, coarse calcifications that are centrally located in areas of fibrosis; these may be seen at CT (20% of cases) or radiography (10%). In hepatocellular adenoma, calcifications may be solitary or multiple and are usually located eccentrically within a complex heterogeneous mass. Calcifications in fibrolamellar carcinoma have been reported in 15%-25% of cases at CT and occur in a wide variety of patterns. Calcifications in intrahepatic cholangiocarcinoma are typically accompanied by a desmoplastic reaction and are visible at CT in about 18% of cases. Calcified hepatic metastases are most frequently associated with mucin-producing neoplasms such as colon carcinoma. Knowledge of the pathologic features of each entity helps radiologists to better recognize the shape, size, density, number, location, and distribution of hepatic calcifications seen on images and to narrow the differential diagnosis.

Calcinosis↗

Clinical and radiologic features of pulmonary edema.

Pulmonary edema may be classified as increased hydrostatic pressure edema, permeability edema with diffuse alveolar damage (DAD), permeability edema without DAD, or mixed edema. Pulmonary edema has variable manifestations. Postobstructive pulmonary edema typically manifests radiologically as septal lines, peribronchial cuffing, and, in more severe cases, central alveolar edema. Pulmonary edema with chronic pulmonary embolism manifests as sharply demarcated areas of increased ground-glass attenuation. Pulmonary edema with veno-occlusive disease manifests as large pulmonary arteries, diffuse interstitial edema with numerous Kerley lines, peribronchial cuffing, and a dilated right ventricle. Stage 1 near drowning pulmonary edema manifests as Kerley lines, peribronchial cuffing, and patchy, perihilar alveolar areas of airspace consolidation; stage 2 and 3 lesions are radiologically nonspecific. Pulmonary edema following administration of cytokines demonstrates bilateral, symmetric interstitial edema with thickened septal lines. High-altitude pulmonary edema usually manifests as central interstitial edema associated with peribronchial cuffing, ill-defined vessels, and patchy airspace consolidation. Neurogenic pulmonary edema manifests as bilateral, rather homogeneous airspace consolidations that predominate at the apices in about 50% of cases. Reperfusion pulmonary edema usually demonstrates heterogeneous airspace consolidations that predominate in the areas distal to the recanalized vessels. Postreduction pulmonary edema manifests as mild airspace consolidation involving the ipsilateral lung, whereas pulmonary edema due to air embolism initially demonstrates interstitial edema followed by bilateral, peripheral alveolar areas of increased opacity that predominate at the lung bases. Familiarity with the spectrum of radiologic findings in pulmonary edema from various causes will often help narrow the differential diagnosis.

Altitude Sickness↗