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R D Tarver

Publications and source records attributed to R D Tarver.

At least 19 recordsLinked to original sources
PubMed2006

Isotropic chest CT examination: diagnostic quality of reformats.

AIM: To evaluate the image quality of axial and coronal reformats obtained from isotropic resolution 40-channel chest computed tomography (CT) examinations. METHODS AND MATERIALS: Thirty consecutive patients with intravenous contrast-enhanced chest CT examinations using a 40-channel CT machine were enrolled for the study. The raw data were reconstructed into two sets of source axial images: 0.9 mm section width and 0.45 mm reconstruction interval (isotropic resolution) and 4mm section width with 3 mm reconstruction interval (anisotropic resolution; group A). The isotropic data set was reformatted into axial and coronal stacks (groups B and C, respectively) with 4 mm section width and 3 mm interval. Three independent readers evaluated stacks A to C using a three-point scale for resolution of right lower lobe segmental bronchi, edge sharpness of major and minor fissures, respiratory motion artefact, reconstruction artefact, noise and overall image quality. RESULTS: The sharpness of fissures scored significantly higher with the coronal reformats (group C) compared with the axial image sets (groups A and B) (p<0.01). Noise in group A scored significantly lower than groups B or C (p<0.01). For other parameters there was no statistical difference between the groups. There was substantial or excellent agreement between the reviewers. CONCLUSION: Isotropic imaging of the chest allows creation of reformats with similar image quality as similar thickness axial source images. These reformats are probably of sufficient quality to form the basis of clinical interpretation.

Adult↗
PubMed2001

Unilateral bronchiectasis and esophageal dysmotility in congenital adult tracheoesophageal fistula.

Tracheoesophageal fistulas (TEF) in adults are most commonly neoplastic, and very rarely congenital in nature. We report a 45-year-old Hispanic male with TEF and initial presentation of minimal hemoptysis. The patient had radiographic evidence of unilateral upper lobe (RUL) bronchiectasis, massive esophageal dilatation, and dysmotility. However, there was no evidence of esophageal malignancy, achalasia, or Chagas' disease. Bronchoscopy revealed a large TEF in the posterior wall of trachea, which was not visualized on esophagram or esophagoscopy. Bronchoalveolar lavage (BAL) cultures grew Mycobacterium avium complex (MAC). Our report illustrates that idiopathic, or congenital, TEF can be associated with esophageal dysmotility, adulthood bronchiectasis, and atypical mycobacterial superinfection.

Bronchiectasis↗
PubMed2000

The value of good medical student teaching: increasing the number of radiology residency applicants.

RATIONALE AND OBJECTIVES: The authors attempted to define the value of good medical student teaching to the profession of radiology by examining the effect of radiology course improvements on the number of 4th-year students applying to radiology residencies. MATERIALS AND METHODS: Course evaluation and residency application data were obtained from six consecutive classes of 4th-year medical students at the study institution, and these data were compared with national data. RESULTS: Between 1995 and 2000, the number of 4th-year U.S. medical students applying to radiology increased 1.6 times. At the study institution, that number increased 4.5 times, a statistically significant difference (P = .020, chi2 test). Student survey data indicate that this increase reflects a general increase in the quality of radiology teaching in the study institution and specific changes in a required 2nd-year medical school course. CONCLUSION: These results strongly suggest that good medical student teaching pays important dividends, not only to the departments that provide it but also to the profession of radiology as a whole. Exposing students to good radiology teaching early in their medical school careers is especially important. Radiology departments that provide outstanding medical student education should be studied to help develop a model of educational best practices.

Chi-Square Distribution↗
PubMed1998

Meandering bullet in the pericardial sac: to remove or not to remove.

Patients with bullets in the pericardial sac without obvious myocardial injuries are rare, making it difficult to analyze the natural history and propose management approaches. We present the case of a meandering bullet in the pericardial sac and a review of the literature.

Adult↗
PubMed1997

Imaging of lung cancer: old and new.

Lung cancer is the leading cause of cancer death in the United States. Lung cancer is frequently encountered by the radiologist, whether the lung cancer is detected on a chest radiograph obtained in a symptomatic patient, or is an incidental finding. The radiologic workup of pulmonary lesions suspected of being lung carcinoma has evolved as new technology has become available. Current imaging modalities which are useful in the workup of suspected lung cancers include plain radiography, computed tomography, magnetic resonance imaging, with the recent addition of positron emission tomography and endoscopic ultrasound. The following article discusses the merits of these imaging modalities and their role in the workup of patients with lung cancer.

Endosonography↗
PubMed1996

Reexpansion pulmonary edema.

Reexpansion pulmonary edema is a rare complication attending the rapid reexpansion of a chronically collapsed lung, such as occurs after evacuation of a large amount of air or fluid from the pleural space. The condition usually appears unexpectedly and dramatically-immediately or within 1 h in 64% of patients and within 24 h in the remainder. The clinical manifestations are varied; they range from roentgenographic findings alone in asymptomatic patients to severe cardiorespiratory insufficiency. The radiographic evidence of reexpansion pulmonary edema is a unilateral alveolar filling pattern, seen within a few hours of reexpansion of the lung. The edema may progress for 24-48 h and persist for 4-5 days. Human data on the pathophysiology of reexpansion pulmonary edema derive from small series of patients, case reports, and reviews of the literature. On the other hand, a larger body of data exists on experimental reexpansion pulmonary edema in cats, monkeys, rabbits, sheep, and goats. This review examines the clinical and experimental evidence for reexpansion pulmonary edema. In addition, we detail the historical background, clinical setting, treatment, and outcome of reexpansion pulmonary edema.

Animals↗
PubMed1996

Pulmonary aspergillosis: a spectrum of disease.

Although many species of the fungus Aspergillus have been identified, the most common human pathogen is A. fumigatus, which has a worldwide distribution. Although any organ may become infected, pulmonary aspergillosis is the most common manifestation. The spectrum of pulmonary aspergillosis includes saprophytic aspergillomas, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis, and invasive aspergillosis. Immune status of the host, and the presence of underlying lung disease are important in determining the type of pulmonary involvement. Thus, the radiographic findings are variable. This article reviews the various manifestations of pulmonary aspergillosis, including the immune status of the patient, the presence of underlying lung disease, and the radiographic appearance of the different entities.

Aspergillosis↗
PubMed1995

Tracheoesophageal fistula due to Wegener granulomatosis.

Most acquired tracheoesophageal fistulas (TEFs) are due to malignant disease processes, with nonmalignant causes infrequently encountered. We report a patient with a TEF caused by Wegener granulomatosis. The radiographic findings of this rare cause of TEF are described.

Adult↗
PubMed1994

Ruptured cystic mesenchymal hamartoma: an unusual cause of neonatal ascites.

Cystic mesenchymal hamartoma is an uncommon benign liver neoplasm usually seen in infants with an asymptomatic abdominal mass [1]. We report a neonate who presented with a ruptured cystic mesenchymal hamartoma which produced respiratory distress due to massive ascites. To our knowledge, this complication has never been reported.

Adolescent↗
PubMed1994

Interventional chest radiology.

Interventional radiology has important applications for the diagnosis and treatment of chest diseases. Fine-needle aspiration biopsy of a lung nodule is the most commonly performed procedure, but lesions in the mediastinum, hilum, and chest wall also can be biopsied. Needle aspiration and catheter drainage help in treating pleural effusion, empyema, and lung and mediastinal abscesses. Emphasis on teamwork and patient care is essential. In this article, the authors offer practical advice on how and when to undertake these procedures and how to manage any associated complications.

Biopsy, Needle↗
PubMed1993

Painful transthoracic needle biopsy: a sign of neurogenic tumor.

Neurogenic tumors most commonly appear initially as posterior mediastinal masses. These tumors, however, may occur in other intrathoracic locations and present a diagnostic challenge. In such cases transthoracic fine-needle aspiration (FNA) often is used to make a definitive diagnosis. This procedure usually does not result in severe pain. We report two patients who experienced severe pain during transthoracic FNA of neurogenic tumors. We believe that severe pain associated with transthoracic needle biopsy of an intrathoracic mass is suggestive of a neurogenic tumor. When pain accompanies this procedure, a cytopathologist should be notified so that specific immunostaining techniques can be performed to confirm the diagnosis.

Adult↗
PubMed1993

Disseminated histoplasmosis in AIDS: findings on chest radiographs.

OBJECTIVE: Our objective was to determine the findings of disseminated histoplasmosis on chest radiographs of patients with AIDS. MATERIALS AND METHODS: Chest radiographs of 50 AIDS patients with documented extrapulmonary histoplasmosis were analyzed retrospectively. The radiographs were evaluated for the presence of parenchymal opacities, pleural effusions, adenopathy, cavitation, and calcified granulomas and lymph nodes. A modification of the International Labour Office scheme was used to classify parenchymal abnormalities as nodular, linear or irregular, reticulonodular, or air-space opacities. RESULTS: Abnormalities were present on radiographs in 23 patients. Nodular opacities were present in 10 patients and were diffusely distributed in nine patients. Linear or irregular opacities were present in seven patients, with diffuse distribution in four and limited involvement in three. Air-space opacities were present in seven patients; the distribution varied from segmental to diffuse involvement of the lung. Small pleural effusions were present in five patients. Adenopathy and Kerley's B lines were each present in three patients. In 27 patients, the chest radiographs were normal. Four of these patients had clinical or microbiological evidence of lung involvement. CONCLUSION: The chest radiographic findings of disseminated histoplasmosis in AIDS patients are varied and nonspecific. The presence of diffuse nodular or linear/irregular opacities in an AIDS patient, especially one who resides in or has resided in an endemic area, should suggest the possibility of disseminated histoplasmosis. Normal findings on chest radiographs do not exclude disseminated infection or lung involvement.

AIDS-Related Opportunistic Infections↗
PubMed1991

Noninfectious and nonmalignant pulmonary disease in AIDS.

Infectious and malignant disease processes are responsible for most pulmonary abnormalities seen in patients with acquired immunodeficiency syndrome (AIDS). There are, however, a number of noninfectious and nonmalignant disorders that can involve the lungs of these individuals. Nonspecific interstitial pneumonitis and lymphocytic interstitial pneumonitis may mimic opportunistic infections both clinically and radiographically. Congestive cardiomyopathy may develop and result in pulmonary edema. Other disorders such as alveolar proteinosis and desquamative interstitial pneumonitis are also reported. Bronchoalveolar lavage, a diagnostic technique frequently employed in AIDS patients, may itself produce pulmonary opacities. Knowledge of these disorders may aid in the evaluation of AIDS patients for whom an infectious etiology for pulmonary abnormalities cannot be found.

Acquired Immunodeficiency Syndrome↗