Search PubMed⌕ Search

Biomedical subjects

R L Schapiro

Publications and source records attributed to R L Schapiro.

At least 37 records · Page 2Linked to original sources

Nuclide imaging and computed tomography in cerebral vascular disease.

This report presents our experience with computed tomographic and radionuclide scans in 224 patients with ischemic or hemorrhagic infarcts or intracerebral hematomas secondary to cerebral occlusive vascular diseases. The results vary according to the site of vascular occlusion. The radionuclide angiograms and static scintigrams show four distinct patterns in cases of occlusion of the middle cerebral artery. Computed tomographic scans exhibit less variation in appearance and have a higher sensitivity in cases of recent ischemic infarction. The "tentorial confluence sign" is an important finding on static scintigrams in patients with occipital infarction; if this sign is not present, this diagnosis should be suspect. Earlier reports have established the value of computed tomography and radionuclide scans in the evaluation of cerebral infarction. In individual cases, however, each of these modalities may render nondiagnostic or false negative findings; combining both both types of examinations and comparing results yield a greater likelihood of an accurate diagnosis of cerebrovascular disease. Computed tomography is clearly more valuable than radionuclide scans in the diagnosis and follow-up of hemorrhagic infarcts or parenchymal hematomas.

Aged↗

Scintigraphic findings in hyperostosis frontalis interna.

Transient diminution of activity was seen on early radionuclide images of the brain in 5 patients with hyperostosis frontalis interna and filled in on subsequent studies. Radiographs confirmed the diagnosis. In 3 patients the changes corresponded extremely well with both modalities. This entity should be considered when diminished activity is seen in the frontal area.

Aged↗

The excessively small ventricle on computed axial tomography of the brain.

Computed axial tomography has made it possible to observe excessively small ventricles in a variety of disorders of the CNS. This finding is presumably due to non-specific and diffuse swelling of brain parenchyma, and is illustrated in cases of trauma, neoplasm, encephalitis, pseudotumor cerebri, metabolic disorder, and probable dilantin effect. It is likely that other causes will be encountered in the future.

Adolescent↗

Brain image manifestation in the patient with cavernous sinus occlusion.

Radionuclide findings in a case of cavernous sinus occlusion by an intracavernous aneurysm are described. A brain image obtained 10 minutes after injection of 99Tc pertechnetate shows diminished activity in the area of the right cavernous sinus and increased activity in the area of the right sylvian veins; these are attributed to abnormal venous blood flow and may serve as a sign of cavernous sinus occlusion.

Cavernous Sinus↗

The normal range and position of the pineal gland on computed tomography.

Precise measurements with the Vanguard Motion Analyzer were made to determine the position of the pineal gland as shown on the Polaroid displays of 145 normal scans. The relatively midline positions of the gland are expressed in terms of percentage shift of the gland in these 145 normal cases is defined by a mean value of 0.8% with a standard deviation of 0.6%. More than 99% of normal CT scans can be expected to show a percentage shift of 2.6% or less.

Cephalometry↗

Computed tomography and radionuclide studies in the diagnosis of intracranial disease.

The accuracy of CT and radionuclide studiies in the diagnosis of intracranial disease is analyzed based on experience in 641 patients. Results indicate that both modalities give reasonably similar precision and that a modest improvement in diagnosis can be expected if both techniques are employed. It is emphasized that the radionuclide studies used routinely included what are rightfully considered adjunctive scanning procedures, so that results must be considered in this light.

Brain Diseases↗

Sequential brain scanning as an adjunctive scanning procedure.

Sequential brain scans were performed at various time intervals of up to four hours after injection of 99mTc pertechnetate in 108 patients who had previously undergone "routine" one-hour brain scans which were considered normal or equivocal. Forty-six patients were proved to have a discrete morphologic brain lesion. Pathologic processes were demonstrated by the sequential scanning technique in all but 6 cases. In nearly a third of these 46 patients (28%), careful observation of the progressive and subtle changes in radioactivity in the whole sequential scan series was necessary for detection of the lesions: they could not be appreciated on any single static scan when viewed independently.

Adenoma, Chromophobe↗

The manifestations of diaphragmatic and juxtadiaphragmatic diseases in the liver-spleen scintigraph.

Diaphragmatic and juxtadiaphragmatic abnormalities can be recognized on liver-spleen scintigraphs by alteration of the normal disparity in height between the liver and the spleen and by flattening of the superior margins of the liver and spleen. A unilateral abnormality is manifested by exaggeration or reversal of the normal disparity in height between the superior margins of the liver and spleen by cephalad or caudad displacement of one of these organs. Bilateral peridiaphragmatic abnormalities are manifested by flattening of the superior margins of the liver and spleen by caudad displacement of both organs.

Diaphragm↗

The diagnostic value of serial brain scanning.

A survey of the literature pertaining to several serial brain scanning procedures has been presented. These procedures include rapid brain imaging, sequential brain imaging, delayed from imaging, and follow-up brain imaging. Applications of these techniques to specific clinical problems have been stressed and the reported results reviewed. Thus, it has been indicated that rapid brain imaging is most useful in detecting lesions secondary to cerebrovascular disease but may also provide some helpful information pertaining to the differential diagnosis of other C.N.S. lesions demonstrated on subsequent static brain scans. Sequential brain imaging is a time-consuming adjunctive procedure which, however, can be extraordinarily helpful in a highly selected group of problem cases which present with relatively small lesions adjacent to normal anatomic structures which themselves have considerable radioactivity. Delayed brain imaging has the distinction of detecting the greatest number of intracranial lesions but is attended by tactical problems in maintaining an optimal patient flow through the department and also has the undesirable consequence of reduced information density and diminished image quality, unless greater radiation doses are injected. Follow-up brain imaging is useful in the differential diagnosis of cerebrovascular and neoplastic disease and in the assessment of effectiveness of radiation therapy.

Adenoma, Chromophobe↗