Biomedical subjects
Publications and source records attributed to T G Lee.
The authors describe a new air contrast technique for B-scan ultrasound to confirm the correct intra-abdominal placement of transfused blood after nine intrauterine transfusions in four patients. Such confirmation by this method is neither dependent on the amount of blood introduced nor masked by fetal ascites.
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The successful management of an Rh-sensitized pregnant patient is reported in whom fetal intrauterine transfusions were utilized despite the presence of fetal ascites before the 26th week of gestation. A new ultrasound air contrast technique is described that confirms the correct intraabdominal placement of the transfused blood. The technique is not dependent on the amount of blood introduced, nor is it masked by fetal ascites.
The authors describe a method for obtaining direct sagittal and coronal computed tomographic (CT) scans of the pelvis using a special accessory table adapted for use in wide-aperture whole-body scanners. In these scans the spatial and density resolution are nearly equivalent to those in axial scans. A case is described in which sagittal scanning helped define a pelvic mass.
Ultrasound plays a major role in the evaluation of mass lesions in the postoperative period. Diagnostic pitfalls may occur in post-splenectomy cases when stomach and bowel loops settle into the splenic fossa and simulate mass lesions. While true masses such as subphrenic abscess, pancreatitis and pancreatic pseudocyst are essentially unchanging in appearance or location when scanned in varying patient positions, pseudomasses of stomach or bowel loops often do change, Awareness of possible post-splenectomy pseudomass is important in order to avoid confusing the gastrointestinal tract with a pathological condition.
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Computed tomography (CT), ultrasound, and 111In-labeled leukocyte scans are all used in the evaluation of abdominal abscesses. In this study, 170 patients in whom one, two, or all three of these modalities were used retrospectively reviewed. Diagnostic accuracy of 96% for CT, 90% for ultrasound, and 92% for 111In leukocyte scans was achieved. It was often necessary to use more than one modality to arrive at a correct diagnosis. The advantages and disadvantages as well as the causes for false positive or false negative interpretations of each of these modalities are reviewed. Analysis of the different examinations resulted in a suggested sequence by which patients can be examined, based upon their clinical condition. Patients who are not critically ill and/or who have no localizing signs should be studied first with 111In-labeled leukocyte scans. If, however, localizing signs should or the patient's condition necessitates prompt intervention, CT or ultrasound should be the first study performed.
Ultrasound (US), because of its ability to distinguish cystic from solid tissue, is an ideal tool for diagnosing masses in the popliteal fossa. Five cases are presented. Two cases show the typical ultrasound images in the most common popliteal mass, a cyst. A third case significantly points out the necessity of further investigations if the US findings are atypical of a simple cyst and the patient is symptomatic. A fourth case demonstrates that the US image can distinguish an aneurysm of the popliteal artery from a cyst. A fifth case demonstrates that a solid tumor in the popliteal fossa, in contrast to that of a cyst, has a characteristic US image. Ultrasound is a simple, quick, noninvasive outpatient procedure available to almost every physician. In most instances, US appears to be the diagnostic procedure of choice following conventional radiography in the evaluation of swelling in the popliteal fossa.
The correct preoperative diagnosis of a wandering spleen is infrequently made either clinically or with conventional radiologic studies. Since ultrasound can readily identify the spleen, it may assist in making this diagnosis. We describe three patients to illustrate the advantages and usefulness of ultrasound. In one postmastectomy patient, the suspected abdominal metastasis was shown to be a displaced spleen, thus obviating the necessity for an exploratory laparotomy. In the other two patients, ultrasound diagnosis was helpful in clinical treatment by localizing the wandering spleen. Ultrasound evaluation is particularly suited for patients with obscure abdominal masses because it is safe, simple, and fast.
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Ultrasonography offers a noninvasive method to visualize antenatal or neonatal anatomy which will lead to early detection and treatment of abnormalities. In these 2 cases, ultrasound allowed prompt diagnosis of hydronephrosis despite normal physical examination and laboratory values at birth.
B-scan ultrasound performed in 6 patients for a total of 15 intrauterine fetal transfusions provided quick, easy, and reliable confirmation of the fetal intra-abdominal placement of transfused blood.
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Angiomyolipoma (AML) IS A BENIGN RENAL NEOPLASM. Preoperative diagnosis is important because of the different surgical approaches to benign and malignant tumors. Angiographic findings of AML and renal carcinoma may be similar and differentiation difficult. B-mode ultraslund examination of AML demonstrates a different image pattern which may be helpfou in differentiation.
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A case of hydranencephaly was demonstrated antenatally by ultrasound and correlated with ventriculography and computed cranial tomography. Prenatal diagnosis of intracranial abnormalities by careful attention to intracranial anatomy is possible and can facilitate obstetrical management.
Intramural intestinal hemorrhage in hemophilia has been diagnosed by ultrasound. The sonographic pattern consists of a tubular anechoic mass containing a core of strong echoes. Recognition of intestinal hematoma is important because of its bearing on treatment and prognosis. To our knowledge, this is the first reported case.