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T J Barloon

Publications and source records attributed to T J Barloon.

At least 37 records · Page 2Linked to original sources
PubMed1993

Comparison of oral cholecystography and ultrasonography for evaluating chronic cholecystitis using patient outcome as the reference standard.

RATIONALE AND OBJECTIVES: The authors compared oral cholecystography (OCG) with ultrasound (US) in the detection of chronic gallbladder disease using clinical outcome, rather than pathology results, as the reference standard. METHODS: The authors interviewed 269 patients who underwent either OCG, US, or both, for evaluation of chronic right upper quadrant abdominal pain. The authors considered patients who underwent cholecystectomy with improved symptoms 1 to 4 years after surgery to be reference-standard positive for gallbladder disease, and patients with objective evidence of an alternative diagnosis (eg, peptic ulcer disease), which improved with therapy as reference-standard negative. RESULTS: The sensitivity and specificity of OCG were 83% and 97%, respectively, and for US, 86% and 90%, respectively. CONCLUSIONS: OCG is comparable with US in evaluating of chronic gallbladder disease. In institutions where OCG is used for diagnosing chronic cholecystitis, it may be reasonable to continue using OCG.

Algorithms↗
PubMed1992

Unusual renal oncocytomas: pathologic and CT correlations.

The unusual features of nine oncocytomas in five patients are reported herein. These include multiplicity in two, bilaterality in two, calcification in one, and association with renal cell carcinomas in three patients. Radiologists should be aware of these findings for this benign renal neoplasm.

Adenoma↗
PubMed1992

CT diagnosis of small-bowel obstruction: efficacy in 60 patients.

We retrospectively compared the CT findings in patients with and without surgically proved small-bowel obstruction to evaluate the role of CT in diagnosing the presence and cause of obstruction. In the patients with obstruction, we compared the CT findings with findings on plain abdominal radiographs and contrast studies of the small intestine. CT criteria used for the diagnosis of obstruction were dilated small-bowel loops proximal to the suspected site of obstruction and collapsed or normal-appearing loops of small bowel distal to the obstruction. Receiver-operating-characteristic analysis suggested the optimum balance of sensitivity and specificity was achieved when 2.5 cm was used to indicate dilatation of the small bowel. On the basis of these criteria, the presence of obstruction was correctly diagnosed in 27 (90%) of 30 patients with proved obstruction, and obstruction was not diagnosed in the patients without obstruction. The cause of the obstruction was evident on CT in 14 of the 30 obstructed patients: abscess (five), neoplastic lesion (three), peritoneal carcinomatosis (three), and other (three). Adhesions were responsible for the obstruction in 13 of 15 patients in whom the cause was not shown on CT. In six patients in whom findings on plain abdominal radiographs were normal, the CT scan was positive for obstruction. However, in the three patients whose CT scans were falsely negative for obstruction, findings suggesting obstruction were seen on plain films. Of 15 patients who had both CT and contrast studies of the small intestine, CT offered more information concerning the cause of obstruction in six (40%), primarily by demonstrating significant extraluminal abnormalities. CT and gastrointestinal contrast studies gave concordant results in eight patients with obstruction. In only one patient did the gastrointestinal contrast study give more diagnostic information. We conclude that CT scanning demonstrates accurately the presence of high-grade small-bowel obstruction and may be the technique of choice when extraluminal abnormalities are suspected or when prompt, efficient, and comprehensive evaluation is required.

Adult↗
PubMed1992

CT analysis of metastatic neoplasms of the kidney. Comparison with primary renal cell carcinoma.

The CT findings in 32 patients with pathologically proven metastases to the kidney were compared to findings in 74 patients with renal cell carcinoma. Fourteen CT criteria were chosen to describe and characterize the lesions and 2 radiologists evaluated the CT images retrospectively according to these criteria. Renal metastases were characterized as small, multiple, bilateral, wedge-shaped, less exophytic, and located within the renal capsule. Renal cell carcinomas were single, unilateral, nonwedge-shaped, and exophytic, and easily transgressed the renal capsule. The sensitivity of CT to discriminate renal cell carcinoma from renal metastasis was 93.2% for renal cell carcinoma, and to discriminate renal metastasis from renal cell carcinoma was 75.0% for renal metastases by computer posterior probabilities. This study indicates that CT is useful for distinguishing these clinically important tumors. By using posterior probability, some unnecessary biopsies may be avoided.

Adult↗
PubMed1991

Fungal pulmonary infections after bone marrow transplantation: evaluation with radiography and CT.

The authors reviewed 55 pairs of chest radiographs and computed tomographic (CT) studies obtained in 33 febrile bone marrow transplant (BMT) recipients. The images were read separately, without knowledge of the clinical diagnosis. Twenty-one episodes of fungal infection were documented. One chest radiograph showed a pneumonia-like opacity, and 17 showed nodular opacities, five with cavitation. In 20 of 21 episodes, CT showed nodules with cavitation (n = 7), halo (n = 4), hazy margin (n = 5), air bronchogram (n = 2), cluster of fluffy nodules (n = 1), or sharp margin (n = 1). In none of the nine bacteremic episodes, however, were there opacities on chest radiographs or CT studies. CT studies demonstrating complicated nodules in febrile BMT patients strongly suggest a fungal infection, whereas negative CT studies suggest bacteremia or non-filamentous fungal infection of nonpulmonary origin. CT appears to add useful information to radiographic analysis during the assessment of febrile episodes in BMT patients, especially when invasive diagnostic procedures pose a high risk.

Adult↗
PubMed1991

High-resolution ultrafast chest CT in the clinical management of febrile bone marrow transplant patients with normal or nonspecific chest roentgenograms.

Plain chest roentgenograms may be normal or show nonspecific abnormalities during the frequent febrile episodes that occur in patients after bone marrow transplantation. In this group, ultrafast 10-mm and 3-mm high-resolution CT scans were prospectively performed in 33 patients to determine if useful information was provided that either changed the patient's clinical management or added confidence to the clinical diagnosis. The 36 symptomatic episodes that occurred in 33 patients included fever in 20 episodes and fever combined with cough, dyspnea, chest pain, or rales in 16. Fourteen chest roentgenograms were interpreted as normal, and 22 were interpreted as demonstrating nonspecific changes; however, none of the roentgenograms was considered helpful in that they did not provide sufficient information for further management. In 2 of 14 episodes in patients with normal chest roentgenograms and in 9 of 22 episodes in patients with nonspecific chest roentgenograms, CT scanning resulted in a change in clinical management that included performing bronchoscopy, increasing or changing antibiotic coverage, starting white blood cell transfusions, requesting surgical biopsy, or a combination of these. In 1 of 14 episodes in patients with normal chest roentgenograms and in 8 of 22 episodes in patients with nonspecific roentgenograms, CT added confidence to the diagnosis. In the remaining 16 episodes, CT scans provided no additional information. We conclude that in many instances, noncontrast ultrafast chest CT scans can provide information that may either change a patient's clinical management or more clearly establish the extent of pulmonary disease.

Adult↗
PubMed1991

MR anatomy and pathology of the hypothalamus.

The hypothalamus, the ventral-most portion of the diencephalon, surrounds the anterior inferior portion of the third ventricle (Fig. 1). It functions primarily as an integrative mechanism for various autonomic and neuroendocrine activities including temperature regulation, water balance, behavior, and appetite. This pictorial essay illustrates the value of MR in depicting the normal anatomy and abnormalities of the hypothalamic region.

Adult↗
PubMed1990

Sigmoid colon fistula complicating ovarian cystadenocarcinoma: a rare finding.

A case of sigmoid colon fistula complicating ovarian cystadenocarcinoma is reported. The entity demonstrated a large air-filled, thin-walled cystic lesion during barium enema examination. The differential diagnosis of distended air-filled cystic lesions is discussed and expanded to include colonic fistula complicating ovarian neoplasms.

Barium Sulfate↗
PubMed1990

Satisfaction of search in diagnostic radiology.

A subset of underreading errors (false-negative responses) in radiology has been attributed to "satisfaction of search," which occurs when lesions remain undetected after detection of an initial lesion. This phenomenon has not been studied in the experimental laboratory. A primary goal of this study was to develop a procedure or paradigm to study satisfaction of search. The authors measured detection accuracy for native lesions in images before and after the addition of a simulated nodular lesion. Simulated and native lesions were not spatially superimposed and the native abnormalities were physically identical with and without the nodules. Only responses related to the native lesion were analyzed. Accuracy parameters of receiver operating characteristic (ROC) curves were estimated by the method of maximum likelihood and jackknife. The average perceptual accuracy of the individual ROC curves as measured by Az and de' was significantly reduced with addition of the nodules (t = 2.364, p = 0.025, t = 2.648, p = 0.017, respectively). Az and de' parameters of the pooled ROC curve showed a similar effect (t = 1.573, p = 0.080; t = 1.934, p = 0.047, respectively). The results indicated a substantial satisfaction-of-search effect, with diminished accuracy in perception of native lesions.

Adolescent↗
PubMed1990

Clinical and radiologic features of malignant neoplasms in organ transplant recipients: cyclosporine-treated vs untreated patients.

The radiologic and clinical features of 37 posttransplantation malignant tumors occurring in 33 organ transplant recipients were reviewed to determine the characteristics of the tumors, particularly in relation to previous treatment (or nontreatment) with cyclosporine. The 37 malignant tumors included lymphomas (eight in patients receiving cyclosporine and four in patients not given cyclosporine) and carcinomas of the skin and lips (11), head and neck (five), colon and rectum (three), uterus (two), vulva (two), lung (one), and urinary bladder (one). The neoplasms of the internal viscera and head and neck were relatively advanced when detected. The neoplasms of the skin, vulva, uterine cervix, and urinary bladder were low-grade malignant tumors. Most of the cyclosporine-induced malignant lesions were lymphomas. The lymphomas in cyclosporine-treated recipients were characterized by early appearance after transplantation; more extensive organ involvement; multiple, homogeneous solid lesions without central low density on CT and sonography; and regression after reduction of cyclosporine dose. We conclude that malignant tumors occurring after transplantation are often advanced and that lymphoma induced by cyclosporine has characteristic features.

Adult↗
PubMed1989

Primary adenocarcinoma of the duodenal bulb: radiographic and pathologic findings in two cases.

We reviewed the radiographic and pathologic findings in 2 patients with primary adenocarcinoma of the duodenal bulb. Barium studies provided important information, characterizing the nature and extent of the lesion, as well as complete evaluation of the descending and horizontal segments of the duodenum before surgical therapy. Early endoscopy is recommended for nonhealing duodenal ulcers, especially if suggestive malignant changes are present.

Adenocarcinoma↗
PubMed1989

Magnetic resonance imaging in the diagnosis and followup of idiopathic retroperitoneal fibrosis.

Four cases of idiopathic retroperitoneal fibrosis are reported. Magnetic resonance and computerized tomographic images were obtained for diagnosis in each case, and followup scans were obtained at various intervals after therapy. In all 4 cases magnetic resonance imaging was equal or superior to computerized tomography in the diagnosis of retroperitoneal fibrosis, outlining the extent of involvement, preoperative planning and assessing response to medical or surgical therapy.

Aged↗
PubMed1989

Vertebral compression fractures: distinction between benign and malignant causes with MR imaging.

Magnetic resonance (MR) imaging was performed on 64 patients with 109 vertebral compression fractures, the cause of which could not be determined from plain radiographs. Twenty-five fractures were due to malignancy; 84 were caused by a benign process. In 22 of the 25 fractures caused by malignancy, MR images showed complete replacement of normal bone marrow, whereas 47 of the 61 benign fractures without history of trauma had complete preservation of normal bone marrow. The remaining 14 benign fractures had incompletely preserved bone marrow in a regular pattern. In two of the three remaining malignant fractures, the bone marrow replacement also was incomplete but with an irregular pattern. In cases of recent trauma or primary bone marrow abnormalities, the configuration and signal of remaining bone marrow were not useful in differentiating among malignancy, osteoporosis, and other benign processes. When criteria based on complete loss or preservation of marrow and marrow configuration in cases of incomplete loss were used, the accuracy in differentiating benign from malignant fractures was 94%. MR imaging may be a useful adjunct in differentiating benign from metastatic fractures and may provide information not available with other imaging methods.

Adolescent↗
PubMed1989

Hepatic lymphoma in cyclosporine-treated transplant recipients: sonographic and CT findings.

The purpose of this study was to determine the CT and sonographic features of hepatic lymphoma developing in organ transplant recipients taking cyclosporine. The four patients included in the study had non-Hodgkin lymphoma. Two of the cases were primary, with no associated lymphadenopathy or extrahepatic lesions. The hepatic lymphomas were characterized by multiple low-density areas on CT scans and hypoechoic areas on sonograms. In three of the four patients, the lesions regressed after the cyclosporine dosage was reduced. We conclude that in cyclosporine-treated organ transplant recipients, hepatic lymphoma should be considered in the differential diagnosis of hepatic lesions with or without lymphadenopathy when multiple low-density lesions are shown by CT and hypoechoic lesions are shown by sonography.

Adult↗
PubMed1988

Small bowel enteroclysis survey.

A survey questionnaire was sent to 125 radiology programs to determine the frequency and indications for the use of small bowel enteroclysis. Sixty-seven of the 84 respondents perform small bowel enteroclysis while 17 do not. The 3 most common indications for enteroclysis are detection of unexplained gastrointestinal bleeding, partial small bowel obstruction, and Crohn's disease. We conclude that although small bowel enteroclysis is a well-established examination, there are wide differences in the frequency with which it is performed, the techniques of examination, and indications for its use.

Barium Sulfate↗