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Biomedical subjects

T M Hudson

Publications and source records attributed to T M Hudson.

At least 37 records · Page 2Linked to original sources
PubMed1984

Digital vascular imaging in children. A preliminary report.

Whereas digital subtraction angiography (DSA) has been extensively used in adults, few reports have dealt with its application in children. We utilized DSA in 52 children, studying various vascular territories. Technically satisfactory studies were obtained in 89%. Motion artifacts is the foremost technical problem. Extremity DSA with arterial injection was highly successful in a number of cases. Thoracic vascular studies were also successful, as were studies of the head and neck, whereas renal and abdominal vessel studies were somewhat less successful. DSA with arterial injection may be expected to replace conventional angiographic studies in selected cases and appears to be an excellent screening method also in children.

Adolescent↗
PubMed1984

Perivascular soft tissue spread of osteosarcoma.

Skeletal scintigraphy of a distal femoral osteosarcoma revealed a band of soft-tissue uptake in the medial thigh extending to the groin, which corresponded to direct perivascular tumor extension.

Adult↗
PubMed1984

Popliteus muscle as a barrier to tumor spread: computed tomography and angiography.

We reviewed 14 patients with primary bone tumors of the proximal tibia whose plain radiographs suggested possible posterior soft tissue extension. Four tumors extended posteriorly and displaced the major vessels on angiography. However, high resolution computed tomography (CT) showed the normal popliteus muscle lying between the tibia and the major vessels in three instances. When CT was equivocal, angiography in the lateral projection with the knee flexed was helpful for further evaluation.

Bone Neoplasms↗
PubMed1984

Aggressive fibromatosis: evaluation by computed tomography and angiography.

Fifteen CT scans of 13 patients who had aggressive fibromatosis were generally accurate in showing the extent of disease, although the CT definition of half or more of the margins of nine lesions was poor. Fibromatosis tumors were typically isodense or slightly hypodense with muscle when no contrast medium was used, and they enhanced to hyperdense with better delineation during infusion of contrast medium. Obliterated intermuscular planes did not always signify disease extension; the relationship to bone was often obscured by beam-hardening artifact; and small blood vessels were often invisible. Arteriograms of seven of eight patients showed some hypervascularity and helped to delineate lesions and vessels that were poorly seen on CT scans. In four instances CT findings were clearer, in two instances arteriographic findings were clearer, and twice the findings were equally clear. Three of six bone scintigrams added accurate information about involvement of adjacent bones. Since fibromatosis can microscopically infiltrate beyond the margins indicated by radiographic studies and even by direct palpation at operation, the surgeon should obtain a wide margin beyond the defined tumor limits.

Adolescent↗
PubMed1984

Benign exostoses and exostotic chondrosarcomas: evaluation of cartilage thickness by CT.

Computed tomograms of 16 benign exostoses and 15 exostotic chondrosarcomas were generally accurate in delineating anatomy for purposes of planning surgery, but they were inaccurate in the detection and measurement of the cartilage caps of the lesions. CT studies of 14 of the benign exostoses failed to show any cartilage cap, although the maximum cartilage thickness of these 14 lesions ranged from 0.1 to 2.5 cm pathologically. CT did demonstrate thick cartilage in 14 of the 15 chondrosarcomas, but the CT measurements of maximum thickness often were imprecise. Altogether, 15 CT studies failed to show any cartilage cap; 14 of these lesions were benign. CT did not reliably detect cartilage caps less than 2.5 cm in maximum thickness, and CT measurement of cartilage thickness was imprecise when the cartilage was 1.5 to 2.5 cm thick. For this reason, CT did not solve the difficult problem of distinguishing between benign exostoses with relatively thick cartilage caps and exostotic chondrosarcomas with relatively thin cartilage.

Adolescent↗
PubMed1984

Scintigraphy of aneurysmal bone cysts.

Bone scintigrams of 25 aneurysmal bone cysts showed abnormal activity in every case. In 22 cases, the activity was correlated with the true pathologic extent of the lesions; only three exhibited a false-positive extended pattern of uptake beyond the true tumor margins. Sixteen scintigrams (64%) revealed increased uptake, chiefly around the periphery of the lesions, with less activity in their centers. This feature could not be explained simply by the cystic nature of the lesions, since aneurysmal bone cysts may contain considerable fibrous tissue septa containing trabeculae of reactive new bone. However, there was no correlation between any specific anatomic or histologic pattern and the intensity and pattern of abnormal scintigraphic activity.

Adolescent↗
PubMed1984

Fluid levels in aneurysmal bone cysts: a CT feature.

Review of 17 computed tomographic (CT) scans of aneurysmal bone cysts revealed fluid levels in six of the lesions; the fluid shifted after repositioning of two patients. Visibility of fluid levels did not correlate with the type of fluid found within the lesions. Detection of fluid levels depended partly on a period of immobilization before CT and on viewing the images with sufficiently narrow window settings.

Adolescent↗
PubMed1984

The comparative value of bone scintigraphy and computed tomography in determining bone involvement by soft-tissue sarcomas.

In seventeen patients with a soft-tissue sarcoma, bone scintigrams were found to be more useful than computed tomograms for evaluating bone involvement. The scintigrams had higher predictive value and higher sensitivity, as there were no false-negative or false-positive scintigrams, while there were three false-positive computed tomograms. Accurate scintigraphy requires the use of high-resolution static gamma-camera images that show the tangential relationship between tumor and bone. The images that are usually made in surveying the skeleton for metastatic disease--routine whole-body bone scans, or even gamma-camera images that provide only anterior and posterior views--are inadequate. They did not demonstrate the true relationship of the tumor to bone in the patients in this study when activity within the tumor itself was superimposed over bone. In such patients, properly selected oblique views sometimes showed that the tumor was clearly separate from normal bone activity. Determination of the relationship of the soft-tissue tumor to bone is an important part of the accurate anatomical staging that is required to select appropriate surgical management.

Adolescent↗
PubMed1983

Radiologic imaging of osteosarcoma: role in planning surgical treatment.

We reviewed radiographic studies of 50 central osteosarcomas to assess their accuracy and contributions to surgical treatment planning. Accurate anatomic delineation was especially important when limb-sparing tumor resection was considered. The plain roentgenograms yielded most of the diagnostic information, and often showed large masses located so that major neurovascular involvement was inevitable. Conventional tomography added little. Computed tomography (CT) usually was accurate in showing tumor extent and relationships to major nerves and vessels. However, CT was less useful when vessels were not seen, when edema and hemorrhage (especially after biopsy) blurred tumor margins, or when tumor margin and soft tissue planes blended together without clear definition. Angiography was essential when vascular relationships were unclear on CT. Scintigraphy occasionally revealed subtle intra-marrow tumor extension, but nonspecific increased uptake beyond the true tumor limits was more common than occult tumor spread.

Adolescent↗
PubMed1983

Radiology of medullary chondrosarcoma: preoperative treatment planning.

We evaluated the radiologic studies of 30 medullary chondrosarcomas with respect to their accuracy in diagnosis and surgical staging. There were 30 sets of plain radiographs, 14 conventional tomograms, 26 radionuclide bone scans, 19 arteriograms, and 15 computed tomograms (CT). Plain radiographs provided most of the diagnostic information although many tumours looked benign. CT provided the most complete anatomic staging, including intra- and extraosseous tumor, and neurovascular involvement. However, it was difficult to be sure about subtle soft tissue invasion. Arteriography remained useful for evaluating major vessel involvement or cortical penetration when CT and conventional tomography were equivocal. Scintigrams disclosed increased uptake, usually corresponding to the true tumor extent; "extended uptake" beyond the tumor was uncommon. Conventional tomography has been largely replaced by CT, but was occasionally useful when the tumor was near the end of a bone.

Adult↗
PubMed1983

Computed tomography of ossifying fibroma of the tibia.

Two ossifying fibromas of the tibia were studied by computed tomography, which showed that the lesions were composed predominantly of high density tissue and that they were located in the cortex. The tissue density indicated that the tumors were diffusely ossified or calcified. The intracortical site is typical of ossifying fibroma, but it is unusual in other lesions of similar appearance.

Adult↗
PubMed1983

Scintigraphy of benign exostoses and exostotic chondrosarcomas.

Technetium-99m diphosphonate scintigraphy of 11 benign exostoses and nine exostotic chondrosarcomas was correlated with pathologic macrosections of the resected tumors. Increased uptake in benign exostoses occurred in areas of enchondral ossification, and uptake in chondrosarcomas occurred in areas where ossification, osteoblastic activity, and hyperemia were found. Uptake was not related to amorphous cartilage calcification. Radiopharmaceutical uptake, therefore, correlated with areas of ossification visible radiographically, and large masses of nonossifying cartilage were not detected. Radionuclide bone imaging did not contribute to the preoperative anatomic evaluation of these tumors, and it did not always distinguish benign from malignant lesions.

Adolescent↗
PubMed1983

Radiology of sacrococcygeal chordoma. Difficulties in detecting soft tissue extension.

Plain radiographs of seven patients with sacrococcygeal chordomas showed sacral destruction, enlarged sacral neural foramina, and, usually, a presacral mass. Conventional tomograms clarified these bone abnormalities, which were often poorly visible on the plain radiographs. Two radionuclide bone scans showed increased peripheral uptake around the lesion, and one showed decreased uptake in the area of destroyed bone. Angiograms demonstrated only vessel displacement, and barium enemas showed only displacement of bowel by large soft tissue masses. Five myelograms were normal. Adequate surgical treatment of sacral chordomas requires a wide radical resection that avoids contaminating the wound with tumor. Therefore, thorough preoperative radiologic evaluation of the anatomic extent of a chordoma is essential. Although computed tomograms in three patients provided the best delineation of the total extent of bone and soft tissue involvement, tumor extension into gluteal muscles and other tissues eluded radiographic detection. The widespread infiltrative growth pattern along soft tissue planes and nerves and into vessels, undetectable by the above listed studies, mandates a cautious approach and a wide surgical margin, to prevent wound contamination and subsequent recurrence.

Aged↗
PubMed1982

Radionuclide bone scanning of osteosarcoma: falsely extended uptake patterns.

The pathologic specimens of 18 osteosarcomas of long bones were examined to correlate histologic abnormalities with abnormalities seen on preoperative 99mTc pyrophosphate or methylene diphosphonate bone scans. Seven scans accurately represented the extent of the tumor. Eleven scans disclosed increased activity extending beyond the radiographic abnormalities. In eight of these, there was no occult tumor extension and in the other three, the scan activity did not accurately portray the skip metastases that were present. Therefore, these 11 scans demonstrated the falsely extended pattern of uptake beyond the true limits of the tumors. Pathologic slides were available for 10 of the 11 areas of bone that exhibited extended uptake. In two instances, there was no pathologic abnormality. In the other eight cases we found marrow hyperemia, medullary reactive bone, or periosteal new bone. This is the first description of these histologic abnormalities of medullary bone in areas of extended uptake on radionuclide bone scans.

Adolescent↗
PubMed1982

Radionuclide bone scanning of medullary chondrosarcoma.

Technetium-99m methylene diphosphonate bone scans of 18 medullary chondrosarcomas of bone were correlated with pathologic macrosections of the resected tumors. There was increased scan uptake by all 18 tumors, and the uptake in 15 scans corresponded accurately to the anatomic extent of the tumors. Only three scans displayed increased uptake beyond the true tumor margins; thus, the "extended pattern of uptake" beyond the true tumor extent is much less common in medullary chondrosarcomas than in many other primary bone tumors. Therefore, increased uptake beyond the apparent radiographic margin of the tumor suggests possible occult tumor spread. Pathologically, there was intense reactive new bone formation and hyperemia around the periphery of all 18 tumors, and there were foci of enchondral ossification, hyperemia, or calcification within the tumor itself in nearly every tumor. Three scans displayed less uptake in the center of the tumors than around their peripheries. One of these tumors was necrotic in the center, but the other two were pathologically no different from tumors that displayed homogeneous uptake on the scan.

Bone Neoplasms↗
PubMed1982

Myositis ossificans: radiologic evaluation of two cases with diagnostic computed tomograms.

Although most physicians associated myositis ossificans with recent, acute trauma, only 40%-60% of patients give such a history. The appearance of a soft tissue mass without a clear history of trauma may suggest a diagnosis of sarcoma, especially because results of a biopsy of the central portion of an area of myositis ossificans may yield immature, undifferentiated tissue resembling a sarcoma. Pain and rapid growth of a mass are more usual in myositis ossificans than in sarcomas, and careful inquiry may reveal stretching injury or chronic trauma associated with normal, vigorous, physical activities. Recognizing the characteristic histologic zoning phenomenon (immature tissue centrally surrounded by more mature tissue and a peripheral shell of benign bone) during the biopsy procedure permits the correct diagnosis of myositis ossificans. Plain radiographs or conventional tomograms may reflect this histologic zoning by demonstrating the typical, mature, outer shell of bone. Although additional radiographic studies are not usually necessary, they may be obtained when the mass is suspected to be a sarcoma. In two patients computed tomographic scans clearly demonstrated well-defined, peripheral shells of mature bone, diagnostic of myositis ossificans.

Adolescent↗