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Biomedical subjects

Theresa C McLoud

Publications and source records attributed to Theresa C McLoud.

12 recordsLinked to original sources
PubMed2006

Acute and chronic pulmonary emboli: angiography-CT correlation.

OBJECTIVE: The objective of our study was to review the classic direct and indirect angiographic signs of acute and chronic pulmonary embolism (PE) and correlate these findings with MDCT. CONCLUSION: CT and angiography have complementary roles in the accurate diagnosis of acute and chronic thromboembolic disease. Conventional angiography should be used as a problem-solving technique after CT angiography has been performed because CT angiography is less invasive.

Acute Disease↗
PubMed2004

Trends in thoracic radiology over a decade at a large academic medical center.

OBJECTIVE: To investigate thoracic radiology usage over and above the secular trends associated with hospital-wide changes in the number of patients over a decade. MATERIALS AND METHODS: We retrospectively reviewed administrative data from our 905-bed tertiary-care hospital between January 1, 1992, to December 31, 2001. Three points of entry to the radiology department were identified: inpatient (IP), outpatient (OP), and the emergency room (ER). The total numbers of patients, imaging studies, chest radiographs, chest CTs, CTs for pulmonary embolism, pulmonary angiograms, ventilation/perfusion scintigrams (V/Qs), lung biopsies, cardiac and chest MRIs, and FDG-PET scans for lung nodules and masses were collected. The significance of trends using linear regression analysis was evaluated. RESULTS: IP and OP numbers have significantly increased over a decade (P = 0.04 and P = 0.01 respectively); ER patient numbers have not. There has been an increase in the ratio of chest radiographs per patient arising from the ER area (P = 0.0002). All 3 areas demonstrated an increase in the ratio of chest CTs per patient: IP (P = 0.0002), OP (P = <0.0001), and ER (P = <0.0001). IP and ER areas demonstrated an increase in the ratio of CTs for pulmonary embolism per patient (P = 0.006, P = 0.04 respectively). There was a decrease in the ratios of pulmonary angiograms and V/Qs per IP (P = 0.02 & P = 0.0003 respectively). Cardiac MRIs per patient demonstrated an increase (IP P = 0.01, OP P = 0.02). FDG-PET for lung nodules and masses per patient demonstrated an increase in IP (P = 0.03) and OP (P = 0.003) areas. The total number of chest imaging studies divided by the total number of imaging studies demonstrated an increase in IP and ER areas (P = 0.02 and P = 0.02 respectively). CONCLUSION: There has been an increase in thoracic radiology usage above secular trends, particularly in the regions of chest CT and FDG-PET. CT is replacing more traditional techniques to diagnose pulmonary embolism for inpatients.

Academic Medical Centers↗
PubMed2003

Voice recognition.

Voice recognition represents one of the new technologies that are changing the practice of radiology. Thirty percent of radiology practices are either currently or plan to have voice recognition (VR) systems. VR software encompasses 4 core processes: spoken recognition of human speech, synthesis of human readable characters into speech, speaker identification and verification, and comprehension. Many software packages are available offering VR. All these packages should contain an interface with the radiology information system. The benefits include decreased turnaround time and cost savings. Its advantages include the transfer of secretarial duties to the radiologist with a result in decreased productivity.

Humans↗
PubMed2003

Small pulmonary nodules: detection at chest CT and outcome.

PURPOSE: To determine the outcome of pulmonary nodules less than 1 cm in diameter detected at chest computed tomography (CT). MATERIALS AND METHODS: Reports of chest CT performed during 6 months were reviewed to find patients with pulmonary nodules smaller than 1 cm in long axis for which repeat CT was recommended. Records were studied to determine whether follow-up had been performed, the initial nodules had changed in size, or nodules had been resected. RESULTS: A total of 3,446 chest CT examinations were performed, with 334 patients meeting inclusion criteria. Three patients underwent nodule resection and had pathologic examination results positive for cancer; 185 underwent follow-up, of whom 13 had results excluded as indeterminate. In the remaining 172 patients, 88 had incomplete characterization because of follow-up of less than 2 years, which left 84 with nodule characterization at follow-up. When these 84 patients were combined with the three patients with nodule resection, the number yielded was 87 patients. Seventy-seven of 87 had benign nodules because of resolution or 2-year stability, and 10 of 87 had malignant nodules because of growth or positive histologic examination results. Nine of 10 with malignant nodules had a known primary neoplasm. CONCLUSION: CT commonly helped identify small nodules. Increase in size occurred infrequently and almost exclusively in patients with a known malignancy.

Adult↗
PubMed2002

Imaging techniques for diagnosis and staging of lung cancer.

Noninvasive imaging modalities continue to offer opportunities in the diagnosis and staging of lung cancer. Positron emission tomography with fluorodeoxyglucose imaging in lung cancer represents an important, new, and accurate tool in the armamentarium of the radiologist. Computed tomography scanning, MR imaging, and PET play a significant role in the selection of patients for curative lung cancer surgery, decreasing the number of unnecessary thoracotomies. The imaging modalities also help to direct the choice of appropriate invasive and surgical procedures.

Diagnostic Imaging↗
PubMedDate not supplied

CT-histologic correlation of the ATS/ERS 2002 classification of idiopathic interstitial pneumonias.

The American Thoracic Society and the European Respiratory Society 2002 classification defines the histologic patterns that provide the basis for a clinico-radiologic-pathologic diagnosis of an idiopathic interstitial pneumonia. Idiopathic pulmonary fibrosis is the clinical term for usual interstitial pneumonia, the characteristic histologic pattern is interstitial fibrosis with temporal heterogeneity, and the radiologic pattern is basal and subpleural areas of ground-glass and reticular attenuation and honeycomb pattern. Nonspecific interstitial pneumonia has cellular or fibrosing patterns of chronic inflammation with temporal homogeneity; the radiologic pattern is subpleural and basal areas of ground-glass and reticular attenuation. Lymphoid interstitial pneumonia results from lymphocyte interstitial infiltration; CT demonstrates ground-glass attenuation and nodular interlobular septal thickening. Respiratory bronchiolitis-associated interstitial lung disease is characterized by bronchiolocentric alveolar macrophage accumulation; CT shows centrilobular ground-glass attenuation. Desquamative interstitial pneumonia is characterized by alveolar macrophage accumulation with predominantly lower zone ground-glass attenuation seen on CT scans. Cryptogenic organizing pneumonia is characterized radiologically by peribronchial ground-glass attenuation and subpleural consolidation. Acute interstitial pneumonia is the clinical term for idiopathic diffuse alveolar damage; the exudative phase is characterized radiologically by diffuse ground-glass attenuation and dependent consolidation, with the additional feature of lung architectural distortion in the organizing phase. Ideally, diagnosis of an idiopathic interstitial pneumonia should be rendered only after all clinico-radiologic-pathologic data have been reviewed.

Adult↗
PubMedDate not supplied

CT angiography of pulmonary embolism: diagnostic criteria and causes of misdiagnosis.

Computed tomographic (CT) pulmonary angiography is becoming the standard of care at many institutions for the evaluation of patients with suspected pulmonary embolism. This pathologic condition, whether acute or chronic, causes both partial and complete intraluminal filling defects, which should have a sharp interface with intravascular contrast material. In acute pulmonary embolism that manifests as complete arterial occlusion, the affected artery may be enlarged. Partial filling defects due to acute pulmonary embolism are often centrally located, but when eccentrically located they form acute angles with the vessel wall. Chronic pulmonary embolism can manifest as complete occlusive disease in vessels that are smaller than adjacent patent vessels. Other CT pulmonary angiographic findings in chronic pulmonary embolism include evidence of recanalization, webs or flaps, and partial filling defects that form obtuse angles with the vessel wall. Factors that cause misdiagnosis of pulmonary embolism may be patient related, technical, anatomic, or pathologic. The radiologist needs to determine the quality of a CT pulmonary angiographic study and whether pulmonary embolism is present. If the quality of the study is poor, the radiologist should identify which pulmonary arteries have been rendered indeterminate and whether additional imaging is necessary.

Adult↗