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Biomedical subjects

W E Torres

Publications and source records attributed to W E Torres.

At least 55 records · Page 3Linked to original sources
PubMed1986

Percutaneous needle biopsy in the diagnosis and classification of lymphoma.

Results of percutaneous needle biopsies were evaluated retrospectively in 58 patients in whom a diagnosis of lymphoma was suspected. The biopsy specimen was diagnostic in 94% of the 36 patients with lymphoma, 20 of whom had recurrent disease and 16 of whom had newly diagnosed lymphoma. Sufficient tissue was obtained in 94% of these positive biopsy specimens to allow histologic subtyping of the lymphoma. Immunohistochemical studies performed on seven of the biopsy specimens allowed immunologic subclassification into B-cell and T-cell types of lymphoma. Our results suggest that the percutaneous needle biopsy is a useful and reliable tool in the diagnosis and classification of lymphoma.

Adolescent↗
PubMed1986

Shunts for portal hypertension: MR and angiography for determination of patency.

Twenty-eight patients with selective and nonselective shunts for portal hypertension were evaluated using magnetic resonance (MR) imaging. Angiographic correlation was obtained in 25 patients. MR imaging enabled the detection of a patent shunt by visualizing the "flow void" phenomenon in 21 patients. Two patients had thrombosed shunts. In these 23 patients, there was no discrepancy between the findings from MR imaging and those from angiography. In the remaining five patients, there was an area of artifact in which no signal was noted, and the shunt could not be evaluated. In all five patients who had this artifact, steel coils were noted in the area of the phenomenon. Thus, MR imaging seems to be an accurate method for detecting shunt patency in all patients with shunts except those who have had prior embolization with steel coils.

Angiography↗
PubMed1986

Delayed hepatic CT scanning: increased confidence and improved detection of hepatic metastases.

Fifty oncologic patients with suspected hepatic metastases were prospectively evaluated by dynamic sequential hepatic computed tomography (DSHCT) and by delayed iodine hepatic computed tomography (DICT) scanning. DICT scanning was performed 4-6 hours following administration of 60 g of intravenous iodine. Both techniques were evaluated for lesion definition relative to the adjacent hepatic parenchyma and for numbers of metastases detected. Metastases were detected by both techniques in 26 patients. Fifteen patients (58%) had lesions better defined by DICT. DICT scanning detected more metastases in seven of these 15 patients. In eight patients (31%), there was no difference between the two techniques in numbers of masses detected or lesion definition. In three cases (11%), metastases were more confidently identified on the initial or DSHCT scan. DICT scanning, as described, is useful in defining and detecting hepatic metastases, especially where there is questionable hepatic involvement or better quantification of size is necessary.

Adult↗
PubMed1986

Percutaneous aspiration and drainage of pancreatic pseudocysts.

Twenty-five patients with pancreatic pseudocysts had therapeutic intervention procedures that included diagnostic aspiration, short-term drainage (aspiration until completely drained), and long-term catheter drainage. Diagnostic aspirations were used to classify the pseudocysts as infected or noninfected. Short-term drainage was performed on six pseudocysts (two infected and four noninfected) with little success. One resolved and five recurred. Fifteen pseudocysts were treated by long-term catheter drainage. Eight of these (four infected and four noninfected) resolved after initial long-term drainage; two others resolved after additional drainage. The cure rate in these 15 patients was 67%. The other five patients were treated surgically after they had been stabilized but not cured by percutaneous drainage. Complications were few and uniformly minor except for one pneumothorax. Percutaneous aspiration should be used in the diagnosis of pancreatic fluid collections. In noninfected pseudocysts, drainage can be curative. In infected pseudocysts, percutaneous drainage is useful to stabilize the patient and can be either a cure or a temporizing measure until surgery can be performed.

Drainage↗
PubMed1985

Percutaneous biopsy of pancreatic masses.

Forty-five percutaneous needle biopsies of pancreatic masses were performed in 41 patients in whom there was clinical or radiological concern for the diagnosis of cancer. Computed tomography (CT) was the imaging technique used in 41 of the 45 biopsies. An overall sensitivity of 85%, specificity of 100%, and accuracy rate of 88% were achieved, with serious complications in three of the 45 attempts (6.7%). These figures show that percutaneous pancreatic biopsies have the potential for greater accuracy than has been previously reported and are relatively safe when compared with surgery.

Adult↗
PubMed1985

Imaging guided percutaneous hepatic biopsy: diagnostic accuracy and safety.

During the 3-year period from May 1981 to June 1984, 145 patients with hepatic abnormalities demonstrated by computed tomography (CT) or ultrasonography (US) underwent 151 imaging guided percutaneous hepatic biopsies. These biopsies were performed with needles ranging in size from 21-gauge aspiration to 14-gauge cutting type. Histologic and cytologic results were correlated with subsequent surgical, autopsy, and clinical follow-ups ranging from 2 months to 3 years. The overall accuracy for imaging-guided biopsies was 92.1% and 98% for diagnosis of malignant lesions. Our complication rate of 1.3% is comparable to that reported in other studies. We discuss indications, techniques, and risks for imaging-guided percutaneous hepatic biopsy.

Adolescent↗
PubMed1985

CT densities in delayed iodine hepatic scanning.

Sixty patients underwent CT scanning of the liver prior to, immediately after, and four hours after intravenous administration of 60% meglumine diatrizoate. Twenty patients received a 50 ml bolus of contrast material (14.6 g of iodine), 20 received 100 ml (29.2 g of iodine), and 20 received 200 ml (58.4 g of iodine). In each group, delayed CT scanning safely raised the inherent density of the liver significantly (increase of 14.3% using 50 ml; 23.9% using 100 ml; and 40.7% using 200 ml). Thus, delayed scanning with doses presently used in abdominal and neurological CT examinations may be helpful in detecting hepatic lesions.

Diatrizoate↗
PubMed1985

CT-guided adrenal biopsy: accuracy, safety, and indications.

Fifty-eight percutaneous needle biopsies of adrenal masses were performed in 53 patients. The technique was initially successful in 44 (83%) of 53 patients. Five patients had second procedures because of initial failure or the possibility of sampling error. Fourteen biopsies were performed in nononcologic patients and 39 in patients with a known malignancy. None of the adrenal masses in nononcologic patients were malignant. Only 18 (46.1%) of the 39 masses in oncologic patients were metastases; the rest represented a variety of nonneoplastic conditions. Seven minor complications occurred in six patients. Two of these patients required transfusions for hypotension or decreases in hematocrit. No correlation was noted between needle size and complications. There were no pneumothoraces. The procedure is an accurate and safe alternative to surgical biopsy.

Adrenal Gland Diseases↗
PubMed1984

Cricopharyngeal muscle hypertrophy: radiologic-anatomic correlation.

There is a divergence of opinion concerning the cricopharyngeal muscle defect commonly seen in the pharyngoesophageal area on barium esophagram. Some observers believe this defect is the result of neuromuscular dysfunction with the demonstration of the unrelaxed muscle bundle; however, others believe it is the result of actual hypertrophy of the cricopharyngeal muscle. Radiologic and pathologic study of 24 unselected autopsy cases revealed cricopharyngeal hypertrophy in 13 cases by radiologic criteria. Histologic examination revealed that the cricopharyngeal muscle thickness was uniformly greater in these cases than in the radiographically normal cases. The cricopharyngeal muscle defect is associated with actual hypertrophy of the cricopharyngeal muscle in many cases.

Autopsy↗
PubMed1984

Thoracic findings in gastrointestinal pathology.

A large variety of gastrointestinal and abdominal pathologic processes can be diagnosed or suspected by their direct effects on the chest. The chest radiograph, as often the first admission film, can aid the radiologist in recommending the appropriate follow-up examinations.

Adult↗
PubMed1983

Biopsy of the right adrenal gland by the transhepatic approach.

A transhepatic computed-tomographic-guided biopsy of a right adrenal mass is described. This method is simpler to perform than the usual posterior biopsy carried out with the patient prone and is less likely to cause a complicating pneumothorax. In seven of eight patients with right adrenal masses, adrenal tissue was obtained and an accurate diagnosis was possible. No complications resulted.

Adrenal Gland Diseases↗
PubMed1982

Liver lesions: comparative accuracy of scintigraphy and computed tomography.

Of 84 cases with both radionuclide and computed tomographic studies of the liver, in 54 the results of the two examinations agreed, in 14 results disagreed, and in 16 cases one of the two tests gave equivocal results. Overall accuracy in detecting or ruling out focal liver disease was 79% for scintigraphy and 98% for computed tomography. In 13 of the 14 patients in whom studies did not agree, the scintigram was falsely negative. In 10 of these 13 false-negative scintigrams, small (less than 2 cm) solitary or multiple lesions were detected on computed tomography in patients who had normal liver function studies. In seven patients in whom both studies agreed, computed tomography provided additional, extrahepatic information that altered clinical management. Scintigraphy was 86% accurate in detecting liver disease when the patient had a gastrointestinal neoplasm, but only 74% accurate for nongastrointestinal neoplasm. Computed tomography was over 94% accurate in both situations. These data indicate an advantage of computed tomography as the initial screening examination for space-occupying lesions of the liver, especially in patients with a primary diagnosis of nongastrointestinal neoplasm.

False Negative Reactions↗
PubMed1982

Effectiveness of CT in evaluating intrathoracic masses.

To compare the effectiveness of computed tomography (CT) with conventional radiography and conventional tomography for evaluating masses in the thorax, 168 masses, 154 of which were histologically verified, which had been examined with CT were reviewed. In 74 instances (44%) CT provided important additional information compared with conventional radiography. Compared to conventional tomography, CT added important information in 15 (23%) of 65 cases. In no case did CT fail to demonstrate pathology shown with the other two methods. Average radiation dose to the chest was 1.3 rad (0.013 Gy) with CT and 0.4 rad (0.004 Gy) with linear tomography. Although CT is associated with slightly greater radiation dose and cost, this review indicates it should be performed directly after plain film examination instead of conventional tomography when further investigation of an intrathoracic mass is indicated.

Adolescent↗
PubMed1981

Gas in the pancreatic bed without abscess.

A series of 259 patients from the Emory University Affiliated Hospitals with clinical suspicion of pancreatic inflammatory or neoplastic disease was reviewed. Seven of the patients had documented gas in a pancreatic mass; three of the cases were proved subsequently not to be pancreatic abscess formation. Two of the seven patients had proven fistulae from pseudocyst to bowel documented either by surgery or on an associated radiologic examination which accounted for the gas. In one additional patient, no fistula was identified at preoperative radiologic examination or at surgery. The awareness of this entity is important in the avoidance of unnecessary surgery. Since patients with spontaneous cystoenteric fistulae improve after rupture into the gastrointestinal tract, this entity should be kept in mind, particularly in the patient who is not toxic. Radiologic evaluation of the gastrointestinal tract to detect fistulous communication, percutaneous aspiration, and culture may prevent unnecessary surgery.

Abscess↗
PubMed1979

Antral mucosal diaphragms in adults.

A group of 53 patients with the diagnosis of antral mucosal diaphragm is reported. In over 50% of the cases the diaphragm was considered an asymptomatic lesion. In addition, an autopsy study in 29 unselected cases is reported with demonstration of five antral mucosal diaphragms in different forms. On the basis of these findings, it is evident that the antral mucosal diaphragm in the adult is not an acquired lesion secondary to peptic ulcer disease, but may be congenital. In addition, techniques of radiologic evaluation of the diaphragm for significant narrowing of the central aperture using the compressed barium tablet, and for significant gastric outlet obstruction using the "barium burger" examination, are described.

Adult↗