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At least 1,351 records · Page 75Linked to original sources
PubMed2003

Multidetector row computed tomography of the aorta and peripheral arteries.

MDCT represents a significant advance on SDCT and the advantages it brings are particularly clear in CTA applications. It allows cost effective assessment of longer segments of vascular territories to be imaged with higher spatial, contrast, and temporal resolution. It has replaced SDCT as the new CT standard and its technical abilities are rapidly approaching the temporal resolution of EBCT. With 3-D post processing tools its main benefit is in imaging studies customized to the patient's pathology, with greater measurement accuracy and reliable longitudinal assessment. MDCTA is increasingly applied not to individual vascular territories but to a complete assessment dictated by the pathology, such as the entire aorta and branch vessels in aneurysm evaluation and the aorta and the coronary arteries in dissection cases or the vascular and non-vascular chest in acute chest pain. Greater accuracy of vessel assessment will lead to a refinement of interventional and surgical techniques for an individual patient and facilitates conservative management of conditions that can be reliably monitored non-invasively and the development of intervention criteria. MDCTA will continue to increase its major role in peripheral vascular evaluation in the future though its reliability in assessing small vessels below the knee and in the foot remains to be conclusively proven to obviate the need for diagnostic catheter angiography.

Aortic Dissection↗
PubMedDate not supplied

Computed tomography-guided fine needle aspiration of peripheral lung opacities. An initial diagnostic procedure?

OBJECTIVE: To evaluate the results of computed tomography (CT)-guided fine needle aspiration (FNA) cytology following negative fiberoptic bronchoscopy and sputum cytology. STUDY DESIGN: Retrospective study of 64 patients who underwent CT-guided needle aspiration of lung opacities over one year. Following a review of the CT studies, patients were selected according to image characteristics of a primary neoplasm and pleural effusion in cases with pleural lesions. The lesions were classified into three categories--intrapulmonary and peripheral pulmonary, pleuropulmonary and pleural--and were localized and aspirated under CT using a fine needle (22-23 gauge) for obtaining cellular material. Lesions diagnosed as benign on FNA cytology were followed by serial CT scans for a period of two years at six-month intervals. RESULTS: Thirty-nine of 64 (61%) lesions were diagnosed as malignant on FNA cytology and 25 of 64 (39%) as benign. There was one false negative case. There were no serious complications from the procedure. CONCLUSION: FNA under CT guidance may be applied as the initial procedure in the diagnosis of peripheral malignant pulmonary lesions, rendering a high diagnostic yield.

Adenocarcinoma↗
PubMed2004

Quantitative evaluation of perfusion and permeability of peripheral tumors using contrast-enhanced computed tomography.

RATIONALE AND OBJECTIVES: Our purpose was to validate contrast-enhanced computed tomography (CECT)-derived quantitative measures of perfusion and permeability against gold standard techniques of fluorescent microspheres and Evan's Blue dye, respectively. MATERIALS AND METHODS: Normal and tumor-bearing (R3230AC) Fischer 344 rats were used. CECT perfusion measurements of normal and tumor tissue were compared with quantitative fluorescent microsphere perfusion measures. CECT permeability measurements from tumors were compared with semiquantitative Evan's Blue Dye permeability estimates. CT images were obtained precontrast and an imaging plane was selected. Serial, stationary images were obtained every 2 seconds for 2 minutes after intravenous bolus of iodinated contrast. Permeability and perfusion were measured by applying Patlak analysis to time-density data from normal tissue or tumor and femoral artery. RESULTS: There was good correlation between fluorescent microsphere and CECT measurements of perfusion (r2 = 0.681, P << 0.001) and between Evan's Blue Dye and CECT measurements of permeability (r2 = 0.873, P = 0.0007). CONCLUSIONS: CECT provides useful, quantifiable measures of perfusion and permeability in peripheral tumors.

Animals↗
PubMedDate not supplied

Hemodynamic and morphologic changes after portal vein embolization: differential effects in central and peripheral zones in the liver on multiphasic computed tomography.

OBJECTIVE: To evaluate hemodynamic and morphologic effects in the liver after portal vein embolization (PVE). METHODS: Hepatic computed tomography scans of 7 patients who had undergone preoperative PVE were retrospectively reviewed. Pre- and post-PVE computed tomography densities were evaluated for the unenhanced, late arterial, and portal venous phases in peripheral and central hepatic regions and in the 3 main hepatic veins. Relative changes in areas in these regions were assessed in 5 evaluable patients with serial post-PVE scans. RESULTS: During the late arterial phase, enhancement was significantly higher after PVE than it was before PVE in the peripheral hepatic regions, and it was higher in the peripheral regions than in the central regions. Enhancement was also significantly higher in the right main hepatic vein than in the middle and left hepatic veins during the late arterial phase. The ratio of areas of the peripheral/central regions decreased significantly after PVE. CONCLUSIONS: Zonal enhancement in the late arterial phase changed after PVE and seemed to be associated with differential parenchymal atrophy. We speculate that the hepatic arterial supply increases peripherally and that peribiliary/periportal plexuses maintain the portal supply centrally.

Absorptiometry, Photon↗
PubMedDate not supplied

[X-ray longitudinal and computed tomography in the diagnosis of peripheral tumor-like formations of the lungs].

Fifty eight patients with peripheral tumor-like formations of the lung (33 with cancer and 25 with benign formations) were examined by longitudinal tomography and CT. The potentialities of the two techniques in detecting the major semeiotic signs of cancer and malignant formations were compared. The main or major signs, such as the shape of shadow and the pattern of outlines, which make it possible to differentiate benign and malignant formations, are virtually equally imaged by the two techniques. CT is superior to X-ray longitudinal tomography in revealing minor calcifications and microdestructions, hyperplastic intrathoracic lymph nodes. The significance of some symptoms for differential diagnosis calls for further clarification.

Adult↗
PubMedDate not supplied

[Computer-assisted evaluation of the status of the peripheral nervous system in alcoholics].

The authors present the principles of work of a computer system destined for evaluation of the results of routine electrophysiological examination of two muscles and four sensory nerves in alcohol-dependent subjects. The range of examinations and the programme based on discrimination analysis make possible, as shown in own investigations, an objective and complete evaluation of the state of the peripheral nervous system in these subjects. The programme is owned by the EMG laboratory of the Institute of Psychiatry and Neurology in Warsaw where it was introduced for clinical diagnosis, but it may be made available to other persons interested in these problems. An electromyograph with a stimulator with current exit averager and minicomputer, e.g. Commodore 64 with a printer are necessary.

Action Potentials↗
PubMed1999

How many myeloid post-progenitor cells have to be transplanted to completely abrogate neutropenia after peripheral blood progenitor cell transplantation? Results of a computer simulation.

Although hematopoietic recovery following high-dose chemotherapy (HD-CT) and peripheral blood progenitor cell (PBPC) transplantation is rapid, there is still a 5- to 7-day period of severe neutropenia which, theoretically, might be abrogated by an additional transplantation of more differentiated myeloid post-progenitor cells (MPPC). However, both the number of MPPC required to abrogate neutropenia as well as the optimum scheduling of MPPC infusions are currently unknown. Therefore, these questions were addressed by applying a computer model of human granulopoiesis. First, model calculations simulating varying levels of chemotherapy dose intensity were performed and compared with typical clinical neutrophil recovery curves. Using this approach, the data for HD-CT without PBPC transplantation could be reproduced by assuming a reduction of stem cells, committed granulopoietic progenitors and proliferating precursors to about 0.001% of normal. PBPC-supported HD-CT was reproduced by increasing the starting values to at least 0.1%, which corresponded to about 1 to 2 x 10(5)/kg transplanted CFU-GM. Interestingly, reproduction of PBPC-supported HD-CT data could be observed for a wide range of starting values (0.1%-10% of normal), thus confirming the clinical observation that hematopoietic recovery after PBPCT cannot be improved by increasing the dose of transplanted cells over a certain threshold. Using the same simulation model, we then studied the effects of an additional MPPC transplantation. The results showed, that at least 5.7 X 10(8) MPPC/kg have to be provided in addition to the normal PBPC graft to avoid neutropenia <100/microL, and that MPPC are best transplanted on days 0 and 6 after HD-CT. Assuming a 100- to 120-fold cellular ex-vivo expansion rate and MPPC representing about 70% of total expanded cells, 5.7 X 10(8) MPPC/kg could be generated starting from 1 to 2 leukapheresis preparations with about 7 to 8 x 10(6) CD34+ PBPC/kg. Considering furthermore, that only a fraction of ex-vivo generated cells will seed and effectively produce neutrophils in-vivo, the required number of MPPC is most likely even higher and, therefore, might be difficult to be achieved clinically. However, the validity of the model results remains to be proven in appropriate clinical studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Bone mineral analysis using single-energy computed tomography.

We present a new method for evaluating in vivo changes in bone mineralization in the peripheral skeleton, using computed tomography (CT). A set of bone mineralization indices are generated from numerous CT images of the patient's distal radius. The cross-sectional anatomy displayed by the CT scan allows for separate evaluation of the cortical and trabecular bone. Correction for possible drift of the CT number scale (Hounsfield scale) is achieved by scanning standard solutions of dipotassium hydrogen phosphate simultaneously with the forearm. Preliminary data indicate that this is a precise method for evaluating in vivo changes in bone mineralization.

Adolescent↗
PubMed2004

Peripheral intrapulmonary lymph node metastases of non-small-cell lung cancer.

Since the development and progress of computed tomographic imaging, peripheral intrapulmonary lymph nodes (IPLNs) have become increasingly described and well-known entities. Intrapulmonary lymph nodes may appear as a solitary pulmonary nodular shadow mimicking a non-small-cell lung cancer (NSCLC) or as multiple nodules masquerading as carcinoma metastases. We describe a case in which IPLNs presented as a clinical "nodular" T4 N0 NSCLC that finally proved to be a pathologic T2 N1 NSCLC, thus raising new questions on this entity.

Carcinoma, Non-Small-Cell Lung↗
PubMed1985

Diffuse peripheral lung disease: evaluation by high-resolution computed tomography.

High-resolution computed tomography (HRCT) was performed on 15 patients who had diffuse peripheral lung disease, and the findings were compared with those of conventional chest radiography and histologic examination. Bullae, interstitial fibrosis with honeycombing, and small granulomas were more clearly and specifically demonstrated on HRCT scans than on conventional chest radiographs in all patients. Histologically proved mild alveolar wall thickening due to alveolitis in cases of sarcoidosis and systemic lupus erythematosus was not detected. HRCT is useful for performing detailed morphological analyses of abnormalities of the peripheral portions of the lung.

Adult↗
PubMed2026

Robotic-assisted transbronchial biopsy versus computed tomography-guided transthoracic needle biopsy for peripheral pulmonary lesions: a systematic review and meta-analysis of direct comparative studies.

Robotic-assisted bronchoscopy (RAB) and computed tomography-guided transthoracic biopsy (CTTB) are competing strategies for sampling peripheral pulmonary lesions (PPLs). Whether they differ in yield or safety is uncertain. To our knowledge, this is the first systematic review restricted to direct comparisons. We searched MEDLINE, Europe PMC, Scopus, Web of Science and ClinicalTrials.gov from inception to 7 July 2026 for studies directly comparing RAB with CTTB in adults with PPLs. The primary outcome was strict 2024 American Thoracic Society/American College of Chest Physicians diagnostic yield. Risk of bias was assessed with ROBINS-I and certainty with GRADE. A cohort-genealogy step identified, per outcome, the largest set of cohorts sharing no patients; only that set was pooled, with Hartung-Knapp and Mantel-Haenszel sensitivity analyses. Five retrospective studies from one US health system were eligible. Four share patients; at most three cohorts are mutually independent. Across those three, diagnostic yield was comparable (risk ratio [RR] 0.99, 95% confidence interval [CI] 0.93-1.06; I&#xb2;=24%; Hartung-Knapp 0.87-1.13), with an identical relative effect under strict and intermediate definitions although absolute yields fell from 88% to 74-84% under strict criteria. Pneumothorax requiring a chest tube and/or admission was about three-quarters less frequent with RAB across all three cohorts (RR 0.25, 95% CI 0.14-0.46; I&#xb2;=0%; Hartung-Knapp 0.07-0.96). Strict yield (RR 0.99) and any pneumothorax (RR 0.06) were reported by two cohorts each and neither survives the few-studies correction. RAB took about 50&#xa0;min longer than CTTB where same-session staging endobronchial ultrasound was counted in the robotic time, but only about 8&#xa0;min longer than CTTB where it was not. Only one cohort reported yield by lesion size category and none reported yield by bronchus sign or lung zone, so lesion-level subgroups could not be pooled. Certainty was low for pleural complications and very low elsewhere. Low-certainty evidence indicates that RAB is associated with fewer pleural complications, with no statistically detectable difference in diagnostic yield; equivalence was not formally established. Because all evidence is retrospective, confined to one health system, and almost never stratified by lesion size or accessibility, these findings are hypothesis-generating and require a multicenter randomized trial.

Humans↗
PubMed1999

[A case of pulmonary alveolar proteinosis presenting with peripheral infiltrates].

We report a case of pulmonary alveolar proteinosis (PAP). A 39-year-old asymptomatic woman was admitted to our hospital because of abnormal shadows on chest X-ray films. Chest X-ray films revealed peripheral infiltrates in both lungs. Computed tomographic examination showed patchy peripheral ground-glass attenuation, concentrated subpleurally. Bronchoalveolar lavage fluid was clear. Because transbronchial lung biopsy findings were inconclusive, a VATS-biopsy was performed. The specimens demonstrated accumulation of proteinaceous materials within alveolar spaces. The patient was given a diagnosis of PAP. Although the distribution of radiographic shadows varies in patients with PAP, perihilar or centralized shadows usually predominate. In our patient, subpleural areas of the lung were affected almost exclusively.

Adult↗
PubMedDate not supplied

Computer networking in an ambulatory health care setting.

Computers are a ubiquitous part of the ambulatory health care environment. Although stand-alone computers may be adequate for a small practice, networked computers can create much more powerful and cost-effective computerized systems. Local area networks allow groups of computers to share peripheral devices and computerized information within an office or cluster of offices. Wide area networks allow computers to securely share devices and information across a large geographical area. Either singly or in combination, these networks can be used to create robust systems to help physicians automate their practices and improve their access to important clinical information. In this article, we will examine common network configurations, explain how they function, and provide examples of real-world implementations of networking technology in health care.

Ambulatory Care↗