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Biomedical subjects

C Wittram

Publications and source records attributed to C Wittram.

At least 19 recordsLinked to original sources
PubMed2002

Mycobacterium avium complex lung disease in immunocompetent patients: radiography-CT correlation.

This study aimed to describe and correlate the chest radiography and CT findings of Mycobacterium avium complex (MAC) lung disease in immunocompetent patients. 26 patients fulfilled The American Thoracic Society criteria for MAC lung disease and underwent chest radiography and CT within 6 weeks of positive cultures. All abnormalities and predominant lobar involvement were recorded and abnormalities on chest radiography were correlated with those on CT. The images were evaluated by two chest radiologists and decisions were reached by consensus. 21 females and 5 males, with an overall mean age of 69 years, were included in the study. All chest radiographs and CT scans were abnormal. On chest radiography, overinflation was demonstrated in 18 patients. CT scan abnormalities included atelectasis (n=17), bronchiectasis (n=24), cavities (n=13), consolidation (n=3), emphysema (n=11), ground-glass opacity (n=8), linear opacities (n=26), mediastinal lymphadenopathy (n=3), nodules (n=25) and pleural disease (n=15). CT findings were at variance with chest radiography findings in 15 lobes. A new feature from this study is that the majority of patients with MAC lung disease demonstrate overinflation on chest radiography. 19% of cases had predominant upper lobe disease, indistinguishable from post-primary Mycobacterium tuberculosis infection. 77% of cases demonstrated the major imaging criteria of MAC lung disease. These are ill defined nodules, bronchiectasis, predominant middle lobe and/or lingular abnormalities, with or without overinflation. We believe that these characteristic radiological signs will assist the physician in the diagnostic work-up of patients with MAC lung disease.

Aged↗
PubMed2000

Bronchiolitis obliterans after lung transplantation: appearance on expiratory minimum intensity projection images.

OBJECTIVE: Bronchiolitis obliterans can manifest as a mosaic pattern of lung attenuation on computed tomographic (CT) scans. This study was conducted to investigate image enhancement using expiratory minimum intensity projection images and to compare these with thin-section scans. METHODS: Eleven patients (21 transplanted lungs) with biopsy-proven bronchiolitis obliterans were studied. Ten 1-mm thin-section scans were acquired helically at the level of the carina after full expiration. Expiratory minimum intensity projection images 10 mm thick were generated from a multiplanar reconstruction of data. Two thoracic radiologists analyzed the images. RESULTS: In comparison with thin-section scans, expiratory minimum intensity projection images demonstrated a greater (in 17 lungs) or equal (in 4 lungs) percentage area of air trapping, with greater conspicuity (in all 21 lungs). Air trapping involved an average of 52% of the cross-sectional area of 1 lung. CONCLUSIONS: Air trapping due to bronchiolitis obliterans is accentuated by forced expiration; minimum intensity projection images improve the detection of differences in lung attenuation. Therefore, expiratory minimum intensity projection images are very useful in demonstrating the mosaic pattern of lung attenuation caused by bronchiolitis obliterans.

Bronchiolitis Obliterans↗
PubMed1997

Nasopharyngeal cavity narrowing associated with posterior maxilla and pterygoid plate fracture: report of three cases.

The CT appearances of three cases with severe nasopharyngeal cavity narrowing are described. In all cases the facial trauma was due to a motor vehicle accident. These cases demonstrate that posterior maxilla and pterygoid plate fractures can cause significant nasopharyngeal soft tissues swelling, most likely due to haemorrhage and/or oedema. Severe nasopharyngeal cavity narrowing could cause difficulty in elective nasogastric tube and endotracheal tube intubation via the nasopharyngeal route.

Accidents, Traffic↗
PubMed1996

Fat suppressed contrast enhanced MR imaging in the assessment of sacroiliitis.

OBJECTIVE: To investigate the role of Gd-DTPA enhancement in the diagnosis of sacroiliitis. PATIENTS AND METHODS: Fifteen patients with definite sacroiliitis, five subjects from an 'equivocal group', and five controls were imaged with Fast STIR, T1-weighted with fat suppression (T1FS) before and after Gd-DTPA. The 'equivocal group' included those who had abnormally high signal on Fast STIR images only suggestive of early sacroiliitis. The enhancement factor was calculated for T1FS images. Patients graded their symptoms at the time of MR imaging. The extent of abnormal enhancement was defined as none, local, or extensive. RESULTS: Fourteen patients with definite sacroiliitis and one patient from the 'equivocal group' demonstrated abnormal Gd-DTPA enhancement of their sacroiliac joints or adjacent subchondral marrow. Correlation between the patients' symptoms and maximal enhancement of the subchondral marrow was r = 0.75, P < 0.01, and the extent of abnormal enhancement was r = 0.68, P < 0.01. CONCLUSION: Fat suppressed Gd-DTPA or Fast STIR images can be used to assess disease activity in patients with sacroiliitis. Abnormal Gd-DTPA enhancement in the 'equivocal group' is important additional evidence suggesting the diagnosis of early sacroiliitis.

Adult↗
PubMed1995

Biphasic synovial sarcoma in the small intestinal mesentery.

BACKGROUND: A 46-year-old man presented with recurrent anemia and polyarthralgia. Investigations revealed a mass in the ileal mesentery, which was resected. Results of routine histologic examination suggested a diagnosis of synovial sarcoma, a rare malignancy usually not reported at this site. METHODS: Tissue was examined immunohistochemically, ultrastructurally, and by fluorescent in situ hybridization to confirm the diagnosis. RESULTS: Immunohistochemical studies revealed widespread labeling for cytokeratins and focal labeling for desmin and vimentin in the epithelial component, with labeling for epithelial membrane antigen in the epithelial and spindle-cell components. Fluorescent in situ hybridization analysis showed the characteristic t(X;18) translocation of synovial sarcoma. CONCLUSIONS: This is a unique case of synovial sarcoma in the small intestinal mesentery. Immunohistochemical labeling confirmed the diagnosis, although, to the authors' knowledge, the pattern of desmin labeling has not been described previously. The clinical association with polyarthralgia, which resolved after removal of the neoplasm, also has not been described previously.

Desmin↗
PubMed1995

Normal variation in the magnetic resonance imaging appearances of the sacroiliac joints: pitfalls in the diagnosis of sacroiliitis.

The purpose of this paper is to define the normal and variable appearances of the sacroiliac joints and adjacent subchondral marrow on unenhanced and enhanced Magnetic Resonance Imaging (MRI). Twenty subjects were imaged with spin-echo T1-weighted (T1), fast spin-echo T2-weighted (T2), T1-weighted with fat suppression (T1FS) and fast short tau inversion recovery (Fast STIR) sequences. Five of these subjects were imaged following intravenous Gd-DTPA administration, and the enhancement factor of the synovial compartment of the sacroiliac joint and subchondral marrow was calculated. The appearance of the cartilage of the synovial compartment on T1 and T2 images is of an intermediate signal bounded by signal void of bone cortex. On T1FS and Fast STIR images the cartilage has an intermediate to high signal. The marrow on T1, T2 and T1FS images has a homogeneous intermediate signal. T1FS images demonstrate the synovial compartment with greater clarity than T1 images. Cortical erosions and subchondral sclerosis were not demonstrated in our subjects, and partial volume artifact between the synovial and ligamentous compartments should not be interpreted as erosions. On Fast STIR images there is normally a region of high signal from the immediate subchondral marrow, which should not be interpreted as early sacroiliitis. Seven subjects demonstrated a patchy distribution of fat within the bone marrow, an appearance which alone does not indicate sacroiliitis. One subject had an accessory articular facet of the sacroiliac joint. The percentage maximal enhancement factor of the synovial compartment of the sacroiliac joint and adjacent subchondral marrow is 52% and 94% on T1FS images respectively. These figures redefine the normal maximal enhancement factors in this region of the body.

Adipose Tissue↗
PubMed1995

Metachondromatosis.

A case of metachondromatosis is reported, the literature reviewed and the implications of the disease are discussed; one possible complication is avascular necrosis of the femoral capital epiphysis.

Exostoses, Multiple Hereditary↗
PubMed1994

The admission chest radiograph after acute inhalation injury and burns.

The admission chest radiographs of 29 patients admitted with acute inhalation injury and burns, who required ventilatory support, were analysed for signs of inhalation injury. Four were excluded because of a history of chronic bronchitis or cardiac failure. 13 had radiological signs of inhalation injury, which included oedema of a nodular, consolidatory and interstitial pattern, and linear opacities due to atelectasis. 12 chest radiographs were normal. Inhalation injury in burns cases often requires clinical, bronchoscopic and blood gas assessment. Although changes were noted on 13/25 chest radiographs, the admission chest radiograph is an insensitive indicator of airway and parenchymal lung damage following acute inhalation injury and burns. We draw attention to the fact that significant lung damage may be present even with a normal initial chest radiograph.

Adolescent↗
PubMed1994

The radiographic appearances of the larynx on the chest radiograph.

100 chest radiographs were reviewed for the normal variable appearances of the larynx. Five radiographs were underexposed and on the remaining 95, contrast between air and soft tissue was identifiable. On 55 radiographs the glottis could be identified, of which 46 had both, eight had none and one had one pyriform recess filled with air. 40 chest radiographs were below the level of the glottis, 34 of which had a convergent appearance of the subglottic region and six had a parallel appearance of the tracheal walls. Appreciation of the variable appearances of the larynx on chest radiography is important before attempting to diagnose laryngeal disease, where practicable standard laryngeal views are recommended.

Adolescent↗