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Biomedical subjects

D J Aronberg

Publications and source records attributed to D J Aronberg.

At least 19 recordsLinked to original sources
PubMed1986

Neck neoplasms: MR imaging. Part I. Initial evaluation.

Untreated neoplasms of the neck (tumors of the oropharynx, supraglottic area, carotid body, and thyroid, in addition to malignant lymphadenopathy) were evaluated in 23 patients with magnetic resonance (MR) imaging. The results were compared with computed tomographic (CT) scans in 20 patients. Contrast between tumor and fat was best on relatively T1-weighted images (500/30-35 [TR msec/TE msec]), whereas separation of tumor and muscle was best with relatively T2-weighted pulse sequences (1,500/90). Balanced images (1,500/30-35) provided best overall image quality and best demonstrated vascular anatomy. MR imaging was usually superior to CT in showing the relationship of tumor mass to muscle. MR imaging and contrast material-enhanced CT were equivalent in most patients in defining vascular anatomy, but MR imaging was superior when intravenous contrast material was not administered. However, CT was more helpful in showing bone and cartilage anatomy, and in some patients CT also was better in showing airway abnormalities. Despite these limitations, MR imaging is a promising imaging technique for studying neoplasms of the neck.

Adult↗
PubMed1986

Neck neoplasms: MR imaging. Part II. Posttreatment evaluation.

Thirty-three patients who had undergone prior surgery and/or radiation therapy for malignant neoplasms of the neck were studied with magnetic resonance (MR) imaging. Twenty-seven of these patients were also evaluated with computed tomography (CT). Ten patients were healthy posttreatment volunteers, and 23 had documented tumor recurrence. MR images better demonstrated normal muscular landmarks, especially in patients with obliterated fat planes. Areas of posttreatment fibrosis or scarring were low in signal intensity with all MR pulse sequences. However, in three patients, high signal intensity from postradiation edema of the supraglottic area mimicked neoplasm. In patients with recurrent tumor, MR imaging was superior to CT in defining the relationship of tumor and muscle and in demonstrating vascular anatomy when no intravenous contrast material was given during the CT examination. In two patients tumor and fibrosis were separated on MR images because of signal intensity differences. CT scans, however, showed adjacent bone and cartilage anatomy better. Our data indicate that an MR examination may be helpful in patients in whom CT is indeterminate either because of anatomical distortion or suboptimal demonstration of vascular anatomy.

Head and Neck Neoplasms↗
PubMed1985

Computer-assisted instruction in radiology.

We developed an interactive computer system to support various educational uses. The system allowed numerous instructors to create lessons or tests in a flexible, personalized fashion. As a pilot project, the system was used to develop and administer a computer-driven final examination in a didactic radiology course for second-year medical students. It was our objective to change the examination into an enjoyable experience that would also bring about long-term learning gains. The computer added immediate feedback to the testing situation.

Computer-Assisted Instruction↗
PubMed1985

Pleural and chest wall invasion in bronchogenic carcinoma: CT evaluation.

CT scans of 47 patients who had peripheral bronchogenic carcinoma contiguous to the pleural surface and who had undergone thoracotomy were retrospectively reviewed. The CT features of the primary neoplasm that were analyzed included the angle and amount of contact with the adjacent pleural surface, associated pleural thickening, fat plane between the tumor and chest wall, rib destruction, and chest wall mass. CT was of limited predictive value in separating those patients who had parietal pleural/chest wall involvement from those who did not. The combination of two or three CT findings (obtuse angle, greater than 3 cm contact with pleural surface, associated pleural thickening) resulted in a sensitivity of 87% and a specificity of 59%. The clinical symptom of focal chest pain, while not as sensitive (67%) as CT, was much more specific (94%) for parietal pleura/chest wall invasion.

Adenocarcinoma↗
PubMed1985

Thoracic wall involvement by Hodgkin disease and non-Hodgkin lymphoma: CT evaluation.

Thoracic computed tomographic (CT) scans of 250 patients with newly diagnosed or recurrent lymphoma revealed thoracic wall involvement in 24 patients (11 with Hodgkin disease, 13 with non-Hodgkin lymphoma). Thoracic wall involvement occurred without contiguous mediastinal or parenchymal involvement in 17 patients. Of these, 13 patients had masses beneath the pectoralis muscles or within the breast, and four had masses arising from the ribs. Five additional patients had mediastinal masses with thymic involvement and parasternal extension through the thoracic wall. Pulmonary parenchymal lymphoma with thoracic wall invasion was noted in the remaining two patients. In five of nine patients receiving radiation therapy, treatment plans were modified by CT demonstration of thoracic wall lymphoma.

Adolescent↗
PubMed1985

MRI and CT of the mediastinum: comparisons, controversies, and pitfalls.

The evolving roles of MR and CT in mediastinal imaging are of keen interest to both the radiologist and the clinician. This article has illustrated the usefulness of both CT and MRI in evaluating the mediastinum. The potential pitfalls and limitations of each modality have been reiterated to help gain a perspective for further application of these technologies. Although MRI has a completely different physical basis compared with CT, current (proton) imaging is still predominantly an anatomic study. If one focuses on the image quality and the information gain (see Table 1), as has been appropriately done in comparison studies, MRI and CT are roughly equivalent imaging techniques. At present, however, technical and economic factors combine to mitigate against MRI. MRI will need to be clearly better than CT to overcome those disadvantages. The two major advantages of MRI, absence of ionizing radiation and lack of necessity for intravenous contrast material, are not important enough factors for most clinical imaging situations. Because of its current disadvantages, primarily the length of examination time, MRI serves predominantly as a second-order problem-solving technique in the mediastinum. CT currently maintains its role as the examination of choice for performing tomography of the mediastinum in the overwhelming majority of clinical situations.

Diagnostic Errors↗
PubMed1984

The superior sinus of the pericardium: CT appearance.

On computed tomography, a mass-like density is often observed, just posterior to the ascending aorta, that occasionally has been mistaken for mediastinal lymph node enlargement. Cadaver studies confirmed this retroaortic structure to be an extension of the pericardial cavity, the superior sinus. Current anatomic texts sometimes depict this space without description. Anatomic studies revealed the presence of a superior sinus in all of the 28 cadavers studied. The mean cross-sectional diameter of the sinus in a coronal plane was 2.5 cm with a range from 1.2 to 3.8 cm. Retrospective review of 116 consecutive adult chest computed tomographic examinations disclosed its presence in 49%. In 15% of the total, the size of the sinus was sufficiently large potentially to simulate mediastinal lymphadenopathy. This normal variant has a characteristic location, shape, and attenuation value by CT that should allow recognition and prevent misinterpretation.

Humans↗
PubMed1984

Utility of CT in detecting postpneumonectomy carcinoma recurrence.

After pneumonectomy for bronchogenic carcinoma, detection of recurrent disease in the ipsilateral hemithorax or mediastinum is often difficult. The authors discuss the utility of CT in the evaluation of 18 postpneumonectomy patients who had developed new clinical symptoms. In six patients without documented tumor recurrence, CT demonstrated a normal postpneumonectomy appearance. In the other 12, CT confirmed the clinical impression of recurrent neoplasm (10 prospectively, two retrospectively), which appeared either as enlarged mediastinal lymph nodes or as a soft-tissue mass projecting into the normal near-water-density postpneumonectomy space. In only five of these patients were plain chest radiographs suggestive of recurrence (two prospectively, three retrospectively). The accurate assessment of the presence and extent of recurrent neoplasm by CT was important in planning radiotherapy in eight patients.

Aged↗
PubMed1984

Normal thoracic aortic diameters by computed tomography.

Although computed tomography (CT) has played an important role in evaluation of the thoracic aorta, no standards for aortic dimensions exist. To establish the range of normal variation of aortic diameters, a retrospective study of 102 chest CT studies in adults without clinical evidence of hypertension, diabetes, cardiovascular disease, or renal disease was performed. The coronal aortic diameter was measured at three levels: just beneath the aortic arch, just above the aortic valve, and at the level of the diaphragm. These measurements showed substantial variation according to age, sex, and thoracic vertebral body width. The ratio between the ascending and descending limbs of the aorta varied markedly with age; younger individuals had significantly higher ratios than older age groups. Knowledge of these values allows more precise CT evaluation in suspected aortic disease, specifically reducing the potential for "overinterpretation" of the normal, but prominent, ascending aortic root.

Adult↗
PubMed1983

Computed tomography of laryngoceles.

Six patients with laryngoceles, two internal and four of the mixed type, were studied with CT. Uncomplicated laryngoceles appear on CT as air-filled structures lying in the paralaryngeal space (internal), lateral neck (external), or in both locations (mixed). Obstruction of the neck of the laryngocele by either tumor or chronic inflammation can result in a fluid-filled structure, producing on CT a well circumscribed mass of either near water or soft-tissue density, depending on its composition. CT proved useful in establishing the definitive diagnosis of a laryngocele and mapping its total extent for treatment planning.

Adult↗
PubMed1983

CT of fibrosing mediastinitis: findings and their utility.

The computed tomographic (CT) manifestations of fibrosing mediastinitis were assessed in seven patients with pathologically proven disease. Computed tomography had been done to evaluate further a mediastinal or hilar mass seen on the conventional chest radiograph or to define extent of disease preoperatively. Findings included a mediastinal or hilar mass (7/7), calcifications of the central mass or in associated lymph nodes (6/7), tracheobronchial narrowing (5/7), and pulmonary infiltrates (4/7). In six of the seven patients, CT demonstrated masses or calcifications that were not evident with conventional radiography. The CT findings often were sufficient to suggest or corroborate the diagnosis of fibrosing mediastinitis, and the extent of the disease process was well depicted. In selected patients the CT findings may be sufficient to exclude the need for diagnostic tissue sampling.

Adult↗
PubMed1983

Extralaryngeal causes of vocal cord paralysis: CT evaluation.

Computed tomography (CT) was used in 33 patients to evaluate possible extralaryngeal causes of vocal cord paralysis (22 left, 11 right). Neoplasm in the lower neck or upper mediastinum (lung, esophagus, thyroid, breast, lymphoma) was found to be the predominant cause (27/33). A negative CT examination correlated with a neuropathic (e.g., diabetes) or idiopathic etiology. CT proved useful in demonstrating or excluding abnormalities in areas that are difficult to evaluate by physical examination or conventional radiography, particularly the aortopulmonary window. The normal anatomy and pathologic masses involving the recurrent laryngeal nerve are illustrated.

Adult↗
PubMed1981

High resolution computed tomography in the staging of carcinoma of the larynx.

The normal anatomy of the larynx as displayed on computed tomography is illustrated. Pathological alterations in patients with carcinoma of the larynx are depicted and discussed. Computed tomography (CT) is recommended as the initial radiological procedure when additional diagnostic information is required to supplement the findings of laryngoscopy. CT provides information regarding deep penetration of tumor, including cartilaginous invasion, and about the inferior extension of neoplasm, including the subglottic area. This knowledge helps to determine whether conservative surgery as opposed to total laryngectomy is possible.

Humans↗
PubMed1981

High CT attenuation values of a benign pulmonary nodule.

Computed tomography (CT) is thought to be a reliable predictor of the benignancy of pulmonary nodules when high attenuation values can be demonstrated. However, the cause of increased attenuation has not been proven. A pulmonary nodule evaluated initially by CT and subsequently followed for 4 years has developed central calcification by conventional tomography. This observation supports the contention that elevated CT attenuation values are the result of microscopic calcification.

Adult↗
PubMed1980

Traumatic fissural hemonpneumothorax.

A case of interlobar air-fluid collections following nonpenetrating chest trauma is presented. Radiographic features which suggest the diagnosis of traumatic fissural hemopneumothorax are discussed.

Aged↗
PubMed1980

Lung carcinoma associated with bullous lung disease in young men.

Over a 6 year period, three cases of pulmonary carcinoma in young men with severe bullous lung disease were seen at Washington University Medical Center. The patients did not have a long cigarette-smoking exposure. It would seem that patients with severe bullous lung disease are at a higher risk for the development of pulmonary neoplasm than the general population. Physicians should be aware of this association to expedite diagnosis and therapy.

Adult↗