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D J DiSantis

Publications and source records attributed to D J DiSantis.

35 records · Page 2Linked to original sources
PubMed1993

A prospective evaluation of transvaginal sonography for detection of ovarian disease.

OBJECTIVE: Despite the expanding role of transvaginal sonography in routine gynecologic examinations, as well as in screening for ovarian cancer, recent reports have noted problems when using the procedure for detecting ovarian masses and visualizing the ovaries in postmenopausal women. Our study was designed to assess prospectively the capability of transvaginal sonography in evaluating the ovary and detecting adnexal masses. SUBJECTS AND METHODS: Transvaginal sonography was used to examine 113 ovaries in 59 women within 72 hr before gynecologic surgery. Ovarian size and echo texture were assessed, and a search was made for adnexal masses. Sonograms were interpreted without knowledge of the clinical history or results of physical examination, and the sonographic findings were compared with surgical and pathologic data. RESULTS: In the 22 premenopausal patients, 16 (76%) of 21 histologically normal ovaries were identified on sonograms, but only 13 (59%) of 22 adnexal masses. Lesions as large as 177 cm3 were not detected. In the 37 postmenopausal patients, 12 (20%) of 59 normal ovaries and six (54%) of 11 adnexal masses were identified. Five malignant masses (largest, 113 cm3) were not detected. CONCLUSION: In this selected population, our ability to detect normal postmenopausal ovaries and ovarian masses was suboptimal in a number of cases. Practitioners should be aware of potential limitations in the use of this technique alone to evaluate the ovary.

Adnexa Uteri↗
PubMed1991

Simplified approach to umbilical remnant abnormalities.

To facilitate an understanding of abnormalities related to the umbilical remnants, the authors present a simplified classification scheme on the basis of embryologic anatomic relationships. In a type 1 remnant, the entire duct (vitelline or urachus) is patent; in type 2, only one end is patent; and in type 3, only the midportion is patent. The authors illustrate and describe various entities in terms of this classification, including patent vitelline duct, umbilical sinus, Meckel diverticulum, vitelline cyst, patent urachus, urachal sinus, urachal diverticulum, and urachal cyst. With this scheme, imaging characteristics of the types of remnant abnormalities can be predicted. The result is a cogent approach to the radiologic evaluation of the patient with a suspected umbilical remnant anomaly.

Humans↗
PubMed1990

Lung cancer staging.

Lung cancer remains a significant cause of death worldwide. A simple, accurate staging system is necessary to plan treatment regimens and to assess their effect on survival rates. In addition, the staging system provides a basis for planning research on newer adjuvant therapies for lung cancer. It should be applicable internationally, facilitating a global effort toward improved survival. The new AJCC staging system was designed to meet these needs, with initial international reports confirming its utility. Since diagnostic radiologists often are instrumental in pretreatment evaluation of these patients, familiarity with this new system is a must.

Humans↗
PubMed1990

Feasibility of digital teleradiology for imaging evaluation of patients with acute right upper quadrant abdominal pain.

To assess the utility of a commercially available digital teleradiology system in evaluating patients with acute pain in the right upper quadrant, hard-copy images from 100 examinations (50 hepatobiliary scintigrams and 50 sonograms of the right upper quadrant) were digitized, transmitted via standard telephone lines, and viewed remotely on a video monitor. Video and hard-copy interpretations were then compared for degree of concordance. For the scintigraphic studies, hard-copy and video images were equal in demonstrating gallbladder and bile duct activity. Video images failed to depict the presence of bowel activity in one case. Gallstones were depicted equally well on hard-copy and video sonographic images. The video interpreters overestimated the presence of abnormal hepatic parenchyma and overlooked one case of right hydronephrosis. The video interpretations of the scintigrams and sonograms showed an overall error rate of 4%, comparable to the rate obtained when radiographs are interpreted remotely with digital teleradiology systems.

Abdominal Pain↗
PubMed1989

CT demonstration of the appendix in asymptomatic adults.

We prospectively examined 103 consecutive adults (67 women, 36 men; mean age: 58.7 years) referred for abdominal and pelvic computed tomography (CT) in whom there was no history of right lower quadrant symptoms or appendectomy. Contiguous 5-mm CT images through the pericecal region were obtained in each subject, once routine scanning was completed. Three radiologists reviewed all CT images and reached a consensus on appendiceal visualization and the quantity of intraperitoneal fat. Statistical methods were applied to the collected data to seek significant associations between a visualized appendix and the following factors: patient age, sex, intraperitoneal fat grade, and the presence of oral contrast in the cecal lumen. The appendix was definitely visualized in only 45 of the 103 patients (43.7%). Analysis of variance revealed no statistically significant correlation between a CT-demonstrated appendix and the four variables examined. The clinical implications of these findings are discussed.

Adolescent↗
PubMed1989

CT of the stomach and duodenum.

CT has become an important tool in the diagnosis and management of diseases that affect the stomach and duodenum. By depicting the bowel lumen, wall, and extramural structures, CT can provide unique information that complements standard air contrast radiography and endoscopy. Proper scanning methods and knowledge of normal anatomy are necessary for optimal results. We utilize the gas contrast technique for organ-specific examination in patients with known or suspected gastroduodenal disease. Gastric adenocarcinoma is an important indication for CT evaluation. Unfortunately, early hopes that CT could accurately stage gastric cancer have not been realized. CT is not as accurate as laparotomy in staging early gastric cancer, primarily owing to its inability to detect small peritoneal implants, diagnose metastases in normal-sized lymph perigastric nodes, and predict pancreatic invasion. Nevertheless, CT retains an important role in depicting gross metastatic disease and guiding percutaneous biopsy, particularly in patients who are deemed poor surgical candidates or have undergone prior gastric resection. A variety of conditions other than primary gastric adenocarcinoma produce recognizable abnormalities on CT. Gastric lipoma, leiomyosarcoma, and varices have a distinctive appearance. Others, including gastritis and uncomplicated peptic ulcer, produce nonspecific gastric wall thickening. Endoscopic correlation and biopsy are required for specific diagnosis in these cases. The duodenum, by virtue of its location in the anterior pararenal compartment of the retroperitoneum, may be involved by numerous benign and malignant conditions. In blunt trauma, complicated pancreatitis, and peptic ulcer disease, as well as primary and metastatic malignancy, CT can provide data that may alter patient management.

Duodenal Diseases↗
PubMed1987

Excretory urography in the emergency department: utility of teleradiology.

To test the feasibility of teleradiology for use with excretory urograms obtained in the emergency department in cases for suspected renal colic, radiographs from 43 patients were digitized, transmitted via standard phone lines, and viewed on a video monitor 2 miles distant. Diagnostic interpretations of the video image and the original radiograph were reviewed for degree of concordance. The video and film images of the 27 examinations showing obstruction were interpreted with 100% correlation. Agreement as to the site of obstruction was present in 93% of cases. Only two-thirds of renal and ureteral calculi seen on the radiographs were discerned on the video images, however. Teleradiology proved as useful for ongoing monitoring and modification of these examinations as for initial interpretation.

Colic↗
PubMed1984

The neck after vertical hemilaryngectomy: computed tomographic study.

Computed tomographic scans in 22 postoperative vertical hemilaryngectomy patients were analyzed retrospectively to determine the normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Twelve patients without clinical evidence of recurrence illustrated the normal postoperative changes: loss of the preepiglottic space fat and the aryepiglottic fold on the operated side, convexity of the residual true vocal cord, and regeneration of the resected thyroid cartilage ala. In the six patients with recurrent neoplasm, the CT manifestations included increased width of the remaining true vocal cord, convexity of the surgically formed pseudocord at glottic level, subglottic tumor, and extralaryngeal neck masses. Recurrence was mimicked in four patients by bulky soft tissue at the endolaryngeal operative site at both CT and laryngoscopy; this was due to hyperkeratosis or granulation tissue in three cases and an inclusion cyst in one case. CT supplemented the physical examination and indirect laryngoscopy, providing information regarding the presence and extent of tumor that was useful in planning the mode or scope of subsequent therapy.

Humans↗
PubMed1984

The neck after total laryngectomy: CT study.

Computed tomographic scans in 23 patients who had undergone total laryngectomy were analyzed retrospectively to determine normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Nine patients without clinical evidence of recurrence illustrated the normal postoperative changes: a round or ovoid neopharynx connecting the base of the tongue with the cervical esophagus and intact fat planes surrounding the neopharynx, neurovascular bundles, and sternocleidomastoid muscles. In the 12 patients with recurrent neoplasm, the CT manifestations included masses involving the internal jugular lymph node chain (adjacent to the neopharynx, neurovascular bundles, or sternocleidomastoid muscles), tracheostomy site, or paratracheal region. Recurrence was mimicked on CT in two patients, one with an abscess and one with metastases from an adenocarcinoma of unknown primary site. In eight patients, a distended neopharyngeal lumen correlated with benign or malignant stricture. CT supplemented physical examination and indirect mirror examination, providing data regarding presence and extent of recurrent tumor and aiding in planning the mode and scope of therapy.

Aged↗
PubMed1983

Barium examination of the pharynx after vertical hemilaryngectomy.

Vertical hemilaryngectomy (VHL) is an effective treatment for localized true-vocal-cord carcinoma. Single- and double-contrast barium pharyngoesophagrams in 13 post-VHL patients (11 with dysphagia or suspected tumor recurrence, and two asymptomatic volunteers) were reviewed retrospectively. The two asymptomatic volunteers illustrated the normal postoperative appearance, demonstrating an unaltered pharynx, with no barium aspiration. Barium aspiration into the laryngeal vestibule or trachea was seen in 10 cases and was the only abnormal radiographic finding in four such patients. Three instances of tumor recurrence were identified. In two such cases, aspirated barium revealed a narrowed, irregular lumen of the residual laryngeal vestibule with a mass protruding into the subglottic part of the airway. The third example of recurrent malignancy was manifested by a tracheoesophageal fistula. Findings on the barium examination mimicked recurrent tumor in four cases. In one instance, a mound of granulation tissue protruding into the subglottic airway was confused with tumor recurrence. In three cases, the radiographs demonstrated apparent narrowing and mucosal irregularity of the residual laryngeal vestibule. This appearance was due to early postoperative edema or to transient deformity of the pliable residual hemilarynx during deglutition, as shown by videotaped fluoroscopy.

Barium↗
PubMedDate not supplied

A double-blind clinical study comparing the safety and efficacy of Hexabrix and Renografin-76 in contrast enhanced computed body tomography.

Hexabrix, a new low osmolality, iodinated contrast medium and the ionic diatrizoate Renografin-76 were studied in a double-blind parallel group comparison to examine safety and efficacy in patients undergoing contrast assisted CT of the liver, spleen and kidney. No significant differences in pulse, respiration and blood pressure before and after injection were noted in the 100 patients studied. Heat sensation in the Hexabrix group was distinctly lower than in those receiving Renografin, but the two groups did not differ with respect to average scores for pain. There was no difference in adverse side effects. Clinical laboratory studies between the groups showed some differences which could not be attributed to the individual contrast agents. While scan quality of both agents was good to excellent, it should be noted that the dose of Hexabrix was not adjusted to compensate for the difference in iodine content (320 mg I/ml vs. 370 mg I/ml for Renografin-76).

Adult↗