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Biomedical subjects

D M Balfe

Publications and source records attributed to D M Balfe.

At least 91 records · Page 5Linked to original sources
PubMed1985

The uterus: in vitro MR-anatomic correlation of normal and abnormal specimens.

Magnetic resonance (MR) images of 12 fresh uterine specimens obtained with a high-resolution surface coil were correlated with findings on gross and microscopic pathologic examination. The uterine wall can be differentiated into three distinct zones: a central high-intensity zone, a junctional low-intensity band, and a peripheral medium-intensity area. Whereas the endometrium (basale and functionale) corresponded to the high-intensity zone, the myometrium correlated best with the combined width of the areas of low and medium signal intensity. The signal intensity of a leiomyoma varied, depending on its cellularity. Primary endometrial and cervical carcinomas were clearly shown on MR images, as were other abnormalities such as adenomyosis and Nabothian cysts. The potential usefulness of MR imaging in detecting and staging uterine neoplasms is discussed.

Adult↗
PubMed1985

Barium pharyngography: comparison of single and double contrast.

In 119 patients referred for barium pharyngography, both single- and double-contrast examinations were performed. The air-contrast examinations were easier to perform and yielded fewer suboptimal studies than the single-contrast examinations. Neither technique proved to be sensitive in the detection of lesions in the oral cavity, but for lesions in the pharynx, the air-contrast technique had a higher sensitivity (87% vs. 33%) and overall accuracy (94% vs. 84%) than the combination of single-contrast radiography and videotaped fluoroscopy. Single-contrast films provided no further information than the combination of the air-contrast views and the videotaped fluoroscopy. The air-contrast examination was clinically helpful in those patients in whom indirect laryngoscopy was difficult.

Aged↗
PubMed1984

"Discphagia": a case report.

An anterior herniated intervertebral disc at the low cervical level caused dysphagia and an extrinsic impression on the esophagus seen on barium swallow. This entity should be added to the differential diagnosis of extrinsic esophageal defects.

Deglutition Disorders↗
PubMed1984

Testicular tumors: oncologic imaging and diagnosis.

The extreme radiosensitivity of testicular seminomas plus recent advances in chemotherapy for nonseminomatous tumors and for advanced seminomas have made long term survival possible in the large majority of patients with testis cancer. Since choice of therapy is determined by tumor histology and extent of disease, accurate clinical staging is critical. Computed tomography (CT) of the abdomen and chest is the imaging procedure of choice for staging testis cancer. Clinical staging accuracy of 80 to 90% can be achieved using CT in combination with radioimmunoassays for beta-HCG and AFP. Ultrasonography (US), while less sensitive and specific than CT for determining nodal status, may be useful in thin patients with sparse retroperitoneal fat; in addition US may play an important role in detecting occult testicular neoplasms and in assessing primary tumor extent within the scrotum. Lymphangiography should be reserved for Stage I patients in whom elective treatment of the retroperitoneum is not planned. Follow-up should include serial radioimmunoassays for serum AFP and beta-HCG and periodic CT examinations of the abdomen and chest. Technical improvements in CT scanners and further experience with the use of tumor markers should help refine our ability to stage and manage patients with testicular tumors. In addition, nuclear magnetic resonance (NMR) imaging and radionuclide imaging following injection of radioactively labelled antibodies to AFP and beta-HCG are new techniques which offer great promise for the future.

Adult↗
PubMed1984

Radiologic staging of gastrointestinal neoplasms.

In this article, the ability of computed tomography as well as other imaging methods to detect local and distant metastases in patients with either newly diagnosed or suspected recurrent gastrointestinal tumors is discussed. The role of the radiologic examination in the diagnosis of complications resulting from different types of treatment is also addressed.

Esophageal Neoplasms↗
PubMed1984

Computed tomography of fatal hepatic rupture due to peliosis hepatis.

Hepatic rupture with subcapsular hematoma and hemoperitoneum is shown by CT in a patient with peliosis hepatis. Peliosis hepatis is pathologically characterized by blood-filled cystic spaces in the liver associated with the administration of anabolic androgenic steroids or oral contraceptive agents, particularly those with large components of estrogen. We report a fatal case in a patient receiving diethylstilbestrol for 3 years. In patients receiving these medications, peliosis hepatis should be considered in the differential diagnosis of low attenuation areas in the liver by CT. These patients are subject to increased risk of spontaneous hepatic rupture.

Aged↗
PubMed1984

Abdominal computed tomography in children with unexplained prolonged fever.

Twenty-eight children with unexplained fever lasting at least 1 week were referred for CT of the abdomen. Of the 28 patients, 22 had clinical and radiographic findings localizing disease to the abdomen prior to CT. In these 22 patients CT correctly detected an abnormality in 19 of 22 (86%) and favorably affected therapy in 13 of 22 (59%). In the six patients without localizing findings CT was abnormal in two and normal in four. Computed tomography was correct in all six patients and favorably affected management in two patients. Our results suggest that in children with fever and findings localizing disease to the abdomen--especially the retroperitoneum--CT is helpful in diagnosing a wide variety of lesions, as well as influencing therapy. If no localizing signs are present, CT has a relatively lower yield.

Abdomen↗
PubMed1984

Gastrohepatic ligament: normal and pathologic CT anatomy.

In a review of 200 consecutive CT scans of the upper abdomen, the structures within the gastrohepatic ligament (GHL) were well seen in 182 (91%). In 85% of these 182 patients, the largest structure visible within the GHL was 6 mm or smaller. A total of 27 patients had a structure larger than 6 mm within the GHL; this finding could be explained in 13 by the presence of a normal anatomic variant. Of the 14 others, 12 had known tumor arising in or known to have spread to the upper abdomen. Two patients had no obvious explanation. Fourteen patients with cancers of the stomach (9 patients), pancreas (3 patients), and esophagus (2 patients) had 57 intact nodes that were evaluated pathologically. Of these 40/40 benign nodes and 10/17 malignant nodes were less than or equal to 8 mm in size. When anatomic variants are excluded, the finding of rounded structures greater than 8 mm in the GHL is a reliable indicator of left gastric node involvement by carcinoma or lymphoma or of coronary venous dilatation.

Humans↗
PubMed1984

The hypertrophied anal papilla: recognition on air-contrast barium enema examinations.

Anal papillae are acquired structures that arise from the base of the rectal columns of Morgagni at the dentate line. They enlarge in response to congestion, irritation, injury, or infection. Although anal papillae are commonly seen endoscopically, they are rarely demonstrated radiographically. Three cases are reported of hypertrophied anal papillae that were demonstrated on air-contrast barium enema examinations. Radiographically an enlarged anal papilla appears as a smooth polyp located just inside the anal verge. Endoscopically it is differentiated from an adenomatous polyp by its white appearance and its origin from the lower (squamous) aspect of the dentate line in the anal canal. Hypertrophied anal papilla should be included in the differential diagnosis of a smooth mass located near the anal verge, especially in a patient with a history of chronic and irritation or infection.

Aged↗
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

Magnetic resonance imaging of abdominal and pelvic lymphadenopathy.

The authors report their experience with magnetic resonance imaging (MR) in 20 patients with CT-proved lymphadenopathy of the abdomen and pelvis. Signal intensity from abnormal nodes was intermediate between fat and muscle (T1 longer than fat and muscle; T2 equal to or slightly shorter than fat but longer than muscle) and was shown best in the spin-echo mode with a TR of 900 msec. and a TE of 30 msec. Abnormal nodes were identified by their increased size and other morphological changes rather than by tissue characteristics established by signal intensity information. Lymphadenopathy due to lymphoma could not be differentiated from that due to metastases. MR detected all lymphadenopathy originally documented by CT and in addition easily distinguished blood vessels from lymph nodes; on the other hand, CT offered better spatial resolution and could be completed in less time.

Abdomen↗
PubMed1984

Radical pancreatectomy: postoperative evaluation by CT.

Twenty-four patients who had undergone radical pancreatic resection were evaluated by CT one week to 11 years after surgery. Eighteen patients had had the Whipple procedure; six had had total pancreatectomy. The region between the aorta and superior mesenteric artery, previously occupied by the uncinate process of the pancreas, is an important area to evaluate for tumor recurrence because periampullary tumors tend to metastasize to the lymph nodes in this region. Tumor recurrence here is readily detectable by CT since radical pancreatectomy leaves this area free of soft tissue attenuation material. Administration of glucagon prior to CT scanning helps fill the afferent jejunal loop with oral contrast material, and thus helps define right upper quadrant anatomy. CT demonstrated postoperative complications or tumor recurrence in 16 of the 24 patients and was 100% accurate in patients who had follow-up.

Adult↗
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↗
PubMed1984

CT evaluation after esophagogastrectomy.

The computed tomographic (CT) scans and barium esophagrams of 25 patients who had undergone esophagogastrectomy were reviewed to assess the utility of CT in the postoperative evaluation of these patients. CT provided information not provided by esophagography in 13 cases; in nine of these 13 cases, the CT scan was instrumental in directing patient management. One anastomotic leak not detected by esophagography was demonstrated by CT. In two patients, esophagography demonstrated mucosal recurrence at the esophagogastric anastomosis which was not shown by CT. Data indicate that CT is a useful method for detecting postoperative complications and extramucosal recurrent disease in this group of patients. Knowledge of the expected postesophagogastrectomy CT appearance is essential for the proper interpretation of postoperative scans.

Adult↗
PubMed1983

Oncologic imaging: kidney and ureter.

Malignant cancers of the kidney and ureter account for only 2-3% of all neoplasms in man. However, early diagnosis and treatment can have a profound effect on patient prognosis and survival. This article seeks to amalgamate a large body of information related to the pathology or primary renal tumors and metastatic disease with current imaging strategies to assist the clinician and enhance his understanding of the wide variety of modern imaging techniques available. Current tumor staging classifications are presented and the various imaging strategies are keyed to detection, definition and treatment options for tumors of the renal parenchyma and ureter. The strengths and limitations of all available imaging modalities are reviewed. An optimal approach to the imaging work up is developed with regard to availability, evolving technology and most importantly, cost efficacy. The controversies and conflicts in imaging and treatment options are explored while constructing a step by step approach that will be both flexible and utilitarian for the clinician faced with daily oncologic management choices.

Adenocarcinoma↗
PubMed1983

Computed tomography in malignant endometrial neoplasms.

Malignant uterine neoplasms are the most common invasive gynecological malignancies. The prognosis depends on the history, the grade, and the stage. Recent reports have stressed that a small percentage of patients with clinically low stage disease have unsuspected metastases. We retrospectively reviewed 61 patients with known malignant uterine neoplasms. In 18 patients with preoperative computed tomographic examinations, these scans detected unsuspected omental metastases in two and pelvic adenopathy in three. There was one false positive and one false negative examination. Computed tomography was superior to the clinical examination in defining the extent of the tumor in five patients. Computed tomography was also helpful in evaluating patients with suspected recurrent disease.

Adenocarcinoma↗
PubMed1983

Computed tomography in the staging of esophageal carcinoma.

The computed tomographic (CT) findings in 52 patients with histologically proved esophageal carcinoma were reviewed. In 30 of these patients, the CT findings were correlated with findings at surgery or autopsy. CT was found to be highly accurate in predicting tumor size and assessing invasion of the tracheobronchial tree and spread to the liver, adrenals, and celiac and left gastric nodes. By quantifying the contact between the tumor and aorta, it was found that the CT appearance correctly predicted the presence or absence of aortic invasion in 24 of 25 cases (five cases were indeterminate). CT was insensitive in detecting metastatic spread to local periesophageal nodes; in these cases the tumor tended to involve the nodes without enlarging them. CT is an accurate method for assessing the spread of esophageal carcinoma. Its use can prevent unnecessary surgery in patients with inoperable tumors.

Adenocarcinoma↗