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Biomedical subjects

D R Haynor

Publications and source records attributed to D R Haynor.

50 records · Page 3Linked to original sources
PubMed1994

Magnetic resonance imaging signal changes in denervated muscles after peripheral nerve injury.

The evaluation of peripheral nerve disorders has traditionally relied on a clinical history, physical examination, and electrodiagnostic studies. Recent studies have used magnetic resonance imaging (MRI) to evaluate a variety of both nerve and muscle disorders. In this article, we describe the use of MRI, using short-tau inversion recovery (STIR) sequences, to evaluate muscle signal characteristics in a variety of peripheral nerve disorders. A total of 32 patients were studied, and 12 representative cases are discussed in detail. Increased STIR signal in muscle was seen in cases of severe axonotmetic injuries involving the transection of axons producing severe denervation changes on electromyography. The increased STIR signal in denervated muscles was seen as early as 4 days after the onset of clinical symptoms, which is significantly earlier than changes detected on electromyography. The MRI signal changes were reversible when the recovery of motor function occurred as a result of further muscle innervation. In cases of neurapraxic nerve injuries, characterized by conduction block without axonal loss, the STIR signal in muscle was normal. These findings show that MRI using STIR sequences provides a panoramic visual representation of denervated muscles useful in localizing and grading the severity of peripheral nerve injury secondary to either disease or trauma. MRI using STIR sequences may therefore play an important role in the prediction of clinical outcome and the formulation of appropriate therapy early after peripheral nerve injury.

Adolescent↗
PubMed1992

Hardware and software requirements for a picture archiving and communication system's diagnostic workstations.

Electronic systems (picture archiving and communications systems [PACS]) for image and multimedia data distribution, archiving, and transmission, represent the future of radiology. The workstation is the point of contact between a PACS and the radiologist or referring physician. Therefore, the acceptance of PACS is highly dependent on workstation functionality and performance. This paper, based on our experience in evaluating commercial workstations and on a review of recent literature, describes hardware and software requirements for diagnostic workstations that could be used for making primary diagnoses in a radiology department. Requirements for PACS workstations for use in referring clinics are also briefly described. These workstations must be able to handle the large volume of images to be viewed efficiently, add new functionality to improve the productivity of physicians, technologists, and other health care providers, and provide enough flexibility to allow the electronic systems to grow as medical imaging technology evolves.

Computer Systems↗
PubMed1992

Diagnosis of lumbar spinal stenosis in adults: a metaanalysis of the accuracy of CT, MR, and myelography.

We undertook a literature synthesis of CT, MR, and myelographic studies to evaluate what is known about the diagnostic accuracy of these imaging tests for the diagnosis of lumbar spinal stenosis in adults without prior surgery. From 116 possibly relevant studies, we reviewed 14 articles that included cases of spinal stenosis with a reference standard other than the imaging tests of interest. Of the studies we reviewed, two involved only MR, nine only CT, and three used both; six studies included myelography. Rating categories of A, B, C, or D were assigned for the quality of research methods used to estimate diagnostic accuracy. All studies received either a C or D rating. Common methodologic problems were failure to assemble a representative cohort for study, small sample size, and failure to maintain independence between image readings and reference standards. Sensitivity ranged from 0.81 to 0.97 for MR, from 0.70 to 1.0 for CT, and from 0.67 to 0.78 myelography. Studies varied greatly in case selection, definition of test and disease categories, and geographic locale, so no pooled estimates could be derived. In asymptomatic patients, abnormal findings appeared on CT or MR in 4-28% of cases and were more common in the elderly. Published studies of the value of CT and MR for the diagnosis of lumbar stenosis lack methodologic rigor and do not permit strong conclusions about the relative diagnostic accuracies of these procedures. For the present, the choice between MR or CT depends on issues such as costs, reimbursements, access to equipment, skill of radiologists, and patient safety. Better studies will be needed to document claims for improvements in imaging accuracy as MR technologies evolve. These studies should emphasize larger sample sizes, more attention to research designs that avoid methodologic biases, and the contribution of imaging diagnoses to ultimate clinical outcome.

Evaluation Studies as Topic↗
PubMed1992

Measurement of tumor resection volumes from computerized images. Technical note.

The authors describe a method for quantitation of the area and volume of the resection cavity in patients who have undergone surgery for brain tumors. Using a slide scanner and Image 1.27, a public domain program for the Apple Macintosh II computer, computerized tomography scans and magnetic resonance images can be digitized and analyzed for a particular region of interest, such as the area and volume of tumor on preoperative and postresection scans. Phantom scans were used to analyze the accuracy of the program and the program users. User error was estimated at 2%, program error was 4.5%. This methodology is proposed as a means of retrospectively calculating the extent of tumor resection.

Humans↗
PubMed1988

Superficial- and deep-tissue temperature increases in anesthetized dogs during exposure to high specific absorption rates in a 1.5-T MR imager.

Superficial- and deep-tissue heating was measured in five dogs during high-specific-absorption-rate radiofrequency (RF) irradiation to see whether significant temperature changes could be produced by a 1.5-T clinical magnetic resonance imager. The RF power output employed was 6.3 times that required for routine imaging. Temperature probes were placed in both deep and superficial tissues, and temperatures were recorded before, during, and after exposure. In each dog, there was a linear temperature increase of several degrees during RF exposure; the maximal average change was 4.6 degrees C in the urinary bladder. The temperature increase was slightly greater in deep tissues than in superficial tissues. The calculated specific absorption rate, based on the temperature change, averaged 7.9 W/kg for all five dogs. These findings argue for continued caution in the design and operation of imagers capable of high specific absorption rates, particularly when they are used for imaging infants or patients with altered thermoregulatory capability.

Absorption↗
PubMed1987

Complex fractures of the proximal humerus: role of CT in treatment.

The authors reviewed the computed tomography (CT) scans, plain radiographs, and subsequent treatment of 17 patients with complex proximal humeral fractures. CT scans and radiographs were compared in the demonstration of fracture lines, displacement of fracture fragments, rotation of fragments relative to their normal positions, and status of the head and articular surface of the humerus. The impact of CT findings on the decision to treat with surgery versus closed reduction and on the choice of surgical procedure was assessed. Surgery was not performed in nine patients because CT scans showed no significant displacement of fragments previously judged displaced or "indeterminate" on radiographs. Surgery was performed in eight patients; CT demonstrated significant abnormalities not definitely shown with radiography. In six of these eight patients, CT scans demonstrated unsuspected abnormalities that directed the choice of surgical procedure. CT scans provide clinically useful information for the treatment of complex proximal humeral fractures when radiographs provide inadequate or indefinite information.

Adult↗
PubMed1987

The utility of MR in planning the radiation therapy of oligodendroglioma.

Newer methods of radiation therapy for treating oligodendroglioma after surgical resection have produced promising results using high doses of radiation. However, these doses are close to those that cause necrosis of normal brain, making the accurate spatial localization of tissue at risk for containing tumor cells more important. Because MR imaging is superior to CT in detecting some types of intracranial disease, nine patients with oligodendroglioma were studied with both MR and CT. Results were compared with surgical findings. In six cases, MR identified some tumor volume found during surgery that was not detected by CT. In addition, the interface between abnormality (tumor plus edema) and normality was depicted much more clearly by MR than by CT in most cases. Such superior depiction of the margins of abnormality is important for radiation therapy planning because of the known tendency of oligodendroglioma to infiltrate adjacent edema, making all areas of abnormality potential tumor-bearing tissue. Finally, MR showed normal brain tissue in areas considered suspicious by CT, because they were not well seen on CT in several patients. In these cases of low-grade oligodendroglioma, MR was believed to be superior to CT in providing information needed for radiation therapy planning because of its ability to distinguish tumor and adjacent edema (considered tissue at risk for containing microscopic tumor) from contiguous normal brain.

Adult↗
PubMed1987

Anatomy of the abductor muscles of the hip as studied by computed tomography.

Computed tomography provides a non-invasive method for studying anatomy in live subjects. The abductor muscles of the hip were studied by using computed tomography to describe their position, size, and orientation. The outlines of the muscles were clearly identifiable; patterns that are associated with trauma, arthritis, and so on, differed from normal. The patterns in eighteen normal hips in twelve adults were mapped in detail. The cross-sectional areas of the abductor muscles were measured and vectors representing the total pull of the abductor muscle in the frontal and sagittal planes were constructed for each hip. The variations in individual and composite muscular anatomy were recorded. The inclination of the axis of the abductor muscle ranged from 17 to 26 degrees (standard deviation, 2.9 degrees) in the frontal plane and from -2 to 14 degrees (standard deviation, 4.2 degrees) in the sagittal plane.

Adult↗
PubMed1986

Radiotherapy planning: direct tumor location on simulation and port films using CT. Part I. Principles.

Although there have been great advances in cancer diagnosis in recent years, it remains difficult to transfer tumor location information from cross-sectional computed tomographic (CT) scans or magnetic resonance images to the simulation and verification films used in planning radiotherapy. A newly developed system uses radioopaque markers attached to the patient as reference points. These markers are identified on both CT scans and simulation films and their locations entered into the treatment planning computer. The tumor and any desired normal structures are then outlined manually on each CT section. Transparent overlays produced by the computer show the position of the reference markers and tumor outlines for any combination of gantry angles and source-film distance. Because the overlays are scaled to the simulation films, the reference points enable precise alignment of overlay and film. The tumor outline thus appears on the simulation or verification films exactly as it is "seen" by the therapy beam, making field verification straightforward and accurate, even on oblique films.

Adult↗
PubMed1986

Changing appearance of the normal uterus during the menstrual cycle: MR studies.

The authors obtained sagittal magnetic resonance (MR) images twice a week from six healthy women during one full menstrual cycle to establish the changes depicted in the uterine layers. Parallel endocrine and ultrasound studies were used to establish the day of ovulation precisely. Consistent changes in the thickness and intensity of the endometrium and myometrium wer noted in all subjects during the menstrual cycle. Both myometrial thickness and endometrial area increased linearly during the follicular (preovulatory) phase of the cycle; the rate of increase dropped significantly during the luteal phase. Two myometrial layers were observed; the best contrast between the layers was demonstrated during the first half of the cycle.

Adult↗
PubMed1985

MR imaging in radiation therapy planning. Work in progress.

Magnetic resonance (MR) imaging may provide information about tumor location, extent, and margins unavailable from other imaging modalities. The impact of MR on radiation therapy planning was investigated in this study. Thirty patients about to undergo radiation therapy underwent routine radiography and computed tomography (CT) to define the extent of their disease. A radiation therapy plan, including portal placement and size, was drawn up based on this information alone. The patients also underwent MR studies. After the original therapy plan was created, the MR study results were made available to the radiation therapist. In 53% (16/30) of the cases, MR information led to a measurable change in the therapy plan; in an additional 33% (10/30), MR information increased confidence in the original plan. MR may become a necessary procedure for radiation therapy planning in many cases.

Humans↗
PubMedDate not supplied

The use of importance sampling techniques to improve the efficiency of photon tracking in emission tomography simulations.

Monte Carlo simulations are widely used to study the transmission and scattering of gamma rays. Use of this method for simulations of emission tomographs suffers from geometric inefficiency resulting from the low solid angle of acceptance of most tomograph designs. We have applied several importance sampling techniques--stratification, forced detection, and weight control through Russian roulette and splitting--to increase the computational efficiency of the Monte Carlo method 10- to 300-fold. A description of these techniques, their validation, and sample performance results are given. Application of importance sampling methods makes it practical to study photon scattering in heterogeneous attenuators on workstations and minicomputers.

Electrons↗