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Biomedical subjects

D Schellinger

Publications and source records attributed to D Schellinger.

At least 19 recordsLinked to original sources
PubMed1992

PACS clinical experience at Georgetown University.

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for 3.5 years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for 3 years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Computer Systems↗
PubMed1992

Isolation of the fourth ventricle causing transtentorial herniation: neurosonographic findings in premature infants.

OBJECTIVE: Significant posthemorrhagic enlargement of the fourth ventricle occurs only in a small minority of patients. Although entrapment or isolation of any ventricle can occur, the fourth ventricle is the most common site. This study was undertaken to better understand enlargement of the fourth ventricle after intraventricular hemorrhage and the neurosonographic features of isolation and transtentorial herniation. MATERIALS AND METHODS: The sonographic records of 1535 premature neonates were reviewed for evidence of intracranial hemorrhage and ventriculomegaly. Cranial sonography was performed within the first 3 days of life in all neonates born in our hospital and within the first week of admission for transferred neonates. Follow-up sonograms were obtained at weekly intervals until discharge from the nursery. Intracranial hemorrhages were classified as severe when the hemorrhage was associated with hydrocephalus, intraparenchymal hemorrhage, or both. RESULTS: Intracranial hemorrhage occurred in 761 (50%) of 1535 patients, with severe hemorrhages in 229. Ten had massive enlargement of the fourth ventricle with isolation in six of the 10 after shunt placement. Isolation of the fourth ventricle causing transtentorial herniation occurred in three. Of the patients with isolation of the fourth ventricle, two had associated infection and ventriculitis caused by Klebsiella oxytoca and one had Candida ventriculoencephalitis. CONCLUSION: The early recognition of the neurosonographic features of an enlarged fourth ventricle causing transtentorial herniation has important therapeutic implications. Although isolation can occur after intraventricular hemorrhage alone, infection and ventriculitis are significant factors in the development of an isolated fourth ventricle.

Cerebral Hemorrhage↗
PubMed1979

Imaging of the pancreas with computed tomography.

In this paper we present our experience with computerized tomographic imaging of the pancreas, both in normal and abnormal conditions. Eighty patients were studied for evaluation of pancreatic disease. A further 50 patients, all with a normal pancreas, were studied for abnormalities of other abdominal organs and served as the control group. Helpful signs in establishing the diagnosis of carcinoma of the pancreas were mass effect within the pancreas, alteration of organ contour and obliteration of retroperitoneal fat planes. We found that differentiation from pancreatitis or retroperitoneal lymphadenopathy may at times be difficult. Our results showed that in 22 out of 23 patients with proven normal pancreas, the pancreas size on the CT display was within the adopted normal range. In 30 patients with proven carcinoma of the pancreas, a pancreatic mass was seen in 24 (83%). Computerized tomography is clearly a valuable method for viewing both normal pancreatic anatomy and anatomical variations and pathologies.

Adipose Tissue↗
PubMed1979

Abdominal aortic aneurysms: diagnostic review and new technique.

A new technique of computed tomography (CT) applied to the diagnosis of abdominal aortic aneurysms is described, and the experience in 58 patients is reviewed. In all instances the abdominal aorta was clearly demonstrated, even when wall calcification was absent. A series of 37 patients with abdominal aortic aneurysm underwent evaluation by physical examination, abdominal roentgenograms, and ultrasonic and CT scanning. Measurements of the transverse diameter at the point of maximal dilatation were compared with the measurements made at operation. CT not only confirmed the diagnosis in all patients but the measurements obtained by this technique were the most accurate, correlating extremely well with the true dimensions of the aneurysm. The addition of contrast enhancement to CT scanning allowed clear delineation of the aortic lumen and intraaneurysmal thrombus, not possible with any other method, including ultrasonography. The technique appears useful as a screening procedure and in the differential diagnosis of a tortuous abdominal aorta. Patients with a small aortic dilatation can be followed accurately by scanning.

Aged↗
PubMed1979

Pectus excavatum deformities simulating mediastinal masses.

Three patients with various pectus excavatum deformities in whom radiographic findings suggested hilar and mediastinal masses are presented. Computed tomography of the chest yielded valuable diagnostic information and made it possible to exclude the existence of these masses. Compression deformity of the heart and great vessels by the pectus deformity is the most likely explanation for these findings.

Adult↗
PubMed1978

Ultrasonography and CT scanning: a comparative study of abdominal aortic aneurysms.

CT scanning has been successfully used in the evaluation of the abdominal aorta in over 70 patients. Half of this group, with abdominal aneurysms, was also studied by ultrasonography and the results compared. Both techniques proved equally reliable in the diagnosis of this entity. Closer correlation to the aneurysmal diameter measured at surgery was obtained by CT scanning; underestimation of size by ultrasonography was a frequent finding. Aortic lumen and intra-aneurysmal thrombus were also more clearly demonstrated by CT when contrast enhancement was added. Evaluation of aneurysmal length is done more effectively by ultrasonography although sagittal reconstruction by CT has been now attempted.

Aorta, Abdominal↗
PubMed1978

Computed tomography of solitary pulmonary nodules: experience with scanning times longer than breath-holding.

Thirty-one patients with solitary pulmonary nodules--18 benign and 13 malignant--proven by either tissue diagnosis or prolonged follow-up were evaluated by computed tomography (CT). A device (ACTA scanner 0100) with scanning times greater than breath-holding was used with full understanding of its related limitations. A retrospective study of the CT features of these nodules led us to establish several criteria for benign nodules. CT evidence of calcium is felt to be the most important feature of benignancy. In the absence of calcium, irregular nodule margins, perinodular fibrosis, satellite nodules, and pleural thickening opposite a peripherally situated nodule are helpful to suggest its benign nature.

Humans↗
PubMed1977

Computed cranial tomography and radionuclide cisternography in hydrocephalus.

Computerized Cranial Tomographic scanning has replaced radionuclide cisternography in screening both adult and pediatric patients for hydrocephalus. Nevertheless, cisternography provides indispensable information about the CSF clearance capacity and remains a valuable adjunct to the excellent anatomic detail provided by CCT scans. In patients without emergency symptoms, cisternography provides the best indication as to whether or not diversionary shunting is likely to relieve the patient's symptoms.

Adult↗
PubMed1977

Computed tomographic patterns of pseudohypertrophic muscular dystrophy: preliminary results.

At present, the diagnosis of pseudohypertrophic muscular dystrophy (PHMD) rests on the clinical picture and the pattern of inheritance and is supported by electrodiagnostic, histologic, and histochemical techniques. In this report we describe the observed computed tomography (CT) changes in six patients with PHMD and compare these abnormal CT scans with scans of the same anatomic region in 16 normal individuals. Scans of patients with polymyositis and sarcoid myopathy are shown for comparison. Two CT patterns, frequently observed in our series, are described.

Absorptiometry, Photon↗
PubMed1977

Computerized axial tomography in clinical pediatrics.

Computerized axial tomography (CAT), a noninvasive radiologie method, provides a new dimension in screening and diagnosis of intracranial pathology. Evaluation of 725 scans in infants and children demonstrates that CAT may be performed with negligible risk, although sedation and restraint are essential to the successful performance of studies in children under 6 years of age. CAT is the preferred initial diagnostic method in suspected hydrocephalls and is accurate in the detection and precise localization of brain tumors. The management of hydrocephalus and brain tumors has been significantly altered by the availability of CAT. Few invasive neuroradiologic procedures are required and pneumography is especially curtailed. Serial scanning is the best available method of monitoring ventricular alterations in hydrocephalus, tumor size during radiotherapy or chemotherapy, and postoperative recurrence of benign neoplasms. Complex intracranial anomalies are detectable with computerized tomography, but complete definition of pathology often requires angiography and air studies. Limited clinical experience in detecting neonatal intraventricular hemorrhage suggests that CAT will be a valuable tool for futlre investigations of that problem.

Adolescent↗
PubMed1976

Computerized tomography and benign intracranial hypertension.

Benign intracranial hypertension (BIH) is a recognized syndrome of unknown origin that conventionally has been diagnosed by excluding an underlying space-occupying lesion using invasive contrast procedures. Computerized tomography (CT) scanning of the head is a safe, accurate method of defining intracranial structures that were previously only discernible by invasive studies. Seven patients with headaches, papilledema, normal mental status, normal brain scan, and normal electroencephalogram had normal CT scans of the head. Patients suspected of BIH can be spared invasive contrast procedures if the CT scan of the head is normal.

Adult↗
PubMed1976

Computerised axial tomography for diagnosis of pancreatic cancer.

Computerised axial tomography demonstrated the presence of a mass lesion in the pancreas in 9 (64%) of 14 patients with histologically confirmed pancreatic cancer. Since this was a retrospective analysis, the percentage of false positive and negative results using this technique is not as yet known. The technique appears accurate in detecting abnormal pancreatic masses of 10 cm in diameter or more, however, for masses less than 10 cm in diameter the yield at present is only 33%. With further technical refinement to increase resolution, the automatic computerised transverse axial scan should prove to be an invaluable procedure for the detection of pancreatic carcinoma, in designing radiation therapy ports, and in providing objective information regarding response of therapy and progression of disease.

Adenocarcinoma↗
PubMed1976

An analysis of the first one thousand cerebral ACTA scans.

The first 1000 ACTA Scans of the brain are analyzed. ACTA Scanning is ideal for evaluating the ventricular system and other CSF containing spaces. High density lesions, such as intracerebral hematomas are depicted with great consistency. The method is less reliable for detecting subdural hematomas. For brain tumor screening, intravenously applied contrast agents are mandatory, so that tumors with subtle density changes can be identified more positively.

Brain Neoplasms↗
PubMed1976

Computed tomography of spinal cord after lumbar intrathecal introduction of metrizamide (computer-assisted myelography).

Computed tomography (CT) of the thoracic and cervical spine was carried out after lumbar intrathecal introduction of a water-soluble radiographic contrast medium (metrizamide). By choice, no head-down position of the patient was used to facilitate craniad movement of the contrast medium; rather, advantage was taken of the normal CSF flow. This technique, referred to as computer-assisted myelography (CAM), permits the demonstration of the metrizamide-containing subarachnoidal spaces surrounding the thoracic and cervical cord. Some examples of the diagnostic possibilities of the method are discussed.

Computers↗
PubMed1976

Computed tomographic evaluation of aortic aneurysms.

Applications of computed tomography are being extended from the brain to other body parts. This report describes CT scanning of abdominal and thoracic aortic aneurysms in 30 patients. CT shows greatest promise in abdominal aortic scanning, where reliable identification of the aorta can be achieved even in the absence of enlargement or calcification. However, current limitations prevent visualization of internal detail such as intimal plaques or mural thrombi. Technical advances are described which should have an important bearing on this.

Aorta, Abdominal↗