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Biomedical subjects

E V Leslie

Publications and source records attributed to E V Leslie.

At least 19 recordsLinked to original sources

Increased pyrophosphate rib uptake: clinical correlation.

Two hundred and thirty-one patients had 270 bone scans. Increased rib uptake was correlated with radiological findings. Interpretation of results whether due to benign or to metastatic disease depends on other observations. These include whether the uptake is localized or along the rib outline, single or multiple, and associated with other abnormal uptake in the rest of the skeleton. Abnormal rib uptake was encountered in 23% of patients scanned for malignant disease and 10% of patients scanned for benign conditions. In the first group 34% were true positive and of these, rib lesions were multiple in 32% and solitary in 2%. In 20% the rib uptake was due to benign conditions and in 46% it was indefinite because of absent radiological findings. In this last difficult group 17% were due to probably early rib metastases and 29% were due to benign causes. Rib metastases were missed in only two cases, 1.1%. One case was multiple myeloma and the other was direct extension from underlying anaplastic lung carcinoma.

Adolescent↗

False positive dynamic imaging of the cerebral circulation due to a congenital anomaly.

False positive dynamic imaging of the cerebral circulation simulating vascular occlusive disease resulted from a clinically insignificant congenital variation in several patients at our institutions. The anomaly consisted of the asymmetrical caliber of the internal carotid and proximal anterior cerebral arteries. The 1 mm difference in the diameter of the internal carotid arteries was sufficient to be appreciated on dynamic imaging. The frequency of this anomaly was found to be 5% in a series of 200 bilateral carotid angiograms.

Adult↗

Computed tomography of the orbit.

In less than a decade computed tomography (CT scanning) had a profound impact on diagnostic radiology. Radiology of the orbit is no exception. As early as 1973, reports published in the radiological literature indicated that this new noninvasive imaging method was a highly effective way of demonstrating intraorbital mass lesions. As CT scanners became widely available, computed tomography became a significant adjunct to ophthalmological diagnosis. Today the main indications for CT scanning of the orbit are (1) suspected mass lesions, most frequently presenting as exophthalmos, (2) orbital trauma, including foreign bodies, (3) some congenital anomalies, and (4) suspicion of extension into the orbit of extraorbital disease processes. Along with ultrasonography, another new noninvasive imaging technique, CT has replaced a number of more invasive and often less effective diagnostic methods, such as orbital pneumography, venography, and arteriography as major imaging techniques in orbital pathology. The paper discusses current practices in the technique of CT scanning of the orbit including the important aspect of radiation dosimetry and the clinical applications, using a number of cases to illustrate its use.

Eye Foreign Bodies↗

Computed tomography of the abdomen.

In a few short years, computed tomography has become an important diagnostic procedure in the examination of the abdomen and pelvis. Its forte lies in its ability to provide cross-sectional views of excellent anatomical detail. Imaging of deep-seated structures such as the pancreas, adrenal glands, and enlarged retroperitoneal lymph nodes is now possible. The ability to distinguish small variations in tissue density enables the radiologist to evaluate the texture of solid structures, and to differentiate them from cysts or abscesses. The addition of contrast enhancement makes it possible to determine the vascularity of a lesson. The major limitation of CT is poorer delineation of structures in thin patients, and in patients in whom voluntary and involuntary motion cannot be interrupted. Computed tomography is compared with other complementary imaging procedures to include sonography, radionuclide imaging, and conventional radiograph procedures. It has replaced invasive diagnostic procedures in many instances. In a given situation, one or more imaging modalities may be appropriate.

Adrenal Glands↗

Radiology of a large cisterna magna cyst. A case report.

A case of a large cisterna magna cyst presented a problem in differential diagnosis. Characteristic changes were shown on plain skull roentgenograms and on radionuclide brain scan. The diagnosis was established on the basis of pneumoencephalography and isotope cisternography. The lesion responded well to surgical management.

Adolescent↗

Efficacy of computed tomography of the abdomen--early results.

Our experience with 153 CT scans of the abdomen and pelvis over the first eight months of availability at our institution has been analyzed. The efficacy in terms of contribution to the diagnosis in each patient was assessed and accuracy determined. CT was found to have made a significant contribution to the diagnosis in patients with diseases of the pancreas, aorta, retroperitoneal structures, and in cases of abdominal and pelvic masses and abcesses. It has been somewhat less helpful in evaluation of liver and renal diseases. Overall, CT scanning appears to be a significant new diagnostic modality in the evaluation of patients with abdominal and pelvic diseases.

Abdominal Neoplasms↗

Abnormal renal uptake in indium-111-chloride scanning.

A patient with severe alcoholic liver disease, in whom there was almost complete suppression of function of the reticuloendothelial system of the liver as noted on a 99mTc-SC scan is discussed. Obstructive biliary disease was suggested on 131I-rose bengal imaging. The depressed RES function was confirmed on 111In-chloride scan, showing abnormal uptake in the kidneys which could be secondary to inflammatory infiltration in the renal parenchyma from urinary tract infection with gamma enterococci.

Adult↗

Clinical experience with [111 In] indium chloride scanning in inflammatory diseases.

Forty-eight patients were scanned with 111 In-chloride in an attempt to identify the cause of fever. Fifteen true positive scans, 30 true negatives, and 3 false negatives were found. Of the 15 true positives, 7 cases of abdominal or pelvic abscess, and 8 cases of alcoholic hepatitis were detected. The 3 false negatives included: 1) an abscess in the anterior abdominal wall; 2) an abscess in the right upper quadrant at the site of a necrotic gallbladder; and 3) a tuberculous abscesss of the lumbar spine. Examples from the different categories, pitfalls in interpretation and advantages and disadvantages of scanning with 111In-chloride will be presented. These studies indicate that 111In-chloride is a safe, reliable scanning agent for abscesses below the diaphragm especially in patients who cannot undergo adequate bowel preparation.

Abdomen↗

High cervical spine and craniocervical junction injuries in fatal traffic accidents: a radiological study.

Postmortem radiographic examinations in 312 victims of fatal traffic accidents were analyzed with respect to injuries to the cervical spine. Most fractures and dislocations in this group were found to involve the craniocervical junction and the upper two cervical segments. Over half were flexion injuries, one-fifth caused predominantly by extension. Flexion and extension views were found to be helpful in demonstrating the instability of many injuries.

Accidents, Traffic↗

Experience with 111-In-chloride scanning in patients with focal defects on 99-mTc-sulfur colloid liver scans.

Thirty-nine patients with focal defects on the technetium liver scan were rescanned using 111-In chloride. Of 20 patients with hepatic malignancy, 11 had positive indium scans. None of the 19 with focal cirrhotic fibrosis had a positive indium scan although 5 of these had primary tumor. Thus, a positive indium scan suggests that the defect is malignant. A negative indium scan is less helpful, failling to distinguish between neoplasm and focal cirrhosis. Positive uptake in an extrahepatic primary neoplasm and negative uptake in the liver suggest that the hepatic lesion is not neoplastic.

Adolescent↗

Postmortem radiology of head neck injuries in fatal traffic accidents.

A series of 146 victims of fatal traffic accidents were subjected to postmortem radiographic examination prior to medicolegal autopsy. A total of 42% were found to have radiographically demonstrable head injuries ranging from relatively simple linear skull fractures to massive skull damage. Free intracranial or intravascular air was demonstrated in more than 60%. A total of 21% had demonstrable neck injuries, most of which were localized to a single level at the craniocervical junction or the upper two cervical vertebrae. Flexion and extension studies of this area are of major importance in demonstrating the injury and locating potentially occult lesions for the forensic pathologist.

Accidents, Traffic↗