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J D Godwin

Publications and source records attributed to J D Godwin.

At least 19 recordsLinked to original sources
PubMed1992

Thoracic actinomycosis: CT findings in eight patients.

The chest radiographs and computed tomographic (CT) scans obtained in eight patients with pathologically proved cases of thoracic actinomycosis were independently reviewed by two observers. All patients were alcoholic men aged 42-62 years. Air-space consolidation, seen on the radiograph and CT scan in each case, was present in the lower lobes in seven patients (88%) and upper lobes in three (38%). Pleural effusion was present in five (62%). Pleural thickening adjacent to the air-space consolidation was identified on the radiograph in four (50%) and CT scan in all eight. Cavitation or central areas of low attenuation not apparent on the radiograph were seen on the CT scan in five cases (62%). Hilar or mediastinal lymphadenopathy was identified on the radiograph in three cases (38%) and on the CT scan in six (75%). Chest-wall invasion occurred in only one case (12%). Thoracic actinomycosis is characterized on CT scans by air-space consolidation with adjacent pleural thickening. CT is superior to radiography in assessing the thoracic manifestations of actinomycosis.

Actinomycosis↗
PubMed1992

Minimum scan speeds for suppression of motion artifacts in CT.

Cardiac and ventilatory motions cause artifacts at chest computed tomography (CT). To determine how short the scan times on third-generation units must be to avoid such artifacts, motion was measured with fast and ultrafast CT scans. Minimum detectable motion was then determined. The longest scan time that avoided a barely perceptible artifact was calculated by dividing the minimum detectable motion by the peak physiologic velocity. The posterior left ventricular wall moved at a maximum velocity of 52.5 mm/sec, necessitating a scan time of 19.1 msec or less to avoid artifact. Lung vessels near the heart moved at 40.5 mm/sec for a scan time of 24.7 msec or less. During quiet breathing, pulmonary vessels moved at 10.7 mm/sec for a scan time of 93.5 msec or less. The authors conclude that the shortest scan time on third-generation units (0.6 second) cannot prevent all artifacts arising from motion in the chest. Even ultrafast scan times (50 msec) are not short enough to eliminate artifacts on these units. Thus, reduction of motion artifacts will require techniques other than fast scanning.

Artifacts↗
PubMed1992

Swyer-James syndrome: CT findings in eight patients.

To determine the importance of chest CT findings in patients with Swyer-James syndrome (unilateral small lung with air trapping) and to compare these findings with those on chest radiographs and scintigrams, we reviewed the CT scans, chest radiographs, and scintigrams of eight patients with the syndrome. Radiographs showed unilateral hyperlucency in seven patients and bilateral asymmetric hyperlucency in one. CT showed that the hyperlucency was unilateral in only three and that hyperlucency in one. CT showed that the hyperlucency was unilateral in only three and that hyperlucent regions on radiographs contained patches of normal lung attenuation in five patients. Conversely, in four patients, CT also showed small hyperlucencies in regions considered normal on radiographs. These lucencies usually had poorly defined margins and irregular shapes (five patients), but sometimes were peripheral, wedge shaped, and sharply demarcated (two patients). CT also showed subtle abnormalities not visible on radionuclide scans in two patients. Air trapping in hyperlucent regions was confirmed by a lack of change in volume on expiratory CT scans in five cases. Bronchiectasis was found in only three patients. CT helps to exclude central bronchial obstruction, cysts, and vascular disease as causes of hyperlucency. By excluding central obstruction, CT may make bronchoscopy unnecessary in some patients. CT is more sensitive than radiographs and radionuclide scans in detecting hyperlucent regions and in showing their distribution. Our experience suggests that bronchiectasis is not a necessary component of the Swyer-James syndrome.

Adolescent↗
PubMed1992

Wegener's granulomatosis: findings from computed tomography of the chest in 10 patients.

Radiographs and computed tomography (CT) scans of the chest were reviewed for 10 patients with pathologically proven Wegener's granulomatosis. The CT scans revealed multiple pulmonary nodules in seven patients and a single nodule in one. The nodules ranged in diameter from 2 mm to 7 cm, and most had irregular margins. All of the nodules larger than 2 cm in diameter showed evidence of cavitation in the CT scans. Additional CT findings included associated areas of consolidation (in two patients), pleural thickening (in two) and pleural effusion (in two). Chest radiographs were available for eight patients, and the CT scans contributed information additional to that available from the radiographs for seven of these. In one patient lung nodules were visible in the CT scans but could not be distinguished from surrounding areas of consolidation in the chest radiographs. CT revealed additional nodules in five of the six patients in whom multiple nodules were seen in chest radiographs and in one of these also revealed cavitation tht was not visible in plain radiographs. CT excluded the possibility of a nodule that was suspected from the chest radiographs in a patient who had been treated previously for Wegener's granulomatosis. The authors conclude that Wegener's granulomatosis is characterized in CT scans by multiple nodules with irregular margins and by cavitation in nodules larger than 2 cm in diameter. CT may also demonstrate nodules and cavitation not apparent in radiographs.

Adolescent↗
PubMed1991

The airway.

Explore the source record for details and available documents.

Bronchial Diseases↗
PubMed1991

Lung abscess caused by Rhodococcus equi.

In the immunocompromised patient, early diagnosis of a lung cavity is essential for appropriate treatment. Rhodococcus equi (formerly Corynebacterium equi) is a variably acid-fast bacterium that can produce cavitary disease in an immunocompromised host. The two cases presented here demonstrate the clinical and radiographic features of R equi lung abscess. The first patient was on long-term corticosteroid therapy for rheumatoid arthritis. The second patient had AIDS. The correct diagnosis in both cases was delayed because acid-fast bacilli seen on smears of sputum were presumed to be Mycobacterium tuberculosis.

Actinomycetales Infections↗
PubMed1991

Panlobular emphysema in young intravenous Ritalin abusers.

We studied a distinctive group of young intravenous Ritalin abusers with profound obstructive lung disease. Clinically, they seemed to have severe emphysema, but the pathologic basis of their symptoms had not been investigated previously. Seven patients have died and been autopsied: in four, the lungs were fixed, inflated, dried, and examined in detail radiologically, grossly, microscopically, and by electron probe X-ray microanalysis. All seven patients had severe panlobular (panacinar) emphysema that tended to be more severe in the lower lung zones and that was associated with microscopic talc granulomas. Vascular involvement by talc granulomas was variable, but significant interstitial fibrosis was not present. Five patients were tested for alpha-1-antitrypsin deficiency and found to be normal, as were six similar living patients. These findings indicate that some intravenous drug abusers develop emphysema that clinically, radiologically, and pathologically resembles that caused by alpha-1-antitrypsin deficiency but which must have a different pathogenesis. Talc from the Ritalin tablets may be important, but the mechanism remains to be elucidated.

Adult↗
PubMed1991

The extrapleural fat in empyema: CT appearance.

Pleural empyema can be accompanied by changes in the adjacent chest wall. We examined the chest wall on computed tomographic scans in 24 patients with pleural effusions. Eighteen patients had pleural empyema and six had transudative effusions. Of the 18 empyema patients, 13 had abnormally high attenuation in the extrapleural tissues. In 12 of these 13, the high attenuation was probably caused by reaction to the pleural infection. In two, it was probably caused by haematoma (one patient had haematoma and empyema). In five patients there was either no clear abnormality in the extrapleural space or an insufficient amount of fat to permit detection of an abnormality, or the parietal pleura could not be distinguished from the pleural fluid because intravenous contrast medium was not given. Of the six patients with proven transudative pleural effusions, all had extrapleural fat which appeared normal. Abnormally high attenuation in the extrapleural tissues can be expected to accompany exudative pleural effusion, particularly empyema, but not transudative effusion.

Adipose Tissue↗
PubMed1991

Computed tomography of air-space disease.

Although computed tomography (CT) has not been used as often in air-space diseases as in interstitial ones, it often provides useful information. Diseases such as early opportunistic pneumonia may be detected by CT before becoming visible on plain radiographs. Also, extent and location are often better defined by CT than by plain radiographs. Accompanying abnormalities such as abscess, lymphadenopathy, and pleural effusion are often clearly demonstrated by CT. This article reviews the CT findings in a variety of air-space diseases, including pneumonia and other infections, radiation pneumonitis and fibrosis, embolism, eosinophilic pneumonia, alveolar proteinosis, bronchioloalveolar carcinoma, lipoid pneumonitis, sarcoidosis, and trauma.

Air↗
PubMed1991

Radiographic changes in cardiac contours following heart transplantation. Clarification by MR imaging.

Chest radiographs of 46 patients who had undergone heart transplantation were reviewed with special attention to abnormalities of the cardiac contours. MR imaging in 3 such patients revealed 3 types of double right cardiac contours: the recipient right atrium combined with the donor right atrium; the donor right atrium combined with the recipient left atrium; and a cardiac fat pad combined with the right atrium. A prominent main pulmonary artery was shown by MR imaging to result from leftward displacement of the main pulmonary artery caused by clockwise rotation and transverse position of the transplanted heart. Recognition of these unique radiographic appearances is of value in assessing transplanted hearts and in avoiding misdiagnosis.

Adolescent↗
PubMed1990

Preliminary experience with portable digital imaging for intensive care radiography.

A digital radiography system based on reusable, photostimulable phosphor technology was evaluated in approximately 3,500 portable chest radiographs of patients in an intensive care unit. The system functioned well in this application. No major problems were encountered in the visualization of tubes or catheters or in the detection of pneumothoraces. Assessment of fluid volume status or the presence of small pleural effusions, especially when these were bilateral, was initially somewhat difficult but became easier as investigators became familiar with the system. Radiologists were quicker than nonradiologists to accept the minimized two-on-one display format. Critical evaluation of the overall performance of digital systems such as this one is needed for a better definition of the system's strengths and weaknesses. Specifically, statistical analyses of the ability to detect disease states such as pneumothoraces, interstitial lung disease, lung nodules, and pleural abnormalities need to be performed.

Aged↗
PubMed1990

Conventional CT of the aorta.

The advent of CT has changed the way thoracic aortic aneurysms and dissections are evaluated. In many cases, CT is the only roentgenographic examination needed beyond plain radiograph. In evaluating aneurysm. CT's advantage over aortography is that it shows the wall and the mural thrombus, not just the contrast column. In some cases of aneurysm, however, particularly those arising near the aortic arch, aortography may be necessary to establish the precise location of the lesion with respect to the brachiocephalic arteries. In evaluating dissection, CT is less invasive and at least as accurate as aortography. As with aortography, the classic findings are contrast-filled multiple channels with intervening intimal flap(s). CT's particular advantage over aortography is that it permits diagnosis of dissection when blood in the false channel is clotted rather than free-flowing. In this case, the diagnosis can be made by demonstrating displaced intimal calcifications or the high-attenuation thrombus in the aortic wall or periaortic tissues. In cases of acute dissection for which emergency surgery is considered, however, aortography is preferred to CT because CT cannot provide information about aortic insufficiency or the condition of critical arterial branches such as the coronary, brachiocephalic, mesenteric, and renal arteries. In follow-up of treated aortic dissection CT is preferred over aortography because it is noninvasive and more informative. Compared with MRI, CT has the advantages of greater reliability and of compatibility with life-support apparatus. MRI is not able to depict calcification, so any displacement of calcification cannot be detected. MRI is most suitable for follow-up of treated patients or for acute patients who are stable or who cannot tolerate intravenous contrast agents. A flexible approach is essential in choosing the appropriate radiographic tests in the work-up of aortic dissection. In this article, a workable strategy is outlined, but the radiologist should not hesitate to change the order of tests or use a second test if results from one test are confusing or inconsistent with other clinical data.

Aortic Dissection↗
PubMed1990

Bronchopulmonary sequestration: CT assessment.

Computed tomographic (CT) scans of 24 bronchopulmonary sequestrations in 23 patients were reviewed. Seventeen sequestrations were diagnosed at surgery, three at angiography, and four on the basis of radiographic or CT findings combined with appropriate history. Sixteen sequestrations were intralobar, and eight were extralobar; 21 were posterobasal. Seventeen occurred on the left side and seven on the right. Anomalous systemic arterial supply was demonstrated by CT in 16 sequestrations. In the others, a systemic artery was not shown, presumably because of unfavorable orientation or small size of the vessel. The lung abnormalities shown by CT were classified into three types: A = cysts containing air or fluid (n = 8), or soft-tissue masses (n = 2); B = emphysematous lung surrounding cysts, and/or soft-tissue nodules (n = 13); and C = lung hypervascularity (n = 2). In only three cases did the chest radiograph show the emphysematous lung tissue. Such emphysematous lung has rarely before been reported as a CT finding, and lung hypervascularity has not, to the authors' knowledge, been reported. The authors conclude that CT can be helpful in the diagnosis and evaluation of bronchopulmonary sequestration. Characteristic manifestations are (a) a complex lesion containing solid or fluid components combined with emphysematous lung or (b) any basal lesion supplied by a systemic artery.

Adolescent↗
PubMed1990

CT appearance of the retroaortic anastomoses of the azygos system.

The terminations of the hemiazygos and accessory hemiazygos veins can be mistaken for normal or enlarged posterior mediastinal lymph nodes on CT scans of the chest. These terminations are termed the retroaortic anastomoses by anatomists. We studied the CT appearances of these veins on scans of one cadaver and seven patients. We found that the retroaortic anastomoses usually were clearly recognizable because of their continuity with the hemiazygos or accessory hemiazygos vein. However, it is sometimes possible to mistake these vessels for lymph nodes, especially when only short segments of the vessel are visible on a CT image or when the vessel is not clearly opacified by contrast material. Familiarity with the CT appearances of the hemiazygos and azygous veins can prevent their being mistaken for normal or enlarged lymph nodes.

Azygos Vein↗
PubMed1989

Adult respiratory distress syndrome from overdose of tricyclic antidepressants.

Adult respiratory distress syndrome (ARDS) from overdose of tricyclic antidepressants (TCA) has been reported but is not well known. During a 1-year period, 81 patients with serious overdose from tranquilizers and other psychotropic drugs were examined. TCA alone induced overdose in 30 patients or were combined with other drugs in 26 patients. Twenty-five (31%) patients had overdose from drugs other than TCA. Chest radiography revealed that 30 (54%) patients with TCA overdose and six (24%) patients with non-TCA overdose had abnormalities. Clinical and radiographic findings consistent with ARDS were noted in five (9%) patients with TCA overdose and none of the patients with non-TCA overdose. Five patients with TCA overdose and one (4%) patient with non-TCA overdose had interstitial edema that never progressed to ARDS. TCA should be added to the list of drugs associated with the development of ARDS.

Antidepressive Agents, Tricyclic↗
PubMed1989

Left azygos lobe.

Left azygos lobe is much rarer than right azygos lobe, but cases have been reported. Computed tomography proved more reliable than plain radiography in the diagnosis of left azygos lobe in a 10-year-old girl.

Azygos Vein↗
PubMed1989

Pulmonary histiocytosis X: comparison of radiographic and CT findings.

The authors retrospectively evaluated radiographs, computed tomographic (CT) scans, and results of pulmonary function tests (when available) for 17 patients with biopsy-proved pulmonary histiocytosis X. In 11 patients, high-resolution CT was used. In 12 patients, CT demonstrated cystic air spaces, usually less than 10 mm in diameter. In three of these 12, cysts were the only abnormality, but in six others, nodules (usually less than 5 mm in diameter) were also present. Two patients had only nodules and one, only emphysema. CT showed that many lesions that appeared reticular on plain radiographs were actually cysts. CT showed no central or peripheral concentration of lesions, but it did reveal that many small nodules were distributed in the centers of secondary lobules around small airways. CT findings correlated better with the diffusing capacity (rho = -0.71) than did the plain radiographic findings (rho = -0.57). Thus, CT was better than radiography at showing the morphology and distribution of lung abnormalities.

Adult↗