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Biomedical subjects

J E Kuhlman

Publications and source records attributed to J E Kuhlman.

At least 19 recordsLinked to original sources
PubMed1992

Phantom for use in lung biopsy training.

A phantom to assist in the teaching of fluoroscopically guided transthoracic needle biopsy of pulmonary lesions was designed. The phantom was constructed of an aluminum and rubber skeleton, wood hemidiaphragms and heart, and foam rubber lungs and was covered with foam rubber. Modeling clay was used to simulate lesions. The authors believe the phantom is of value in helping increase the confidence and proficiency of the radiologist during the first few biopsy procedures with an actual patient.

Biopsy, Needle↗
PubMed1992

Spiral CT of the pancreas with multiplanar display.

This essay illustrates the findings obtained with spiral CT imaging in pancreatic disease. Features of spiral CT--fast scanning, dynamic injection of contrast material allowing optimal vessel opacification, and supplemental multiplanar imaging--promise to provide increased accuracy in the diagnosis and staging of pancreatic disease. With further development of continuous (spiral/helical) scanning technology, this technology should expand to cover a wider range of applications.

Adolescent↗
PubMed1991

Pulmonary Aspergillus chest wall involvement in chronic granulomatous disease: CT and MRI findings.

Pulmonary Aspergillus infection in patients with chronic granulomatous disease tends to involve the chest wall and consequently carries a high mortality rate. We report the findings of computed tomography (CT) and magnetic resonance imaging (MRI) in three such cases. One patient underwent both CT and MRI, one, CT only, and one, MRI only. In all three, both CT and MRI demonstrated pulmonary consolidations with direct extension to the adjacent chest wall. In both patients who were examined by CT, scans revealed permeative osteolytic changes of adjacent rib or spine compatible with osteomyelitis. In both patients who were examined by MRI, adjacent chest wall involvement was depicted on T1-weighted images and showed increased signal intensity on T2-weighted images. In one of these patients, the chest wall lesion was well defined on T2-weighted images, an appearance compatible with abscess. Epidural extension was demonstrated on MRI in the other patient, who later developed paraparesis. We suggest that CT and MRI have a complementary role in evaluating chest wall invasion by pulmonary Aspergillus infection in chronic granulomatous disease.

Adolescent↗
PubMed1991

Three-dimensional imaging of the lung in vivo: work in progress.

It has previously been demonstrated that three-dimensional (3D) displays of the lung and bronchial tree can be generated from computed tomography (CT) scans of lung specimens. Subsequent refinement of the reconstruction algorithms has allowed high-resolution reconstructions of lungs in vivo. With the introduction of low-dose CT scan protocols, use of the technique may become more common in the radiologic community. The many potential clinical applications for 3D imaging of the lung include an aid to bronchoscopy and improved surgical planning. We present the technical details for 3D imaging of the lungs in vivo as well as three representative case studies.

Adult↗
PubMed1991

Data base management in radiology: a simplified approach.

The increasing availability of personal and departmental computers in radiology departments has led to increasing interest in data management. Data base management software must be system compatible, simple, and flexible to insure its acceptance and constant use. Once in place, such a system streamlines the daily documentation of interesting cases for conference, follow-up, research, and quality assurance. The authors have developed such a data base program for tracking computed body tomography cases in their department, which can be run as a portable computer to maximize ease of access and therefore usage.

Database Management Systems↗
PubMed1991

The role of chest computed tomography in the diagnosis of drug-related reactions.

Computed tomography (CT) of the chest provides important information toward the diagnosis of drug-induced lung disease. CT's ability to demonstrate subtle parenchymal and pleural changes, small nodules, and adenopathy is valuable in the early detection of drug-related reactions. CT is also of value in monitoring the appearance, progression, and resolution of pulmonary damage in patients receiving potentially toxic drugs. The CT appearances of specific drug reactions are reviewed, including the spectrum of CT findings in bleomycin toxicity and amiodarone-induced lung disease.

Amiodarone↗
PubMed1991

CT and anatomic study of postcatheterization hematomas.

The appearance of hematomas resulting from transfemoral catheterization as depicted with computed tomography (CT) has been infrequently reported. The authors devised a system for classifying the CT appearance of such iatrogenic hematomas that is based on the anatomic location and route of bleeding. There are four different types of hematomas: retroperitoneal, intraperitoneal, groin and thigh, and abdominal wall. Bleeding spreads along the fascial planes, and the type of hematoma probably depends on whether the bleeding is confined to the femoral sheath or spreads into the femoral triangle. Recognition of the different types is essential as they may have different clinical implications.

Abdominal Muscles↗
PubMed1991

Retroperitoneal and pelvic CT of patients with AIDS: primary and secondary involvement of the genitourinary tract.

Although genitourinary tract disorders are common in acquired immunodeficiency syndrome (AIDS), little attention has been paid to their manifestations on computed tomographic (CT) scans. The authors reviewed the CT scans of 86 patients infected with the human immunodeficiency virus for CT manifestations of primary or secondary involvement of the genitourinary tract. Genitourinary tract abnormalities identified in the 86 patients included nephromegaly in 34 (40%), hilar adenopathy in 30 (35%), bladder wall thickening in 19 (22%), medullary hyperattenuation in 12 (14%), renal calcifications in seven (8%), adnexal masses in five (6%), hydronephrosis in four (5%), pyelonephritis in three (3%), renal abscesses in three (3%), and solid renal masses in three (3%). Although these abnormalities are seen on CT scans in many other diseases, in the AIDS patient they often indicate the presence of an AIDS-related renal disease or involvement of the genitourinary tract by an AIDS-related neoplasm or infection.

AIDS-Associated Nephropathy↗
PubMed1991

Complications of radiation therapy: CT evaluation.

Radiation therapy is an important technique for treating cancer. In the evaluation of the results of radiation therapy with computed tomography (CT), radiation-induced injuries to normal tissues are often detected. Common complications include pneumonitis, calcified lymph nodes, gastric ulceration, enteritis, hepatitis, cystitis, nephritis, osteitis, and insufficiency fractures. Rare complications include spontaneous pneumothorax, thymic cysts, vascular calcifications, and osseous sarcomas. Radiation-induced injury can usually be diagnosed from characteristic CT appearances and knowledge of the radiation port, radiation dose, and time interval since therapy. CT findings that cannot be explained on the basis of radiation therapy or that are suggestive of recurrent disease must be further evaluated.

Adult↗
PubMed1991

CT of lymphoma: spectrum of disease.

Computed tomography (CT) is the study of choice for the detection and staging of Hodgkin and non-Hodgkin lymphoma. CT enables accurate measurement of both tumor extent and volume and provides information that can be used to plan an appropriate therapeutic regimen as well as follow patient response to therapy. This article presents a systematic review of the common and uncommon appearances of lymphoma in the chest and abdomen. Potential pitfalls and limitations of CT in staging and follow-up are also addressed.

Hodgkin Disease↗
PubMed1991

CT of posterior mediastinal masses.

This article presents an algorithmic approach to the evaluation of posterior mediastinal masses seen with computed tomography (CT). CT remains the study of choice, since it not only can be used to help confirm the presence of these masses, but it also helps define the (a) location and extent of the lesion, (b) adjacent organ involvement, or (c) vascular involvement. Causes of posterior mediastinal masses include esophageal lesions, congenital or acquired vascular lesions, foregut cysts, intrathoracic goiters, mediastinal pseudocysts, fat-containing tumors, adenopathy, neurogenic tumors, infectious spondylitis, and vertebral tumors. From the CT appearance of the lesion, one can often distinguish among the various masses and identify their origin and cause. This information enables patient triage and therapy to be expedited and, in most cases of posterior mediastinal masses, allows a correct diagnosis to be made solely on the basis of the CT examination.

Blood Vessels↗
PubMed1991

Pulmonary atelectasis: signal patterns with MR imaging.

To assess the signal characteristics of different types of pulmonary atelectasis on magnetic resonance (MR) images, the authors studied obstructive atelectasis (OA) in 17 patients and nonobstructive atelectasis (NOA) in 25 patients. All patients underwent electrocardiographically gated MR imaging studies of the thorax with standard spin-echo sequences. No signal differences were observed between either type of atelectasis on T1-weighted images. Conversely, OA and NOA appeared significantly different on spin-density-weighted images (P less than .001) and on T2-weighted studies (P less than .0001). On T2-weighted images, all 17 cases of OA appeared hyperintense, whereas 22 of 25 cases of NOA demonstrated a very low signal intensity. Differences in the pathophysiology of OA and NOA presumably account for this observation. In OA, alveolar air is totally resorbed and secretions accumulate in the obstructed lung. The resulting increase in free fluid prolongs the T2 relaxation times and leads to high signal intensity on T2-weighted images. In NOA, the short T2 relaxation time of lung tissue in the absence of secretions and potential magnetic susceptibility effects due to residual air are likely to be responsible for the low T2 signal pattern.

Electrocardiography↗
PubMed1991

Diffuse esophageal leiomyomatosis in a patient with Alport syndrome: CT demonstration.

In a patient with progressive dysphagia, postprandial vomiting, and a history of Alport syndrome, barium and manometric studies had been interpreted as consistent with achalasia, but a subsequent computed tomographic (CT) scan of the thorax was suggestive of a lower esophageal intramural mass. Multiple leiomyomas of the esophagus were later proved at thoracotomy. Differences between adult and pediatric leiomyomas and the association of leiomyomas with Alport syndrome are discussed.

Adolescent↗
PubMed1991

Pseudomembranous colitis: CT evaluation of 26 cases.

Pseudomembranous colitis (PMC) is an infectious colitis usually occurring as a complication of antibiotic use. The computed tomographic (CT) appearances of 26 patients with PMC were reviewed. Twenty-three patients demonstrated an abnormal bowel wall, with an average wall thickness of 14.7 mm (range, 3-32 mm); in three patients, bowel wall thickness was normal. Contrast material trapped between thickened folds corresponded to the broad transverse bands described on plain radiographs. Pancolonic involvement was seen in 13 cases, while seven patients had right-sided involvement only; three patients had bowel wall thickening limited to the rectosigmoid only. Although the CT appearance of PMC is not highly specific, the diagnosis may be suggested in the proper clinical setting.

Adolescent↗
PubMed1991

Focal pulmonary lesions in patients with AIDS: percutaneous transthoracic needle biopsy.

The authors performed percutaneous transthoracic needle biopsy (PTNB) in 13 patients with acquired immunodeficiency syndrome (AIDS) and previously undiagnosed focal pulmonary lesions. Findings with PTNB were diagnostic in 11 of 13 cases. Complications included minimal hemoptysis in one case and small pneumothoraxes in two cases, one of which required chest tube drainage. The authors did not experience the high complication rate reported previously by some authors who used this diagnostic procedure in AIDS patients. In cases in which findings at fiberoptic bronchoscopy with transbronchial biopsy and lavage failed to provide a diagnosis, PTNB provided a reliable, relatively safe diagnostic tool to establish the cause of pulmonary masses or focal infiltrates in AIDS patients.

Acquired Immunodeficiency Syndrome↗