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Biomedical subjects

J F Healy

Publications and source records attributed to J F Healy.

At least 19 recordsLinked to original sources

Lack of clinically significant gross structural abnormalities in MRIs of older patients with schizophrenia and related psychoses.

The authors examined the reports of MRI brain studies of 69 patients with DSM-III-R-diagnosed psychotic disorders (30 early-onset and 24 late-onset schizophrenia patients and 15 with other psychoses) and 41 normal comparison subjects. Participants' ages ranged from 45 to 87 years. A qualitative rating scheme determined type and severity of clinically detectable abnormalities, including volume loss, infarcts, lacunae, and white matter hyperintensities. In this clinically well-characterized sample, the vast majority of the MRIs were within normal limits. There were no significant differences between psychosis patients and normal comparison subjects or between early-onset and late-onset schizophrenia patients in frequency, type, or severity of gross structural abnormalities. The results indicate that late-onset schizophrenia and related disorders can exist without clinically significant gross structural abnormalities in the brain.

Age of Onset

Metallic spinal artifacts in magnetic resonance imaging.

STUDY DESIGN: The magnetic resonance artifact susceptibility of traces of surgical aluminum, titanium, and stainless steel in a human spine model was investigated. Metallic filings were deposited in noncontiguous disc spaces in five human thoracic spines before magnetic resonance imaging with spin echo and gradient echo sequences. OBJECTIVES: Spin echo and gradient echo sequences were used for quantitate and compare void artifact produced by commonly used surgical metals. This was compared to a liquid paraffin control. SUMMARY OF BACKGROUND DATA: No significant susceptibility artifact was seen with any metal in all spin echo sequences, including T1 (TR 600, TE 12), T2 (TR 2000, TE 30), proton density (TR 2000, TE 80), and fast T2 scanning (TR 3800, TE 96, Ef). METHODS: Sagittal magnetic resonance imaging permitted void artifact quantification and comparison between different metallic alloys. Two neuroradiologists, working on a blinded basis, evaluated all data and rated the void susceptibility artifact on a scale of 1 (least) to 4 (greatest). RESULTS: In general, the magnitude of an imaging artifact during magnetic resonance imaging correlated with the magnetism of the metal. Nickel, found in a larger concentration in 316L than in 304 stainless steel, decreases the magnetic resonance artifact of specific metals because of its ability to stabilize iron in a non-magnetic state. Therefore, the 316L stainless steel yielded less artifact production than 304 stainless steel on gradient echo imaging. CONCLUSION: If upon gradient echo imaging in the postoperative period significant artifact production is noted, stainless steel deposition should be suspected as the causative agent. In this situation, spin echo techniques should be the first approach for attempting optimal visualization of the spinal cord and soft tissue structures.

Aged

MR detection of white matter disease of the brain in patients with HIV infection: fast spin-echo vs conventional spin-echo pulse sequences.

OBJECTIVE: Although fast spin-echo images and slower spin-echo images have similar contrast characteristics, the two techniques have not yet been shown to be equivalent in all aspects of brain imaging. To determine if the two sequences are equivalent, we compared detection of white matter lesions, image quality, and artifact degradation on fast spin-echo and spin-echo proton density-weighted and T2-weighted MR images of the brain in prospectively selected patients who were seropositive for HIV. SUBJECTS AND METHODS: Fast spin-echo and spin-echo MR images of the brain were obtained in 153 consecutive subjects. The images were reviewed independently by three experienced neuroradiologists. The size, number, and location of white matter lesions were compared for the two techniques. Image quality, motion artifact, CSF flow artifact, and gray-white matter differentiation were graded on a five-point scale. RESULTS: No statistical difference was found in gray-white matter differentiation. Overall image quality, CSF flow artifacts, and motion artifacts were slightly worse on the fast spin-echo images (p < .05). Although some variability existed in the detection of lesions less than 5 mm in diameter, the differences was small, and all larger lesions were detected by both techniques. Agreement between fast spin-echo and conventional spin-echo techniques was nearly exact with respect to characterizing findings in brain as either normal or abnormal. CONCLUSIONS: Fast spin-echo and spin-echo MR of the brain produce images of similar quality and show white matter lesions equally well. These results support the replacement of slower, conventional spin-echo pulse sequences with faster fast spin-echo sequences.

AIDS Dementia Complex

The false sulcus: an early sign of intracranial mass.

The importance of asymmetry of the cerebral sulci in detecting intracranial mass lesions in the hemisphere where the mass compresses the sulci has been emphasized. Occasionally, the hemisphere that appears to have the large sulci is, in fact, the abnormal side. The apparent large sulci representing early white matter edema are often the earliest computed tomography manifestation of an intracranial mass.

Adult

Computed tomographic evaluation of metatases to the orbit.

The computed tomographic (CT) findings in 22 patients with metastases to the orbit were evaluated. All the metastases appeared to be unilateral on CT. Sixty-eight percent of the patients showed evidence of aggressive adjacent bone destruction. Sixty-eight percent of the patients had intracranial metastatic disease, 46% had direct intracranial extension of the tumor, and 23% had CT evidence of separate intracranial metastases. Fifty-nine percent of the orbital metastases were extraconal, 19% were intraconal, and 19% were both intraconal and extraconal; one case of metastases to the globe was detected. All 13 patients examined before and after contrast showed evidence of enhancement.

Adult

Computed tomography of orbital trauma.

Ten cases of trauma to the orbit and orbital region are presented to illustrate the efficacy of computed tomography in the radiologic evaluation of these injuries. CT was able to detect subarachnoid hemorrhage, retrobulbar hematoma, orbital cellulitis, foreign bodies, intraglobal and intraorbital air, dislocated lens, blowout, and tripod fractures in these patients.

Adolescent

Renal devitalization using 95 per cent ethyl alcohol.

Preoperative embolization of renal arteries with solid material before nephrectomy is a standard procedure for the treatment of renal cell carcinoma. However, it often is difficult to use these materials and sometimes special equipment is required. We have used 95 per cent ethyl alcohol in 3 patients to devitalize kidneys with tumors. Our results show 95 per cent ethyl alcohol to be safe, effective and easy to use. When combined with epidural anesthesia alcohol embolization is well tolerated by the patient, and its destructive effect is complete and limited to the selected organ.

Embolization, Therapeutic

Postembolic colonic infarction.

From a total of 23 cases from five hospitals, acute colonic mucosal necrosis developed in three patients following transcatheter embolotherapy for colonic hemorrhage. Although embolic therapy for lower gastrointestinal bleeding is associated with appreciable risk, these risks are less than those of emergency operation for hemorrhage. The alternative transcatheter therapeutic modality, vasopressin infusion, is often associated with continued or recurrent hemorrhage, is relatively contraindicated in patients with coronary disease, and produces numerous complications. Transcatheter embolotherapy is recommended for patients with colonic bleeding who have a contraindication to vasopressin administration, who are refractory to vasopressin, or who rebleed following treatment with vasopressin.

Aged

Computed tomographic illustration of cavum vergae.

This paper presents 3 examples of cavum vergae, a normal variant in cranial computed tomography (CCT) and pneumoencephalography. The CCT appearance of cavum vergae is illustrated in both axial and coronal planes, and the means of distinguishing cavum vergae from cavum velum interpositum and cystic lesions of the third ventricle by reference to normal anatomical landmarks is discussed.

Cerebral Ventriculography