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Biomedical subjects

K A Miles

Publications and source records attributed to K A Miles.

18 recordsLinked to original sources
PubMed1992

Degenerative disc disease in the lumbar spine: another cause for focally reduced activity on marrow scintigraphy.

A patient is presented in whom a focal reduction in marrow activity in the lumbar spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently shown to be due to fatty infiltration of marrow in association with disc degeneration. Degenerative disease in the lumbar spine has not been previously described as a cause of abnormal bone marrow distribution by such means and needs to distinguished from a more serious pathology, such as malignant infiltration and vertebral infection, which it may mimic. In a retrospective review of 33 nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of reduced marrow activity in the lumbar spine consistent with that caused by degenerative changes.

Adult↗
PubMed1992

Scintigraphic abnormalities in patients with painful hip replacements treated conservatively.

A retrospective review of the scintigraphic appearances of 98 painful hip replacements was made. 16 patients (16%) underwent revision surgery whereas in the remaining 82 hips (84%), symptoms settled with conservative management. 73 of these (89%) had at least one area of increased activity on delayed diphosphonate scintigraphy with 27% having increased activity in three or more areas around the femoral component. Hips with increased activity at the lesser trochanter and tip were less likely to undergo spontaneous resolution of symptoms. Uncemented prostheses were more likely to have multiple areas of increased activity. Abnormalities in dynamic bone scintigraphy and gallium studies were also seen in patients whose symptoms resolved without surgery. Whereas a normal bone scintigram indicates that loosening or infection is most unlikely, the presence of increased activity does not necessarily indicate a need for revision surgery, even when multiple areas are present. A period of conservative management should be considered before operative intervention is undertaken.

Diphosphonates↗
PubMed1992

Leg muscle scintigraphy with 99Tcm-MIBI in the assessment of peripheral vascular (arterial) disease.

A technique for using 99Tcm-methoxyisobutylisonitrile (MIBI) to evaluate leg muscle perfusion in the assessment of peripheral vascular disease (PVD) is described and evaluated. The uptake of MIBI in muscle groups is quantified and normalized to whole body activity. Eleven patients with PVD undergoing angiography and nine controls were studied. There was a significant difference in MIBI uptake in the calf (P less than 0.000 01) and thigh (P less than 0.0001) between the two groups on exercise. The technique has a sensitivity of 91% and specificity of 94% for the diagnosis of PVD. The technique can also effectively evauate the severity of disease as shown by significant correlations between exercise calf flow and angiographic severity (P less than 0.05) and Doppler ankle/arm pressure measurements (P less than 0.0005). Single photon emission tomography (SPET) of the calves was also performed in five controls and five patients with PVD. Uptake was significantly reduced in all muscle areas in patients with PVD and, amongst those with PVD, uptake was lower in muscle groups by occluded arteries. The potential role of 99Tcm-MIBI in the assessment of PVD and its advantages over other methods of assessment are discussed.

Aged↗
PubMed1991

Colour perfusion imaging: a new application of computed tomography.

We describe a new application for imaging with computed tomography (CT) in which a quantifiable map of tissue perfusion is created and displayed by means of a colour scale. A rapid sequence of images is acquired without table movement immediately after a bolus intravenous injection of radiographic contrast medium. The rate of enhancement in each pixel within the chosen slice can then be used to determine perfusion. The technique provides a quantifiable display of regional perfusion combined with the high spatial resolution afforded by CT.

Color↗
PubMed1991

Measurement of tissue perfusion by dynamic computed tomography.

A method for quantifying tissue perfusion by dynamic computed tomography (CT) is described. By applying a nuclear medicine data processing technique to time-density data from a single-location dynamic CT sequence, tissue perfusion can be determined from the maximum gradient of the tissue time-density curve divided by the peak enhancement of the aorta. Using this method, splenic perfusion was measured at 1.2 ml min-1 ml-1, normal renal cortical perfusion at 2.5 ml min-1 ml-1 and normal renal medullary perfusion at 1.1 ml min-1 ml-1. Changes in cortical and medullary perfusion in renal failure and hypertension were demonstrated. The ability of dynamic CT to provide quantitative functional information is not well recognized and is potentially of value when studying structures, such as the renal cortex and medulla, that cannot be anatomically resolved by standard functional imaging techniques.

Contrast Media↗
PubMed1990

Percutaneous transluminal angioplasty of occlusions of the femoral and popliteal arteries by subintimal dissection.

A technique for recanalization of femoral and popliteal arterial occlusions by intentional subintimal dissection is described. Recanalization with this technique was attempted in 71 occlusions of the femoro-popliteal segment with a mean length of 11.4 cm. Primary technical success was achieved in 54 (76%) cases, with complications occurring in 4 (5.6%). Of 44 successful cases reviewed at a mean follow up of 6 months, 37 (84%) were either asymptomatic or improved. The technique has proved to be an effective method of treating occlusions of the femoral and popliteal arteries with an acceptable complication rate. It may allow successful angioplasty where the standard intraluminal method fails, particularly when reconstructive surgery is the only option.

Aged↗
PubMed1990

Staging of renal cell carcinoma by dynamic computed tomography: a prospective comparison of two techniques.

Two dynamic computed tomographic methods used for staging renal carcinoma in 46 patients are described and compared. Twenty-eight patients were examined using an infusion technique during incremental dynamic scanning across the kidneys with contrast administered via an arm vein. Eighteen patients were staged using a technique comprising a single location dynamic scan sequence at the level of the renal hilum followed by an incremental sequence during an infusion of contrast into the femoral vein. When compared with overall pathological staging, the arm vein infusion technique correctly staged 20 patients (72%) with four patients (14%) understaged and four (14%) overstaged. The femoral vein infusion and single location dynamic scanning technique correctly staged 11 (61%) patients with three (17%) overstaged and four (22%) understaged. The femoral vein infusion with single location scanning was more accurate in demonstrating tumour involvement of the renal vein (83.3% correct vs. 78.6%), inferior vena cava (94.4% correct vs. 89.3%) and lymph nodes (88.9% correct vs. 78.6%) but was less accurate in assessing extracapsular spread (77.8% correct vs. 96.4%). The additional information obtained from the single location dynamic sequence is sufficiently valuable for this part of the second technique to be used in any scanning protocol for staging renal carcinoma.

Carcinoma, Renal Cell↗
PubMed1989

PET scanning.

Explore the source record for details and available documents.

Humans↗
PubMed1989

Disruption of the radiocapitellar line in the normal elbow.

Disruption of the radiocapitellar line (RCL) can be a useful sign in injured elbows in children. Although originally described only in the true lateral projection, it has become generally accepted to apply the sign to any radiographic projection. However, it is not clear how to draw the line in the anteroposterior projection when there is prominent bowing of the radial shaft. Five cases are presented where the RCL, when drawn on radiographs of uninjured elbows, either did not pass through the capitellum (one case) or only passed tangential to it (four cases). In these cases, the elbow was not in the standard anteroposterior or lateral position. Radiologists and clinicians involved in trauma should be aware that radiographic positioning and normal bowing of the radial shaft can affect the validity of this sign and that it is best applied only to the true lateral projection as originally described.

Child, Preschool↗
PubMed1989

Ultrasonic demonstration of the elbow fat pads.

Elevation of the fat pads around the elbow joint is a well recognised radiological sign of a joint effusion which may be due to trauma or other inflammatory process. There are occasions when plain radiographs fail to demonstrate this sign. A case is reported in which elevation of the posterior fat pad and an elbow joint effusion were demonstrated ultrasonically. Comparative ultrasound examination of the normal elbow in this patient and examination of 40 normal elbows, in adults and children, consistently demonstrated the normal anterior and posterior fat pads except in one patient aged 4 days where the fat pads could not be clearly seen. The normal ultrasonic appearances are described. Ultrasound examination may be useful in patients where plain radiographs have failed to demonstrate the position of the fat pads.

Adipose Tissue↗
PubMed1988

The incidence and prognostic significance of radiological abnormalities in soft tissue injuries to the cervical spine.

The radiographs and initial clinical findings of 73 patients who had sustained trauma to the cervical spine without bony injury in vehicle collisions were reviewed. The patients were also re-examined clinically two years after the injury. Forty eight (65.8%) had abnormal radiographs at presentation--prevertebral soft tissue swelling in 15 (20.6%), degenerative changes in 15 (20.6%), and an angular deformity between two adjacent vertebral bodies in 27 (37.0%). Prevertebral soft tissue swelling was found to have no significance with respect to clinical outcome and showed no association with the presence of an angular deformity. Degenerative changes are associated with a poor prognosis. The presence of an angular deformity was found to carry a good prognosis in this group of patients. The exact mode of injury is not associated with any specific radiographic appearance except that "roll overs" and side collisions are more likely to cause angulation in the cervical spine.

Adult↗
PubMed1988

Is prevertebral soft tissue swelling a useful sign in injury of the cervical spine?

A group of 58 patients with suspected injuries of the cervical spine were reviewed retrospectively. Prevertebral soft tissue swelling occurred in 20 (49 per cent) of 41 patients with definite bone injury. Soft tissue swelling occurred significantly more frequently with injuries to the anterior portion of the cervical spine than to the posterior vertebral elements. No significant correlation was found between soft tissue swelling and level of injury and age of the patient. Out of 17 patients with cervical injuries, 4 (24 per cent) who were subsequently considered not to have sustained bony injury demonstrated apparent soft tissue swelling. The absence of soft tissue swelling should not be considered as evidence for no bony injury. Its presence does not necessarily indicate bony injury.

Adolescent↗
PubMedDate not supplied

CT staging of renal carcinoma: a prospective comparison of three dynamic computed tomography techniques.

Three dynamic computed tomographic methods used for staging of renal carcinoma in 70 patients are described and compared. Twenty-eight patients were examined using incremental dynamic scanning across the kidneys whilst infusing contrast via an arm vein (technique 1). Eighteen patients were staged using a single location dynamic scan sequence at the level of the renal hilum followed by an incremental sequence during an infusion of contrast into the femoral vein (technique 2). Twenty-four patients were examined using a single location sequence at the level of the renal veins and a rapid bolus incremental dynamic technique (technique 3). Technique 1 correctly staged 20 patients (72%) with 4 patients (14%) understaged and 4 (14%) overstaged, technique 2 correctly staged 11 (61%) patients with 3 (17%) overstaged and 4 (22%) understaged and technique 3 staged 17 (71%) correctly with 3 (13%) understaged and 4 (17%) overstaged. The techniques using single location scanning were more accurate in demonstrating tumour involvement of the renal vein and inferior vena cava but were less accurate in assessing extracapsular spread. Technique 3 was the most accurate in the diagnosis of lymph-node involvement. As accurate pre-operative knowledge of vascular involvement by tumour is more important to the surgeon than the presence of extracapsular spread, the combined single location and incremental scan technique is advocated.

Carcinoma, Renal Cell↗