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Biomedical subjects

L P Harter

Publications and source records attributed to L P Harter.

12 recordsLinked to original sources
PubMed1997

Intraosseous venous drainage anomaly in patients with pretibial varices: imaging findings.

PURPOSE: To determine a set of distinctive imaging findings seen in symptomatic patients with pretibial varices. MATERIALS AND METHODS: Medical records and imaging studies of patients who presented with pretibial varices over an 8-year period were collected from four institutions. Findings in six symptomatic patients with pretibial varices were retrospectively reviewed. Radiographic and magnetic resonance (MR) imaging findings were available from all six patients; findings from several other modalities were also available in some patients. RESULTS: Conventional radiographs showed a small osteolytic defect in the anterior cortex of the midtibia and a prominent, longitudinally oriented, radiolucent groove in the proximal half of the tibial diaphysis. MR images showed pretibial varices connected to an enlarged vessel in the tibia that eventually exited through the nutrient foramen. Computed tomographic (three patients), sonographic (four patients), venographic (four patients), arteriographic (two patients), and surgical (three patients) findings demonstrated that these patients had an unusual intraosseous varix that traversed the anterior cortex, medullary cavity, and posterior cortex of the tibia. CONCLUSION: Recognition of these findings can prevent misdiagnosis and may prove helpful in the planning of appropriate treatment.

Adolescent↗
PubMed1992

Malignant seeding of the needle track during stereotaxic core needle breast biopsy.

Early reports demonstrated the diagnostic advantage of large-core (14-gauge) biopsy over fine-needle aspiration biopsy of nonpalpable lesions of the breast without apparent significant increase in morbidity. A case of malignant seeding of the needle track after a large-core biopsy of a mucinous carcinoma of the breast is documented. The potential for increased risk of tract seeding of malignancy must be considered.

Adenocarcinoma, Mucinous↗
PubMed1989

Bone abnormalities of the knee: prevalence and significance at MR imaging.

Focal abnormal signal intensity within the distal femoral condyles or proximal tibial plateaus is frequently seen on T1- or intermediate-weighted magnetic resonance (MR) images of the knee. To characterize the prevalence and significance of these findings better, a retrospective study of MR imaging of the knee, performed on the first 434 consecutive patients at a primarily outpatient community MR imaging center, was undertaken. A signal intensity loss demonstrated on images with a short echo time (20 or 25 msec) was divided into three types based on morphologic criteria. A type 1 finding was a diffuse, often reticulated signal intensity loss in the metaphyseal and epiphyseal regions of bone. A type 2 loss was associated with an interruption in the smooth, black cortical line. A type 3 finding was a profound signal intensity loss primarily restricted to the immediate subcortical region. Seventeen percent of all cases revealed a type 1 or 2 loss that may have been compatible with acute bone injuries. These bone lesions were frequently associated with tears of the anterior cruciate ligament and contralateral collateral ligament, but infrequently these lesions were detected with plain radiography and arthroscopy. When associated with a weight-bearing cortex, bone injuries detected with MR imaging may explain clinical symptoms of pain on weight bearing, and type 1 injuries may represent regions of bone at increased risk for the subsequent development of insufficiency fractures if the bone is not adequately protected during trabecular healing.

Adolescent↗
PubMed1983

CT demonstration and guided aspiration of unusual adrenal metastases.

Certain malignant neoplasms commonly metastasize to the adrenal glands, whereas others do so only infrequently. In the latter circumstance, an adrenal mass is likely to be benign. We report 3 patients with malignant neoplasms (hepatoma, transitional cell carcinoma of the bladder, and squamous cell carcinoma of the vulva) that do not commonly metastasize to the adrenals in whom computed tomographic (CT) demonstration and guided aspiration of adrenal masses significantly affected patient management. CT guided aspiration of adrenal masses is safe and accurate and is recommended whenever a diagnosis of adrenal metastasis would alter the staging or therapy of the primary neoplasm.

Adrenal Gland Neoplasms↗
PubMed1983

Ultrasonic evaluation of common bile duct stones: prospective comparison with endoscopic retrograde cholangiopancreatography.

Ultrasound is the modality of choice for the diagnosis of cholelithiasis and for the evaluation of the intra- and extrahepatic biliary tree in the patient with jaundice, but its role in the diagnosis of choledocholithiasis is less certain. We prospectively examined 90 patients who were to undergo endoscopic retrograde cholangiopancreatography (ERCP) by performing right upper quadrant sonography immediately prior to ERCP. We assessed the size of the intra- and extrahepatic ducts and the presence or absence of calculi. ERCP, which was successfully performed in 77 of 94 attempted examinations, percutaneous transhepatic cholangiography, or surgical follow-up composed the diagnostic standard for comparison. Ultrasound was not accurate in the diagnosis (sensitivity, 25%) or exclusion (value of a negative study, 73%) of choledocholithiasis. Furthermore, in the postcholecystectomy patient population, ultrasound assessment of biliary duct size is not a useful predictor of biliary disease. For symptomatic postcholecystectomy patients, we recommend ERCP as the initial diagnostic modality.

Bile Duct Diseases↗
PubMed1983

CT-guided fine-needle aspirations for diagnosis of benign and malignant disease.

In 133 consecutive patients, 149 diagnostic fine-needle aspirations were performed in order to diagnose a suspected neoplastic or infectious disease. Most of these procedures were performed on, but not limited to, the pancreas (37), liver (28), lung (28), other intraabdominal sites (25), and retroperitoneum (15). The overall accuracy for both suspected malignant and infectious diseases was 90%. An increase in sampling accuracy was demonstrated when there was immediate evaluation of the aspirated material by a cytopathologist using a "fast" stain technique.

Biopsy, Needle↗
PubMed1982

CT-guided aspiration biopsy of the thorax.

Percutaneous needle aspiration biopsy of thoracic lesions was performed under the guidance of computed tomography (CT) in 28 patients. The lesions chosen for CT guidance of needle placement were those not amenable to demonstration by biplane fluoroscopy: lesions in or adjacent to the mediastinum or hila; peripheral lesions; and small or ill-defined lesions, such as cavitary masses. The accuracy of the technique was assessed on the basis of pathological and radiographic confirmation of the cytologic diagnoses. The sensitivity of the technique was 84% (16/19), the specificity was 100% (6/6), and the overall accuracy was 88% (22/25). Inadequate specimens were obtained in two patients, and another patient could not complete the procedure. Pneumothorax, which developed in 17 patients, was remedied by intercostal tube drainage in three. There was one mild episode of hemoptysis, which resolved spontaneously. We recommended that CT-guided aspiration biopsy of thoracic lesions be used when the type, size, or position of the lesion makes fluoroscopic guidance of the needle unreliable.

Biopsy, Needle↗
PubMed1982

Disproportionate left hepatic lobe size in the fetus: ultrasonic demonstration.

The lateral segment of the left lobe of the liver is a useful window for abdominal sonography. An autopsy series suggested relative enlargement of the left lobe in infants and fetuses. The authors evaluated the relative size of the lateral segment of the fetal left lobe (L) compared with the remainder of the liver (R) in 89 obstetric ultrasonograms; the mean ratio L:R was 1.04. The same ratio was determined for 50 adults undergoing abdominal computed tomography, and the mean L:R was 0.76, which differs significantly from that in the fetus (P < 0.001). Normal values for L:R in fetuses and in adults may be useful in detecting a variety of hepatic diseases and possibly intrauterine growth retardation.

Adult↗
PubMed1982

Inability of relative fetal hepatic lobar size to diagnose intrauterine growth retardation.

It has been demonstrated by autopsy and by ultrasonography that the fetal left hepatic lobe is proportionately larger than that in the adult, probably because of increased supply of oxygenated blood from the umbilical vein. Intrauterine growth retardation (IUGR) is associated with impairment of the fetal blood supply, and might affect the left lobe disproportionately. The authors evaluated the relative size of the lateral segment of the fetal left lobe (L) compared with the remainder of the liver (R) in 88 obstetrical sonograms from 53 patients with IUGR. There was no statistically significant difference in the mean ratio of L/R between normal and IUGR fetuses. There was also no evidence of decreasing L/R in IUGR fetuses with serial examinations. The L/R ratio does not discriminate between normal fetuses and those with IUGR.

Adult↗
PubMed1982

Ultrasonic evaluation of abdominal aortic thrombus.

Ultrasonograms of 38 patients and computed tomograms of 21 patients with abdominal aortic aneurysms (AAA) were retrospectively reviewed. In 69 per cent of cases in which intraluminal thrombus was demonstrated, sonography revealed a high-amplitude linear echo along the luminal surface of the thrombus. Although calcification could be easily visualized within the aortic wall by computed tomography, it was seen at the lumen--thrombus interface in only one patient. In addition, a resected aortic aneurysm with thrombus, when scanned in a water bath in vitro, demonstrated this echo pattern at the luminal-thrombus interface on sonography but revealed no calcification on pathologic examination. An explanation of the source of this echo pattern and a caution against misinterpretation of this echo pattern as the aortic wall in a dissection or leaking aneurysm with hematoma are presented.

Aorta, Abdominal↗