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L P Lawler

Publications and source records attributed to L P Lawler.

11 recordsLinked to original sources
PubMed2001

Results of and comments on the 2000 survey of the American Association of Academic Chief Residents in Radiology.

RATIONALE AND OBJECTIVES: The American Association of Academic Chief Residents in Radiology (A3CR2) annually surveys radiology residency programs on issues related to training. The objective is to highlight national similarities, differences, and trends to help programs establish standards and improve residency training. MATERIALS AND METHODS: Questionnaires were mailed to 180 accredited diagnostic radiology residency training programs in the United States. The survey covered the usual general topics and more specific topics considered every 4 years; for 2000 the latter were on-call issues and the chief residency year. RESULTS: Completed surveys were returned from 63 programs (35%). Important findings included increased caseload and call commitments, especially for smaller programs. Resident salaries appear to have increased more than the consumer price index. Nonemergent after-hour coverage and teleradiology are now a large part of the resident work practice. Women continue to be underrepresented, with a trend downward. Chief residents are more involved in organizing preparation for board examinations and have greater office facilities and more administrative duties. CONCLUSION: This survey provided useful insights. All levels of residency face increased workloads. On-call hours have not changed, but the work has intensified and the use of teleradiology has increased. Many programs have adopted a "night-float" system, and nonemergent after-hours coverage should be considered in any program evaluation. Continued vigilance and sustained efforts are required to ensure that radiology is considered as a specialty by both men and women. With increased demands on attending physicians' time, chief residents may need to take on more administrative responsibilities.

Curriculum↗
PubMedDate not supplied

Extrahepatic arterioportal venous fistula: multidetector CT and volume-rendered angiographic imaging.

We present a case of unsuspected extrahepatic arterial-main portal venous fistula diagnosed by multiphase computed tomography with three-dimensional volume-rendered computed tomographic angiography. To our knowledge, this entity has not been reported previously in the literature, and it represents an example of pathology that may only be detected and clarified with multiphase imaging with three-dimensional rendering. This finding has great clinical importance in patient management.

Adult↗
PubMedDate not supplied

Variations in anatomy of the middle hepatic vein and their impact on formal right hepatectomy.

BACKGROUND: We evaluated the incidence of variations of the middle hepatic vein (MHV) branches and their impact on formal right hepatectomy for living-donor liver transplantation. METHODS: Fifty consecutive patients who underwent hepatic multidetector row computed tomography (CT) were evaluated. Three-dimensional volume rendering techniques were used to evaluate the different branching patterns of the MHV. An incision plane was constructed to simulate a formal hepatectomy along Cantlie's line, immediately to the right of the MHV. The number of transected vessels was recorded by consensus of two observers. RESULTS: In 11 patients (22%) the MHV had no major (>5 mm) branches. In 15 patients (30%) a major branch was seen draining the right lobe, and in 10 patients (20%) a major branch was seen draining each lobe. In five patients (10%) two major branches were seen draining the right lobe and a single branch draining the left lobe. The remaining nine patients (18%) had other variations, including one patient (2%) with the right hepatic vein arising from the MHV. A formal hepatectomy along Cantlie's line was truly avascular in 15 patients (30%). CONCLUSION: A formal right hepatectomy can be performed without transecting major branches of the MHV in one-third of patients. In the remaining two-thirds, one or more major branch of the MHV will need be transected. Preoperative knowledge of these variations is critical for surgical planning.

Adult↗
PubMedDate not supplied

Conjoined twins: multiorgan system evaluation by multidetector CT and 3D volume rendering.

Conjoined twins, though uncommon, continue to present some of the most challenging questions for current diagnosis and therapy. The myriad of presentations demands a thorough multisystemic imaging evaluation before fully informed therapeutic and ethical decisions can be made. We present an unusual case of asymmetric omphaloischiopagus conjoined twins who were evaluated by multidetector CT and 3D volume rendering. This single technique can provide a large amount of information from a single study that can negate the need for some other imaging tests and can complement those other tests that remain necessary. We would suggest that when a CT examination is considered to evaluate this condition, an imaging interpretation that is independent of acquisition plane and that has multisystem versatility should be considered.

Abnormalities, Multiple↗
PubMedDate not supplied

Multi-detector row CT of thoracic disease with emphasis on 3D volume rendering and CT angiography.

Multi-detector row computed tomography (CT) with three-dimensional (3D) volume rendering provides a unique perspective on thoracic anatomy and disease. Multi-detector row CT allows shorter acquisition times, greater coverage, and superior image resolution. Three-dimensional volume rendering now permits real-time, interactive modification of relative pixel attenuation in an infinite number of planes and projections. In vascular imaging, this technique provides image quality that equals or surpasses that of conventional angiography. Its use has expanded to aid in diagnosis and surgical planning, often obviating conventional or digital angiography and reducing costs. It is reliable in depicting clot and the pulmonary vasculature and may also be used to evaluate thoracic venous anomalies (eg, pulmonary arteriovenous malformations) and to plan therapy. Airway imaging with multi-detector row CT with 3D volume rendering is particularly useful in the planning and follow-up of stent placement. In diffuse lung disease, this technique can increase nodule detection and help differentiate between small nodules and vessels. It is also helpful in imaging the musculoskeletal system and the thoracic cage. Multi-detector row CT with 3D volume rendering has enhanced the conventional roles of thoracic CT and challenged the supremacy of other imaging modalities. It will likely play a leading role in future radiologic research and practice.

Angiography↗