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Biomedical subjects

M K Wolverson

Publications and source records attributed to M K Wolverson.

At least 37 records · Page 2Linked to original sources

CT in aortic trauma.

A diagnosis of aortic transection was made at computed tomography (CT) in four of 10 patients with acute multiple trauma suspected of having thoracic aortic injuries. There were no false-negative or false-positive examinations. The CT findings of an injured aorta were (1) false aneurysm, (2) linear lucency within the opacified aortic lumen caused by the torn edge of the aortic wall, (3) marginal irregularity of the opacified aortic lumen, (4) periaortic or intramural aortic hematoma, and (5) dissection. The extent of associated mediastinal hemorrhage and the amount of blood in the pleural space were not useful as indicators of aortic injury. Similarly, shift of the trachea and esophagus or absence thereof was found in patients with or without aortic tear.

Accidents, Traffic↗

High-resolution real-time sonography of scrotal varicocele.

Real-time sonography of the scrotal veins was performed in 13 subjects with clinically obvious or small varicocele and in 10 normal controls. In normals, the vessels were 0.5-1.5 mm in caliber and a main draining vein up to 2 mm often was seen. In all varicoceles, numerous dilated, tortuous, branching vessels of uniform size were observed. Vessels of different lesions varied in caliber from 2 to 5 mm. Blood flow was seen in some normal vessels, and sluggish flow was observed in all varicoceles. The direction of visualized flow and the influence on flow of the upright position and Valsalva maneuver were shown with confidence only in large and medium-sized lesions. In these the findings were consistent with incompetence of the internal spermatic venous system. The cystic spaces in multiloculated spermatoceles or epididymal cysts varied more in size, were not tubular or branching, and no flow phenomenon was seen at high gain settings. Sonography provides an alternative to other noninvasive tests for detection of a small varicocele, especially in the infertile patient.

Adult↗

The role of computed tomography in pelvic fractures.

Adequate radiologic demonstration of the extent of pelvic fractures facilitates planning of their treatment by the orthopedic surgeon. Traditionally, this evaluation has been by conventional radiology. This report details results of computed tomography (CT) in the evaluation of pelvic fractures in 34 patients. In most cases, CT was able to identify and delineate the extent of fractures, demonstrate displacement of the involved bones, localize bone fragments and characterize joint derangements. Many of these features were better demonstrated at CT compared with conventional radiographs. In particular, in 10 patients loose bodies were seen at CT that were not evident on conventional radiography. The extent of associated soft tissue injury is also well shown by CT and demonstrated peripelvic or intraarticular fluid collections can be aspirated under CT guidance to rule out sepsis. This study suggests that CT is useful in the assessment of major pelvic fractures.

Acetabulum↗

Normal thymus: CT characteristics in subjects under age 20.

The chest computed tomographic (CT) scans of 40 subjects aged 20 or younger were analyzed retrospectively with special attention to the anterior mediastinum and the thymus. Thirty-four of the patients were considered to have normal CT appearances of the anterior mediastinum; neoplasm was suspected at this site in the other six. In the normal group, the gland was consistently identified as a characteristic anterior mediastinal structure. It had smooth, undulating, lateral contours tending to be convex laterally in the very young and concave laterally at an older age, although there was overlap in many in whom the shape of the lateral contours was a combination of convex, concave, or straight. A sharp angular contour to the lateral margin of the thymus was seen occasionally and is also thought to be characteristic of normal thymus. The posterior border of the gland molded to the heart and great vessels in all patients. The anterior contour was molded to the anterior chest wall or had a pointed shape directed toward the sternum. Molding to the mediastinum and chest wall was not found or was present to only a limited degree in the patients with anterior mediastinal tumor. Attenuation values varied between different normal glands and within the same gland on both pre- and postcontrast scans. Recognition of normal variation in the CT appearance of the thymus in young patients may prevent false-positive diagnosis of neoplasm.

Adolescent↗

Utility of CT-guided abdominal aspiration procedures.

Over 200 consecutive diagnostic needle aspiration procedures of the abdomen were performed under computed tomographic (CT) guidance. Biopsies were done of the liver in 88 patients, the pancreas in 28, the kidney in 20, and the retroperitoneum in 32; 30 underwent an aspiration procedure for characterization of an intraabdominal fluid collection. Accuracy of diagnosis was very high for hepatic (99%) and renal (100%) biopsies and in characterization of fluid collections (100%). Accuracy for retroperitoneal biopsy was 87.5% and for pancreatic biopsy 82%. Overall accuracy for all sites was 95%. There were one false-negative diagnosis for the liver and five false-negative diagnoses for the pancreas. Insufficient material was obtained for diagnosis in four instances of retroperitoneal biopsy. There were no false positives. The technique is facilitated by rapid CT scan time, large aperture gantry, and rapid CT image reconstruction. Twenty gauge needles were used more frequently than 22 gauge needles because of their greater rigidity and ease of control. CT-guided diagnostic aspiration procedures are particularly useful for diagnosis of small, deep-seated lesions and in evaluation of lesions found in severely ill patients. An experienced cytologist is essential to the success of the technique.

Abdomen↗

Spina bifida and unilateral focal destruction of the distal femoral epiphysis.

Focal destruction of the postero-lateral distal femoral epiphysis was present on radiographs in two children with spina bifida and objective lower limb sensory loss. Each patient presented with painless swelling of the knee. In one patient the epiphysis showed sclerosis and fragmentation associated with a defect. In the second patient the destructive change was the dominant radiographic abnormality and simulated bone tumor. Computed tomography in this patient showed a bone fragment occupying the defect suggesting epiphyseal fracture. The lesion in each patient was believed to be traumatic in origin and to represent a stage in the development toward neuropathic arthropathy.

Child, Preschool↗

CT diagnosis of venous pseudotumors in the chest and abdomen.

Appearances simulating neoplastic masses were found in five patients undergoing computed tomographic (CT) scanning of the chest and abdomen for a variety of indications. In each case the appearance was shown to be due to dilated collateral venous channels in association with portal hypertension or interruption of the inferior vena cava. The vascular origin of the masses was confirmed by CT scanning during intravenous bolus injection of contrast. Angiographic confirmation was obtained in three subjects. Enlarged collateral veins should be considered in the differential diagnosis of appearances suggesting mediastinal or abdominal lymphadenopathy at CT scanning.

Abdominal Neoplasms↗