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Biomedical subjects

M P Williams

Publications and source records attributed to M P Williams.

At least 19 recordsLinked to original sources
PubMed1992

Current imaging of childhood urinary infections: prospective survey.

OBJECTIVES: To assess whether ultrasonography alone is adequate for routine screening of childhood urinary infection, whether clinical features determine the need for further investigations, and which investigations are most appropriate. DESIGN: Prospective survey of children with proved urinary infection and a preinvestigation record of clinical features. Ultrasonography and intravenous urography were routine, with choice of further studies determined by ultrasonographic findings. SETTING: A children's hospital and two district general hospitals in Mersey region. MAIN OUTCOME MEASURES: Sensitivity and specificity of ultrasonography both generally and in relation to clinical features. Accuracy of intravenous urography compared with radioisotope examinations. RESULTS: Specificity of ultrasonography was good (99% (95% confidence interval 96% to 100%)) but sensitivity modest (43% (32% to 55%)), principally with respect to detecting vesicoureteric reflux and renal scarring. Among older children (aged 2-10 years) with positive ultrasound results and fever or vomiting the sensitivity in detecting reflux (with and without renal scarring) was 78% (62% to 89%) and the specificity 69% (60% to 78%); in detecting renal scarring (with and without reflux) the sensitivity was 100% (80% to 100%) and specificity 65% (56% to 74%). Renal scarring and obstructive uropathies were better assessed by radioisotope examinations than by intravenous urography. CONCLUSIONS: Ultrasonography alone is inadequate for routine screening of childhood urinary infection. Though further investigations remain advisable in infants, in older children they can be restricted to a minority who have positive ultrasound examinations or have had fever or vomiting. Radioisotope examinations largely eliminate the need for intravenous urography.

Child↗
PubMed1992

The association of germ cell tumours of the testis with sarcoid-like processes.

Sarcoid-type pulmonary lymphadenopathy associated with testicular cancer is a rare condition which has been previously reported in only 14 cases. Earlier case reports have failed to distinguish between generalized sarcoidosis as opposed to a local granulomatous reaction to tumour. We describe a further 8 cases of the association and provide strong supportive evidence for systemic sarcoidosis in 5 of our patients. In 3 of our patients with systemic sarcoidosis there was coexisting testicular cancer requiring additional treatment. We therefore advise caution in the interpretation of the clinical and histological findings in these patients, and recommend thorough investigation of all such cases.

Adult↗
PubMed1992

Multicystic renal dysplasia detected by prenatal ultrasonography. Natural history and results of conservative management.

In a review of 44 infants with multicystic renal dysplasia diagnosed prenatally by ultrasonography, contralateral anomalies, bilateral disease and other non-urinary congenital anomalies were rare. In approximately two-thirds of infants the lesion was impalpable and in 2 cases involution had occurred prenatally. All but 5 were managed conservatively and without complications, and partial or complete involution of the lesion occurred in more than 50% during follow-up. It was concluded that the natural history of this anomaly is usually benign and that conservative management is advisable.

Female↗
PubMed1992

Natural history of obstructed and pseudo-obstructed megaureters detected by prenatal ultrasonography.

In a series of 38 patients with non-refluxing megaureters detected by prenatal ultrasonography, 89% were males and 16% had associated ipsilateral or contralateral urinary anomalies. By renographic criteria, 36% of ureters were not obstructed; renal function was never impaired initially and, on follow-up, spontaneous resolution of dilatation was common. Infective urinary calculi developed in 3 of the boys. In ureters obstructed by renographic or pressure-perfusion criteria, 79% exhibited normal renal function initially. Most such patients were managed expectantly; on follow-up, functional deterioration occurred in 2 patients, while in the remainder dilatation usually persists but without change in function.

Child, Preschool↗
PubMed1992

The radiological imaging of bronchial atresia.

The clinical and radiological findings in three cases of bronchial atresia are presented. Bronchial atresia has a characteristic plain radiographic appearance in the majority of cases. Computed tomography may be required to confirm the diagnosis. The condition often presents to the radiologist as an incidental finding on the chest radiograph in a patient undergoing investigation for an unrelated problem.

Adolescent↗
PubMed1991

CT scanning in epidural lymphoma.

This study describes the clinical features and CT findings in 18 patients with epidural lymphoma seen in a large oncology hospital over a four-year period. The variety of CT appearances seen in epidural lymphoma are illustrated. The importance of recognition of small volume epidural disease on body CT is stressed. Patients with apparently minor CT abnormalities may have significant epidural disease. The prognosis for these patients with minimal symptoms and small volume disease is much better than for those with classical signs of cord compression and more obvious abnormalities on imaging.

Adolescent↗
PubMed1990

Mimics of metastases from testicular tumours.

This paper presents 10 patients with a diagnosis of testicular tumour in whom computed tomography (CT) at staging or follow-up demonstrated abnormalities which mimic the appearance of metastatic testicular tumour. The entities mimicking metastases were sarcoidosis, mushroom worker's lung, lymphoma and phaeochromocytoma. Representative examples of these lesions are illustrated and features which may enable the radiologist to differentiate them from metastatic testicular tumour are discussed.

Adrenal Gland Neoplasms↗
PubMed1990

Pulmonary lacunae: sequelae of metastases following chemotherapy.

This study describes the appearance of thin-walled cavities arising at the sites of pulmonary metastases from germ cell tumours treated with chemotherapy. We have termed these 'pulmonary lacunae'. They occur with a prevalence of approximately 7% in patients with multiple pulmonary metastases from testicular teratoma.

Adolescent↗
PubMed1990

Magnetic resonance imaging in extranodal pelvic lymphoma.

A practical MRI strategy for the investigation of pelvic pain in patients with suspected recurrent lymphoma is described and illustrated in five patients. A T1-weighted sagittal examination of the lumbo-sacral spine is used to examine the vertebral bone marrow, spinal canal, exit foraminae and para-aortic lymph nodes. T2-weighted and balanced images are obtained in the axial plane through the pelvis. The balanced images give an excellent demonstration of pelvic lymph nodes and the T2-weighted images are sensitive to the presence of abnormal soft tissue masses and marrow disease.

Adult↗
PubMed1990

Magnetic resonance imaging in the detection of skeletal metastases in patients with breast cancer.

Eighty-four patients with breast cancer at high risk of bone metastases were investigated with magnetic resonance imaging (MRI) of the thoracolumbar spine. Of 58 patients with normal limited skeletal surveys (LSS) and bone scans (BS), 4 (7%) had MR images compatible with malignant infiltration. Fourteen patients had abnormal bone scans with normal or non-diagnostic plain films; 7 of these patients (50%) had MR images compatible with malignant infiltration. Twelve patients had single or multiple wedge collapses of uncertain aetiology on plain film; MR demonstrated metastatic disease as the cause of wedge collapse in 7 (58%). MRI may define a group of patients with extra-osseous relapse who have occult metastatic disease. Although the detection rate in patients with primary breast cancer is low (4/45), MRI is of value in determining the cause of wedge collapse in postmenopausal women with breast cancer and may elucidate the cause of an abnormal bone scan with normal or non-diagnostic plain films.

Bone Neoplasms↗
PubMed1989

Role of computed tomography scanning in the management of Ewing's sarcoma.

It is well established when imaging patients with primary bone malignancy that on occasions computed tomography (CT) scanning can offer unique information. It is less clear, however, in what circumstances this information will lead to a change in patient management. This study reviewed the results of CT examinations in 32 patients with Ewing's sarcoma and examined the influence of CT on patient management in different clinical circumstances. CT provided new information on a total of 75 occasions out of 153 examinations. Management was changed on 17 occasions as a direct result of the CT scan findings. Overall, 50% of patients had their management altered as a result of CT. Follow-up CT scans in the chest more frequently influenced patient management than did either staging or follow-up scans of the primary site.

Adolescent↗
PubMed1989

Computed tomography scanning and post-lymphangiogram radiography in the follow-up of patients with metastatic testicular cancer.

The use of computed tomography (CT) and lymphangiography in the follow-up of 50 patients with intra-abdominal metastatic testicular cancer was assessed. The pattern and time course of loss of lymphangiographic contrast medium from different node groups is described. Computed tomography was more effective than lymphangiography in assessing the presence of residual metastatic disease and showed residual disease in 21 patients when lymphangiography follow-up radiographs showed evidence of disease in only seven. In the detection of relapse, lymphangiography follow-up showed evidence of nodal enlargement in four of eight cases when CT showed evidence of relapse in all eight. Computed tomography is superior to lymphangiography in the follow-up of patients with metastatic testicular cancer both in monitoring response of known disease to treatment and in the detection of relapse.

Abdominal Neoplasms↗