PubMed Health⌕ Search

Biomedical subjects

R A Fawcitt

Publications and source records attributed to R A Fawcitt.

15 recordsLinked to original sources
PubMed2002

Evaluation of angiography performed by radiographers and nurses.

AIM: To evaluate out-patient angiography performed by nurses and radiographers. MATERIALS AND METHODS: A protocol for out-patient angiography performed by nurses and radiographers was drawn up and approved by the Trust's Risk Management Committee. Following training, two experienced radiographers and one nurse undertook elective peripheral or renal angiography according to the protocol on 187 patients. Angiograms were performed using a 3F catheter introduced into the abdominal aorta from a femoral approach. Patients were discharged after 2 hours and contacted by telephone the following morning. RESULTS: No patient refused consent for the procedure. One hundred and seventy-two patients underwent successful catheterization without assistance from a radiologist. Radiologist assistance was required with femoral puncture or catheter/guidewire manipulation in 15 cases (8%). Images were considered diagnostic by the reporting radiologist in all but one case. This patient was recalled for further aortogram and pressure measurements. There was a single puncture site complication due to transient stenosis of the common femoral artery at the puncture site. This is thought to have been the result of subintimal injection of local anaesthetic, and it resolved spontaneously over 30 minutes. There were no delayed complications. CONCLUSION: Experienced nurses and radiographers can rapidly acquire the skills to perform diagnostic angiography safely and efficiently.

Allied Health Personnel↗
PubMed1986

Carotid ligation: what happens in the long term?

The authors reviewed a consecutive series of 115 patients who underwent common carotid ligation during the period 1954-1984. Average follow-up was 10 years. Seventy-three (63%) patients presented following a subarachnoid haemorrhage (SAH) and 42 (36%) presented with the mass effect of an unruptured aneurysm. Thirty-nine (34%) patients were lost to follow-up of whom 27 had had a previous SAH. Forty-six (63%) of the 73 patients traced had suffered a SAH and amongst this group, 11 patients (24%) died from a proven or suspected recurrent haemorrhage within 10 years of ligation. The fatal recurrent haemorrhage rate was, therefore, 2.4%/year. Thirty (71%) of the 42 patients who presented with unruptured aneurysms were traced. Seven of these (23%) died: two following haemorrhage, 1 year and 16 years after carotid ligation and three patients died as a direct consequence of carotid ligation. Check angiographic studies were available for 55 patients following carotid ligation, a mean of 8.4 years after the procedure. Thirteen were conventional angiograms and 42 were intravenous angiograms obtained using the digital subtraction technique. Seventy-six per cent of the aneurysms visualised on the initial studies were either smaller or had apparently disappeared. Only four new aneurysms were detected and in two of these instances, the initial angiographic studies had been incomplete. The authors conclude that the annual rate of fatal recurrent haemorrhage from an intracranial aneurysm following common carotid ligation is of a similar magnitude to that of the natural history of conservatively managed ruptured intracranial aneurysms. Moreover, carotid ligation apparently does not prevent haemorrhage from a previously unruptured aneurysm and the procedure appears to carry a significant morbidity and mortality, even in patients with an unruptured aneurysm.

Adult↗
PubMed1979

An analysis of the spatial distribution of attenuation values in computed tomographic scans of liver and spleen.

An autocorrelation analysis of the attenuation values in computed tomographic scans has been performed for a total of 35 normal and eighteen cirrhotic patients. The results confirm preliminary observations on a smaller sample which suggested that this technique may be used to separate normal and cirrhotic livers. The noise structure in a region within the spleen was also examined and found to change in the presence of cirrhosis.

Humans↗
PubMed1978

Computed tomography in the diagnosis of diseases of the paranasal sinuses.

The authors investigated 31 patients suffering from benign and malignant lesions of the paranasal sinuses. Clinical, conventional radiological methods and computed tomography were used. In benign lesions CT added little significant information to that obtained by conventional radiological methods. In malignant lesions, however, CT provides additional valuable information. It gives a clear picture of the posterior, superior and orbital extent of paranasal tumours. It also shows the extent of the tumour into the infratemporal fossa.

Adult↗
PubMed1978

Computed tomographic scanning in liver disease.

The non-invasive diagnostic technique of computed tomograph (CT) has been assessed in 100 patients with established liver disease. CT can differentiate extra- from intrahepatic cholestasis and may define the obstructing lesion in the former group. It is of value in detecting infiltrations with fat or iron, and provides useful information in patients with cirrhosis and metastatic deposits. At present it appears of less value in the diagnosis of non-fibrotic parenchymal liver disease.

Chronic Disease↗
PubMed1978

A clinical evaluation of isotope scanning, ultrasonography and computed tomography in pancreatic disease.

In a prospective study of 46 patients with suspected pancreatic disease the provisional diagnoses arrived at independently by isotope scanning (IS), ultrasonography (USS) and computed tomography (CT) have been compared. In the control group, IS and CT were associated with a higher false positive rate than USS; The isotope scan was abnormal in most patients with proven chronic pancreatitis and cancer. The results from USS and CT were similar when structural changes were present. USS was superior in diagnosing pancreatic carcinoma and was a convenient means to follow the progression of acute pancreatitis to final resolution or the development of a pseudocyst. CT proved especially useful in accurately delineating cysts, pseudocysts and calculi prior to planning surgery and in assessing disease in contiguous viscera.

Evaluation Studies as Topic↗
PubMed1978

Tissue characterization by an analysis of the distribution of attenuation values in computed tomography scans: a preliminary report.

Attenuation values as measured by a computed tomography scanner are distributed in both magnitude and space. The distribution in magnitude can be described by the mean, standard deviation, and skewness of histograms of attenuation values. The distribution in space can be characterized by auto-correlation functions or histograms of gradients. Using these measures of scan structure, it has been shown that the spatial distribution of attenuation values can be influenced by tissue. Also, there are some indications that changes in tissue structure corresponding to disease can be detected.

Atrophy↗
PubMed1978

Computed tomography in the evaluation of the solitary or unilateral nonfunctioning kidney.

Computed tomography (CT) using the EMI CT5000/5005 scanner was performed on 14 patients with a solitary functioning kidney demonstrated by other radiological investigations. Examinations before and after intravenous injection of contrast material have been undertaken. In the majority of cases, the patients were referred as a "nonfunctioning kidney" following excretion urography. Other referrals included previous nephrectomy or solitary kidneys. In all cases, the CT scan made possible the definitive diagnosis. The diagnosis included unsuspected hydronephrosis, vestigial kidney, contracted kidney secondary to chronic pyelonephritis and calculus, recurrence of a hypernephroma, and lymphomatous infiltration. Valuable information was obtained about the vascular pedicle, the renal collecting systems, the perinephric space, and the retroperitoneal space including the paraaortic lymph nodes. Furthermore, the increased sensitivity of the technique in detecting lower concentrations of iodine provided information regarding renal function. It is concluded that the noninvasive nature of CT makes it a valuable adjunct in the further investigation of such patients.

Adult↗
PubMed1978

Computed tomography, ultrasound, and cholestatic jaundice.

Computed tomography detected the presence of dilated ducts in 15 of 18 cases with extrahepatic obstructive jaundice and demonstrated the obstructing lesion in 18 out of 25. The cause of the obstruction was detected in the absence of duct dilatation, and calculi which were radiolucent on conventional radiographs were demonstrated. Ulstrasound detected dilated ducts in eight of 10 cases, but demonstrated the cause of the obstruction in only one of 13 cases. Both techniques are capable of demonstrating dilated ducts in the majority of cases, but computed tomography is better at detecting the cause of the obstruction.

Bile Duct Neoplasms↗
PubMed1978

Computed tomography in pancreatic disease.

Computed tomography (CT) of the pancreas has been evaluated in 50 patients with established exocrine pancreatic disease and 20 patients without pancreatic disease. Increase in size, irregularity in outline and heterogeneity of composition of the pancreas implied disease but were in no way specific to any particular disease entity. In acute pancreatitis, following complete resolution, the pancreas appeared normal whereas incomplete resolution was associated with non-specific swelling and heterogeneity of density. The extent and location of pseudocysts could be accurately delineated. In chronic pancreatitis, duct calculi, duct dilatation and large intrapancreatic cysts aided the differentiation between focal enlargement due to chronic pancreatitis and expansion due to cancer. Hepatic metastases and abnormalities of the biliary system seen in association with cancer further aided this differentiation.

Ampulla of Vater↗
PubMed1977

Computer tomography of the spinal canal using metrizamide.

Eleven patients have been examined by whole body CT employing the EMI CT 5000 following lumbar injection of 10 ml of metrizamide (Amipaque) 170 mg I/ml. The distribution, flow and dilution of the contrast medium have been investigated. The results suggest that whilst metrizamide is necessary in the spinal canal to demonstrate the neural axis and pathologic processes affecting it, it appears to enter the extracellular space of the spinal cord during the first hour and achieves an equilibrium in the subarachnoid space and spinal cord from 3 to 6 hours. The medium may concentrate in a second compartment, possibly intracellular, from 3 to 6 hours. The effect of spectral filtering by metrizamide on the attenuation values of the spinal cord has been modelled and shown not to be significant at the anticipated dilution of the medium in the cerebrospinal fluid space and the spinal canal.

Humans↗
PubMed1976

Radiodiagnosis of intracranial pearly tumours with particular reference to the value of computer tomography.

The radiological appearances of 22 histologically proven epidermoid and dermoid tumours occurring in four sites are presented - (1) the petrous apex and cerebellopontine angle, (2) the suprasellar region, (3) the cerebral hemispheres and (4) the cerebellum and 4th ventricle. Pathognomonic radiological changes are only uncommonly demonstrated by conventional neuroradiological techniques. Computer assisted tomography employing an EMI scanner has demonstrated diagnostic appearances. The availability of detailed density changes occurring within the tumours together with additional intracranial information makes computer tomography the investigation of choice.

Adult↗