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R J Stanley

Publications and source records attributed to R J Stanley.

At least 91 records · Page 5Linked to original sources
PubMed1982

Computed tomography of the pancreas: three second scanning versus 18 second scanning.

Diagnostic accuracy of pancreatic computed tomography (CT) using a 3 s scanner was compared to our previously published results using an 18 s scanner. Technically unsuccessful examinations have decreased to less than 1%. Pancreatic masses were detected prospectively in 83% of patients with pancreatic carcinoma and retrospectively in all such patients. False negative diagnoses of normal pancreas in proven pancreatic carcinoma were reduced fourfold down to 6%. False positive diagnoses of pancreatic carcinoma remained less than 1% but were not significantly reduced compared to our second year's experience using an 18 s scanner. Interpretation errors and errors due to limitations of CT as a diagnostic technique are discussed.

Acute Disease↗
PubMed1982

Epidermoid hidradenoma. A clinicopathologic study.

Clinical and histopathologic data in 8 cases of epidermoid hidradenoma are presented. Most of the tumors were in the head and neck, and most of the patients were middle-aged and older adults. Generally, the lesions were asymptomatic nodules that sometimes showed ulceration or rapid growth. Despite having some histologic atypia or focal mitotic activity, the tumors were found to be benign on long-term evaluation. This epidermoid variant should not be otherwise differentiated from the benign group of solid-cystic hydradenomas, because cytologic variability did not predict a significant change in prognosis.

Adenoma, Sweat Gland↗
PubMed1982

Evaluation of renal masses considered indeterminate on computed tomography.

Of 815 renal masses studied by computed tomography (CT), 60 did not fit the criteria for cyst or neoplasm and thus were called indeterminate. When artifacts were present, the likely diagnosis was a simple cyst; when no artifacts were present to explain atypical features in cyst-like masses, further investigation was necessary. Angiography was useful in only 16%, while ultrasound combined with cyst aspiration was diagnostic in 84%. All solid lesions required surgical investigation. Ultrasound with or without aspiration is recommended for all cyst-like renal masses thought to be indeterminate on CT.

Abscess↗
PubMed1982

A prospective comparison of the evaluation of biliary obstruction using computed tomography and ultrasonography.

A total of 103 consecutive patients with suspected biliary obstruction were studied using both computed tomography (CT) and ultrasound (US) to evaluate the relative accuracy of the methods. In 47 patients with confirmed obstruction, CT and US were comparable accurate in differentiating obstruction from nonobstruction. The precise level of obstruction was identified by CT in 88% and by US in 60%; the cause of obstruction was accurately predicted by CT in 70% and by US in 38%. Both methods detected useful additional information, such as cholelithiasis or retroperitoneal adenopathy. The authors use US as a screening examination; if there is doubt about the level and cause of sonographically demonstrated obstruction, CT has proved to be an accurate means of further evaluation.

Aged↗
PubMed1982

CT of calcified renal masses.

The ability to evaluate the composition and to precisely locate calcifications within renal masses resulted in more accurate evaluation of 21 calcified renal masses by computed tomography than by standard radiographic techniques. Of 11 solid tumors, computed tomography demonstrated a soft-tissue mass extending beyond the calcification in nine cases of renal cell carcinoma. Of 10 benign cystic lesions, all six lesions characterized by a uniform water-density center, calcification confined to the wall, and no detectable soft-tissue mass were benign cysts. Three additional cystic lesions (xanthogranulomatous pyelonephritis, multilocular cystic nephroma, and a cyst containing calcified debris) were believed to represent benign lesions prospectively due to the absence of a soft-tissue mass. Only peripherally calcified lesions with a central attenuation higher than accepted for benign cysts were indeterminate by computed tomography. The significance of the computed tomographic findings in terms of malignant potential and patient management is discussed.

Adenocarcinoma↗
PubMed1982

Renal cell carcinoma: angiography in the CT era.

Accurate preoperative staging of renal cell carcinoma determines which patients may benefit from surgery and influences the surgical approach to potentially curable lesions. Recently, computed tomography has been shown to be as accurate as angiography for staging renal tumors, suggesting that angiography may be limited to those cases where clarification of equivocal computed tomographic findings or additional staging information would alter the therapy. To test this hypothesis, the radiographic evaluation of 42 patients with renal cell carcinoma was reviewed. Of the 42 patients, 24 (57%) were examined by computed tomography alone, while 18 (43%) had angiographic and computed tomographic examinations (nine venograms and 11 arteriograms). Seven of the nine venograms obtained for diagnosis or staging added additional information or clarified an equivocal computed tomographic finding, but none of the 11 arteriograms added significant diagnostic information. Venograms were particularly useful in patients with bulky right-sided lesions. Computed tomographic staging of renal cell carcinoma can be accepted by urologists and has, in fact, reduced the use of routine preoperative angiography in our medical center.

Adenocarcinoma↗
PubMed1982

Superficial ulcerating necrobiosis in rheumatoid arthritis. A variant of the necrobiosis lipoidica-rheumatoid nodule spectrum?

Although necrobiosis is not a precise term, it primarily refers to collagen changes found in association with the palisading granulomas seen in granuloma annulare, necrobiosis lipoidica diabeticorum (NLD), and rheumatoid nodules. While the pathogenesis of each of these conditions remains unknown, immune complex vasculitis and delayed hypersensitivity mechanisms have been postulated. Two patients are described, having "classic" rheumatoid arthritis with chronic, superficial, ulcerating, discrete lesions on their lower legs that histologically were interpreted as NLD. While the argument for a chance association of NLD and rheumatoid arthritis could be advanced, the occurrence of identical lesions in two patients with high-titer rheumatoid factor, rheumatoid nodules, and some clinical and microscopic evidence of a low-grade rheumatoid vasculitis suggests a new subset of patients with necrobiotic palisading granulomas.

Aged↗
PubMed1981

Evaluation of three effervescent agents for double-contrast upper gastrointestinal radiography.

The agent used to introduce gas into the stomach is an important factor in determining the quality of double-contrast upper gastrointestinal radiography. The efficacy of 3 effervescent agents formulated for use in double-contract upper gastrointestinal radiography was evaluated in 300 patients. Patients found 2 granular preparations (E-Z-Gas granules and Baros) easier to swallow than a powdered agent (E-Z-Gas powder). Bubble formation and flocculation of barium in the stomach were less of a problem with Baros. Differences in mucosal coating and visualization of area gastricae were not statistically significant.

Bicarbonates↗
PubMed1981

Computed tomography in the evaluation of mediastinal widening.

Computed tomography was employed in 71 patients to assess a widened mediastinum detected on plain chest radiography. In 92% of the patients, CT correctly identified normal variants, sift-tissue density masses or vascular abnormalities as the cause of mediastinal widening. In 8% of the scans, all performed early in our experience, CT diagnosis was indeterminate (4%) or incorrect (4%). In 58% of the cases, a specific and correct CT diagnosis was made, which obviated further and more invasive diagnostic evaluation. CT scanning can differentiate vascular from avascular causes of mediastinal widening, and provide a specific and conclusive diagnosis in many instances. Invasive diagnostic procedures should be reserved for the few cases in which CT is indeterminate or additional preoperative information is required.

Aged↗
PubMed1981

Computed tomography of gastric neoplasms.

The authors analyzed the clinical and CT findings in 100 normal subjects and 31 patients with gastric disease to determine the significance of thickening of the gastric wall. Ninety per cent of the normal individuals had a wall thickness less than 1 cm with adequate distension of the lumen. Twenty-nine of the 31 patients with gastric disease (94%) had a wall thickness greater than 1 cm. Adenocarcinoma and lymphoma could not be reliably distinguished based solely on the pattern of gastric wall involvement, although most lymphomas had a lobular luminal contour while advanced adenocarcinomas had flattened inner margins. All 4 leiomyosarcomas were seen as large extragastric masses, and some had calcification or central necrosis. CT was helpful in assessing metastatic spread in 25 patients. While it could not distinguish between neoplastic and inflammatory disease or among histological types of tumor, it was a sensitive detector of gastric disease.

Adenocarcinoma↗
PubMed1981

High resolution computed tomography in the staging of carcinoma of the larynx.

The normal anatomy of the larynx as displayed on computed tomography is illustrated. Pathological alterations in patients with carcinoma of the larynx are depicted and discussed. Computed tomography (CT) is recommended as the initial radiological procedure when additional diagnostic information is required to supplement the findings of laryngoscopy. CT provides information regarding deep penetration of tumor, including cartilaginous invasion, and about the inferior extension of neoplasm, including the subglottic area. This knowledge helps to determine whether conservative surgery as opposed to total laryngectomy is possible.

Humans↗
PubMed1981

Use of CT in evaluation of postcystectomy patients.

Twenty-one patients with prior cystectomy for transitional cell carcinoma of the bladder were evaluated by computed tomography. In eight patients who developed local pelvic recurrence, CT diagnosis was correct in seven. CT also detected distant metastasis in five patients and local pelvic abscesses in two additional patients. Our data show CT to be a more sensitive means than conventional radiologic methods including gray scale sonography in the detection of local recurrence and postoperative complications. Examples of normal postcystectomy changes in the pelvis as well as recurrent disease and surgical complications are illustrated. The pitfalls and the proper role of CT in these patients are also discussed.

Adult↗