Computed tomography of the abdomen. Early experience with the EMI body scanner.
Explore the source record for details and available documents.
Computers↗
Biomedical subjects
R R Hattery
Publications and source records attributed to R R Hattery.
Performance evaluation and quality assurance of computed tomography scanners, with illustrations from the EMI, ACTA, and Delta scanners.
Performance evaluation of equipment for computed tomography (CT) involves the integration of: (a) establishing performance criteria; (b) designing and implementing test procedures; and (c) reconciling test results in terms of desired performance. Precision (noise), contrast scale, linearity, accuracy, spatial independence, spatial resolution, artifacts, reproducible performance, and patient exposure are several parameters discussed, as are problems of measurement with regard to non-water bath scanners. Performance and quality control tests for the ACTA, Delta, and EMI scanners are outlined. Guidance for the prospective purchaser of CT equipment is presented as a summary of the ideas discussed.
Computers↗
Computed tomography of the body: initial clinical trial with the EMI prototype.
A review of the first 400 cases examined on one of three prototype EMI body scanners is presented. During the initial evaluation phases, it became obvious that computed tomography of the body has tremendous potential in the evaluation of various organs and disease states. The technique has been most useful in evaluating patients with known or suspected abdominal neoplasm, particularly lesions of liver, pancreas, retroperitoneum, and kidney. Too few cases have been studied to realistically quantitate its impact on the total field of medical diagnostic imaging.
Abdominal Neoplasms↗
Pulmonary involvement by histiocytosis X in the pediatric age group.
The lungs may be involved by histiocytosis X either as part of a generalized disease or as a separate entity, primary pulmonary histiocytosis X. The former is much more frequent in the pediatric age group, and although it occurs primarily in those who are quite sick with widely disseminated disease, the lung involvement rarely caused symptoms and almost invariably clears. By contrast, primary pulmonary histiocytosis X is mainly seen in young adult males and frequently leads to severe disability. Twelve patients less than 20 years old with lung involvement by histiocytosis X are presented.
Adolescent↗
Neonatal pneumopericardium.
Three cases of neonatal pneumopericardium are presented. Detailed ventilatory measurements and chest roentgenographic changes are described for each of the three patients. The literature of neonatal pneumopericardium is reviewed, and based on that review and our own cases, we offer guidelines for managing these patients.
Adolescent↗
Initial clinical experience with computerized tomography of the body.
Computerized tomography of the body, now possible with an instrument that can complete a scan rapidly enough to permit patients to suspend respiration, adds an important new dimension to radiologic diagnosis. Cross-sectional antomy is uniquely reconstructed to provide accurate diagnostic information for various disorders throughout the body.
Ascites↗
Urinary tract tomography.
The application of the priniciples of linear tomography to enhance the visualization of the kidneys during excretory urography represents a major advancement in the quality of excretory urography. The ability to visualize the renal parenchyma and renal outlines on tomograms has resulted in a significant increase in the detection of renal masses, parenchymal scars, and adrenal tumors. The use of tomography may also contribute significantly to the evaluation of patients with various other urinary tract diseases. It has been our practice during the past 5 years to obtain linear tomograms as a routine procedure during excretory urography in all adults and in selected pediatric patients. We believe that tomograms of the kidneys represent an important part of the excretory urogram and should be done as a routine procedure.
Acute Kidney Injury↗
Ultrasound evaluation of the popliteal space. Comparison with arthrography and physical examination.
Ultrasound scanning techniques were used to examine the popliteal space in 102 knees. In 30 of 34 knees in which arthrograms were also obtained, the information obtained from both tests was the same. In two instances in which there were different results, the presence of palpable popliteal cysts was confirmed by ultrasound scans but not by arthrography, and in two other cases, small asymptomatic cysts were seen on arthrograms but not on ultrasound scans. In the 68 other knees, ultrasound scans were helpful in the differential diagnosis of popliteal cysts, popliteal artery aneurysms, thrombophlebitis, and a solid poplitieal mass. The results indicate that ultrasound scanning is a valuable, rapid, safe, accurate technique in evaluating patients with symptoms or findings related to the popliteal space.
Aneurysm↗
Caliceal diverticulum.
Records of 72 consecutive patients with caliceal diverticula, representing an incidence of 4.5 per 1,000 excretory urograms, were studied. Of these 72 patients, 39 per cent had a history of recurrent infections and an equal number had stone-containing diverticula. However, only 17 per cent had roentgenographic evidence of pyelonephritis. Similarity of incidence in children and adults, as well as a paucity of renal infection and scarring, supports an embryologic etiology. In our experience the need for surgical intervention is much less than is suggested in the literature.
Adolescent↗
Radiolucent filling defects of the renal pelvis: classification and report of unusual cases.
Eight cases of unusual radiolucent filling defects in the renal pelvis and calices are reported. With reference to the literature and these cases, such defects have been classified etiologically as tumors, calculi, blood clots, air bubbles, congenital anomalies, vascular phenomena, infections and associated conditions, foreign bodies and miscellaneous conditions. Most of these conditions are rare but their accurate delineation with modern diagnostic techniques will allow for more conservative surgical procedures and for maximal preservation of renal substance.
Adult↗
Excretory urographic localization of adrenal cortical tumors and pheochromocytomas.
An excretory urographic evaluation of 124 surgically proved adrenal tumors comprising 65 pheochromocytomas, 36 cortical adenomas and 23 cortical carcinomas is reported. The addition of linear tomography improved the diagnostic accuracy over conventional excretory urography. All types of tomographic examinations demonstrated at least 70% of adrenal tumors. Excretory urographic procedures are relatively safe, simple and economical and should be used as the initial step in attempting to localize clinically suspected and chemically diagnosed adrenal tumors.
Adenoma↗
Vesicoureteral reflux in adults.
Vesicoureteral reflux was detected in 200 adults seen in a 4 year period. In group 1 (no history of urinary tract infection and negative urine cultures), all patients had abnormalities on excretory urograms that were suggestive of reflux. In patients with a history of recurrent urinary tract infection (groups 2 and 3), the excretory urograms showed an abnormality in 79 per cent of those with negative cultures and in 83 per cent of those with positive cultures. Thus, reflux should be suspected in patients with a history of recurrent urinary tract infection even if infection cannot be documented with urine culture. Urographic evidence of renal parenchymal scarring, ureteral dilatation, or mucosal striations should also suggest the possibility of vesicoureteral reflux even when the patient may have no urinary tract symptoms. Voiding cystourethrography should be performed in all adults with these findings to exclude the possibility of vesicoureteral reflux.
Adolescent↗
Acute renal failure after excretory urography in diabetic patients.
Currently used contrast media for excretory urography are generally considered safe even in the presence of renal insufficiency. Isolated reports of acute oliguric renal failure in diabetic patients after excretory urography have been documented. We describe eight such patients who developed this complication. The approximate incidence of recognized acute oliguric renal failure in diabetics undergoing excretory urography was 2 in 1000 as compared with none in more than 100 000 procedures done in nondiabetic patients. Six of the diabetic patients with acute renal failure recovered; two required hemodialysis, never regaining self-sustaining renal function. If detected early, acute renal failure in this setting can often be managed conservatively. Attempts to induce diuresis have been discouraging.
Acute Kidney Injury↗
Experience with lymphoceles after renal transplantation.
Of 215 patients who underwent renal transplantations at the Mayo Clinic, six (2.8 percent) developed perirenal lymphoceles. Diagnosis was made between 5 weeks and 14 months after operation. In all six patients, renal function decreased and eventually a lower quadrant abdominal mass developed. Ipsilateral leg edema, fluid retention, and development of diastolic hypertension should also increase suspicion as to the possibility of lymph collection in the perirenal space. Excretory urography with tomography delineated the lymphocele in each instance; B scan ultrasound may be an additional valuable diagnostic tool. Drainage procedures readily restored normal renal function and, in one instance, drainage also restored the blood pressure to normal. Percutaneous needle aspiration seems to be a temporary measure only, and marsupialization is the preferred definite procedure.
Adult↗