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Biomedical subjects

S Lähde

Publications and source records attributed to S Lähde.

At least 19 recordsLinked to original sources
PubMed1992

Combined CT-guided biopsy and cytology in diagnosis of bony lesions.

The results of 44 trephine (OD 1.4-4 mm) biopsies and 39 fine needle (0.7-0.9 mm) aspirations of skeletal, mainly vertebral, lesions performed under CT-guidance in 54 patients were evaluated. The fine needle sample was aspirated through the trephine as a complementary procedure in 29 patients and a fine needle aspiration only was performed in 10 patients. Trephine biopsy only was performed in 15 patients. Sufficient material for histologic and cytologic analyses was obtained in 93% (41/44) and 97% (38/39) and a correct benign or malignant diagnosis was obtained in 84% (37/44) and 90% (35/39), respectively. Among the combined examinations the fine needle aspiration alone was diagnostic in 2 cases while the trephine specimen alone provided diagnostic material in 2 cases. In 24 cases both the cytologic and histologic samples were adequate for diagnostic purposes. In one case both methods gave false-negative results. The combined use of cytologic and histologic samples in CT-guided bone biopsies increased diagnostic accuracy. The aorta was perforated once with a 1.4-mm needle but without sequelae. CT-guided bone biopsy was found to be a safe, reliable and cost-efficient method.

Adult↗
PubMed1991

Assessing non-resectability of lung cancer. The value of thoracic computed tomography.

To investigate whether the assessment of resectability of lung cancer can be reliably made on the basis of computed tomography (CT), the thoracic CT scans of 96 lung cancer patients who were operated on, and in whom the tumour was classified to be of stage III at preoperative CT or at thoracotomy, were analysed. Of the patients, 58 underwent complete resection of the tumour, whereas thoracotomy resulted in non-complete resection or exploration only in 38 cases. Overlapping of the CT findings in the groups of complete and non-successful resection was observed. The majority of tumours with apparent growth to the carina, trachea, oesophagus or great vessels at CT were completely resected. Tumours that only bordered on the pleura could not be distinguished from those with pleural invasion. Mediastinal lymph node enlargement did not always mean metastatic spread. We conclude that there is no definite sign that identifies non-resectability of lung tumours, and a certain proportion of non-curative thoracotomies must be accepted.

Adult↗
PubMed1991

Ultrasound diagnosis of lumbar disc degeneration. Comparison with computed tomography/discography.

Transabdominal ultrasound (US) imaging was compared with computed tomography (CT)/discography in order to assess whether the former could be used for screening discs to be examined by CT/discography, or could be used to replace CT/discography. A total of 56 discs in 29 patients was examined by both methods. The US findings were classified as local or generalized disc lesions, and the CT/discography findings according to the Dallas Discogram Description. The sensitivity of US for recognizing a discographically painful and deteriorated disc was 0.95, and its specificity was 0.38. Correspondingly, the predictive value of a positive US finding was 1.53, and that of a negative finding was 0.13. US is considered suitable for screening discs prior to CT/discography.

Adult↗
PubMed1991

Effect of immobilization on carbonic anhydrase III and myoglobin content in human leg muscle.

Carbonic anhydrase III and myoglobin concentrations were measured from vastus medialis muscle samples before and 6 weeks after postoperative leg immobilization following knee ligament reconstruction. Seven patients were immobilized with conventional cast so that the knee joint was fixed at 20 degrees flexion. Seven other patients used braces allowing a motion of 30-70 degrees. The atrophy of the medial part of musculus quadriceps was estimated by computer tomography. No difference in carbonic anhydrase III and myoglobin concentrations or muscle atrophy between the cast and brace groups was observed. The cross-sectional area of the medial part of musculus quadriceps decreased 38% during immobilization. The specific concentrations of carbonic anhydrase III and myoglobin remained unaltered. Due to the remarkable postoperative atrophy of the muscle the total carbonic anhydrase III and myoglobin contents, however, decreased significantly (37% and 31%, respectively). The results suggest that the net breakdown of carbonic anhydrase III and myoglobin during disuse atrophy occur at the same rate as the average net degradation of mixed muscle proteins and that the process is independent of the immobilization procedure.

Adult↗
PubMed1991

CT for predicting the resectability of lung cancer. A prospective study.

In order to assess the accuracy of CT in predicting the resectability of lung cancer, a prospective study was performed on 96 patients undergoing thoracotomy. The tumors were classified preoperatively according to the TNM classification and the new international staging system for lung cancer, and scored as being resectable by lobectomy or pulmectomy, potentially resectable by lobectomy or pulmectomy, or nonresectable. Of the tumors predicted to be resectable or potentially resectable, 86.6% and 63% were radically resected, respectively, and the need for lobectomy versus pulmectomy was correctly estimated in 81.3% of them. The insufficiency of CT for defining lymph node metastases and infiltrative tumor growth was considered a marked disadvantage of the method.

Adult↗
PubMed1991

Accuracy of adrenal biopsy guided by ultrasound and CT.

We reviewed the results of fine needle biopsy of the adrenal glands guided by ultrasonography or CT in 56 patients. The final diagnoses, obtained at operation, autopsy or follow-up were: metastasis (n = 22), adenoma (n = 21), adrenal cyst (n = 6), hematoma (n = 3), lymphoma (n = 1), pheochromocytoma (n = 1), lymph node (n = 1), and amyloid mass (n = 1). Sufficient cytologic material was obtained in 96.4% (54/56). The overall accuracy to differentiate benign from malignant disease was 85.7% (48/56), 2 were false-negative, one was false-positive. The biopsy was inconclusive ("possibly malignant") in 3 patients, 2 of whom had an additional cutting needle biopsy yielding a correct positive finding. No complications occurred. We conclude that in disseminated malignant disease with suspected adrenal metastases diagnostic results can be obtained with guided fine needle biopsy. Biopsy in primary adrenal lesions is helpful, especially if the aspirate of the lesion turns out to be composed of something other than adrenal cells.

Adrenal Gland Neoplasms↗
PubMed1991

Renal angiomyolipoma. Ultrasonographic, CT, angiographic, and histologic correlation.

The findings at ultrasonography (US), CT, and angiography in 13 patients with renal angiomyolipomas were compared with histologically determined proportions of fatty, myogenic, and vascular components. The angiomyolipoma was composed mainly of fat in 4 cases, half of fat in 2, mainly of myogenic tissue in 4, and was hemorrhagic in 3. US showed high echogenicity in 10 patients, while CT demonstrated attenuation values of fat in 3 tumors with mainly fat tissue but gave non-specific findings in the other cases. The angiographic findings were considered specific for angiomyolipoma in 2 out of 11 cases (18%). Low fat content and hemorrhagic areas caused diagnostic difficulties at both US and CT. The diagnostic algorithm for renal angiomyolipoma is discussed.

Adult↗
PubMed1991

Computed tomography of hepatic haemangiomas: a chance for a definite diagnosis.

The CT features of 66 hepatic haemangiomas and 77 malignant mass lesions were evaluated in a retrospective study. On plain CT the attenuation values of haemangiomas varied from 30 to 50 HU, and 57 (86.4%) of them were homogeneous in density. Two haemangiomas did not enhance after contrast injection, while the others showed immediate peripheral rim-like enhancement, 46 (69.7%) of which enhanced intensely and 18 faintly. 45 (68.2%) haemangiomas enhanced completely, 19 (28.8%) becoming hyperdense within 2 to 13 min (median 5.5 min) and 26 isodense in 3-45 min (median 8 min). The central opacification was incomplete in 19 (28.8%) lesions. The attenuation values in the malignant tumours varied from 10 to 58 HU on the plain scans and 50 (64.9%) were non-homogeneous in density. After contrast injection, 2 did not enhance, 2 enhanced homogeneously and 73 (94.8%) non-homogeneously. Predominantly peripheral enhancement was seen in 42 (54.5%) of the malignant lesions, with 35 (45.5%) being classed as faint and 7 (9.1%) intense. The attempt to identify the haemangiomas among the malignant lesions resulted in 35 true-positive results reflecting a sensitivity of 64.8%, a specificity of 100%, and an accuracy of 85.5%. The results of this study suggest that a proportion of haemangiomas presents CT features which justify a confident diagnosis.

Adult↗
PubMed1990

Lumbar disc degeneration. Correlation between CT and CT/discography.

Computed tomography (CT) images of 59 discs in 30 patients suffering from low back pain were compared with CT/discography images of the same discs in order to assess the correlation between intradiscal damage and changes in annular configuration and density. The discs were graded in CT as not bulging, slight protrusion, advanced protrusion or disc herniation, and were checked for local areas of hypodensity. General degeneration and annular disruption in CT/discography were evaluated separately according to the Dallas Discogram Description, on a scale of non-existent, slight, moderate, or severe. Most discs with a slight protrusion in CT showed severe annular disruption in CT/discography. Discs with advanced protrusion showed in addition a severe general degeneration. Disc herniation was associated only with severe annular disruption. Local hypodensity proved to be a specific but insensitive sign of annular disruption. It is concluded that a bulging disc is a sign of intradiscal damage and should be noted even when there is no nerve entrapment present.

Adolescent↗
PubMed1989

The significance of residual stenosis after decompression for lumbar spinal stenosis.

Thirty-one patients with degenerative or combined degenerative and developmental lumbar spinal stenosis diagnosed by myelography and at subsequent surgery were thoroughly examined by computed tomography (CT) to reveal the completeness of the decompression and its correlation with the outcome. Complete elimination of the stenosis was achieved in 10 cases (32%) of whom 9 (90%) showed improvement. Various combinations of residual stenosis (some type of stenosis of the lateral part of vertebral canal at the laminectomy sites and also central stenosis outside the laminectomy field) were observed in 21 cases (68%). Of these, 14 (67%) had nearly complete, subtotal decompression with minimal or some residual stenosis, 7 (33%) had only minor decompression of the most constricted part of the spinal canal with a considerable amount of residual stenosis. The latter groups showed improvement in 8 cases (57%) and 6 cases (86%), respectively. Three patients (10%) with increased postoperative symptoms had only minimal or some residual stenosis. The significance of these findings is discussed.

Female↗
PubMed1989

Pancreatitis in patients with chronic inflammatory bowel disease.

We describe six patients with acute pancreatitis associated with chronic inflammatory bowel disease (IBD) and no other etiological factor of pancreatic disease in a series of 513 patients with IBD. Five of the 6 patients had Crohn's disease and one indeterminate colitis; four had simultaneous symptoms of active colitis. The pancreatis was not caused by drugs or duodenal involvement of IBD. Our study suggests that pancreatic disease is one of the extra-intestinal manifestations of IBD, in particular of Crohn's disease.

Acute Disease↗
PubMed1988

Computed tomography as the primary radiological examination of lumbar spine.

A series of 235 patients examined by lumbar CT because of sciatica or other low back disorder was studied. The need of additional examinations and correlations to surgical findings were evaluated. Inadequate information was the cause of additional examination, mostly myelography in 20 patients (8.5%). It was concluded that lumbar CT is a suitable first examination of the lumbar spine in sciatica and low back pain. The indications to complementary myelography and its benefit are discussed.

Adolescent↗
PubMed1988

Examination of the sprained ankle: anterior drawer test or arthrography?

The accuracy of the anterior drawer test for the diagnosis of recent lateral ligament tears in the ankle was evaluated in a series of 192 patients using surgical or arthrographic findings for reference. Considerable overlapping of results was obtained in ankles with and without ligament tear. Twenty-eight per cent of the anterior talofibular ligament tears, and 38% of the combined anterior talofibular and calcaneofibular tears were not detected, and single and combined tears could not be differentiated. It is concluded that the anterior drawer test is too unreliable as a basis for any decision regarding surgical treatment of a recent sprain. Therefore, arthrography is recommended as the method of choice in such cases of recent ankle sprain, where the need of surgery has to be supported by X-ray analysis.

Adolescent↗
PubMed1988

CT features of recurrent lumbar disc herniation.

The CT findings of 29 patients with recurrent lumbar disc herniation, confirmed at reoperation, were analyzed. The shape of the recurrent herniation varied from a shallow bulge to round or triangular mass. Every lesion presented density numbers compatible with disc material. An enhancement study was made in six cases, and the lesions remained non-enhanced. Density measurement on CT proved reliable in the differential diagnosis between recurrent disc herniation and postoperative scar.

Adult↗
PubMed1988

The value of axial view in the radiography of shoulder girdle--experiences with a new modification of positioning.

A series of 117 patients underwent radiography of the shoulder girdle, performed using a modification which allowed the examination of also severely injured patients in the axial view. The findings in the frontal and axial views were compared. A total number of 161 pathological findings were discovered; out of them 30 were visible only in the frontal view and 49 only in the axial view. The series indicates that the axial view can be taken painless in patients with recent injury, and that the frontal and axial views considerably supplement each other.

Arthritis↗
PubMed1987

Bilateral isolated internal iliac aneurysms presenting as pelvic tumours.

A case of a bilateral isolated internal iliac aneurysm is presented. A male patient of 74 years of age had a sudden attack of pain in the right lower abdomen. A superficial haematoma was the only finding at primary ultrasonography (US), while seven weeks later a control US visualised a pelvic expansion, but the aetiology was not recognised. The CT finding was pathognomonic for an aneurysm, the diagnosis being "bilateral iliac aneurysms". Digital subtraction angiography (DSA) defined the aneurysms as existing in the internal iliac arteries.

Aged↗
PubMed1987

Comparison of the radiation doses in lumbar CT and myelography.

The radiation doses of the vertebral bodies and ovaries in lumbar CT and myelography were compared using a phantom. The CT examinations were performed with two different scanners using four different programs. At CT the radiation maximum doses of the vertebral bodies were higher than at myelography but the ovarian doses were lower. The radiation exposure does not prevent the use of CT instead of myelography, but the area of examination and the number of pictures should be limited to the minimum based on the clinical enquiry.

Female↗