PubMed Health⌕ Search

Biomedical subjects

S S Sagel

Publications and source records attributed to S S Sagel.

At least 19 recordsLinked to original sources
PubMed1992

Pulmonary nodular opacities after transbronchial biopsy in patients with lung transplants.

Focal nodular opacities were seen on 26 of 74 (35%) postbiopsy radiographs obtained in 39 patients who underwent lung transplantation. The subsequent clinical course and diagnostic evaluation suggested that the opacities were due to focal hemorrhage at the biopsy sites. This finding was evident on only three of 40 (8%) postbiopsy radiographs obtained in 40 control patients who underwent transbronchial biopsy for diffuse interstitial lung disease. The differential diagnosis of new pulmonary nodular opacities in lung transplantation patients should include focal postbiopsy hematomas, because of their relatively frequent occurrence in this clinical situation.

Adult↗
PubMed1992

Omental flap in lung transplantation.

Some surgeons performing lung transplantation will wrap the bronchial anastomosis with omentum in an attempt to improve healing. The authors retrospectively reviewed the chest radiographs and computed tomographic (CT) scans of 31 patients who underwent lung transplantation with bronchial omentopexy to determine the CT appearance of the intrathoracic omentum and the frequency and type of chest radiographic manifestations created by the omental flap. The omental flap was seen at CT in all patients, was predominantly of fatlike attenuation, and contained linear areas of increased attenuation representing omental vessels. In 16 patients (52%), a total of 29 chest radiographic findings that corresponded to the omental flap were seen. There was no statistically significant correlation between the type of operative procedure and the presence of a chest radiographic correlate for the omentum. The results showed that the omental flap is a potential diagnostic pitfall on post-lung transplantation chest radiographs; when there is confusion, however, the omentum can be identified with CT because of its attenuation value and characteristic course.

Adolescent↗
PubMed1992

Spiral CT: decreased spatial resolution in vivo due to broadening of section-sensitivity profile.

Comparable conventional and spiral computed tomographic (CT) scanning protocols for transaxial (n = 30) and multiplanar reformation (MPR) (n = 15) imaging were performed to image the adrenal gland and the upper pole of the right kidney in the same patient, without use of intravenously administered contrast media. The sharpness of soft-tissue-fat interfaces oriented in the transverse (xy) and longitudinal (z) directions was measured as the maximum and full width at half maximum (FWHM) of the edge attenuation profile first derivative. Edge sharpness was qualitatively assessed by three blinded reviewers, who used a four-point scale. In vivo transaxial CT studies showed that the conventional scans produced slightly sharper edges than the spiral scans (mean difference of spiral and conventional FWHM = 0.30 mm [P < .05] [in z direction] and 0.21 mm [P < .05] [in xy direction]). In vivo MPR studies showed that interfaces in the xy plane were significantly less sharp with spiral scanning, whereas interfaces in the z direction were equivalent for conventional and spiral scanning (mean difference of spiral and conventional FWHM = 0.03 mm [P > .05] [in z direction] and 1.19 mm [P < .05] [in xy direction]). Significant respiratory misregistration was present on seven of 15 (47%) conventional MPR scans and on no spiral MPR scans.

Adipose Tissue↗
PubMed1991

Anatomy of the major fissure: evaluation with standard and thin-section CT.

The major fissures of the right and left lungs were studied with standard computed tomography (CT) (10-mm-thick sections) and thin-section CT (2-mm-thick sections) in 50 patients. On standard CT scans, the major fissures were seen in 90%-100% of cases at each of three selected levels. They usually appeared as hypoattenuating bands and less often as lines or hyperattenuating bands. Although in most cases the major fissure was seen as a line on thin-section CT scans, this appearance was more common in the upper portion of the left major fissure than in the upper portion of the right major fissure. A "double-fissure sign" was most frequently seen at the base of the left lung; however, the sign was also seen at higher levels, with approximately equal frequency in the right and left lungs. An incomplete major fissure was noted in the right lung in 32 cases (64%) and in the left lung in 26 cases (52%). The upper and middle portions of the left major fissure were less frequently incomplete than were the comparable portions of the right major fissure. Thin-section CT provided better delineation of the major interlobar fissures than did standard CT.

Aged↗
PubMed1991

High-attenuation mediastinal masses on unenhanced CT.

On unenhanced CT scans, a variety of mediastinal masses contain areas with attenuation values higher than the attenuation value of the chest wall musculature. The increased attenuation may be diffuse or focal and may be a result of calcium deposition, high iodine content, or areas of acute hemorrhage. This report illustrates the gamut of high-attenuation mediastinal masses seen on unenhanced CT. Masses that are of high attenuation only on IV contrast-enhanced images (e.g., aberrant vessels) are not included.

Aortic Aneurysm↗
PubMed1991

Artifacts in computed radiography.

Storage-phosphor digital radiographic systems are becoming widely used in a variety of diagnostic procedures. The equipment is reliable and produces images of consistently high quality. However, the images may contain artifacts directly related to the digital techniques used, to the phosphor imaging plate, or to radiography in general. This article illustrates many of the artifacts encountered that are specific to computed radiography, some of which can simulate pathologic lesions. Their causes and remedies are discussed briefly.

Algorithms↗
PubMed1991

Motion artifact simulating aortic dissection on CT.

We recently imaged two patients clinically suspected of having aortic dissection whose contrast-enhanced CT examinations, obtained on a new scanner with a 1-sec scanning time, showed findings suggesting an ascending aortic dissection. The subsequent clinical course and evaluation implied that the CT findings were predominantly artifactual. We identified identical artifacts in 18% of 50 consecutive contrast-enhanced CT examinations performed for a variety of indications on the same scanner. The double-lumen artifact, simulating an intimal flap, occurs in the proximal ascending aorta and is limited to one or two contiguous transaxial images. The artifact was not detected on two other CT units. We believe the artifact arises from motion of the aortic wall and the surrounding pericardial recesses during image acquisition.

Adult↗
PubMed1990

Computer facilitation of the resident selection process.

A personal computer software system has been designed and implemented to facilitate the numerous complex tasks involved in the resident selection process. The computer tracks the status of each candidate, monitors each application for incomplete documentation, generates personalized correspondence, computes and maintains a scoring system based on evaluation by each Resident Selection Committee member, and provides various data printouts (eg, list of candidates by medical school; persons granted an interview; and ranking lists). Developed with the intent to share with the academic community, the system improves organization and accuracy, and notably decreases time spent by administrative assistants and staff members in the resident selection process.

Computer Systems↗
PubMed1990

Digital mobile radiography.

A storage phosphor digital imaging system has been used to perform virtually all of an increasing number of mobile (portable) projectional roentgenographic examinations in a busy hospital. Approximately 130 such studies are done per day, of which about 110 are chest examinations. The processing unit suffices to keep pace with peak activity in the radiology department. This technique has decreased the repeat rate for portable anteroposterior chest radiographic examinations from 4.5% to less than 1% and has resulted in an even more dramatic reduction in the rate for lateral or decubitus chest examinations as well as for studies of the abdomen and those done in the operating room. The diagnostic accuracy and confidence level achieved in interpreting the complementary pair of digital images has been equivalent to or has exceeded that obtained with conventional mobile analog film-screen radiographs.

Equipment Design↗
PubMed1989

Indeterminate mediastinal invasion in bronchogenic carcinoma: CT evaluation.

The computed tomographic (CT) scans of 80 patients with bronchogenic carcinoma classified as indeterminate for direct mediastinal invasion were retrospectively reviewed after the patients had undergone thoracotomy. Forty-eight (60%) of the masses were resectable, without invasion of the mediastinum, 18 (22%) focally invaded the mediastinum but were technically resectable, and 14 (18%) invaded the mediastinum and were not technically resectable. Although in most circumstances in this relatively small subset of patients CT was not helpful in differentiating masses with and without mediastinal invasion, CT was able to separate a large group of masses that were likely to be technically resectable. Thirty-six (97%) of 37 masses with one or more of these CT findings were considered technically resectable: contact of 3 cm or less with mediastinum, less than 90 degrees of contact with aorta, and mediastinal fat between mass and mediastinal structures. Of these 36 masses, 28 were resectable without mediastinal invasion, and eight were resectable with focal limited mediastinal invasion.

Adult↗
PubMed1989

Pneumothorax: appearance on lateral chest radiographs.

The appearance of pneumothorax on lateral radiographs obtained with the patient erect were reviewed in 100 patients (122 total examinations). A pneumothorax could be seen on the lateral projection in 89% of the examinations (109 of 122). The displaced pleural line was most frequently identified anteriorly or posteriorly and was less commonly identified at the lung apex or in a subpulmonic location. In 11 cases, an air-fluid level was the only recognizable finding of a pneumothorax on the lateral projection. Although in 27% of examinations (32 of 122) the pneumothorax was either not seen (11%) (n = 13) or was a subtle finding (16%) (n = 19), in 14% of examinations (17 of 122) the lateral projection provided helpful information to supplement the posteroanterior projection.

Adult↗
PubMed1989

Bronchial impaction in lobar collapse: CT demonstration and pathologic correlation.

Bronchial (or mucoid) impaction refers to the accumulation of inspissated secretions (mucus and/or inflammatory products) within a bronchus, usually accompanied by bronchial dilatation. This process may be caused by abnormal mucociliary transport and excessive production of mucus. In other cases, a discrete lesion may be present that obstructs the bronchus with inspissated secretions accumulating distal to the obstructing lesion. Lobar collapse may result in either case if a lobar bronchus is occluded by the excessive mucus or a discrete obstructing lesion. The CT manifestations of bronchial impaction in four patients with lobar collapse are described. In two patients, the lobar collapse and distal bronchial impaction were produced by a central obstructing bronchogenic carcinoma, whereas the other two patients had an abnormal mucus accumulation without a discrete bronchial obstruction. On CT, the impacted bronchi, best seen on postcontrast images, appeared as relatively low-attenuation branching structures extending from the hilum peripherally into the more opaque enhancing atelectatic lung. In the three patients who had surgical resection of the involved lobe, pathologic examination confirmed the dilated bronchi, filled with mucus (one patient), fibrinopurulent exudate (one), or mucous plugs with Aspergillus hyphae (one). This unique pattern of impaction within a collapsed lobe should be recognized on CT and prompt a search for a possible central obstructing lesion.

Bronchi↗
PubMed1986

Mediastinal lesions in children: comparison of CT and MR.

Magnetic resonance (MR) imaging was compared with computed tomography (CT) in 13 children with mediastinal abnormalities. CT and MR provided comparable information regarding the presence and size of the mediastinal lesions. The MR imaging technique that was most reliable in detecting a mass was a T1-weighted spin-echo pulse sequence. MR better discriminated mediastinal masses and enlarged nodes from vascular structures and was more sensitive than CT in detecting intraspinal extension. However, CT demonstrated calcification and bronchial abnormalities not seen on MR images. It is concluded that MR may be more helpful than CT in evaluating posterior mediastinal tumors, since there is a likelihood of intraspinal extension. In other cases, however, CT continues to be the procedure of choice to supplement plain radiography in children with suspected mediastinal neoplasms.

Adolescent↗