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Biomedical subjects

T L Angtuaco

Publications and source records attributed to T L Angtuaco.

33 records · Page 2Linked to original sources

Ultrasound imaging as a screening study for malignant soft-tissue tumors.

Fifty patients who had a palpable soft-tissue mass and an apparently normal radiograph were studied with ultrasound imaging before excision or biopsy of the lesion was done. As shown by the sonograms, thirty-five lesions had a discrete echo pattern (usually reduced echoes and a clearly defined lesional margin) and fifteen had an ill defined pattern (similar to the pattern of the surrounding normal tissues with no definable lesional margin). Fourteen lesions were malignant and thirty-six, benign. The sonograms of all fourteen malignant lesions showed a discrete pattern, while the sonograms of the benign ones showed twenty-one discrete and fifteen ill defined patterns. Therefore, the malignant lesions produced a discrete pattern in every instance, and every lesion that produced an ill defined pattern was benign. Fourteen of the fifty lesions were cystic; of these, thirteen were benign and one was malignant. The sonograms correctly identified the cyst in seven of the thirteen benign lesions and in the one malignant cystic lesion. Based on these findings, we concluded that all palpable soft-tissue masses that appear to be discrete on a sonogram should be diagnosed without delay by examination of a specimen taken at biopsy, whereas lesions that have an ill defined appearance on a sonogram may be assumed to be benign and may safely be observed in selected patients.

Algorithms↗

Inferior vena caval filters: noninvasive evaluation.

Transvenous inferior vena caval filters were placed in 32 patients (21 bird's nest [BN] and 11 Kimray-Greenfield [K-G] filters). Positive contrast cavography was performed before and immediately after filter placement as well as during long-term follow-up studies. In 23 patients, computed tomographic (CT) scanning was also performed; in 10 patients, real-time ultrasound (US) study was used as an adjunct. CT scans of the BN filter showed one case of hemorrhage and one case of air embolism, both of which were not recognized at cavography. CT scanning of the K-G filter demonstrated two cases of deep penetration of the prongs and one large retroperitoneal hematoma. Real-time US scanning played a major role in checking the final position of the filter and in determining its stability during repositioning of the upper prongs of one BN filter. Noninvasive examinations, including CT and US scanning, are valuable adjuncts in immediate and long-term follow-up study of patients with inferior vena caval filters.

Embolism, Air↗

Effect of manganese on human placental spin-lattice (T1) and spin-spin (T2) relaxation times.

Human placentas were obtained immediately following delivery and incubated with manganese chloride (MnCl2) in concentrations ranging from 0.002 to 2.0 mM. Proton density, T1 and T2 were measured at times ranging from 5-200 minutes. There was rapid uptake of manganese by the placenta producing a dose-dependent decrease in placental T1 and T2. The major effect of manganese uptake was shortening of T1 suggesting that the contrast between placenta and myometrium will be enhanced predominantly for T1-dependent imaging pulse sequences.

Chlorides↗

Incidental hydronephrosis on bone scintigraphy: sonographic verification.

We studied 98 kidneys in 55 patients with bone scintiscans and renal sonography. Among the 29 kidneys in which hydronephrosis was suspected on bone scintiscans only 12 were truly hydronephrotic by renal ultrasound. In the other 17 cases extrarenal pelves, postural stasis, early urinary tract obstruction or renal parenchymal disease may have contributed to the discrepant findings. By ultrasound criteria there were no false negative readings for hydronephrosis on scintiscan. While it is safe to interpret absence of hydronephrosis caution should be used in diagnosing hydronephrosis, since less than half of the cases actually will have the disease when suspected on a bone scintiscan.

Bone and Bones↗

Prenatal diagnosis of central nervous system abnormalities.

Fetal anomalies have been the subject of innumerable publications both in the prenatal and neonatal literature. This has significantly increased in the last 10 years, mainly because of the advent of high-resolution ultrasound equipment and improvement of scanning techniques. In addition, guidelines issued by professional organizations involved in prenatal diagnosis have encouraged a more universal approach to the imaging and documentation of prenatal findings. The fetal central nervous system is the most frequently investigated organ system, mainly because of its easy accessibility and prominence even in the early stages of embryologic development. The biparietal diameter was the first fetal measurement to be widely used in determining gestational age. As investigators gained more experience, the appearance of ultrasound images achieved the resolution that allows direct comparisons with gross specimens and more recent sophisticated techniques of computed tomography and magnetic resonance imaging. Now endovaginal ultrasound can document early first trimester development and compare it to known embryologic landmarks. Interest in demonstrating the ultrasound counterpart of central nervous system structures in the early stages of development has resulted in a plethora of articles proving the unique ability of ultrasound in imaging the developing fetus. In view of all these developments, the beginning ultrasound specialist is faced with the challenge and responsibility not only of being familiar with the literature but also of the mastery of scanning techniques that allow accurate prenatal diagnosis. It is therefore helpful to review key developmental milestones in embryologic life and correlate them with the corresponding prenatal ultrasound appearance. In addition, the changing appearance of the developing fetus has created a need for a systematic approach in the evaluation of structures so routine protocols can be established. This has been the subject of other publications that allow the novice to draw from the cumulative experience of different centers around the world. It is important to pay attention to the specifics described in the literature when duplicating results in one's laboratory. The frustration of not being able to reproduce results is common, especially when technical limitations prevent imaging under ideal conditions. This is especially true in patients who are first seen in the later third trimester with no prior prenatal care.(ABSTRACT TRUNCATED AT 400 WORDS)

Brain↗

CT of emphysematous gastritis.

Emphysematous gastritis is a serious, often fatal condition. It is the result of destruction of the mucosal membrane with subsequent bacterial invasion of the stomach. We have encountered two cases at CT. Recognition is important since early intervention may be lifesaving.

Adult↗

Prenatal diagnosis of complicated abdominal wall defects.

The accurate prenatal diagnosis of anterior abdominal wall defects is important because it affects patient management and prognosis. The pathophysiology of each defect leads to key characteristics that make it possible to differentiate one entity from another. Among these features are the location of the defect in relation to cord insertion, the size and contents of the defect, and the associated anomalies. This article reviews the underlying defects, the characteristic ultrasound findings, the associated anomalies, and the prognosis of simple and complicated abdominal wall defects. The basic features of simple abdominal wall defects (i.e., omphalocele and gastroschisis) were used as the initial points of assessment. A comparison of the different features of these abnormalities and how they differ from one another resulted in the development of criteria that facilitated the understanding of the different ultrasound manifestations of these anomalies.

Abdominal Muscles↗

CT findings in abdominal actinomycosis.

The diagnosis of abdominal actinomycosis is difficult because of its relative infrequency and imitation of other diseases. We present four cases in which these difficulties in diagnosis were experienced and show the utility of CT in suggesting this disease. Aspiration, biopsy, and proper culture technique, in conjunction with typical CT findings of transfascial and multiple organ involvement, led to the proper diagnosis in all cases.

Abdomen↗