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Biomedical subjects

W D Foley

Publications and source records attributed to W D Foley.

At least 109 records · Page 6Linked to original sources

Percutaneous liver biopsy in difficult cases simplified by CT or ultrasonic localization.

Repeat liver biopsy guided by CT and ultrasound was performed in ten prospectively selected patients with chronic liver disease, small liver size, and a previous unsuccessful biopsy. Biopsy sites selected by both radiographic techniques were essentially similar and within 1 cm of each other. The bulk of the liver was located more posteriorly and superiorly than expected, explaining the failure of the previous unsuccessful biopsies. Adequate cores of liver 1-2.5 cm in length were easily obtained with radiologic guidance. This technique is especially useful in patients with chronic active hepatitis complicated by cirrhosis.

Biopsy

Coronal upper abdominal anatomy: technique and gastrointestinal applications.

The coronal approach to the upper abdomen provides a valuable additional ultrasonographic view of the subphrenic and perirenal area bilaterally, and the hepatic and subhepatic region on the right. In patients with large amounts of overlying gas-filled bowel loops, it may provide the only ultrasonographic view into the high abdominal region. Reformatted coronal computed tomography may be used as a teaching aid and in demonstrating upper abdominal coronal anatomy. However, because of limited spatial resolution coronal computed tomography may be available and may be helpful in the evaluation of the upper abdomen.

Abdomen

Perinephric abscess with renal cell carcinoma.

A case of perinephric abscess with renal cell carcinoma is presented. Hematuria is uncommon in cases of perinephric abscess. When hematuria is present in a patient with perinephric abscess further evaluation is necessary to rule out an associated malignant process.

Abscess

Reformatted coronal display of upper abdominal computed tomography: comparison with ultrasonography.

The coronal plane is the most common format used for descriptions of the radiographic and surgical anatomy of the upper abdomen. Coronal reformatted computed tomographic (CT) studies of the upper abdomen were compared to coronal ultrasonic images of equivalent cephalocaudad dimension obtained with a water path echoscope. In most cases, the reformatted CT images were equivalent or superior in the display of selected mass lesions and their anatomic relationships. Direct coronal CT studies should be useful in the evaluation of upper abdominal pathology.

Abdomen

Ultrasonic evaluation of fetal kidneys.

Fetal renal morphology, technique and frequency of reliable visualization of the kidneys, and renal size were evaluated in 177 apparently normal fetuses. The kidneys were not reliably identified before 15 post-menstrual weeks and were seen in fewer than 50% of cases prior to 17 weeks. However, between 17 and 22 weeks (the critical time for genetic counseling) one or both kidneys were seen in 90% of cases, with both being identified in 75%. After 20 weeks, one or both kidneys were identified in approximately 95%. With high-resolution equipment, positive identification of one or both fetal kidneys should be possible in a large percentage of cases after 20 post-menstrual weeks.

Female

The effect of varying spatial resolution on the detectability of diffuse pulmonary nodules. Assessment with digitized conventional radiographs.

Detection and discrimination of miliary disease and small pulmonary nodules were tested at six levels of spatial resolution varying between 0.3 and 2.5 l.p./mm, and receiver operating characteristic (ROC) curves were generated. The test images were obtained by digitizing selected normal and abnormal standard film/screen radiographs. Although there was no statistically significant difference in observer performance between 0.5 and 2.5 l.p./mm, the findings may have clinical relevance. Further observer detection studies of different disease processes are planned to help formulate performance standards for an electric digital radiographic device for chest imaging.

Diagnosis, Differential

Computed tomography of the normal and abnormal pancreatic duct: correlation with pancreatic ductography.

Eighty-seven patients underwent both pancreatic computed tomography (CT) and pancreatic ductography. Measurements of pancreatic ducts identified by CT correlated well with measurements from pancreatic ductograms. The anatomic relationships of the pancreatic duct to the margins of the pancreas, and the pancreatic and common bile ducts at their junction were clarified. In 86% of both normal and abnormal ducts at least a part of the duct was identified when optimal CT technique was used. Pancreatic CT is particularly helpful in identifying abnormalities proximal to duct obstruction. CT identification of an abnormal pancreatic duct is a sensitive indicator of pancreatic disease.

Humans

CT of sacroiliitis.

Sacroiliitis is often difficult to diagnose with certainty using conventional radiographs and radionuclide scanning. Computed tomography was used to study the sacroiliac joints in 20 consecutive patients clinically suspected of having sacroiliitis on initial evaluation. Of these 20 patients, 17 fulfilled conventional clinical criteria for sacroiliitis; computed tomography demonstrated changes of sacroiliitis in 12 of these 17 patients. CT revealed no changes of sacroiliitis in the three patients who failed to meet conventional clinical criteria for sacroiliitis. Conventional radiography demonstrated diagnostic changes of sacroiliitis in only five patients. Seven patients with CT changes of sacroiliitis had equivocal or negative conventional films. CT therefore seems superior to conventional radiography in detecting sacroiliitis.

Arthritis

Computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease: a comparative study.

A prospective study was performed comparing the sensitivity of computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic disease. Forty patients with suspected pancreatic carcinoma, acute recurrent or chronic pancreatitis, and/or jaundice were studied. CT was the most sensitive study in evaluation of pancreatitis. ERCP was most accurate in evaluation of pancreatic malignancy. Ultrasonography was the least sensitive method in detecting pancreatic disease and dilatation of the extrahepatic biliary ducts.

Endoscopy

Demonstration of the normal extrahepatic biliary tract with computed tomography.

When optimum computed tomography (CT) technique and computed angiotomography are utilized, the normal extrahepatic biliary ducts (equal to or less than 6 mm in diameter in patients without cholecystectomy) can be demonstrated in approximately 30% of clinical scans. Measurement of the anteroposterior diameter of the bile duct is more accurate than recording the transverse diameter, since the apparent transverse dimension will vary depending on the orientation of the duct in the plane of section. Phantom studies indicate that the absolute error of measurement is approximately one pixel diameter irrespective of duct diameter. The normal and abnormally dilated extrahepatic biliary ducts should be distinguished with CT.

Cholangiography

CT evaluation of esophageal and upper abdominal varices.

Recognition of major abdominal visceral vessels is an integral part of the interpretation of upper abdominal computed tomography (CT) studies. Perivisceral portal systemic varices appear as lobulated or discrete rounded tubular densities in characteristic sites, including periesophageal, perigastric, and peripancreatic locations, the pararenal spaces, and the gallbladder fossa. To avoid confusion with lymphadenopathy and soft tissue tumors, the varices can be specifically identified using contrast enhancement techniques and fast scan times. In portal hypertension, contrast enhanced CT can be used to define both the extrahepatic portal system and the location of the perivisceral varices.

Abdomen

Computed tomography in the demonstration of hepatic pseudoaneurysm with hemobilia.

Pseudoaneurysm with hemobilia is an infrequent complication of blunt hepatic trauma. The definitive test for demonstrating an aneurysm is hepatic angiography. The potential value of contrast enhanced computed tomography in defining the surgical approach and demonstrating coexistent hematoma and abscess is illustrated in a case of posttraumatic hemobilia.

Adult

Digital radiograph of the chest using a computed tomography instrument.

Digital radiography (DR) was compared with conventional chest radiography in patients with mediastinal adenopathy, sarcoidosis, and metastatic adenocarcinoma. Contrast resolution was improved by the new technique, offering a wider latitude and edge enhancement. While small, low-contrast details were resolved best by conventional radiography, DR was superior for resolution of nodules. With further improvement of spatial and contrast resolution, DR could become the preferred technique of chest radiography.

Adenocarcinoma

Sagittal and coronal image reconstruction: application in pancreatic computed tomography.

The application of coronal and sagittal image reconstruction in the display of the normal pancreas and peripancreatic region is illustrated. The use of standard reproducible reference points for multiplanar reconstruction is suggested. Reconstruction computed tomography displays more anatomic structures in the coronal and sagittal planes than ultrasonography and accurately displays the craniocaudad extent of pancreatic pathology.

Humans

Xenon contrast enhancement in computed body tomography.

Xenon has been investigated as a contrast medium for conventional radiography, and in vitro as a contrast medium for computed tomography. The authors evaluated xenon contrast enhancement in vivo for CT body scanning. Nine healthy subjects had CT scans before and during xenon inhalation. Concentrations of xenon used varied from 10--50%. Consistent useful changes in attenuation from inhaled xenon were found in the lung but not in abdominal organs. Lung attenuation varied linearly with the xenon concentration in the inhaled gas. Inhalation of xenon concentrations greater than 30% resulted in side effects. Further studies are required to demonstrate whether xenon contrast enhancement is of diagnostic value in computed tomography.

Clinical Trials as Topic