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W K Loftus

Publications and source records attributed to W K Loftus.

17 recordsLinked to original sources
PubMed1999

Sonographic measurement of splenic length: correlation with measurement at autopsy.

PURPOSE: The purpose of this study was to determine the correlations between the sonographic measurement of splenic length and the actual splenic length, volume, and weight. METHODS: Before autopsy, sonographic measurements of splenic length were obtained in 30 cadavers, and these values were compared with the actual length, volume, and weight of the spleen at autopsy. RESULTS: There were clear linear correlations between maximum sonographic length and actual length (r = 0.831), volume (r = 0.817), and weight (r = 0.810). CONCLUSION: This study shows that a single, simple sonographic measurement gives a clinically useful indication of true splenic size.

Aged↗
PubMed1999

Diagnosis of peritonsillar infections: a prospective study of ultrasound, computerized tomography and clinical diagnosis.

Peritonsillar infections include cellulitis and abscess (quinsy). Clinical diagnosis is often supplemented by diagnostic drainage (aspiration or incision) in an effort to distinguish abscess from cellulitis. In a prospective study of 14 patients we have shown that clinical impression alone is unreliable (sensitivity 78 per cent, specificity 50 per cent). Computerized tomography (CT) (sensitivity 100 per cent, specificity 75 per cent) and intraoral ultrasound (sensitivity 89 per cent, specificity 100 per cent) are much more reliable. We propose that intraoral ultrasound could play a useful role in the clinical assessment of peritonsillar infections helping to improve accuracy in distinguishing abscesses from cellulitis.

Adolescent↗
PubMed1999

Ultrasound, CT and colonoscopy of colonic cancer.

Barium enema and colonoscopy are commonly used for the investigation of suspected colonic cancer. These techniques are relatively invasive and both the investigation and the preceding bowel preparation are demanding, particularly in the elderly. A prospective, blinded trial was conducted to compare ultrasound (US) and CT with colonoscopy. CT and colonoscopy were performed on 50 patients with symptoms suggesting colonic cancer. Both radiological investigations were performed prior to the bowel preparation for colonoscopy. US was performed without any preparation and oral contrast medium was the only preparation used for CT. Colonoscopy detected six cancers, all of which were diagnosed by both US and CT. In addition, US and CT diagnosed a further cancer not seen on colonoscopy due to an incomplete study. US had a sensitivity and specificity of 100% and CT a sensitivity of 100% and a specificity of 84%. US and CT were poor at diagnosing polyps. If the detection of polyps greater than 2 cm is included then US sensitivity falls to 67% and CT sensitivity falls to 89% and specificity rises to 88%. In conclusion, both US and CT are possible alternatives to colonoscopy in the investigation of symptomatic patients with suspected colonic cancer. The use of these techniques could markedly reduce the need for colonoscopy in this patient population with attendant cost savings. Non-invasive imaging has particular advantages in the elderly who cope poorly with both the bowel preparation and the procedure.

Adult↗
PubMed1998

Renal length in Chinese children: sonographic measurement and comparison with western data.

PURPOSE: The purpose of this study was to determine the normal range of renal length in Hong Kong Chinese children and compare it with Western data. METHODS: Two hundred fifty children undergoing routine abdominal sonography were examined prospectively, and the maximum length of 1 kidney per child was recorded. Ages ranged from newborn to 19 years, and there were 109 girls and 141 boys. Similar data from Australian children involved maximum lengths of both kidneys in 554 children ranging in age from newborn to 14 years. There were 361 girls and 193 boys. No children had known renal disease. RESULTS: There was no statistically significant difference between the mean renal lengths of girls and boys. Statistical comparison of the data from Hong Kong and Australia showed no significant difference except in the 8-12 month age group (this difference is unlikely to be clinically significant). Although direct statistical comparison with published data on kidney lengths in 203 U.S. children was not possible, plots of the three sets of data were strikingly congruent. CONCLUSIONS: Despite expectations that smaller body size in Hong Kong children might equate to smaller kidneys, comparison with 2 sets of Western data showed no clinically significant difference in renal length between the 3 groups.

Adolescent↗
PubMed1998

Ultrasound assessment of mild splenomegaly: spleen/kidney ratio.

BACKGROUND: Ultrasound may detect mild splenomegaly before it is clinically palpable. Knowledge of the normal range of spleen size in the population being examined is a prerequisite. Racial differences in splenic length could result in incorrect interpretation of splenic measurements. OBJECTIVE: To measure the normal values of splenic length in Hong Kong Chinese children and compare the results with Western data; to determine whether there is a constant ratio of the length of the spleen to the left kidney, which could be used to diagnose splenomegaly without reference to a nomogram. MATERIALS AND METHODS: Ultrasound was used to measure maximum splenic and left kidney length in 256 Chinese children to obtain normal values for spleen length and to determine the spleen/kidney ratio. Results. Splenic length in Chinese children is similar to Western children up to the age of about 15 years. The spleen/left kidney ratio is strikingly constant with a mean value of 1. Using 2 SD above the mean as a guide, the upper limit of normal for the spleen/kidney ratio is 1.25. CONCLUSION: Splenomegaly should be suspected in children if the spleen is more than 1.25 times longer than the adjacent kidney.

Adolescent↗
PubMed1998

Peritonsillar abscess appearance on intra-oral ultrasonography.

The ultrasound appearances of peritonsillar abscesses (PTA) in 15 patients with clinically suspected peritonsillar infection were assessed using intra-oral sonography and computed tomography (CT). The ultrasonic appearances of an isoechoic rim with a hypoechoic centre were seen in the majority of cases, but a homogeneous isoechoic pattern was also recognized. The different ultrasonic appearances did not correlate with the number of symptomatic days. A central hypoechoic area with a surrounding isoechoic rim pattern was less likely if the volume of pus relative to the whole abscess was less than 10% on CT. Although the percentage of necrosis within the abscesses increased with time, the homogeneous isoechoic appearing abscesses, with less than 10% necrosis, did not fit in temporally and based on our findings it was not possible to predict the ultrasound appearances according to the duration of symptoms.

Adolescent↗
PubMed1998

The role of ultrasound and oesophagography in the management of acute suppurative thyroiditis in children associated with congenital pyriform fossa sinus.

The thyroid is remarkably resistant to infection. Hence, when an infection does occur, the presence of a pyriform fossa sinus must be considered, particularly if it is recurrent and left sided. The aim of this paper is to alert radiologists to the existence, clinical presentation, and ultrasonographic and oesophagographic appearances of a pyriform fossa sinus. We present the role of ultrasound and oesophagography in five children with pyriform fossa sinus associated with suppurative thyroiditis. In four children the abnormality was on the left and on the right in one.

Abscess↗
PubMed1998

Clinical prediction of post-extubation radiological changes of the chest in newborn infants.

OBJECTIVE: Whether a chest radiograph should be performed routinely in all infants after extubation, or selectively only in those with clinical deterioration, is a controversy in neonatal unit practice. This study tested the hypothesis that most cases of post-extubation radiological deterioration in the lungs could be detected by clinical assessment. METHODS: A chest radiograph was performed at 8 h post-extubation in 100 episodes of extubation in 85 newborn infants ventilated for a variety of lung diseases. Each infant was assessed at the same time by a neonatologist blinded to the radiological findings, to determine whether a chest radiograph would have been requested based on clinical judgement. The infants were continuously monitored for their respiratory and oxygenation status before and after extubation. RESULTS: Compared to the pre-extubation chest radiographs, 23 of the 100 post-extubation chest radiographs showed either deterioration of the pre-existing lung pathologies or appearance of significant new pathologies. The clinicians' assessment failed to detect most of the deterioration, with a sensitivity of only 21.7%. Systematic analysis of the infants' clinical parameters showed that the development of significant intercostal/subcostal retraction, and an increase in inspired oxygen concentration by > or = 7% after extubation, were the best predictors of post-extubation radiological deterioration (sensitivity 82.6%, specificity 62.3%, positive predictive value 39.6%, and negative predictive value 92.3%). Serial blood gas in contrast had little predictive value. CONCLUSION: We conclude that most cases of radiological deterioration of the lungs after extubation are clinically predictable, provided the correct clinical criteria are used.

Blood Gas Analysis↗
PubMed1997

Normal splenic size in a Chinese population.

To establish the normal range for the length of the spleen in the Hong Kong Chinese population we used ultrasonography to examine 783 patients not known to have any condition likely to be associated with splenic enlargement. The results show a rapid growth in splenic length up to age 20 years, followed by a mild decrease. A statistically significant difference is seen between male and female subjects from about 15 to 40 years with spleens of men being about 0.5 cm longer. Using 2 standard deviations above the mean as a guide, we recommend 12 cm as the upper limit of normal in this population.

Adolescent↗
PubMed1997

Atypical computed tomography appearance of a duodenal diverticulum.

The typical CT appearance of a duodenal diverticulum is of a rounded air collection with or without fluid or contrast. An unusual case in which gas bubbles mixed with particulate matter mimicked faecal material in the large bowel is presented here. A similar appearance has been described in abnormally dilated small bowel, usually associated with obstruction, and is probably due to stasis of undigested food.

Aged↗
PubMed1996

Nasolacrimal duct opacity on CT.

A retrospective analysis of 100 coronal sinus CT scans was performed to investigate the frequency of opacity of the nasolacrimal duct and determine if there was any correlation between the pattern of duct opacity and the presence of inflammatory sinus disease. The study showed that the nasolacrimal ducts are opaque in the majority of normal people and that there is no relationship to inflammatory sinus disease.

Adolescent↗