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Jaffe MH, Hosgood G, Taylor HW, Kerwin SC, Hedlund CS, Lopez MK, Davidson JR, Miller DM, Paranjpe M. Immunohistochemical and clinical evaluation of p53 in canine cutaneous mast cell tumors. Vet Pathol 2000; 37:40-6. [PMID: 10643979 DOI: 10.1354/vp.37-1-40] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
One hundred twenty-six cutaneous mast cell tumors obtained by excisional biopsy from 106 dogs were evaluated using immunohistochemical staining for the presence of p53 protein. A standard avidin-biotin immunohistochemical protocol was used incorporating a polyclonal antibody of rabbit origin (CM-1) as the primary antibody. Histopathologic grading of tumors was performed on hemotoxylin and eosin-stained samples. There was a significant difference in the percentage of cells staining positive for p53 for the histopathologic grades (P = 0.0005). Grade III tumors had a significantly greater p53 content than did grade I or II tumors (P < 0.05). Clinical data obtained retrospectively was available for 54 dogs. Tumor recurred in 19 of 54 (35.2%) dogs. Twenty-nine dogs died by the end of the study; 9 of 29 (31.0%) died of mast cell tumor disease. Histopathologic grade showed a significant negative association with survival time. Both clinical stage and histopathologic grade showed a significant negative association with time to recurrence. The percentage of cells staining positive for p53 did not significantly improve the forward analysis. Immunohistochemical detection of p53 did not appear useful in characterizing the clinical association between cutaneous mast cell tumor cellular features and survival time or time to tumor recurrence in dogs.
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Affiliation(s)
- M H Jaffe
- Department of Veterinary Clinical Science, Louisiana State University School of Veterinary Medicine, Baton Rouge 70803, USA
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2
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Abstract
Medical records of 55 dogs with a diagnosis of cutaneous mast cell tumour were reviewed. Twenty-seven of the dogs were treated with surgery plus deionized water and the remaining 28 with surgery alone. A survival analysis was performed to determine whether deionized water, as an adjunct to surgery for cutaneous mast cell tumour, affected survival time or time to tumour recurrence. Dogs in which mast cell tumour recurred had a significantly shorter survival time compared with dogs with no recurrence (P = 0.05), regardless of the method of treatment. A significant negative association between tumour recurrence and method of treatment (P = 0.0097) and clinical stage (P = 0.0223) was observed. Dogs treated with surgery and deionized water had a significantly shorter time to recurrence of their mast cell tumour (P = 0.0113). Based on these results, deionized water does not appear to be beneficial in prolonging survival time or time to tumour recurrence for dogs with cutaneous mast cell tumours.
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Affiliation(s)
- M H Jaffe
- Department of Veterinary Clinical Sciences, Louisiana State University School of Veterinary Medicine, Baton Rouge 70803, USA
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3
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Jaffe MH, Grooters AM, Partington BP, Camus AC, Hosgood G. Extensive venous thrombosis and hind-limb edema associated with adrenocortical carcinoma in a dog. J Am Anim Hosp Assoc 1999; 35:306-10. [PMID: 10416775 DOI: 10.5326/15473317-35-4-306] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 10-year-old, spayed female, mixed-breed dog was referred for evaluation of bilateral hindlimb edema and weakness. Abdominal ultrasonography showed increased echogenicity of the lumen of the caudal vena cava from the level of the urinary bladder to the level of the cranial pole of the right kidney. Bilateral saphenous venograms displayed numerous filling defects in the caudal vena cava, right external iliac vein, right femoral vein, and the right common iliac vein. Extensive venous thrombosis was diagnosed, and the animal was euthanized. Necropsy confirmed the presence of venous thrombosis and revealed a right adrenocortical carcinoma that had invaded the caudal vena cava.
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Affiliation(s)
- M H Jaffe
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge 70803-8410, USA
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4
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Paushter DM, Zeman RK, Scheibler ML, Choyke PL, Jaffe MH, Clark LR. CT evaluation of suspected hepatic metastases: comparison of techniques for i.v. contrast enhancement. AJR Am J Roentgenol 1989; 152:267-71. [PMID: 2783503 DOI: 10.2214/ajr.152.2.267] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Although IV injection of contrast material is widely used for detection and follow-up of hepatic metastases on CT, the optimal method of contrast enhancement has not yet been defined. A prospective study was performed in 50 consecutive patients with suspected hepatic metastases. Lesion size and detectability were compared on unenhanced CT scans, scans obtained during a bolus injection of contrast material (early bolus phase), and scans obtained during a rapid infusion after the loading bolus. A total of 60 hepatic lesions were evaluated in 26 patients, 19 with histologic confirmation of metastases and seven with strong supportive evidence. The bolus phase allowed detection of 15% more lesions than did examination during the rapid-infusion phase. Lesion size varied, depending on the timing and method of contrast administration; the largest measurements were obtained during bolus injection of contrast material. In addition, bolus administration of contrast material subjectively resulted in the best lesion detection. Because the three techniques of IV contrast enhancement may produce different size measurements, sequential examinations must be tailored appropriately. Scanning during the bolus phase is technically possible with current CT equipment and is recommended as the primary CT screening examination for hepatic metastases.
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Affiliation(s)
- D M Paushter
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007-2197
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5
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Abstract
We report a case in which a focally spared area of pancreatic tissue in a gland otherwise replaced by fat created a "pseudomass" mimicking neoplasm on sonography and CT. The "pseudomass" appearance was related to the anomalous ductal anatomy in pancreas divisum. The spared area of pancreas creating a "pseudomass" was drained by the dorsal duct and the remainder of the pancreas that had undergone relative fatty replacement was drained by the ventral duct.
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Affiliation(s)
- P M Silverman
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007
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Bertagnolli ME, Loebenberg M, Benjamin SB, Fleischer DE, Collen MJ, Lewis JH, Cattau EL, Jaffe MH. Use of endoscopic ultrasound in patients with esophageal motility disorders. Gastroenterol Nurs 1989; 12:98-9. [PMID: 2487833 DOI: 10.1097/00001610-198901220-00004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
New technology has combined the endoscope with ultrasound in an effort to enhance the visualization of the gastrointestinal tract. With a modified standard endoscope that has an ultrasound transducer built into the tip, high frequency ultrasonic beams can be targeted in close proximity to existing lesions. This results in better quality resolution which enhances the evaluation of the targeted lesion. In addition, esophageal wall thickness can be evaluated and assessed as to its role in esophageal function.
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7
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Clark A, Zeman RK, Choyke PL, White EM, Burrell MI, Grant EG, Jaffe MH. Pancreatic pseudotumors associated with multifocal idiopathic fibrosclerosis. Gastrointest Radiol 1988; 13:30-2. [PMID: 3350266 DOI: 10.1007/bf01889019] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Two patients with multifocal idiopathic fibrosclerosis and sclerosing cholangitis developed biliary obstruction due to a fibrotic pancreatic pseudotumor. The masslike fibrosis mimicked pancreatic carcinoma on sonography and cholangio-pancreatography. In one patient sonography was successfully used to assess the response of the pseudotumor to corticosteroid therapy.
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Affiliation(s)
- A Clark
- Department of Radiology, Georgetown University Hospital, Washington, D.C
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8
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Abstract
Twelve patients with known pancreas divisum underwent thin-section computed tomography (CT) to determine the capability of CT to depict this pancreatic anomaly. Focal pancreatic enlargement was present in five patients. Two distinct pancreatic moieties separated by a fat cleft were noted in three patients; a fourth patient had focal atrophy in the distribution of the dorsal pancreas. The two pancreatic moieties were identified at the same craniocaudal level in all four of these patients. The dorsal duct was depicted in all 12 patients, while the short ventral duct was seen in only five of the 12 patients. Failure of the ventral and dorsal pancreatic ducts to fuse was identified in all five patients in whom both ducts were seen. CT may not enable specific diagnosis of pancreas divisum in the majority of patients. If, however, distinct pancreatic moieties or unfused ductal systems are evident, the diagnosis may be confidently suggested.
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Affiliation(s)
- R K Zeman
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007-2197
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Zeman RK, Cronan JJ, Rosenfield AT, Lynch JH, Jaffe MH, Clark LR. Renal cell carcinoma: dynamic thin-section CT assessment of vascular invasion and tumor vascularity. Radiology 1988; 167:393-6. [PMID: 3357945 DOI: 10.1148/radiology.167.2.3357945] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Dynamic thin-section computed tomography (CT) was used to evaluate renal cell carcinoma in 80 patients. The lesion was correctly staged with CT in 90% of patients. With use of the dynamic technique, the ipsilateral renal vein was depicted in 99% of patients. Extension of the tumor to the renal vein or the inferior vena cava was correctly detected in 18 of 19 patients. Actual depiction of tumor thrombus was a far more accurate indicator of renal vein invasion than was the identification of isolated renal vein enlargement. Dynamic thin-section CT of the kidney should be considered the routine method for comparison studies with other newer cross-sectional techniques in the evaluation of renal cell carcinoma.
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Affiliation(s)
- R K Zeman
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007
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Zeman RK, Benjamin SB, Cunningham MB, Nauta RJ, Fleischer DF, Lewis JH, Collen MJ, Cattau EL, Jaffe MH. Small bowel obstruction due to Garren gastric bubble: radiographic diagnosis. AJR Am J Roentgenol 1988; 150:581-2. [PMID: 3257613 DOI: 10.2214/ajr.150.3.581] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- R K Zeman
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007
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Zeman RK, Clements LA, Silverman PM, Paushter DM, Garra B, Jaffe MH, Clark LR. CT of the liver: a survey of prevailing methods for administration of contrast material. AJR Am J Roentgenol 1988; 150:107-9. [PMID: 3257105 DOI: 10.2214/ajr.150.1.107] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The members of the Society of Body Computed Tomography were surveyed to determine the most frequently used method of administering contrast material in CT studies of the liver. The respondents represented CT departments performing liver examinations in 22 institutions. No department relied solely on noncontrast scans. In 12 (54%) of 22 institutions, only contrast-enhanced scans were performed. The preferred dose for enhancement was 150 ml of 60% contrast material. Eight (36%) of the 22 respondents obtained images during the administration of a bolus of contrast material, whereas nine (41%) obtained images during the administration of a sustained drip infusion given after a loading bolus. Follow-up in 1987 revealed that two departments had switched to obtaining images during the administration of a bolus. The availability of CT power injectors and refinements in the rapid-scanning capabilities of CT scanners have increased the popularity of obtaining images of the liver during the administration of a bolus of contrast material. Despite this, in many departments, contrast material is still administered via drip infusion in CT studies of the liver.
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Affiliation(s)
- R K Zeman
- Department of Radiology, Georgetown University Hospital, Washington, DC 20007
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12
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Jaffe MH, Fleischer D, Zeman RK, Benjamin SB, Choyke PL, Clark LR. Esophageal malignancy: imaging results and complications of combined endoscopic-radiologic palliation. Radiology 1987; 164:623-30. [PMID: 2441429 DOI: 10.1148/radiology.164.3.2441429] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Fifty-one patients with advanced cancer of the esophagus underwent 191 endoscopic palliative procedures, including bouginage, laser therapy, bipolar electrocoagulation, and stent placement. In three patients free perforations developed; these were treated immediately and no sequelae developed. Perforations confined within the tumor mass were diagnosed with CT in two patients and did not require treatment. Methods of endoscopic palliation are discussed with reference to the radiologic studies and techniques. The radiologist must evaluate tumor topography and esophageal wall thickness with computed tomography and esophagography to aid in the choice of palliative therapy. Knowledge of each technique and its risks by the radiologist is essential for useful consultation with the endoscopist before, during, and after the procedure.
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Abstract
The clinical and radiologic features of 27 patients with renal metastases arising from eight different types of nonlymphomatous primary malignancies are presented. Renal metastases were generally detected late in the course of the malignancy. In 23 patients there were no symptoms referable to the kidney. Urinalysis was normal in nine patients and showed microscopic hematuria in nine, gross hematuria in four, and proteinuria in four. Radiologically, metastases were usually multifocal; however, metastases arising from colon, lung, and breast carcinoma were sometimes large, solitary, and otherwise indistinguishable from primary renal cell carcinoma. Three of four melanoma metastases and three of seven lung metastases infiltrated the perinephric space. Computed tomography was the most sensitive modality, depicting renal metastases in all 24 cases in which it was employed, followed by ultrasound and intravenous urography. In patients with a history of malignancy, renal metastases outnumbered renal cell carcinomas by approximately 4:1. This study indicates that a new renal lesion in a patient with advanced, noncurable cancer is more likely metastatic than primary and that biopsy in this setting is unlikely to be of aid.
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Abstract
Pelvic hematomas following prostatic biopsy are rare. We describe 2 cases of hematomas occurring in the prevesical space (space of Retzius) following transrectal biopsy. Computed tomography (CT) was useful in defining the extent of the hematoma and showing density changes related to the age and suppuration of the hematoma. While cystography has been used to diagnose prevesical hematomas, CT better assesses the size of the hematoma and changes that may occur over time.
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Abstract
The clinical diagnosis of cervical aortic arch rests on the detection of a pulsatile mass in the supraclavicular fossa. Unfortunately, clinical differentiation of a cervical arch from an aneurysm of the great vessels can be difficult. Dynamic computed tomography (CT) can aid in this differentiation and avert the need for angiography.
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Brody JM, Miller DK, Zeman RK, Klappenbach RS, Jaffe MH, Clark LR, Benjamin SB, Choyke PL. Gastric tuberculosis: a manifestation of acquired immunodeficiency syndrome. Radiology 1986; 159:347-8. [PMID: 3961166 DOI: 10.1148/radiology.159.2.3961166] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A Haitian man with acquired immunodeficiency syndrome (AIDS), fever, malaise, and diarrhea is described. A computed tomographic (CT) scan showed a retrogastric mass with an associated ulcer. An upper gastrointestinal tract study showed an ulcer with both benign and malignant features. Endoscopy revealed a malignant-appearing ulcer, but cultures and histologic examinations of surgical biopsy specimens indicated gastric tuberculosis. The relationship between tuberculosis and AIDS is discussed.
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Zeman RK, Cronan JJ, Rosenfield AT, Choyke PL, Paushter DM, Clark LR, Jaffe MH, Schiebler ML. Computed tomography of renal masses: pitfalls and anatomic variants. Radiographics 1986; 6:351-72. [PMID: 3685502 DOI: 10.1148/radiographics.6.3.3685502] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
An awareness of potential pitfalls in CT imaging of renal masses helps to reduce needless imaging procedures and surgery.
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Affiliation(s)
- R K Zeman
- Department of Radiology, Georgetown University Hospital, Washington, D.C. 20007
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Choyke PL, Thickman D, Kressel HY, Lynch JH, Jaffe MH, Clark LR, Zeman RK. Controversies in the radiologic diagnosis of pelvic malignancies. Radiol Clin North Am 1985; 23:531-49. [PMID: 3903844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Although vast differences exist among the many pelvic malignancies, several unifying concepts emerge from this discussion. First, there is a different role for diagnostic imaging for each type of pelvic malignancy. The radiologist should be aware that although the radiographic findings may be similar, the clinical impact varies greatly with a particular tumor. Second, although clinical staging is notoriously inaccurate, nevertheless diagnostic imaging techniques only improve upon but do not replace it because of false-positive and false-negative results. Third, because of the high false-negative rates of most of the modalities in use, negative studies do not in fact rule out the presence of disease. A surgical procedure may still be needed. Finally, several new techniques, including MRI and transrectal or transurethral ultrasound, may improve the accuracy rates. These developments will probably further enliven the controversies surrounding the radiologic evaluation of pelvic malignancies.
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Zeman RK, Burrell MI, Dobbins J, Jaffe MH, Choyke PL. Postcholecystectomy syndrome: evaluation using biliary scintigraphy and endoscopic retrograde cholangiopancreatography. Radiology 1985; 156:787-92. [PMID: 4023244 DOI: 10.1148/radiology.156.3.4023244] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We prospectively studied 30 patients with postcholecystectomy syndrome to determine the efficacy of biliary scintigraphy in the detection of stenosis of the sphincter of Oddi. All patients underwent endoscopic retrograde cholangiopancreatography (ERCP). Biliary scintigraphy disclosed stenosis of the sphincter by agreement with the ERCP or surgical findings in nine (90%) of ten patients and in eight (100%) of eight patients with biliary obstruction from other causes. Retention of activity at 2 hours in visually prominent ducts was the best predictor of abnormal biliary drainage. Biliary scintigraphy is a useful, noninvasive screening test for the detection of postcholecystectomy biliary obstruction.
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Zeman RK, Cronan JJ, Rosenfield AT, Choyke PL, Clark LR, Jaffe MH, Paushter DM, Schiebler ML. Imaging approach to the suspected renal mass. Radiol Clin North Am 1985; 23:503-29. [PMID: 2997834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The authors present their algorithmic approach to the detection, characterization, and staging of renal masses. Based on classification of urographic findings, the patient may be triaged to the appropriate cross-sectional or invasive imaging modality that will result in the most cost-effective management.
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Zeman RK, Paushter DM, Schiebler ML, Choyke PL, Jaffe MH, Clark LR. Hepatic imaging: current status. Radiol Clin North Am 1985; 23:473-87. [PMID: 3903843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The radiologist needs to be aware of the varied appearance of hepatic mass lesions and be prepared to recommend the most cost-effective imaging approach. In this article, the authors discuss their hepatic imaging experience, common pitfalls, and current recommendations.
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Clark LR, Jaffe MH, Choyke PL, Grant EG, Zeman RK. Pancreatic imaging. Radiol Clin North Am 1985; 23:489-501. [PMID: 2997833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In this article, the pancreas is evaluated with regard to the controversies surrounding this organ from a clinical standpoint, and an approach to imaging modalities is examined. The roles of computed tomography, ultrasound, endoscopic retrograde cholangiopancreatography, and magnetic resonance imaging are put into proper perspective.
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Pien EH, Zeman RK, Benjamin SB, Barth KH, Jaffe MH, Choyke PL, Clark LR, Paushter DM. Iatrogenic sclerosing cholangitis following hepatic arterial chemotherapy infusion. Radiology 1985; 156:329-30. [PMID: 3160062 DOI: 10.1148/radiology.156.2.3160062] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A case of common hepatic duct stricture secondary to hepatic artery chemotherapy infusion is described. CT and endoscopic retrograde cholangiopancreatography (ERCP) may be used in concert to differentiate this entity from other causes of jaundice--namely, hepatic replacement by tumor, porta hepatis adenopathy, and chemotherapy hepatotoxicity.
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Clark LR, Jacobs NM, Zeman RK, Jaffe MH, Moser BE, Choyke PL, Paushter DM, Schiebler ML. Enhanced pancreatic CT imaging utilizing a geometric magnification technique. Invest Radiol 1985; 20:531-8. [PMID: 4044196 DOI: 10.1097/00004424-198508000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Computed tomography (CT) using a geometric magnification technique was found to improve spatial resolution in phantom studies when compared with conventional third-generation geometry images. The clinical feasibility of using geometric magnification, small focal spot size, and dynamic contrast enhancement was studied in 143 patients referred to CT for clinically suspected pancreatic disease. This population included 46 patients with a normal pancreas and 36 patients subsequently proven to have primary pancreatic carcinoma. Using this new technique in conjunction with dynamic contrast enhancement resulted in high quality pancreatic images. Despite the limitations in tube current associated with a small focal spot size and low total heat capacity of the system, clinical imaging was not adversely affected. Use of the geometric magnification technique is recommended in departments where it is technically feasible.
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Mangano FA, Zaontz M, Pahira JJ, Clark LR, Jaffe MH, Choyke PL, Zeman RK. Computed tomography of acute renal failure secondary to rhabdomyolysis. J Comput Assist Tomogr 1985; 9:777-9. [PMID: 4019835 DOI: 10.1097/00004728-198507010-00021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Two patients with rhabdomyolysis and renal failure were imaged with CT. The presence of a striate nephrogram, nephromegaly, and perinephric fluid has not previously been described on CT. Although nonspecific, these findings suggest the diagnosis of acute tubular blockade, and, once identified, administration of additional urographic contrast medium should be avoided.
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Zeman RK, Schiebler M, Clark LR, Jaffe MH, Paushter DM, Grant EG, Choyke PL. The clinical and imaging spectrum of pancreaticoduodenal lymph node enlargement. AJR Am J Roentgenol 1985; 144:1223-7. [PMID: 3890486 DOI: 10.2214/ajr.144.6.1223] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Pancreaticoduodenal lymph node enlargement, regardless of cause, has been a source of imaging confusion because of its propensity to mimic pancreatic malignancy yet not cause biliary obstruction. Thirty-eight patients with pancreaticoduodenal adenopathy were imaged with several methods. Pancreaticoduodenal lymphadenopathy could be distinguished from intrinsic pancreatic abnormality on only 44% (14/32) of CT scans and 54% (6/11) of sonograms. Demonstration of intact tissue planes separating adenopathy from pancreas and, to a lesser degree, extrapancreatic vascular displacement were the most helpful diagnostic signs. Surprisingly, 31% of patients had biliary obstruction. Care must be taken in distinguishing metastatic lymphadenopathy from primary pancreatic tumors. The presence or absence of jaundice should not be considered a helpful sign.
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Feuerstein IM, Zeman RK, Jaffe MH, Clark LR, David CL. Perirenal cobwebs: the expanding CT differential diagnosis. J Comput Assist Tomogr 1984; 8:1128-30. [PMID: 6501621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Although initially described as representing collateral venous structures, perirenal cobwebs may be due to a variety of benign and malignant conditions. Six representative cases illustrating the broad differential diagnosis are presented.
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Abstract
The authors examined 139 patients thought to have early, partial, or intermittent biliary obstruction, using sonography, hepatobiliary scintigraphy, and in selected cases contrast cholangiography. Of 125 patients with a well-established final diagnosis, sonography and scintigraphy disagreed in 29 (23%). Scintigraphy revealed early or low-grade obstruction in 13 patients who had no evidence of dilated ductules, while 7 patients with dilatation from prior stone passage or biliary surgery showed normal clearance. The authors conclude that in a preselected population in whom early or low-grade biliary obstruction may be present, disagreement between sonography and scintigraphy is not rare, and the absence of sonographically detectable dilatation does not exclude obstruction.
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Abstract
The interaction between the various noninvasive and invasive imaging modalities used to evaluate the liver, biliary tract, and pancreas is demonstrated in this article. By understanding this interaction and correlating noninvasive studies, the clinician will avoid diagnostic redundancy and the need for invasive testing may be reduced.
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Bowerman RA, Donn SM, Silver TM, Jaffe MH. Natural history of neonatal periventricular/intraventricular hemorrhage and its complications: sonographic observations. AJR Am J Roentgenol 1984; 143:1041-52. [PMID: 6385669 DOI: 10.2214/ajr.143.5.1041] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Cranial sonography is an established procedure for the detection of neonatal intracranial hemorrhage. A 3 year experience in imaging such infants is reviewed. Representative examples are presented to comprehensively illustrate the spectrum of sonographic appearances of intracranial hemorrhage and its complications from the initial hemorrhage to resolution. Diagnostic problems in the initial staging of the grade of hemorrhage and in evaluating subsequent ventricular changes are addressed.
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Abstract
Numerous radiographic and scintigraphic imaging modalities are now available for evaluating the gastrointestinal system. With a well-formulated plan based on patient history, physical examination, and laboratory values, together with knowledge of patient preparation techniques and consultation, an efficient customized approach to gastrointestinal disease can be accomplished.
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Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) are well established diagnostic studies for pancreatic evaluation. We conducted a study to determine whether performing these examinations in tandem increased diagnostic accuracy. Patients undergoing ERCP with successful cannulation of the pancreatic duct and who could be placed in the gantry of our CT scanner within 30 min were included in the study. The combined examination, or endoscopic retrograde computed tomography of the pancreas (ERCTP), provided additional useful information in several types of patients including those who had intrapancreatic air without clinical abscess, those with apparent total obstruction of the pancreatic duct on ERCP, and those who were post partial pancreatectomy and were being considered for additional surgery. No additional useful information was provided in patients with a normal ERCP or in routine cases of pancreatitis.
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Abstract
The relative frequencies of the different sonographic features and patterns of uterine leiomyomas have been examined by prospective and retrospective analyses of the sonograms in 41 proven cases. The original sonographic reports correctly predicted the presence of myomas in 27/45 studies (sensitivity = 60 per cent). Retrospective analyses of the sonograms revealed abnormalities in 32/41 patients (sensitivity = 78 per cent). Most myomatous uteri had two or more sonographic abnormalities, most frequently uterine contour irregularity (76 per cent), altered echo texture (68 per cent) and/or enlargement (66 per cent). Minimal contour irregularity at the interface between the uterus and the bladder deserves emphasis as a subtle diagnostic sign of leiomyoma. Careful attention to the uterus in examining a patient referred for an adnexal mass should improve the diagnostic accuracy of myoma detection by sonography.
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35
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36
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37
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38
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Abstract
The sonographic features of eight surgically confirmed pheochromocytomas are described and correlated with pathologic findings. The purely solid masses were homogeneous or heterogeneous sonographically. Pathologic examination of the gross specimen provided explanations for the variety of sonographic findings. Two tumors had large cystic components due to old blood. Other hypoechoic areas corresponded to necrosis pathologically. Hyperechoic areas represented hemorrhage. Generally, pheochromocytomas are quite large, sharply marginated, and usually have a significant solid component with or without central necrosis or hemorrhage. Recognition of these features should facilitate their identification on sonography.
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40
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Abstract
The gray-scale ultrasonic features of Wilms tumor are reported with pathologic comparison. The most consistent ultrasonic features are large size, sharp margination, and echogenic heterogeneity. The frequently observed anechoic areas correlated with hemorrhage and necrosis. A rare case of mesoblastic nephroma is included for comparison. Pitfalls in diagnosis are discussed.
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