ABSTRACT
Clinical observations on patients with hemobilia secondary to percutaneous biliary procedures and laboratory studies on animals with experimentally induced hemobilia indicate that the presence of fresh blood or clot within the biliary tree may yield an erroneous impression of duct size in ultrasound examinations. Recognition of this potential source of error becomes increasingly important as the use of percutaneous procedures for the relief of biliary obstruction increases.
Subject(s)
Hemobilia/diagnosis , Ultrasonography , Animals , Bile Ducts/pathology , Dogs , False Negative Reactions , Hemobilia/etiology , Humans , Iatrogenic DiseaseABSTRACT
Two hundred and one biopsies of the pancreas and/or extrahepatic bile ducts were performed in 173 patients using primarily ultrasound (US) or fluoroscopic guidance. Computed tomographic (CT) guidance was used twice. The success rate for detecting malignancy was 82.4%. Patients with primary ductal carcinoma had the lowest success rate. Seven complications occurred: five vasovagal reactions, one fever, and one acute pancreatitis in a patient with a normal variation, which resembled a mass. In this large series, aspiration biopsy of the pancreas and extrahepatic bile ducts proved to be a safe and reliable procedure that often can be performed on an outpatient basis. Fluoroscopic and US guidance are satisfactory for the majority of biopsies. CT guidance probably should be reserved for patients who undergo a repeat biopsy, or when US fails to adequately demonstrate the pancreas.
Subject(s)
Bile Duct Neoplasms/pathology , Bile Ducts/pathology , Pancreas/pathology , Pancreatic Neoplasms/pathology , Aged , Aged, 80 and over , Biopsy/methods , Female , Fluoroscopy , Humans , Male , Middle Aged , UltrasonographySubject(s)
Bile Ducts/pathology , Hemobilia/diagnosis , Ultrasonography , Aged , Dilatation, Pathologic/diagnosis , False Negative Reactions , Humans , MaleABSTRACT
A critical review was made of the CT findings in 300 patients who underwent axial CT of the lumbar spine in which spondylolysis and/or spondylolisthesis had been diagnosed. Findings indicate that axial CT is superior to conventional radiographs in several areas: (1) for consistent and accurate demonstration of spondylolysis, (2) for disclosing the various changes in the apophyseal joints associated with degenerative and reverse spondylolisthesis, and (3) for uncovering minimal degrees of spondylolisthesis by the presence of a pseudobulging disk in many cases with equivocal or negative radiographs. Axial CT is a highly accurate method for diagnosing and evaluating spondylolysis and all types of spondylolisthesis.
Subject(s)
Lumbar Vertebrae , Spondylolisthesis/diagnostic imaging , Tomography, X-Ray Computed , Adult , Humans , Male , Spondylolysis/diagnostic imagingABSTRACT
Follow-up sonographic studies of five infants whose initial sonograms had displayed evidence for the diagnosis of cholelithiasis demonstrated spontaneous resolution of the gallbladder defects. These defects may have been caused by tumefactive sludge with acoustic shadowing. Whether sludge or gallstones are being imaged, in the absence of other clinical or imaging evidence of biliary tract disease, conservative (i.e., nonsurgical) management and serial sonograms are recommended.
Subject(s)
Cholelithiasis/diagnosis , Ultrasonography , Female , Follow-Up Studies , Humans , Infant , Infant, Newborn , MaleABSTRACT
CT studies on 212 normal elderly individuals were analyzed for ventricular enlargement and cortical atrophy. Results show a positive correlation between ventricular enlargement and age with greater degrees of ventricular enlargement and cortical atrophy in men as compared to women. While some degree of atrophy is common in normal elderly individuals it is mild, minimal, or noexistent in 86%.
