Dieter Schellinger

Computed tomography in patients with homonymous visual field defects—A. Clinico-radiologic correlation

Abstract CT Scans were obtained in 39 patients with homonymous visual field defects and analyzed in conjunction with the results of neurologic and neuro-ophthalmologic examination. Nineteen patients had infarcts involving the optic radiations or the occipital lobes. The CT scan findings correlated with the age, size and location of the infarct. Large hemispheric infarcts were associated with dense homonymous hemianopsias. Six patients in this series had primary or metastasic neoplasm, CT again demonstrated a close correlation between the location of the lesions and the resulting field defects. Six patients had arterio-venous malformations of the occipital lobe. In three of them, CT scans identified an occipital lobe hematoma and separated these patients from those with cerebral infarction.

PACS clinical experience at Georgetown university

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for 3.5 years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for 3 years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Completion of a Hospital-Wide Comprehensive Image Management and Communication System

A comprehensive image management and communication (IMAC) network has been installed at Georgetown University Hospital for an extensive clinical evaluation. The network is based on the AT&T CommView system and it includes interfaces to 12 imaging devices, 15 workstations (inside and outside of the radiology department), a teleradiology link to an imaging center, an optical jukebox and a number of advanced image display and processing systems such as Sun workstations, PIXAR, and PIXEL. Details of network configuration and its role in the evaluation project are discussed.

Computed cranial tomography and radionuclide cisternography in hydrocephalus

Computerized Cranial Tomographic scanning has replaced radionuclide cisternography in screening both adult and pediatric patients for hydrocephalus. Nevertheless, cisternography provides indispensable information about the CSF clearance capacity and remains a valuable adjunct to the excellent anatomic detail provided by CCT scans. In patients without emergency symptoms, cisternography provides the best indication as to whether or not diversionary shunting is likely to relieve the patients symptoms.

PACS clinical experience at Georgetown University

Georgetown University Hospital has been operating an image management and communications system (IMACS or PACS) for three-and-a-half years. This work was initially funded under the Army Medical Research and Development Command Digital Imaging Network Systems (DINS) project. The system was taken from a research system supporting only radiology tasks to one extended to clinical use, and has been used in clinical work for two-and-a-half years. This paper will summarize our PACS clinical experience and will describe the operational features implemented and those still necessary.

Contributions of magnetic resonance imaging in the evaluation of optic gliomas

Eleven patients with gliomas in the optic chiasm were studied using a 0.5 Tesla superconducting system and third generation computed tomography scanners. All tumors were identified with both modalities, but in the majority of cases, the posterior extension of the tumor and its relationship to adjacent brain, important to both prognosis and management, were shown better by magnetic resonance imaging.

A Complete Image Management and Communications Network for the Neuroradiology Service at Georgetown University Hospital

A complete image management and communications system has been installed at Georgetown University Hospital (GUH). The network is based on the A T & T CommView® System. In the Neuroradiology Division, this comprehensive network supports a multiscreen workstation with access to multiple imaging modalities such as CT and MRI from both the hospital and a remote imaging center. In addition, the radiologist can access these images from various workstations located throughout the hospital as well as from remote sites such as the home. Among the radiology services supported by the network, neuroradiology has the greatest need for such a system with extensive daily requirements involving the remote imaging center and on-line consultation around the clock. By providing neuroradiology with all available communication links, the radiologist can monitor, diagnose, and consult. The remote site has a subsystem capable of acquiring images and transmitting them over a high speed T1 data circuit. The GUH neuroradiologist can view these images on the neuro workstation or any of the workstations available in the Hospital. Fast and easy access to the images allows a radiologist to monitor multiple examinations as well as to utilize the workstation for diagnosis. To provide the neuroradiologist quick access to images at all times, a PC-based Results Viewing Station (RVS) has been placed in a doctors home. Images may be sent to the RVS, or the user may request images from the central database at the hospital. Images can be viewed at home either as they are transmitted, or following transfer of a whole study. The efficiency and effectiveness of the systems capabilities with special regard to remote and teleradiology (RVS) operations have been studied for the neuroradiology service. This paper will discuss the current clinical acceptance and use, problems in implementation, and ways these difficulties are being surmounted.

The Role of Duplex Carotid Sonography, Digital Subtraction Angiography, and Arteriography in the Evaluation of Transient Ischemic Attack and the Asymptomatic Carotid Bruit

This article reviews the uses of arteriography, venous digital subtraction angiography, and duplex carotid sonography in the evaluation of patients with an asymptomatic carotid bruit or carotid system transient ischemic attack. It concludes with a description of the authors guidelines for their use.

Imaging of the pancreas with computed tomography

In this paper we present our experience with computerized tomographic imaging of the pancreas, both in normal and abnormal conditions. Eighty patients were studied for evaluation of pancreatic disease. A further 50 patients, all with a normal pancreas, were studied for abnormalities of other abdominal organs and served as the control group. Helpful signs in establishing the diagnosis of carcinoma of the pancreas were mass effect within the pancreas, alteration of organ contour and obliteration of retroperitoneal fat planes. We found that differentiation from pancreatitis or retroperitoneal lymphadenopathy may at times be difficult. Our results showed that in 22 out of 23 patients with proven normal pancreas, the pancreas size on the CT display was within the adopted normal range. In 30 patients with proven carcinoma of the pancreas, a pancreatic mass was seen in 24 (83%). Computerized tomography is clearly a valuable method for viewing both normal pancreatic anatomy and anatomical variations and pathologies.