George N. Stein

Nonuniform attenuation in computed tomography study of the cirrhotic liver.

Diffuse hepatocellular processes are not well imaged by most radiologic modalities. At present, CT has not added significantly to the evaluation of hepatocellular disease, particularly in the cirrhotic liver. The CT patterns of cirrhosis previously described are reviewed, and the pathophysiology of cirrhosis is discussed. In 3 cases, a pattern was seen in cirrhotic livers characterized by nonuniform attenuation with varied response to administration of intravenous contrast agents. With further evaluation of fatty infiltration and cirrhosis, CT may prove helpful in understanding these disease processes.

A Co-Operative Evaluation of Mammography in Seven Teaching Hospitals

The diagnostic criteria and radiographic technic of mammography were described in the American literature by Leborgne (1) in 1951 and Gershon-Cohen (2) in 1953. Prior to Egans report in 1960 (3), however, the examination was not performed as a routine in the majority of radiology departments in hospitals of the Philadelphia area. Many radiologists had attempted mammography only to abandon it after failing to achieve the accuracy of interpretation of published reports (4). Because of the unchanging death rate from breast cancer and the possibility of earlier accurate diagnosis suggested by Egan, a group of radiologists representing seven teaching hospitals2 in Philadelphia undertook in 1962, at the suggestion of Dr. Eugene P. Pendergrass, to study the value of mammography as a diagnostic tool. The primary purpose of the project was to determine the accuracy of mammography in diagnosis and its usefulness in the management of the breast patients of the physicians and surgeons practicing in the participating...

Complications of “No Arteriography”

Vascular opacification studies are becoming increasingly important in diagnostic radiology, in part owing to recent advances in surgery and in part because of the unique value of these procedures in diseases of abdominal and retroperitoneal structures which previously resisted diagnosis by conventional radiographic technics. Abnormalities of the cardiovascular system considered inoperable a decade ago are now successfully treated after an accurate preoperative diagnosis. Paralleling the increased frequency of vascular examinations is a growing number of reports of complications resulting from their use (1–3). We have been uncertain as to what extent these complications allegedly due to the angiographic procedure were iatrogenic or actually a complication of the patients primary disease. In our department, several days often elapse between scheduling and performing an elective arteriographic procedure. Occasionally, such scheduled studies are cancelled, and we have investigated the causes for cancellation...

Arteriography in diagnosis of abdominal disease.

Selective arteriography is a valuable aid in the diagnosis of otherwise obscure gastrointestinal disorders. Its usefulness is described with particular reference to lesions of the liver, pancreas and spleen and primary disorders of the gastrointestinal arterial system. Percutaneous selective arteriography of the celiac and the mesenteric arteries has been successfully applied in the preoperative determination of the site of gastrointestinal bleeding.

Radiology of colonic diverticular disease

Nonsurgical diagnosis of colonic diverticulosis and most complications of diverticular disease is best established by barium enema study. Multiple diverticula can produce narrowing and shortening of the colon that is unrelated to any complication occurring in the diverticula. The diagnosis of diverticulitis is made radiologically be demonstrating the effects on the lumen of the bowel of the pathologic changes visible on gross inspection, eg, local abscess, intramural dissection, fistula, obstruction. Frequently the radiologic findings are subtle.

Extrinsic Pressure Defects on the Duodenal Loop in Mesenteric Occlusive Disease

Atherosclerotic occlusions of the mesenteric vessels can be recognized and treated in the chronic state, but frequently portions of the gastrointestinal tract are gangrenous before the diagnosis is considered. The clinical picture of postprandial abdominal pain, anorexia, and weight loss with laboratory findings of malabsorption should suggest mesenteric vascular disease (1, 3, 4, 9, 11). Thefindings, however, are often vague or may mimic other more common causes of abdominal pain. In addition, the commonly employed studies for abdominal disease have not been helpful in alerting the physician to this possibility. Gastrointestinal barium examinations have either been negative or have shown nonspecific changes in the small bowel such as those observed in the malabsorption syndrome. Confirmation and localization of the lesions have required abdominal aortography or selective visceral arteriography. Further experience in mesenteric vascular disease has suggested to us that the collateral circulation developin...