John H. Feist

The characteristic angiographic criteria of malignancy.

Angiograms of proved malignant neoplasms were evaluated to identify criteria of malignancy and to compare their incidence with nonmalignant controls. Three angiographers studied the material, which was then analyzed by a shared-time computer, and a strategy was developed for evaluating the data. This double-blind study revealed that perivascular cuffing (encasement) was the most reliable criterion; in its absence, neovascularity and associated arterial and venous occlusion and deformity were of equal importance. The absence of neovascularity strongly suggests benignancy.

Extra- and intrasplenic artery aneurysms in portal hypertension.

Extra- and intrasplenic arterial aneurysms have occasionally been encountered in cases of portal hypertension both with and without cirrhosis. The exact pathogenesis is speculative; however, it is postulated that hyperkinetic splenic circulation, probably related to hepatic arterial insufficiency or hypoplasia, constitutes the primary pathogenic mechanism. Other factors such as splenomegaly and hormonal influence may be contributory.

Pheochromocytoma with Large Cystic Calcification and Associated Sphenoid Ridge Malformation

Pheochromocytoma need not be considered a rare neoplasm since it is seen with relative frequency in nearly every large tumor clinic. Calcification within a pheochromocytoma, however, is quite unusual, and its occurrence in the region of the adrenal glands rarely leads to suspicion of such a tumor. We have been able to collect only 16 published cases in which calcium was radiographically demonstrable (2, 8, 15). The following case is the only one described to date with large cystic calcification. The concurrent presence of other radiographic stigmata of neuroectodermal dysplasia will be described and discussed. Case Report2 A 74-year-old white male was admitted to the private medical service of the Presbyterian Hospital of Pittsburgh Sept. 4, 1959, because of intermittent diffuse lower abdominal pain associated with palpitation and headaches, which had been present for approximately fifteen years. Two months prior to admission, the episodes of pain became increasingly frequent and severe and were at times ...

In Vivo Behavior of Artificial Aortic and Mitral Valve Prostheses: Preliminary Observations

Rapid objective assessment by cinefluorography of the functional status of prosthetic heart ball-valves, either during routine postoperative examinations or in the presence of suspected complications (Table I), became practical once radiopaque material had been incorporated in the balls. The major advantages of this innovation are: (a) cinefluorographic study of mobility of the ball and of its retaining case and (b) prompt and positive localization of dislocated balls. We have, therefore, begun a follow-up program of serial examinations of intracardiac ball-valves. Two cases are presented herein,2 and a tentative outline of our criteria of normalcy by cinefluorography is presented. No evidence to date indicates that impregnation of the silicone rubber (Dow-Corning Silastic) with barium sulfate alters its mechanical characteristics according to laboratory testing, its durability, or its chemical, hydrostatic, or electrostatic resistance in vivo. Analysis of the first 100 patients with sutureless valves (1)...

Diagnosis of esophageal varices. Improvement of diagnostic accuracy by cinefluorography.

Correct diagnosis of esophageal varices is a universal concern in roentgenology. Nearly every patient suspected of varices undergoes a radiographic-fluoroscopic examination. The criteria for roentgenologic diagnosis are well known (1, 2). Until recently it has been said that conventional esophagography with fluoroscopy is grossly unreliable, since a correct diagnosis is established in only 15 to 50 per cent of cases (3–5). The advent of image intensification has rendered esophagography considerably more precise and accurate, and we believe that with reasonable care varices are currently identified correctly in 50 to 75 per cent of the cases. More definitive diagnostic methods, although statistically more accurate, tend to be somewhat more complex, uncomfortable, and perhaps hazardous: esophagoscopy, mesenteric portography (6), splenoportography (7), and direct visualization during laparotomy or autopsy. None of these methods, however, is totally reliable. For example, during endoscopy varices may become o...

Cardiac Aneurysm and Nonaneurysm

Abstract Contrary to traditional concepts, contour and apparent pulse are not reliable criteria in distinguishing aneurysms from certain solid masses of the heart or other viscera. This distinction can often be made without contrast material by means of cinefluorographic observations. Criteria for separating aneurysms and similar lesions are offered.