Marvin E. Goldberg

Acute Liver Abscess in Chronic Granulomatous Disease of Childhood

Liver abscess is a common complication of chronic granulomatous disease of childhood (CGD). Early surgical excision and drainage of the abscess are necessary. The liver scan is an invaluable means of diagnosing liver abscess early in such children. Of 11 patients with CGD studied, 4 were proved to be normal, 6 showed focal defects due to liver abscess, and one showed diffuse decreased uptake due to fatty infiltration. A high degree of suspicion of this complication should be maintained when a child presents with fever of undetermined etiology.

CT appearance of antibiotic-induced colitis

Eleven abdominal computed tomographic (CT) examinations were performed in 10 patients with antibiotic-induced colitis. The clinical, endoscopic, and CT findings are presented. The most common CT findings were colonic dilatation and bowel wall thickening. However, small bowel dilatation was commonly seen. Intramural gas and ascites were less frequent findings. The diagnosis of antibiotic-induced colitis was rarely made before CT examination. Consequently, attentiveness to these CT abnormalities can expedite specific treatment. When these findings are noted on CT they represent the equivalent of toxic megacolon and administration of rectal contrast is contraindicated.

Comparison and Performance of Anger Cameras

Measurements of sensitivity, spatial resolution, dead time, and field uniformity, as well as imaging of phantoms, provide a satisfactory means of evaluating and comparing Anger camera systems. The authors recommend that these parameters be measured periodically to detect deterioration of performance. A clinical evaluation of images depends upon the type of cathode-ray tube display and associated film response. Thus, given an optimized camera system, an appropriate display format is also required for best results.

Progressive CT appearance of hepatic metastases from colorectal carcinoma.

An 8-year retrospective review of 106 serial computed tomographic (CT) examinations performed on 32 patients with colorectal carcinoma metastatic to the liver was done to determine if the CT appearance of such metastases changed with a favorable response to chemotherapy or with progression of disease. Of these 32 patients, 15 underwent placement of an infusion pump for delivery of chemotherapy directly into the hepatic artery, 3 underwent partial hepatectomy, 1 underwent both procedures, and 13 underwent neither. Regression of hepatic metastases (7 patients), only seen following infusion pump placement, was associated with a decrease in size and an increase in margination of lesions. In two of these patients regression of metastases was seen in one area of the liver with subsequent progression or development of metastases in another region, presumably due to preferential delivery of chemotherapeutic agent. Progression of disease (23 patients) was associated with an increase in both size and number of lesions that became progressively less well marginated. Development of poorly marginated or infiltrative characteristics at the periphery of the lesion was associated with a poor prognosis. Thus, the CT characteristics of hepatic metastases from colorectal carcinoma differ with a favorable response to chemotherapy and with progression of disease.

Renal size in fabry’s disease

Measurement of renal size in patients with Fabry’s disease — angiokeratoma corporis diffusum, universale — shows renal enlargement in the third decade, followed by a decrease in kidney size in the fourth and fifth decades. These changes are apparent before the deterioration of renal function signals impending renal failure.

Intracranial Tumors: Correlation of Angiography with Dynamic Radionuclide Studies

In a group of 100 supratentorial brain tumors, 23% demonstrated increased activity during the dynamic portion of the brain scan. Increased activity correlates best with the following angiographic characteristics: (a) increased size of supplying vessels, and (b) vascular supply simultaneously from both parenchymal and meningeal arteries. Increased activity has no correlation with the presence of early venous drainage, peritumoral edema, or degree of tumor vascularity and/or stain.

Limitations of Available Gamma Camera Oscilloscopes for Whole-Body Bone Image or Minified Multi-Image Display1

The limits of image minification on conventional cathode-ray tubes were determined for two commercially available Anger cameras. For medium intensity settings, it was found that minification of more than 8 to 1 (Pho/Gamma HP) and 6 to 1 (Nuclear Data 60), respectively, would result in degradation of system resolution.

Image review station for the surgical intensive care unit of the Hospital of the University of Minnesota: design and workflow evaluation

A simple image review station has been designed for the surgical intensive care unit (SICU) of the Hospital of the University of Minnesota. The review station provides clinicians with digitized copies of all conventional films taken while a patient is in the SICU. The image review station consists of a single screen SPARCstation IPX. Images are acquired through a Kodak film digitizer and managed in cooperation with a bedside electronic medical record system on this unit. The review station software maintains a detailed log of all interactions that is routinely downloaded to a relational database for analysis of usage patterns.