Department of Radiology and Imaging Sciences Works

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    Cribside Neurosonography: Real-Time Sonography for Intracranial Investigation of the Neonate
    (American Society of Neuroradiology, 1981) Edwards, Mary K.; Brown, David L.; Muller, Jans; Grossman, Charles B.; Chua, Gonzalo T.; Radiology and Imaging Sciences, School of Medicine
    A prospective study was made of 94 real-time sonographic sector scans of 56 neonates in a 6 month period. The examinations were performed using the anterior fontanelle as an acoustic window. In 17 cases, computed tomography (CT) head scans were available for comparison. In no case did the CT and sonographic examination disagree as to the size of the lateral ventricles. Abnormalities detected by sonography include ventriculomegaly, intracerebral hematomas, a congenital glioma, and several cystic lesions. Sonographic sector scanning produces excellent, detailed images of dilated lateral and third ventricles, uses no ionizing radiation, is less expensive than CT, and can be performed in the isolette, minimizing the risk of hypoxia and hypothermia. At Methodist Hospital Graduate Medical Center, sonography has replaced CT as the initial method of investigation of ventricular size. CT plays a complementary role in the evaluation of the posterior fossa, intracranial hemorrhage, and mass lesions.
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    Computed Tomography and Thin-Section Tomography in Facial Trauma
    (American Society of Neuroradiology, 1984) Kreipke, Donald L.; Moss, Jack J.; Franco, James M.; Maves, Michael D.; Smith, David J.; Radiology and Imaging Sciences, School of Medicine
    The efficacy of radiographic methods in detecting and classifying facial fractures was assessed. Thirty-one patients with maxillofacial trauma were studied with plain radiography, coronal and lateral pluridirectional tomography (PT), and axial and direct coronal computed tomography (CT). PT and CT were compared to assess how many fractures each method could demonstrate. In addition, plain films were used in combination with each special study to see how efficacious each combination was at classifying fractures into types, such as blow-out, tripod, etc. To reflect the fact that it is sometimes impossible to obtain lateral PT or direct coronal CT scans at this institution, the same analysis was done using just coronal PT and axial CT. With two projections, CT was better than PT at demonstrating fractured surfaces (168 vs. 156) and in classifying fractures in combination with plain films (48 vs. 43). However, when only one projection from each special study was used, PT surpassed CT in showing fractures (137 vs. 124) and in classifying fractures (42 vs. 40). Failures with each method occurred when the plane of section was parallel or oblique to the plane of the structure being examined, that is, axial CT failed to show the floor of the orbit well and coronal PT failed to show the anterior maxillary sinus wall well. Imaging in two planes, including the coronal plane, is desirable for greatest accuracy in fracture detection, whether by CT, PT, or both. CT is generally better for the display of soft-tissue abnormalities.
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    Thrombus simulating flow void: a pitfall in diagnosing aqueductal patency by high-field MR imaging
    (American Society of Neuroradiology, 1987) Augustyn, Gary T.; D'Amour, Peter G.; Scott, John A.; Worth, Robert M.; Radiology and Imaging Sciences, School of Medicine
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    Right subclavian steal associated with aberrant right subclavian artery
    (American Society of Neuroradiology, 1988) Rowe, David M.; Becker, Gary J.; Scott, John A.; Conces, Dewey J., Jr.; Radiology and Imaging Sciences, School of Medicine
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    Choroid plexus infections: neuroimaging appearances of four cases
    (American Society of Neuroradiology, 1992) Mathews, Vincent P.; Smith, Richard R.; Radiology and Imaging Sciences, School of Medicine
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    Familial hypophosphatemic rickets causing ocular calcification and optic canal narrowing
    (American Society of Neuroradiology, 1995) Caldemeyer, Karen S.; Smith, Richard R.; Edwards-Brown, Mary K.; Radiology and Imaging Sciences, School of Medicine
    In a case of familial hypophosphatemic rickets, marked bone thickening caused narrowing of the optic canals, resulting in bilateral optic atrophy. The case also showed metastatic calcification in the walls of both globes.
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    Melanotic neuroectodermal tumor of infancy
    (American Society of Neuroradiology, 1995) George, Joseph C.; Edwards, Mary K.; Jakacki, Regina I.; Kho-Duffin, Jennie; Radiology and Imaging Sciences, School of Medicine
    We present a case of malignant melanotic neuroectodermal tumor of infancy arising in the skull and secondarily invading brain. The central tumor was hyperintense to brain on T1-weighted images and hypointense to brain on T2-weighted images. This appearance corresponded to the surgical and histologic findings of melanin-containing tumor.
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    Meningeal myelomatosis: CT and MR appearances
    (American Society of Neuroradiology, 1995-08) Moran, Catherine C.; Anderson, Caryn C.; Caldemeyer, Karen S.; Smith, Richard R.; Radiology and Imaging Sciences, School of Medicine
    Meningeal myelomatosis is a rare feature of multiple myeloma. We report a case of IgG-kappa myeloma presenting as bilateral intracranial extraaxial masses.
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    Central nervous system cryptococcosis: parenchymal calcification and large gelatinous pseudocysts
    (American Society of Neuroradiology, 1997-01) Caldemeyer, Karen S.; Mathews, Vincent P.; Edwards-Brown, Mary K.; Smith, Richard R.; Radiology and Imaging Sciences, School of Medicine
    In an 11-year-old immunocompetent girl with protracted cryptococcal infection of the central nervous system, CT showed multiple areas of parenchymal calcification. MR imaging showed large gelatinous pseudocysts around the brain stem. These imaging features and the child's age are unusual for intracranial cryptococcosis.
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    Pharmacokinetics and consistency of pericardial delivery directed to coronary arteries: direct comparison with endoluminal delivery
    (Wiley, 1999-01) Stoll, Hans‐Peter; Carlson, Kathy; Keefer, Larry K.; Hrabie, Joseph A.; March, Keith L.; Radiology and Imaging Sciences, School of Medicine
    BACKGROUND AND HYPOTHESIS: Pharmacologic modulation of the contents of the pericardial space has been shown to influence the response of coronary arteries to balloon injury. Endoluminal (EL) local delivery of various drugs into coronaries has been found to be limited by short residence time, as well as by highly variable deposited agent concentration. We hypothesized that compounds placed into the pericardial space (P) would penetrate into coronary tissue with greater consistency than seen after EL delivery and provide for prolonged coronary exposure to agents. METHODS AND RESULTS: 125I-labeled basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), albumin, or 131I-labeled diazeniumdiolated albumin (NONO-albumin) were delivered as model/therapeutic proteins into the porcine pericardial space (n = 15 pigs) or into coronaries using an EL delivery catheter (n = 48 arteries). In subjects receiving 125I-labeled proteins, the delivery target or mid-regions of the left anterior descending (LAD) and left circumflex (LCx) arteries were harvested at 1 h or 24 h for gamma-counting and autoradiography, and fractional intramural delivery (FID) or retention measured as percent agent in 100 mg artery/agent in infusate for both time points. In the animals receiving 131I-labeled NONO-albumin, serial gamma imaging was employed to evaluate the rate of redistribution in individual animals following either pericardial or endoluminal delivery. At 1 h, FID values ranged from 0.00064 to 0.0052% for P delivery (median 0.0022%), and from 0.00021 to 6.7 for EL delivery (median 0.27%). At 24 h, FID values ranged from 0.00011 to 0.003 for P delivery (median 0.0013), and from 0.0002 to 1.4 for EL delivery. The estimated T1/2 for bFGF redistribution from the vascular tissue was 22 h (P) and 7 h (EL), respectively, while the directly determined T1/2 values for NONO-albumin redistribution from the delivery region were 22.2 h (P) and 2.5 h (EL). CONCLUSIONS: These data show that pericardial fluid contents can access coronary arteries with intramural concentrations which typically vary by 10-15-fold, while EL delivery results in a remarkably wide intramural concentration range with up to 33,000-fold variability. The apparent redistribution rate is more rapid following EL delivery, possibly due to sustained diffusive tissue loading from the pericardial space. Pericardial delivery appears to offer substantial advantages over EL administration with respect to residence time and reproducibility.