Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1989
Twenty-seven patients with brain glioma were scanned using 123I-labeled monoclonal antibodies aga... more Twenty-seven patients with brain glioma were scanned using 123I-labeled monoclonal antibodies against epidermal growth factor receptor (EGFR1) or placental alkaline phosphatase (H17E2). Successful localization was achieved in 18 out of 27 patients. Eleven out of 27 patients were also studied using a nonspecific control antibody (11.4.1) of the same immunoglobulin subclass and observable tumor localization was also achieved in five patients. The specificity of targeting was assessed by comparing images obtained with specific and nonspecific antibodies and by examining tumor and normal tissue biopsies after dual antibody administration. Ten patients with recurrent grade III or IV glioma who showed good localization of radiolabeled antibody were treated with 40-140 mCi of 131I-labeled antibody delivered to the tumor area intravenously (n = 5) or by infusion into the internal carotid artery (n = 5). Six patients showed clinical improvement lasting from 6 mo to 3 yr. One patient continue...
The pelvic pain syndrome is a major cause of morbidity in young multiparous women. Psychotherapeu... more The pelvic pain syndrome is a major cause of morbidity in young multiparous women. Psychotherapeutic, medical and surgical treatments are available and therefore accurate diagnosis is important. This article reviews the imaging methods available for the diagnosis of ovarian varices and pelvic venous congestion.
Liver lobe disparity consequent upon lobar atrophy with compensatory hypertrophy of the contralat... more Liver lobe disparity consequent upon lobar atrophy with compensatory hypertrophy of the contralateral lobe is a pathological entity usually encountered with high bile duct obstruction and is associated with particular diagnostic and operative problems, discussed here by reference to 10 patients. The hypertrophied lobe presented as an abdominal 'mass' in all 10 whilst the atrophied lobe imitated a 'cold' area on liver scintigraphy and was misinterpreted as a tumour in 2 cases. The operative difficulties, exemplified by 8 patients, arise from the distortion of the configuration of the liver, the alteration of the anatomical relations of the vascular and biliary structures, and the reduced functional capacity of the atrophied liver. Pre-operative diagnosis of the condition is important to allow optimal treatment.
Four patients with chronic gastrointestinal blood loss of obscure aetiology were investigated by ... more Four patients with chronic gastrointestinal blood loss of obscure aetiology were investigated by visceral angiography. All showed angiographic abnormalities in the caecum with characteristic features seen in angiodysplasia as well as other conditions such as inflammatory bowel disease, carcinoma. All four patients had a malignant cause for their angiographic appearance. This paper stresses the importance of reviewing previous examinations before accepting a diagnosis of angiodysplasia. The angiographic features of contrast pooling on the anti-mesenteric border of the caecum or ascending colon, a dilated intramural vein and early filling of a draining vein imply that serious pathology is present. Belli, A.-M. & Hemingway, A.P. (1991). Clinical Radiology 44, 31-33. M a l i g n a n t 'Angiodysplasia' Angiodysplasia is a condition of u n k n o w n aetiology associated with acute or chronic intestinal haemorrhage. It affects the caecum and ascending colon predominantly, although it has been described in the small bowel and stomach (Roberts et al.
Dilatation of the veins of the broad ligament and ovarian plexi cause a very specific clinical en... more Dilatation of the veins of the broad ligament and ovarian plexi cause a very specific clinical entity called the pelvic congestion or pelvic pain syndrome. The ultrasound and Doppler appearances of this condition are unique and should be easily recognized. We describe these appearances in one patient and review the literature.
The diagnosis of caecal volvulus is usually made when the patient presents as an emergency with a... more The diagnosis of caecal volvulus is usually made when the patient presents as an emergency with an acute abdomen. Both plain abdominal films and a barium enema may be helpful in confirming the diagnosis. A detailed history will, in many cases, reveal previous episodes of similar but less severe pain and in those patients who have a barium enema examination between such attacks the study usually reveals no abnormality. The present report describes a patient in whom an initially normal barium enema produced a dramatic result at the end of the study.
Annals of the Royal College of Surgeons of England, 1985
The results of selective visceral angiography and colonoscopy were compared in the diagnosis of a... more The results of selective visceral angiography and colonoscopy were compared in the diagnosis of angiodysplasia of the large bowel. Fifty six patients were diagnosed as having angiodysplasia on angiography and 34 of these patients also underwent colonoscopy. Twenty three of the colonoscopies were positive giving a diagnostic yield of 68%. Three colonoscopies were negative and eight were incomplete. Colonoscopy was useful in the diagnosis of concomitant disease and also provided the clinician with the therapeutic possibility of electrocoagulation. Colonoscopy at operation proved to be a valuable technique in assessing the extent of angiodysplasia prior to resection.
■ List the current imaging techniques used to investigate subfertility. ■ Describe the growing ro... more ■ List the current imaging techniques used to investigate subfertility. ■ Describe the growing role of imaging in optimization of therapeutic options for treatable causes of subfertility. ■ Discuss the role of imaging in fertility preservation and restoration. See www.rsna.org/education/search/RG.
Annals of the Royal College of Surgeons of England, 1987
Postoperative gastrointestinal bleeding may be difficult to diagnose and treat. Selective viscera... more Postoperative gastrointestinal bleeding may be difficult to diagnose and treat. Selective visceral angiography localised the bleeding site in seven out of ten episodes of obscure postoperative gastrointestinal haemorrhage, and in two cases radiological embolisation was used successfully to control the bleeding. Angiography, preferably during an episode of haemorrhage, is recommended whenever possible for patients with undiagnosed postoperative gastrointestinal bleeding.
The results of transcatheter renal artery embolization are presented in a small group of patients... more The results of transcatheter renal artery embolization are presented in a small group of patients with end-stage renal disease. Five of the patients were suffering from severe drug-resistant hypertension, one from rejection of a renal transplant and one had heavy haematuria from a transplant kidney. All seven patients benefited from the procedure with no significant morbidity. The procedure of renal artery embolization and its potential complications are discussed. It is concluded that renal ablation by transcatheter embolization is not only effective, but also has a significantly lower morbidity and mortality than surgical nephrectomy in this group of patients with end-stage renal disease and associated problems.
The investigation and treatment of 131 patients with 'obscure' gastrointestinal bleeding has been... more The investigation and treatment of 131 patients with 'obscure' gastrointestinal bleeding has been reviewed. One hundred and six patients were assessed electively for recurrent haemorrhage, 25 presented as emergencies. The major presenting feature was melaena (55 patients), anaemia (35), rectal bleeding (34), haematemesis (six) and ileostomy bleeding (one). The lesions responsible for haemorrhage were colonic angiodysplasia (52 patients), small bowel vascular anomalies (16), Meckel's diverticula (nine), small bowel smooth muscle tumours (seven), gastric vascular anomalies (four), chronic pancreatitis (three), colonic diverticular disease (three) and 16 other miscellaneous lesions. No lesion was found in 21 cases. Lesions were first shown by visceral angiography (69 patients), at laparotomy (23), on endoscopy (11), on gastrointestinal contrast radiological studies (four), and at ERCP (three). Lesions which were undetectable at operation increased markedly with age (p<0O0001). Expert visceral angiography is strongly recommended before surgery in patients over 45 years of age and after laparotomy when no cause has been found. Exploratory laparotomy is recommended at an early stage for younger patients, and for older patients after non-diagnostic angiography. The cause of gastrointestinal haemorrhage is identified by routine investigations in about 95% of cases. 2 The remaining patients with 'obscure' gastrointestinal bleeding are frequently difficult to manage and often undergo extensive investigation and even laparotomy without diagnosis. The aim of this paper is to review the overall experience of the investigation of obscure gastrointestinal bleeding at this hospital, in particular to determine the method of diagnosis or localisation of haemorrhage and the relative incidence of different underlying conditions. Methods PATIENTS Over a six year period 131 patients with obscure gastrointestinal bleeding were investigated at the Hammersmith Hospital. The large majority (87%) were referred from other hospitals for specialist
Twenty patients with superior vena caval obstruction (SVCO) due to malignancy were managed using ... more Twenty patients with superior vena caval obstruction (SVCO) due to malignancy were managed using the Gianturco Z stent. Three patients had adjunctive thrombolysis. The primary clinical success was 90% (18120 patients). Thirteen patients were free of SVCO to death or follow-up without re-intervention (primary patency= 65%). Three patients had re-intervention for recurrent symptoms, two successfully (secondary long-term patency= 75%). Stenting of the SVC is a valuable, under-used technique for the symptomatic relief of superior vena caval obstruction.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine, 1989
Twenty-seven patients with brain glioma were scanned using 123I-labeled monoclonal antibodies aga... more Twenty-seven patients with brain glioma were scanned using 123I-labeled monoclonal antibodies against epidermal growth factor receptor (EGFR1) or placental alkaline phosphatase (H17E2). Successful localization was achieved in 18 out of 27 patients. Eleven out of 27 patients were also studied using a nonspecific control antibody (11.4.1) of the same immunoglobulin subclass and observable tumor localization was also achieved in five patients. The specificity of targeting was assessed by comparing images obtained with specific and nonspecific antibodies and by examining tumor and normal tissue biopsies after dual antibody administration. Ten patients with recurrent grade III or IV glioma who showed good localization of radiolabeled antibody were treated with 40-140 mCi of 131I-labeled antibody delivered to the tumor area intravenously (n = 5) or by infusion into the internal carotid artery (n = 5). Six patients showed clinical improvement lasting from 6 mo to 3 yr. One patient continue...
The pelvic pain syndrome is a major cause of morbidity in young multiparous women. Psychotherapeu... more The pelvic pain syndrome is a major cause of morbidity in young multiparous women. Psychotherapeutic, medical and surgical treatments are available and therefore accurate diagnosis is important. This article reviews the imaging methods available for the diagnosis of ovarian varices and pelvic venous congestion.
Liver lobe disparity consequent upon lobar atrophy with compensatory hypertrophy of the contralat... more Liver lobe disparity consequent upon lobar atrophy with compensatory hypertrophy of the contralateral lobe is a pathological entity usually encountered with high bile duct obstruction and is associated with particular diagnostic and operative problems, discussed here by reference to 10 patients. The hypertrophied lobe presented as an abdominal 'mass' in all 10 whilst the atrophied lobe imitated a 'cold' area on liver scintigraphy and was misinterpreted as a tumour in 2 cases. The operative difficulties, exemplified by 8 patients, arise from the distortion of the configuration of the liver, the alteration of the anatomical relations of the vascular and biliary structures, and the reduced functional capacity of the atrophied liver. Pre-operative diagnosis of the condition is important to allow optimal treatment.
Four patients with chronic gastrointestinal blood loss of obscure aetiology were investigated by ... more Four patients with chronic gastrointestinal blood loss of obscure aetiology were investigated by visceral angiography. All showed angiographic abnormalities in the caecum with characteristic features seen in angiodysplasia as well as other conditions such as inflammatory bowel disease, carcinoma. All four patients had a malignant cause for their angiographic appearance. This paper stresses the importance of reviewing previous examinations before accepting a diagnosis of angiodysplasia. The angiographic features of contrast pooling on the anti-mesenteric border of the caecum or ascending colon, a dilated intramural vein and early filling of a draining vein imply that serious pathology is present. Belli, A.-M. & Hemingway, A.P. (1991). Clinical Radiology 44, 31-33. M a l i g n a n t 'Angiodysplasia' Angiodysplasia is a condition of u n k n o w n aetiology associated with acute or chronic intestinal haemorrhage. It affects the caecum and ascending colon predominantly, although it has been described in the small bowel and stomach (Roberts et al.
Dilatation of the veins of the broad ligament and ovarian plexi cause a very specific clinical en... more Dilatation of the veins of the broad ligament and ovarian plexi cause a very specific clinical entity called the pelvic congestion or pelvic pain syndrome. The ultrasound and Doppler appearances of this condition are unique and should be easily recognized. We describe these appearances in one patient and review the literature.
The diagnosis of caecal volvulus is usually made when the patient presents as an emergency with a... more The diagnosis of caecal volvulus is usually made when the patient presents as an emergency with an acute abdomen. Both plain abdominal films and a barium enema may be helpful in confirming the diagnosis. A detailed history will, in many cases, reveal previous episodes of similar but less severe pain and in those patients who have a barium enema examination between such attacks the study usually reveals no abnormality. The present report describes a patient in whom an initially normal barium enema produced a dramatic result at the end of the study.
Annals of the Royal College of Surgeons of England, 1985
The results of selective visceral angiography and colonoscopy were compared in the diagnosis of a... more The results of selective visceral angiography and colonoscopy were compared in the diagnosis of angiodysplasia of the large bowel. Fifty six patients were diagnosed as having angiodysplasia on angiography and 34 of these patients also underwent colonoscopy. Twenty three of the colonoscopies were positive giving a diagnostic yield of 68%. Three colonoscopies were negative and eight were incomplete. Colonoscopy was useful in the diagnosis of concomitant disease and also provided the clinician with the therapeutic possibility of electrocoagulation. Colonoscopy at operation proved to be a valuable technique in assessing the extent of angiodysplasia prior to resection.
■ List the current imaging techniques used to investigate subfertility. ■ Describe the growing ro... more ■ List the current imaging techniques used to investigate subfertility. ■ Describe the growing role of imaging in optimization of therapeutic options for treatable causes of subfertility. ■ Discuss the role of imaging in fertility preservation and restoration. See www.rsna.org/education/search/RG.
Annals of the Royal College of Surgeons of England, 1987
Postoperative gastrointestinal bleeding may be difficult to diagnose and treat. Selective viscera... more Postoperative gastrointestinal bleeding may be difficult to diagnose and treat. Selective visceral angiography localised the bleeding site in seven out of ten episodes of obscure postoperative gastrointestinal haemorrhage, and in two cases radiological embolisation was used successfully to control the bleeding. Angiography, preferably during an episode of haemorrhage, is recommended whenever possible for patients with undiagnosed postoperative gastrointestinal bleeding.
The results of transcatheter renal artery embolization are presented in a small group of patients... more The results of transcatheter renal artery embolization are presented in a small group of patients with end-stage renal disease. Five of the patients were suffering from severe drug-resistant hypertension, one from rejection of a renal transplant and one had heavy haematuria from a transplant kidney. All seven patients benefited from the procedure with no significant morbidity. The procedure of renal artery embolization and its potential complications are discussed. It is concluded that renal ablation by transcatheter embolization is not only effective, but also has a significantly lower morbidity and mortality than surgical nephrectomy in this group of patients with end-stage renal disease and associated problems.
The investigation and treatment of 131 patients with 'obscure' gastrointestinal bleeding has been... more The investigation and treatment of 131 patients with 'obscure' gastrointestinal bleeding has been reviewed. One hundred and six patients were assessed electively for recurrent haemorrhage, 25 presented as emergencies. The major presenting feature was melaena (55 patients), anaemia (35), rectal bleeding (34), haematemesis (six) and ileostomy bleeding (one). The lesions responsible for haemorrhage were colonic angiodysplasia (52 patients), small bowel vascular anomalies (16), Meckel's diverticula (nine), small bowel smooth muscle tumours (seven), gastric vascular anomalies (four), chronic pancreatitis (three), colonic diverticular disease (three) and 16 other miscellaneous lesions. No lesion was found in 21 cases. Lesions were first shown by visceral angiography (69 patients), at laparotomy (23), on endoscopy (11), on gastrointestinal contrast radiological studies (four), and at ERCP (three). Lesions which were undetectable at operation increased markedly with age (p<0O0001). Expert visceral angiography is strongly recommended before surgery in patients over 45 years of age and after laparotomy when no cause has been found. Exploratory laparotomy is recommended at an early stage for younger patients, and for older patients after non-diagnostic angiography. The cause of gastrointestinal haemorrhage is identified by routine investigations in about 95% of cases. 2 The remaining patients with 'obscure' gastrointestinal bleeding are frequently difficult to manage and often undergo extensive investigation and even laparotomy without diagnosis. The aim of this paper is to review the overall experience of the investigation of obscure gastrointestinal bleeding at this hospital, in particular to determine the method of diagnosis or localisation of haemorrhage and the relative incidence of different underlying conditions. Methods PATIENTS Over a six year period 131 patients with obscure gastrointestinal bleeding were investigated at the Hammersmith Hospital. The large majority (87%) were referred from other hospitals for specialist
Twenty patients with superior vena caval obstruction (SVCO) due to malignancy were managed using ... more Twenty patients with superior vena caval obstruction (SVCO) due to malignancy were managed using the Gianturco Z stent. Three patients had adjunctive thrombolysis. The primary clinical success was 90% (18120 patients). Thirteen patients were free of SVCO to death or follow-up without re-intervention (primary patency= 65%). Three patients had re-intervention for recurrent symptoms, two successfully (secondary long-term patency= 75%). Stenting of the SVC is a valuable, under-used technique for the symptomatic relief of superior vena caval obstruction.
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Papers by Anne Hemingway