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Biomedical subjects

A Gouliamos

Publications and source records attributed to A Gouliamos.

At least 37 records · Page 2Linked to original sources

Radiotherapy effects on vertebral bone marrow: easily recognizable changes in T2 relaxation times.

The effect of localized radiotherapy on vertebral bone marrow was demonstrated in two patients using quantitative MRI studies with pixel-by-pixel measurement of T2 relaxation times with generation of T2 images. Conventional T1-weighted spin-echo images were obtained as well. Irradiated vertebral bone marrow was found to have longer T2 relaxation times than the neighboring nonirradiated bone marrow. These changes corresponded to the increased signal intensity on T1-weighted images and to the field of radiotherapy and were noted 2.5 to 32 mo after radiotherapy. Radiologists should be aware of the increased T2 relaxation times in irradiated bone marrow to correctly assess spinal disorders in irradiated patients. The reported T2 changes may reflect the abundance of adipose cells that proliferate in bone marrow after radiotherapy, or may indicate an additional histological change, such as bone marrow necrosis or edema. Conclusive histological proof remains to be obtained.

Bone Marrow↗

Abdominal aortic aneurysm combined with a second intraabdominal non vascular disease--a clinical study and surgical treatment.

The surgical tactics in cases of aneurysm of the infrarenal abdominal aorta and a second intraperitoneal operative procedure are not uniform in the literature and still remain a matter of debate. In 170 aneurysms of the abdominal aorta there were 18/170 (10.5%) other co-existent surgical non-vascular diseases as follows: Thirteen cases with symptomatic or asymptomatic cholecystopathy, one case with abdominal hernia, three cases with Ca of the colon and one case with Ca of the liver. In 9 cases, the aneurysm and the gallbladder were removed concomitantly, in 3 cases only aneurysmectomy was carried out due to cardiopulmonary problems, of which in two cholecystectomy was carried out in a second stage. In one case with cholecystitis, the gallbladder was removed and aneurysmectomy followed one month after. Aneurysmectomy and sigmoidectomy were carried out in one case and in a second similar case sigmoidectomy preceded followed by aneurysmectomy 6 months later. In one case aneurysmectomy and restoration of the abdominal hernia was performed concomitantly, while two more cases, one with liver lobectomy and another with orthosigmoidectomy due to Ca. No one of the above patients presented with any infection of the graft or other postoperative complication. No other complications were noted during a follow-up period of 19 months. The one stage operation management of infrarenal abdominal aortic aneurysm and a second (intra-abdominal) surgical procedure is feasible if appropriate care is given to the technical details and due consideration to the rules of antisepsis, without affecting surgical morbidity and mortality of the patient.

Aged↗

Percutaneous drainage of intra-abdominal abscesses using large lumen tubes under computed tomographic control.

OBJECTIVE: To describe our experience of percutaneous drainage of intra-abdominal abscesses with large-bore catheters under computed tomographic control. DESIGN: Retrospective study. SETTING: Teaching hospital, Greece. SUBJECTS: 185 Patients treated for abdominal abscesses during the period 1989-94. INTERVENTIONS: Needle aspiration (n = 27), drainage through conventional pigtail catheters (n = 22), and drainage through large-bore (8-16F) Argyle drains (n = 136). MAIN OUTCOME MEASURES: Morbidity. RESULTS: The overall success rate was 166/185 (92%). Of the 136 patients for whom the large-bore drains were used, 9 (7%) developed major complications (bowel fistula, n = 5; and pneumothorax and haemorrhage, n = 2 each) and 10 (7%) developed minor complications (obstruction of the tube, n = 4; dislocation of the tube, n = 3; bleeding from the wound, n = 2; and haematoma of the liver, n = 1). There were no deaths. CONCLUSION: Large-bore Argyle drains are efficient and safe for the percutaneous drainage of certain types of abdominal abscesses.

Abdominal Abscess↗

MRI in the investigation of patients with myelopathy thought to be due to multiple sclerosis.

The role of cerebral and spinal cord MRI was investigated in 65 patients with myelopathy suspected of having demyelinating disease. Cerebral MRI demonstrated lesions compatible with demyelination in 80% and spinal cord MRI in 68.6%. In 28.5% of our patients brain lesions were present with normal spinal cord images, but in 17% spinal cord lesions were depicted with a normal brain MRI. The combination of the two examinations demonstrated lesions in 97% of the patients. The frequency of coexistent cerebral lesions in patients with spinal cord lesions was over 85% in patients with chronic disease but only 28.5% in patients with acute myelitis.

Adolescent↗

Gadopentetate dimeglumine-enhanced MR in the diagnosis of the Tolosa-Hunt syndrome.

A 54-year-old man first was admitted with a right oculomotor nerve palsy that ameliorated spontaneously. Two months later, he was readmitted with right proptosis, ophthalmoplegia, and optic nerve involvement. MR showed an enlarged right cavernous sinus. There was dramatic improvement after high doses of steroids. MR findings 10 months later were normal. Thus, the diagnosis of the Tolosa-Hunt syndrome was established.

Cavernous Sinus↗

Correlation between spinal cord MRI and clinical features in patients with demyelinating disease.

Localisation of spinal cord lesions by MRI was correlated with neurological symptoms and signs in 16 patients with clinical and laboratory evidence of multiple sclerosis. There was good correspondence between spinal cord lesions and motor tract signs. On the other hand, superficial or deep sensory disturbances correlated with spinal cord lesions in only about a quarter of the patients. MRI of the spinal cord appeared to explain the myelopathy in 11 patients, while in 3 there was strong clinical evidence of more extensive demyelinating lesions. In 7 of the 16 patients MRI of the brain was normal.

Adolescent↗

A comparative study between Gd-DTPA and oral magnetic particles (OMP) as gastrointestinal (GI) contrast agents for MRI of the abdomen.

In the present study we compared two gastrointestinal contrast agents--Gd-DTPA, a positive signal, and oral magnetic particles (OMP), a negative signal contrast agent--in patients who were referred for MR imaging of the abdomen. Altogether 60 patients were examined with the former and 28 patients with the latter contrast before and after the administration of contrast media. Gd-DTPA was given either per os or per rectum. In comparing the results, it was shown that the diagnostic accuracy of postcontrast MRI in both groups was more or less similar to CT but much higher as compared with plain MRI. In the OMP series, first the contrast between the GI-filled lumen and the surrounding fat was much superior to that of the Gd-DTPA and, second, there was no evidence of any artifacts from bowel motion. However, the overall accuracy of the Gd-DTPA group was better compared with that of the OMP group. This was due to underfilling of the distal bowel because the OMP in those patients was administered only per os. Finally, Gd-DTPA had a more pleasant taste and fewer side effects. It is concluded that both contrast media are suitable for the upper abdomen because the results are comparable, whereas for the lower abdomen Gd-DTPA is superior because it can be used from both routes.

Abdomen↗

Localized mastoiditis simulating a facial nerve schwannoma on MRI.

A case of a single inflamed mastoid air cell is described. This was initially interpreted as a facial nerve schwannoma on MRI examination. Careful evaluation of the signal characteristics and additional findings from the high resolution CT examination helped to establish the correct diagnosis.

Adult↗

Oral magnetic particles as a contrast agent for MR imaging of the abdomen. A phase III clinical trial.

Twenty patients were investigated with MR imaging of the abdomen before and after the administration of oral magnetic particles in the form of a per os solution for opacification of the gastrointestinal lumen. The parameters which were evaluated were a) distribution of the contrast medium in the gastrointestinal tract, b) delineation with the contrast medium of the region of interest c) image quality of general contract effect of the contrast medium d) diagnostic accuracy compared with CT and plain MRI of the same region. At a concentration of 0.5 mg/oral magnetic particles produced a constant negative signal from the gastro- intestinal tract in all spin echo sequences (T1 weighted, T2 weighted, proton density). Its diagnostic accuracy was similar to CT but better than plain MR examination of the same region in 70% of the cases. The diagnostic accuracy was inferior in the lower abdomen because of underdistension of the bowel. Perhaps the solution to the problem would be the combined per os and per rectum administration of the contrast medium.

Abdomen↗

Retrocrural masses of extramedullary hemopoiesis in beta-thalassemia.

A case of extramedullary hemopoiesis in an 18-yr-old girl suffering from beta-thalassemia is reported. Extramedullary hemopoietic masses were localized apart from the paraspinal region in the retrocrural areas as well as the presacral region associated with massive destruction of the sacrum. The importance of recognition of hemopoietic masses in these regions in conditions other than hereditary hemolytic anaemias is briefly discussed.

Adolescent↗

Magnetic resonance angiography compared to intra-arterial digital subtraction angiography in patients with subarachnoid haemorrhage.

In order to evaluate the sensitivity and specificity of magnetic resonance angiography (MRA) in spontaneous subarachnoid haemorrhage, 14 patients with recent haemorrhage verified by CT or lumbar puncture were investigated with both selective intra-arterial digital subtraction angiography (IA-DSA) and MRA by two independent teams, each having the same preangiographic information. The results were compared with each other and whenever possible (all positive cases except one) with those of surgical intervention. Seven patients were identified by MRA and IA-DSA as having a single aneurysm on the circle of Willis, 1 an aneurysm of the posterior inferior cerebellar artery 1 an aneurysm of the internal carotid artery (siphon) and 2 patients with two aneurysms on the circle of Willis. MRA and IA-DSA both failed to demonstrate aneurysms in 2 cases. Three patients had negative results on both methods and no surgical intervention was attempted. The aneurysms ranged from 0.3 to 1.5 cm in size. In most cases there was agreement between MRA and DSA, leading us to believe that, if the proper protocols are followed, MRA is a powerful alternative to other established methods in the detection of intracranial aneurysms. At this stage it will not replace IA-DSA prior to surgery, but the ability to obtain various projections using 3D MRA may improve surgical planning.

Adolescent↗

Gd-DTPA as an intestinal contrast agent for MR imaging of the lower abdomen: phase III clinical trial.

Thirty-one patients were investigated with magnetic resonance (MR) imaging of the lower abdomen before and after the administration of gadopentetate dimeglumine (Gd-DTPA) solution per os or per rectum or from both routes for the opacification of the intestinal tract. The parameters evaluated were: (a) contrast medium distribution, (b) degree of filling of the bowel lumen, (c) contrast between the bowel lumen and the surrounding normal or pathological structures, and (d) whether the administration of the contrast agent improved the diagnostic ability of MR compared to computed tomography (CT) or plain MR of the same region. Gd-DTPA, at a concentration of 1 mmol/L, produced a positive signal irrespective of its dilution in the bowel and good contrast between the bowel lumen and the adjacent tissues or any possible pathological lesions. From the diagnostic point of view, after the administration of contrast medium, MR is comparable to CT and much superior to plain MR. It is concluded that opacification of the bowel with Gd-DTPA solution will improve the diagnostic yield of MR imaging of the lower abdomen.

Abdomen↗

Extracapsular (satellite) hydatid cysts.

Sixteen percent of hydatid cysts in the liver in 185 patients examined by computed tomography (CT) showed daughter cysts located exterior to the fibrinous membrane of the main hydatid cysts. We call these extracapsular or satellite cysts. Extracapsular cysts have the same appearance as endogenous daughter cysts. Preoperative demonstration of these cysts is useful for planning an appropriate surgical treatment and reduction of the recurrence rate.

Adult↗

Differential diagnosis of space-occupying lesions of the liver with MR imaging.

In a retrospective study of 84 patients who underwent MRI examination of the liver the qualitative parameters margin, shape, internal structure, signal intensity and the presence of a capsule were evaluated in 152 lesions comprising 48 hemangiomas, 54 secondary deposits, 23 hepatomas, 8 simple cysts, 17 hydatid cysts, 1 abscess and 1 focal fatty infiltration. Our main objective was to differentiate hemangiomas from secondary deposits and hepatomas. In hemangiomas the combination of smooth margin (98%) round or oval shape (90%) homogeneity (96%) very high signal intensity on T2-weighted sequence (94%), and the complete absence of capsule helped to distinguish them from secondary deposits and hepatomas in the majority of cases. It is concluded that with MR imaging we can establish the diagnosis of focal lesions of the liver in about 95% of cases.

Adolescent↗

Low back pain due to extramedullary hemopoiesis.

Two cases of extramedullary hemopoiesis in the lower spinal column are reported. One of them was due to thalassemia major and the other to thalassemia intermedia. CT and MRI studies showed paraspinal and presacral masses respectively which caused nerve root compression. It is concluded that the differential diagnosis of low back pain and radicular or pseudoradicular pain should include extramedullary hemopoiesis.

Adult↗