Search PubMed⌕ Search

Biomedical subjects

C S Zee

Publications and source records attributed to C S Zee.

At least 73 records · Page 4Linked to original sources
PubMed1981

Lipomas of the corpus callosum associated with frontal dysraphism.

Using computed tomography (CT), we have been able to identify the combined occurrence of lipoma of the corpus callosum and dysraphic lesions associated with frontal bone defects in two cases. In one case, there was a true encephalocele, and in the other case a lipoma with cartilaginous tissue was present. Such combinations are very rare; thus, the impetus to report these cases. The disorganization of the central nervous system was extensive in the first infant and was associated with profound developmental delay, while the second infant had much less anatomical abnormality, and development to date is normal. Bony defects (on skull films), typical appearances of lipoma of the corpus callosum, and characteristics of the dysraphic lesions (on CT) were seen. Angiography was obtained in the infant with a true encephalocele.

Abnormalities, Multiple↗
PubMed1980

Computed tomography in child abuse head trauma.

Forty-five head trauma cases from 177 child-abuse patients are reported. Intracranial injuries include acute epidural and subdural hematomas, subdural effusion, cerebral contusion, and atrophy (subdural effusion and cerebral contusion being most frequently seen). Incidence of skull fracture among the 45 patients is about 38%. Sixty-five percent of the 17 skull fracture patients also had intracranial injury, and 78% of the 28 patients with normal skulls had intracranial injury. CT should be the primary tool for evaluating child-abuse head trauma.

Brain Concussion↗
PubMed1980

Unusual neuroradiological features of intracranial cysticercosis.

The authors describe various new neuroradiological findings in cysticercosis cerebri. Features discussed include: (a) contrast enhancement in cysticercosis, including enhancement of an intraventricular cyst, basal meningeal enhancement, and enhancement in association with granulomatous reaction to cysticercosis; (b) positional cyst alterations, including cyst mobility and positional changes in cyst configuration; (c) neuroradiological features of foramen of Monro obstruction, which may be unilateral or bilateral, and may be due to cysts or adhesions; and (d) unusual angiographic features, including two cases of ring stains which corresponded to ring enhancement on CT, and a mycotic aneurysm associated with cysticercosis. For this study, the authors evaluated 102 cases of cysticercosis; 12 case reports are presented herein.

Adult↗
PubMedDate not supplied

Role of stereotactic biopsy in the diagnosis and management of brain tumors.

Stereotactic biopsy has evolved as a powerful and safe tool to provide tissue diagnoses with minimal disruption of normal functioning brain. It plays a significant role in the management of malignant brain tumors, where the benefit of open surgery might not justify the concomitant risks. Stereotactic procedures are closed procedures, and thus direct feedback is not provided to the surgeon during manipulation of brain tissue. This difference from most other neurosurgical procedures necessitates rigor in the preoperative workup, the planning of the procedure, and the conduct of the procedure. The success of the procedure is measured by the ability of the team to make an accurate histopathological diagnosis of the lesion; in experienced hands, the rate of success should exceed 95%. Complications and mortality can be minimized with appropriate attention to detail.

Biopsy↗
PubMedDate not supplied

The motion artifact suppression technique (MAST) in magnetic resonance imaging: clinical results.

The Motion Artifact Suppression Technique (MAST) is a method which uses a series of gradient echos that are computed to cancel velocity, acceleration and pulsatility components of involuntary motion in MR imaging. A total of 916 patient studies were performed over a nine month period using MAST sequences with a TE 40, 60, 80, 100, 120, and 26/112. There was considerable improvement in long TR, long TE images. Cerebrospinal fluid flow artifacts were reduced. Body and spine images had reduced flow and respiratory artifacts. Spin rephasing in blood vessels caused increase intraluminal signal. This might be useful for cardiovascular imaging.

Blood Circulation↗
PubMedDate not supplied

Magnetic resonance imaging of pediatric spinal dysraphism.

Thirty pediatric patients with spinal dysraphism were studied with magnetic resonance imaging. A variety of dysraphic anomalies were visualized, including syringohydromyelia, tethered cord, widened spinal canal, meningomyelocele, lipomyelomeningocele, lipomeningocele, intraspinal lipoma, congenital dermal sinus tract, and scoliosis. In 29 of 30 cases, MRI diagnostically visualized spinal cord and dysraphic anatomy. A combination of T1-weighted sagittal and axial imaging planes provided the most complete visualization. In specific cases, T2-weighted examinations were useful in demonstrating likely regions of inflammation bordering infected sinus tracts. MRI demonstrates a wide variety of dysraphic spinal anomalies and effectively screens children for occult spinal dysraphism.

Adult↗
PubMedDate not supplied

Magnetic resonance angiography in neck masses.

Carotid MR angiography has primarily been used to evaluate for stenotic lesions. We performed 2D time of flight MR angiography in 25 patients with palpable neck masses. There were 23 masses confirmed histologically. Two of the masses represented abnormal carotid arteries. Carotid deviation was seen in 23 of 25 (92%) of patients. Widening of the carotid bifurcation was identified in seven patients, including four carotid body tumors, one inflammatory mass, one benign salivary gland tumor, and one schwannoma. Increased vascularity was identified in one carotid body tumor and in one metastatic papillary carcinoma of the thyroid. MR angiography may be useful to demonstrate flow within vessels and represents a familiar imaging display for surgical planning. Splaying of the carotid bifurcation is useful in demonstrating carotid space lesions.

Adolescent↗
PubMedDate not supplied

CT myelography in spinal cysticercosis.

Four cases of spinal cysticercosis were found in a series of 356 cases of CNS cysticercosis studied neuroradiologically. Cysticercal cysts were seen to migrate within the spinal subarachnoid space on myelographic studies. All four patients presented initially with hydrocephalus, which supports the notion that spinal leptomeningeal cysts have migrated from an intracranial site of origin. Computed tomographic myelography (metrizamide) allowed better localization and definition of the spinal cysticercal lesions.

Adult↗
PubMedDate not supplied

MR imaging of neurocysticercosis.

Magnetic resonance (MR) was performed in 50 patients with neurocysticercosis. Comparison was made with other neuroradiological imaging modalities including CT, myelography, CT ventriculography, and CT myelocisternography. Eighteen patients were found to have intraventricular cysts. In several patients, these were multiple and 22 intraventricular cysts were discovered. Although 4 of the 22 ventricular cysts were missed by MR, T1-weighted images can play a significant role in the early detection of intraventricular cysticercosis cysts, showing the cyst wall (9 of 22), a high intensity mural nodule (6 of 22), and increased signal intensity of the cyst fluid (5 of 22). Cisternal cysts (14 cysts in 10 patients) could be identified; they appear similar to intraventricular cysts, but mural nodules are infrequently seen (1 of 14). Twenty-nine patients had 69 parenchymal cysts. An attempt was made to assess the viability of these parenchymal lesions by matching the CT and MR findings with the Escobar pathologic staging system. Neuroimaging findings seemed compatible with early parenchymal lesions in the vesicular stage in 11 instances. Findings in cases with later stage cysts tend to support the concept that a dying larva provokes pronounced inflammatory reaction in the adjacent brain. Computed tomography remains the superior modality for depicting parenchymal calcifications within dead larvae. A case of a spinal cysticercosis cyst demonstrated with MR (in a patient with extensive intracranial cisternal cysts and a fourth ventricular cyst) is described.

Adolescent↗
PubMedDate not supplied

Evolution of central necrosis in a meningioma: CT and MR features.

A 44-year-old patient underwent CT and magnetic resonance (MR) imaging and was found to have a typical appearing meningioma. The meningioma was of increased density relative to brain and enhanced homogeneously on CT. It was slightly hypointense on T1-weighted MR images and isointense on T2-weighted MR images relative to cortex. Thirty days later, repeat CT and MR scans showed change of the tumor consistent with central necrosis. An area of central low density developed on the CT scans, and a central high signal developed on the T2-weighted MR images. Pathological sectioning confirmed central necrosis of a syncytial meningioma.

Adult↗
PubMedDate not supplied

Lhermitte-Duclos disease: CT and MR findings.

The typical CT findings of Lhermitte-Duclos disease (dysplastic gangliocytoma of the cerebellum) are a hypodense nonenhancing unilateral posterior fossa mass, with or without adjacent occipital thinning, hydrocephalus, and calcification. Magnetic resonance (MR) has been found to be very helpful, and superior to CT, in delineating the margins of the lesion for determining the extent of surgical resection. Since recurrence is known, MR is important in the follow-up of these patients. To our knowledge this is the first reported case that included MR examination with administration of gadolinium. There was no enhancement of the lesion, consistent with previous reports of no contrast enhancement on CT.

Adult↗
PubMedDate not supplied

MR imaging of pineal region neoplasms.

Twenty-eight patients with tumor of the pineal region underwent magnetic resonance (MR) examination. Gadolinium DTPA was given to 13 patients. Histologic confirmation was obtained in all patients, including 10 germinomas, 4 pineocytomas, 4 pineoblastomas, 5 astrocytomas, 2 teratomas, 1 choriocarcinoma, 1 mixed germ cell tumor, and 1 metastasis from breast carcinoma. Pineal region neoplasms have remarkable heterogeneity in both histopathologic and MR appearances. Gadolinium DTPA enhanced MR increases the specificity of diagnosing pineal region neoplasms. In addition, Gd-DTPA provides better delineation of the tumor margin and demonstrates cystic components of the neoplasm. Our approach to pineal region neoplasms is to make a decision about whether stereotaxic biopsy or surgery should be performed on a certain patient. When a pineal region neoplasm is diagnosed as benign, such as a benign teratoma, on the basis of imaging, surgery is performed to resect the entire lesion. When a definitive diagnosis is not possible, sterotaxic biopsy is performed to obtain histological diagnosis for treatment planning. Gadolinium DTPA enhanced MR plays an extremely important role in target selection in stereotaxic biopsy of pineal region neoplasms and is also useful in the early detection of intracranial seeding. Spinal seeding is demonstrated on MR as well, thus alleviating the need for a contrast myelogram. Finally, Gd-DTPA enhanced MR can be used to monitor the effects of the various treatment modalities employed for pineal region neoplasms.

Adolescent↗
PubMedDate not supplied

SPIR MRI in spinal diseases.

We report on our experience with the fat suppression technique of spectral presaturation with inversion recovery MR in imaging certain spinal disorders. This technique may assist in demonstrating or excluding the presence of fat within a lesion (such as lipoma, dermoid, teratoma) or within a normal structure (i.e., vertebral body or epidural space). The method can also be used to suppress normal fat (such as marrow or epidural fat) thus increasing the conspicuity of adjacent high signal intensity lesions seen on T1-weighted images (such as blood and contrast-enhancing tumors or inflammatory lesions).

Abscess↗
PubMedDate not supplied

MRI of intraventricular cysticercosis: surgical implications.

OBJECTIVE: Our goal was to evaluate the role of Gd-enhanced MR in the diagnosis and surgical planning of intraventricular cysticercosis cysts. MATERIALS AND METHODS: Thirty-three patients with intraventricular cysticercosis were evaluated with Gd-enhanced MRI including follow-up studies ranging over time periods from 6 months to 8 years. The patient age ranged from 17 to 65 years. All had lived in Mexico or Central America. RESULTS: Twenty patients had surgical removal of the cysts. The majority of patients (18 of 20) who had surgical removal of the cyst showed improvement with resolution of hydrocephalus. Two of 20 patients required additional shunting to alleviate hydrocephalus. In these two patients, Gd-enhanced MR showed cyst wall enhancement. Ependymitis with adhesion was found at surgery in these two patients. Nine patients had shunt placement; one of nine patients showed cyst enlargement 2.5 years later that required surgical removal. Of the remaining eight patients, four showed irregular, thick, ring-like enhancement mimicking a neoplasm on follow-up imaging studies. Four patients with cysts in the lateral ventricle did not require treatment. Two of the four patients showed irregular, thick, ring-like enhancement on follow-up imaging studies. CONCLUSION: Gadolinium-enhanced MR is more sensitive than contrast-enhanced CT for detecting ependymitis, which is essential in deciding whether surgical removal of the cyst or shunt placement is indicated. A degenerating intraventricular cysticercosis cyst may present as an irregular, thick, ring-like enhancing lesion or a nodular enhancing lesion with varying degrees of surrounding edema, mimicking a neoplasm.

Adolescent↗
PubMedDate not supplied

CT anatomy of the craniovertebral junction in infants and children.

Computed tomographic (GE 9800) images of 129 patients (from newborn to 18 years old) with no evidence of cervical spine pathology were reviewed retrospectively from available material to evaluate normal anatomic appearances in childhood. The synchondroses may appear solid at soft-tissue window settings, while, with appropriate bone-window settings, a lucent line will be seen. Residual lucency and then (generally) sclerosis were seen at synchondroses past the age of classic anatomic fusion. A transversely oriented groove on the undersurfaces of the occipital condyles was imaged in children ages 5-12 years. This groove is described radiologically in that age range for the first time in this report. The development of the ossification centers of C1 was illustrated with CT. The two vertically oriented, rod-shaped ossification centers of the lower dens develop a bilobed appearance in axial section when they begin to fuse. An apparent deficiency of the cortex seen posteriorly in this area (in children as old as 7 years) represents the last remnant of the cleft between the dens centers. The cord was always outlined distinctly by CSF at soft-tissue settings at the foramen magnum and C1 levels without intrathecal or IV contrast enhancement. This anatomic feature is particularly useful since it enables the evaluation of the spinal canal in this region in some cases (especially craniovertebral junction anomalies) without the need for intrathecal contrast materials.

Adolescent↗
PubMedDate not supplied

Follow-up pathology of cranial computed tomography: pitfalls in clinical-radiological evaluation.

Interpretation of cranial computed tomography in five patients and angiography in one of these patients contributed significantly to primary clinical diagnoses and management; however, the diagnoses were incorrect. The lesions in the radiographic studies were correlated with classical clinical findings. Associated and generally unappreciated clinical or radiographic findings also were present and could have lead to reconsideration of at least some of the primary diagnoses. The unusual or unique presentations resulting in underdiagnosis or overdiagnosis lead to nonbeneficial or improper care. Cerebrovascular and infectious diseases found in most of these cases are recognized as common areas of diagnostic difficulty by previous and present follow-up pathological studies.

Adult↗