Search PubMed⌕ Search

Biomedical subjects

D K Yousefzadeh

Publications and source records attributed to D K Yousefzadeh.

At least 19 recordsLinked to original sources
PubMed2001

Traumatic prenatal sigmoid perforation due to amniocentesis.

A variety of fetal injuries, including those inflicted to the gastrointestinal tract by amniocentesis, have been reported before. This brief report describes the first documented case of sigmoid perforation owing to the common procedure of amniocentesis that manifested as abdominal distention at birth. A potential link between this complication and a recent increased incidence of "intrauterine spontaneous perforation" of the gastrointestinal tract has been mentioned. Practicing radiologists are encouraged to inquire directly about the history of amniocentesis in unexplained cases of intrauterine intestinal perforation.

Amniocentesis↗
PubMed2001

Retroperitoneal abscess and mycotic aortic aneurysm: unusual septic complications of central vascular line placement in premature infants.

OBJECTIVE: To describe the sonographic appearance of unusual septic complications after central vascular line placement in premature infants. METHODS: Two case reports are presented. RESULTS: The first patient had a retroperitoneal abscess after percutaneous central venous catheter placement. The second patient had a ruptured mycotic aneurysm of the abdominal aorta after umbilical arterial catheter placement. CONCLUSIONS: Retroperitoneal abscess and aortic aneurysm should be considered in patients with histories of long-standing catheters or line sepsis. Both of these complications are readily diagnosed on the basis of sonography.

Aneurysm, Infected↗
PubMed2000

Scapular duplication.

Scapular duplication is an exceedingly rare congenital anomaly. We present a unique case of left-sided duplication without additional malformations other than those involving the left upper extremity. Treatment of similar cases has been successful, and further work-up for additional anomalies should be undertaken. Other conditions in the spectrum of developmental deformities of the shoulder are discussed.

Humans↗
PubMed1999

The interrupted bronchus: a fluoroscopic sign of bronchial foreign body in infants and children.

OBJECTIVE: The objective is to describe the characteristic features of the interrupted bronchus sign and to determine the value of this sign in detection of bronchial foreign bodies. The interrupted bronchus sign refers to disruption of the air column in the main bronchi seen by fluoroscopy. CONCLUSION: The interrupted bronchus sign has a sensitivity of 100% for detection of foreign bodies in the main bronchi. This sign is particularly helpful when chest radiography shows atelectasis or pneumonia. The specificity of this sign for foreign bodies is only 71% because other endobronchial lesions can disrupt the air column. Nevertheless, the interrupted bronchus sign indicates the presence of bronchial occlusion and signifies the need for bronchoscopy. This sign is not sensitive for detection of foreign bodies in lobar or segmental bronchi.

Bronchi↗
PubMed1999

Manual epigastric compression during upper gastrointestinal examination of neonates: value in diagnosis of intestinal malrotation and volvulus.

OBJECTIVE: This paper describes the value of manual epigastric compression during upper gastrointestinal examination in establishing the diagnosis of intestinal malrotation and volvulus in five neonates. CONCLUSION: In two patients, the location of the duodenojejunal junction was near normal. Manual compression revealed abnormal mobility of the duodenojejunal junction, indicating malrotation. In three other patients, the duodenum was completely obstructed. Manual compression unequivocally displayed the anatomy of midgut volvulus by allowing contrast material to pass beyond the point of obstruction.

Congenital Abnormalities↗
PubMed1998

Duodenum and duodenal-jejunal junction in children: position and appearance after liver transplantation.

PURPOSE: To correlate upper gastrointestinal study findings of the position of the duodenum and duodenal-jejunal junction in children after liver transplantation with transplant type, age at transplantation, indication for transplantation, and history of surgery or malrotation. MATERIALS AND METHODS: Upper gastrointestinal studies in 23 children with a liver transplant were reviewed by two pediatric radiologists, and appearance and position of the duodenum and duodenal-jejunal junction were recorded. Findings were correlated with transplant type, age at transplantation, indication for transplantation, and history of surgery or malrotation. RESULTS: The duodenum and duodenal-jejunal junction were visualized on anteroposterior spot radiographs in 18 children. In 10 children, the duodenum and the junction were elevated and to the right of the spine; in two, the first and second portions of the duodenum were elevated, but the junction was normally located. These 12 children had undergone segmental liver transplantation. In the remaining six children, the duodenum and junction were normally positioned; three of these children had a whole liver transplant, and three had a segmental transplant. CONCLUSION: The duodenum and duodenal-jejunal junction are often malpositioned in children with a left lobe or left lateral segmental liver transplant. Without documented bowel obstruction, however, these children should be observed and followed up clinically.

Child↗
PubMed1995

Septic arthritis of the elbow in children: the role of sonography.

Twelve children with suspected septic arthritis of the elbow were prospectively studied with plain-film radiography and ultrasound. Imaging data were correlated with clinical history and final diagnosis. Joint effusion was seen by sonography in six patients, four of whom underwent ultrasound-guided joint aspiration, confirming the diagnosis of septic arthritis in two patients and excluding it in two. Of nine patients whose plain films showed only soft tissue swelling, seven had one or more significant findings with sonography: joint effusion (without fat pad elevation on lateral plain films) in three patients, periosteal reaction in two, and epitrochlear mass in three. Sonography confirmed soft tissue swelling alone in two patients, thus excluding the diagnosis of septic arthritis and obviating unnecessary attempts at joint aspiration. Sonography of the elbow is an informative, easily performed examination, which is capable of showing both intra- and extra-articular abnormalities not apparent by plain radiography. Both the demonstration of pathologic changes and the failure to show joint fluid may affect clinical management.

Adolescent↗
PubMed1995

Internal mammary compartment: window to the mediastinum.

PURPOSE: To determine the role of internal mammary ultrasonography (US) in assessment of the mediastinum. MATERIALS AND METHODS: In 66 patients (age range, 2 days to 18 years old; mean age 6.5 years) US imaging with spectral and color Doppler was used to examine the internal mammary region. Forty-four patients were suspected to have mediastinal masses; 22, vascular abnormalities. RESULTS: Five patients had abnormal internal mammary arterial flow (reversed in one). Internal mammary vein flow was reversed or absent in 10 patients with vein obstruction or Glenn shunts. Eight of 23 patients with lymphoma had internal mammary adenopathy. None of six patients with infectious mediastinal adenopathy and no patients with other benign mediastinal masses or vascular abnormalities had visualized internal mammary nodes. CONCLUSION: US and Doppler imaging of the internal mammary vessels and nodes provide valuable information about the nature of mediastinal masses and vascular disease. Flow pattern in the internal mammary vessels may elucidate abnormalities of central vessels.

Adolescent↗
PubMed1995

Sonographic demonstration of a normal thyroid gland excludes ectopic thyroid in patients with thyroglossal duct cyst.

OBJECTIVE: Preoperative thyroid scintigraphy has been performed in patients with presumed thyroglossal duct cyst to document a normal thyroid and to exclude the possibility of an ectopic thyroid mimicking a thyroglossal duct cyst. Often, an ectopic thyroid is the patient's only functioning thyroid tissue, and its removal will result in hypothyroidism. The purpose of this study was to determine whether demonstration of a normal thyroid gland by sonography in children with thyroglossal duct cyst can exclude ectopic thyroid and thereby obviate routine preoperative thyroid scintigraphy. MATERIALS AND METHODS: We studied 30 patients with pathologically proved thyroglossal duct cysts who had neck sonograms. The sonograms were evaluated for the presence or absence of a normal thyroid gland. The medical records of these children were also reviewed. Three children had normal preoperative radionuclide thyroid scans. All the children were clinically euthyroid preoperatively. Follow-up was available in 15 of the 30 patients, and all of these patients were clinically euthyroid postoperatively. RESULTS: A sonographically normal thyroid gland was detected in all patients. CONCLUSION: Preoperative sonographic identification of a normal thyroid gland in patients with thyroglossal duct cyst confirms a source of thyroid hormone separate from the thyroglossal duct cyst and thus excludes ectopic thyroid. Routine thyroid scintigraphy is not necessary.

Child↗
PubMed1994

Sclerosis of the mastoid air cells as an indicator of undiagnosed otitis media in children with Down's syndrome.

We hypothesized that many children with Down's syndrome have undiagnosed otitis media. In a 1989 study of lateral neck radiographs of 22 children with Down's syndrome, we found that 64% had sclerosis of the mastoid air cells, indicating untreated or inadequately treated otitis media. We reviewed the lateral neck radiographs of 53 children with Down's syndrome and interviewed their parents regarding the diagnosis of otitis media. Mastoid air cells were found to be sclerotic in 22 (42%) of study subjects; 32% of these had no known history of otitis media. For the 68% of children diagnosed as having had otitis media, the most common symptoms were fever (61%) and cough or coryza (58%). Sclerosis of the mastoid processes was not associated with a high frequency of otitis media (> 20 episodes) or a higher frequency of hearing loss, but was associated with subsequent myringotomy and insertion of a ventilatory tube (P = .038). Our finding of sclerotic mastoids in 42% of children with Down's syndrome raises the possibility that children with Down's syndrome have unidentified or inadequately treated episodes of otitis media.

Adolescent↗
PubMed1993

Anatomic features of reduced-size liver transplant: postsurgical imaging characteristics.

In this retrospective review, the authors evaluated the anatomic and imaging features of 140 reduced-size liver transplants in 120 boys and girls; 100 of these patients (83.3%) were 2 years old or younger. The authors reviewed the surgical reports, plain radiographs, contrast material-enhanced studies of the gastrointestinal tract, duplex Doppler and color Doppler ultrasound (US) scans, and computed tomographic (CT) scans. Understanding the anatomic features associated with transplantation was crucial to understanding the post-surgical imaging characteristics. Changes in visceral anatomic structure caused a variety of imaging appearances, some of them misleading: (a) Some patients had unusual bowel gas patterns on plain radiographs because of a shift in location by bowel loops; (b) gastrointestinal studies showed gastric compression by an oversized left lobe that mimicked mass effect; and (c) displacement or migration of the duodenum, jejunum, or cecum into the right hepatic fossa sometimes mimicked malrotation. Pitfalls were created by fluid and gas collections at the transected edge. US and CT were often used to further assess anatomic structures after surgery; color Doppler was especially helpful in vascular localization.

Adolescent↗
PubMed1993

Sonography of the chest in children.

Sonography is an extremely important tool in the evaluation of the chest in children. Its easy availability, versatility, and portability make it an obvious choice as the next diagnostic examination after an abnormal chest radiograph. Patience and meticulous technique coupled with good anatomic knowledge will produce useful studies. Sonography is equivalent and sometimes superior to CT because of its Doppler ability and superior fluid and tissue characterization. It is most helpful in the assessment of anterior and middle mediastinal masses, opaque chest, and pleural and juxta-diaphragmatic abnormalities; in the classification of perplexing radiographs; and in the assessment of peripheral chest lesions. Sonography provides guidance for diagnostic and therapeutic aspiration, providing not only excellent anatomic demonstration, tissue characterization, and vascular information but also immediate access to bacteriologic and tissue diagnosis when required.

Child↗
PubMed1992

Hypoplastic posterior arch of C-1 in children with Down syndrome: a double jeopardy.

Radiographs of 38 children with Down syndrome (aged 2-3 years) were retrospectively evaluated for hypoplasia of the posterior arch of the C-1 vertebra. The anteroposterior dimensions of the posterior arch of C-1 were measured and compared with those of an age- and sex-matched control group. The posterior arches of C-2 to C-5 were similarly evaluated. Radiographs demonstrated hypoplasia of the posterior arch of C-1 in 26%. This anomaly of C-1 was an isolated event; sagittal diameters of C-2 to C-5 were within normal limits compared with those of the control group and published standards. Because of the known, potentially devastating atlantoaxial dislocation in Down syndrome, the increased prevalence of a second C-1 anomaly causing preexistent narrowing of the vertebral canal is of clinical concern. A hypoplastic posterior arch of C-1 may amplify the risk of spinal cord damage following atlantoaxial subluxation, as the subsequently smaller vertebral canal has less room for dorsal movement of the odontoid process. This potential "double jeopardy" of C-1 vertebral abnormalities should be recognized and assessed on cervical spine screening radiographs in children with Down syndrome.

Cervical Vertebrae↗
PubMed1992

Neonatal and pediatric sonography.

This paper reviews the contribution of sonography in assessing common and some less common neonatal and pediatric disorders. The samples reflect the strength or currently perceived weaknesses of sonography and duplex Doppler studies in both neonates and children. Controversies, when present, are highlighted to provoke thought and remind us that many of the premises on which we base our research are, themselves, still shaky. Comments are provided to encourage complementary studies by other investigators or by the original authors. Because of their significance for the practice of pediatric radiology and sonography, two studies, one adult and one experimental, are incorporated. Since there is still plenty of room for improving sonographic techniques and technology and because new developments, such as the use of contrast agents, are in the horizon, the true limitations of sonography and duplex and color Doppler is yet unknown. Therefore, because of the well-known advantages of using sonography in children, we must exhaust all our efforts, "tricks," and resources as a sonographer before we subject the child to more invasive, stressful, and expensive studies. Meanwhile, knowledge of the strength of other modalities should help us avoid undue bias and single-mindedness.

Beckwith-Wiedemann Syndrome↗
PubMed1991

Fibroinflammatory tumor of the liver causing biliary cirrhosis in an infant.

We report the case of a 21-month-old child with a fibroinflammatory tumor of the liver causing biliary obstruction. The patient had fever, diarrhea, and jaundice. Abdominal ultrasonography, computerized tomography, and endoscopic retrograde cholangiopancreatography demonstrated the tumor to be in the porta hepatis. Growth of the mass resulted in destruction of the common hepatic duct, and chronic obstruction led to biliary cirrhosis over 4 months' time. Histologic study of the tumor revealed a fibrous stroma infiltrated by inflammatory cells. The patient was successfully treated with an orthotopic liver transplantation and is doing well 18 months following initial diagnosis without evidence of recurrence.

Fibroma↗