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Biomedical subjects

D R Radin

Publications and source records attributed to D R Radin.

At least 19 recordsLinked to original sources
PubMed1995

Abdominal tuberculosis in patients infected with the human immunodeficiency virus.

We compared the presentation of abdominal tuberculosis in 43 patients infected with the human immunodeficiency virus (HIV) and in 35 patients without HIV infection. Fever, weight loss, and extraabdominal lymphadenopathy were more common in HIV-infected patients, whereas ascites and jaundice were more frequent in patients without HIV infection. Intraabdominal lymphadenopathy and visceral lesions, visualized on computed tomography scans, were more common in HIV-infected patients, whereas ascites and omental thickening were more frequent in patients without HIV infection. Aspirates of abdominal lymph nodes were the only samples revealing acid-fast bacilli in eight HIV-infected patients, yielding a rapid diagnosis. Disseminated tuberculosis was present in 93% of the HIV-infected patients, compared with 31% of those without HIV infection; tuberculosis contributed to death in 23% of HIV-infected patients and in 31% of those without HIV infection. We conclude that abdominal tuberculosis in HIV-infected patients is almost invariably a manifestation of disseminated disease and results in significant mortality.

Abdomen↗
PubMed1995

Idiopathic localized dilatation of the ileum in adults: findings on barium studies.

OBJECTIVE: Idiopathic localized dilatation of the ileum is a rare entity characterized by a sharply demarcated segmental dilatation of the small bowel that is in line with the lumen. It is probably congenital in origin. Although more commonly diagnosed in children, it presents in adults as occult gastrointestinal (GI) bleeding or less often with abdominal pain. On pathologic examination, the mucosa may be ulcerated, but otherwise the wall is relatively normal. We analyzed the radiographic findings in nine previously unreported cases of this condition in adults. MATERIALS AND METHODS: Collaborative efforts resulted in the collection of nine cases from multiple institutions. In five cases, an enteroclysis had been performed; in three, a conventional small bowel series had been performed; and in one, the lesion was seen on a barium enema with reflux into the ileum. The mean age of patients was 52 years. In seven cases, pathologic correlation was available. In the other two patients, long-term clinical follow-up and repeat studies confirmed the diagnosis. Resected specimens showed a thin but otherwise normal wall with normal ganglion cells and nerve plexuses. Ulceration was noted in six of the seven resected cases. Two cases contained heterotopic gastric mucosa. GI bleeding and/or anemia was the most common (77%) presenting symptom. Abdominal pain and/or obstruction was present in slightly less than half the patients (44%). RESULTS: Lesions were 6-21 cm long and 4-13 cm wide, and all were located in the ileum. The dilated segments were bilobate in three cases, multilobate in three, spherical in two, and tubular in the other. The dilated area was always in line with the long axis of the bowel, not projecting to the side. No surrounding masses were seen. Except in three patients in whom ulcers were noted, the mucosa was normal. CONCLUSION: Idiopathic localized dilatation of the ileum should be suspected whenever a sharply demarcated area of lobulated small bowel dilatation is seen in a middle-aged patient with occult GI bleeding. The axial orientation distinguishes this condition from small bowel diverticula (including Meckel's). The lack of surrounding mass, mucosal irregularity, hypermotility, or fistulae help differentiate it from other causes of small bowel dilatation.

Adult↗
PubMed1994

Angiomatosis of the abdominal wall: imaging findings in three adults.

Radiologic studies were reviewed of three men (aged 25, 26, and 53 years) with angiomatosis of the abdominal wall. Studies included plain radiography (n = 2), computed tomography (n = 3), magnetic resonance imaging (n = 2), and ultrasonography (n = 1). Intraabdominal (n = 3), scrotal (n = 1), and intrathoracic (n = 1) extension of the fatty infiltrating process was seen, with multiple serpentine structures, some containing calcified phleboliths, representing proliferating vessels. Enlargement of muscles (n = 2), bone (n = 1), and kidney (n = 1) adjacent to the angiomatosis also occurred.

Abdominal Muscles↗
PubMed1993

Primary esophageal lymphoma in AIDS.

In a patient with acquired immunodeficiency syndrome (AIDS) and primary esophageal lymphoma, esophagography and computed tomography (CT) demonstrated a large ulcerated mass involving the distal esophagus. Although rare, the diagnosis of esophageal lymphoma should be considered in patients at risk for AIDS when the radiologic findings are not typical for infectious esophagitis or Kaposi's sarcoma.

Esophageal Neoplasms↗
PubMed1993

AIDS-related non-Hodgkin's lymphoma: abdominal CT findings in 112 patients.

OBJECTIVE: Non-Hodgkin's lymphoma is a common complication in patients with HIV infection. The purpose of this study was to analyze the abdominal CT findings in a large series of patients with this condition. MATERIALS AND METHODS: We retrospectively reviewed the abdominal CT examinations of 110 men and two women (21-62 years old; average, 39 years) with untreated AIDS-related lymphoma, as defined by the Centers for Disease Control. Lymphoma was the initial AIDS-defining illness in 79% of the patients. RESULTS: Abdominal CT scans showed normal findings or only mild enlargement of the liver or spleen in 36% of the 112 patients, whereas evidence of intraabdominal lymphoma was seen in 64%. Evidence of focal lymphomatous involvement was seen on abdominal CT scans in 58 (98%) of 59 patients in whom the predominant signs and symptoms were related to the abdomen and in 14 (26%) of 53 patients with extraabdominal signs or symptoms. In the 64% of patients with evidence of intraabdominal lymphoma, lymph node enlargement was seen in 56% and extranodal disease was seen in 86%. Extranodal sites of involvement in the 72 patients with evidence of intraabdominal lymphoma included the gastrointestinal tract (54%), liver (29%), kidney (11%), adrenal gland (11%), lower genitourinary tract (10%), spleen (7%), peritoneum and omentum (7%), pancreas (5%), epidural space (4%), bone (3%), and muscle (1%). Mild enlargement of the liver or spleen was present in a minority of cases. Moderate or marked hepatomegaly (cephalocaudal span > 20 cm) and splenomegaly (cephalocaudal span > 15 cm) were even less common and occurred only in the presence of focal hepatic lesions. CONCLUSION: Our results show that AIDS-related lymphoma may affect any abdominal organ, most commonly lymph nodes, the gastrointestinal tract, liver, kidney, and adrenal gland. Hepatic or splenic enlargement was uncommon and was not often seen as an isolated finding in the absence of evidence of abdominal lymphoma.

Abdominal Neoplasms↗
PubMed1993

Hepatic focal nodular hyperplasia: findings with color Doppler sonography.

Color Doppler sonographic images of five patients with a total of six lesions of FNH were reviewed. All cases were confirmed pathologically. All six lesions showed increased intralesional flow in comparison to surrounding liver parenchyma on color Doppler sonography. Four of the six lesions showed significant peripheral flow; two of the six lesions showed central flow radiating peripherally from a central vessel. We conclude that increased color Doppler flow may be a characteristic feature of FNH. Increased internal flow has also been reported in HCC and hepatic metastatic disease. Considerable overlap is seen in color Doppler flow patterns. However, in patients clinically at low risk for malignancy, detection of a liver mass with increased color Doppler flow should suggest the diagnosis of FNH.

Blood Flow Velocity↗
PubMed1992

Diagnosis of primary hyperaldosteronism: importance of correlating CT findings with endocrinologic studies.

Twenty patients with primary hyperaldosteronism had endocrinologic and radiologic studies to distinguish aldosterone-producing adenoma from idiopathic hyperaldosteronism due to bilateral micro- or macronodular hyperplasia of the adrenal cortex. In addition to examination for changes in the plasma level of aldosterone associated with postural changes and measurement of the plasma level of 18-hydroxycorticosterone, all 20 patients had CT examination of the adrenal glands. In three patients with normal adrenal glands on CT and three patients with CT evidence of two solitary nodules, one in each adrenal gland, a diagnosis of idiopathic hyperaldosteronism was confirmed by endocrinologic findings (five patients) or 131I-6 beta-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy (one patient). In nine patients with a solitary adrenal nodule on CT, a diagnosis of aldosterone-producing adenoma was confirmed by surgery (seven patients) or hormone sampling via the adrenal veins (two patients). However, in three patients with a solitary adrenal nodule on CT, a diagnosis of idiopathic hyperaldosteronism was suggested by endocrinologic findings (three patients) and confirmed by the results of NP-59 scintigraphy (two patients) or adrenal venous sampling (one patient). In addition, in two patients with CT evidence of three adrenal nodules (two in one gland, one in contralateral gland), a diagnosis of aldosterone-producing adenoma was suggested by endocrinologic findings in both patients and confirmed by surgery in one. Although high-resolution CT is highly accurate for the detection of aldosterone-producing adenoma, significant diagnostic errors can occur in patients with primary hyperaldosteronism if CT findings are not correlated with results of endocrinologic studies.

18-Hydroxycorticosterone↗
PubMed1992

Budd-Chiari syndrome: detection with color Doppler sonography.

The value of color Doppler sonography in evaluating newly diagnosed Budd-Chiari syndrome in five patients was studied. Hepatic venous findings included absence of vessels (one patient), flow reversal (two patients), narrowing (four patients), and tortuosity (three patients). Detected collaterals included hepatic venous to hepatic venous (four patients), hepatic venous to subcapsular systemic venous (two patients), and portosystemic (three patients). Hepatic venous spectral Doppler waveforms were flat and essentially aphasic in four patients, indicative of distal hepatic venous compression. The inferior vena cava was markedly compressed in two patients and slightly compressed in one. Color Doppler sonography allowed more reliable and confident identification of irregular, compressed, or otherwise abnormal hepatic veins than did conventional sonography. Color Doppler sonography also showed collateral vessels that were undetected with conventional sonography or other imaging techniques. Our results suggest that color Doppler sonography may be a valuable tool in the initial diagnosis and evaluation of suspected Budd-Chiari syndrome.

Budd-Chiari Syndrome↗
PubMed1992

Liver trauma and transection of the inferior vena cava. Sentinel contrast sign and hepatic perivenous tracking.

CT of a child with severe liver trauma due to a seat belt injury demonstrated avulsion of a portion of the lateral segment of the left lobe of the liver. The location of nondependent extravasated contrast material aided in identification of the visceral fracture site (the sentinel contrast sign). Associated transection of the inferior vena cava was evidenced by hypoattenuating zones adjacent to all the major hepatic veins and vena cava (hepatic perivenous tracking). Recognition of these two signs is important so that the radiologist can help the surgeon select the optimal operative approach.

Accidents, Traffic↗
PubMed1991

Intraabdominal Mycobacterium tuberculosis vs Mycobacterium avium-intracellulare infections in patients with AIDS: distinction based on CT findings.

Abdominal CT scans of 71 patients with AIDS who had proved disseminated infection due to Mycobacterium tuberculosis (27 patients) or Mycobacterium avium-intracellulare (44 patients) were reviewed retrospectively to identify radiologic features that can be used to distinguish the two infections. CT findings in patients with disseminated M. tuberculosis included focal lesions in the liver (11%), spleen (30%), kidneys (19%), pancreas (7%), and gastrointestinal tract (15%) and lymph nodes with central or diffuse low attenuation (93%). CT findings in patients with disseminated M. avium-intracellulare included marked hepatomegaly (20%); marked splenomegaly (14%); focal lesions in the liver (9%), spleen (7%), and kidneys (2%); diffuse jejunal wall thickening (18%); lymph nodes with central low attenuation (14%); and enlarged lymph nodes exclusively of homogeneous soft-tissue density (55%). The presence of focal visceral lesions and low-attenuation lymph nodes suggests disseminated M. tuberculosis, whereas marked hepatic and splenic enlargement, diffuse jejunal wall thickening, and enlarged soft-tissue-density lymph nodes suggest disseminated M. avium-intracellulare. Recognition of these CT features can lead to a tentative diagnosis so that appropriate therapy can be instituted before the results of mycobacterial cultures become available.

Acquired Immunodeficiency Syndrome↗