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Biomedical subjects

E K Fishman

Publications and source records attributed to E K Fishman.

At least 73 records · Page 4Linked to original sources
PubMed1999

Cryptococcoma of the sacrum.

Cryptococcoma of the sacrum was the initial presentation of systemic cryptococcosis in a patient on chronic steroid therapy for autoimmune hepatitis. The bone lesion was the only overt manifestation of systemic cryptococcal disease, which preceded other clinical manifestations and led to the subsequent diagnosis of systemic infection.

Adult↗
PubMed1999

Anomalies of the inferior vena cava and renal veins: embryologic and surgical considerations.

Anomalies of the inferior vena cava and renal veins occur infrequently but if unidentified can lead to significant morbidity during surgical exploration. An understanding of the embryologic development of the vena cava and its tributaries is necessary to understand the genesis of these sometimes complex anomalies and their accompanying anatomic variants. Newer radiologic modalities in the form of spiral computed tomography (CT) and three-dimensional reconstruction of spiral CT allow clear definition of the anatomy of these anomalies. Variations in the embryologic evolution of the vena cava dictate the different venous anomalies that may be encountered in the retroperitoneum. Additionally, the utility of newer radiologic modalities in the identification of these anomalies is discussed.

Humans↗
PubMed1999

Imaging of thoracic aortic disease.

Computed tomography, magnetic resonance imaging, and transesophageal echocardiography represent the relatively noninvasive techniques available for imaging thoracic aortic disease, especially in the evaluation of aneurysms and dissections. The article discusses the technique and application of these modalities in the evaluation of thoracic aorta. Imaging appearances of the commonly encountered pathologies of the thoracic aorta are presented and discussed, and potential pitfalls of technique and diagnosis are addressed.

Aortic Dissection↗
PubMed1999

CT of epithelial ovarian tumors.

Ovarian cancer is the second most common gynecologic malignancy in the United States and causes more deaths than any other cancer of the female reproductive system. Approximately two-thirds of patients have tumors that have spread beyond the pelvis at the time of diagnosis. Ovarian tumors arise from the surface epithelium or mesothelium, germ cells, or the gonadal stroma. Epithelial ovarian tumors include serous, mucinous, endometrioid, clear cell, and undifferentiated tumors. In general, the likelihood of malignancy increases with increasing solid-tissue elements and thicker septa. Surgery is central to the management of ovarian cancer. At the initial exploratory laparotomy, surgicopathologic staging and debulking of the tumor are undertaken. Patients with advanced cancer frequently undergo second-look surgery after chemotherapy to detect any residual disease. CT can provide staging information for preoperative planning and determination of surgical resectability, demonstrate tumor response to therapy, and allow detection of persistent or recurrent disease. However, a major limitation of CT is the lack of sensitivity for detection of small tumor implants, especially on the small intestine or mesentery. Dedicated CT of the pelvis is best performed with spiral CT. Ovarian carcinoma can spread by means of intraperitoneal implantation, lymphatic invasion, and hematogenous dissemination.

Adenocarcinoma, Clear Cell↗
PubMed1999

Renal artery stenosis: CT angiography--comparison of real-time volume-rendering and maximum intensity projection algorithms.

PURPOSE: To compare results of helical computed tomographic (CT) angiography with real-time interactive volume rendering (VR) to CT angiography with maximum intensity projection (MIP) for the detection of renal artery stenosis. MATERIALS AND METHODS: Twenty-five patients underwent both conventional and CT angiography of the renal arteries. Images were blindly reviewed after rendering with MIP and VR algorithms. MIP images were viewed in conjunction with axial CT images; VR models were evaluated in real time at the workstation without CT images. Findings in 50 main and 11 accessory renal arteries were categorized as normal or by degree of stenosis. RESULTS: All arteries depicted on conventional angiograms were visualized on MIP and VR images. Receiver operating characteristic (ROC) analysis for MIP and VIR images demonstrated excellent discrimination for the diagnosis of stenosis of at least 50% (area under the ROC curve, 0.96-0.99). Although sensitivity was not significantly different for VR and MIP (89% vs 94%, P > .1), specificity was greater with VR (99% vs 87%, P = .008 to .08). Stenosis of at least 50% was overestimated with CT angiography in four accessory renal arteries, but three accessory renal arteries not depicted at conventional angiography were depicted at CT angiography. CONCLUSION: In the evaluation of renal artery stenosis, CT angiography with VR is faster and more accurate than CT angiography with MIP. Accessory arteries not depicted with conventional angiography were depicted with both CT angiographic algorithms.

Adult↗
PubMed1999

Helical CT amniography of congenital diaphragmatic hernia.

OBJECTIVE: Accurate prenatal diagnosis of congenital diaphragmatic hernia is important for perinatal planning and potential fetal surgery. We describe the application and usefulness of helical CT amniography in the evaluation of suspected congenital diaphragmatic hernia in three fetuses. CONCLUSION: Helical CT amniography is an efficient means for evaluation of congenital diaphragmatic hernia. Accurate diagnosis was made in all three patients.

Amnion↗
PubMed1999

Clinical integration of three-dimensional helical CT angiography into academic radiology: results of a focused survey.

OBJECTIVE: Our objective was to determine whether three-dimensional helical CT angiography has become part of current academic radiology practice. SUBJECTS AND METHODS: A 19-part questionnaire was sent to the 83 members of the Society of Computed Body Tomography and Magnetic Resonance residing in the United States. The survey consisted of questions addressing the current use of CT angiography, including the number of CT angiographic studies performed weekly, the most common indications for using CT angiography, and the current techniques used for CT angiography. Information about the dose, timing, and types of IV contrast agents used was also requested. Results were limited to the responses of physicians practicing at academic centers. RESULTS: Responses were received from 39 members on staff at academic centers. These 39 members represent 67% (31/46) of the institutions surveyed, 87% (27/31) of which are from institutions that perform CT angiography. At 37% of these 27 institutions, more than 10 CT angiographic procedures are performed a week. Evaluation of the abdominal aorta is the most common indication for CT angiography. Of the 27 institutions performing CT angiography, 85% (23/27) use nonionic contrast agents exclusively for CT angiography. All 27 institutions use a separate workstation for CT angiography. Combinations of rendering algorithms (i.e., shaded-surface display, maximum intensity projection, volume rendering, and multiplanar reconstructions) are used at 25 (93%) of the 27 institutions for creating CT angiograms. CONCLUSION: CT angiography has become integrated into academic radiology practice, with 27 (87%) of the 31 academic institutions surveyed performing CT angiography and 10 (37%) of the 27 institutions performing more than 10 CT angiographic examinations a week.

Angiography↗