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Biomedical subjects

E Kazam

Publications and source records attributed to E Kazam.

At least 55 records · Page 3Linked to original sources

The reliability of the results of ultrasound detection of fluid collections in the early postceliotomy period.

The results of this prospective clinical study have demonstrated a low rate of false-positive abdominal sonographic findings in patients undergoing routine studies the seventh day after abdominal surgical procedures. It is concluded that any intraperitoneal fluid collection detected by ultrasound examination in a patient postoperatively demonstrating signs and symptoms of abdominal sepsis (fever, leukocytosis, pain, tenderness, persistent ileus, excessive drainage, wound changes and so on), should be considered as the source, as abdominal fluid collections do not persist as a "normal" part of the healing process one week after extensive biliary tract or colonic operations. Sonography is a highly specific procedure for the detection of abdominal abscesses after the seventh postoperative day. The type of procedure, type of incision, type of closure, presence of drains, history of prior intraperitoneal surgical procedures and operative blood loss did not affect the accuracy of the test. Postoperative ultrasonography is a specific, sensitive and accurate test and is widely applicable to almost all groups of patients.

Ascitic Fluid↗

CT of the hyperdense renal cyst: sonographic correlation.

The computed tomographic (CT) appearances of 19 hyperdense renal cysts in nine patients are reported. Sixteen of these cysts were found over a period of only 1 year with state-of-the-art CT equipment. Hyperdense renal cysts are probably more common than suggested by case reports. Their rate of detection can be expected to increase with the wider availability of fast CT scanners using thin collimation. A CT diagnosis of benign hyperdense renal cyst can be made if a lesion meets all of the following criteria: (1) smoothly outlined imperceptible wall with sharp demarcation from the kidney; (2) before intravenous contrast injection, homogeneous internal content with CT numbers 40%-240% higher (70%-240% higher for lesions 10 mm or more in diameter) than renal parenchyma; and (3) after intravenous contrast injection, persistent internal homogeneity and insignificant enhancement (less than 6%) relative to normal renal cortex. For masses exceeding 15 mm in diameter, sonography can be a valuable confirmatory test.

Aged↗

Accessory fissures of the liver: CT and sonographic appearance.

Invaginations of the liver by the diaphragm form accessory fissures that may mimic the major hepatic fissures on sectional images. Accessory fissures are most common in the superior right hepatic lobe. Their average incidence on computed tomographic (CT) scans is 25%. Their frequency increases with age, approaching 70% in the seventh and eighth decades. Their depth may equal or exceed 2 cm in one-third of cases. Multiple accessory fissures may mimic pathologic liver nodules on CT and may be associated with diaphragmatic scalloping or eventration on the chest film. When only parts of these fissures are seen sonographically, they may be mistaken for echogenic liver lesions. The differentiation of accessory fissures from the major hepatic fissures, from pathologic lesions, and from sonographic pseudofissure artifacts is discussed.

Adolescent↗

Computed tomography of the abdomen.

The CT applications described above are based on our experience with an integrated ultrasound-CT approach, tailored to the patient and aimed at reducing radiation and invasive diagnostic procedures. This approach is not presented as the ideal example to be followed by all. Rather, it is only a sample of the many possible uses of CT. Though there may be many disagreements with our approach, there can be no doubt that CT has revolutionized diagnostic abdominal imaging, to the benefit of all concerned.

Abscess↗

CT appearance of diaphragmatic pseudotumors.

Invaginations of the muscular fibers of the diaphragm into the upper abdomen may appear as nodules of soft tissue density on computed tomographic (CT) sections in deep inspiration. If these nodules indent the adjacent stomach or distal transverse colon, they may mimic small mural tumors or metastatic implants. Similar nodules protruding from the diaphragmatic crura into the adjacent retroperitoneal fat may be mistaken for enlarged lymph nodes on CT. Differential diagnosis of these pseudotumors from pathologic lesions is based on their continuity peripherally with the diaphragm and their separation from the hollow viscera by subdiaphragmatic fat. Decubitus and expiratory CT sections are valuable diagnostic aids.

Adolescent↗

CT diagnosis of congenital lobar emphysema.

Congenital lobar emphysema can be diagnosed by conventional chest films, but it may be difficult to determine which is the affected lobe or the etiology. This report presents the computed tomographic (CT) appearance of this entity and also emphasizes the significant role CT may have in its diagnosis.

Humans↗

Large posterior abdominal masses: computed tomographic localization.

Large posterior abdominal masses, particularly those in the right upper abdomen, may be difficult to localize correctly into the peritoneal or retroperitoneal compartments. The following signs were found to be reliable CT indicators of retroperitoneal location: obliteration of the perinephric fat outlining the psoas muscle; lateral displacement of the fat outlining the posterior right lobe of the liver; rotation of the intrahepatic portal veins to the left; anterior displacement of the inferior vena cava and renal veins; and anterior displacement of the ascending colon, descending duodenum, or pancreatic head.

Abdominal Neoplasms↗

The perihepatic spaces: computed tomographic and ultrasound imaging.

The appearance of perihepatic fluid collections on sectional imaging is discussed. The coronary ligamentous attachments of the right lobe of the liver to the diaphragm delineate a bare area that separates the right subphrenic and posterior subhepatic spaces. These attachments explain the configuration of right perihepatic fluid collections on sectional images and allow differentiation of subphrenic, posterior subhepatic, and pleural fluid with ultrasound and computed tomography. More medially, the caudate lobe of the liver invaginates the superior recess of the lesser sac, so that fluid collections within this recess may mimic intrahepatic masses on sectional images. This is illustrated with anatomic sections, computed tomographic scans, and ultrasound images.

Abdomen↗

CT diagnosis of mediastinal and thoracic inlet venous obstruction.

The diagnosis of mediastinal or thoracic inlet venous obstruction can be made reliably by chest computed tomography (CT), and depends on the opacification of collateral venous channels during the continuous infusion of intravenous contrast media. The sectional anatomy of these collateral pathways is illustrated by examples from 50 consecutive patients. An understanding of this anatomy facilitates the diagnosis of obstruction of the superior vena cava or its major tributaries during routine chest CT. Although CT was inferior to contrast venography in opacifying peripheral collateral veins and determining the degree of obstruction, the information provided by CT obviated venography in most patients in this series. CT may be the initial procedure of choice in suspected mediastinal venous obstruction.

Adolescent↗

Ultrasonography, computerized transaxial tomography and pathology of angiomyolipoma of the kidney: solution to a diagnostic dilemma.

The review of 9 anatomically proved cases of angiomyolipomas of the kidney has revealed characteristic findings of marked echoes on ultrasonography and areas of fat attenuation on computerized transaxial tomography. These 2 findings should resolve the diagnostic dilemma in this benign lesion and prevent the need for operation intervention in most cases.

Adult↗

Sonographic evaluation of the nonfunctioning kidney.

The results of B-mode ultrasound examinations in 113 consecutive patients with unilateral renal nonfunction or severe azotemia were reviewed. The causes of nonfunction included the following: hydronephrosis; renal parenchymal disease; renal agenesis; atrophy or dysplasia; multicystic, medullary cystic, and polycystic kidneys; renal arterial or venous occlusive disease; extensively infiltrating neoplasm. The sonographic findings were consistent with the final diagnosis in 92 percent of the cases. A coronal view of the kidney for diagnosing hydronephrosis is described. This view demonstrates the dilated calyces in continuity with the renal pelvis and, when combined with transverse views, improves the reliability of the sonographic diagnosis of hydronephrosis. In cases where the renal landmarks appear totally normal, obstruction can be excluded as a cause of nonfunction, and retrograde pyelography may be avoided. The sonographic manifestations of other parenchymal abnormalities associated with nonfunction, such as cystic renal disease, glomerulonephritis, and renal transplant rejection, are also discussed.

Abscess↗