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Biomedical subjects

E Weinberger

Publications and source records attributed to E Weinberger.

At least 37 records · Page 2Linked to original sources
PubMed1995

Comparison of helical and conventional chest CT in the uncooperative pediatric patient.

The objective of this study was to compare the quality of conventional and helical computed tomography (CT) images in children unable to breath-hold. Sixteen patients (age range 1.1-7.5 years) underwent both conventional and helical chest CT on a General Electric HiSpeed Advantage scanner at a mean study interval of 3.8 months. Conventional 0.6-s scans were reconstructed with standard algorithm while 1.0-s helical studies were reconstructed with standard and bone algorithms. Three blinded observers retrospectively evaluated the images. There was no significant difference in motion, image sharpness and anatomic resolution for helical and conventional scans reconstructed with standard algorithm. Furthermore, image sharpness (P < 0.001) and visibility of bronchi (P < 0.001) were improved when helical images were reconstructed with bone algorithm. We conclude that motion artifact severity, image sharpness and anatomic resolution for helical and conventional 0.6-s chest CT are similar when the images are reconstructed with an identical algorithm. Helical CT may be preferable because of the faster examination times and the ability to reconstruct overlapping images as an adjunct for problem solving. Also, with the scanner used, bone algorithm reconstruction can be employed to improve image sharpness and anatomic resolution.

Artifacts↗
PubMed1995

Nontraumatic pediatric musculoskeletal MR imaging: comparison of conventional and fast-spin-echo short inversion time inversion-recovery technique.

PURPOSE: To compare conventional short inversion time inversion-recovery (STIR) with fast spin-echo (FSE) STIR techniques to evaluate suspected nontraumatic musculoskeletal abnormalities. MATERIALS AND METHODS: Thirty STIR and FSE-STIR examinations in 26 pediatric patients with suspected nontraumatic musculoskeletal abnormalities were prospectively evaluated. Qualitative (subjective) and quantitative (five-point rank score) analyses of the images were performed. RESULTS: FSE-STIR was faster than STIR (mean, 2 minutes 25 seconds and 6 minutes 35 seconds, respectively). Fat suppression was slightly better with STIR. Image degradation due to motion was judged similar. Lesion contrast to muscle was slightly better with STIR than FSE-STIR, and lesion contrast to fat was equivalent. Qualitatively, lesion conspicuity was similar: All lesions were seen with both techniques. CONCLUSION: FSE-STIR can replace STIR when an inversion-recovery fat-suppression sequence is desired. Considerable imaging time is saved.

Adolescent↗
PubMed1995

MR imaging of bone marrow in children with osteosarcoma: effect of granulocyte colony-stimulating factor.

OBJECTIVE: Granulocyte colony-stimulating factor (GCSF) is used to stimulate myeloid cell production and function in children undergoing chemotherapy for osteosarcoma. We hypothesize that GCSF can cause reconversion of marrow from fatty to hematopoietic and that this change can be detected by MR imaging at sites away from the primary tumor. This benign effect of treatment should not be confused with tumor spread. MATERIALS AND METHODS: MR images of marrow of the affected and contralateral limbs were retrospectively reviewed for 16 patients with osteosarcoma of the femur or tibia; nine of these patients had received GCSF. A grade was assigned to marrow signal intensity at sites away from the tumor, and findings before and after treatment were compared. The validity of MR image interpretation was assessed by comparing the signal intensity of marrow with the histologic appearance of marrow at 19 resection margins. RESULTS: Changes consistent with reconversion were seen on MR images in seven of nine patients who had received GCSF in addition to chemotherapy and in none of seven patients who had received chemotherapy alone. The difference in proportions was statistically significant (p = .006; Fisher's exact test, two tailed). The histologic appearance of marrow at the resection margins agreed with the interpretation of the short-Tl inversion recovery sequence in all cases (100%). CONCLUSION: The findings suggest that GCSF causes changes in the MR imaging appearance of marrow. Histologic correlation supports the hypothesis that these changes are attributable to reconversion from fatty to hematopoietic marrow. Awareness of this finding is important to avoid false-positive diagnosis of marrow metastases.

Adolescent↗
PubMed1995

Hematopoietic marrow regeneration in pediatric patients undergoing spinal irradiation: MR depiction.

PURPOSE: To evaluate changes in vertebral marrow signal intensity that occur over time in children undergoing craniospinal radiation therapy, specifically evaluating for the occurrence and timing of marrow regeneration. METHODS: MR images of nine pediatric patients (ages 4 to 12 years) with posterior fossa medulloblastoma who received total spinal irradiation (24 to 40 Gy) and had at least three MR examinations were reviewed. Signal intensity to vertebral body marrow was graded by two pediatric neuroradiologists who were blinded to patient identity and to the timing of the studies. RESULTS: Eight of nine patients demonstrated increasing signal intensity of the vertebral marrow after irradiation, consistent with conversion of hematopoietic to fatty marrow. In each of these patients, this was followed by subsequent decreasing signal intensity in a mottled or peripheral band pattern indicating recovery of hematopoietic marrow. CONCLUSION: Changes in vertebral body signal intensity consistent with marrow reconversion commonly are seen in pediatric patients 11 to 30 months after they undergo total spinal irradiation.

Bone Marrow↗
PubMed1992

Bacterial ileocecitis caused by Escherichia coli O157:H7.

Escherichia coli O157:H7 is most commonly linked to hemorrhagic colitis and the hemolytic uremic syndrome. Diagnostic ultrasound was used to demonstrate terminal ileum abnormalities suggestive of bacterial ileocecitis, a recently described entity that resembles acute appendicitis, in a patient whose stool culture yielded E. coli O157:H7. This case extends the spectrum of disease caused by E. coli O157:H7 and expands the number of organisms that can cause bacterial ileocecitis.

Child↗
PubMed1992

Sonographic diagnosis of intestinal malrotation in infants: importance of the relative positions of the superior mesenteric vein and artery.

OBJECTIVE: An abnormal relative position of the superior mesenteric vein and artery can be present in patients with intestinal malrotation. We undertook this retrospective study to see how often we could determine the relative position of these vessels on abdominal sonograms in infants and how often abnormal position of the vessels was associated with malrotation. MATERIALS AND METHODS: We reviewed the radiology files and medical records of 337 infants with vomiting who were referred for sonography because of possible pyloric stenosis. We used sonograms and written reports to determine the position of the superior mesenteric vessels. The position was considered normal when the superior mesenteric vein was to the right of the superior mesenteric artery on transverse sonograms. The position was considered abnormal when the vein was directly ventral to the artery or when the vein was to the left of the artery. Sonographic findings were compared with results of upper gastrointestinal series when possible and with clinical outcome. RESULTS: The relative positions of the superior mesenteric vein and artery were evident in 249 (74%) of the 337 patients. Abnormal orientation of the mesenteric vessels was detected in nine patients. In five patients, the superior mesenteric vein was located to the left of the artery, and all five had intestinal malrotation. In four patients, the superior mesenteric vein was directly ventral to the artery, and one of these had malrotation. CONCLUSION: Sonographic assessment of the relative positions of the mesenteric artery and vein is an important adjunct in the examination of infants with suspected pyloric stenosis. Patients in whom sonograms show an abnormal position of the vessels should have further examination to detect malrotation.

Congenital Abnormalities↗
PubMed1992

A pilot study of suramin in the treatment of progressive refractory follicular lymphomas.

Ten patients with progressive follicular lymphomas (seven with follicular mixed lymphomas, three with follicular, small cleaved cell lymphomas) with clinical indications for systemic therapy received parenteral suramin. Each had failed from one to six prior chemotherapeutic regimens and three had in addition received prior radiation therapy. All had measurable disease and nine of the ten had documented bone marrow involvement at the start of therapy. Suramin was administered at an initial infusion rate of 350 mg/m2/day, which was then modified on the basis of subsequent weekly plasma suramin concentrations in order to reach a final plasma concentrations of 250-350 micrograms/ml. Treatment cycles were repeated at eight week intervals. Nine of ten patients are evaluable for response. Five of nine evaluable patients achieved a partial remission as defined by a greater than 50% decrease in the sum of the product of all measurable lesions. Sites of response include: Peripheral (five patients) and central (four patients) adenopathy, disappearance of biopsy-proven skin involvement (one patient), malignant pleural effusions (one patient) and shrinkage of an enlarged spleen (two patients). Disappearance of B symptoms occurred in the one responder with these symptoms. Response duration varied from 3 to 9 months (mean 5.6 months) with time to subsequent systemic therapy varying from 5 to 12 months (mean 8 months). Drug related toxicity included the development of polyradiculopathy (one case), liver function abnormalities (three cases), thrombocytopenia (five cases), vortex keratopathy (two cases) and bacterial infection (two cases). We conclude that suramin has significant activity against follicular lymphomas refractory to standard chemotherapy and that its precise role in the treatment of lymphoproliferative neoplasms in general warrants further investigation.

Adult↗
PubMed1991

Linear areas of echogenicity in the thalami and basal ganglia of neonates: an expanded association. Work in progress.

A retrospective review of 2,320 neonatal cranial sonograms obtained in 1,324 patients identified 25 patients with areas of echogenicity in their thalami and basal ganglia that were of a linear or branching linear distribution. Four of these patients had cytomegalovirus infection. Other major diagnoses encountered included Down syndrome, trisomy 13 syndrome, neonatal asphyxia, non-immune hydrops, and fetal alcohol syndrome. Results of the study suggest a broader etiologic basis for linear areas of echogenicity in the basal ganglia and thalami of children than has previously been reported. These patients warrant complete screening for possible in utero infection and perhaps also chromosomal analysis.

Basal Ganglia↗
PubMed1990

Partial deletion of the long arm of chromosome 11 [del(11)(q23.3----qter)] with abnormal white matter.

A patient with partial deletion of the long arm of chromosome 11[del(11)(q23.3----qter)] had macrocephalic trigonocephaly, growth and mental retardation, congenital heart defect, and characteristic facial appearance familiar to that of 33 other reported patients with this deletion. Computed tomography (CT) and magnetic resonance imaging of this infant's brain demonstrated abnormality of the supratentorial white matter. This may represent either deficiency or delay in myelination or possibly a demyelination process. No abnormalities in white matter were described in seven of 33 previously reported patients whose brains were examined by ultrasound, CT, or autopsy.

Abnormalities, Multiple↗
PubMed1990

Renal involvement in children with lymphoma: comparison of CT with sonography.

In order to determine whether real-time sonography or contrast-enhanced CT was better for detecting renal involvement by lymphoma in children, we retrospectively studied 44 patients (6 months to 19 years of age) in whom lymphoma was diagnosed at our hospital during a 5-year period. In no patient was there any clinical evidence of renal disease at the time of presentation. In 39 patients, sonographic and CT findings were similar (normal in 36 patients and showing extrinsic mass effects on the kidneys in three patients). In five patients with non-Hodgkin lymphoma whose contrast-enhanced CT scans showed low-attenuation renal nodules, renal sonography was normal in two, showed renal enlargement in two, and showed a solitary hypoechoic nodule in one patient with multiple, bilateral nodules on CT. Tissue diagnosis of the renal lesions was not obtained, but in the four patients who had follow-up CT, the renal abnormalities resolved after chemotherapy. Our findings suggest that contrast-enhanced CT is superior to sonography for detection of renal lymphoma in children.

Adolescent↗