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Biomedical subjects

H Kangarloo

Publications and source records attributed to H Kangarloo.

At least 73 records · Page 4Linked to original sources

Tongue and oropharynx: findings on MR imaging.

Ten healthy subjects and 44 patients with diseases of the tongue or oropharynx were studied with magnetic resonance (MR) imaging. Axial, coronal, and sagittal images with a thickness of 4 mm were obtained with a pixel size of 0.75 X 0.75 mm on a 256 matrix. Nineteen of the patients underwent computed tomography (CT). Nine of those patients later had surgery, and the specimens were obtained for organ sectioning. These three studies as well as clinical history and physical examination findings were correlated. MR imaging was equal to or better than CT in those patients having both examinations. However, neither CT nor MR allowed recognition of histologic features or detection of microscopic spread of disease. Direct coronal and sagittal imaging planes on MR imaging allowed visualization of intrinsic tongue musculature, not possible with CT; this was important in recognizing subtle tumor extension. For these reasons, MR is the imaging method of choice for studying diseases of the tongue and oropharynx.

Adult↗

Accurate demonstration of hepatic infarction in liver transplant recipients.

Serial HIDA scanning has proven to be a valuable tool in the postoperative management of liver transplant patients. Previous reports have documented its efficacy in detecting biliary leakage, abscess, and rejection. We have also found HIDA scanning to be a sensitive method for detecting early hepatic infarction before ultrasonographic changes occur. Two cases are presented to demonstrate the characteristic findings seen with hepatic infarctions.

Child↗

Real-time sector ultrasound in the evaluation of suspected abnormalities of diaphragmatic motion.

Real-time sector ultrasonography is the only imaging procedure that can simultaneously evaluate the paradiaphragmatic spaces, the hemidiaphragms themselves, and their motion. Our experience with the use of real-time ultrasonography in the evaluation of 14 cases of suspected abnormalities of diaphragmatic motion and position is presented. With the exception of an equivocal examination in a patient who was completely respirator dependent, all of the sonographic diagnoses were consistent with available clinical and imaging follow-up. Real-time sector ultrasonography should be used as the primary imaging modality for evaluation of suspected abnormalities of diaphragmatic motion and position.

Abnormalities, Multiple↗

Urinary tract infection in infants and children evaluated by ultrasound.

Fifty-nine pediatric patients with urinary tract infection (UTI) underwent renal ultrasonography, excretory urography, and voiding cystourethrography. The imaging procedures were analyzed retrospectively to determine their relative effectiveness in detecting abnormalities that might predispose the patient to UTI. Voiding cystourethrography provided valuable information, particularly the presence or absence of vesicoureteral reflux, that could not be obtained from the other procedures. Excretory urography was less specific than ultrasonography in the majority of patients, with the exception of those who had renal scarring. The authors recommended ultrasonography as the initial imaging procedure in the evaluation of children with UTI. When the sonogram is normal, excretory urography is not considered necessary, but voiding cystourethrography is thought to be essential. If sonography is abnormal, excretory urography and/or other follow-up studies are indicated.

Adolescent↗

Interventional radiology in infants and children: clinical and technical aspects.

The authors performed 53 extravascular interventional procedures in 47 pediatric patients between July 1981 and September 1983. Except for transhepatic cholangiography in patients without intrahepatic biliary dilatation, the success rate was high. There were few complications, and none that were life-threatening or required surgery. More than 90% of procedures were performed without general anesthesia. Factors essential to safe and successful intervention in infants, children, and adolescents, in the authors' opinion, include (a) active involvement by the radiologist, (b) guidance by real-time imaging, (c) careful matching of needles, catheters, and guide wires to patient size, and (d) adequate sedation and analgesia.

Abdomen↗

Computed tomography in stage III neuroblastoma.

This multicenter study was designed to determine if CT can assess operability in stage III neuroblastoma. Nineteen children (11 boys, eight girls), aged 2-51 months, considered to have, by conventional clinical and radiographic examinations, localized neuroblastoma that crossed the midline were examined by CT. After intravenous and oral contrast media enhancements, CT was able to show the relation of the tumor to the adjacent vital vessels: aorta, celiac axis, and superior mesenteric artery. In all 15 patients, tumors that encased the aorta or its major branches were unresectable. However, three of four tumors crossing the midline but not coming into contact with the aorta or adherent only to one side of the vessel could be resected. Because surgery currently plays the major role in the treatment of neuroblastoma, the relation of the tumor to the aorta and great vessels is a more reliable and important factor in predicting the outcome of these children than the extension and location of the tumor with reference to the midline. CT after intravenous contrast enhancement can establish this relation and assess resectability.

Abdominal Neoplasms↗

Hydronephrosis in childhood--reliability of ultrasound screening.

The reliability of gray scale sonography for the screening of hydronephrosis is assessed in a retrospective clinical study of pediatric patients. The sensitivity was 89% and the specificity 95%. Discrepancies between the ultrasound and urographic diagnosis of mild hydronephrosis--which was usually not clinically significant--accounted for all of the errors. False positive studies can be reduced by scanning the kidneys with the bladder empty. False negative examinations may be due to the contrast induced diuresis of the urogram.

Adolescent↗

Interventional radiologic procedures in the renal transplant.

Percutaneous interventional procedures can be valuable in the evaluation and treatment of urologic complications of renal transplantation. Thirty-three patients underwent percutaneous procedures, including relief of obstruction by catheter nephrostomy, diagnostic antegrade pyelography with Whitaker testing, aspiration of various fluid collections (lymphocele, hematoma, urinoma, and abscess), and renal artery angioplasty, during a three year period at three institutions, to provide temporizing treatment and anatomic data. Surgical intervention was sometimes avoided, but more often it could be deferred to allow the patient to stabilize prior to surgery. Complications that required surgery occurred in two patients.

Adolescent↗

Renal osteodystrophy in children undergoing continuous ambulatory peritoneal dialysis.

This paper describes a retrospective evaluation of the course of renal bone disease in 14 children undergoing treatment with continuous ambulatory peritoneal dialysis (CAPD) for an average of 11.9 +/- 1.5 months (mean +/- SE). The patients were divided in two groups according to the changes in serum alkaline phosphatase activity during the period of observation: five patients had alkaline phosphatase activity that decreased or was relatively stable (group I), and nine patients exhibited a rising serum alkaline phosphatase activity (group II). Serial radiological examinations showed adequate control of renal osteodystrophy in the patients of group I, whereas the patients of group II had no improvement or worsening of their bone disease. Group I had higher serum calcium and lower parathyroid hormone levels than group II at the end of period of observation despite similar dosage of vitamin D metabolite. The progression of bone disease was not related to the duration of CAPD or type of previous treatment for end stage renal disease. The observation that the radiological manifestations of secondary hyperparathyroidism were prevented in patients whose serum calcium levels were frequently above 2.62 mmol/liter (group I) while serum calcium levels between 2.25 and 2.50 mmol/liter in group II patients failed to lead to regression of secondary hyperparathyroidism is consistent with the existence of altered "set-point" regulation of the parathyroid gland in children undergoing CAPD.

Adolescent↗

High-resolution spinal sonography in infants.

High-resolution, real-time sonography of the spine revealed significant anatomic details in 29 infants, including nine with congenital malformations. Transverse sections were most useful for detecting osteochondral anomalies and for evaluating the symmetry of the spinal column and its soft-tissue contents. Longitudinal sections augmented the transverse sections and provided the most detailed anatomy of the cord and spinal arteries. A normal screening sonographic examination obviates ionizing radiation and invasive procedures, while an abnormal study implies the need for further, complementary diagnostic investigations.

Humans↗

Fetal hydronephrosis: problems in diagnosis and management.

Experience with the prenatal diagnosis and management of four cases of congenital renal abnormalities is presented. Neither prenatal intervention nor early delivery was indicated in any of these patients. The current enthusiasm for aggressive management of fetal renal abnormalities may underestimate difficulties in prenatal diagnosis and overestimate the potential benefits of early intervention.

Adult↗

Sonography of extrathoracic left-to-right shunts in infants and children.

Experience with high-resolution, real-time sonography of four infants with differing extrathoracic left-to-right shunts is presented. Intracranial and parahepatic arteriovenous malformations gave rise to congestive heart failure as their primary or sole manifestation. Partial anomalous pulmonary venous return to the inferior vena cava in one patient and to the portal vein in another was associated with other congenital cardiac anomalies. Once an arteriovenous malformation was suspected, sonography was useful as the initial imaging procedure to localize it and to direct attention to the most useful and least hazardous studies for detailed evaluation.

Arteriovenous Malformations↗

Increased risk of gallstones in children receiving total parenteral nutrition.

Twenty-one children receiving long-term total parenteral nutrition were prospectively evaluated for the presence of gallstones. Using ultrasonography, nine children (43%) were found to have cholelithiasis, and five have since undergone cholecystectomy. Only children with ileal disorders or previous resection developed stones. In the select group of patients with ileal disorders or previous resection, the prevalence of stones was 64%, nearly twice that which has been observed in similarly defined adults not receiving total parenteral nutrition. Data from this study suggest that the prolonged administration of parenteral nutrition significantly enhances the risk of gallstone formation already imposed by a previous ileal resection or disorder. Periodic ultrasonograms provide a safe and accurate means of monitoring high-risk patients during and after prolonged total parenteral nutrition therapy.

Adolescent↗