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Biomedical subjects

J Kabala

Publications and source records attributed to J Kabala.

At least 19 recordsLinked to original sources
PubMed2005

Signal intensity, clinical activity and cross-sectional areas on MRI scans in thyroid eye disease.

The signal intensity from inflamed extra-ocular muscles on short tau inversion recovery (STIR)-sequence magnetic resonance imaging (MRI) is known to correlate with clinical scores of thyroid eye disease (TED) severity. Twenty-one patients who had undergone repeated MRI scanning for TED were studied retrospectively. Signal intensity of extra-ocular muscles (from STIR-sequence MRI) and cross-sectional area (from STIR and T1 MRI) were correlated with Mourits' clinical activity score (CAS). The area of highest signal intensity within the most inflamed extra-ocular muscle, and the average cross-sectional signal intensity of the most inflamed extra-ocular muscle reliably correlated with CAS, and this was maintained as disease activity changed over time. In contrast, isolated measures of muscle cross-sectional area did not correlate with CAS. The extra-ocular muscle cross-sectional area calculated from STIR-sequence MR images was greater than that measured on T1 images. This suggests that muscle area from STIR-sequence MRI may also detect peri-muscular inflammation. We conclude that the peak signal intensity from the most inflamed extra-ocular muscle remains the most reliable correlate of clinical disease activity obtained from these images. STIR-sequence MRI scans provide a number of useful measures of disease activity in TED.

Anatomy, Cross-Sectional↗
PubMed2004

Imaging of testicular tumours.

This article reviews the diagnosis, pathology and imaging of testicular tumours, predominantly germ cell tumours. It will discuss the imaging techniques used in their diagnosis, staging and surveillance.

Diagnosis, Differential↗
PubMed2001

Percutaneous retrograde varicocele embolisation using tungsten embolisation coils: a five year audit.

OBJECTIVE: To assess the efficacy of percutaneous retrograde varicocele embolisation using Spirale tungsten coils over a period of five years. PATIENTS AND METHODS: Fifty consecutive patients underwent local anaesthetic day case varicocele embolisation via a right femoral approach. Venous anatomy was identified and classified. Morbidity and recurrence were recorded at three month clinical follow up. RESULTS: The procedurewas technically successful in 94% of the patients. The varicocele recurred in 16%, the majority of whom had complex venous anatomy. 8% of the patients complained of discomfort at follow up. CONCLUSIONS: Although the coils used in this study have been withdrawn, a high technical success rate is described with failure being predominantly due to complex venous anatomy.

Adolescent↗
PubMed2001

Serial STIR magnetic resonance imaging correlates with clinical score of activity in thyroid disease.

PURPOSE: To assess the correlation between inflammatory activity in extraocular muscles measured with serial short tau inversion recovery (STIR) sequence magnetic resonance imaging (MRI) scans and clinical disease activity in thyroid eye disease. METHODS: In this retrospective study, 22 patients with thyroid eye disease who had undergone serial MRI scans using the STIR sequence were assessed. The signal intensity ratio (SIR) of the most inflamed extraocular muscle was compared with the Mourits score (a clinical measure of thyroid eye disease activity). RESULTS: The SIR value has previously been shown to correlate with clinical activity of thyroid eye disease. In a particular patient the SIR value increases in proportion with the clinical features of the disease as assessed by the Mourits rating system. When the change in STIR sequence MRI is compared with the change in Mourits score rating for a given patient the correlation is highly significant (p < 0.001). CONCLUSIONS: This study confirms that serial STIR sequence MRI scans correlate with clinical disease activity. Inflammatory activity in the most inflamed muscle (as measured by SIR) reflects overall disease activity. SIR values obtained from MRI scans provide a useful measure of disease activity and may help in the monitoring and treatment of this condition.

Female↗
PubMed2001

Investigation of upper tracts after resolution of symptoms due to ureteric calculi.

OBJECTIVE: To determine whether patients with proven ureteric calculi on IVU require repeat IVU after resolution of symptoms and passage of calculus on plain X-ray. METHODOLOGY: IVU reports for a 12-month period were obtained and notes and X-rays of those patients with ureteric calculi were reviewed. Presentation, management and subsequent imaging after resolution of symptoms were determined for each patient. All X-rays were reviewed by a uroradiologist. RESULTS: Fifty-eight patients were investigated for the study. All initial IVUs showed upper tract dilation or obstruction. Forty-three eventually passed their calculi spontaneously and of these, 18 had KUB, all of which showed passage of the calculus and 25 had repeat IVU, 22 of which were normal. The 3 abnormal IVUs showed persisting calculi which were visible on the plain film. Fifteen patients required surgical intervention and all had repeat IVU, of which 5 were abnormal. CONCLUSION: This study suggests that following resolution of symptoms due to ureteric colic, patients who pass their calculi spontaneously can be followed up by KUB. Only those with persistent calculi on KUB or those who have had surgical intervention require repeat IVU.

Follow-Up Studies↗
PubMed2001

Error in radiology.

The level of error in radiology has been tabulated from articles on error and on "double reporting" or "double reading". The level of error varies depending on the radiological investigation, but the range is 2-20% for clinically significant or major error. The greatest reduction in error rates will come from changes in systems.

Magnetic Resonance Imaging↗
PubMed1999

Magnetic resonance imaging in the diagnosis of asymmetrical bilateral masseteric hypertrophy.

Asymmetrical bilateral masseteric hypertrophy or unilateral masseteric hypertrophy may present a diagnostic dilemma. While the history and clinical examination are important in differentiating this benign condition from parotid and dental pathology, they cannot necessarily exclude rarer malignant lesions of or within the muscle itself. We present a case where MRI provided clear and elegant confirmation of our provisional clinical diagnosis by illustrating both the soft tissue features and the logical corresponding bony features of this condition, thus obviating the need for further invasive investigations.

Adolescent↗
PubMed1999

Internal iliac artery embolisation for intractable bladder haemorrhage in the peri-operative phase.

Intractable haemorrhage from the bladder wall during transurethral resection of bladder tumour is uncommon but potentially catastrophic. Internal iliac artery embolisation is a minimally invasive technique, which is now widely practised to stop bleeding from branches of these arteries is situations including pelvic malignancy, obstetric and gynaecological emergencies and trauma. We report its successful use peri-operatively, in an unfit, elderly patient with uncontrolled bleeding.

Aged↗
PubMed1997

Air gun pellet injuries: the safety of MR imaging.

The ferromagnetism, and therefore the safety in a magnetic resonance (MR) examination, of the most widely available air gun pellets has been tested. While many are made of lead and are not ferromagnetic, some contain steel and are deflected strongly in a magnetic field. There must therefore be careful consideration before undertaking MR examinations of patients with embedded air gun pellets.

Contraindications↗
PubMed1997

Role of preoperative localization in the management of primary hyperparathyroidism.

BACKGROUND: The advantages of preoperative localization in the management of primary hyperparathyroidism have not been clearly demonstrated. The aim of this study was to investigate prospectively the accuracy of three localization techniques in patients with this condition. METHODS: Forty-nine consecutive patients with primary hyperparathyroidism underwent ultrasonography, magnetic resonance imaging (MRI) and technetium-thallium (Tc-Tl) subtraction scanning before surgery, during which an attempt was made to identify all parathyroid glands. A scan was regarded as correct if it identified an enlarged parathyroid gland on the correct side of the neck as subsequently demonstrated at surgery. RESULTS: Ultrasonography had a sensitivity of 38 per cent (18 correct scans in 47 patients) with a positive predictive value of 78 per cent. The sensitivity of MRI was 72 per cent (34 of 47) with a predictive value of 92 per cent. Tc-Tl scanning was 60 per cent sensitive (28 of 47) with a predictive value of 85 per cent. Two patients with negative neck explorations were subsequently found to have mediastinal adenomas. CONCLUSION: Ultrasonography, MRI and Tc-Tl scanning have limited value as localization techniques and the relatively low sensitivity of these investigations means they are of no value before first-time surgery.

Adult↗
PubMed1996

Bilateral metastatic spread of testicular teratoma to mandibular condyles.

The clinical and radiological features of a patient with metastatic spread of testicular teratoma to both mandibular condyles are presented. It is suggested that in patients with known systemic malignancy, a local metastatic deposit should be considered as a possible cause of unexplained pain in the temporomandibular joints.

Adult↗
PubMed1996

Magnetic resonance imaging in thyroid eye disease.

We examined 25 patients with thyroid eye disease, using both the STIR (Short Tau Inversion Recovery) sequence and cine MRI techniques. A number of characteristic features can be seen on the cine MRI. There is muscle enlargement with restriction of movement and, in the burnt-out phase of the disease, reduced elasticity of the muscles is manifest as their failure to stretch on eye movement. This is in contrast to the active phase of the disease, where although the muscles are enlarged, muscle stretching is clearly visible. The STIR sequence gives an assessment of muscle water content, and hence a high signal is seen in active disease. Combining these techniques is useful in assessing the level of disease activity in thyroid eye disease, and helps in planning further management.

Disease Progression↗
PubMed1995

Primary and recurrent inverting papilloma: appearances with magnetic resonance imaging.

Inverting papilloma of the sinonasal cavity is of importance because of its association with squamous cell carcinoma and its tendency to local recurrence. Appearances of inverting papilloma have only been reported infrequently, and never in recurrent cases. We present the magnetic resonance imaging (MRI) appearances of four cases of inverting papilloma, three of which are recurrent.

Aged↗
PubMed1995

An anatomical, histological and magnetic resonance imaging study of the nasal septum.

Considerable variations are present in the thickness of the normal nasal septum. These were studied and measured in cadavers and from MRI scans. In addition, a histological analysis was performed to determine whether cavernous tissue is present at any point in the septum. The nasal septum reaches maximum thickness antero-superiorly where the mucosa may be as thick a 5.0 mm (average 3.5 mm) and the minimum thickness lies inferiorly where the mucosa is often thinner than 0.5 mm. The area of maximum septal thickness lies at the region of the nasal valve and its contribution towards nasal airway resistance must be significant. No cavernous tissue was identified in the nasal septum.

Adult↗
PubMed1995

Neuropathic urinary retention in the absence of neurological signs.

We present two cases of painless urinary retention secondary to central intervertebral disc prolapse. In neither case were there signs or symptoms suggesting an underlying neurological insult. Both patients voided spontaneously following neurosurgical intervention. The classical features of acute cauda equina compression may be absent in patients with central lumbar disc protrusion. Painless urinary retention may be the only physical sign.

Adolescent↗
PubMed1994

The STIR sequence MRI in the assessment of extraocular muscles in thyroid eye disease.

Nineteen patients with thyroid eye disease were examined with magnetic resonance imaging using the Short Tau Inversion Recovery (STIR) sequence and compared with normal controls. The Signal Intensity Ratio (SIR) of each of the four recti was obtained by comparison with the signal intensity of the adjacent temporalis muscle. The SIR was compared with disease activity assessed using Werner's grading system, a clinical inflammatory score, and the range of extraocular movements. Results show that a high SIR is associated with a high index of disease activity. This technique is likely to prove useful in assessing disease activity and planning the management of thyroid eye disease, particularly with respect to immunosuppression.

Adult↗