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Biomedical subjects

M A Feldberg

Publications and source records attributed to M A Feldberg.

At least 37 records · Page 2Linked to original sources
PubMed1990

Retroperitoneal cystic lymphangioma section imaging in two cases, and review of the literature.

Two patients with retroperitoneal cystic lymphangioma are reported with a review of the medical literature. In one, the patient was asymptomatic from the lesion but had a computed tomography (CT) and an ultrasound to evaluate the extent of disease with a known carcinoma of the colon. The second patient presented with an acute abdominal pain requiring surgical management. CT on this patient showed multiple cystlike cavities filled with fluid, in a retroperitoneal location. The preoperative diagnosis of retroperitoneal cystic lymphangioma was confirmed at surgery. Magnetic resonance (MR) performed on the second patient gave better delineation of craniocaudal extent and showed one of the cysts to have probable hemorrhage.

Adult↗
PubMed1989

Grey Turner's sign and Cullen's sign in acute pancreatitis.

Four patients with acute pancreatitis presenting with Grey Turner's sign or Cullen's sign have been studied by computed tomography (CT). These observations help confirm the precise anatomic pathways by which the extravasated pancreatic enzymes and their effects lead to these cutaneous discolorations. Grey Turner's sign is produced by spread from the anterior pararenal space to between the two leaves of the posterior renal fascia and subsequently to the lateral edge of the quadratus lumborum muscle. Communication may be established to the posterior pararenal space and to the structures of the flank wall. The lumbar triangle, a site of anatomic weakness on the flank wall, may serve as a structural predisposition. Cullen's sign can be seen to be secondary to the tracking of liberated pancreatic enzymes to the anterior abdominal wall from the inflamed gastrohepatic ligament and across the falciform ligament. Another more direct pathway may be extension from inflammatory changes of the small mesentery or greater omentum to the round ligament, and then to properitoneal fat deep to the umbilicus.

Abdomen↗
PubMed1989

Magnetic resonance appearance of adrenal hemorrhage in a neonate.

The Magnetic Resonance (MR) appearance of adrenal hemorrhage in a neonate is described and compared with Ultrasound (US). The value of US studies in adrenal neonatal hemorrhage is well known. We present the MR appearance of this common condition.

Adrenal Gland Diseases↗
PubMed1989

Magnetic resonance imaging of the cerebral aqueduct. Signal intensity time curves demonstrated by fast acquisition with multiple excitation (FAME).

Using cardiac-gated fast acquisition with multiple excitation (FAME), time curves of the cerebral aqueduct signals were derived in 19 healthy volunteers and 14 patients. A mean curve of the normal subjects was determined during systole. A relatively stable point of time was found at 270 msec after the R-wave supposed to be the reversal of the flow of cerebral-spinal fluid in the aqueduct. Different curves were noticed in complete aqueductal obstruction (n = 2); in other pathologic states, such as cerebral tumor (n = 3), normal pressure hydrocephalus (n = 3), and brain atrophy (n = 1), no different signal time curves were observed. Parameters such as aqueduct diameter, cerebro-spinal fluid volume and brain compliance are probably other important factors in aqueduct liquor flow.

Adolescent↗
PubMed1989

Percutaneous transluminal renal angioplasty: initial and long-term results.

Renal artery stenosis in 201 patients with hypertension was treated with percutaneous transluminal renal angioplasty (PTRA). A total of 213 procedures were performed as treatment of 262 separate stenosis. The stenosis was caused by atherosclerosis in 134 cases and by fibromuscular dysplasia (FMD) in 52 cases; the cause was indeterminate in 27 cases. Of the 213 procedures, 172 were successful or resulted in improvement, for a technical success rate of 80.8%. The initial clinical results could be evaluated in 210 cases; cure or improvement was achieved in 80%. There were 23 cases in which neither technical nor clinical success was achieved. Data on the remaining 187 cases were the basis of this long-term follow-up study. The cumulative patency rate at 5 years was 80% in the atherosclerosis group, 89% in the FMD group, and 74% in the indeterminate group. The mortality was less than 1%. Because spasm occurred in 33 cases, causing an infarction in ten instances, antispasmodic medication seems warranted. These long-term results indicate that PTRA is the treatment of choice in patients with renovascular hypertension.

Angioplasty, Balloon↗
PubMed1989

Comparison of Telebrix Gastro and Gastrografin in abdominal computed tomography.

Palatability as well as the side effects and computed tomographic image quality associated with the oral use of Telebrix Gastro (ioxithalamate) and Gastrografin (amidotrizoate) in bowel opacification were compared in a double-blind study involving 100 patients in a 24-hour protocol. There was a tendency (p = 0.07) for Telebrix Gastro to show greater palatability. The difference between the 2 groups in terms of patient discomfort was too small to reach statistical significance (p less than 0.09). There was no statistical difference between the agents with respect to image quality. In 87% of cases in both groups bowel filling was adequate.

Contrast Media↗
PubMed1987

Pancreatic lesions and transfascial perirenal spread: computed tomographic demonstration.

Computed tomographic (CT) findings in 105 cases of pancreatitis and 107 cases of pancreatic carcinoma were analyzed retrospectively to determine the occurrence and roentgenologic signs of penetration of the anterior renal fascial planes in relation to clinical symptoms. In pancreatitis, the perirenal fat was infiltrated in 7% to variable extents by extrapancreatic fluid collections, either as asymptomatic fluid lying alongside renal fascial planes and perirenal septa (5 cases) or as well-circumscribed fluid collections causing clinical symptoms (2 cases). In pancreatic carcinoma the occurrence of retropancreatic extension to a perirenal space was rarer (3%). Distinction on CT between perirenal involvement from the pancreas and primary adrenal or renal lesions with anterior spread can prevent unnecessary surgery.

Adenocarcinoma↗
PubMed1987

The peritoneal ligaments and mesenteries: pathways of intraabdominal spread of disease.

The abdomen has been conveniently divided anatomically and clinically into specific intraperitoneal and extraperitoneal sites. A recognition of the pathways of spread and localizing features of infections, malignancies, and traumatic collections has immeasurably extended diagnostic imaging capabilities. Yet, while the abdomen may be visualized as subdivided into compartments, it must also be essentially appreciated that these compartments are an actual or potential interconnecting network. In the upper abdomen peritoneal reflections comprise 11 major ligaments and mesenteries. These are generally readily recognizable on computed tomographic scans by either their typical location and organ relationships or the landmarks provided by their major constituent vessels. These ligaments and mesenteries provide continuity of anatomic planes, which permits the spread of disease between intraperitoneal compartments, between extraperitoneal spaces, and between intraperitoneal and extraperitoneal localized sites.

Gastrointestinal Diseases↗
PubMed1987

Percutaneous transluminal renal angioplasty in children and adolescents.

Percutaneous transluminal renal angioplasty (PTRA) was performed in 12 children and adolescents with renal artery stenosis. Patients were divided into three groups: those with a short stenosis in the middle or distal part of the renal artery (n = 5), those with a short stenosis at or near the origin of the renal artery (n = 3), and those with a long stenosis at or near the origin (n = 4). The patients in the first group responded to PTRA. Those in the second group had a poor clinical response, and dilation was unsuccessful in the patients in the third group, who remained hypertensive. The location and length of the renal artery stenosis and its underlying cause appear to be important in determining the results of PTRA.

Adolescent↗
PubMed1986

Direct coronal and direct sagittal CT of abdomen and pelvis: an approach to staging malignancies.

Direct coronal and sagittal CT images are of high quality and are applicable to a majority of patients in daily practice. Because of the fact that transverse scans alone can be misleading, direct CT images in two or more different planes greatly enhance one's capability to stage neoplasms that are complex and extensive. The integrity of the margins of an organ, in the presence of tumor, is best determined by coronal or sagittal scanning. Lesions of the adrenal and kidney and retroperitoneal processes with possible extension into liver or other adjacent organs can be evaluated best using the combination of transverse and coronal or sagittal scans of the upper abdomen. Depending on the origin of pelvic lesions, the radiologist must consider in every individual case the performance of either direct coronal or sagittal sections or both. This judgment is based on the findings on the transverse scans, understanding of anatomic relationships of the pelvic viscera and knowledge of staging systems and their implications with respect to therapeutic decisions. In such a tailored approach, multiplanar CT facilitates improved presurgical evaluation. In some cases, the true extent of the lesion can only be seen in the coronal or sagittal planes. A potential new role for direct multiplanar CT is that it may be used as a sort of "gold standard" for the analysis of multiplanar ultrasound and MRI studies.

Abdominal Neoplasms↗
PubMed1986

Delayed rupture of renal artery after renal percutaneous transluminal angioplasty.

Two cases are reported in which rupture of the renal artery occurred many hours after renal percutaneous transluminal angioplasty. Delayed rupture can be recognized by the angiographic appearance and by the presence of persistent flank pain. The typical angiographic finding is a poorly defined zone of contrast medium at the site of perforation.

Adult↗
PubMed1986

CT demonstration of calcified post-thrombotic inferior vena cava.

A calcified thrombus in the inferior vena cava is imaged and exactly located by computed tomography in an adult presenting with acute phlebitis complicating deep venous thrombosis. It is the purpose of this case report to discuss the rare finding of inferior vena caval (IVC) calcification and to demonstrate the computed tomographic (CT) findings of a calcified post-thrombotic inferior vena cava.

Acute Disease↗
PubMed1985

Computed tomography in complicated acute appendicitis.

Due to the position and length of the appendix, intraabdominal abscesses after perforation in complicated acute appendicitis may occur in several different and sometimes unsuspected anatomical locations. Five patients are described with proven complicated acute appendicitis and inflammatory processes in multiple sites: anterior pararenal space, general retroperitoneum, subcutaneous fat space, intraperitoneal cavity, and small bowel mesentery. A confusing case of ileocecal carcinoid with mesenteric involvement is also presented. In all cases complicated acute appendicitis was diagnosed on CT prior to surgery, except in 1 case in which a pelvic abscess developed after intramural cecal bleeding in a patient with hemophilia B.

Abdomen↗
PubMed1985

Role of CT in diagnosis and management of complications of diverticular disease.

The clinical complications of diverticular disease may be unclear. Seven patients with complicated diverticulitis of the transverse, descending, and sigmoid colon were examined with computed tomography. Exact knowledge of the anatomical relationships of the transverse, descending, and sigmoid colon and neighboring structures are a prerequisite for understanding and interpreting the extensions of peridiverticular disease. Computed tomography proved to be useful in evaluating the presence and extent of sequelae of perforations, and, as a consequence, influenced the planning and timing of treatment.

Abscess↗