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Biomedical subjects

M A Sandler

Publications and source records attributed to M A Sandler.

At least 55 records · Page 3Linked to original sources
PubMed1984

Ultrasonic and computed tomographic features of mucocele of the appendix.

The ultrasonic features in three cases and computed tomographic (CT) findings in one case of mucocele of the appendix are presented. This entity appeared cystic on sonography and may have high-intensity echoes within it. The wall was not thickened and did not contain calcification, unlike previous descriptions. On CT, the mass was of soft tissue density, while previously, it had been described as cystic. Although mucocele of the appendix has a more variable appearance on sonography and CT than previously reported, a correct preoperative diagnosis can be made in most cases. Barium enema examination or calcification in the wall or in the mass itself may be necessary to distinguish this entity from lymphoma if the lesion is of soft tissue density on CT.

Aged↗
PubMed1983

Differentiation of focal intrahepatic lesions with 99mTc-red blood cell imaging.

The appearance of focal hepatic lesions on 99mTc-sulfur colloid images is nonspecific. As it is important to distinguish hemangiomas from other lesions prior to biopsy, a prospective study was performed using 99mTc-labeled red blood cells. Dynamic perfusion and delayed blood-pool images (1-2 hours) were obtained and lesion activity categorized as increased, equal, or decreased compared with the liver. Of 21 patients studied, 9 (43%) had one or more hepatic hemangiomas, and 8 of these 9 patients (89%) demonstrated increased blood-pool activity. The 12 nonhemangiomatous lesions consisted of 7 metastatic tumors, 2 hepatomas, 1 cirrhotic nodule, and 2 hepatic cysts. None of these 12 patients had increased activity on delayed blood-pool images. Early dynamic images of hepatic hemangiomas demonstrated variable activity (vascularity) and were not useful in differentiating hemangiomas from other lesions. Sensitivity was 89% and specificity 100%. Although liver enzymes are usually normal with hepatic hemangiomas, they may also be normal in metastatic disease. The authors recommend that delayed blood-pool imaging be performed prior to biopsy, particularly in patients without a known primary tumor or those with normal liver enzyme levels.

Adult↗
PubMed1983

Computed tomographic features of esophageal intramural pseudodiverticulosis.

A patient with esophageal intramural pseudodiverticulosis (EIPD) was examined with computed tomography (CT). CT demonstrated marked thickening of the esophageal wall, diffuse irregularity of the esophageal lumen, and intramural gas collections--features typical of this entity. In the proper clinical setting, CT can confirm the diagnosis of EIPD, especially when other studies are equivocal. However, this case also demonstrates some of the limitations of CT in differentiating benign and malignant esophageal disorders.

Diverticulum, Esophageal↗
PubMed1983

Adult polycystic kidney disease: presymptomatic diagnosis for genetic counselling.

We evaluated 30 first degree relatives of 9 patients with end-stage renal disease secondary to adult polycystic kidney disease. The diagnostic accuracy of renal ultrasonography was compared with intravenous pyelogram with nephrotomography. In 27 patients the two tests were in agreement. In 3 patients both tests were abnormal but findings on IVP did not completely agree with ultrasonography. For early detection and genetic counselling, we recommend ultrasonography as the initial screening procedure for the evaluation of asymptomatic family members of a patient with APKD. IVP should only be considered if ultrasonogram is abnormal but not diagnostic of APKD.

Adolescent↗
PubMed1982

Renal parenchymal disease: sonographic-histologic correlation.

A retrospective study of 109 patients who underwent renal biopsy was designed to correlate the sonographic appearance of the kidney with the histologic changes and clinical and laboratory findings in various renal parenchymal diseases. The clinical, pathologic, and sonographic data were analyzed blindly and independently by a team from each corresponding discipline. There was no correlation between the specific sonographic appearance and the type of renal disease. There was a significant correlation between renal length and the prevalence of global sclerosis, focal tubular atrophy, and the number of hyaline casts per glomerulus. A significant positive correlation was also found between cortical echogenicity and the severity of global sclerosis, focal tubular atrophy, the number of hyaline casts per glomerulus, and focal leukocytic infiltration. While there was overall significant correlation between the degree of cortical echogenicity and blood urea nitrogen and creatinine concentrations in each group, a wide range of variance was present. It is not currently feasible to distinguish different types of renal medical disorders using diagnostic ultrasound.

Adolescent↗
PubMed1982

Sonographic findings in perforation of the gallbladder.

The sonographic findings in 13 patients with proven gallbladder perforation are described. Two patients were scanned immediately before and after gallbladder perforation. The sonographic findings before gallbladder perforation were gallbladder distension (one case) and gallbladder wall edema (one case). Pericholecystic collections develop after gallbladder perforation. These collections have a varied sonographic appearance ranging from anechoic to complex collections, and their internal characteristics seem to depend on the duration of the pericholecystic process. The residual gallbladder lumen or calculi can be identified within or peripheral to the pericholecystic process. The most acceptable mechanism for perforation of the gallbladder is: (1) impaction of a calculus in the cystic duct; (2) gallbladder distension due to secretion into its lumen by mucous glands located in the walls of the gallbladder; (3) vascular impairment of the gallbladder due to distension of the viscus; and (4) ischemia, necrosis, and perforation of the gallbladder wall. Gallbladder perforation is a significant complication of acute cholecystitis associated with morbidity and mortality. Detection of this complication of acute cholecystitis by clinical means is difficult since the patient's symptoms are similar to those of uncomplicated acute cholecystitis. The inherent resolution of sonography offers an excellent display of the gallbladder and surrounding tissues allowing detection of pericholecystic collection secondary to gallbladder perforation.

Abscess↗
PubMed1982

Disease in the femoral triangle: sonographic appearance.

Twenty-nine patients had sonographic evaluation of the femoral triangle because of pain or swelling. The entities diagnosed by sonography were abscesses (seven), cellulitis (three), hematoma (five), nodal enlargement (four), aneurysm of the femoral artery (three), and thrombophlebitis of the femoral vein (seven). Both abscesses and hematomas were poorly defined primarily anechoic masses. Soft-tissue swelling but no distinct masses were present in cellulitis, and all cases of adenopathy were well defined anechoic masses. Aneurysms were also primarily well defined, pulsatile, anechoic masses except mycotic aneurysm, which may present as a primarily solid mass. The sonographic features of thrombophlebitis which has received scant attention in the sonographic literature are stressed. Findings suggest a dilated anechoic vein is characteristic of this entity. Although the sonographic findings or clinical data of many of these entities may be nonspecific, when used in combination, the correct diagnosis can usually be obtained.

Abscess↗
PubMed1981

Ultrasonic features of pyogenic liver abscesses.

Ultrasonic features of 21 surgically confirmed pyogenic liver abscesses in 18 patients were analyzed. Typical lesions were round or ovoid with a discrete, irregular, echo-poor margin. The number and intensity of internal echoes and sound transmission were variable. Such lesions can be aspirated percutaneously for definitive preoperative diagnosis. Pyogenic liver abscesses appear to have more ragged walls and are less frequently elliptical or multilocular than abscesses elsewhere in the abdomen.

Adolescent↗
PubMed1981

Acute post-transplantation renal failure: differential diagnosis by ultrasound.

Sonograms of 35 patients with cadaveric renal allografts were reviewed. The patients included five with successful renal transplantations, seven with acute tubular necrosis, 19 with acute rejection, one with complete occlusion of the renal artery, and three with stenosis of a renal artery. During the course of acute tubular necrosis, the renal anatomy remained sonographically unaltered. During the course of acute rejection, there was a spectrum of sonographic findings including increase in renal volume, decreased amplitude of the renal sinus echoes, enlarged medullary pyramids, indistinct corticomedullary boundary, increased echogenicity of the renal cortex, areas of decreased parenchymal echogenicity, sparse cortical echoes, and perirenal fluid collections as a result of hematoma or crescentic collection of fluid around the kidney. In both arterial occlusion and stenosis, no sonographic abnormalities of renal anatomy were seen and the only finding was lack of normal post-transplantation hypertrophy. Our study encourages the use of sonography in acute post-transplantation renal failure. If serial ultrasound studies are available and correlation with clinical and laboratory data and nuclear medicine studies are obtained, the correct diagnosis may be reached without the use of invasive procedures.

Acute Kidney Injury↗
PubMed1981

Sonographic findings in complicated peptic ulcer.

The sonographic findings in 7 patients with complicated peptic ulcer are reported. Of 4 patients with perforated ulcers, 2 had a subphrenic fluid collection, 1 had subhepatic extraluminal fluid, and 1 had an inflammatory mass in the gallbladder fossa. The ulcer penetrated into the liver in 1 and the pancreas in 2. The sinus tract between the duodenum and the liver could be seen. The patients with penetrating ulcer had a solid mass indistinguishable from other solid pancreatic masses.

Aged↗
PubMed1980

Ultrasonic features and radionuclide correlation in liver cell adenoma and focal nodular hyperlasia.

Ultrasonic features of three cases of liver cell adenoma (LCA) and two cases of focal nodular hyperplasia (FNH) are presented. These tumors have similar sonographic appearances presenting either as solid masses or containing sonolucent areas due to hemorrhage or necrosis. Although these ultrasonic features in patients with an area of decreased activity on 99mTc-sulfur colloid (Tc-SC) liver scans are not specific for LCA or FNH, such findings in the appropriate clinical setting are suggestive of these lesions. The combination of a solid mass on ultrasonography and a normal Tc-SC radioisotope liver study may be relatively specific for uncomplicated FNH.

Adult↗
PubMed1979

The effect of the distended urinary bladder on placental position and its importance in amniocentesis.

Ultrasonography was performed using the full-bladder technique in 58 patients with intrauterine gestations. Postvoiding scans were then obtained to assess changes in placental position and determine the optimal window for amniocentesis. Twenty-two of the 41 patients with gestations between 13 and 21 weeks and 4 of the 17 with gestations between 24 and 34 weeks had changes in placental position after voiding, presumably due to the effect of the distended bladder on uterine position. These findings should be considered when using ultrasound to locate a suitable window for amniocentesis.

Amniocentesis↗
PubMed1979

Gray-scale ultrasonic features of ovarian teratomas.

Forty patients with pelvic masses were examined with ultrasound; surgical exploration subsequently revealed an ovarian teratoma. The echographic appearance of the lesions was extremely variable. Although a number of characteristic features of teratomas have been described (axial location, solid mural component, acoustic shadow, and "hair/fluid level"), these occurred only in a minority (17/40) of patients. When the clinical setting suggests an ovarian teratoma, the ultrasonographer should consider it regardless of the internal architecture and consistency of the mass.

Adolescent↗
PubMed1978

The spectrum of ultrasonic findings in endometriosis.

Ten cases of endometriosis presenting as pelvic masses are reviewed. Ultrasonically, these lesions were classified into three categories: cystic, mixed, and solid. In the cystic pattern, none had the smooth, well-defined wall and totally echo-free appearance characteristic of a simple cyst. Instead, the wall was shaggy and somewhat irregular with some evidence of septation. In the mixed type, the echographic appearance was compatible with pelvic inflammatory disease of an infectious etiology. In 3 cases with the solid pattern, the ultrasound appearance suggested ovarian malignancy. When the clinical setting and the age of the patient are suggestive of endometriosis, the sonographer should consider this possibility in his differential diagnosis of pelvic masses, regardless of the consistency of the lesion.

Adnexal Diseases↗