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Biomedical subjects

M Graif

Publications and source records attributed to M Graif.

At least 55 records · Page 3Linked to original sources
PubMed1986

Anuria in a premature infant due to ureteropelvic fungal bezoars.

Systemic candidiasis with renal involvement is a well recognised complication of intensive care in premature newborns. However, the development of reversible obstructive oliguric acute renal failure has not been well documented. We report a premature infant who developed anuria associated with bilateral candidal bezoar formation in the renal collecting system. The sonographic appearance of the renal fungus balls is described. Treatment by surgical removal of the bezoars, open placement of nephrostomy tubes and intravenous antifungal therapy resulted in apparent complete recovery.

Amphotericin B↗
PubMed1986

MRI in acoustic neuroma: a review of 35 patients.

This retrospective study is aimed to assess the diagnostic efficacy of MRI in relation to contrast enhanced CT and air-CT-cisternography. MRI examinations were performed in 35 patients with suspected neurosensorial damage and suggestive of acoustic neuroma: 27 presented on MRI with unilateral tumors, 3 patients had a bilateral tumor and 5 patients were negative on all imaging modalities. The total number of acoustic neuromas detected was therefore 33. To date microscopic analysis has been performed on 12 tumors and histological data based on type Antoni A and Antoni B classification is available. Contrast enhanced CT detected 19 tumors, yielding an overall sensitivity rate of 58%. Air-CT cisternography identified an additional 5 tumors with a sensitivity rate of 100%. MRI identified 33 acoustic neuromas in 30 patients and was negative in 5 patients (sensitivity and accuracy 100%). Considering sensitivity in relation to location, MRI was much better than contrast enhanced CT for internal auditory canal (IAC) tumors (100% versus 36%) and better for cerebello-pontine angle tumors (CPA) tumors (100% versus 68%). The evolution of MRI technique, the various pulse sequences used and their actual selection is discussed. Seven patients received a paramagnetic contrast agent (Gadolinium-DTPA) with the additional benefit of a better demonstration of the tumor. The results suggest that MRI is the best non invasive technique for demonstrating acoustic neuromas.

Adolescent↗
PubMed1986

Magnetic resonance imaging of the retroperitoneum.

The results of magnetic resonance imaging (MRI) examinations in 50 patients with histological or clinical diagnoses of retroperitoneal disorders and 20 normal volunteers are presented. An increase in relaxation time (T1) was recognised in most pathological conditions except for four liposarcomas and one adrenal cortical neoplasm and one metastatic lesion of the same gland. Inversion recovery (IR) provided the best tissue contrast, enabling the detection of small lesions. Flow-dependent sequences and sagittal imaging planes were particularly helpful in the evaluation of aortic aneurysms. Ferric ammonium citrate used as an oral paramagnetic contrast agent and a short T1 inversion recovery sequence gave encouraging initial results in recognising bowel loops. Gadolinium-DTPA injected intravenously provided tumour enhancement, indicating vascular perfusion and demarcating tumour margins. An attempt to eliminate motion artefacts was carried out in 15 volunteers and six patients either by a new software system (respiratory ordered phase encoding) or by using short T1 inversion-recovery to suppress the high signal from fat. The same pulse sequence results were useful in demonstrating subcutaneous fistulous tracts by eliminating the adjacent fat. The actual role of MRI in the investigation of the retroperitoneum in view of current technical developments is discussed.

Abscess↗
PubMed1986

Gadolinium-DTPA in the assessment of liver tumours by magnetic resonance imaging.

The effect of gadolinium-DTPA (Gd-DTPA, Schering AG) as a magnetic resonance imaging (MRI) contrast agent was studied in 15 patients with liver tumours. A dose of 0.1 mmol/kg was used. An analysis of the time-course of enhancement, a comparison of four different pulse sequences, and a dose-comparison study were carried out with monitoring of haematological and biochemical parameters before and after injection of Gd-DTPA. Maximum enhancement, that is, increase in signal intensity, was noted on IR1400/400/13 between 10 and 20 min after injection while on SE580/40 and SE580/80 maximum enhancement was noted 30 min after injection. In some cases enhancement was noted up to 120 minutes after injection. SR1000/13f sequences showed very little enhancement. On comparison with contrast-enhanced X-ray computed tomography (CT), enhancement was greater on MRI in seven cases, equal in six and less in two, as assessed subjectively. Additional lesions were shown in one case using Gd-DTPA compared to precontrast enhanced MRI scans. However, no additional lesions were seen on contrast-enhanced MRI scans compared to contrast-enhanced CT scans. Gd-DTPA is capable of enhancing liver tumours on MRI and may have a place in the assessment of the operability of such lesions.

Contrast Media↗
PubMed1986

Acoustic neuromas: Gd-DTPA enhancement in MR imaging.

Magnetic resonance (MR) imaging examinations were performed in ten patients with 12 acoustic neuromas before and after intravenous administration of 0.1 mmol/kg body weight gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA). The degree of enhancement was greatest with the inversion recovery sequence 1,500/500/44 (repetition time [TR]/inversion time/echo delay time [TE]), followed by spin-echo (SE) 544/44 (TR/TE) sequences, then by SE 1,500/44 and SE 1,500/80 sequences. After enhancement there was a 50% reduction for measured T1 values, 33% for T2, and no significant change for proton density. There were no toxic effects on patients. Enhanced CT scans failed to demonstrate lesions in six of 12 cases. Air-CT technique improved sensitivity in four of five cases. Enhanced MR imaging added significant clinical information in two small intracanalicular tumors and in one recurrent tumor.

Adult↗
PubMed1986

Contrast-enhanced magnetic resonance imaging of tumours of the central nervous system: a clinical review.

The clinical application of the intravascular paramagnetic contrast agent gadolinium-DTPA for magnetic resonance imaging (MRI) imaging of tumours of the central nervous system (CNS) has been assessed over the past 3 years. Various patterns of contrast enhancement were observed, and situations in MRI where the administration of contrast medium may be useful have been defined. These include lesions which are isointense with normal brain matter, the separation of tumour from surrounding oedema, evaluation of the degree of blood-brain barrier breakdown, delineation of tumours obscured by overlying calcification on computed tomography (CT) and in the investigation of lesions in anatomical areas where CT has known limitations (brain stem, cervical spine). Changes in relaxation times in normal and abnormal tissues following contrast medium, toxicity and dosage of gadolinium-DTPA, and MRI pulse sequence techniques are reviewed.

Astrocytoma↗
PubMed1985

Parathyroid localization. Sonographic-surgical correlation.

Sonographic localization of enlarged parathyroid gland was performed in 37 patients suspected of hyperparathyroidism who underwent surgical exploration of the neck. Nine of those patients were clinically asymptomatic. Most of the others presented with urolithiasis. The sonograms were obtained by conventional and high resolution realtime (10 mHz). Of the 37 patients, 31 patients had a single adenoma, three patients had two adenomas, and two patients had hyperplasia. Analysis of the results has shown accuracy of 84 per cent. The sensitivity of the procedure was 79.5 per cent and the specificity was 98 per cent. The exact side and location of the enlarged parathyroid in relation to the thyroid gland was predicted in 91 per cent. The false-negative cases were due to abnormal location (gland in mediastinum or incorporated within the thyroid). The false-positive findings were all colloid cysts located at the periphery of the thyroid parenchyma. Preoperative confirmation and localization of enlarged parathyroid glands facilitated the decision for surgical intervention, especially in hypercalcemic asymptomatic patients and in high operative risk patients. The duration of operation and postoperative complications were significantly reduced.

Adolescent↗
PubMed1984

The pylorus in infancy: overall sonographic assessment.

A prospective ultrasonic evaluation of the pylorus was performed in two groups of infants, a control group and a group of infants clinically suspected of having hypertrophic pyloric stenosis (HPS). The mean pyloric length in the hypertrophied condition was 84% longer than the mean length in the normal. The mean and standard deviation (sd) for the transverse diameter and pyloric wall thickness in the normals were 7.45 +/- 2.2 mm and 2.3 +/- 0.7 mm respectively, while the corresponding measurements for the mean and sd in HPS were 13.4 +/- 1.6 mm and 4.5 +/- 0.9 mm. In most of the HPS cases the known morphological changes of the antro-pyloric region such as: impingement on the fluid filled antrum, pre-pyloric antral thickening, extension of fluid into the proximal portion of the pyloric canal and the angle formed between antral peristaltic wave and pyloric mass, were observed. Detection of these changes furnished further criteria for highly accurate diagnosis of HPS even of borderline cases.

Female↗
PubMed1984

Hyperechoic foci in the gallbladder wall as a sign of microabscess formation or diverticula.

Abdominal sonography in 7 patients with acute biliary disease revealed focal echo collections within the wall of the gallbladder in addition to cholelithiasis and diffuse mural thickening. A prospective study was conducted, comparing in vivo and in vitro sonography of the gallbladder with histopathological findings. In 3 patients, microscopy of the hyperchoic tissue showed microabscesses. In 4, intramural diverticula containing inspissated bile, small stones, or cholesterol crystals were seen. The authors caution that hyperchoic foci within the wall of the gallbladder may indicate intrinsic disease separate from cholelithiasis or cholecystitis.

Abscess↗
PubMed1984

Torsion of the ovary: sonographic features.

The sonographic findings in 19 cases of surgically proven torsion of the ovary are described. In all cases the affected ovary was markedly enlarged; in 32% of cases a small amount of fluid was detected in the cul-de-sac. More significant in terms of specificity was the demonstration in 14 (74%) of the 19 cases of small cystic structures scattered around the periphery of the organ. Sonographic demonstration of these structures, presumably prominent follicles, can suggest the preoperative diagnosis of ovarian torsion.

Adult↗
PubMed1983

Rhabdomyosarcoma of the cord: ultrasonic evaluation.

A rare case of paratesticular rhabdomyosarcoma in a young adult is described, emphasizing the role of ultrasonic preoperative examination in evaluating the consistency and extension of the scrotal mass for surgical management.

Adult↗
PubMed1983

Sonographic differentiation of extra- and intrahepatic masses.

The sonographic features in the evaluation and differentiation of extra- and intrahepatic masses were assessed in two groups of patients. These signs included discontinuity of the liver capsule, internal invagination or external bulging of the liver capsule, formation of a retroperitoneal fat wedge, displacement of the intrahepatic portal vessels or hepatic veins, shift of the inferior vena cava, and displacement of the right kidney. Evaluation of the results in 25 patients in whom the mass was intrahepatic and in 33 with an extrahepatic mass indicates that internal invagination of liver capsule (81.8%), its discontinuity (33.3%), formation of triangular fat wedge (75.7%), shift of the inferior vena cava anteromedially (36.3%), and anterior displacement of right kidney (28.1%) are the signs most frequently observed in extrahepatic masses. The characteristic features of the intrahepatic masses were displacement of hepatic vascular radicles (84%), external bulging of the liver capsule (56%), and posterior shift of the inferior vena cava (32%). The evaluation of masses in the right upper abdomen according to these criteria gives an accurate definition of their anatomic origin. However, masses exceeding 10 cm in diameter may present diagnostic problems.

Adenocarcinoma↗
PubMed1982

Sonographic demonstration of the right ascending lumbar vein.

The right ascending lumbar vein has not previously been described in the sonographic literature. This vein is an important part of the abdominal prevertebral anastomotic network and appears sonographically as an anechoic tubular structure lying dorsal and parallel to the inferior vena cava. It was detected in 14 of 20 randomly selected patients who underwent routine abdominal sonography and had a mean diameter of 2.0 mm +/- 0.8 SD. In another six patients with abnormal blood flow in the inferior vena cava, dilated lumbar veins were demonstrated.

Child↗