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Biomedical subjects

M J Gelfand

Publications and source records attributed to M J Gelfand.

At least 73 records · Page 4Linked to original sources
PubMed1984

Upper abdominal trauma in children: imaging evaluation.

One hundred consecutive children with serious blunt upper-abdominal injury were evaluated prospectively to assess the accuracy and usefulness of emergency computed tomography (CT) compared with liver-spleen scintigraphy and sonography. Ninety-five hemodynamically stable patients were imaged. The results of this 20-month study indicate that CT has fewer false negatives and false positives than scintigraphy or sonography, that CT is useful in abdominal trauma, and that CT provides the most information of any single diagnostic imaging test commonly available.

Abdominal Injuries↗
PubMed1983

Evidence of left ventricular aneurysm by thallium-201 myocardial scintigraphy.

TI-201 myocardial scintigrams from 100 patients were reviewed for evidence of left ventricular aneurysms without prior knowledge of the clinical or angiographic data. Scintigraphic evidence of left ventricular aneurysms was considered present when TI-201 myocardial activity extended outward from the expected left ventricular contour in a region adjacent to an area of resting scintigraphic hypoperfusion. Scintigraphic findings suggestive of left ventricular aneurysm were detected in four patients, of whom three had angiographic evidence of left ventricular aneurysm. In the fourth patient, a dilated, akinetic left ventricular apex was present but an angiographic diagnosis of left ventricular aneurysm was not made. In three additional patients with angiographic evidence of left ventricular aneurysm, scintigraphic criteria for left ventricular aneurysm were absent. Although ungated TI-201 myocardial scintigraphy is an insensitive technique for the detection of left ventricular aneurysm, a characteristic scintigraphic pattern should suggest that a left ventricular aneurysm is present.

Female↗
PubMed1983

Decreased gallium uptake in acute hematogenous osteomyelitis.

Decreased radiopharmaceutical uptake was noted on both bone and gallium scans in the case of acute hematogenous osteomyelitis of the right ilium (acetabular roof). This combination of findings is probably rare. The mechanism of decreased gallium uptake is unknown, but may be related to decreased blood flow.

Acetabulum↗
PubMed1983

Bone scintigraphy in slipped capital femoral epiphysis.

Tc-99m diphosphonate bone scans were performed on 11 children with slipped capital femoral epiphysis. On pinhole hip images, seven hips in seven patients had increased radionuclide uptake in the physis and adjacent proximal femoral metaphysis where the slip had occurred. Three hips in three patients had decreased radionuclide uptake in the femoral head on the side of the slipped epiphysis, indicating compromise of the femoral head blood supply. Three or more months following internal fixation, three children had scintigraphy that showed loss of the usual focal uptake in the physis and adjacent proximal femoral metaphysis. Bone scintigraphy in pediatric patients with slipped capital femoral epiphysis is valuable in defining the metabolic status of the femoral head. Absence of radiopharmaceutical uptake in the affected femoral head indicates that the femoral head is at risk for development of radiographic changes associated with aseptic necrosis.

Child↗
PubMed1983

Radiation absorbed-dose estimates for the liver, spleen, and metaphyseal growth complexes in children undergoing gallium-67 citrate scanning.

Quantitative conjugate-view external counting techniques were applied to estimate the radiation dose to the liver, spleen, and metaphyseal growth complexes (distal femur and proximal tibia) for ten pediatric patients undergoing gallium-67 scanning procedures. The effective half-life of Ga 67 in these organs was approximately 78 hours. The dose per unit of administered activity for the liver and spleen was between 0.3 and 4.0 rad/mCi (0.08 to 1.08 Gy/GBq) and 0.5 and 7.0 rad/mCi (0.13 to 1.89 Gy/GBq), respectively. For the metaphyseal growth plates, the range was 2.3 to 14.3 rad/mCi (0.62 to 3.86 Gy/GBq).

Adolescent↗
PubMed1982

Radionuclide angiographic and echocardiographic quantitation of left-to-right shunts in children with ventricular septal defect.

Pulmonary to systemic blood flow ratios (Qp:Qs) were estimated in 16 children with ventricular septal defects using simultaneous echocardiography and radionuclide angiography, and compared to Qp:Qs measured at cardiac catheterization by the Fick principle method (Fick). When ratios of echographic left atrial dimensions (LAD) to body surface area (LAD/M2), body length (LAD/ht), and aortic root diameter (LAD/Ao) were compared to the Qp:Qs determined by Fick, the correlation coefficients were r = 0.70 for LAD/M2, r = 0.66 for LAD/ht, and r = 0.54 for LAD/Ao. The correlation coefficients between Qp:Qs by Fick, and left ventricular dimensions/M2 and fractional shortening of the left ventricle were not significant. The correlation coefficients between Qp:Qs and the ratios estimated by gamma-variate and area-ratio analysis of radioisotope pulmonary dilution curves were r = 0.92 and r = 0.84, respectively. Thus, radionuclide angiography provided more accurate quantitation of left to right shunting through a ventricular septal defect than echocardiography. However, difficulty in obtaining adequate bolus injections of the radioisotope may result in technical failures whereas echocardiographic measurement is possible in almost all pediatric patients. Finally, the gamma-variate method cannot accurately quantitate shunt ratios greater than 3.5 to 1.

Adolescent↗
PubMed1982

Postoperative evaluation of the Fontan procedure by radionuclide angiography.

Seven patients were evaluated by radionuclide angiography (RNA) following Fontan-like procedures for complex cyanotic congenital defects. Both first-pass and ECG gated equilibrium angiography were performed in each. Residual right-to-left shunts, right atrial (RA) outflow and pulmonary arterial obstruction, and left ventricular dysfunction were demonstrated by these techniques. In addition, RA ejection fraction (RAEF) by gated equilibrium scan was measured in each patient. Relatively low RAEF was seen in conjunction with residual obstruction to pulmonary flow. RNA is useful in the postoperative evaluation of patients after Fontan procedures.

Adolescent↗
PubMed1981

Imaging of irradiated liver with Tc-99m-sulfur colloid and Tc-99m-IDA.

In three cases, irradiated regions of liver failed to concentrate Tc-99m-sulfur colloid. In two of these three, imaging with Tc-99m-acetanilide iminodiacetic acid (IDA) agents within five days showed near normal hepatic uptake of this hepatobiliary imaging agent. The hepatic parenchymal cells may be imaged with Tc-99m-IDA in some irradiated regions of liver, despite loss of reticuloendothelial cell function.

Aged↗
PubMed1981

Radionuclide bone imaging in spondylolysis of the lumbar spine in children.

Bone scintigraphy and radiography were performed in seven children with back pain. Six of the children with radiographic evidence of a pars interarticularis defect also had abnormal scintigrams. Increased uptake of the bone imaging agent occurred at six of the ten sites of radiographic pars interarticularis defects, implying increased bone metabolic activity. However, the location of scintigraphic abnormalities did not correspond to the location of radiographic abnormalities in several cases. Possible explanations for the discordant findings are: (a) normal bone metabolism at the site of an old spondylolysis and (b) radiographically inapparent stress fractures. Measurements of absorbed radiation dose indicate that plain radiography, including oblique views where appropriate, has a lower absorbed radiation dose than scintigraphy or tomography and should be performed prior to these studies.

Adolescent↗
PubMed1980

Pinhold imaging: utility in testicular imaging in children.

Pinhole imaging of the testis was done in ten boys with suspected testicular torsion. In three of the ten cases, pinhold images were easier to interpret than images obtained with a converging collimator. In six of the ten cases, pinhold images were required for interpretation of the study, because converging images could not be interpreted.

Adolescent↗
PubMed1979

Dose to the liver and spleen in pediatric patients undergoing technetium-99m sulfur colloid scans.

Quantitative conjugate view external counting techniques were applied to determine radiation dose to the liver and spleen in pediatric patients undergoing 99mTc-sulfur colloid (Tc-SC) liver scans. The effective half-life of 99mTc-SC was 5.8 +/- 0.23 hours and 5.2 +/- 0.68 hours in the liver and spleen, respectively. Dose per administered activity ranged from 0.34 to 0.63 rad/mCi (92 to 170 muGy/MBq) for the liver and 0.35 to 1.96 rad/mCi (95.0 to 530.0 muGy/MBq) for the spleen. The spleen to liver dose ratio ranged from 1.0 to 4.9. These values are compared with results extrapolated from published adult data to the pediatric population.

Adolescent↗
PubMed1978

Radionuclide imaging of Meckel's diverticulum in children.

Fifty-eight children were studied for the presence of Meckel's diverticulum by scintigraphy with 99mTc-pertechnetate. Meckel's diverticulum was found at surgery in 6 of 6 patients with positive radionuclide studies and in 2 of 48 patients with negative studies. Four studies could not be interpreted because of widespread intestinal activity. Using the criteria described in this paper, false-positive readings did not occur.

Adolescent↗
PubMed1978

Dose to the metaphyseal growth complexes in children undergoing 99mTc-EHDP bone scans.

The spatial temporal distribution of radionuclides in children may differ greatly from that accepted for adults. Following injection of a bone-seeking agent (99mTc-EHDP), radioactivity in the metaphyseal growth complexes of the distal femur and proximal tibia was quantitated in a series of children 4 to 16 years of age, using a gamma camera/computer system. The dose to the growth plate was fount to range from 0.8 to 4.7 rads when adjusted to an administered activity of 200 muCi/kg, compared to approximately 0.6 rad to the adult skeleton for a corresponding study.

Adolescent↗