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Biomedical subjects

M Wolverson

Publications and source records attributed to M Wolverson.

10 recordsLinked to original sources
PubMed1994

Computed tomography as a screening exam in patients with suspected blunt aortic injury.

BACKGROUND: Chest computed tomography (CT) screening of patients with blunt trauma for thoracic aortic injury is controversial. This study was undertaken to determine whether CT could exclude aortic injury and be used to select patients for aortography. METHODS: Computed tomography and aortography were used to evaluate 155 patients with blunt trauma. Computed tomography scans were reviewed separately by four attending radiologists who were unaware of the patients' clinical course and angiographic findings. RESULTS: Eight of 155 patients had aortic injuries requiring operation. Computed tomography scans in five patients were read as positive by all reviewers. One scan was read as positive by three reviewers and as negative by one. Two scans were read as positive by two radiologists and as negative by two. After poor scans were excluded, the combined sensitivity of CT for detecting aortic injury was 88%, specificity was 54%, positive predictive value was 9%, and negative predictive value 99%. CONCLUSIONS: The sensitivity of CT scan for indicating the need for aortography is observer dependent. As CT manifestations of aortic injury are often subtle, CT does not reliably exclude aortic injury.

Adolescent↗
PubMed1994

Analysis of radiocontrast-induced nephropathy by dual-labeled radionuclide clearance.

RATIONALE AND OBJECTIVES: This study was devised to develop a method of measuring the acute effects of radiocontrast media on renal function and assessing the relationship of the dose of radiocontrast media infused with the incidence of radiocontrast-induced renal failure. In addition, the drug adenosine phosphate-magnesium chloride (ATP-MgCl2) was evaluated as a renoprotective agent. METHODS: Eighteen patients with pre-existing renal impairment, (serum creatinine greater than 133 mumol/L) were randomized to receive a continuous infusion of ATP-MgCl2 or placebo before and during a radiocontrast procedure. Subjects were monitored with daily serum creatinine and with radionuclide renal clearance studies at baseline, during, and 24 hours after the radiocontrast procedure. RESULTS: There was an initial deterioration in renal clearance in the entire study group (from 44.2 +/- 4.6 to 32.6 +/- 3.9 mL/min, P = .001) which was independent of the dose of radiocontrast infused. There was a persistent deterioration in renal clearance only in those who received greater than 135 mL of contrast media (from 48.6 +/- 7.8 to 37.1 +/- 3.9 mL/min, P = .05). There also was an increase in serum creatinine that persisted only in those subjects who received greater than 135 mL of contrast media (230 +/- 27 to 283 +/- 44 mumol/L, P = .01). CONCLUSION: Persistent deterioration in renal function after radiocontrast administration appears to be dose-dependent and is not prevented by the use of ATP-MgCl2. Radionuclide techniques are useful in monitoring acute changes in renal function during radiocontrast procedures and may be of value in assessing renal impairment in future intervention studies.

Acute Kidney Injury↗
PubMed1985

Computed tomography in the pretreatment assessment of carcinoma of the cervix.

Fifty-nine patients with primary or recurrent carcinoma of the cervix were evaluated by computed tomography as part of their presurgical evaluation. The computed tomography staging results were compared with the surgical staging. Computed tomography staging was accurate in 71% (42 of 59), whereas clinical staging was accurate in 66% (39 of 59). In assessing paraaortic nodes by CT, there were 10 true-positive, 20 true-negative, 1 false-positive, and 2 false-negative results (sensitivity, 83%; specificity, 95%), for an overall accuracy of 91%. For pelvic nodes, there were 10 true-positive, 11 true-negative, 3 false-positive, and 6 false-negative results (sensitivity, 62.5% specificity, 78%), for an overall accuracy of 70%. Excretory urograms and barium enemas provided no information not obtained by computed tomography and are probably unnecessary if computed tomography is used as a routine staging examination. At present, computed tomography should not replace clinical assessment of extent of the disease. Its chief advantage over clinical staging is its ability to detect metastases beyond the true pelvis.

Adenocarcinoma↗
PubMed1982

Budd--Chiari syndrome in a child.

We describe a 14-month-old female who presented with hepatomegaly 1 month after abdominal trauma. Eight years later, radiographic and histologic studies confirmed the diagnosis of Budd--Chiari syndrome with evolution to cirrhosis.

Abdominal Injuries↗
PubMed1981

CT findings in thoracic aortic dissection.

Computed tomography (CT) findings in 11 cases of aortic dissection were correlated with aortographic, surgical, or postmortem findings. In another two patients, the CT findings were considered diagnostic of aortic dissection but no further workup was performed. All the CT examinations were made before and after bolus injection of contrast. Many of the familiar angiographic signs were appreciated on CT, such as a thickened aortic wall, septum between two opacifying lumens, differential time density between the two lumens, and compression of the true lumen. No false-positive or false-negative studies were encountered. This experience suggests that CT is a reliable, noninvasive method for the diagnosis of aortic dissection.

Aged↗
PubMedDate not supplied

Computed tomography of omental liver packs.

Hypodense liver lesions with attenuation coefficients indicative of fat density were seen on CT of three patients followed up for suspected metastatic spread of gastrointestinal malignancy. Knowledge of previous hepatic surgery using omental packing for hemostasis in the setting of liver trauma or lobectomy was useful in preventing a false-positive interpretation of postoperative complications.

Adult↗