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Biomedical subjects

R Dominguez

Publications and source records attributed to R Dominguez.

81 records · Page 5Linked to original sources

Imaging of common congenital anomalies of the brain and spine.

The term congenital anomalies refers to those processes that are present before or at birth. In congenital brain anomalies these defects are usually manifested as structural abnormalities. The central nervous system (CNS) starts forming at approximately the 17th day of intrauterine life and myelination is almost completed at about the 18th month of life when the brain reaches adult characteristics. For the purpose of this article, the major CNS abnormalities are reviewed according to the time of insult, beginning with the earlier ones. This article does not attempt to be a complete review; the emphasis is on illustrating the most important CNS anomalies utilizing ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging.

Brain↗

Diagnostic imaging update in skeletal dysplasias.

The mystique of bone dysplasias is gradually vanishing. A short historical overview introduces the subject of short stature. The pathogenesis and controversial classification of skeletal dysplasias are discussed and summarized in two tables; the use of different imaging modalities is laid out along the sequential diagnostic approach and review of common orthopedic complications. References to such advances in treatment as bone marrow transplantation, bone lengthening, and the encouraging positive effect of growth hormone therapy complete this updated revision.

Achondroplasia↗

Radiological evaluation of the craniocervical junction in bone dysplasias and other related syndromes.

The craniocervical junction, a vital but anatomically complex region, presents additional interpretative challenges in patients with skeletal dysplasias and other syndromes involving the musculoskeletal apparatus. Our objective was to review the radiological evaluation used in such conditions; to do so, we identified retrospectively all of the occipitocervical studies done during the last 3 years at our institution on patients with skeletal dysplasias and related syndromes. The 28 cases thus found were reviewed and the different diagnostic modalities identified; the diagnostic findings were summarized and classified into osseous and soft tissue abnormalities. The standard criteria for cervical instability and cord compression were compared with measurements reported in our selected cases. The lateral radiograph of the cervical spine was the first diagnostic test, followed by additional flexion-extension views and sagittal spin-echo magnetic resonance imaging; no conclusive diagnostic criteria for occipitoatlantal instability in children with bone dysplasias were identified.

Adolescent↗

Neonatal herpes simplex pneumonitis.

Four new cases of neonatal herpes pneumonia and five cases from the literature were assessed. Clinical presentations, laboratory abnormalities, and radiographic features were analyzed in an effort to establish helpful criteria for early institution of antiviral therapy. Any neonate who develops respiratory distress between the third and 14th days of life and has a chest radiograph that reveals prominent hilar with a central interstitial infiltrate is at high risk for herpes pneumonia. Antiviral therapy pending antigen detection and culture results should be strongly considered in any such patient when the etiology of pneumonitis is unknown and any of the following is found: (1) thrombocytopenia; (2) evidence of disseminated intravascular coagulation; (3) elevated values in liver function tests; (4) a positive result in a rapid screening test for herpes simplex virus; (5) lymphocytic pleocytosis of the cerebrospinal fluid; (6) development of vesicular skin lesions; or (7) further deterioration in clinical status during treatment with antibiotics.

Female↗

Aortic dissection: diagnosis and follow-up with helical CT.

Acute aortic dissection is a cardiovascular emergency that requires prompt diagnosis and treatment. Helical computed tomography (CT) allows diagnosis of acute aortic dissection with a sensitivity and specificity of nearly 100%. With helical CT, a dissection involving the ascending aorta (type A in the Stanford classification) can be differentiated from one distal to the left subclavian artery (type B). Helical CT can also be used to identify atypical forms of aortic dissection such as intramural hematoma, penetrating atherosclerotic ulcer, ruptured type B dissection, and atypical configurations of the intimal flap. Helical CT is useful in follow-up of aortic dissection by allowing assessment of early and late changes after surgery or medical treatment. Such changes include postoperative complications of type A dissection, healing of intramural hematoma, progression of intramural hematoma, and aneurysms of the true or false lumen. Helical CT can also be used to monitor potentially life-threatening ischemic complications of abdominal branch vessels.

Aortic Dissection↗

Chiari III malformation: imaging features.

PURPOSE: To analyze and discuss the MR and CT features of Chiari type III malformations. PATIENTS AND METHOD: MR and CT studies in nine neonates born at term with Chiari type III malformations were retrospectively reviewed. RESULTS: High cervical/low occipital encephaloceles were present in all cases. Hypoplasia of the low and midline aspects of the parietal bones was seen in four patients. The encephaloceles contained varying amounts of brain (cerebellum and occipital lobes, six cases; cerebellum only, three cases), ventricles (fourth, six cases; lateral, three cases), cisterns, and in one case, the medulla and pons. Associated anomalies included: petrous and clivus scalloping (five cases/nine cases), cerebellar hemisphere overgrowth (two cases/nine cases), cerebellar tonsillar herniation (three cases/seven cases), deformed midbrain (nine cases), hydrocephalus (two cases/nine cases), dysgenesis of the corpus callosum (six cases/nine cases), posterior cervical vertebral agenesis (three cases/eight cases), and spinal cord syrinxes (two cases/seven cases). In four patients who underwent surgical resection and closure, aberrant deep draining veins and ectopic venous sinuses within the encephaloceles were found. Pathology examination of the encephalocele (four cases/nine cases) showed multiple anomalies (necrosis, gliosis, heterotopias, meningeal fibrosis) that were not demonstrable by either MR or CT. The marked disorganization of the tissues contained within the cephalocele may account for the lack of MR sensitivity to these abnormalities. CONCLUSION: Preoperative determination of the position of the medulla and pons is essential and is easily accomplished by MR. To avoid surgical complications, the high incidence of venous anomalies should be kept in mind.

Cerebellum↗