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Biomedical subjects

R S Shapiro

Publications and source records attributed to R S Shapiro.

139 records · Page 8Linked to original sources
PubMedDate not supplied

Systemic venous enhancement patterns during dynamic abdominal CT.

In 25 patients we assessed the enhancement of abdominal venous structures during dynamic computed tomography (CT). The degree of venous enhancement demonstrated great variation. In six instances (out of 250 observations) a vessel was visually perceived as not enhancing and potentially thrombosed, including three gonadal veins. CT measurements were helpful in identifying enhancement, but were occasionally low enough that thrombosis remained a radiological consideration. The great variation in venous enhancement makes the diagnosis of thrombosis suspect, based on CT alone. Corroboration of this finding is suggested, when clinically relevant.

Abdomen↗
PubMedDate not supplied

CT diagnosis of acquired intercostal lung herniation.

Intercostal lung herniation is a rare complication of trauma, best demonstrated by computed tomography. Most intercostal lung herniations are the result of direct trauma to the chest wall or occur at sites of prior percutaneously placed chest tubes. We present two cases of acquired intercostal lung herniation.

Aged↗
PubMedDate not supplied

CT appearance of the Syed-Neblett device for interstitial brachytherapy of gynecologic malignancies.

Radiation therapy is an important adjuvant treatment for gynecological malignancies. However, the maximum amount of radiation treatment is limited by the side effects to the normal local tissue. We present a brief summary of the use and appearance of the Syed-Neblett intracavitary device. This device allows delivery of radioactive implants to a local tumor resulting in maximum dosage to tumor tissue, but limiting dosage to the surrounding normal tissue.

Adenocarcinoma↗
PubMedDate not supplied

Underassessment of lower extremity deep venous thrombosis using color flow Doppler compared to compression sonography.

The aim of this paper is to compare the accuracy of color Doppler to compression sonography in the diagnosis of lower extremity deep vein thrombosis. Longitudinal color flow imaging was performed in 60 lower extremities in patients with clinically suspected deep venous thrombosis (DVT). The study was then repeated by a blinded examiner using transverse compression sonography. The results were then correlated. Thirty-five examinations were negative by both color flow and compression methods. Twenty thrombi were diagnosed on compression sonography, while only 13 were diagnosed by the color flow method. Thirty-five percent of thrombi were missed using color flow imaging alone. We conclude that compression sonography should remain an integral part of the assessment of lower extremity DVT, as a significant number of thrombi might be overlooked using longitudinal color flow imaging alone. This is especially true in non-occlusive thrombi that are adherent to the vessel wall.

False Negative Reactions↗
PubMedDate not supplied

Massive pneumatosis intestinalis: CT diagnosis.

Pneumatosis cystoides intestinalis is a rare condition characterized by multiple subserosal or submucosal gas filled cysts within the wall of a segment of bowel. It is associated with numerous conditions, both intra and extraabdominal in nature. The condition may be asymptomatic or may present clinically as nausea, vomiting, diarrhea or other signs of intestinal obstruction. With rupture of the cysts, pneumoperitoneum may be a finding. In a patient with vague clinical presentation, this finding radiographically may lead to a clinical dilemma as many of these patients have comorbid conditions which are also associated with intestinal perforation. The authors present the case of a 47-year-old obese black female found to have massive pneumatosis intestinalis of the tranverse colon with a small amount of free intraperitoneal air. This case highlights the importance of recognizing pneumatosis intestinalis as a possible mimic of free intraabdominal air as well as a possible cause of benign pneumoperitoneum.

Female↗
PubMedDate not supplied

MRI of the liver. A pictorial essay.

Magnetic resonance imaging (MRI) is an extremely useful modality for evaluation of the complex pathophysiology of the liver. The high degree of soft tissue contrast afforded by MRI accurately detects and characterizes both focal and diffuse abnormalities of the liver. In this article we present a pictorial review of MRI of the liver.

Contrast Media↗
PubMedDate not supplied

MRI findings in adenosquamous carcinoma of the gallbladder.

In this report, we present the MRI findings of adenosquamous carcinoma of the gallbladder, a rare type of gallbladder malignancy. MRI examination not only helped established the diagnosis but also accurately depicted the extent of involvement of the adjacent liver. The ability to image in multiple planes was also useful in assessing the anatomic location of the tumor and in determining that the patient could be treated with surgical resection.

Aged↗
PubMedDate not supplied

Color Doppler applications in hepatic imaging.

Color Doppler sonography is an important modality in the non-invasive evaluation of the liver. It is commonly used to evaluate vascular changes which accompany cirrhosis. Doppler techniques are also used to evaluate patients who have undergone liver transplantation or transjugular intrahepatic portosystemic shunt (TIPS) placement. This review describes the various applications of color Doppler in hepatic imaging.

Humans↗
PubMedDate not supplied

Microcystic features at US: a nonspecific sign for microcystic adenomas of the pancreas.

Microcystic adenoma of the pancreas is a benign tumor with no malignant potential and may not require surgery if it is asymptomatic. In the past, a mass containing more than six small (<2-cm) cysts at ultrasonography (US) has been considered to be diagnostic for microcystic adenoma. However, a retrospective study of 36 patients with focal or diffuse pancreatic lesions containing over six small cysts demonstrated that this finding can occur in a wide variety of neoplastic and inflammatory lesions, most of which are malignant. These lesions included adenocarcinoma (n = 18), mucinous cystadenocarcinoma (n = 2), islet cell carcinoma (n = 1), lymphoma (n = 1), sarcoma (n = 1), metastases (n = 2), pancreatitis (n = 4), and adenoma (n = 7). Thus, a finding of multiple small cysts in a pancreatic mass is not specific for microcystic adenoma, and if diagnosis is based on US findings alone, many malignant tumors will be misdiagnosed as microcystic adenomas. Furthermore, computed tomography provides only limited assistance in this setting due to overlapping findings. Needle biopsy can be highly accurate in diagnosing both microcystic adenoma and other malignant lesions and should generally be performed for all lesions with the US features described earlier.

Adenoma↗
PubMedDate not supplied

Malignant degeneration of nonirradiated juvenile laryngeal papillomatosis.

Malignant degeneration in nonirradiated juvenile laryngeal papillomatosis is exceedingly rare. Review of the world literature reveals one case in the English literature and two in the German literature. A 23-year-old patient, representing the youngest reported case in English literature, is presented.

Adult↗
PubMedDate not supplied

Temporal bone fractures in children.

Fifty children with temporal bone fractures were treated during a 40-month period. The diagnosis and management of temporal bone fractures in children is reviewed. The author's cases are classified as to longitudinal and transverse fractures, and the figures are presented for age distribution, sex, cause, loss of consciousness, CSF otorrhea, hearing loss, permanent tympanic membrane perforations, and facial nerve involvement. The author has followed a conservative method of management. Permanent impairment was not frequent, although all the patients with transverse fractures suffered total loss of hearing in the involved ear.

Child↗
PubMedDate not supplied

The artificial heart as a bridge to transplant: ethical and legal issues at the bedside.

The healthy survival of two thirds of patients who receive the total artificial heart as a bridge to transplant is argument for continued use of this technology. Patient selection, informed consent, and treatment termination are the ethical and legal issues that are important at the bedside. Optimum patient selection requires clinical judgment, appropriate institutional review, and the elimination of socioeconomic barriers to transplant. Informed consent enables the patient to participate in the decision and to consider the question of treatment termination in a personalized fashion. Favorable public perception and successful implementation of this bridge to transplant are linked to the quality of this physician-patient communication.

Ethics, Medical↗