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Biomedical subjects

T L Slovis

Publications and source records attributed to T L Slovis.

At least 37 records · Page 2Linked to original sources
PubMed1998

Appropriate imaging in children with skull fractures and suspicion of abuse.

PURPOSE: To define the role of computed tomography (CT) in children aged 2 years and younger with head trauma, suspected abuse, and normal neurologic findings. MATERIALS AND METHODS: From 1992 through 1995, 87 consecutive children with skull fractures visible at plain radiography were referred to child protective services for evaluation of suspected abuse. Their cases were retrospectively reviewed. RESULTS: Of 67 children with normal neurologic findings, 35 (52%) were not referred for CT. No patient in this group developed delayed findings requiring further evaluation. Of the 32 (48%) who underwent head CT, only six (19%) had evidence of acute intracranial injury, despite the presence of minimal depression and stellate, multiple, and diastatic fractures. Of 20 children with acute neurologic findings, 16 (80%) had positive CT scans, which led to neurosurgical intervention in nine (45%). CONCLUSION: No child with normal neurologic findings had a clinically important abnormality depicted at CT. CT scans did not alter clinical management, clinical outcome, or legal outcome. Thus, routine CT of all patients with skull fractures in this population may be unnecessary.

Battered Child Syndrome↗
PubMed1998

Proton magnetic resonance spectroscopy in children with Sturge-Weber syndrome.

Quantitative proton magnetic resonance spectroscopy was performed on six children with Sturge-Weber syndrome following gadolinium enhanced magnetic resonance imaging (MRI). MRI revealed only unilateral involvement in all cases. The mean concentration (mmol/kg wet weight) of the neuronal marker N-acetyl-aspartate was significantly reduced by 37% in the ipsilateral gadolinium enhanced volume of interest compared to a similarly placed contralateral volume of interest (5.39 +/- 1.70 [SD] vs 8.50 +/- 1.14, P < .005, two-tailed paired Student's t-test). Decreased N-acetyl-aspartate in the ipsilateral volume of interest was observed in all patients studied. No significant differences were found in the concentrations of creatine/phosphocreatine or choline compounds between the ipsilateral and contralateral volumes of interest. These findings give possible new insight into the pathophysiology of this disease and suggest that quantitative proton magnetic resonance spectroscopy may be useful for the early characterization and monitoring of neuronal dysfunction or loss in infants and children with Sturge-Weber syndrome.

Adolescent↗
PubMed1997

Thoracic neuroblastoma: what is the best imaging modality for evaluating extent of disease?

BACKGROUND: Thoracic neuroblastoma accounts for 15% of all cases of neuroblastoma. A minority of children with thoracic neuroblastoma will have dumbbell tumors, i.e., intraspinal extension, but only half these patients will have neurologic signs or symptoms. HYPOTHESIS: MR imaging is the single best test to evaluate the extent of thoracic and spinal disease in thoracic neuroblastoma after the diagnosis of a mass is established on plain film. MATERIALS AND METHODS: A retrospective multi-institutional investigation over 7 years of all cases of thoracic neuroblastoma (n = 26) imaged with CT and/or MR were reviewed for detection of the extent of disease. The chest film, nuclear bone scan, and other imaging modalities were also reviewed. The surgical and histologic correlation in each case, as well as the patients' staging and outcome, were tabulated. RESULTS: The chest radiograph was 100% sensitive in suggesting the diagnosis. MR imaging was 100% sensitive in predicting enlarged lymph nodes, intraspinal extension, and chest wall involvement. CT was 88% sensitive for intraspinal extension but only 20% sensitive for lymph node enlargement. CT was 100% sensitive in detecting chest wall involvement. Direct comparison of CT and MR imaging in six cases revealed no difference in detection of enlarged lymph nodes or chest wall involvement. Neither test was able to detect remote disease, as noted by bone scan. CONCLUSION: The chest film is 100% sensitive in suggesting the diagnosis of thoracic neuroblastoma; MR imaging appears to be the single best test for detecting nodal involvement, intraspinal extension, and chest wall involvement.

Adolescent↗
PubMed1997

Imaging of arteriovenous malformation following stereotactic radiosurgery.

BACKGROUND: Stereotactic radiosurgery allows for a high dose of focused radiation to be delivered to a small lesion such as an arteriovenous malformation (AVM). The clinical change and brain response over time to this localized high-dose radiation can be quite striking. OBJECTIVE: The objective of this study to describe and analyse the imaging changes following radiotherapy for AVMs. MATERIALS AND METHODS: The clinical presentation and the imaging changes following radiotherapy in two patients were studied over the course of 1-2 years. RESULTS: The imaging findings include diffuse low attenuation and contrast enhancement on CT. High-signal lesions were apparent on T2-weighted MR images with prominent contrast enhancement on T1-weighted images. Ring enhancement occurred over time. While new changes appeared over 12 months, these changes diminished during the second year. CONCLUSION: Radiotherapy induces inflammatory changes that are generally reversible but can lead to parenchymal destruction. These imaging changes are often nonspecific and therefore must be interpreted in light of clinical symptomatology and the time course since treatment. These patients should receive routine MR imaging within 3 months after radiosurgery with follow-up imaging at 6, 12, and 18 months.

Brain↗
PubMed1997

Evaluation of contrast media for bronchography.

BACKGROUND: Bronchography is occasionally needed for the evaluation and management of some congenital pulmonary anomalies as well as some acquired diseases, usually of the tracheo- bronchial tree. There is currently no effective, approved contrast agent for this imaging techniq ue. OBJECTIVE: We evaluated five agents (barium sulfate, iohexol, propyliodone oily, propyliodone aqueous, and perflubron) in terms of image quality, histologic changes, and effects on hemodynamics, blood gases, and standard laboratory tests in New Zealand White rabbits. MATERIALS AND METHODS: Animals were anesthetized and intubated. Each contrast agent (0.25 ml/kg) was administered intratracheally. Three animals in each group had intravenous lines placed for blood sampling and blood pressure monitoring and were sacrificed at 1 h. An additional three animals for each agent were sacrificed at 24 h and 1 week after imaging. Blood samples were taken immediately before contrast instillation and at 1 h postbronchography. Fluoroscopic images were recorded on standard VHS video tape and evaluated in blind fashion. Segments of lung tissue and bronchi were obtained for histologic examination. RESULTS: Necrosis and/or inflammatory infiltrates were noted in 78 % of the bronchograms performed with propyliodone aqueous, 67 % with propyliodone oily, 55 % with perflubron, and 33 % with iohexol 120, 240 and 350. No histologic damage was observed with barium. The propyliodones gave the best-quality imaging results and the most histologic changes. Iohexol, in any concentration, gave the least acceptable images and a moderate number of histologic changes. Barium sulfate demonstrated acceptable images with virtually no histologic changes. CONCLUSION: From the histologic and imaging results, barium is the best available contrast material for bronchography.

Animals↗
PubMed1996

Orbital sonography in children.

Orbital sonography with color-flow Doppler imaging is a relatively new technology with significant application in the pediatric patient. This review stresses the primary indications for pediatric ophthalmic ultrasound and also discusses those instances where the use of ultrasound supplements other imaging studies.

Child↗
PubMed1995

Characterization of superior sagittal sinus blood flow velocity using color flow Doppler in neonates and infants.

The objective of the investigation was to determine what effect intracranial pathology has on alterations of superior sagittal sinus blood flow, and to determine the role of color flow Doppler imaging of the superior sagittal sinus in the diagnosis of intracranial pathology in the neonate and infant. One hundred examinations were performed prospectively in 96 patients. The velocity was determined with an angle correction at 30-60 degrees and was obtained with and without gentle transducer compression. Superior sagittal sinus thrombosis was identified in two patients by the absence of flow. Multiple t-tests for independent measures showed no clinically significant differences between flow velocities with regard to intracranial hemorrhage, ventriculomegaly, extracorporeal membrane oxygenation therapy or prematurity. The authors conclude that color flow Doppler can accurately diagnose superior sagittal sinus thrombosis and may be used to screen high risk neonates such as those with thrombosis elsewhere or those treated with extracorporeal membrane oxygenation. No clinically significant associations were found between superior sagittal sinus flow velocity and any of the parameters evaluated in this study.

Blood Flow Velocity↗
PubMed1995

Cyclosporin A toxicity: MRI appearance of the brain.

Neurotoxicity is a recognized complication with the use of Cyclosporin A (CSA) in bone marrow and organ transplantation patients. Most common symptoms are seizures and altered mental status which are usually transient. We report three cases of transient neurotoxic episodes in patients receiving CSA after a bone marrow transplant. There were reversible low-attenuation changes on CT and bright T2-weighted signal changes on MRI in the cortex and/or white matter of the cerebral hemispheres. All three patients, when given lower maintenance doses of CSA, were free of recurrent neurotoxic effects.

Adolescent↗
PubMed1995

Anomalous intracranial venous drainage mimicking orbital or cavernous arteriovenous fistula.

A 9-year-old child presented with right eye swelling and bluish discoloration over the periorbital region. MR and CT displayed prominent vessels within the orbit and in the facial region, suggesting a carotid-cavernous fistula. Doppler ultrasound indicated the vascular engorgement was not secondary to a proximal arteriovenous shunt. Arteriography with its inherent time sequence image capability prompted the proper diagnosis of bilateral atresia of the sigmoid sinuses.

Arteriovenous Fistula↗
PubMed1995

Maxillary sinus marrow hyperplasia in sickle cell anemia.

Marrow hyperplasia is a sequela of sickle cell anemia (SCA) and may be seen in the skull in children after 5 years of age [1]. The facial bones, except for the mandible and orbits, are usually not involved [1-3]. We report an unusual case of a 28-month-old black boy with SCA who presented with extensive marrow hyperplasia of the maxillary sinuses in addition to severe calvarial and mandibular changes. The imaging characteristics on CT (similar to other sites of marrow hyperplasia) and MR (low signal on both T1 and T2 sequences) should aid in making the correct diagnosis.

Anemia, Sickle Cell↗