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Biomedical subjects

A P Brady

Publications and source records attributed to A P Brady.

At least 19 recordsLinked to original sources
PubMed1999

Ultrasound of testicular epidermoid cysts.

The ultrasound findings of focal intratesticular lesions may sometimes be characteristic of benign pathology, which accounts for approximately 5% of all testicular tumours. Three cases of epidermoid cysts of the testis are presented along with a review of the literature. Recognition of the typical ultrasound appearances of this entity in a clinical situation of painless testicular swelling in the absence of a history of trauma and signs of inflammation can make testis-sparing surgery feasible.

Adult↗
PubMed1995

Fibrin sealant in interventional radiology: a preliminary evaluation.

Tisseel, a fibrin sealant not approved for use in the United States, was tested in abdominal fistulas and sinuses (13 patients) and interventional biliary procedures (11 patients). The two components of Tisseel were introduced via a double-lumen catheter and formed a fibrin gel at the point of contact. Tracts were sealed permanently in seven fistulas and sinuses and in all 11 biliary cases.

Adult↗
PubMed1995

Ultrasound guidance in percutaneous gastrostomy and gastrojejunostomy.

OBJECTIVE: To evaluate the utility of ultrasound (US) guidance in the percutaneous placement of gastric feeding tubes in patients in whom placement of a nasogastric tube is not possible. PATIENTS AND METHODS: Records from feeding tube placements performed between January 1991 and August 1994 were reviewed. Of the 238 procedures performed, 27 cases (11%) involved initial US guidance, rather than nasogastric tube assistance, because of upper gastrointestinal obstruction. RESULTS: US allowed rapid puncture and subsequent insufflation of the stomach in 26 of the 27 patients, and there were no complications related to its use. In the other patient the position of the transverse colon prevented suitable visualization for puncture, and surgical placement of the feeding tube was necessary. CONCLUSION: US guidance is a safe and effective means by which the stomach can be punctured and distended before placement of a percutaneous feeding tube for patients in whom nasogastric intubation is not possible.

Aged↗
PubMed1995

Intrahepatic sequestered segment of liver presenting as focal fatty change.

Focal fatty change of the liver is a lesion that is often discovered on imaging studies and must be distinguished from space-occupying lesions. The pathogenesis is unknown. We report a lesion of focal fatty change in which the portal supply and biliary drainage were anomalous so that the lesion represents sequestered liver tissue. Because insulin favors the development of steatosis, the pathogenesis of focal fatty change could be explained if the aberrant portal supply contained more insulin than the main portal vein, as would occur if the portal supply arose from pancreatic veins via the parabiliary venous plexus of Couinaud. Furthermore, focal fatty sparing could be explained if the spared segment was supplied by veins draining from the stomach that carry blood with lower insulin levels than the main portal vein.

Adult↗
PubMed1994

Case report: magnetic resonance demonstration of haemorrhagic acoustic neuroma.

A 70-year-old patient with a history suggestive of acoustic neuroma developed sudden neurological symptoms. CT showed an enhancing mass in the left cerebello-pontine angle thought to be a meningioma. Magnetic resonance (MR) with gadolinium enhancement demonstrated appearances consistent with a haemorrhagic acoustic neuroma, a diagnosis confirmed at surgery. The literature regarding haemorrhagic intracerebral tumours and MR appearances of acoustic neuroma is reviewed.

Aged↗
PubMed1994

Colorectal cancer overlooked at barium enema examination and colonoscopy: a continuing perceptual problem.

PURPOSE: To evaluate reasons for missed diagnosis of colorectal carcinoma at barium enema (BE) examination and colonoscopy and determine if standards have improved since a similar study in 1981. MATERIALS AND METHODS: Relevant studies obtained within 3 years of diagnosis in 161 patients with colorectal carcinoma treated in 1990 were reviewed. RESULTS: Twenty-seven carcinomas were overlooked at BE examination and seven at colonoscopy. Fifteen percent of BE examination errors were purely perceptive (ie, the tumor was visible in retrospect). Another 15% were purely technical. Combined perceptive and technical errors occurred in 45% of cases. Interpretive errors (ie, the lesion was misinterpreted as benign) occurred in 25% of cases. CONCLUSION: Similar reasons for missing diagnoses of colorectal cancer at BE examination were seen in 1990 and 1981, with a high rate of perceptive errors. Double reading BE studies may reduce this rate, and readiness to perform BE examination after an incomplete colonoscopy may reduce colonoscopic "misses."

Barium Sulfate↗
PubMed1994

Hepatic interstitial laser photocoagulation: demonstration and possible clinical importance of intravascular gas.

PURPOSE: To investigate gas formation during hepatic interstitial laser photocoagulation (ILP). MATERIALS AND METHODS: In vitro, ILP was performed with a neodymium yttrium aluminum garnet laser on a piece of liver in a water bath. In vivo, nine pigs underwent 24 ultrasound (US)-monitored ILP procedures. Fiber tips were more than 1 cm from (n = 16) or adjacent to (n = 8) intrahepatic veins. The gas production seen on US images was graded on a scale of 0 to 4. Precordial Doppler US was performed in all cases. RESULTS: In vitro, smoke bubbles emanated from the vessels during ILP. In vivo, US showed intravascular gas production during nine of 15 exposures of at least 500 seconds duration. Gas production scores of 2 or more were recorded for nine exposures. Intracardiac gas was identified on eight precordial Doppler US recordings. All animals survived. CONCLUSION: Gas was detected in the heart during some ILP exposures. Patients with a probe-patent foramen ovale (24% prevalence) could be at risk for paradoxic air embolus during ILP.

Animals↗
PubMed1994

Focal nodular hyperplasia of the liver--an imaging conundrum.

Focal nodular hyperplasia is a common benign tumour of the liver that usually does not require treatment. This tumour can be difficult to distinguish noninvasively from other lesions in young patients that may require intervention, such as hepatic adenoma and fibrolamellar carcinoma. The authors report three cases of histologically proven focal nodular hyperplasia and one case in which the imaging features strongly suggested this tumour. These cases illustrate many of the variable imaging features of focal nodular hyperplasia. The authors review the typical imaging findings for focal nodular hyperplasia, hepatic adenoma and fibrolamellar carcinoma, indicate the areas of overlap that make noninvasive diagnosis impossible and discuss the role of percutaneous biopsy in establishing the definitive diagnosis.

Adult↗
PubMed1994

Perforated jejunal diverticulosis: radiologic diagnosis.

Jejunoileal diverticulosis, which is usually asymptomatic, is commonly found at autopsy or during small-bowel barium examination. Perforation of diverticula can cause generalized or localized intra-abdominal inflammatory disease, depending to some extent on the site of the perforation. The authors describe a patient with perforation of a jejunal diverticulum; the condition mimicked colonic inflammatory disease clinically and ultrasonographically. The correct diagnosis was made on the basis of the findings of cross-sectional imaging and barium examination.

Diverticulum↗
PubMed1993

A technique for magnetic resonance imaging of the temporomandibular joint.

T1-weighted Magnetic Resonance Imaging (MRI) of 72 temporomandibular joints (TMJs) of symptomatic patients and normal subjects was performed after they had been clinically classified. The images were then interpreted by two radiologists, blinded to the clinical classification. The technique of imaging used a head coil for bilateral imaging, allowing a 3-position study in under 1 h. Correlation between MRI and clinical classification at the level of normal vs abnormal was achieved in 61/72 joints, giving a sensitivity of 79% and a specificity of 91% for MRI relative to the clinical assessment. True coronal images were of no added value. The addition of supplemental gradient-echo images was helpful in 12/15 joints. Osseous condylar abnormalities were present in 15 joints, all of which had otherwise identifiable disc abnormalities. Diminished condylar translation was a useful indirect sign of non-reducing disc displacement. We conclude that MRI is a very useful and reliable technique in TMJ imaging. The technique described is applicable to any MR unit, without the need for dedicated coils.

Adolescent↗
PubMed1993

Transient global amnesia after cerebral angiography with iohexol.

Transient global amnesia is an unusual neurologic phenomenon that occasionally occurs after angiography, usually of the cerebral vessels. It represents a benign event, and normal function is ultimately restored, but the amnesia may be frightening for both the patient and the physician until its nature is recognized. The authors describe two cases of transient global amnesia occurring after cerebral angiography with iohexol, outline the criteria for the diagnosis and discuss the proposed mechanism of the phenomenon.

Adult↗
PubMed1992

Post-laparoscopic cholecystectomy bilomas--preliminary experience.

The incidence of biloma formation after laparoscopic cholecystectomy (LC) is, in the early experience of many centres, significantly higher than after open cholecystectomy. We describe four cases representative of the possible spectrum of post-LC bile leaks and review the literature regarding the radiologic investigation and management of this complication. We suggest that post-LC bilomas should initially be drained percutaneously. Endoscopic cholangiography (ERC) should then be used to identify the source of the leak, but sphincterotomy and/or stent placement may be best reserved for those whose leaks do not resolve after 10 days of free drainage. Surgery is recommended only for major biliary injury and for leaks that remain unresolved after sphincterotomy and/or stenting. An algorithmic summary of this approach is presented.

Adult↗
PubMed1990

Moyamoya disease--imaging with magnetic resonance.

We report a case of moyamoya disease in a young adult female, in whom the initial clinical and radiological features were considered to be compatible with multiple sclerosis. The subsequent development of cerebral infarction led to the typical moyamoya features being found on carotid angiography. Magnetic resonance imaging (MRI) features of dilated collateral arteries were then recognized, and the initial MRI findings considered to represent demyelination were reinterpreted as areas of infarction. Although rare, moyamoya disease should be considered in the differential diagnosis in young patients presenting with symptoms and signs suggestive of multiple sclerosis. The diagnosis may be suggested by typical MRI findings.

Adult↗