PubMed Health⌕ Search

Biomedical subjects

A S Lev-Toaff

Publications and source records attributed to A S Lev-Toaff.

48 records · Page 3Linked to original sources
PubMed1988

Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography.

High-resolution CT (HRCT) has the ability to demonstrate both asbestos-related pleural disease and parenchymal abnormalities consistent with asbestosis. The role of CT in the diagnosis of asbestosis can be defined by comparing it with radiography. We evaluated 60 men who had a history of occupational exposure to asbestos and whose outside chest radiographs were considered abnormal. Chest radiographs (inside films) and HRCT were performed in all patients at our institution and were interpreted independently by experienced radiologists. Outside film results were compiled from the submitted reports. The final conclusion regarding the interpretation of the radiologic examinations was determined by consensus when disagreements existed. Positive predictive values (the likelihood that a positive report is correct) for pleural disease were: outside films 56%, inside films 79%, HRCT 100%. The positive predictive values for parenchymal disease were: outside films 51%, inside films 83%, HRCT 100%. The addition of HRCT to chest radiography is most useful in eliminating false-positive diagnoses of asbestos-related pleural disease caused by subpleural fat and false-positive diagnoses of parenchymal asbestosis in patients with extensive plaques or emphysema obscuring lung detail. The interpretation of chest radiographs in patients exposed to asbestos is often extremely difficult and subjective, and we recommend that positive findings (except calcified plaques) be confirmed with HRCT.

Asbestos↗
PubMed1988

Endoscopic laser therapy for carcinoma involving the esophagus: the value of pretreatment computed tomography.

Computed tomographic (CT) scans of the esophagus were performed on 15 patients with carcinoma of the esophagus or gastroesophageal junction prior to endoscopic laser therapy (ELT). The scans were evaluated for proximity to adjacent structures, symmetry, and luminal deviation, to help the endoscopist plan the route for therapy. A total of 50 procedures were performed without any serious complications. Pretreatment CT scans are a useful adjunct to ELT for carcinomas of the esophagus.

Adult↗
PubMed1987

Leiomyomas in pregnancy: sonographic study.

With ultrasound monitoring, analysis of the behavior of uterine leiomyomas (fibroids) and their impact on the course of pregnancy was undertaken in a group of 113 patients. Fibroid size changes were analyzed on the basis of trimesters. In the second trimester, smaller fibroids increased in size, whereas larger fibroids decreased in size. In the third trimester, a decrease in size was documented regardless of initial size. The most common patterns of echotexture were hypoechoic, heterogeneous, and echogenic rim. The development of a heterogeneous pattern or anechoic/cystic spaces on a follow-up study was accompanied in seven of ten patients by severe abdominal pain, compared with 12 cases of abdominal pain in 103 patients without such echotexture changes. Although the number of patients was small, the development of these patterns apparently indicates significant degeneration of the fibroid. Fibroids located in the lower uterine segment were accompanied by a higher frequency of cesarean section and retained placenta. Fibroids located in the uterine corpus were more frequently associated with early abortions. Multiple fibroids were accompanied by a higher frequency of malpresentation and premature contractions compared with cases with one or two fibroids.

Adult↗
PubMed1987

Hepatic infarcts: new observations by CT and sonography.

Until recently hepatic infarcts were rarely diagnosed before autopsy and were nearly always fatal. Four cases of hepatic infarcts, three of them nonfatal, were diagnosed and followed by CT (three cases), sonography (two cases), arteriography (two cases), and sulfur colloid liver-spleen scan (one case). In three patients with multiple subsegmental hepatic infarcts, most of the lesions were round or oval and centrally located. Only a minority of the lesions were wedge-shaped and peripheral. The early lesion appears hypoechoic on sonography, and CT shows a poorly demarcated low-density region. Later, lesions become confluent with more distinct margins. Bile lakes are a late sequela of large infarcts. Gas formation within sterile infarcts is newly described in two cases. Hepatic infarcts have a variable appearance on CT and sonography and are not reliably distinguished from other lesions such as abscess or necrotic neoplasm.

Adult↗
PubMedDate not supplied

CT assessment of abdominal hemorrhage in coagulopathic patients: impact on clinical management.

BACKGROUND: To assess how computed tomography (CT) affected clinical management in coagulopathic patients with suspected spontaneous abdominal hemorrhage. METHODS: Fifty-four patients with coagulopathy underwent CT for possible abdominal hemorrhage. Medical records were reviewed retrospectively for pre-CT management strategy, degree of clinical suspicion for abdominal hemorrhage, CT findings, and post-CT management strategy. RESULTS: Abdominopelvic CT demonstrated hemorrhage in 31/54 (57%) of patients; 20/54 (37%) of patients had retroperitoneal hemorrhage, 2/54 (4%) had hemoperitoneum, and 9/54 (17%) had hemorrhage confined to the thigh, groin, and/or abdominal wall. CT directly affected clinical management in 28/54 (54%) cases; 17/31 (55%) CT scans that were positive for hemorrhage had a clinical impact versus 11/23 (48%) negative CT scans. This difference was not statistically significant (p = 0.61). CT scans with a higher pretest suspicion for abdominal hemorrhage were more likely to have hemorrhage detected (p = 0.0046) but not more likely to have a clinical impact (p = 0.73). CONCLUSIONS: CT to assess for abdominal hemorrhage had a direct impact on clinical management in about one-half of coagulopathic patients. Positive and negative CT studies were equally likely to affect management.

Abdomen↗