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Anne C Roberts

Publications and source records attributed to Anne C Roberts.

16 recordsLinked to original sources
PubMed2005

Endocavitary three-dimensional ultrasonographic assistance for transvaginal or transrectal drainage of pelvic fluid collections.

PURPOSE: Determine the feasibility of using three-dimensional ultrasonography (3D US) to assist in planning and performing endocavitary drainage of deep pelvic fluid collections. MATERIALS AND METHODS: Retrospective review of images and medical records of 16 patients in whom endocavitary 3D US was used during transvaginal or transrectal drainage of 17 deep fluid collections. 3D US was assessed regarding its ability to display the relevant structures, whether new information was provided compared with pelvic computed tomography (CT) and conventional two-dimensional US (2D US) displays, and whether this information altered drainage techniques. RESULTS: Targeted fluid collections were visualized in all patients. 3D US added information in 11 of 16 patients (69%) that, in turn, resulted in adjustment of interventional technique in eight of 16 patients (50%). Specific features of 3D US that provided new information included the simultaneous display of three orthogonal US images, display of reconstructed US image plane orientations not possible with 2D US, and the ability to interactively scroll images through complex structures to assess for communication between the loculations. An attached needle guide was used in 15 of 16 patients to improve the precision of needle placement. CONCLUSION: Endocavitary 3D US is feasible for assistance in transvaginal and transrectal drainage procedures, usually adds new information, frequently alters interventional technique, and permits precise access needle placement.

Abscess↗
PubMed2004

Transjugular intrahepatic portosystemic shunt creation as treatment for refractory chylous ascites and chylothorax in a patient with cirrhosis.

The etiology of chylothorax is usually considered to consist of four major categories: tumors, trauma, idiopathic conditions, and miscellaneous conditions. It appears that chylothorax is a rare and underreported manifestation of cirrhosis resulting from transdiaphragmatic passage of chylous ascites. This condition can be debilitating as a result of respiratory compromise from a large volume of pleural fluid, as well as metabolic derangements, malnutrition, and immunologic impairment from loss of vital lymphatic constituents. Herein the authors present a case of a 46-year-old male patient with cirrhosis and complications of high-volume chylous ascites and chylothorax who was successfully treated with creation of a transjugular intrahepatic portosystemic shunt.

Chest Tubes↗
PubMed2003

Three-dimensional ultrasonography for planning percutaneous drainage of complex abdominal fluid collections.

PURPOSE: To identify information provided by three-dimensional (3D) ultrasonography (US) useful for percutaneous drainage of complex abdominal fluid collections. MATERIALS AND METHODS: 3D US evaluation of the collection structure and spatial relationship of items of interest was performed immediately before percutaneous access of 46 complex fluid collections in 26 patients (28 procedures). Procedurally useful information was tabulated and analyzed. RESULTS: In five of 28 procedures (18%), 3D US could not visualize the fluid collections. In 21 of 23 procedures (91%) with adequate US visualization, 3D US provided unique helpful information: in 20 of 21 (95%), the direction of access was selected to favor subsequent manipulation; in 17 of 21 (81%), a single access site could be used for multiple drains; in 17 of 21 (81%), the location of the drain was determined; in 11 of 21 (52%), the number of drains was altered; and in six of 21 (29%), high-risk deep collections were accessed via connections from safer superficial collections. 3D US provided no additional information in two of 23 procedures (9%) and provided misinformation regarding interconnections between collections in two of 23 (9%). Percutaneous drainage was curative in 20 of 26 patients (77%). CONCLUSION: In sonographically suitable situations, 3D US can add substantial information on structure and spatial relationships to optimize initial drainage of complex fluid collections.

Abdominal Abscess↗
PubMed2002

Main portal vein access in transjugular intrahepatic portosystemic shunt procedures: use of three-dimensional ultrasound to ensure safety.

PURPOSE: To document the safety of main portal vein (PV) access to create transjugular portosystemic intrahepatic shunts (TIPS), provided that three-dimensional ultrasonography (3D US) can document the puncture to have entered a surface of the PV suitable for tamponade. MATERIALS AND METHODS: In 11 patients who underwent conventional TIPS creation (n = 10) or a transjugular portacaval shunt procedure (n = 1), the puncture was found angiographically to enter the main PV. In seven cases, this occurred at the PV bifurcation and, in four, it occurred in the superior third of the PV. 3D US was used to determine whether the point of PV entry was functionally intrahepatic or extrahepatic. The puncture site was deemed to be intrahepatic if liver covered the puncture site on all three orthogonal imaging planes (sagittal, coronal, and transverse). If the puncture site was surrounded by liver, the access was used to deploy a metallic stent (uncovered, n = 10; covered, n = 1). Medical records and follow-up cross-sectional imaging studies were reviewed for evidence of hemorrhage complications. Pathologic correlation was performed in one explanted liver and autopsy specimens in five other patients. RESULTS: In nine of 11 patients, 3D US was diagnostic and confidently verified that liver completely covered the portal vein access site. In two patients with diagnostically uncertain 3D US results, transcatheter injection of contrast medium documented no extravasation. All TIPS and direct portacaval shunt procedures were technically successful. No hemorrhagic complications occurred. Examination of pathologic specimens documented this portion of the portal vein to be extraperitoneal, but attached to the superior surface of the caudate lobe with fibrous tissue and small portal vein branches. CONCLUSIONS: The bifurcation and posterior aspect of the superior third of the main PV can be safely used for TIPS procedures, provided access is proven to be surrounded by liver. 3D US can usually confidently determine if the PV entry site is functionally intrahepatic.

Adult↗
PubMedDate not supplied

Single-pass percutaneous liver biopsy for diffuse liver disease using an automated device: experience in 154 procedures.

PURPOSE: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18 G Express core needle biopsy system. METHODS: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed. The number of needle passes, type of guidance, change in hematocrit level, and adequacy of specimens for histologic analysis were evaluated. RESULTS: All biopsies were performed for histologic staging of chronic liver diseases. The majority of patients had hepatitis C (134/153, 90.2%). All patients were discharged to home after 4 hr of post-procedural observation. In 145 of 154 (94%) biopsies, a single needle pass was sufficient for diagnosis. US guidance was utilized in all but one of the procedures (153/154, 99.4%). The mean hematocrit decrease was 1.2% (44.1--42.9%). Pain requiring narcotic analgesia, the most frequent complication, occurred in 28 of 154 procedures (18.2%). No major complications occurred. The specimens were diagnostic in 152 of 154 procedures (98.7%). CONCLUSIONS: Single-pass percutaneous US-guided liver biopsy with the INRAD 18 G Express core needle biopsy system is safe and provides definitive pathologic diagnosis of chronic liver disease. It can be performed on an outpatient basis. Routine post-biopsy monitoring of hematocrit level in stable, asymptomatic patients is probably not warranted.

Abdominal Pain↗