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Biomedical subjects

D A Sarti

Publications and source records attributed to D A Sarti.

At least 19 recordsLinked to original sources

Thyroid incidentalomas. Prevalence by palpation and ultrasonography.

BACKGROUND: Thyroid nodules are commonly identified on autopsy examination. There are relatively few descriptions, however, of the frequency with which thyroid nodules are encountered incidentally during the course of other investigations. METHOD: Prospective study to examine the prevalence of thyroid nodules in asymptomatic North American subjects, with palpation findings compared with findings on high-resolution ultrasonography. RESULTS: Palpable nodules were identified in 21 (21%) of 100 subjects, with nine solitary nodules (9%) and 12 multiple nodules (12%). In comparison, only 33 subjects were found to be free of any nodules by ultrasonography. Of the 67 subjects with abnormal ultrasound findings, 22 had solitary nodules (22%) and 45 had multiple nodules (45%). The prevalence of nodules was greater in women (72%) than in men (41%) (P < .02). A concordance rate of 49% was noted between ultrasound and findings by palpation. CONCLUSIONS: The data indicate that thyroid abnormalities are very common incidental findings, emphasizing the need for a conservative approach when such lesions are encountered incidentally.

Adult↗

Spontaneous regression of interval benign cysts of the breast.

PURPOSE: To evaluate the natural history of nonpalpable interval breast cysts detected at mammography and diagnosed at sonography in an asymptomatic female population. MATERIALS AND METHODS: The imaging records of 5,000 consecutive patients (aged 35-77 years [mean, 51 years]) seen in one breast center over a 6-month period were reviewed. Serial studies of those patients with documented evidence of interval benign breast cysts were evaluated for the subsequent course of such lesions with regard to regression, stability, or enlargement seen at mammography. RESULTS: Interval cysts were found in 53 patients (68 cysts), approximately 1% of the studied population. More than half of these lesions spontaneously regressed in 1 year, most of them completely. By 2 years, nearly two-thirds had regressed. By 5 years, only 12% of the lesions had not shown regression. CONCLUSION: Interval breast cyst formation is not uncommon, and most of these benign lesions will undergo spontaneous regression or remain stable. Further intervention is not required for interval benign cysts.

Adult↗

A multidisciplinary approach to the early detection of ovarian carcinoma: rationale, protocol design, and early results.

OBJECTIVE: This study was undertaken to determine the feasibility of currently available tests to detect ovarian cancer at a curable stage. By studying women at risk for the disease on the basis of their family histories of cancer, we hope to gain insight into the genetics and biologic characteristics of ovarian cancer. STUDY DESIGN: Asymptomatic women with a family history of cancer are interviewed by geneticists to obtain accurate pedigree and epidemiologic data. Screening tests including transvaginal ultrasonography, color Doppler imaging, CA 125 measurement, and other investigative biomarkers are performed between cycle days 3 and 8 and repeated biannually. RESULTS: A total of 597 women without symptoms were screened between July 1991 and June 1992. Cystic or complex adnexal masses were detected in 6.2% of patients. A pulsatile index value < 1.0 was measured in 80% of premenopausal patients and 24% of postmenopausal patients, whereas a resistance index value < 0.4 occurred in 12% of premenopausal and 3% of postmenopausal patients. A CA 125 level > 35 U/ml was found in 11.4% of the study participants. To date, one stage IA borderline ovarian tumor and one endometrial carcinoma have been found. CONCLUSIONS: Ovarian cancer screening needs to be investigated in a controlled fashion to determine means that will ultimately improve the survival from the disease.

Adult↗

Congenital hydrocephalus in two pregnancies following the birth of a child with a neural tube defect: aetiology and management.

A family is described with congenital hydrocephalus occurring in two pregnancies following the birth of a child with a neural tube defect (NTD). Prenatal diagnosis of hydrocephalus at mid-gestation was achieved by ultrasonography. The increased frequency of hydrocephalus among sibs of probands with a NTD and vice versa suggests that, following the birth of a child with either malformations, subsequent pregnancies should be monitored at mid-gestation by amniotic fluid AFP and serial ultrasound examination.

Female↗

Correlation of biparietal and fetal body diameters: 12--26 weeks gestation.

One hundred thirty-four obstetrical diagnostic sonographic examinations were performed on patients of 12--26 gestational weeks. The following abdominal diameter measurements were obtained: (1) anteroposterior transverse diameter; (2) right-to-left transverse diameter; (3) average of (1) and (2); and (4) greatest longitudinal diameter. These measurements were plotted against the respective biparietal diameters, and normal statistical distribution curves were developed. These curves have proven helpful in cases with a questionable disproportionate relation between the fetal head and body size in early pregnancy. The data have facilitated identification of fetal abnormalities sufficiently early in the pregnancies to permit advising therapeutic abortion. Five cases outside the normal range are discussed and compared to normal. In several cases, the sonographic results played a major role in the decision-making process of the patient involved.

Adult↗

Ultrasonographic spectrum of choledochal cysts in children.

Four different sonographic patterns which may be encountered in choledochal cyst are described. The most common form is concentric dilatation of the common bile duct (Type I). Rarely eccentric dilatation of the common bile duct, diverticulum, may be seen (Type II). Both forms of the disease may (Types IB and IIB) or may not (Types IA and IIA) be asso"iated with intrahepatic biliary dilatation.

Child↗

The ultrasonic and biochemical diagnosis of pancreatitis in children.

Pancreatic ultrasonography and the determination of serum amylase and amylase creatinine clearance ration were performed on 17 normal children and on 35 children with abdominal pain. In all 17 normal subjects the echodensity of the pancreas was equal to or greater than that of the liver. Nineteen patients with abdominal pain had reduced echodensity of the pancreas when compared to that in normal children, and two of the 19 had pseudocysts. Serum amylase values and/or amylase creatinine clearance ratio correlated poorly with ultrasonic and clinical evidence of pancreatitis.

Adolescent↗

Ultrasonography of the diaphragmatic crura.

The diaphragmatic crura are being recognized with increasing frequency on routine sonograms. In a study of 100 random patients the right crus was seen in parasagittal scans in 50% of patients and in transverse scans in approximately 90%. The left crus was not specifically identified on parasagittal scans, but was visible in about 50% of patients on transverse scans. Longitudinal coronal approaches can significantly improve visualization of the crura.

Diaphragm↗

Cholecystosonography--the junctional fold.

Three cases are presented in which a fold occurred along the posterior wall of the gallbladder at the junction of the body and infundibulum at cholecystosonography. On the initial supine scans, this finding suggested a small polyp in 1 case and a calculus in the other 2. Familiarity with this normal variant as well as adherence to correct scan methodology should help to further reduce erroneous diagnoses.

Gallbladder↗