Biomedical subjects

I M Lande

Publications and source records attributed to I M Lande.

9 recordsLinked to original sources

PubMed1988

Adnexal and cul-de-sac abnormalities: transvaginal sonography.

Sixty-seven patients selectively chosen from 354 undergoing conventional transabdominal (TA) sonography for evaluation of a clinically suspected adnexal mass subsequently underwent transvaginal (TV) sonography either because the TA sonograms were technically suboptimal or because it was not possible to characterize with certainty an abnormality identified with TA sonography. TV sonography added diagnostically useful information in 25 of 28 patients with cystic pathologic changes in the adnexa uteri. Eight of 12 patients with tuboovarian abscess and nonspecific adnexal masses visualized with TA sonography had tube-shaped fluid collections characteristic of pyosalpinx identified with TV sonography. TV sonography added diagnostically useful information in all seven patients with diseases of the cul-de-sac (rectouterine fossa) and allowed differentiation of adnexal from primary uterine disease in three patients with TA sonograms on which findings were equivocal. It also expedited the diagnosis of a tubal pregnancy in ten of 14 patients and was useful in the detection of adhesions and perforated intrauterine devices. These results indicate that adjunctive TV sonography can provide important diagnostic information.

Adnexal Diseases↗

PubMed1988

Focal liver lesions.

Despite rapid technologic advances, and the introduction of new, competitive imaging techniques, ultrasound, although a mature modality, remains a versatile and indispensible technology. Ease, access, low cost, and accuracy will assure its central role in the investigation of localized hepatic lesions for the foreseeable future.

Child↗

PubMed1988

Prenatal diagnosis of fetal anomalies using ultrasound and MRI.

In conclusion, it is unlikely that MRI will replace ultrasound as the primary obstetric imaging modality in the near future. Ultrasound has a proven record of accuracy and safety in addition to its easy access and low cost. MRI has promise, however, in providing crucial information in patients with underlying medical or surgical conditions that would ordinarily require ionizing radiation for evaluation. Currently, MRI is helpful in evaluating gross fetal anomalies and disturbances of fetal growth and development when ultrasound is limited by oligohydramnios or maternal obesity. Further experience is required to determine the value of spectroscopy and quantitative relaxation times regarding fetal metabolism and fetal well-being. Technologic improvements and software updates will reduce imaging time and increase spatial resolution, thus rendering MRI more competitive with existing imaging techniques. The ultimate role, however, that MRI will have in the evaluation of the fetus is currently undefined.

Congenital Abnormalities↗

PubMed1987

Second-trimester polyhydramnios: evaluation with US.

The sonograms of 40 patients with second-trimester polyhydramnios were reviewed to determine (a) whether fetal and maternal conditions occur as often during second-trimester polyhydramnios as during third-trimester polyhydramnios, (b) the frequency of persistence of polyhydramnios into the third trimester, and (c) how sonography can help in maternal and fetal management. Second-trimester polyhydramnios often (62%) persisted into the third trimester. The frequencies of maternal (25%) and fetal (12%) conditions were similar to those previously reported for third-trimester polyhydramnios. Fetal anomalies were always identified on the sonogram that initially demonstrated polyhydramnios. Fetal outcome was excellent in the nondiabetic patient with polyhydramnios in whom no fetal abnormalities were detected on sonograms. In polyhydramnios associated with maternal diabetes mellitus, however, the pregnancy was often (71%) complicated by premature labor or macrosomia. In such patients serial sonographic follow-up is indicated.

Amniotic Fluid↗

PubMed1987

The mistaken or indeterminate CT diagnosis of hepatic metastases: the value of sonography.

Small liver cysts may be mistakenly diagnosed as metastatic disease on screening CT of the abdomen in patients with known carcinoma. These cysts can appear solid as a result of volume averaging. On retrospective review of 122 patients with known extrahepatic malignancies and liver lesions on CT, 77 had metastases, three had large cysts, and two had cavernous hemangiomas. The other 40 were found to have single or multiple, small (less than 2-cm), low-density lesions. In 33 patients these were proven to be benign hepatic cysts by sonography, follow-up CT, or clinical course. The initial CT interpretations in these patients had been metastatic disease in seven (21%), benign cysts in five (15%), and indeterminate in 21 (64%). Since the distinction between cysts and metastases has important clinical implications, sonography should be used whenever the true nature of these lesions cannot be determined by CT.

Cysts↗

PubMed1986

Sickle-cell nephropathy: MR imaging.

To study the nephropathy associated with sickle-cell disease (SCD), spin-echo magnetic resonance (MR) imaging of the kidneys was performed in 19 SCD patients, six with beta-thalassemia major (BTM), and ten healthy individuals as controls. Eleven SCD patients had decreased relative cortical signal, most evident on T2-weighted images. No correlation with serum ferritin, urine-concentrating ability, serum blood urea nitrogen, or creatinine levels was established. Iron deposition in the renal cortices of sickle-cell nephropathy patients may, at least in part, be responsible for the relatively diminished cortical signal intensity. No BTM patients, all of whom were clinically and biochemically in iron overload from frequent transfusions, demonstrated diminished renal cortical signal intensity. This suggests that renal changes in SCD seen on MR images are not due simply to systemic iron overload per se but perhaps reflect abnormalities of iron metabolism in the renal cortex peculiar to SCD nephropathy.

Adolescent↗

PubMed1986

The sonographic evaluation of fetal anomalies in oligohydramnios between 16 and 30 weeks gestation.

The sonograms of all patients with oligohydramnios between 16 and 30 weeks gestation seen over a 4-year period were reviewed to determine (1) whether sonographically detectable fetal anomalies were present, and (2) when these anomalies were present, how this information was used in maternal fetal management. Cases of ruptured membranes and fetal demise were excluded from the study. Sixteen patients with severe oligohydramnios were identified. On postmortem examination, nine had urinary tract anomalies, one had evidence of a chronic intrauterine infection, and four had no anomalies. There were only two neonatal survivors: one had no anomalies while the other had posterior urethral valves. These findings confirm that second trimester oligohydramnios has a poor prognosis and is often associated with anomalies of the urinary tract. Sonography aids in the clinical management of such patients.

Amniotic Fluid↗

PubMed1986

The antenatal sonographic visualization of cloacal dysgenesis.

Hydronephrosis associated with a septated cystic structure in the fetal pelvis in the absence of an otherwise identifiable fetal bladder should alert the sonographer to the possibility of a persistent cloaca. Problems associated with compromised urinary tract drainage and the associated oligohydramnios occurring early in gestation as well as frequent association of anomalies with other organ systems must be addressed. Squamous epithelia in fetal bladder aspirate is further supportive evidence for the diagnosis.

Adult↗

PubMedDate not supplied

CT manifestations of Richter syndrome.

Richter syndrome is an uncommon complication of chronic lymphocytic leukemia characterized by its transformation into diffuse histiocytic lymphoma. We present two documented cases of Richter syndrome and its radiographic manifestations, which have not previously been reported. These include hepatosplenomegaly, diffuse marked adenopathy, and involvement of the skeletal system. The diagnosis of Richter syndrome should be suggested when these radiographic findings occur with chronic lymphocytic leukemia.

Aged↗