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Biomedical subjects

J J Abrahams

Publications and source records attributed to J J Abrahams.

At least 19 recordsLinked to original sources
PubMed1999

[Dental CT in pathologic changes of the maxillo-mandibular region].

CT with multiplanar reconstruction of the jaws (DentaScan) is the method of choice for the radiographic assessment of the mandible and maxilla. It is instrumental in delineating the relationship between bony lesions and the adjacent anatomy. Therefore, this technique allows precise evaluation of the intricate details of the oral cavity. Using it, distinct characterization of pathology including infectious, metabolic, congenital and neoplastic lesions can be obtained.

Diagnosis, Differential↗
PubMed1998

Mandibular sigmoid notch: a window for CT-guided biopsies of lesions in the peripharyngeal and skull base regions.

Biopsy of lesions in the peripharyngeal and skull base regions frequently is difficult with standard computed tomography-guided retromandibular and retromaxillary approaches. An alternative approach via the mandibular sigmoid notch (concave superior margin of the mandibular ramus) was used in 13 patients. It provided easy access to deep lesions and to areas such as the skull base and clivus, which are unapproachable with other methods.

Aged↗
PubMed1998

Inflammatory disease of the jaw: appearance on reformatted CT scans.

OBJECTIVE: Before the development of dental CT reformatting software, much of the radiographic assessment of the mandible and maxilla was performed in the dentist's office using plain radiographs. The widespread use of dental reformatting software, however, has caused the radiologist to take a more active role in evaluating the jaw. Unfortunately, most radiologists have had little experience in this area, and many of the CT findings are undescribed. Our objective, therefore, was to determine the CT appearance of dental-related inflammatory disease of the jaw and to discuss the mechanisms causing such disease. MATERIALS AND METHODS: Reformatted CT scans of 400 patients referred for dental implant assessment were evaluated for abnormalities related to infection of dental origin, inflammation of dental origin, or both. The diagnosis was confirmed by surgery, clinical presentation, classic plain film appearance, or a combination of the three. RESULTS: The following disease processes were identified and described: periodontal lesions, periapical lesions, condensing osteitis, disuse bone atrophy associated with edentia, and maxillary sinus abnormalities associated with dental disease. CONCLUSION: Inflammatory diseases of the jaw and their sequelae are frequently seen on CT scans of patients referred for examination before dental implantation. Because radiologists now take an active role in evaluating the jaw, they need to become familiar with these findings.

Adult↗
PubMed1998

Mandibular erosion from silastic implants: evaluation with a dental CT software program.

Silastic implants used to augment the chin during cosmetic surgery may cause erosive bone changes and complications. We describe the radiologic appearance of these changes and the dental CT reformatting programs by which they may be assessed. Multiplanar CT scans of four patients with Silastic chin implants were evaluated retrospectively for implant density, presence and size of bone defects, relationship of defects to root apices, relationship of defects to mental foramen, and associated findings. The dental CT software program was instrumental in delineating the relationship between the bone defects and the root apices.

Humans↗
PubMed1996

Efficacy of transcutaneous computed tomography--guided fine needle aspiration biopsy in patients with laryngeal squamous cell carcinoma, probable failed radiation therapy, and negative transmucosal biopsies.

For patients with suspected recurrent/persistent laryngeal squamous cell carcinoma (SCC) after external beam radiotherapy (EBRT), routine transmucosal biopsies obtained during direct laryngoscopy may fail to reveal active carcinoma. We evaluated transcutaneous computed tomography-guided fine needle aspiration (CTGFNA) in three consecutive patients who had a persistently fixed true vocal fold after EBRT that had been administered for laryngeal SCC and who had multiple negative transmucosal laryngeal biopsies. All three CTGFNA biopsies were positive, but final pathology confirmed invasive SCC in only one of the three patients. Despite its theoretical advantages, CTGFNA in its present form requires further assessment and/or modification.

Aged↗
PubMed1996

Dental disease: a frequently unrecognized cause of maxillary sinus abnormalities?

OBJECTIVE: Periodontal disease may be a frequently unrecognized cause of maxillary sinus disease. The purposes of this study were to determine if maxillary sinus disease is more prevalent in patients with periodontal disease than in an age-and-sex-matched control group and to show radiographically an association of focal maxillary sinus disease with periodontal disease. MATERIALS AND METHODS: Maxillary DentaScans (General Electric Medical Systems, Milwaukee, WI) of 84 patients (168 maxillary sinuses) with periodontal disease were retrospectively evaluated for the simple presence or absence of maxillary sinus disease. This group was compared with an age-and-sex-matched control population of 84 patients who were referred for head or neck CT scans in which the maxillary sinuses (including their inferior aspects) were visualized. For the likelihood of sinus disease in patients compared with controls, an odds ratio and a 95% confidence interval were calculated using the SYSTAT version 5.2 (SYSTAT, Evanston, IL). In the second portion of the study, the subject population alone was graded in the following fashion to establish a causal relationship: grade 0, no sinus disease; grade 1, focal sinus disease not adjacent to periodontal disease (unlikely to be caused by periodontal disease); grade 2, nonfocal sinus disease (complete opacification, air-fluid levels, or diffuse mucoperiosteal thickening; indeterminate cause), and grade 3, focal sinus disease adjacent to periodontal disease (likely to be caused by periodontal disease). RESULTS: In the subject population--patients with periodontal disease who were referred for DentaScans--100 of 168 (60%) sinuses had sinus disease; in the control population, only 49 of 168 (29%) sinuses had sinus disease. The odds ratio for maxillary sinus disease in the patient population compared with controls was 3.6 (95% confidence interval, 2.3-5.6; p<.0001). The grading results of the subject population in the second portion of the study were grade 0, 68 sinuses (41%); grade 1, four sinuses (2%); grade 2, 32 sinuses (19%); and grade 3, 64 sinuses (38%). CONCLUSION: We have demonstrated a twofold increase in maxillary sinus disease in patients with periodontal disease and have shown a causal relationship. Recognition of this relationship may have an impact on the clinical management of patients, particularly those planning implant surgery.

Confidence Intervals↗
PubMed1996

Sentinel transoral hemorrhage from a pseudoaneurysm of the internal maxillary artery: a complication of CT-guided biopsy of the masticator space.

A patient presented with transoral hemorrhage 3 months after CT-guided percutaneous biopsy of the masticator space, prompting concern about sentinel hemorrhage from impending carotid artery rupture related to prior radical head and neck surgery and radiation therapy. Angiographic evaluation showed the internal carotid artery to be normal but demonstrated a pseudoaneurysm of the buccal branch of the internal maxillary artery exactly corresponding to the site of prior fine-needle biopsy.

Aneurysm, False↗
PubMed1995

Anatomy of the jaw, dentition, and related regions.

The jaw has traditionally been evaluated by dentists and oral surgeons using conventional panoramic and intraoral films. Recently, CT software programs specifically developed to evaluate dental implant patients have provided radiologists with a new window through which to assess anatomy and pathology of the jaw. The anatomy of this region, including the dentitian, and related structures are discussed in this section.

Adult↗
PubMed1995

Dental implants and dental CT software programs.

Dental implants are titanium cylinders that are surgically implanted into the jaw to allow fixation of a permanent dental prosthesis. These have provided an attractive alternative to standard removable dentures and have become quite popular. To assess these patients preoperatively, CT software programs were developed that display multiple axial, cross-sectional, and panoramic images of the jaw. As a result, new dialogues and interactions were created between radiologists and dentists, and this in turn brought new territories and unfamiliar diseases to the radiologists' view. The purpose of this article is to familiarize the radiologist with dental implants, the surgical procedure, dental CT software programs, and related dental pathology.

Dental Implantation, Endosseous↗
PubMed1995

Oral-maxillary sinus fistula (oroantral fistula): clinical features and findings on multiplanar CT.

OBJECTIVE: Oroantral fistula, an abnormal communication between the oral cavity and the maxillary sinus, is infrequently diagnosed radiologically. The purpose of this study was to describe the CT findings and clinical features of oroantral fistula and to show that dental CT multiplanar reformatting programs can be instrumental in diagnosing this condition. SUBJECTS AND METHODS: The study included eight patients with clinically confirmed oroantral fistula or with radiologic evidence of oroantral fistula. Fistula size, degree of alveolar atrophy, nature of maxillary sinus disease, and related dental disease were assessed along with the clinical presentations. RESULTS: The most frequent CT findings were bony discontinuity of the maxillary sinus floor, communication between the oral cavity and the sinus, soft-tissue opacification of the ipsilateral maxillary sinus, focal areas of alveolar atrophy, and associated periodontal disease. In 6 of 8 patients there was 100% opacification of the ipsilateral maxillary sinus, and in 5 of 8 patients the contralateral sinus appeared completely normal. The fistula size ranged from 13.5 mm2 to 189 mm2. CONCLUSION: The appearance of oroantral fistula on multiplanar CT imaging is disruption of the bony floor of the maxillary sinus with soft-tissue opacification of the ipsilateral sinus. Dental reformatted CT can be useful for evaluating patients suspected of having oroantral fistula, and this condition may be found incidentally in patients referred for evaluation for osseointegrated root-form dental implants.

Adult↗
PubMed1995

Diagnostic radiology of the cranial base.

The skull base is a complex interface for bone, nerves, vessels, and musculature. With knowledge of the underlying anatomy, with an understanding of the strengths of CT and MR imaging, and with a familiarity of the commonest lesions, a rational approach to diagnostic imaging can be made, narrowing the clinical differential diagnosis and simplifying presurgical planning.

Adenoma↗
PubMed1995

Tomographic studies of human jaws to assess potentials for preserving the blood supply in rim mandibulectomies.

Rim mandibulectomy, resecting the aveolar segment of the mandible while preserving the inferior cortical arch, has been shown to be a biologically and surgically sound procedure. In order to study the surgical anatomy of the mandible and determine the reproducibility of the anatomic markers and neurovascular supply, we studied serial tomographic cuts of 50 living human mandibles (21 males, 29 females; ages 17 to 87). The dentition was complete in 13, partial in 30, and edentulous in 7. The review showed that the location of anatomic structures was symmetrical in all these adult patients regardless of age, sex, or extent of dentition. (The only significant difference was in the height of the alveolus, which was decreased in edentulous patients.) The data show that in performing a rim mandibulectomy, the blood supply may be preserved in most patients if at least 11 mm of vertical height is preserved of the inferior cortex of the body of the mandible.

Adolescent↗
PubMed1993

The role of diagnostic imaging in dental implantology.

Dental implants are titanium cylinders that are surgically implanted into the jaw to allow fixation of a permanent dental prosthesis. Dental computed tomographic (CT) software programs that display multiple axial, cross-sectional and panoramic images of the jaw have been developed to assess these patients preoperatively. The development and use of these programs, the implant surgical procedure, and related dental anatomy and oral pathology are discussed.

Dental Implantation↗
PubMed1992

Imaging in endocrine disorders.

Imaging of the pituitary, adrenal and thyroid glands plays an integral role in the evaluation of endocrinopathies involving those glands. Magnetic resonance imaging is currently the study of choice in evaluating the pituitary. As for the adrenal, computed tomography and magnetic resonance are probably equally sensitive in detecting adenomas and carcinomas. The endocrinologic and radiologic evaluation of the thyroid gland involves the use of mainly nuclear medicine scanning and ultrasonography. Imaging is playing an increasingly critical role in the evaluation and differential diagnosis of various endocrine disorders involving the pituitary, thyroid and adrenal glands.

Adrenal Gland Diseases↗
PubMed1989

Coil holder and marker system for MR imaging of the total spine.

To improve the efficiency of magnetic resonance imaging of the total spine, the authors developed a coil holder and marker system to accurately localize the level of the spine imaged. The patient's external auditory canal and the alignment light on the imager are lined up with marks on the coil holder. The spine is then imaged in three segments by using a 24-cm field of view. The device has been successful in 20 of the 23 patients in whom it was used. The three failures were due to technical problems.

Humans↗
PubMed1989

MR imaging of intracranial fluid levels.

Six patients with seven intracranial fluid levels were evaluated with both CT and MR at 1.5 T. A surgical diagnosis was obtained in six of the seven instances. MR was found to be superior to CT in detecting intracranial fluid levels, and the MR signal characteristics were helpful in identifying their contents. These cases demonstrate the necessity for a slightly different approach to lesions with fluid levels. In one patient, imaging in the prone position allowed detection of a solid component; in several others, detection of the fluid level was dependent on the selection of nonroutine windows and levels. Fluid levels are classified with respect to their components and MR features. MR is superior to CT in imaging fluid levels. The appearance of fluid levels on MR varies with their composition, the ratio of the components, the sequence parameters, and the position of the patient.

Adolescent↗