Avulsion fracture of the apophysis of the ischial tuberosity.
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Biomedical subjects
Publications and source records attributed to J Lim-Dunham.
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OBJECTIVE: To familiarize the radiologist with the variable sonographic appearance of the involuting ductus venosus in neonates. METHODS: Five sick neonates ranging in age from 24 to 42 weeks had abdominal sonographic examinations to check for intra-abdominal diseases. RESULTS: Doppler sonography showed a patent ductus venosus in 3 neonates and a ductus venosus with thrombosis in 2 neonates. The ductus venosus was identified in the liver between the left portal vein and the inferior vena cava. In 2 patients, follow-up sonography showed that the ductus venosus progressively had thrombosis and then disappeared. CONCLUSIONS: The ductus venosus in a neonate has a variable sonographic appearance depending on its stage of involution. Its detection in a sick neonate can lead to inadvertent diagnosis of a hepatic varix, an abscess, or a tumor.
RATIONALE AND OBJECTIVES: To study splenic perfusion with use of computed tomography (CT). METHODS: Twenty-six control patients without splenoportal disease, six with cirrhosis, and seven with other splenic disease were examined with electron-beam CT. Twenty-five milliliters of iohexol (300 mg of iodine per milliliter) was given intravenously at 10 mL/sec followed by a saline bolus. Multiple single-level axial sections were acquired 8-90 seconds after injection. Perfusion was calculated by dividing maximal splenic enhancement by the area under the circulation-corrected aortic time-enhancement curve. Subjective assessments of enhancement heterogeneity were made, and regional perfusion was calculated in 10 patients with heterogeneous enhancement. Total splenic volume and blood flow were computed in 21 patients. RESULTS: Mean perfusion (controls: 1.29 mL/min/mL, miscellaneous group: 1.07 mL/min/mL) was close to predictions. There was a trend toward lower perfusion in cirrhotic patients (0.87 mL/min/mL), but the difference was not statistically significant. Total splenic blood was increased in patients with cirrhosis (P < .01). Marked perfusion heterogeneity was observed in 41% of spleens, but by 2 minutes splenic enhancement was uniform. CONCLUSION: CT shows promise in the study of splenic blood flow.
Ultrasound (US)-guided peripheral venipuncture was performed for peripheral insertion of 222 central venous catheters over a 12-month period. Initial placement was successful in 218 patients but unsuccessful in eight; placement was successful in four the next day (success rate, 98%; complication rate, 5%). Catheters were in place from 3 days to 6 months (mean, 36 days). US guidance allowed successful venipuncture for placement of central venous catheters in children.