PubMed Health⌕ Search

Biomedical subjects

K M Vitellas

Publications and source records attributed to K M Vitellas.

At least 19 recordsLinked to original sources
PubMed2002

MR cholangiopancreatography in patients with primary sclerosing cholangitis: interobserver variability and comparison with endoscopic retrograde cholangiopancreatography.

OBJECTIVE: The purpose of our study was to determine the degree of interobserver variability and correlation between MR cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) for the presence of bile duct strictures in patients with primary sclerosing cholangitis. MATERIALS AND METHODS: For this retrospective study involving 26 patients with primary sclerosing cholangitis, 31 MR cholangiopancreatograms were compared with 30 endoscopic retrograde cholangiopancreatograms. The MR cholangiopancreatograms were independently interpreted by two abdominal radiologists in a blinded, randomized manner for overall image quality, extent of ductal visualization, and the presence and location of bile duct strictures. Unweighted multirater kappa coefficient values were estimated for each comparison. RESULTS: Visualization of more than 50% of the expected ductal length was possible in the extrahepatic, central intrahepatic, and peripheral intrahepatic bile ducts in 99%, 88%, and 69% of the MR cholangiopancreatograms and 100%, 86%, and 52% of the endoscopic retrograde cholangiopancreatograms, respectively. Strictures were detected in the extrahepatic, central, and peripheral ducts in 53%, 68%, and 87% of the MR cholangiopancreatograms and 73%, 67%, and 63% of the endoscopic retrograde cholangiopancreatograms, respectively. The interobserver agreement for stricture detection was 61% for MR cholangiopancreatography and 76% for ERCP. MR cholangiopancreatographic findings were consistent with ERCP findings for the presence of strictures in 69% of the cases. CONCLUSION: In patients with primary sclerosing cholangitis, MR cholangiopancreatography better shows the bile ducts and can depict more strictures, especially of the peripheral intrahepatic ducts, than ERCP. MR cholangiopancreatography can be used to noninvasively diagnose and follow up patients with primary sclerosing cholangitis.

Adult↗
PubMed2001

Magnetic resonance cholangiopancreatography (MRCP) of intraductal papillary-mucinous neoplasm (IPMN) of the pancreas: case report.

The intraductal papillary-mucinous neoplasm (IPMN) is the rarest of the cystic pancreatic tumors. Endoscopic retrograde cholangiopancreatography (ERCP) is currently the gold standard for evaluating IPMN's and can demonstrate dilatation of the main duct or side branches, mural nodules, filling defects, and communication between the tumor and the main pancreatic duct. Recent literature has shown that MRCP may be more sensitive and specific in the diagnosis of IPMN In this case report, we present a patient with IPMN of the pancreas where MRCP was superior to ERCP in characterizing the tumor.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2001

Biliary cystadenocarcinoma: seven year follow-up and the role of MRI and MRCP.

Biliary cystadenomas and their malignant counterparts, biliary cystadenocarcinomas, are rare cystic tumors that arise from hepatobiliary epithelium. Ultrasound (US) and computed tomography (CT) are the initial imaging modalities used for the evaluation of biliary cystic tumors, but are not specific. MRI and MRCP, because of increased contrast and spatial resolution, may be a more specific imaging modality in the detection of biliary cystic neoplasms. We present a case of biliary cystadenocarcinoma imaged by MRI and MRCP in a 65 year-old man managed conservatively for 7 years.

Aged↗
PubMed1999

Fine-needle aspiration with flow cytometric immunophenotyping for primary diagnosis of intra-abdominal lymphomas.

Cytomorphology in conjunction with immunophenotypic characterization is becoming increasingly used for the primary diagnosis of non-Hodgkin's lymphomas (NHL). This combination is especially advantageous for the diagnosis of intra-abdominal and intrathoracic lymphomas, since unlike superficial lesions, open biopsy of deep-seated tissues is more invasive and more costly, and is associated with a higher risk. We report the cytologic and immunophenotypic features of intra-abdominal NHL obtained by fine-needle aspiration (FNA). Twenty-two cases of intra-abdominal lesions obtained by image-guided FNA where flow cytometry was also performed were reviewed. Of the 22 studied cases, 7 were classified as large-cell lymphoma, 5 as follicular center-cell lymphoma, 2 as small noncleaved-cell lymphoma, 2 as lymphoplasmacytoid lymphoma, one as small lymphocytic lymphoma, and one as marginal-zone lymphoma. In the remaining 4 cases where the immunophenotypic pattern was not definitive, the cytomorphologic features were of small cleaved cells in 3 cases and of mixed small cleaved and large cells in one case. We successfully classified 9 of the 10 patients on whom histologic confirmation was obtained. The successful primary classification of most intra-abdominal non-Hodgkin's lymphomas can be done with a combination of cytology and flow cytometry, and this can be the initial approach in patients with deep-seated lesions. Diagn. Cytopathol. 1999;21:98-104.

Abdominal Neoplasms↗
PubMed1996

The calcaneus: applications of magnetic resonance imaging.

The calcaneus is the largest bone in the foot and is an important primary weightbearing structure. Pathologic processes that affect this bone may manifest in a variety of clinical presentations, including pain, abnormal motion, instability, or fracture. The purpose of this article is to present a pictorial essay of the wide spectrum of pathologic entities that may affect the calcaneus, emphasizing applications of magnetic resonance imaging and characteristic magnetic resonance features of these processes.

Calcaneus↗
PubMed1993

Idiopathic eosinophilic esophagitis.

A retrospective review was performed of 13 patients with the diagnosis of idiopathic eosinophilic esophagitis (IEE) occurring alone or in conjunction with idiopathic eosinophilic gastroenteritis (IEG) to identify clinical, radiographic, endoscopic, manometric, and therapeutic similarities. All patients presented with esophageal symptoms, predominantly dysphagia. An allergic disorder was present in 10 (77%) patients, and peripheral eosinophilia was present in 12 (92%) patients. Clinical investigation disclosed esophageal strictures in 10 patients, motility disorders in three, ulcerations in two, a cervical web in one, and a mucosal ring in one as the cause of esophageal symptoms. A proximal esophageal stricture was the single most common esophageal abnormality demonstrated. IEE should be included in the differential diagnosis of dysphagia and should be suggested in a patient with an allergic disorder, peripheral eosinophilia, and concurrent abdominal symptoms, especially in conjunction with IEG. Prompt diagnosis is extremely important since treatment with steroids produces rapid clinical remission in most patients.

Adolescent↗
PubMedDate not supplied

Radiographic manifestations of eosinophilic gastroenteritis.

Eosinophilic gastroenteritis (EG) is a rare inflammatory disease of unknown etiology, characterized by focal or diffuse eosinophilic infiltration of the gastrointestinal tract. Although little over 250 cases of EG have been reported in the literature, EG is probably more common than reports in the literature would indicate. A retrospective review of 25 patients with EG along with a review of the literature was done to identify clinical, laboratory, radiographic, and therapeutic features. An allergic disorder was present in 14 (56%) and a peripheral eosinophilia was present in 24 (96%) of our patients. The most common radiographic manifestations of the stomach and small bowel included stenosis and fold thickening, respectively. Thirteen patients had esophageal involvement, with the esophageal stricture being the most common abnormality found in these patients. Steroids produced a good therapeutic result in most patients; the remaining patients responded to cromolyn and/or surgery.

Adult↗
PubMedDate not supplied

Cirrhosis: spectrum of findings on unenhanced and dynamic gadolinium-enhanced MR imaging.

The appearance of the cirrhotic liver on computed tomography can be difficult to evaluate and can frustrate the radiologist distinguishing benign from malignant lesions. Hepatic edema, fibrosis, atrophy, and vascular abnormalities are common in the cirrhotic liver and produce derangements in morphology, attenuation, and perfusion, limiting the accurate characterization of hepatic masses. With the development of fast magnetic resonance (MR) sequences and dynamic postgadolinium-enhanced imaging, most hepatic lesions with uncertain etiology on computed tomography can be accurately characterized on MR imaging. We describe MR imaging techniques useful for imaging cirrhosis and its complications. We also illustrate the spectrum of findings in the cirrhotic liver on dynamic gadolinium-enhanced MR imaging, including reticular and confluent fibrosis, fatty infiltration, hemochromatosis, regenerating nodules, dysplastic nodules, hepatocellular carcinoma, and sequela of portal hypertension.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

Castleman disease mimicking a hepatic neoplasm.

Castleman disease, or angiofollicullar hyperplasia, is a rare cause of lymph node enlargement. This most commonly occurs within the thorax, although rare extrathoracic presentations have been described. Only two cases with hepatic localization have been reported. We present a case of Castleman disease within the porta hepatis masquerading as a hepatic neoplasm.

Adult↗