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Biomedical subjects

M B Isikoff

Publications and source records attributed to M B Isikoff.

At least 19 recordsLinked to original sources
PubMed1983

Abdominal aspiration biopsies. Sonographic v computed tomographic guidance.

One hundred eighty-four diagnostic aspirations performed on 169 patients were reviewed (1) to define the decision process regarding which guidance method (sonography v computed tomography) should be used on any given patient, and (2) to determine, once a guidance method was chosen, its accuracy and complication rate. Sonographic guidance (84%) proved to be an effective method for obtaining a correct diagnosis in 98% (110/112) of cystic masses and 79% (34/43) of solid masses. Computed tomography (16%) was used when sonography could not identify the mass or when the mass was small, deeply located, and often solid. Computed tomographic guidance provided a correct diagnosis in 100% (13/13) of cystic masses and 81% (13/16) of solid masses.

Abdomen↗
PubMed1983

The role of percutaneous aspiration in the diagnosis of pancreatic abscess.

Percutaneous aspiration should be performed on pancreatic/peripancreatic fluid collections when an abscess is suspected. Thirty-one percutaneous aspirations were performed on 21 such patients and seven (33%) proved to have an abscess. A Gram stain after the aspiration is important, as it can make an immediate diagnosis of an abscess. By helping make an early diagnosis, percutaneous aspiration might reduce the high mortality rate associated with a pancreatic abscess while avoiding surgery in those who have sterile fluid collections. Two complications (6%) occurred: superinfection of a pseudocyst and a hemoperitoneum.

Abscess↗
PubMed1982

Acute pancreatitis: clinical vs. CT findings.

In a prospective study of 91 patients with acute pancreatitis, computed tomographic (CT) findings were correlated with the clinical type of acute pancreatitis. In acute edematous pancreatitis (63 patients; 16 with repeat CT), CT was normal (28%) or showed inflammation limited to the pancreas (61%). Phlegmonous changes were present in 11%, including one patient with focal pancreatic hemorrhage, indicating that clinically unsuspected hemorrhagic pancreatitis can occur. In acute necrotizing (hemorrhagic, suppurative) pancreatitis (nine patients; eight with repeat CT), no patient had a normal CT scan and 89% had phlegmonous changes. One patient had hemorrhagic pancreatitis and three had abscesses. In acute exacerbation of chronic pancreatitis (10 patients; three with repeat CT), there were pancreatic calcifications (70%), a focal mass (40%), and pancreatic ductal dilation (30%). On follow-up CT, the findings of acute pancreatitis did not always disappear with resolution of the clinical symptoms. This was especially true of phlegmonous pancreatitis, where the CT findings could persist for months.

Abscess↗
PubMed1981

The clinical significance of acute pancreatic hemorrhage.

Computed tomography (CT) has the ability to demonstrate acute hemorrhage both within the pancreatic parenchyma and the adjacent retroperitoneal spaces. It was found that during the acute phase of pancreatic hemorrhage (about 1-7 days) the CT number of hemorrhage is significantly greater than that of the gland. At the present time the true incidence of pancreatic hemorrhage and the relation of the CT demonstration of hemorrhage to the clinical entity of hemorrhagic pancreatitis is unclear. The CT, laboratory, and clinical findings in eight patients with acute pancreatitis were analyzed to help answer these questions. This limited experience suggests pancreatic hemorrhage is more frequent than hemorrhagic pancreatitis as currently defined clinically.

Acute Disease↗
PubMed1981

Diagnostic imaging of acute pancreatitis: prospective study using CT and sonography.

A prospective study using sonography and computed tomography (CT) was performed on 102 patients consecutively identified as having acute pancreatitis to see which method provided the most information. Each examination was graded for visualization of the pancreas, extent of disease, and the detection of complications. CT was found to be of significantly greater value than sonography due to the high percentage (38%) of nondiagnostic studies with the latter method. Of the 102 patients, 70% had abnormal CT studies, including 18% with extrapancreatic phlegmons, 10% with pseudocysts, 5% with acute hemorrhage, and 3% with pancreatic abscesses.

Acute Disease↗
PubMed1981

The sonographically solid appearing benign cystic teratoma.

The sonographic appearance of 6 solid benign cystic teratomas (in 5 patients) was reviewed. Three of these tumors were difficult to identify due to the presence of acoustical shadowing obscuring the posterior portions of the tumors. This appearance was mistaken ultrasonically for bowel gas. The tumors were diagnosed by abdominal radiographs showing calcifications, teeth and/or radiolucency due to fat. With the presence of a clinically palpable pelvic mass in a young woman, and an apparently normal sonogram, an abdominal radiograph should be considered to look for evidence of a benign cystic teratoma.

Adolescent↗
PubMed1980

Para-aortic lymphocyst.

Although numerous articles regarding the etiology, incidence, complications, and management of pelvic lymphocysts have been published in the American literature since 1958, there has been no mention of para-aortic lymphocyst as a complication of para-aortic node dissection. Two recent cases of symptomatic para-aortic lymphocyst have prompted a review of our para-aortic node dissection technique when this procedure is not combined with a more extensive pelvic lymphadenectomy. Our modification in technique is to use retroperitoneal para-aortic drainage by constant pressure-controlled suction following closure of the posterior parietal peritoneum, and the results in our first 15 patients are presented. There were no complications related to the drainage technique. Abdominal ultrasound and intravenous urography have proved to be excellent diagnostic tools in the initial evaluation and subsequent follow-up of para-aortic lymphocytes.

Adolescent↗
PubMed1980

Retroperitoneal processes involving the psoas demonstrated by computed tomography.

Twenty-five patients were found to have retroperitoneal pathology involving the psoas muscle including nine patients with inflammatory lesions, three with hematomas, seven with adenopathy, one patient with leukemic infiltration of the psoas, and five with retroperitoneal tumors. Computed tomography (CT) offers a unique method to investigate pathological processes that affect the psoas. In addition, the abdominal films on 24 of the patients were analyzed to correlate the value of radiography with that of CT. Computed tomography confirms the belief that the mere presence of a retroperitoneal mass will not necessarily obliterate the psoas.

Abscess↗
PubMed1980

Gallium-67 radionuclide imaging in acute pyelonephritis.

The symptoms and clinical course of patients with acute pyelonephritis are variable; likewise, urinalysis, blood cultures, and excretory urography may be normal or equivocal. The ability of gallium-67 to accumulate in areas of active inflammation was useful in the diagnosis of acute pyelonephritis in 12 cases. A multiplane tomographic scanner was used for imaging four of these patients. Initial experience with this scanner is also discussed.

Acute Disease↗
PubMed1980

Sonography of the renal arteries: left lateral decubitus position.

Despite the routine visualization of many of the major branches of the abdominal aorta using current state of the art sonography equipment, the renal arteries are still infrequently seen in normal patients and are rarely seen in patients with abdominal aortic aneurysms. Longitudinal scanning in the left lateral decubitus position will frequently visualize the origin of the renal arteries from the aorta and/or the right renal artery as it crosses under the inferior vena cava. Using this technique the renal arteries in 16 of 20 patients were visualized. The experience with this technique so far is limited to three patients with aortic aneurysm. In two, the relation of the aneurysm to the renal arteries could be delineated.

Aorta, Abdominal↗
PubMed1980

CT of acute pancreatitis: interim assessment.

a retrospective review of 102 ptients with the clinical diagnosis of acute pancreatitis undergoing computed tomographic (CT) evaluation during a 9 month period revealed 32 patients with abnormal CT scans. All 32 had enlargement of the pancreas. The extent of inflammatory process on these patients was examined. Twenty patients exhibited a phlegmonous mass extending into the region of the lesser sac. There was involvement of the left anterior pararenal space in 13 (the right in three and both in four). Eight patients demonstrated involvement of the posterior pararenal space, and in seven of these the inflammatory process extended down the psoas muscle into the pelvis. Five patients had involvement of the transverse mesocolon and small bowel mesentery. Eight patients developed a pseudocyst during the acute phase of the disease, 11 developed a pancreatic abscess, and two showed evidence of pancretic hemorrhage. This experience prompted a prospective study of the clinical course of acute pancreatitis relative to the extent of disease as recognized by CT.

Abscess↗
PubMed1980

Diagnostic imaging of hepatic abscesses: a retrospective analysis.

Seventeen patients with pathologically proven intrahepatic abscesses seen over a 12 month period were retrospectively evaluated. Of these 17 patients, 16 had at least three of the four commonly used imaging techniques for the evaluation of hepatic abscesses, including scintigraphy with technetium-99m-labeled sulfur colloid and gallium-67 citrate, sonography, and computed tomography. Of the 17 abscesses, 12 were of pyogenic and five were of amebic origin. Technetium-99m sulfur colloid correctly identified 14 of 16 abscesses; gallium, nine of 10; sonography, 12 of 16; and computed tomography, 15 of 17. The rational approach to the diagnosis of intrahepatic abscesses should be a 99mTc sulfur colloid scan followed, if necessary, by either sonography or CT. In equivocal cases a gallium scan may be of value.

Adult↗
PubMed1980

Diagnostic and therapeutic aspirations of fluid containing masses: the role of ultrasound and computed tomography.

Twenty-eight patients have undergone diagnostic and/or therapeutic aspiration of fluid containing masses at Jackson Memorial Hospital over the last 8 months. The majority were diagnosed and aspirated under ultrasonic control while in a few cases CT was required. In 19 patients, a therapeutic aspiration was attempted. In 17, this was successful, none of these patients required surgical intervention. The role of ultrasound and CT in the diagnosis and treatment of fluid collection is emphasized. The technique for both diagnostic and therapeutic aspirations is stressed as well.

Abscess↗
PubMed1980

Sonographic patterns of ectopic pregnancy - how do they help in making the diagnosis?

The diagnosis of ectopic pregnancy is clinically difficult. To determine how the different sonographic patterns help in making the diagnosis of ectopic pregnancy, the ultrasound examinations of twenty-three patients were retrospectively reviewed. Four sonographic types of ectopic pregnancy were found: Type 1--Cystic adnexal mass with a fetal pole. Type 2--Cystic adnexal mass with no fetal pole. Type 3--Complex or solid adnexal mass. Type 4--Pelvis fluid with no mass. In Type 1, a specific ultrasound diagnosis of ectopic pregnancy could be made. In Types 2, 3 and 4 the sonographic findings although suggestive of an ectopic pregnancy were not specific. In these cases the diagnostic accuracy was increased if culdocentesis was performed when ultrasound demonstrated fluid in the pelvis. Unlike previous reports, uterine size, endometrial echoes and myometrial echoes were found to be of no value in making the diagnosis. The positive pregnancy test increased the diagnostic specificity of the ultrasound examination. Even if the pelvic sonogram was normal, an ectopic pregnancy could not be excluded if the pregnancy test was positive.

Adolescent↗
PubMed1980

Sonic silhouetting of the aorta.

The diagnosis of diseases involving and arising from structures around the abdominal aorta has been described. Sonic silhouetting of the wall of the aortic due to lymphomatous involvement of the para-aortic lymph nodes is well known. It may be found with metastatic para-aortic lymphadenopathy, retroperitoneal fibrosis and pancreatic carcinoma where the tumor is adjacent to the aortic wall. Sonic silhouetting of the aorta associated with a pancreatic mass indicates malignancy. Extensive sonic silhouetting due to pancreatic carcinoma can have the appearance of a clot containing abdominal aortic aneurysm.

Adult↗