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Biomedical subjects

M I Shaff

Publications and source records attributed to M I Shaff.

At least 19 recordsLinked to original sources
PubMed1988

Computed tomography and magnetic resonance imaging of the acute abdomen.

CT is a noninvasive investigation that in many instances is more sensitive in elucidating intra-abdominal and retroperitoneal disease than is conventional radiography. With modern scanners, the procedure is rapid and efficient and suitable for the most severely ill and infirm. The scans are easily interpretable, and the anatomic and morphologic depiction of disease is readily understood by those with surgical training. Information regarding the state of the bowel wall, mesentery, and intraperitoneal and retroperitoneal structures is displayed in greater detail than by any other diagnostic imaging modality. The use of intravenous contrast medium is rarely essential. The concentration of iodinated contrast needed for opacification of the bowel is no greater than 2 per cent to 5 per cent and will not complicate bowel surgery, as would standard upper gastrointestinal or barium enema studies. Abscess, free air, calcium, and intraperitoneal fluid are very sensitively detected. CT is extremely useful in aiding surgical decision making in the acute abdomen and is complementary to or has replaced conventional studies.

Abdomen, Acute↗
PubMed1988

Cat-scratch disease: report of a case with liver lesions and no lymphadenopathy.

The usual presentation of cat-scratch disease (CSD) is a subacute regional lymphadenitis following cutaneous inoculation. We present the case of a 10-yr-old white female with a 4-wk history of abdominal pain and fever, without associated lymphadenopathy. A 67Ga scintigram showed inhomogenous uptake by the liver. An abdominal computed tomographic (CT) scan revealed multiple low density lesions in the liver and the spleen, that were confirmed at laparotomy. Stellate microabscesses were seen on a wedge biopsy of the liver and a CSD antigen skin test was positive. CSD should be considered in the differential diagnosis of liver lesions, even in the absence of lymphadenopathy. This case emphasizes the importance of inhomogeneous 67Ga uptake by the liver.

Abscess↗
PubMed1987

Magnetic resonance imaging of the adrenal glands.

Although CT should be used as the initial procedure, MRI potentially can identify most adrenal masses without the hazard of ionizing radiation or the injection of iodinated contrast material.

Adenoma↗
PubMed1985

Imaging of the ischiorectal fossa.

A retrospective evaluation of 500 routine abdominal computed tomography scans revealed 21 cases of ischiorectal fossa disease in 16 patients. Pathologic processes included involvement by primary and secondary neoplasms, usually of gynecologic origin; rectal prolapse; and abscess. These abnormalities can be missed if the ischiorectal fossae are not included in routine abdominal scans. The anatomy of the ischiorectal fossae and their relationship to other pelvic organs are well demonstrated with high-resolution computed tomography scans as well as by magnetic resonance imaging.

Abdomen↗
PubMed1985

Primary aldosteronism: computerized tomography in preoperative evaluation.

We reviewed the value of computerized tomography (CT) in the preoperative evaluation of 34 patients with primary aldosteronism. All 34 patients entered a standard protocol including saline suppression testing, abdominal CT scanning, and adrenal venous sampling. Surgical pathologic findings, biochemical determinations, and clinical response to adrenalectomy were the criteria used to evaluate 68 adrenals in 34 patients. Of 36 diseased glands 17 were correctly identified by CT (48%). Of the 32 normal glands, 29 were identified correctly by CT (91%). Thus, CT is not sensitive (0.48), but very specific (0.91) in Conn's syndrome. Our patients were divided into two groups: group 1 were those scanned between 1977 and 1980, group 2 were those scanned from 1981 to 1983 with a high-resolution GE-8800 scanner. CT results in group 2 showed no significant improvement in specificity (0.92), but improvement in sensitivity (0.58) over group 1 (specificity 0.90, sensitivity 0.42). Furthermore, CT is less sensitive in patients with smaller tumors than in those with larger tumors.

Adenoma↗
PubMed1985

Clinical magnetic resonance imaging with nuclear medicine correlation.

The current role of magnetic resonance imaging (MRI) in different organ systems is discussed and compared to nuclear medicine and to other available clinical diagnostic modalities. The value of optimizing radiofrequency pulse sequence selection to provide additional tissue characterization is also described. The results of nuclear medicine and MRI studies in 56 patients are compared to evaluate the clinical diagnostic contribution of each imaging modality for various pathological processes. In addition, the state-of-the-art MRI systems and future development in MRI technology with its potential contribution is defined.

Abdomen↗
PubMed1985

Abdominopelvic computed tomography: evaluation in patients undergoing second-look laparotomy for ovarian carcinoma.

Preoperative abdominopelvic computed tomography results and operative findings were compared in 52 patients undergoing second-look laparotomy to confirm tumor status. Seventeen true-negative, 22 false-negative, and 13 true-positive scans were found. The sensitivity was 0.38, specificity was 1.0, and diagnostic accuracy was 0.58. Negative studies were associated with positive findings at laparotomy in 42% of all cases. Fourteen patients were identified who had computed tomography that would have enabled an attempt at the diagnosis of persistent cancer by computed tomography-directed needle aspiration or biopsy, thus avoiding laparotomy. Assuming 80% accuracy of needle aspiration, the cost of computed tomography in all 52 patients is considerably outweighed by the savings that could have been realized by eliminating the need for second-look surgery in these 11 women.

Antineoplastic Agents↗
PubMed1979

Diagnosis and control of diverticular bleeding by arteriography and vasopressin infusion. A report of 2 cases.

Large-bowel bleeding usually arises from either angiodysplasia or colonic diverticula. Diverticular bleeding is more common in the right or the transverse colon, even though diverticula are more common on the left. Arteriography in these patients may identify the bleeding site, and in some cases vasopressin infusion controls the bleeding. Embolization of the large bowel is not recommended because of the danger of necrosis.

Aged↗
PubMed1979

The accelerated diagnosis of jaundice with ultrasonography and narrow-needle cholangiography.

The accuracy of ultrasonography in the diagnosis of jaundice in 70 patients has been compared with that of transhepatic cholangiography and the results of surgery and liver biopsy. A simplified system of grouping the ultrasonic data is presented. The results indicate that ultrasonography is capable of differentiating obstructive from non-obstructive jaundice in 94% of cases and of defining the correct anatomical level in 85% of cases. The accuracy of narrow-needle cholangiography was 100% for obstructive jaundice and 66% normal duct entry rate for non-obstructive jaundice.

Bile Ducts↗
PubMed1979

A radiological approach to infertility--hysterosalpingography.

The hysterosalpingograms of 98 patients with infertility were reviewed with reference to technical problems, radiological features of each pathology and accuracy of reporting. Findings were confirmed by review of the reports of laparotomy or laparoscopy on all patients. Of the total number of fallopian tubes investigated (196), 70 hydrosalpinges were correctly diagnosed from a total of 77. Agreement between HSG and operation was achieved in 123 of 127 fallopian tubes with peritubal adhesions, in all six of those with cornual spasm and in eight with cornual occlusion. In 16 of 20 fallopian tubes with partial distal occlusion, reporting was correct. With the potential accuracy of HSG diagnosis, we contend that it should be a preliminary procedure in every case, and in many may be the only investigation of tubal patency required prior to surgery or conservative management.

Constriction, Pathologic↗
PubMed1977

Ultrasonic diagnosis of thanatophoric dwarfism in utero.

There are several types of short-limbed neonatal dwarfism. Before the delineation of thanatophoric dwarfism many dwarfs who died early in infancy were labeled "achondroplastic." Intrauterine radiological diagnosis is possible and the clinician may be alerted to the possibility of the condition by noting short squat limbs with a relatively large head on ultrasound examination, especially in cases of hydramnios.

Adult↗