Biomedical subjects

Nadir Ghanem

Publications and source records attributed to Nadir Ghanem.

25 records · Page 2Linked to original sources

PubMed2003

Ectopic thyroid gland in the porta hepatis and lingua.

A rare case of an ectopic thyroid gland in the porta hepatis and in the tongue in an asymptomatic euthyroid 24-year-old woman is reported. A solitary inhomogeneous, hypoechogenic and hyperechogenic mass in the porta hepatis was accidentally discovered by ultrasonography. Subsequent computed tomography demonstrated a heterogeneous, well-defined tumor with small calcifications without signs of environmental invasion. A hemangioma and focal nodular hyperplasia were excluded by blood pool and hepatobiliary scintigraphy. Surprisingly, fine-needle aspiration cytology revealed normal thyroid tissue. (123)I-scintigraphy confirmed the presence of ectopic dual thyroid tissue in the hepatic porta and lingua. At clinical inspection the lingual thyroid gland was palpable and visible, and appeared solid and spheroidal. The subhepatic, ectopic thyroid mass was resected. Postoperatively, thyroid hormone replacement was started to prevent an enlargement of the lingual thyroid. Today, 4 years after surgery, the patient remains euthyroid.

Adult↗

PubMed2003

Amorphous silicon, flat-panel, x-ray detector versus storage phosphor-based computed radiography: contrast-detail phantom study at different tube voltages and detector entrance doses.

RATIONALE AND OBJECTIVES: Evaluation of the contrast-detail performance of an active-matrix flat-panel x-ray detector in comparison with a storage phosphor system with special regard to the potential of dose reduction. METHODS: A digital x-ray detector based on cesium iodide (CsI) and amorphous silicon (a-Si) technology was compared with a fifth-generation storage phosphor system. A lucite plate with 36 drilled holes of varying diameters and depths was used as contrast-detail phantom. At 45 kVp, 70 kVp, and 113 kVp, images at 8 different detector entrance doses ranging between 0.3 microGy and 40 microGy were obtained. On soft-copy displays, 3 masked observers evaluated the detectability of each aperture in each image according to a 5-point scale. The mean sum scores of corresponding images were compared. RESULTS: For all tube voltages and detector entrance doses, the images obtained with the CsI/a-Si detector resulted in better observer contrast-detail performance as compared with the images of the storage phosphor system. The CsI/a-Si system allowed a calculated dose reduction of 39% at 45 kVp, 68% at 70 kVp, and 81% at 113 kVp as compared with the storage phosphor system, without loss of contrast-detail detectability. CONCLUSIONS: Under the conditions of the chosen experimental design, the CsI/a-Si system provided a superior contrast-detail performance as compared with the storage phosphor system. The potential of dose reduction increased with rising tube voltage.

Cesium↗

PubMed2003

CT-guided radiofrequency heat ablation of malignant lung tumors.

BACKGROUND: Radiofrequency heat ablation (RFA) is an advanced minimal-invasive technique for the treatment of primary and secondary malignancies in several organs. This article presents the successful percutaneous computed tomography (CT)-guided radiofrequency heat ablation of a peripheral bronchiogenic carcinoma and four lung metastases in three patients. MATERIAL/METHODS: Pain relief in a palliative care situation was the indication for RFA treatment in two patients. A primary curative tumor treatment with RFA was intended in one patient, who refused surgery. All procedures were performed under conscious sedation and local anesthesia. RESULTS: RFA treatment was carried out without major complications in these patients. No signs of infection or significant bleeding were observed. One patient developed a pneumothorax two days after the procedure, which was drained sufficiently. All patients had elevated temperatures, up to 38.5 degrees C for three days after RFA, due to tumor lysis. Pain relief was possible. Control CT scans three months after percutaneous RFA revealed shrinkage of the treated tumor nodules. CONCLUSIONS: Percutaneous RFA was successfully performed in three patients. CT-guided percutaneous RFA of non-resectable lung neoplasms may be a complement to chemotherapy and radiation therapy. Further clinical experience and prospective studies are needed to determine the long-term efficacy and safety of RFA in the treatment of lung tumors.

Catheter Ablation↗

PubMed2002

Prenatal diagnosis of Milroy's primary congenital lymphedema.

Milroy's primary congenital lymphedema (PCL) (hereditary lymphedema type I, Milroy disease) is present at birth, and mostly affects the dorsal aspects of feet. It is mostly a life-long condition but does not affect longevity. Complications are rare except for chronic discomfort and warmness of affected areas. PCL is an autosomal dominant disease with incomplete penetrance due to a mutation in the gene locus encoding for VEGFR3 with resultant dysgenesis of microlymphatic vessels. We report on two fetuses where ultrasonographic examination at 15 weeks of gestation showed significant edema of the dorsal aspects of both feet with no evidence of other major malformations. Whereas in one fetus the edema resolved completely, it persisted in the second fetus and proved after birth to be of lymphedematous nature. To the best of our knowledge, this is the first report of early prenatal diagnosis of primary congenital lymphedema via fetal ultrasonographic examination and of spontaneous resolution of lymphedema during fetal life.

Adult↗

PubMed2002

Comparative diagnostic value and therapeutic relevance of magnetic resonance imaging and bone marrow scintigraphy in patients with metastatic solid tumors of the axial skeleton.

PURPOSE: To evaluate the comparative impact of magnetic resonance imaging (MRI) and bone marrow scintigraphy (BMS) in bone marrow metastases of solid tumors. METHODS: In 20 patients with solid tumors MRI of the axial skeleton and whole-body BMS were retrospectively reviewed. Detectability of metastases, extent of disease and therapeutic implications were assessed. RESULTS: In 15/20 (75%) patients MRI and BMS concordantly revealed bone marrow metastases of the axial skeleton. In nine of these 15 patients (60%) MRI showed more metastases. Local radiotherapy or surgery was performed in seven of these cases (78%). BMS detected additional metastases of the appendicular skeleton in 8/15 (53%) patients. In 4/20 cases (20%) the imaging findings were discordant. In three patients with degenerative changes (n=2) or lipoma (n=1) BMS was false positive. In another patient BMS failed to detect metastases proven by MRI and clinical follow-up resulting in subsequent radiation therapy. One patient had normal bone marrow. CONCLUSION: MRI appears to be more sensitive and specific in the detection of bone marrow metastases in the axial skeleton and is of clinical importance for subsequent local therapy.

Bone Marrow Neoplasms↗

PubMed2002

Pheochromocytomas: detection with 18F DOPA whole body PET--initial results..

PURPOSE: To evaluate fluorine 18 ((18)F) dihydroxyphenylalanine (DOPA) whole-body positron emission tomography (PET) as a biochemical imaging approach for detection of pheochromocytomas. MATERIALS AND METHODS: (18)F DOPA PET and magnetic resonance (MR) imaging were performed in 14 consecutive patients suspected of having pheochromocytomas (five sporadic, nine with von Hippel-Lindau disease); metaiodobenzylguanidine (MIBG) scintigraphy was performed in 12 of these patients. The individual imaging findings were assessed in consensus by specialists in nuclear medicine and radiologists blinded to the results of the other methods. The findings of the functional imaging methods were compared with those of MR imaging, the reference standard. Histologic verification could be obtained in eight patients with nine tumors. RESULTS: Seventeen pheochromocytomas (11 solitary, three bifocal; 14 adrenal, three extraadrenal) were detected with MR imaging. (18)F DOPA PET and MR imaging had concordant results in all 17 tumors. In contrast, MIBG scintigraphy had false-negative results in four patients with three adrenal tumors smaller than 2 cm and one extraadrenal tumor with a diameter of 3.6 cm. On the basis of these data, sensitivities of 100% for (18)F DOPA PET and of 71% for MIBG scintigraphy were calculated. Specificity was 100% for both procedures. CONCLUSION: (18)F DOPA PET is highly sensitive and specific for detection of pheochromocytomas and has potential as the functional imaging method of the future.

Adolescent↗

PubMedDate not supplied

Sinonasal computed tomography in patients with Wegener's granulomatosis.

The goal of this study was to describe pathologies of sinonasal CT in patients with Wegener's granulomatosis. Between 1993 and 2004, sinonasal CT was performed in 28 patients (15 male, 13 female) with Wegener's granulomatosis. The following imaging findings were assessed on the CT scans: mucosal thickening, subtotal opacification, air-fluid level, bony destruction, sclerosing osteitis, bony thickening, orbital mass, and saddle nose deformity. Of the 28 patients, 61% showed mucosal thickening in the nasal cavity and 75% in the paranasal sinuses. A subtotal opacification of the paranasal sinuses was detected in 25%, and of the mastoid cells in 7% of patients. Fifty-seven percent of patients had bony destruction of the nasal cavity, and 54% of the paranasal sinuses. CT revealed sclerosing osteitis of the paranasal sinuses in 21%, and of the mastoid cells in 18% of patients. Bony thickening of the paranasal sinuses was detected in 18%, and of the mastoid cells in 14% of patients. With respect to all imaging findings, the maxillary sinuses were the most frequently affected paranasal sinuses. The authors conclude that the following sinonasal CT findings are observed in patients with Wegener's granulomatosis: (1) bony destruction, mainly of the nasal cavity, maxillary sinuses, and mastoid cells; (2) sclerosing osteitis, mainly of the maxillary sinuses and mastoid cells; (3) bony thickening, mainly of the maxillary sinuses and mastoid cells; and (4) mucosal thickening, mainly of the maxillary sinuses. These findings are, however, nonspecific and should be combined with other clinicopathologic and laboratory studies to confirm the diagnosis of Wegener's granulomatosis.

Adult↗