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Olga R Brook

Publications and source records attributed to Olga R Brook.

10 recordsLinked to original sources
PubMed2006

16-MDCT coronary angiography versus invasive coronary angiography in acute chest pain syndrome: a blinded prospective study.

OBJECTIVE: The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant coronary artery disease in patients hospitalized for acute chest pain syndrome. SUBJECTS AND METHODS: Sixty-six consecutive patients (52 men and 14 women; average age, 57 +/- 11 [SD] years) who were hospitalized for acute chest pain syndrome underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 +/- 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS: CT coronary angiography was technically successful in 59 patients (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant coronary artery disease in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION: CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant coronary artery disease in patients hospitalized for acute chest pain syndrome. Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of patient heart rates.

Acute Disease↗
PubMed2004

Antegrade MDCT pyelography for the evaluation of patients with obstructed urinary tract.

OBJECTIVE: The purpose of this study was to design an alternative imaging technique to CT urography in patients with high-grade urinary tract obstruction, with or without impaired renal function, that uses the superior resolution of MDCT and avoids IV contrast material administration. CONCLUSION: Antegrade MDCT pyelography is an alternative imaging technique to CT urography in patients with high-grade urinary tract obstruction with or without impaired renal function. It enables accurate diagnosis of the level of obstruction, as well as its etiology, including nephroureterolithiasis, urothelial tumors, primary congenital megaureter, uretero-pelvic junction stenosis, ureteral edema, ureteral stricture, retroperitoneal fibrosis, and pelvic lymphadenopathy.

Adult↗
PubMedDate not supplied

Difference of CBD width on US vs. ERCP.

PURPOSE: To investigate the relationship between US and ERCP in the measurement of common bile duct (CBD) width after application of Compound and Harmonic imaging on ultrasound. METHODS: We prospectively evaluated the CBD width as measured on endoscopic retrograde cholangiopancreatography (ERCP) and ultrasonography (US), applying Compound and Harmonic US techniques, on 100 patients. Furthermore, we retrospectively re-examined US and ERCP images of 48 patients who underwent ERCP and US during the same hospitalization period. RESULTS: The average difference in measurements by US compared to ERCP was 2.3 mm (P < 0.01) in the retrospective and 1.9 mm in the prospective study (P < 0.001). The average difference in measurements between US and ERCP in post-cholecystectomy patients was 4.0 mm in the retrospective study (10 patients), and 3.8 in the prospective study (25 patients). The difference between the measurements on both examinations decreased with increasing CBD width. There was a good correlation between ERCP and US measurements of CBD width (r = 0.73 for all patients and r = 0.88 for patients with intact gallbladder, P < 0.001). CONCLUSIONS: There is a gap between measurement of CBD width on US and ERCP of about 2 mm. The application of Compound and Harmonic techniques in the prospective study probably enabled a more accurate sonographic measurement.

Adult↗
PubMedDate not supplied

A new pitfall on abdominal PET/CT: a retained surgical sponge.

Positron emission tomography (PET)/computed tomography (CT) and multidetector CT findings of an abdominal retained surgical sponge (RSS) are presented. A PET/CT study performed for evaluation of a suspected abdominal tumor demonstrated the inconclusive finding of a hypometabolic area surrounded by increased 2-[fluorine-18] fluoro-2-deoxy-D-glucose uptake. Follow-up contrast-enhanced multidetector CT suggested the correct diagnosis of an RSS. This is the first known report of the PET/CT appearance of an RSS.

Abdomen↗
PubMedDate not supplied

Pitfalls of the lactating breast on computed tomography.

Breasts are usually only incidentally included in computed tomography (CT) scans of the abdomen and chest in spite of the fact that pathologic findings are not rare. Because postpartum women are normally healthy, they rarely require examination; therefore, the presentation of lactating breasts on a CT scan is poorly known. The most common postpartum breast feature is engorgement, which is characterized by painful swelling associated with a sudden increase in milk volume, lymphatic and vascular congestion, and interstitial edema. Its appearance on a CT scan does not seem to have been described in the literature to date. The CT picture of a lactating breast shows the enlarged gland with bilateral cord- and mass-like hyperattenuated tissue. After abrupt cessation of breast-feeding, the edema component supervenes and breast tissue may become hypoattenuated. In such cases, further ultrasound evaluation is needed. We present 3 cases of postpartum breast engorgement as seen on CT.

Adenocarcinoma↗
PubMedDate not supplied

Late visual and auditory toxicity of radiotherapy for nasopharyngeal carcinoma.

AIMS AND BACKGROUND: Classical irradiation of carcinoma of the nasopharynx involves large fields and high doses; therefore, significant late toxicity and late side effects are to be expected. Given the fact that nasopharyngeal carcinoma (NPC) is a relatively radiosensitive disease and a significant proportion of patients are long-term survivors, late visual and auditory complications of treatment are of utmost concern for patients and radiation oncologists. The aim of this study was to evaluate the long-term visual and auditory toxicity in patients treated with radiotherapy for NPC. METHODS AND STUDY DESIGN: Forty-three long-term survivors (including 11 children), following definitive radiotherapy for NPC, underwent a thorough visual and auditory evaluation 2-22 years after their treatment. Ophthalmological examination consisted of anamnesis of dry eye syndrome and visual acuity, visual acuity testing, slit-lamp examination, Schirmer test, fundus examination, and intraocular pressure measurement, as well as fluorescein angiography in patients with pathological vascular findings in the fundus examination. Audiological evaluation included anamnesis of hearing loss, tinnitus or vertigo, examination of the ears and nasopharynx, audiogram, and tympanogram. RESULTS: Radiation retinopathy was found in 16% of patients by fundus examination, with one patient (2.3%) developing blindness. Severe dry eye syndrome was present in 26%. Fifty-six percent had some degree of hearing impairment, with 74% showing severe sensorineural hearing loss. Fifty-eight percent of patients reported tinnitus and 26% reported suffering from dizziness. Radiation retinopathy as well as all manifestations of auditory toxicity were found to bear a direct correlation with dose per fraction. CONCLUSIONS: Unless there is tumor involvement, the orbital contents should be completely excluded from the target volume. Auditory toxicity is significant when treating NPC with two-dimensional techniques.

Adolescent↗