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S Apter

Publications and source records attributed to S Apter.

At least 37 records · Page 2Linked to original sources
PubMed2000

CT diagnosis of malpositioned chest tubes.

Insertion of a chest tube into the pleural space is standard management for various pleural disorders. Malpositioning of chest tubes in extrathoracic, intraparenchymal and mediastinal locations and in the fissures is common. Malpositioning results not only in inadequate drainage of air and fluid but may also result in increased morbidity and mortality. Diagnosis of a malpositioned tube is sometimes difficult to establish on a chest radiograph. CT, however, has proven to be extremely accurate in evaluating the position of a chest tube and has often provided additional valuable information with significant therapeutic impact.

Adult↗
PubMed2000

Paraffin oil bezoar impacted in the small bowel: CT findings.

A case of a paraffin oil bezoar impacted in the small bowel, resulting from the prolonged use of paraffin oil as treatment for increasing constipation in a patient with metastatic ovarian carcinoma, is described. Although pharmacobezoars are reported in the literature, we could not find a description of the CT findings of a paraffin oil bezoar.

Adenocarcinoma↗
PubMed1999

Hydatid cyst presenting as a soft-tissue thigh mass in a child.

We report a rare case of intramuscular hydatid cyst in a boy who presented clinically as having a soft-tissue thigh mass. A high level of awareness concerning the occurrence of these cysts is important, especially in regions where Echinococcus is endemic. Surgical treatment follows the principles of malignant tumour, namely, wide surgical resection.

Adolescent↗
PubMed1999

Imaging of mucocoele of the appendix with emphasis on the CT findings: a report of 10 cases.

AIM: Mucocoele of the appendix denotes an obstructive dilatation of the appendiceal lumen due to abnormal accumulation of mucus. It is sometimes associated with pseudomyxoma peritonei, which predicts a malignant origin. We present the CT findings and additional imaging studies of 10 patients with neoplastic appendiceal mucocoele and discuss the clinical implications. MATERIALS AND METHODS: Abdominal CT findings from 10 patients with appendiceal mucocoele were reviewed. Barium enema, US and MRI were additionally performed in three patients. There were five men and five women aged 45-80 years. Special attention was directed to the shape and nature of the mass, its relation to the caecum and the presence of ascites or peritoneal implants, as well as possible additional ovarian tumours in female patients. RESULTS: The mucocoele was an incidental finding in five patients. They were either spherical or elongated cystic lesions, attached to the wall of the caecum, six of them with mural calcification. Ascites were present in six patients and hypodense large peritoneal implants representing pseudomyxoma peritonei in four. Pathologically the series included five cases of cystadenoma (in one, a malignant pseudomyxoma peritonei subsequently developed), four cases of cystadenocarcinoma and one villous adenoma (this patient later developed pseudomyxoma peritonei). Pseudomyxoma peritonei was found in five cases. Three women had associated ovarian cystic tumour. CONCLUSION: The appearance of an appendiceal mucocoele is quite characteristic and can be diagnosed on CT. CT can also depict additional findings suggesting pseudomyxoma peritonei. In women with an appendiceal mucocoele the ovaries should be examined closely for cystic tumour and vice versa.

Aged↗
PubMed1999

Bezoars in the stomach and small bowel--CT appearance.

AIM: The aim of this study was to present the computed tomography (CT) appearance of trichobezoars, phytobezoars and other unusual ingested material. MATERIALS AND METHODS: Seven patients diagnosed on CT with bezoars in the stomach or small intestine were reviewed with special attention on the characteristics of the intraluminal mass and the presence of proximal dilatation. RESULTS: There were six women and one man aged 14-81 years. CT was performed because of abdominal pain and a palpable abdominal mass. In none of the cases was the diagnosis suspected clinically. Four patients had a trichobezoar occupying the entire lumen of the stomach. It appeared as a concentric inhomogeneous mass with entrapped air, surrounded by contrast material. In the other three patients the bezoar was confined to the small intestine and was composed respectively of vegetable fibres, ingested toilet paper and an olive stone. The first two had a mottled appearance whereas the last one was small, spherical and well defined. Variable proximal dilatation of the small bowel was present in all three. CONCLUSION: With the increased use of CT in the evaluation of patients with non-specific abdominal pain, it is important to recognize the CT appearance of bezoars, as this diagnosis is often not suspected clinically.

Adolescent↗
PubMed1999

Double-helical CT as a new tool for tracking of allograft atherosclerosis in heart transplant recipients.

RATIONALE AND OBJECTIVES: Tracking the progression of allograft atherosclerosis in heart transplant recipients is currently accomplished using invasive techniques. If its monitoring feasibility is demonstrated, spiral CT could be a non-invasive alternative for this objective. METHODS: Twenty-four consecutive heart transplant patients (21 men, 3 women, mean age 55 +/- 11 years) were scanned using double-helical CT. The first scan was performed 1.9 +/- 1.3 years after transplantation. After 2 years of follow-up, 4 patients died and the remaining 20 underwent a second scan. All scans were performed according to a previously reported double-helical CT protocol. RESULTS: The incidence of coronary calcification at the first scan was 4.2% (1/24); it increased to 40% (8/20) at the second scan (P < 0.001). Spiral CT identified new but very mild calcific deposits in seven patients with a mean total calcium score of 6.7 +/- 4.0. CONCLUSIONS: Double-helical CT is a viable tool to diagnose and track newly developed allograft atherosclerosis.

Adult↗
PubMed1999

Positive antineutrophil cytoplasmic antibodies-associated vasculitis presenting with hemoptysis and a mediastinal mass.

A patient with end-stage renal failure, due to IgA nephropathy, was found to have a mediastinal mass. Biopsy specimen of the mass showed a necrotizing vasculitis. Antineutrophil antibodies to myeloperoxidase were strongly positive. To our knowledge, no case of a mediastinal mass due vasculitis has been reported in the literature, and our observation should lead to broadening of the spectrum of clinical manifestations of vasculitis.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1999

Risk factors associated with postpartum ovarian vein thrombosis.

Thrombosis of the ovarian vein is a remarkable process occuring within a few days of labor in 1:500-1:2000 women. Its presentation is characterized by fever, abdominal pain and occasionally by a palpable abdominal mass that in earlier years sometimes lead to explorative laparotomy. With the advent of modern imaging techniques the diagnosis can be made relatively easily. The pathogenesis has been attributed to an infectious process expanding from the uterus to the right ovarian vein and stasis. A predisposition towards thrombosis has not been so far explored. In this study we retrospectively analysed the clinical features, diagnosis and treatment of 22 patients with objective documentation of post partum ovarian vein thrombosis (POVT) and assessed potential risk factors. In 11 of the 22 patients (50%) inherited prothrombotic risk factors were detected as follows: 4 were heterozygous for factor V G1691A, 2 had protein S deficiency, one had protein S deficiency and was heterozygous for factor V G1691A, and 4 were homozygous for MTHFR C677T. Eight of the 11 patients who bore a prothrombotic predisposition underwent cesarean section. Taken together, the data suggest that POVT may result from the combined effect of an infection, cesarean section and a prothrombotic tendency.

Adult↗
PubMed1998

Reconstruction of the sternum and chest wall with methyl methacrylate: CT and MRI appearance.

The aim of our study was to define the appearance of methyl methacrylate grafts replacing resected sternum and ribs on CT and MRI and how the sternal graft may mimic an abnormally sclerotic sternum on CT images. We reviewed the CT scans of nine patients who had undergone chest wall resection (eight with malignant and one with benign disease) and reconstruction with a composite of methyl methacrylate and Marlex mesh graft. One of them had an MRI study as well. The size, shape and CT attenuation were assessed on mediastinal and bone window settings. The sternal graft was seen on mediastinal and even better on bone windows as an abnormally wide, irregularly shaped structure, somewhat denser than the normal sternum. The chest wall prosthesis replacing resected ribs was seen as a continuous dense structure and of similar attenuation as that of the sternal graft. On MRI the prosthesis appeared as a well-defined structure with no signal. Reconstruction of the chest wall with methyl methacrylate appears on CT as a diffusely dense sclerotic bone lesion not unlike a malignant lesion. The possibility of a graft has to be included in the differential diagnosis in these cases.

Adolescent↗
PubMed1998

Pyelocalyceal diverticula containing milk of calcium--CT diagnosis.

OBJECTIVE: To present the computed tomography (CT) findings of pyelocalyceal diverticula containing milk of calcium in seven patients. MATERIAL AND METHODS: Three patients were examined because of flank pain, one because a malignant lesion was suspected and the three others were examined for unrelated symptoms. Three repeated scans to the kidney area were performed in every patient: an unenhanced scan, post-contrast scan and a delayed scan. RESULTS: Unenhanced scans demonstrated an intraparenchymal round lesion with calcific material localized either at the inferior border or filling almost the entire cavity. On post-contrast scans a contrast-fluid level appeared, with some enhancement of the clear fluid in the upper part of the cyst. A further rise in the contrast-fluid level or total opacification with a density identical to that of the collecting system was obtained on delayed scans. CONCLUSION: Pyelocalyceal diverticula containing milk of calcium present on CT as a partially calcified renal mass. Slight opacification soon after injection may be mistaken for enhancement arousing suspicion of a tumour. However, a delayed scan will demonstrate a densely opacified cyst filled with contrast from the collecting system which is virtually pathognomonic of the lesion.

Adult↗
PubMed1998

Intussusception in adults: CT diagnosis.

PURPOSE: Intussusception in adults is nowadays usually diagnosed on computed tomography (CT), as CT is often the first modality for the investigation of prolonged abdominal pain from which these patients suffer. We wish to present the CT, clinical and pathological findings of 16 adult patients with intussusception seen over a 5-year period. MATERIALS AND METHODS: The abdominal scans of 16 patients with intussusception were reviewed. Special attention was directed to the location of the mass, its shape and fat content, possible underlying pathology and dilatation of the bowel proximally. The findings were correlated with clinical and pathological data. RESULTS: Eight men and eight women, aged 34-81 years, were studied. The most frequent indication for CT was prolonged abdominal pain. CT findings included an inhomogeneous soft tissue mass, target or sausage-shaped, depending on the angle of the CT beam vs. the intussusception, with a fatty component in 14 of the 16. Intussusception was enteroenteric (six), ileocolic (three), or colocolic (seven). Complete small bowel obstruction was present only in one case and some bowel dilatation in three. The underlying pathology could be diagnosed on CT in only two cases of lipoma. Nine patients had an underlying malignant process, eight of them unsuspected. Of the other five, two had coeliac disease, two were classified as idiopathic and one had a necrotic polyp of undetermined pathology. CONCLUSION: Intussusception on CT presented a characteristic mass lesion containing fat stripes in almost all patients. Obstruction was rarely seen. Malignant lesions were the most common cause and therefore early diagnosis and prompt intervention are essential.

Abdominal Pain↗
PubMed1998

Calcification in untreated non-Hodgkin's mediastinal lymphoma.

We report a case of calcifications in mediastinal non-Hodgkin's lymphoma. Although calcification may occur in lymphoma after chemotherapy or radiotherapy in areas of fibrous healing and scar formation, it has been reported only rarely in untreated non-Hodgkin's lymphoma.

Adult↗
PubMed1998

CT angiography of superior mesenteric artery syndrome.

OBJECTIVE: Our purpose was to describe the use of CT angiography and three-dimensional (3D) reconstruction in the diagnosis of superior mesenteric artery syndrome in three patients. CONCLUSION: CT angiography combined with 3D reconstructions is a noninvasive technique that may have a complementary diagnostic role similar to that of angiography in patients with a classic clinical presentation suggestive of superior mesenteric artery syndrome. CT angiography combined with 3D reconstructions should be considered in patients who might otherwise require angiography.

Adult↗
PubMed1997

[Multidisciplinary approach to the treatment of musculo-skeletal tumors].

Tumors of the musculoskeletal system are relatively rare. They occur mostly in the young, while in older age groups metastases and myeloma are more prevalent. Treatment has undergone major change in the past 20 years with the introduction of neoadjuvant treatment protocols. According to recent reports 5-year survival rates have increased from 20% to 60-70%. These new protocols involve the use of modern imaging modalities, immunohistochemical pathological analysis and improved surgical technics. This has required establishment of multidisciplinary teams of experts to escort the patient through all the steps of current treatment.

Bone Neoplasms↗