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Biomedical subjects

S K Sussman

Publications and source records attributed to S K Sussman.

At least 19 recordsLinked to original sources
PubMed1998

Renal lymphoma: spectrum of CT findings and potential mimics.

Renal lymphoma has a broad spectrum of imaging manifestations. Typical patterns of renal lymphoma include multiple renal masses, solitary masses, diffuse infiltration, and invasion from contiguous retroperitoneal disease. Isolated perirenal disease is probably the most atypical form of renal lymphoma and has a variety of appearances, including small curvilinear densities and soft-tissue nodules or plaques. In general, the CT diagnosis of renal lymphoma is not difficult because most patients already have a known diagnosis of lymphoma. Nevertheless, it is important to be familiar with both the typical and the atypical manifestations of renal lymphoma because numerous disease processes, normal variants, and artifacts may potentially mimic renal lymphoma.

Adult↗
PubMed1993

Renal streak artifact during contrast-enhanced CT: comparison of low versus high osmolality contrast media.

Two hundred abdominal computed tomographic (CT) scans in 200 patients, 100 performed with low osmolality contrast (ioversol 68%, 100 ml) and 100 performed with high osmolality contrast (diatrizoate meglumine 60%, 150 ml), were retrospectively evaluated for the presence of renal streak artifact. Contrast was administered by hand injection at a rate of approximately 1-2 ml/s and sequential scanning was employed. Of the scans performed with high osmolality contrast, 70% had no artifact, 28% had minimal artifact, and only 2% had marked artifact. Only 26% of the exams performed with low osmolality contrast were artifact-free, whereas 53% demonstrated minimal artifact and 21% demonstrated marked artifact. The likelihood of encountering renal streak artifact when using low osmolality contrast agents is almost seven times greater than when high osmolality contrast agents are used.

Adult↗
PubMed1991

Time-dependent scar enhancement in magnetic resonance imaging of the postoperative lumbar spine.

Magnetic resonance imaging (MRI) has become a principal modality in the evaluation of the post-operative lumbar spine. Gadolinium-diethylenetriamine-pentaacetic acid (Gd-DTPA) can often facilitate differentiation of scar from recurrent disc herniation according to established criteria. Scar has been believed to enhance predictably. We reviewed the contrast-enhanced MR scans of 44 patients who were examined for recurrent back pain following disc surgery and attempted to assess the enhancement characteristics of scar as a function of the time interval between initial surgery and the imaging study. In 44 patients, scar was believed to be present at 32 of 49 disc levels. The degree of enhancement was related to the postoperative interval; those studies performed no later than 9 months after surgery tended to exhibit the greatest degree of enhancement. Surgical confirmation of these MRI findings was available in 12 patients. In patients examined long after surgery, scar enhancement may be less intense than in those examined shortly after surgery, or even nonexistent. This temporal factor should be considered when using contrast material to differentiate scar from recurrent disc herniation in post-operative examinations of the lumbar spine.

Adult↗
PubMed1991

Cross-sectional imaging of idiopathic solitary renal vein varix: report of two cases.

Two cases of solitary renal vein varices are reported which presented as incidental findings on abdominal computed tomography (CT) and were initially thought to represent retroperitoneal lymph nodes. Contrast-enhanced CT, magnetic resonance imaging (MRI), and Doppler ultrasound (US), all demonstrated the vascular nature of these masses suggesting the correct diagnosis. When a rounded soft tissue density mass is seen on noncontrast-enhanced CT either in or contiguous to the renal hilum, a renal vein varix must be excluded. Doppler US, MRI, or dynamic contrast-enhanced CT should be done to exclude a renal varix as the cause.

Aged↗
PubMed1991

Nonvascular intervention in the genitourinary tract.

The past few years have seen significant expansion in interventional genitourinary radiology. Balloon dilatation of the prostate is a new, safe procedure that may be offered as a surgical alternative to high-risk patients as well as to younger patients wishing to avoid surgical complications. The procedure is contraindicated in patients with middle lobe hypertrophy, carcinoma, very large glands, or a history of retention. Because of the lack of large randomized controlled studies, the procedure should still be considered investigational. Transcervical fallopian tube recanalization for proximal tubal occlusion is another new outpatient procedure with low morbidity and cost compared with the more expensive alternatives of in vitro fertilization and tubal microsurgery. Pregnancy rates approach 60% in selected subgroups of patients. Furthermore, selective salpingography may provide diagnostic information not available with conventional hysterosalpingography. The most recent advance in renal parenchymal biopsy has been the development of an automated biopsy gun, which, in conjunction with real-time ultrasonographic monitoring, has increased the ease, speed, and accuracy of the procedure and significantly decreased complications.

Biopsy, Needle↗
PubMed1990

Hypointense renal cell carcinoma: MR imaging with pathologic correlation.

In two pathologically documented cases of renal cell carcinoma, the appearance of the tumors at magnetic resonance (MR) imaging was markedly hypointense relative to normal renal parenchyma on both T1- and T2-weighted spin-echo images. Pathologic examination of both tumors revealed diffuse iron scattered throughout the tumors. The paramagnetic effect of the iron may account for this unusual hypointense appearance at spin-echo imaging, independent of pulse sequence.

Carcinoma, Renal Cell↗
PubMed1990

Optimizing heparin utilization in angiographic flush solutions.

Various concentrations of heparin in angiographic flush solutions are employed during angiography. In an effort to determine whether differences in outcome are seen when either high or low concentrations of heparin in angiographic flush solutions are utilized, two groups of patients were evaluated. There was no difference in outcome and a small systemic effect from heparin was seen in both groups. Use of a low concentration of heparin is suggested for routine angiography.

Angiography↗
PubMed1990

CT anatomy of the internal mammary vessels: importance in planning percutaneous transthoracic procedures.

Knowledge of the anatomy of the internal mammary vessels is important to avoid hemorrhagic complications when an anterior parasternal approach is used for percutaneous transthoracic procedures such as biopsy and empyema drainage. We examined 100 consecutive CT scans of the thorax to assess both the number of internal mammary vessels and their relation to the sternum. The mean distance from the sternum to the most medial vessel, the internal mammary vein, was 1.03 +/- 0.25 cm on the right side and 0.98 +/- 0.23 cm on the left side. The mean distance from the sternum to the most lateral vessel, the internal mammary artery, was 1.57 +/- 0.30 cm on the right and 1.47 +/- 0.30 cm on the left. Three internal mammary vessels were present in 20% of cases on the right side and in 18% on the left side. In nine patients, the internal mammary artery was greater than 2.0 cm from the lateral border of the sternum. We recommend an approach that is greater than 2.5 cm from the sternal border when performing parasternal percutaneous transthoracic procedures in order to avoid hemorrhagic complications from injury to the internal mammary vessels. A "safe" window does exist medially between the sternal border and the internal mammary vein but should be used only in procedures performed under CT guidance.

Adolescent↗
PubMed1988

Deep venous thrombosis evaluation with limited-flip-angle, gradient-refocused MR imaging: preliminary experience.

Sixteen patients (17 lower extremities) were prospectively examined with venography and limited-flip-angle, gradient-refocused magnetic resonance (MR) imaging for the presence or absence of deep venous thrombosis. Thrombosed vessels showed decreased-to-absent signal intensity, while patent vessels had high signal intensity. In 16 of 17 extremities, MR images allowed accurate detection and localization of the thrombi found with venography. In the remaining extremity, MR imaging allowed correct identification of thrombus in the iliac and femoral veins but incorrectly demonstrated clot in the calf and popliteal veins. MR imaging with limited-flip-angle, gradient-refocused pulse sequences appears to be a sensitive, noninvasive means of detecting deep venous thrombosis.

Female↗
PubMed1988

Gastric adenocarcinoma: CT versus surgical staging.

Seventy-five patients with gastric carcinoma underwent preoperative staging with computed tomography (CT). In 14 patients, CT failed to demonstrate lymphadenopathy despite the presence of malignant lymph nodes at surgery. In 13 patients, CT demonstrated enlarged nodes, but no malignant involvement was found at surgery. Although spread to the pancreas was correctly predicted in three patients with lack of fat plane between tumor and pancreas, five patients lacking a fat plane had no invasion, whereas eight patients with an intact fat plane had invasion. Thirty-five patients (47%) were incorrectly staged with CT:23 (31%) were understaged and 12 (16%) were overstaged. CT does not accurately display the true extent of disease in patients with gastric carcinoma and therefore should not be used routinely for staging.

Adenocarcinoma↗
PubMed1988

Peripheral artery atherectomy: description of technique and report of initial results.

Percutaneous transluminal atherectomy has been developed for treatment of peripheral artery stenoses. The atherectomy catheter is inserted through a sheath, and the resection window of the catheter is positioned adjacent to the vascular stenosis. The balloon is inflated, and the motor-driven cutting blade advanced. The balloon is then deflated, the catheter withdrawn, and the atheromatous material, which resembles the resected material of an endarterectomy, removed from the catheter. This process is repeated until the resection provides an adequate lumen. To date, 12 arterial lesions (three common iliac, two external iliac, four superficial femoral, and three popliteal artery) in ten patients have been resected with excellent angiographic results. The conditions of seven patients who underwent atherectomy for relief from claudication were improved by the criteria of ankle/arm ratios and/or claudication distance. Three patients successfully underwent atherectomy for limb salvage. More data on long-term patency and restenosis rates are needed before the ultimate role of atherectomy in the management of peripheral artery disease can be determined.

Adult↗
PubMed1988

Fibromuscular dysplasia of renal arteries: comparison of intravenous digital subtraction angiography with conventional angiography.

Intravenous digital subtraction angiography (IV-DSA) was compared with conventional arteriography (CA) in 14 patients with fibromuscular dysplasia (FMD) of at least one renal artery. IV-DSA identified 29 of the 34 renal arteries detected by CA. A diagnostic quality IV-DSA examination was obtained in 23 of 29 renal arteries (78%). In adequately imaged renal arteries, IV-DSA correctly identified 12 of 20 FMD renal arteries, misdiagnosed 8 FMD renal arteries as normal and correctly identified 3 normal renal arteries. These poor results, due to poor spatial resolution and subtraction artifacts inherent in the IV-DSA system, warrant careful interpretation of negative examinations and further evaluation of high risk patients.

Angiography↗
PubMed1987

Digital intravenous subtraction angiography in the evaluation of reconstructed renal arteries.

Digital intravenous subtraction angiography (DISA) was used to evaluate 28 patients who had undergone renal artery reconstruction either as part of a renal transplant procedure or for treatment of renovascular hypertension. Satisfactory visualization of the renal artery was obtained in 26 cases, and the clinical questions were adequately answered in these cases. The findings included a variety of possible outcomes and demonstrate the adequacy of DISA as a means of evaluating the results of renal artery surgery. Technical and anatomic factors affecting the quality of the examination are discussed. The cases also illustrate the critical importance of thorough familiarity with the surgical procedures in general and of mutual discussion between surgeon and radiologist in optimizing the DISA examination in a given patient.

Adult↗