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Biomedical subjects

S Mahboubi

Publications and source records attributed to S Mahboubi.

At least 37 records · Page 2Linked to original sources
PubMed1996

Innominate artery compression of the trachea in infants.

Compression of the airway by the innominate artery has been a controversial cause of stridor and apnea in infants. Magnetic resonance imaging has been applied to document the possible association of segmental tracheomalacia. Forty infants with symptoms of stridor were studied, 7 of 40 infants aged 3-21 months (mean 10 months) had innominate artery compression on the trachea. Five infants were treated conservatively and two infants underwent surgery. Flattening of the trachea was longer than the mass compression point by the innominate artery. Therefore, intrinsic abnormality of the trachea is the basis of the respiratory symptom.

Airway Obstruction↗
PubMed1996

Tethered cord and associated vertebral anomalies in children and infants with imperforate anus: evaluation with MR imaging and plain radiography.

PURPOSE: To evaluate in children and infants with imperforate anus the prevalence and types of occult myelodysplasia that may result in tethered cord and the association of these lesions with vertebral anomalies. MATERIALS AND METHODS: Records and images were retrospectively reviewed in 86 patients who underwent spine magnetic resonance imaging and had either low-level imperforate anus (n = 30), intermediate-level imperforate anus (n = 15), or high-level imperforate anus (n = 41). RESULTS: Thirty-one of 86 patients (36%) had occult myelodysplasia suggestive of tethered cord (27% of all patients with low-, 33% of all patients with intermediate-, and 44% of all patients with high-level lesions). Of these 31 patients, 16(52%) were asymptomatic, 24, (77%) had a thickened fatty filum, 13 (42%) had normal conus position, and 23 (74%) had vertebral anomalies. Twenty-four of the 31 patients (77%) underwent surgical untethering. CONCLUSION: A substantial number of patients with all types of imperforate anus have occult myelodysplasia that may necessitate surgical intervention, including those patients with normal spine radiographs.

Abnormalities, Multiple↗
PubMed1996

Magnetic resonance imaging of skewfoot.

Magnetic resonance imaging was used to visualize the ossified and unossified portions of the bones and soft tissues of the feet in order to evaluate the tarsometatarsal anatomy in sixteen children, three months to six years old (mean, fifteen months old), who were seen in the orthopaedic clinic with a suspected diagnosis of skewfoot. Twenty-seven feet were clinically abnormal and five were normal. Of the abnormal feet, twenty-six had a radiographic diagnosis of skewfoot and one, of simple metatarsus adductus. Of the skewfeet, seven had a talocalcaneal angle of 45 degrees or more as measured on the lateral radiograph and six had a talocalcaneal angle of 45 degrees or more as measured on the anterior radiograph. Valgus deformity of the hindfoot was not apparent on clinical examination in any of the children. The talocalcaneal angles measured on the magnetic resonance images corresponded poorly with those measured on the radiographs, possibly because it is not possible to simulate weight-bearing during magnetic resonance imaging or because the effect of partial volume averaging on thin sections. However, magnetic resonance imaging demonstrated the shapes of the bones and the positions of the unossified portions of the bones. Magnetic resonance imaging showed lateral subluxation of the navicular in twenty-four skewfeet, plantar subluxation in ten, and medial subluxation of the first metatarsal on the medial cuneiform in twenty-five. The alignment of the lateral margin of the calcaneus and cuboid on the magnetic resonance images was normal in all patients. Magnetic resonance imaging has the unique ability to show the cartilaginous and ossified portions of the developing bones of the foot.

Child↗
PubMed1995

The pediatric airway.

Accurate diagnosis is important in the evaluation of airway disorders of infants and children. Today, multiple imaging techniques are available to evaluate the pediatric airway. In general, it is best to start with simple and readily available examinations, which may provide a diagnosis in most cases, and progress to more sophisticated studies only in cases where needed.

Bronchi↗
PubMed1995

Langerhans cell histiocytosis: presentation and evolution of radiologic findings with clinical correlation.

Radiologic images and medical records of 42 children with Langerhans cell histiocytosis (LCH) (histiocytosis X) were reviewed to evaluate the presentation of the disease and the evolution of the radiologic findings. There were 26 male and 16 female patients aged 3 months to 18 years. Twenty-two patients presented with localized disease; 20 presented with multifocal disease. Four patients developed diabetes insipidus. Two patients had organ dysfunction. The radiologic findings were largely due to destructive bone lesions; 83% of the patients had at least one affected bone. Isolated soft-tissue masses, interstitial lung disease, and central nervous system abnormalities were also seen. Of patients in whom results of appropriate follow-up were available, 91% showed improvement in their lesions, 43% developed new lesions, and 92% had good clinical outcomes. LCH is usually a self-limited disease with a varied clinical and radiologic presentation. The prognosis is generally poor in children with organ dysfunction. In the absence of organ dysfunction, children with either localized or multifocal LCH have an excellent prognosis.

Adolescent↗
PubMed1994

Postoperative evaluation of pulmonary arteries in congenital heart surgery by magnetic resonance imaging: comparison with echocardiography.

Palliative and corrective operations for the treatment of cyanotic congenital heart disease frequently involve or potentially influence the size of the pulmonary arteries. Echocardiography and magnetic resonance imaging (MRI) are two noninvasive imaging techniques currently used to assess morphologic abnormalities of the pulmonary arteries. The purpose of this study was to evaluate the role of MRI in comparison with echocardiography for defining morphologic changes of the pulmonary arteries after congenital heart surgery. The MRI scans and echocardiograms of 33 patients with surgery involving or affecting the pulmonary arteries were compared. The pulmonary outflow tract, pulmonary confluence, right and left pulmonary arteries, and surgical shunts were separately evaluated. Cineangiography and surgical reports were used to confirm findings. MRI and echocardiography were equivalent for demonstrating abnormalities of the right ventricular outflow tract, main pulmonary artery, and a variety of pulmonary shunts. MRI was superior to echocardiography in demonstrating abnormalities of the right and left pulmonary arterial branches (p < 0.001). MRI is effective for monitoring pulmonary arterial status after surgery and is superior to echocardiography for the evaluation of the right and left pulmonary arteries.

Adolescent↗
PubMed1994

Prevention of radiation enteritis in children, using a pelvic mesh sling.

Between 1986 and 1991, the authors used polyglycolic acid mesh slings (placed at or above the sacral promontory) in eight children with pelvic malignancies to exclude all small bowel from the pelvis during pelvic radiation therapy. The only complications of this treatment were prolonged postoperative ileus (one patient) and temporary, partial small bowel obstruction (one patient). The average amount of radiation administered to the pelvis postoperatively was 5,349 +/- 556 cGy. In one of the eight patients, gastrointestinal symptoms (diarrhea for 24 hours) developed during radiation therapy. Early radiological evaluation confirmed that the small bowel was out of the pelvis in all five of the patients studied. Mesh disruption occurred between 2 and 5 months postoperatively (mean, 3.4 +/- 1.5 months) and was often identified symptomatically by the patient. Seven of the eight survived, with disease remission in six. Pelvic disease was absent at the time of death in the one patient who did not survive. Throughout the follow-up period (mean, 20 months) no survivor has had delayed symptoms of radiation enteritis. In children with pelvic malignancies in whom aggressive application of pelvic irradiation is required, the use of an absorbable pelvic mesh sling appears efficacious in preventing radiation-associated enteritis.

Child↗
PubMed1994

Magnetic resonance imaging of airway obstruction resulting from vascular anomalies.

Accurate diagnosis is important in the evaluation of airway disorders of infants and children. Today, multiple imaging techniques are available to evaluate the pediatric airway. We performed magnetic resonance (MR) imaging of the airway in 16 infants and children with symptoms of airway obstruction. Fourteen of 16 patients symptoms were related to compression of the airway by vascular structure. MR imaging was useful in the diagnosis and management of these patients without the need for more invasive procedures.

Aorta↗
PubMed1993

Acute liver rejection: evaluation with cell-directed MR contrast agents in a rat transplantation model.

Enhancement patterns with gadolinium (4s)-4-(4-ethoxybenzyl)-3,6,9-tris (carboxylatomethyl)-3,6,9-triazaundecandioic acid (EOB) diethylenetriaminepentaacetic acid (DTPA), a hepatocyte-directed magnetic resonance (MR) contrast agent, and superparamagnetic iron oxide particles (SPIO), a Kupffer cell-directed contrast agent, were compared at MR imaging in rat models of allogeneic and syngeneic liver transplantation. Light and electron microscopy were performed to monitor the morphologic changes in these livers and revealed typical findings in acute rejecting liver (allogeneic transplants) and normal architecture in syngeneic transplants. Liver enhancement with Gd-EOB-DTPA at MR imaging was delayed and prolonged with transplantation, and even more with rejection, but the level of enhancement when compared with that of control rats remained unaffected. Uptake of SPIO was decreased in the acutely rejecting livers but was normal in the syngeneic transplantation model. Enhanced MR imaging with cell-directed contrast agents depicted decreased phagocytotic activity in acute transplant rejection and enabled the excretory function of hepatocytes to be monitored. Additionally, Gd-EOB-DTPA may be applied advantageously for detection of focal lesions in transplanted livers.

Acute Disease↗
PubMed1993

Relationship between the ossification center and cartilaginous anlage in the normal hindfoot in children: study with MR imaging.

OBJECTIVE: Although many reports have documented when ossification centers can first be visualized on radiographs, few studies have evaluated the position of the ossification center within its cartilaginous anlage. In the skeletally immature child, the ossification centers of the tarsals are used to evaluate the positions of the tarsals and their interrelationships. It is convenient to assume that tarsal ossification begins in the center of its cartilaginous anlage and proceeds in a radial fashion; however, this may not be the case. Accordingly, we used MR imaging to evaluate the location of the ossification centers of the tarsals within their cartilaginous anlage in the mid and hindfoot in children. MATERIALS AND METHODS: MR studies of 69 feet in 40 children, 3 months to 7 years old (mean, 2.5 years), were reviewed retrospectively. The location of the ossification center within its cartilaginous anlage and the percentage of ossification of the cartilaginous anlagen of the talus, calcaneus, cuboid bone, and navicular bone were determined from coronal and sagittal images. In the talus, the difference between the orientation of the long axis of its ossification center and the long axis of its cartilaginous anlage was measured on coronal and sagittal images. RESULTS: Early talar ossification was centered on the neck of the talus; the proximal aspect of the bone ossified last. The long axis of the talar ossification center and the long axis of its cartilaginous anlage differed in orientation. Early calcaneal ossification was centered on the distal two thirds of the cartilaginous anlage of the calcaneus; the proximal aspect and the area of the subtalar joint ossified last. Early navicular ossification was centered on the central or lateral third of the navicular cartilaginous anlage; the medial aspect ossified last. The ossification center of the cuboid bone was in the middle of the cuboidal cartilaginous anlage. CONCLUSION: Our results show that early ossification in the talus, calcaneus, and navicular bones does not begin in the center of the bones' cartilaginous anlagen. The orientations of the long axis of the talar ossification center and the long mid axis of its cartilaginous anlage are different. Therefore, part of the changes in the alignment of the tarsals seen on radiographs with growth is due to ossification beginning and proceeding eccentrically within the cartilaginous anlage and not to a true change in the alignment of the tarsals. These data provide new information about the normal development of the child's hindfoot and midfoot.

Cartilage↗
PubMed1993

Correlative imaging of pelvic soft tissue sarcomas in children.

The authors retrospectively reviewed 15 cases of pelvic soft tissue sarcoma treated at the Children's Hospital of Philadelphia during a recent 6-year period. These patients were treated before the availability of magnetic resonance imaging. The authors compared ultrasonography, computed tomography, and excretory urography/voiding cystourethrography for establishing the diagnosis and following the progression/regression of the disease. Results were correlated with clinical, surgical, and pathologic findings. Although computed tomography and ultrasonography were both capable of characterizing the size and texture of the lesion, computed tomography was superior in defining disease arising from the pelvic sidewall. Both techniques effectively identified residual mass at the tumor site, but neither could differentiate active tumor from inactive tumor, posttherapy inflammation, or fibrosis. Excretory urography/voiding cystourethrography provided no information that could not be gleaned from either ultrasonography or computed tomography.

Child↗
PubMed1992

Malignant endobronchial lesions of adolescence.

Rare primary endobronchial malignancies were diagnosed in four adolescents: atypical bronchial carcinoid, mucoepidermoid carcinoma, bronchogenic (squamous cell) carcinoma, and non-Hodgkin's lymphoma. Metastatic disease was evident in each case. Three of the four patients died within one year of diagnosis. This paper describes each of these entities, illustrates their plain film and CT abnormalities (bronchial "cut-off", hilar mass, local congestive edema, lobar collapse, hyperinflation), and discusses the utility of CT in their diagnosis.

Adolescent↗
PubMed1992

Diagnosis of liver disease in children: value of MR angiography.

We retrospectively studied the clinical use of MR angiography, a gradient-echo technique susceptible to motion, in the preoperative evaluation of the hepatic vasculature in children with liver disease. Twenty imaging examinations were performed in 18 patients 3 months to 10 years old (mean, 2.3 years). Eleven patients had liver tumors and seven had cirrhosis associated with biliary atresia, cystic fibrosis, and short-bowel syndrome. Respiratory motion artifacts were present in most patients, but all MR angiographic studies were technically adequate. Comparing MR angiograms with spin-echo images, we found that vascular visualization was better with MR angiography in 12 cases (60%), equal in five (25%), and worse in three (15%). In 10 of 20 cases, MR angiography provided additional vascular information not present on spin-echo images. MR angiography is a useful adjunct to spin-echo imaging for assessing hepatic vascular anatomy in children with liver disease.

Angiography↗
PubMed1991

Diagnosis and follow-up of children with Wilms' tumor: correlative study of ultrasound and computed tomography. Report of eighteen cases.

A retrospective study of 18 children with Wilms' tumor was performed to compare the efficacy of ultrasound (US) and computed tomography (CT) for the diagnosis, staging, and follow-up evaluation of these patients. US and CT were found to be complementary to one another in evaluation of Wilms' tumor. In one patient, CT was more accurate than US in determining the organ of origin of a very large tumor. US is superior to CT for the evaluation of thrombosis in IVC. It can define whether or not the thrombus is attached to the wall of the IVC. This finding has a major impact on the management of the patient.

Adolescent↗
PubMed1989

Computed tomography of cervical cystic hygroma in the neck.

The computed tomography findings in 4 infants and children with surgically proved cystic hygroma of the neck were reviewed and correlated with pathologic specimens. Cervical cystic hygroma characteristically appears on CT scan as a multiloculated cystic mass with smooth septa of variable thickness, which enhances uniformly following bolus injection of contrast media administration. This CT pattern can usually be used to differentiate cystic hygromas from other cervical masses such as soft tissue sarcomas. CT is also helpful in determining the extent of the lesion prior to the surgery and in assessing the recurrences.

Child↗
PubMed1989

Tracheomegaly in children.

Three children with tracheomegaly were studied by CT scan at The Children's Hospital of Philadelphia. Normal age-related tracheal dimensions were obtained from a study by Griscom (1). Tracheomegaly was defined as tracheal dimensions greater than 2 SD above normal. In two of our patients, tracheomegaly was associated with intubation and ventilatory support, and in the third, it was associated with recurrent pneumonia and chronic bronchitis. In this article, we discuss the etiologies of tracheomegaly in our patients and review the literature on the subject.

Child↗
PubMed1989

Nondiaphyseal osteoid osteomas in the pediatric patient.

Nondiaphyseal osteoid osteomas lack the classic roentgenographic appearance of diaphyseal lesions. This may delay diagnosis and treatment. This paper reports on seven children with nondiaphyseal osteoid osteoma seen consecutively. Delay in making the diagnoses, once the children were examined by orthopedic surgeons, averaged six months. Absence of the classic roentgenographic appearance led to the delay in these cases. The difficulty in diagnosing the lesion on routine roentgenograms derives from the specific reaction to the lesion by cancellous bone as compared to cortical bone. Bone scans proved to be sensitive at locating a focal area of intense uptake but lacked the specificity to make the diagnosis. Computed tomography (CT) was quite specific at making the diagnosis and localizing the lesion for biopsy. How to differentiate between osteoid osteoma and osteomyelitis by CT is described. When osteoid osteoma is suspected in nondiaphyseal locations, CT is likely to aid in the diagnosis and localization of the lesion for biopsy.

Adolescent↗