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Biomedical subjects

S Youssefzadeh

Publications and source records attributed to S Youssefzadeh.

At least 37 records · Page 2Linked to original sources

Reduction of adverse events in MRI of the breast by personal patient care.

PURPOSE: To determine the difference in anxiety reactions in patients undergoing standard (non-breast) magnetic resonance imaging (MRI) compared to breast magnetic resonance imaging (MRM) and to evaluate the influence of patient information before the breast imaging examination on the rate of premature termination of the procedure. MATERIALS AND METHODS: Over 2 years, 5837 non-breast and 336 breast magnetic resonance examinations were performed at our institution. One group of breast MRM patients (n = 144) received detailed information and a second group (n = 189) received only routine information before MRI. The rates of premature termination were recorded for all groups. RESULTS: In 0.5% (27/5837) of patients undergoing standard MRI examinations the study had to be stopped prematurely. Of the breast MRM patients, those who had received only routine information had a significantly higher rate of premature termination when compared to the better-informed patients and those undergoing standard MRI (5.5%, 10/189, P= 0.01). A significantly lower rate of premature termination occurred in the better-informed breast group (0%, 0/144). CONCLUSION: MRM is associated with an increase in patient anxiety and higher rates of incomplete examination than other MR procedures. We recommend careful patient preparation including detailed verbal information before MRM and support during the procedure to obtain optimal patient compliance.

Anxiety↗

A study of the effects of patient anxiety, perceptions and equipment on motion artifacts in magnetic resonance imaging.

We investigated to see if motion artifacts (MA) occurring in magnetic resonance imaging (MRI) are related to prescan anxiety measures and test the feasibility of identifying patients at risk for the development of MA before scanning. Furthermore, to determine a possible influence of constructional differences between a 1.5 and a 0.5 tesla scanner on the frequency of MA. Two hundred and ninety-seven first time MRI patients were surveyed before and after imaging with anxiety and attitude questionnaires. Frequency and impact on diagnostic quality of MA were documented. 12.8% of all scans showed MA not related to normal body pulsations. In 6.4% the diagnostic quality was impaired. Constructional differences did not influence the frequency of MA. Also, anxiety as determined with the most common anxiety measuring instrument was not related to the development of MA. Concern about the technical apparatus identified 70.6% of all individuals developing MA. Patients at risk for the development of MA can be identified prior to scanning. It seems necessary to further develop reliable methods to detect them and to evaluate strategies to prevent MA.

Adult↗

[Cholestasis syndrome in newborn infants: value of gallbladder ultrasound].

PURPOSE: Evaluation of sonography in the assessment of changes of the biliary system of newborn infants receiving total parenteral nutrition. PATIENTS AND METHODS: In 20 premature infants on mechanical ventilation, the influence of two different amino acid solutions (Vaminolac, Paedamin) in the development of neonatal cholestasis was analysed. The patients were randomised in two groups. Group 1 (n = 11) received Paedamin, group 2 (n = 9) received Vaminolac. RESULTS: There was no statistically significant influence of the amino acid solution on the development of cholestasis. However, the majority of the children with cholestasis (8 of 11) presented with sepsis. CONCLUSION: Bacterial infections seem to be closely related to the development of cholestasis. Sludge formation within the bile ducts represents a sensitive sonographic parameter for the diagnosis and follow-up of cholestasis secondary to total parenteral nutrition.

Amino Acids↗

Coaxial technique: approach to breast core biopsies.

PURPOSE: To assess the feasibility of the coaxial core breast biopsy technique performed under stereotactic and ultrasound (US) guidance in vitro and in vivo. MATERIALS AND METHODS: Biopsies were performed in vitro and in vivo with a coaxial technique. In vitro, the true needle-tip deviation was measured with a breast phantom on a stereotactic device with alteration of x and y axes. In vitro US studies were performed to evaluate the optimal technique for harvesting sufficient material for histologic work-up. In 205 patients, coaxial biopsy was performed in 210 suspicious lesions under US (61 lesions) or stereotactic (patient in the sitting position, n = 67; patient in the prone position, n = 82) guidance. In addition, the coaxial system was used for preoperative localization. Surgery and histologic work-up were performed in all cases. RESULTS: In vitro, the true needle-tip deviation was found to be less than indicated on the stereotactic device. A factor was introduced to correct this error. For US guidance, angulation or rotation of the coaxial needle within the lesion proved to be the best technique to increase the size of histologic specimen. Of the 210 lesions, 112 were benign and 98 were malignant. Agreement between biopsy results and final postsurgical histologic analysis was found in 205 cases (98%). CONCLUSION: The coaxial breast biopsy technique is an accurate, simple, and time-saving method performed under stereotactic or US guidance.

Adult↗

Diaphragmatic dysfunction after heart or lung transplantation.

BACKGROUND: The aim of this study was to evaluate the incidence and outcome of diaphragmatic dysfunction in patients after heart or lung transplantation and to assess the value of bedside sonography for the detection of diaphragmatic dysfunction. METHODS: We prospectively evaluated 33 heart transplant recipients and 27 lung transplant recipients by use of sonography of the diaphragm and fluoroscopy. RESULTS: Diaphragmatic dysfunction, diagnosed with ultrasonography and confirmed with fluoroscopy, was present in four heart transplant recipients (12.1%) and two lung transplant recipients (7.4%) and such dysfunction led to a statistically significant higher incidence of pneumonia during hospitalization and a nonstatistically significant increased length of intubation compared with patients with normal diaphragmatic function. CONCLUSION: Diaphragmatic dysfunction, which can be reliably diagnosed with bedside sonography, is common after heart and lung transplantation and seems to have a negative influence on patient recovery.

Adult↗

Use of resistance index for the diagnosis of breast tumours.

AIM: To determine whether the resistance index (RI) contributes to the differential diagnosis of breast masses. PATIENTS AND METHODS: In 56 breast tumours colour-coded Doppler sonography was performed and their resistance indices calculated from their spectral Doppler tracings. Histologic evaluation was obtained by excision biopsy. RESULTS: In seven of 28 benign tumours (25%) no lesion was seen on ultrasound. In another seven benign tumours, no intratumoral vessels were demonstrated. The resistance index of the remaining 14 lesions (50%) varied between 0.5 and 0.75 with a mean value of 0.62 (standard deviation 0.08). Ultrasound missed one of 28 carcinomas (3.5%) and in one other tumour (3.5%) no flow was demonstrable. The resistance index of 26 malignant tumours varied between 0.56 and 0.9 with a mean value of 0.7 (standard deviation 0.08). CONCLUSION: Breast malignancies have higher resistance indices with a wider range as assessed by colour-coded Doppler ultrasound (81% exceed 0.6) than do benign lesions. Due to the considerable overlap of the range of the resistance index, the measurements in any single patient may not be diagnostic. The absence of flow does not definitively exclude malignancy.

Adolescent↗

[Ultrasound diagnosis of the popliteal fossa].

Sonography of the knee is a well-established method for the diagnosis of palpable tumors. However, evaluation of the menisci, cruciate ligaments, and hyaline cartilage is controversial. Despite the variable echogenicity and extension of different diseases, many distinct sonographic signs are different in cysts, solid neoplasms, and vascular diseases. The investigator must be familiar with various patterns of popliteal cyst formation: crescent-shaped, cross-shaped, slitlike, and grape-like cysts. Because of diagnostic and economic reasons the following concept should provide guidance when diagnosing lesions of the popliteal fossa: the first step of diagnostic imaging should include plain film radiography and sonography. In a second step MRI and/or arthroscopy should be performed.

Aneurysm↗

[Magnetic resonance imaging of breast implants. Significance compared to mammography and ultrasonography].

Magnetic resonance imaging (MRI), mammography and ultrasonography were performed in 44 consecutive women (mean age 45 [29-70] years) with a total of 73 silicone breast implants. The implant had been inserted after mastectomy for cancer in 15 patients, for cosmetic breast augmentation in 29. MRI proved to be superior to the other two imaging modalities with respect to assessing implant content, capsule and surrounding tissues. In 39 patients MRI clearly demarcated the implant from the residual breast tissue. But in four patients the lateral MRI assessment was impaired by phase artefact and in one other by movement artefacts in a restless patient. Implant thickness was underestimated by mammography and ultrasonography compared with MRI. In nine cases mammography showed retromammary parenchyma, while MRI did so in 20. The posterior wall of the implant was visualized by mammography in only one patient, but in all of them by MRI. Ultrasonography failed in all patients to show the entire implant circumference. In three cases MRI was the only imaging method which revealed a defect in the implant capsule with extrusion of silicone.

Adult↗

[Recurrent renal vein thrombosis in a premature infant. Doppler ultrasound diagnosis and follow-up].

Renal vein thrombosis (RVT) is a rare disorder in neonates. Early diagnosis is mandatory since immediate thrombolytic therapy favours prognosis. Our case report describes RVT demonstrated by Duplex Doppler Ultrasound. A possibly characteristic sequence of changes in the echogenicity of the renal parenchyma and in the Duplex Doppler flow pattern of the renal arteries could be found.

Blood Flow Velocity↗

[The long-term changes after the implantation of silicone breast prostheses].

In a prospective study 60 patients with unilateral or bilateral mammary implants underwent mammography and sonography. Location, form and structure of the implants were evaluated. Additionally capsular fibrosis and its influence on the imaging quality of parenchyma was scored. We found increasing implant deformities and increasing density of the implants with increasing postoperative interval. There was poor statistically significant correlation between the thickness of the periprosthetic capsular and the postoperative interval in prepectoral implants (r = 0.555, p < 0.01); in case of subpectoral implants there was no such correlation. In 88% of the cases imaging quality was scored as adequate by two independent observers, with additional views in all cases. We conclude that sufficient imaging quality for the assessment of parenchyma and of potential implants complications may be obtained by the combination of mammography and sonography.

Adult↗

[Plasmacytoma of the nose and paranasal sinuses with intracranial and orbital extension].

A rare case of a solitary extramedullary plasmocytoma of the nasal cavity and the paranasal sinuses with orbital and intracranial extension of a 61-year old male patient was examined clinically, histologically and immunohistologically. The interrelationship of the generalised disease (multiple myeloma = MM) and the solitary extramedullary form (extramedullary plasmocytoma = EMP) is discussed as well as the importance of the magnetic resonance imaging in the diagnosis of tumours of the facial part of the skull.

Antineoplastic Combined Chemotherapy Protocols↗

[The sonography of laryngeal cysts].

To evaluate the sonographic appearance of laryngeal cysts, ultrasound examinations of 7 patients were evaluated retrospectively. The ultrasound studies were correlated with endoscopic findings. In two cases, the diagnosis was confirmed histologically, and in 4 patients, a CT examination was additionally performed. The endolaryngeal space could be well seen if the thyroid cartilage was not calcified (n = 6), whereas in one patient, the endolaryngeal part of the cyst could not be seen because of complete calcification of the thyroid cartilage. The laryngeal cysts presented as unechoic (n = 4) or hypoechoic (n = 3) masses, which demonstrated smooth margins in all cases and ranged in size from 6 to 38 mm. In three cases, the cyst was located in the endolaryngeal space, and in 4 cases, it extended cranial of the thyroid cartilage into the pre-epiglottic space. All cysts were closely related to the inner surface of the thyroid cartilage, from which they were delineated by a thin hyperechoic band in all cases.

Adult↗

Comparison of dual energy X-ray absorptiometry of the proximal femur with morphologic data.

Measurements of bone mineral density (BMD) of the proximal femur (including femoral neck, Ward's triangle and trochanteric region) were compared with the Singh index grading in 40 normal subjects (20 male, 20 female) and in 116 patients (18 male, 98 female) referred for assessment of possible osteoporosis. Additionally, the BMD and the Singh index of 12 cadaver specimens (6 male, 6 female) of the proximal femur were compared with each other and with the histomorphology of the femoral necks of the specimens. Although there was a good correlation of Singh index with BMD in the group of male patients with suspected osteoporosis and in the series of bone specimens, there was a poor correlation in the group of female patients as well as in the normal controls and in the patient population as a whole. There was also poor correlation of Singh index values with histomorphologic data, whereas the BMD measurements correlated well with the amount of calcified bone found histologically in the femoral necks of the bone specimens. We conclude that the Singh index cannot be used to predict BMD of the proximal femur accurately.

Absorptiometry, Photon↗

[Better evaluability of post-therapeutic mammograms using a double-exposure technic. A prospective perception study].

The authors have found the results of a dual-exposure technique for the breast which proved very useful for evaluations following surgery and irradiation. The technique consists of double exposure of the treated breast on two films, one with the exposure data of the normal breast and one with two additional mAs steps. The two films demonstrate anatomical details better than conventional techniques. The over-exposed film shows 18% more reticular patterns than the standard exposure. The authors believe that the dual-exposure technique is a valuable adjunct in the management of the postoperative breast-cancer patient.

Austria↗

Spiral CT during selective accessory renal artery angiography: assessment of vascular territory before aortic stent-grafting.

We evaluated the vascular territory of accessory renal arteries in cases where the vessel might be overlapped by an aortic stent-graft. Spiral CT during selective accessory renal artery angiography was performed in four patients with abdominal aortic aneurysms (including one with a horseshoe kidney). The volume of the vascular territory of each renal artery was measured using a software program provided by the CT unit manufacturer. The supernumerary renal arteries perfused 32%, 37%, 15%, and 16% of the total renal mass, respectively. In two patients, stent-grafts were implanted, which resulted in occlusion of the supernumerary renal artery. The volume of the renal infarction was equal to the volume perfused by the artery as calculated before implantation of the stent-graft. The method proposed is accurate for estimating the size of the expected renal infarction. It might help to determine whether placement of a stent-graft is acceptable.

Aorta, Abdominal↗