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S Z Jafri

Publications and source records attributed to S Z Jafri.

At least 19 recordsLinked to original sources
PubMed1996

Genitourinary tract gas: imaging evaluation.

Gas-forming infections of the genitourinary tract may manifest as life-threatening conditions, often requiring aggressive medical and surgical management. Accurate interpretation of the radiologic studies is essential for early and accurate diagnosis of gas within the renal parenchyma or collecting system, bladder, uterus, and scrotum. Three distinct entities are associated with renal or perirenal gas: emphysematous pyelonephritis, emphysematous pyelitis, and gas-forming perirenal abscess. Gas in the bladder may occur secondary to emphysematous cystitis or a vesicoenteric fistula and must be differentiated from air introduced by means of instrumentation. Uterine gas usually indicates an underlying infection or a neoplasm. Gas in the scrotum is most commonly due to an infectious process or bowel herniation into the scrotal sac. Before institution of a specific therapeutic regimen, an effort should be made to establish the exact location of gas in the genitourinary tract. Plain radiography, including tomography, and ultrasonography are useful screening modalities. Although in some cases urography, barium enema studies, and other contrast material-enhanced studies enable a diagnosis to be made, in many patients computed tomography is the definitive diagnostic technique.

Adult↗
PubMed1995

Are pelvic computed tomography, bone scan and pelvic lymphadenectomy necessary in the staging of prostatic cancer?

OBJECTIVE: To investigate the effectiveness and economy of pelvic computed tomography (CT), bone scan and pelvic lymphadenectomy as staging modalities in patients undergoing radical prostatectomy. The use of prostate specific antigen (PSA) and Gleason's score as adjuncts to predict extracapsular disease were also evaluated and their economic implications examined. PATIENTS AND METHODS: Between January 1990 and June 1993, 861 men were newly diagnosed with prostate cancer, of whom 409 underwent surgery. All patients underwent pelvic CT scans and PSA analysis. Patients undergoing surgery had pre-operative bone scans and Gleason's scoring of their pathological tissue. RESULTS: Only 13 (1.5%) of 861 men had positive pelvic CT scans. Of the 409 patients who underwent surgery, all had negative pelvic CT and bone scans, and all underwent a modified pelvic lymphadenectomy; 192 (47%) had extracapsular disease. Only 15 (3.7%) patients who underwent surgery were found to have positive nodes. CONCLUSIONS: The use of pelvic CT and bone scans for clinical staging in patients with a PSA level of < or = 20 ng/mL should not be advocated because they have a very low yield and are not cost effective. We question the role of a modified pelvic lymphadenectomy for staging purposes, either by an open or laparoscopic procedure, because the yield of positive diagnoses is very low.

Bone Neoplasms↗
PubMed1993

CT of congenital and acquired abnormalities of the spleen.

Computed tomography (CT) is an excellent imaging modality for demonstrating the size, shape, and position of the spleen, as well as for depicting intrasplenic pathologic features. However, it has limited value in the diagnosis of splenic involvement by lymphoma. Greater accuracy in diagnosing splenic lymphoma may be obtained by demonstrating adenopathy in the splenic hilum or by showing focal splenic defects, in addition to splenomegaly. In discussing the normal anatomy of the spleen, congenital variations (eg, accessory spleen, polysplenia, asplenia, and wandering spleen), and acquired abnormalities such as those resulting from trauma, infection, infarction, cysts, and neoplasms, this article provides evidence that CT is valuable in showing a wide variety of splenic variations and abnormalities while simultaneously allowing evaluation of the remaining intraabdominal structures. The cases presented demonstrate both the value and limitations of CT in the examination of patients with congenital and acquired abnormalities of the spleen.

Humans↗
PubMed1992

Color Doppler ultrasound of the genitourinary tract.

This paper discusses the role of color Doppler ultrasonography (CDU) as it applies to the genitourinary tract. CDU is beneficial in evaluating both the native and allograft kidney in the diagnosis of renal arterial and venous stenosis, arteriovenous fistulas, pseudoaneurysms, arterial and venous thrombosis, and in the characterization and staging of renal masses. CDU has redefined the role of ultrasonography in the evaluation of the scrotum as it relates to testicular torsion, inflammatory disorders and varicoceles. Early results of CDU in prostate carcinoma and benign prostate hypertrophy have shown limited success. Identifying and assessing the neurovascular bundle may have an impact on the staging of prostate carcinoma. It is hoped that the future addition of ultrasound contrast agents will further establish the role of color Doppler in the diagnosis of a variety of genitourinary diseases and disorders.

Female Urogenital Diseases↗
PubMed1991

Sonography of large scrotal infections.

We have described 14 cases of large scrotal infections with diffuse involvement of testis and epididymis, thick septations within the cavity, and associated thickening of the scrotal wall and tunica albuginea. The combination of these findings should help distinguish this process from a diffuse neoplastic involvement of the testis where the scrotal wall is almost always of normal thickness. The presence of patchy inhomogenous testicular echo pattern should alert the sonologist to the presence of diffuse suppurative epididymo-orchitis, which may result in necrosis with subsequent orchiectomy in such patients.

Epididymitis↗
PubMed1991

Clinical and imaging features of rhabdoid tumor of the kidney.

Rhabdoid tumor of the kidney (RTK) is a rare, highly malignant neoplasm of childhood. The clinical profile of this neoplasm differs from that of Wilms' tumor. We present two cases of RTK. In both our cases, large bulky masses with poorly defined margins and calcifications were demonstrated. The clinical and imaging findings are compared with other childhood renal neoplasms.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Endorectal sonography in the evaluation of rectal and perirectal disease.

Endorectal sonography initially was developed for evaluation of the prostate and now has been adapted for evaluation of rectal and perirectal disease. We used endorectal sonography to evaluate a spectrum of diseases, including primary and recurrent rectal carcinoma, metastases, villous adenoma, leiomyosarcoma, endometriosis, sacrococcygeal teratoma, chordoma, retroperitoneal cystic hamartoma, pelvic lipomatosis, diverticulitis, and perirectal abscess. The technique has been useful in localization of perirectal abscesses and in sonographically guided biopsy of perirectal masses. Knowledge of normal sonographic anatomy of the rectum is essential in the evaluation of rectal and perirectal disease. In this essay, we describe the technique of endorectal sonography and illustrate the sonographic findings in a variety of diseases.

Abscess↗
PubMed1990

Nonoperative management of the adult ruptured spleen.

The risk of postsplenectomy sepsis has led to increased enthusiasm for preservation of the spleen. From January 1984 to December 1988, 51 consecutive adult patients with ruptured spleen sustained from blunt trauma were examined. Thirty-four patients (67%) had their conditions hemodynamically stabilized at the time of hospital admission and were placed on a regimen of strict bed rest with intensive monitoring. The average hemoglobin value at hospital admission in this group was 126 +/- 18 g/L, with an average drop of 17 +/- 14 g/L during their hospitalization; 14 patients required transfusions averaging 3 U each. Nonoperative treatment was successful in 33 (97%) of 34 patients; one patient whose condition deteriorated clinically underwent splenectomy on the fifth hospital day. These patients have been followed up for an average of 28 months with no sequelae from their splenic injury. We conclude that a nonoperative approach is a viable alternative in stable adult patients with splenic injuries due to blunt trauma when intensive monitoring is available.

Adult↗
PubMed1990

Transrectal ultrasound appearance of granulomatous prostatitis.

Granulomatous prostatitis is an uncommon condition that can masquerade as prostatic carcinoma on both digital rectal exam and prostate ultrasound. It occurs most often after acute urinary tract infection, transurethral prostate resection, or needle biopsy. It can be seen in systemic granulomatous diseases and after intravesical bacillus Calmette-Guerin (BCG) therapy for bladder carcinoma. In some cases it is idiopathic. Six patients who underwent transrectal ultrasound of the prostate and subsequent transrectal ultrasound-guided biopsy had histologic diagnosis of granulomatous prostatitis. One patient was undergoing BCG therapy for bladder cancer. Two patients had recent urinary tract infections. The other three patients had no known predisposing conditions. Sonographically, the glands were enlarged in five patients, with multiple large and small hypoechoic zones throughout the peripheral, transition, and central zones. The appearance was similar to that seen in diffuse prostatic carcinoma. In one patient, a solitary hypoechoic lesion in the peripheral zone, indistinguishable from carcinoma, was present. Granulomatous prostatitis should be considered in the differential diagnosis of focal and diffuse abnormality with prostatic ultrasound.

Adult↗
PubMed1989

Computed tomographic evaluation and staging of cecal carcinoma.

The preoperative computed tomographic (CT) scans of 14 patients with biopsy-proven primary adenocarcinoma of the cecum were reviewed to assess clinical presentation, CT findings, and value of staging by CT. The correlation of CT evidence for tumor invasion beyond the bowel wall with histopathology had predictive value of negative examination of 33% with sensitivity of 78%. More importantly, the correlation of metastatic nodal involvement by CT had predictive value of negative examination of 22% with sensitivity of only 12%. Of chief concern was the involvement of pericolic and mesenteric nodal chains that were not discernible by CT. Computed tomographic tumor staging was accurate in 57% of cases and upgraded in 43%. This study concludes that, although predictive values of positive CT examination are high, CT tends to underestimate disease extent.

Adenocarcinoma↗
PubMed1989

Computed tomography of chest wall masses.

The authors argue that CT is superior to other imaging techniques for the examination of the bones and soft tissues of the chest wall. They also note the importance of CT in planning therapy for lesions involving these structures. In support of these theses they present computed tomograms showing 26 different types of lesion involving the chest wall ranging from sternal fracture to malignant fibrous histiocytoma. Malignant neoplasms involving the chest wall by metastasis or direct extension from the breast, lung or mediastinum are emphasized.

Humans↗
PubMed1988

Small renal cell carcinomas: resolving a diagnostic dilemma.

Thirty-nine patients with pathologically proved renal cell carcinomas 3 cm or les in diameter were examined. Results of intravenous urography (n = 30) were true positive in 20 patients and false negative in ten (sensitivity, 67%). Renal ultrasound (US) (n = 29) had true-positive results in 23 patients and false-negative results in six (sensitivity, 79%); computed tomography (CT) (n = 36) had true-positive results in 34 and false-negative results in two (sensitivity, 94%). For selective renal angiography (n = 35%), the results were true positive in 26 and false negative in nine (sensitivity, 74%), with typical hypervascular renal cell carcinomas demonstrated in 17. Finally, the findings of percutaneous fine-needle aspiration biopsy were true positive in one of five patients when US guidance was used (sensitivity, 20%) and in five of eight when CT guidance was used (sensitivity, 62%). Small renal cell carcinomas are more frequently encountered in clinical practice than heretofore realized, and they are best imaged by CT.

Adult↗
PubMed1987

Sonographic detection of interstitial pregnancy.

Interstitial pregnancy is a rare form of ectopic pregnancy that carries a higher morbidity and mortality than other tubal pregnancies. The sonographic findings in 11 cases of proven interstitial pregnancy were reviewed and compared with 12 cases published thus far. An ectopic pregnancy was diagnosed in all cases, and an interstitial location was suspected in five cases preoperatively. An eccentrically located gestational sac surrounded by an asymmetric myometrial mantle and a separate empty uterine cavity with endometrial echoes were the most common findings in our cases. When an interstitial pregnancy is suspected by sonography, confirmation by laparoscopy is recommended.

Adolescent↗
PubMed1987

Urographic and computed tomographic demonstration of ureteroarterial fistula.

Ureteroarterial fistulas are uncommon. We report a patient who developed a spontaneous fistula between the right iliac artery aneurysm and the right ureter. The diagnosis was made by a retrograde pyelogram and body computed tomography. The fistula was ultimately treated by simple transvesical ligation of the distal ureter. A brief description of the case is provided and the cause and management of ureteroarterial fistula are discussed.

Aneurysm↗
PubMed1987

Duodenal neoplasms: role of CT.

In a retrospective study of 14 cases of duodenal neoplasms evaluated by computed tomography (CT), there were four primary adenocarcinomas of the duodenum, one lymphoma, five metastatic carcinomas, two duodenal lipomas, one villous adenoma, and one leiomyoma. The CT findings were diagnostic in patients with duodenal lipomas. In 11 cases, a primary origin of the mass was clearly identifiable in the duodenum. Thickening of the bowel wall, tumor necrosis, ulceration, and intraluminal defects were common. The relationship of the masses to adjacent structures was clearly shown on CT scans. Extraluminal extent of the lesion was noted on CT scans in seven patients; however, at surgery only four of six were found to have extramural disease. The presence of adenopathy, liver metastases, and vascular and mesenteric invasion were also demonstrated on CT scans. Twelve patients underwent upper gastrointestinal tract series. A duodenal abnormality was seen in all 12 patients, but the extramural extent and distant metastatic involvement could not be seen on these examinations. CT scans allowed the accurate staging of eight of ten malignant lesions and thus helped in the management of duodenal tumors.

Adenocarcinoma↗
PubMed1986

Ultrasound evaluation of uncommon renal transplant complications.

Twenty-five patients who had undergone renal transplants developed uncommon complications that were detected and followed serially with sonography. Two patients developed renal calculi, which produced hydronephrosis in both instances. Other uncommon causes of postoperative hydronephrosis occurred in 5 cases; the causes included ureteral necrosis, ureteral stricture, and a renocutaneous fistula. Eight cases of renal infarction, manifesting 3 different sonographic appearances, were encountered. The presence and disappearance of postoperative gas in the collecting system were documented in 3 patients. The other unusual abnormalities detected involving the transplanted kidney include tuberculosis, pyonephrosis, 3 solitary cysts, a corpus lutem cyst simulating a perinephric fluid collection, and massive urinary ascites.

Adolescent↗