PubMed Health⌕ Search

Biomedical subjects

T L Slovis

Publications and source records attributed to T L Slovis.

At least 19 recordsLinked to original sources
PubMed1992

Recurrent pneumatosis intestinalis in young infants.

In 67 infants with necrotizing enterocolitis (NEC) at Children's Hospital of Michigan from 1987-1990, three had recurrent pneumatosis intestinalis (PI) after the neonatal period and after hospital discharge. All three infants were premature (26-34 weeks), and one had an additional risk factor of gastroschisis. All three had their initial episode of NEC within the first month of life. Two had bowel resections, and one was treated medically. 15 h to seven months after discharge from the hospital, all three infants developed recurrent PI at ages ranging from 2.5 to 9 months. Two of the infants had free intraperitoneal air. Though all three infants had PI, only one had true recurrent NEC with ischemic bowel and died. This baby was the only one with rotazyme positive stools. The second infant, who had surgery for gastroschisis, had incomplete obstruction secondary to adhesions resulting in PI. Since surgery this infant has thrived. The third infant had extensive PI of the colon with free air. At surgery there was no evidence of bowel perforation. The free air was attributed to rupture of one of the many colonic cysts of PI. Subsequently, the child has done well. Recurrent PI in infants who have had NEC is unusual and the causes are varied. Because more neonates are surviving NEC, the pediatric radiologist needs to be aware of this delayed complication.

Age Factors↗
PubMed1992

Aberrant thymus--MR assessment.

Aberrant thymic tissue, particularly when it is located posteriorly, can present a diagnostic dilemma. Once a mediastinal "lesion" is defined on the plain film, MR is the most efficient and best diagnostic test for defining the nature of the mass and showing its relationship to other mediastinal structures. Two cases of aberrant thymic tissue, one on the right side and one on the left, are presented to elucidate the unique role of MRI.

Choristoma↗
PubMed1992

Imaging of Wilms' tumor: what is important!

The imaging of Wilms' tumor needs to be quite focused so that the oncologist and surgeon can most precisely stage the patient before operation. The imager needs to be exact about the extent of the primary tumor and define any invasion into the adjacent soft tissues. The ability to detect nodal disease is quite difficult but clearly influences the preoperative approach and staging. Children with large tumors extending across the midline in whom primary resection may lead to tumor spillage are prime candidates for preoperative chemotherapy, and the imager has significant input in making this decision. The imager must define metastases in the lungs and the liver and evaluate the risk of bilateral tumor (particularly metachronous) by searching the index kidney for multifocal lesions or nephroblastomatosis in either kidney.

Child↗
PubMed1992

Congenital subglottic hemangioma: frequency of symmetric subglottic narrowing on frontal radiographs of the neck.

OBJECTIVE: This study was undertaken to determine how often symmetric subglottic airway narrowing is present in cases of infantile subglottic stenosis and to determine if the radiographic finding has any association with the anatomic location of the hemangioma. MATERIALS AND METHODS: All cases (n = 12) of endoscopically proved subglottic hemangioma from 1976 to 1991 were collected from the records at Children's Hospital of Michigan. In 10 cases, high-kilovoltage magnification studies or frontal radiographs of the neck were available for review by two observers who classified the subglottic narrowing as either symmetric or asymmetric. The radiographic findings in these 10 cases were then compared with the location and extent of the lesion as described endoscopically. RESULTS: In 50% of cases (n = 5), narrowing of the subglottic airway was symmetric. In four of these the hemangioma was either situated on the posterior wall or was circumferential, and in the remaining one an associated marked fibrotic reaction to a lateral wall lesion was present. All other lesions were on the lateral wall, and asymmetric subglottic airway narrowing was consistently shown on radiographs. CONCLUSION: Our results show that subglottic hemangioma often manifests as a symmetric subglottic airway narrowing and that the anatomic location of the hemangioma appears to be associated with the appearance on radiographs.

Glottis↗
PubMed1991

The clinical usefulness of teleradiology of neonates: expanded services without expanded staff.

Teleradiology was utilized to link an offsite, high-risk nursery to the Department of Pediatric Radiology of Children's Hospital of Michigan. Interpretations via teleradiology were made in 4200 examinations and taken as the final reading. There was no expansion of either professional or technical personnel at either hospital to accomplish these ends. During the initial 3 months of the study, 40% of the teleradiographic images were double-read to evaluate the accuracy of the technique. During the subsequent 9 months, 17% of the cases were double-read, for an overall double-reading of 23%. There was a 98% agreement between the interpretations made using teleradiology and those made using hard copy. In no instances of the 2% (20 cases) in which there was disagreement between readings did the difference have clinical significance. Our results indicate that teleradiology linkage for interpreting neonatal examinations serves as a valuable tool for expansion of subspecialty expertise, allows more expedient recognition of abnormalities in the neonate, and facilitates faster transport to the appropriate tertiary care center.

Computer Communication Networks↗
PubMed1991

Comparison of indium-111 scintigraphy and colonoscopy with histologic study in children for evaluation of colonic chronic inflammatory bowel disease.

Indium-111 leukocyte scanning and colonoscopy were performed in 19 children and adolescents with chronic inflammatory bowel disease to study the correlation of evaluation between these two diagnostic modalities in comparison to histologic study for colonic disease. Seven patients had ulcerative colitis, 10 had Crohn's disease, and two patients had no specific diagnosis after evaluation. The sensitivity of indium-111 scan was 18%, specificity was 62.5%, and accuracy for diagnosing colonic disease was only 37%. In comparison, sensitivity and specificity for colonoscopy were 100 and 57%, respectively. Furthermore, accuracy with colonoscopy was 84%. Our data suggest that the usefulness of scans is limited to patients in whom standard diagnostic procedures are contraindicated. In addition, it is essential to confirm the visual diagnostic impression on colonoscopy with histologic study.

Adolescent↗
PubMed1991

Transcranial sonography through the burr hole for detection of ventriculomegaly. A preliminary report.

Detection of ventriculomegaly in a child with a ventricular shunt is important in the diagnosis of shunt malfunction. The feasibility of visualizing the ventricles through a 2-cm burr hole, with the use of a small-footprint 7-MHz transducer, was evaluated in five infants. Each burr hole remained patent during the study (2-6 months), and in all infants correlation between views through the anterior fontanelle and the burr hole were in agreement. When ventriculomegaly can be detected by this technique, the need for CT evaluation may be obviated. Further study is necessary to evaluate extended burr holes in older children compared to their CT examinations.

Arachnoid Cysts↗
PubMed1990

Accuracy of ultrasonic bladder volume measurement in children.

The accuracy of ultrasonography in assessing the bladder volume in 13 children with normal bladder contours was determined using the formula D x H x W (depth x height x width) with a mean error of 15.7%. This formula tends to overestimate the bladder volume in these patients. Multiplication by a correction factor of 0.9 yields a mean error of 11.5%. The accuracy of this evaluation is not dependent upon the bladder volume as the mean error was the same in those children whose bladder volume was either less than or greater than 150 cc. In addition, the accuracy of ultrasonography in assessing bladder volume was evaluated in 7 patients with an abnormal bladder contour (trabeculation, diverticula, etc.); mean error was 14.7%. In these 7 patients there was no predictable under or overestimation of bladder volume. In the children with abnormal bladder contours on ultrasound, the correction factor of 0.9 should not be used, as it does not add to the accuracy of the procedure in any individual patient. This technique is still valuable, however, in children with an abnormal bladder for it allows estimation of the extent of emptying without invasive catheterization.

Adolescent↗
PubMed1990

Congenital neuroblastoma: evaluation with multimodality imaging.

The authors retrospectively evaluated 12 patients with congenital (neonatal) neuroblastoma to assess the utility of newer imaging modalities. Findings at prenatal ultrasound (US), performed in four patients, were nonspecific (hydramnios and hydrops fetalis) in two and consistent with a suprarenal mass (one solid, one cystic) in the other two. Postnatal US helped accurately detect adrenal tumors (solid or complex, with one exception) but was less accurate in the diagnosis of metastatic disease to the liver. Computed tomography accurately depicted all primary tumors and liver metastases. Magnetic resonance (MR) imaging helped establish the correct diagnosis in three patients. This study again confirmed the benign course of neonatal neuroblastoma, with 50% of the patients classified with stage IV-S disease and two deaths occurring in the series, both due to complications. Therefore, aggressive diagnostic imaging is less desirable, and US is therefore very useful, despite its limitations. The prenatal detection and solid appearance of a suprarenal mass makes the diagnosis of neuroblastoma very likely, as does the presence of liver lesions. In the absence of these characteristic findings, US should be repeated to exclude adrenal hemorrhage. MR imaging seems to be a good alternative in some instances.

Adrenal Gland Neoplasms↗
PubMed1990

Sonographic and Doppler features of infantile hepatic hemangiomas with pathologic correlation.

The sonograms of five patients with a diagnosis of infantile hepatic hemangioma were retrospectively reviewed to analyze their sonographic and Doppler characteristics. Three patients had single lesions, whereas two had multifocal involvement. All lesions except one were hypoechoic, well-circumscribed, and solid; the exception was hyperechoic. Findings of high flow, ie, large draining veins, an abrupt change in aortic caliber, and the presence of Doppler signal throughout the lesion were seen in three of five patients. The sonographic findings correlate well with the pathologic findings of multiple vascular channels separated by fibrous septa. The major differential diagnosis of infantile hepatic hemangioma includes hepatoblastoma and metastatic neuroblastoma. Although some of their sonographic features may simulate a hemangioma, large draining veins and changes in aortic caliber are not reportedly seen. Doppler flow was not seen in either of these malignant neoplasms in our study and, to date, has only been reported peripheral to three cases of hepatoblastoma and not at all in metastatic neuroblastoma. We propose an algorithmic approach dependent upon the sonographic-Doppler appearance.

Hemangioma, Cavernous↗
PubMed1979

Intrathoracic kidney.

Five cases of intrathoracic kidney are presented, and the literature is reviewed. The diagnosis was made incidentally in 3 patients who had chest radiographs because of upper respiratory tract infections and in 1 infant on a follow-up radiograph after recovery from hyaline membrane disease. The fifth patient had an abdominal mass. All 5 patients had a left intrathoracic kidney, and 2 had a left Bochdalek hernia. An intrathoracic kidney should be considered in the differential diagnosis of a posterior mediastinal mass.

Child, Preschool↗
PubMed1978

Visualization of the intestinal tract by amniography in a fetus with esophageal atresia.

In pregnancies complicated by hydramnios, amniography can be used for the detection of fetal gastrointestinal obstruction. A case is presented in which the appearance of contrast material in the fetal gastrointestinal tract was noted in an infant who proved to have esophageal atresia and tracheoesophageal fistula. Presumably, the contrast reached the intestinal tract by aspiration and passage through the fistula.

Adult↗
PubMed1978

Hemophilus influenzae type b pneumonia in 43 children.

Using positive blood, lung, or pleural fluid cultures as definitive criteria for bacterial infection, 43 examples of Hemophilus influenzae type b pneumonia were identified in a 43-month period. The mean age of the patients was 26 months; 12% were older than 5 years of age. Associated infections were found in 34 patients and included upper respiratory infections, otitis media, epiglottitis, and meningitis. Positive nasopharyngeal cultures were observed in only 33%. Radiologically, segmental or lobar infiltrates accounted for 85% of the pneumonias. In two cases, death was attributed to the pneumonia alone. Treatment with penicillin G or ampicillin was equally effective. Our data suggest that H. influenzae pneumonia is commonly a serious infection that cannot be distinguished clinically or radiologically from other pneumonias.

Ampicillin↗
PubMed1978

Sonographic evaluation of mesenteric and omental masses in children.

Masses in the mesenteries and omentum are often difficult to diagnose by conventional radiographic techniques. Gray scale sonography was a valuable adjunct to radiographic vector analysis in four children with such masses. Masses that are clearly separable from the liver and spleen and do not distort identifiable extraperitoneal structures are probably intraperitoneal. In children most cystic intraperitoneal masses are related to the mesenteries, omentum, ovary, or bile ducts. An anterior fluid collection with internal septa (which might be mistaken for loculated ascites) is the typical sonographic appearance of an omental cyst. Echogenic masses are more difficult to evaluate: careful study of the acoustical features yielded important information in cases of omental lipoma and rhabdomyosarcoma metastatic to the mesenteries and omentum.

Abdominal Neoplasms↗
PubMed1978

Wilms' tumor to the heart: clinical and radiographic evaluation.

The clinical and radiographic appearances of four children with cardiac extension of Wilms' tumor and four cases from the literature are described. Four of the eight children were seen for "cardiac problems" and four for "routine" Wilms' tumor. In those "routine" cases, there were no clinical suggestions of inferior vena cava or cardiac extension. Preoperative screening for tumor extension may be crucial. However, because of the rarity of cardiac extension, it would be appropriate to screen patients by noninvasive methods such as gray scale ultrasound of the abdomen, echocardiography, or computed tomography before any invasive procedure is considered.

Abdominal Neoplasms↗