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Shah MR, Flusberg M, Paroder V, Rozenblit AM, Chernyak V. Transient arterial phase respiratory motion-related artifact in MR imaging of the liver: an analysis of four different gadolinium-based contrast agents. Clin Imaging 2017; 41:23-27. [DOI: 10.1016/j.clinimag.2016.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 08/30/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
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2
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Paroder V, Flusberg M, Kobi M, Rozenblit AM, Chernyak V. Pancreatic cysts: What imaging characteristics are associated with development of pancreatic ductal adenocarcinoma? Eur J Radiol 2016; 85:1622-6. [PMID: 27501898 DOI: 10.1016/j.ejrad.2016.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE To assess relationship between pancreatic cysts (PC) and pancreatic ductal adenocarcinoma (PDAC) and to compare imaging features of PC in subjects who develop PDAC and those who do not. MATERIAL AND METHODS This case-control IRB-approved HIPAA-compliant study included patients with PDAC (cases) and lung cancer (controls), diagnosed between 1/1/05-1/1/14. The most recent abdominal CT/MR of each patient done >6months prior to cancer diagnosis date was reviewed by radiologist blinded to case/control status. Presence of PC, number and size of largest PC, presence of main pancreatic duct (MPD) dilatation (MPD >3mm) were recorded. Simple PC was defined as lack of calcifications, septations and enhancement. Logistic regression models with binary outcome of PDAC were constructed. RESULTS There were 88 cases and 273 controls with mean ages of 69.6 years (±10.3) and 69.8 years (±12.0), respectively (p=0.864). PC were present in 21.6% (19/88) cases and in 9.2% (25/273) controls (p=0.002). The OR of PC for development of PDAC was 2.83, adjusting for age, sex and race (p=0.001). Mean PC size was 14.8mm (±8.7) in cases and 7.6mm (±8.0) in controls (p=0.007). PC were solitary in 6 (31.6%) of 19 cases and 21 (84.0%) of 25 controls (p=0.001). There was no significant difference in proportions of simple cysts or MPD dilatation between cases and controls. Multiple PC had 8.2 times increased odds of PDAC compared with solitary PC, adjusting for cyst size (p=0.007). CONCLUSION Multiple PC are associated with 8.2 times higher odds of PDAC compared with solitary PC.
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Affiliation(s)
| | - Milana Flusberg
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Mariya Kobi
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Alla M Rozenblit
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
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Ricci ZJ, Kaul B, Stein MW, Chernyak V, Rozenblit AM, Oh SK, Flusberg M, Mazzariol FS. Improving diagnosis of atraumatic splenic lesions, Part III: malignant lesions. Clin Imaging 2016; 40:846-55. [DOI: 10.1016/j.clinimag.2016.02.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/26/2016] [Accepted: 02/17/2016] [Indexed: 12/18/2022]
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Ricci ZJ, Oh SK, Stein MW, Kaul B, Flusberg M, Chernyak V, Rozenblit AM, Mazzariol FS. Solid organ abdominal ischemia, part I: clinical features, etiology, imaging findings, and management. Clin Imaging 2016; 40:720-31. [DOI: 10.1016/j.clinimag.2016.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/26/2016] [Accepted: 02/17/2016] [Indexed: 02/08/2023]
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Ricci ZJ, Mazzariol FS, Flusberg M, Chernyak V, Oh SK, Kaul B, Stein MW, Rozenblit AM. Improving diagnosis of atraumatic splenic lesions, part II: benign neoplasms/nonneoplastic mass-like lesions. Clin Imaging 2016; 40:691-704. [DOI: 10.1016/j.clinimag.2016.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/16/2016] [Accepted: 02/03/2016] [Indexed: 02/07/2023]
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Ricci ZJ, Mazzariol FS, Kaul B, Oh SK, Chernyak V, Flusberg M, Stein MW, Rozenblit AM. Hollow organ abdominal ischemia, part II: clinical features, etiology, imaging findings and management. Clin Imaging 2016; 40:751-64. [PMID: 27317221 DOI: 10.1016/j.clinimag.2016.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/16/2016] [Accepted: 02/17/2016] [Indexed: 12/20/2022]
Abstract
Acute hollow organ ischemia commonly presents with acute pain prompting radiologic evaluation and almost always requires urgent treatment. Despite different risk factors and anatomic differences, ischemia is commonly due to low flow states but can also be due to arterial and venous occlusion. Radiologic diagnosis is critical as many present with nonspecific symptoms. Contrast-enhanced computed tomography (CT) is the modality of choice. Magnetic resonance imaging (MRI) is preferred in suspected appendicitis in pregnant patients and is superior in biliary necrosis. This article provides a pictorial review of the CT/MRI features of hollow abdominal organ ischemia while highlighting key clinical features, pathogenesis, and management.
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Affiliation(s)
- Zina J Ricci
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Fernanda S Mazzariol
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Bindu Kaul
- Department of Diagnostic Radiology, Jack D. Weiler Hospital of the Albert Einstein School of Medicine, 1825 Eastchester Rd., Bronx, NY 10461.
| | - Sarah K Oh
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Victoria Chernyak
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Milana Flusberg
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Marjorie W Stein
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
| | - Alla M Rozenblit
- Department of Diagnostic Radiology, Montefiore Medical Center of the Albert Einstein School of Medicine, 111 E 210th St., Bronx, NY 10467.
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Ginsburg D, Paroder V, Flusberg M, Rozenblit AM, Chernyak V. Diagnosis of acute cholecystitis: why do patients get multiple studies? Emerg Radiol 2015; 23:49-55. [DOI: 10.1007/s10140-015-1358-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/19/2015] [Indexed: 12/29/2022]
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Chernyak V, Patlas MN, Menias CO, Soto JA, Kielar AZ, Rozenblit AM, Romano L, Katz DS. Traumatic and non-traumatic adrenal emergencies. Emerg Radiol 2015; 22:697-704. [PMID: 26482245 DOI: 10.1007/s10140-015-1357-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/13/2015] [Indexed: 12/13/2022]
Abstract
Multiple traumatic and non-traumatic adrenal emergencies are occasionally encountered during the cross-sectional imaging of emergency department patients. Traumatic adrenal hematomas are markers of severe polytrauma, and can be easily overlooked due to multiple concomitant injuries. Patients with non-traumatic adrenal emergencies usually present to an emergency department with a non-specific clinical picture. The detection and management of adrenal emergencies is based on cross-sectional imaging. Adrenal hemorrhage, adrenal infection, or rupture of adrenal neoplasm require immediate detection to avoid dire consequences. More often however, adrenal emergencies are detected incidentally in patients being investigated for non-specific acute abdominal pain. A high index of suspicion is required for the establishment of timely diagnosis and to avert potentially life-threatening complications. We describe cross-sectional imaging findings in patients with traumatic and non-traumatic adrenal hemorrhage, adrenal infarctions, adrenal infections, and complications of adrenal masses.
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Affiliation(s)
| | - Michael N Patlas
- Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, ON, Canada. .,Division of Emergency/Trauma Radiology, Department of Radiology, Hamilton General Hospital, 237 Barton Street East, Hamilton, ON, Canada, L8L 2X2.
| | - Christine O Menias
- Department of Radiology, Mayo Clinic School of Medicine, Scottsdale, AZ, USA
| | - Jorge A Soto
- Department of Radiology, Boston University, Boston, MA, USA
| | - Ania Z Kielar
- Division of Abdominal and Pelvic Imaging, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Alla M Rozenblit
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Luigia Romano
- Department of Radiology, Cardarelli Hospital, Naples, Italy
| | - Douglas S Katz
- Department of Radiology, Winthrop-University Hospital, Mineola, NY, USA
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Le J, Flusberg M, Rozenblit AM, Chernyak V. T1-hyperintense renal lesions: can high signal predict lack of enhancement? ACTA ACUST UNITED AC 2015; 40:3175-81. [DOI: 10.1007/s00261-015-0539-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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10
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Chernyak V, Flusberg M, Rozenblit AM. Response. Radiology 2015; 276:309. [PMID: 26307817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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11
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Esterson YB, Flusberg M, Oh S, Mazzariol F, Rozenblit AM, Chernyak V. Improved parenchymal liver enhancement with extended delay on Gd-EOB-DTPA-enhanced MRI in patients with parenchymal liver disease: associated clinical and imaging factors. Clin Radiol 2015; 70:723-9. [PMID: 25921617 DOI: 10.1016/j.crad.2015.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/11/2015] [Accepted: 03/19/2015] [Indexed: 12/18/2022]
Abstract
AIM To establish the effect of prolonged hepatobiliary phase (HBP) delay time on hepatic enhancement in patients with parenchymal liver disease (PLD). MATERIALS AND METHODS Gadoxetate disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) examinations with HBP were obtained after 20- (HBP-20) and 30-minute (HBP-30) delays in patients with PLD. For each patient, the Model for End-Stage Liver Disease (MELD) score, total and direct bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), prothrombin time (PT), and partial thromboplastin time (PTT) were recorded. Signal intensities of the liver, main portal vein, and spleen on pre-contrast, HBP-20, and HBP-30 were documented. Signal intensities were used to calculate liver relative enhancement (LRE), liver-spleen index (LSI), and liver-portal vein index (LPI) for HBP-20 and HBP-30. Improved hepatic enhancement was considered if two or more indices were higher on HBP-30 than HBP-20. A logistic regression model was constructed with improved hepatic enhancement as the outcome. RESULTS One hundred and twenty-nine patients underwent 142 MRIs. Mean LRE, LSI, and LPI each increased from HBP-20 to HBP-30 (p = 0.004, p < 0.001, and p < 0.001, respectively). Seventy-two point five percent of cases demonstrated improved hepatic enhancement. The odds ratios for improved hepatic enhancement were 0.85 for MELD score (p = 0.02) and 3.2 for the 3 T scanner (p = 0.02), adjusted for age and sex. CONCLUSION Increasing HBP delay to 30 minutes improves hepatic enhancement in patients with PLD, particularly if using a 3 T scanner. This effect is attenuated with higher MELD scores.
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Affiliation(s)
- Y B Esterson
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - M Flusberg
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - S Oh
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - F Mazzariol
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - A M Rozenblit
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - V Chernyak
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Chernyak V, Flusberg M, Haramati LB, Rozenblit AM. Response. Radiology 2015; 274:939-940. [PMID: 25859595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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13
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Chernyak V, Flusberg M, Haramati LB, Rozenblit AM, Bellin E. Incidental pancreatic cystic lesions: is there a relationship with the development of pancreatic adenocarcinoma and all-cause mortality? Radiology 2015; 274:161-9. [PMID: 25117591 PMCID: PMC4334243 DOI: 10.1148/radiol.14140796] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To establish the effect of incidental pancreatic cysts found by using computed tomographic (CT) and magnetic resonance (MR) imaging on the incidence of pancreatic ductal adenocarcinoma and overall mortality in patients from an inner-city urban U.S. tertiary care medical center. MATERIALS AND METHODS Institutional review board granted approval for the study and waived the informed consent requirement. The study population comprised cyst and no-cyst cohorts drawn from all adults who underwent abdominal CT and/or MR November 1, 2001, to November 1, 2011. Cyst cohort included patients whose CT or MR imaging showed incidental pancreatic cysts; no-cyst cohort was three-to-one frequency matched by age decade, imaging modality, and year of initial study from the pool without reported incidental pancreatic cysts. Patients with pancreatic cancer diagnosed within 5 years before initial CT or MR were excluded. Demographics, study location (outpatient, inpatient, or emergency department), dates of pancreatic adenocarcinoma and death, and modified Charlson scores within 3 months before initial CT or MR examination were extracted from the hospital database. Cox hazard models were constructed; incident pancreatic adenocarcinoma and mortality were outcome events. Adenocarcinomas diagnosed 6 months or longer after initial CT or MR examination were considered incident. RESULTS There were 2034 patients in cyst cohort (1326 women [65.2%]) and 6018 in no-cyst cohort (3,563 [59.2%] women); respective mean ages were 69.9 years ± 15.1(standard deviation) and 69.3 years ± 15.2, respectively (P = .129). The relationship between mortality and incidental pancreatic cysts varied by age: hazard ratios were 1.40 (95% confidence interval [ CI confidence interval ]: 1.13, 1.73) for patients younger than 65 years and 0.97 (95% CI confidence interval : 0.88, 1.07), adjusted for sex, race, imaging modality, study location, and modified Charlson scores. Incidental pancreatic cysts had a hazard ratio of 3.0 (95% CI confidence interval : 1.32, 6.89) for adenocarcinoma, adjusted for age, sex, and race. CONCLUSION Incidental pancreatic cysts found by using CT or MR imaging are associated with increased mortality for patients younger than 65 years and an overall increased risk of pancreatic adenocarcinoma.
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Affiliation(s)
- Victoria Chernyak
- From the Departments of Radiology (V.C., M.F., L.B.H., A.M.R.), Medicine
(E.B.), and Epidemiology & Population Health (E.B.), Montefiore Medical Center,
111 E 210th St, Bronx, NY 10467
| | - Milana Flusberg
- From the Departments of Radiology (V.C., M.F., L.B.H., A.M.R.), Medicine
(E.B.), and Epidemiology & Population Health (E.B.), Montefiore Medical Center,
111 E 210th St, Bronx, NY 10467
| | - Linda B. Haramati
- From the Departments of Radiology (V.C., M.F., L.B.H., A.M.R.), Medicine
(E.B.), and Epidemiology & Population Health (E.B.), Montefiore Medical Center,
111 E 210th St, Bronx, NY 10467
| | - Alla M. Rozenblit
- From the Departments of Radiology (V.C., M.F., L.B.H., A.M.R.), Medicine
(E.B.), and Epidemiology & Population Health (E.B.), Montefiore Medical Center,
111 E 210th St, Bronx, NY 10467
| | - Eran Bellin
- From the Departments of Radiology (V.C., M.F., L.B.H., A.M.R.), Medicine
(E.B.), and Epidemiology & Population Health (E.B.), Montefiore Medical Center,
111 E 210th St, Bronx, NY 10467
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Chernyak V, Flusberg M, Kurteva T, Ghavamian R, Rozenblit AM. Accuracy of prostate measurements on MRI with and without an endorectal coil. Clin Imaging 2014; 39:85-8. [PMID: 25457525 DOI: 10.1016/j.clinimag.2014.09.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 08/31/2014] [Accepted: 09/29/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess accuracy of prostate measurements with and without endorectal coil (ERC). MATERIALS AND METHODS Anteroposterior (AP), transverse (TX) and craniocaudal (CC) measurements were recorded from 49 prostate magnetic resonance images (MRIs) done both with and without ERC. Prostate weight was calculated as follows: AP*TX*CC*π/6. Prostate dimensions and weight were obtained from radical prostatectomy pathology report. RESULTS After ERC placement, AP decreased by 0.71 cm [95% confidence interval (CI) 0.80-0.61], TX and CC increased by 0.26 cm (95% CI 0.18-0.33) and 0.25 cm (95% CI 0.16-0.35), respectively. Agreement between weight on pathology and MR was excellent: intraclass correlation coefficient (ICC) without ERC=0.96, ICC with ERC=0.90. CONCLUSION Although ERC distorts measurements and despite a tendency to underestimate the prostate weight, absolute agreement between prostate weight on pathology and MRI is excellent, both with and without ERC.
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Rosenblum JK, Dym RJ, Sas N, Rozenblit AM. Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia: findings on unenhanced CT. J Radiol Case Rep 2013; 7:21-5. [PMID: 24421934 DOI: 10.3941/jrcr.v7i12.1518] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Gallbladder torsion is a rare cause of acute gangrenous cholecystitis; its occurrence within an abdominal hernia has not been previously reported. We present such a case occurring within a parastomal hernia and imaged with unenhanced CT.
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Affiliation(s)
| | - R Joshua Dym
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
| | - Norman Sas
- Department of Surgery, Montefiore Medical Center, Bronx, NY, USA
| | - Alla M Rozenblit
- Department of Radiology, Montefiore Medical Center, Bronx, NY, USA
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Ioffe E, Hakimi AA, Oh SK, Ginzburg N, Williams SK, Kao L, Rozenblit AM, Ghavamian R, Agalliu I. Reply. Urology 2013. [DOI: 10.1016/j.urology.2013.04.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dym RJ, Chernyak V, Rozenblit AM. MR imaging of renal collecting system with gadoxetate disodium: Feasibility for MR urography. J Magn Reson Imaging 2013; 38:816-23. [DOI: 10.1002/jmri.24059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 01/07/2012] [Indexed: 11/06/2022] Open
Affiliation(s)
- R. Joshua Dym
- Department of Radiology; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York USA
| | - Victoria Chernyak
- Department of Radiology; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York USA
| | - Alla M. Rozenblit
- Department of Radiology; Albert Einstein College of Medicine and Montefiore Medical Center; Bronx New York USA
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Hakimi AA, Faleck DM, Agalliu I, Rozenblit AM, Chernyak V, Ghavamian R. Preoperative and Intraoperative Measurements of Urethral Length as Predictors of Continence After Robot-Assisted Radical Prostatectomy. J Endourol 2011; 25:1025-30. [DOI: 10.1089/end.2010.0692] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A. Ari Hakimi
- Department of Urology, Montefiore Medical Center, Bronx, New York
| | - David M. Faleck
- Department of Urology, Montefiore Medical Center, Bronx, New York
| | - Ilir Agalliu
- Department of Epidemiology and Population Health, Montefiore Medical Center, Bronx, New York
| | | | | | - Reza Ghavamian
- Department of Urology, Montefiore Medical Center, Bronx, New York
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Chernyak V, Kim J, Rozenblit AM, Mazzoriol F, Ricci Z. Hepatic enhancement during the hepatobiliary phase after gadoxetate disodium administration in patients with chronic liver disease: The role of laboratory factors. J Magn Reson Imaging 2011; 34:301-9. [DOI: 10.1002/jmri.22635] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 04/06/2011] [Indexed: 12/31/2022] Open
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Chernyak V, Rozenblit AM, Greenspun DT, Levine JL, Milikow DL, Chia FA, Erhard HA. Breast reconstruction with deep inferior epigastric artery perforator flap: 3.0-T gadolinium-enhanced MR imaging for preoperative localization of abdominal wall perforators. Radiology 2008; 250:417-24. [PMID: 19037016 DOI: 10.1148/radiol.2501080307] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively evaluate 3.0-T gadolinium-enhanced magnetic resonance (MR) imaging for localization of inferior epigastric artery (IEA) perforators before reconstructive breast surgery involving a deep inferior epigastric perforator (DIEP) flap. MATERIALS AND METHODS This study was exempt from institutional review board approval, and the requirement for informed patient consent was waived. Data were collected and stored in compliance with HIPAA regulations. Nineteen patients (mean age, 46.3 years) underwent three-dimensional gadolinium-enhanced 3.0-T MR imaging of the abdomen before undergoing DIEP flap breast reconstruction. Up to four of the largest perforators arising from the IEA on each side of the umbilicus were identified. The diameter, intramuscular course, and distance from the umbilicus of each perforator were recorded. One of the marked perforators on each side was labeled "the best" on the basis of an optimal combination of perforator features: diameter, intramuscular course, and location with respect to the flap edges. MR findings were compared with intraoperative findings. The two-tailed Student t test was used to compare the mean diameters of all perforators with the mean diameters of the perforators labeled as the best. RESULTS There were 30 surgical flaps, and 11 (58%) of the 19 patients underwent bilateral flap dissection. At surgery, 122 perforators were localized, and 118 (97%) of these perforators-with a mean diameter of 1.1 mm (range, 0.8-1.6 mm)-had been identified at preoperative MR imaging. Thirty perforators with a mean diameter of 1.4 mm (range, 1.0-1.6 mm) were labeled as the best at MR imaging. Thirty-three perforators were harvested intraoperatively, and all of these had been localized preoperatively. Twenty-eight (85%) of these 33 perforators were labeled as the best at MR imaging. CONCLUSION Gadolinium-enhanced 3.0-T MR imaging can be used to accurately localize IEA perforators and to select the optimal perforator to be harvested for DIEP flap reconstructive breast surgery.
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Affiliation(s)
- Victoria Chernyak
- Departments of Radiology and Plastic Surgery, Montefiore Medical Center, Bronx, NY 10467, USA
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Abstract
PURPOSE OF STUDY To investigate frequency and morphology of focal pelvic lesions (FPLs) in patients after open inguinal hernioplasty with a prosthetic mesh. MATERIALS, METHODS AND PROCEDURES Patients who had open prosthetic inguinal hernioplasties between 1999 and 2004 and subsequent pelvic computed tomography were identified. Computed tomography of each patient was evaluated by 2 observers. The presence of an FPL at the internal inguinal ring (IIR) and its shape, size, and attenuation were recorded. The findings were compared with the type of surgical mesh used for the repair. RESULTS There were 93 patients, 86 men, with a mean age of 62.4 years (range, 14-89 years) who underwent 96 hernioplasties, with plug or flat mesh used in 71 and 25 cases, respectively. There were 96 computed tomographies obtained between 1 and 46 months (mean, 15.4 months) after surgery. Focal pelvic lesions were identified in 69 (72%) of 96 cases. Focal pelvic lesions were found in 63 (89%) of 71 cases repaired with a plug, but in only 6 (24%) of 25 cases repaired with a flat mesh (P < 0.0001). One hundred percent of FPLs corresponded to the surgical site and were located deep to the IIR. Focal pelvic lesions were ovoid or round in 65 (94%) and 4 (6%) cases, respectively; all were well defined. Focal pelvic lesions had a mean diameter of 2.4 cm (range, 1.3-3.9 cm) and mean attenuation value of 17 Hounsfield units (range, -4 to 64 Hounsfield units). CONCLUSIONS A low attenuation, ovoid, or round FPL located at the IIR is a common postoperative finding in patients after open inguinal hernioplasty performed with a plug mesh.
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Affiliation(s)
- Victoria Chernyak
- Department of Radiology, Montefiore Medical Center, Bronx, NY, 10467, USA.
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Chernyak V, Rozenblit AM, Patlas M, Cynamon J, Ricci ZJ, Laks MP, Veith FJ. Type II Endoleak after Endoaortic Graft Implantation: Diagnosis with Helical CT Arteriography. Radiology 2006; 240:885-93. [PMID: 16868280 DOI: 10.1148/radiol.2403051013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To retrospectively assess endoleak shapes and locations within aneurysms to differentiate type II from type I and type III endoleaks. MATERIALS AND METHODS The institutional review board granted an exemption for this HIPAA-compliant study; patient informed consent was not required. A retrospective review of arterial phase helical computed tomographic (CT) studies and medical records was performed for 39 patients (29 men, 10 women; age range, 60-89 years; mean, 78.5 years) who had an endoleak after endoaortic graft implantation for treatment of abdominal aortic aneurysm and who subsequently underwent angiography (n = 25), surgery (n = 8), or long-term follow-up (n = 6) to classify their endoleak into a specific type. At CT, endoleak shape (tubular or nontubular) and location (central or peripheral) were recorded. An endoleak was classified as type II if it contained a peripheral tubular component (PTC) near the aortic wall, with or without an identifiable feeding vessel. Endoleaks without these features were classified as type I or III. The Fisher exact test was used to assess associations between CT findings and endoleak type. RESULTS There were 22 type II and 17 type I or III endoleaks. CT enabled correct identification of 22 (100%) of 22 type II endoleaks, all of which contained a PTC. Of 17 type I or III endoleaks, only two (12%) contained a PTC and were misclassified as type II endoleaks; the remaining 15 (88%) were correctly classified. Overall, CT enabled correct identification of endoleaks as type II or type I or III in 37 (95%) of 39 patients. PTCs were significantly more common (P < .001) in type II than in type I or III endoleaks, with a sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of 100%, 88.2%, 94.9%, 100%, and 91.7%, respectively. CONCLUSION A PTC is a statistically significant predictor of type II endoleak in most patients.
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Affiliation(s)
- Victoria Chernyak
- Departments of Radiology and Surgery, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, USA.
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24
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Abstract
OBJECTIVE We review the cross-sectional imaging findings of six cases of pathologically proven renal medullary carcinoma in patients with sickle cell trait. MRI findings were available in three of the patients. To our knowledge, only one previous report has addressed MRI features of this rare disease. CONCLUSION In young patients with sickle cell trait, an infiltrative renal mass with associated retroperitoneal adenopathy and caliectasis are characteristic findings of renal medullary carcinoma on CT and MRI.
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Affiliation(s)
- Netta M Blitman
- Department of Radiology, Albert Einstein College of Medicine, Children's Hospital at Montefiore, 3400 Bainbridge Ave., Bronx, NY 10467, USA
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25
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Abstract
A healthy 17-year-old girl presented to the emergency department with a 1-day history of left upper quadrant abdominal pain associated with nausea and vomiting. Her hematocrit was 22. On physical examination, she had left upper quadrant fullness and tenderness. Initial computed tomography revealed a large, loculated, left-sided retroperitoneal hematoma. Blood pool scintigraphy with labeled red cells revealed a very large photon-deficient area with 3 areas of active bleeding in the upper margin of the cold area. An angiogram showed active extravasation from the left inferior phrenic artery. The patient was felt to have had spontaneous adrenal hemorrhage, likely within a preexisting, large adrenal cyst. Spontaneous hemorrhage into an adrenal cyst is a rare entity that can be life-threatening if not treated early in its course.
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Affiliation(s)
- Daniel B Lerer
- Department of Nuclear Medicine and Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, USA
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26
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Rozenblit AM, Patlas M, Rosenbaum AT, Okhi T, Veith FJ, Laks MP, Ricci ZJ. Detection of endoleaks after endovascular repair of abdominal aortic aneurysm: value of unenhanced and delayed helical CT acquisitions. Radiology 2003; 227:426-33. [PMID: 12676973 DOI: 10.1148/radiol.2272020555] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess unenhanced and delayed phase computed tomographic (CT) images combined with arterial phase images for detecting endoleaks after endovascular treatment for abdominal aortic aneurysm (AAA). MATERIALS AND METHODS CT scans were retrospectively evaluated for the presence of endoleaks after endovascular treatment of AAAs in 33 patients with endoleak (positive group) and 40 patients without evidence of endoleak or aneurysm enlargement (negative group). All patients underwent unenhanced and biphasic contrast material-enhanced CT. The CT scans were reviewed in the following combinations: (a) arterial phase and unenhanced scans (uniphasic/unenhanced set), (b) arterial and delayed phase scans only (biphasic set), and (c) arterial and delayed phase scans with unenhanced scans (complete set). Each set was reviewed by two radiologists blinded to the diagnosis of endoleak. Findings were recorded as positive, negative, or indeterminate for endoleak. RESULTS Within the positive group, endoleaks were diagnosed with the uniphasic/unenhanced, biphasic, and complete image sets in 30 (91%), 32 (97%), and 33 (100%) patients, respectively. With the uniphasic/unenhanced set, three (9%) endoleaks (seen only on delayed phase images) were missed. With the biphasic set, one (3%) endoleak was interpreted as indeterminate. Within the negative group, uniphasic/unenhanced, biphasic, and complete image sets were negative for endoleaks in 100%, 80%, and 100% of patients, respectively. With the biphasic set, results were indeterminate in 20% of cases. CONCLUSION A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.
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Affiliation(s)
- Alla M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E 210th St, Bronx, NY 10467, USA.
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27
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Rozenblit AM, Kim A, Tuvia J, Wenig BM. Adrenal histoplasmosis manifested as Addison's disease: unusual CT features with magnetic resonance imaging correlation. Clin Radiol 2001; 56:682-4. [PMID: 11467874 DOI: 10.1053/crad.2000.0713] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- A M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA
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28
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Sahgal A, Veith FJ, Lipsitz E, Ohki T, Suggs WD, Rozenblit AM, Cynamon J, Wain RA. Diameter changes in isolated iliac artery aneurysms 1 to 6 years after endovascular graft repair. J Vasc Surg 2001; 33:289-4; discussion 294-5. [PMID: 11174780 DOI: 10.1067/mva.2001.112702] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Precise diameter changes in iliac artery aneurysms (IAAs) after endovascular graft (EVG) repair are yet to be determined. This report describes the midterm size changes in isolated IAAs 13 to 72 months after treatment with an EVG. METHODS From January 1993 to April 1999, 31 patients with 35 true isolated IAAs (32 common iliac and 3 hypogastric) had these lesions treated with EVGs and coil embolization of the hypogastric artery or its branches. The EVG used in this study consisted of a balloon-expandable stent attached to a polytetrafluoroethylene graft. Contrast-enhanced spiral computed tomographic scans were performed at 3- to 6-month intervals to follow the aneurysms for change in diameter and endoleaks. RESULTS Thirty patients had a decrease in the size of their iliac aneurysms with EVG repair. All EVGs remained patent. All patients, except for one, were followed up for 13 to 72 months (mean, 31 months). The pretreatment aneurysm size ranged from 2.5 to 11.0 cm in diameter (mean, 4.6 +/- 1.62 cm). After EVG treatment, the aneurysms ranged from 2.0 to 8.0 cm in diameter (mean, 3.8 +/- 1.36 cm). The change in aneurysm diameter ranged from 0.5 to 3.1 cm (mean, 1.1 +/- 0.62 cm) with an average change of -0.516 +/- 0.01 cm/y for the first year. Five patients died of their intercurrent medical conditions during the follow-up period. One of the patients had a new endoleak and an increase in common iliac aneurysm size 18 months after EVG treatment, despite an early contrast-enhanced computed tomographic scan that showed no endoleak. This patient's aneurysm ruptured, and a standard open surgical repair was successfully performed. Another patient had a decrease in hypogastric aneurysm size after EVG treatment and no radiographic evidence of an endoleak, but eventually the aneurysm ruptured. He was successfully treated with a standard open surgical repair. CONCLUSIONS EVGs can be an effective treatment for isolated IAAs. Properly treated with EVGs, IAAs decrease in size. The enlargement of an IAA, even if no endoleak can be detected, appears to be an ominous sign suggestive of an impending rupture. IAAs that enlarge should be closely evaluated for an endoleak. If an endoleak is detected, it should be eliminated if possible. If an endoleak cannot be found, open surgical repair should be considered.
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Affiliation(s)
- A Sahgal
- Division of Vascular Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York, NY 10467, USA
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29
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Abstract
OBJECTIVE Incompetent and dilated ovarian veins have been reported in association with pelvic congestion syndrome. We postulate that incompetent and dilated ovarian veins are often an incidental CT finding, with a low diagnostic value. To verify our hypothesis, we studied the frequency of incompetent and dilated ovarian veins seen on CT in asymptomatic women. MATERIALS AND METHODS We retrospectively analyzed helical CT scans and medical records of 34 consecutive female renal donors between 18 and 46 years old (mean age, 33 years). An incompetent and dilated ovarian vein was defined as a contrast-filled vein measuring 7 mm or greater, seen during the arterial phase of helical CT. RESULTS Incompetent and dilated ovarian veins were found in 16 (47%) of 34 asymptomatic women. All 16 women had left ovarian vein involvement; six (37.5%) had bilateral involvement. The mean diameters for the left and right (incompetent and dilated) ovarian veins were 9.1 mm and 8.8 mm, respectively (range, 7-12 mm). Of 16 women with incompetent and dilated ovarian veins, 15 (94%) were parous. Of 18 women with normal ovarian veins, nine (50%) were parous. Overall, incompetent and dilated ovarian veins were found in 15 (63%) of 24 parous women, and in one (10%) of 10 nonparous women (p < 0.05). CONCLUSION Incompetent and dilated ovarian veins are frequently seen on CT in asymptomatic parous women. As an isolated finding, it is unlikely to be associated with pelvic congestion syndrome.
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Affiliation(s)
- A M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, 111 E. 210th St., Bronx, NY 10467, USA
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30
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Rozenblit AM, Cohen-Schwartz D, Wolf EL, Foxx MJ, Brenner S. Case reports. Stercoral perforation of the sigmoid colon: computed tomography findings. Clin Radiol 2000; 55:727-9. [PMID: 10988058 DOI: 10.1053/crad.1999.0173] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, USA
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31
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Palm SJ, Russwurm GP, Chang D, Rozenblit AM, Ohki T, Veith FJ. Acute enlargement and subsequent rupture of an abdominal aortic aneurysm in a patient receiving chemotherapy for pancreatic carcinoma. J Vasc Surg 2000; 32:197-200. [PMID: 10876224 DOI: 10.1067/mva.2000.105665] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We report a case of ruptured abdominal aortic aneurysm (AAA) in a patient receiving chemotherapy for pancreatic cancer. We reviewed the literature on the effects of corticosteroids and chemotherapy on aaa formation and discuss possible mechanisms for drug action to promote aneurysm expansion and rupture. If cancer and AAA coincide and curative chemotherapy is possible, a potential impact of chemotherapy on AAA expansion should be considered.
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Affiliation(s)
- S J Palm
- Division of Vascular Surgery, Department of Surgery, Montefiore Medical Center, Bronx, NY 10467, USA
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32
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Abstract
OBJECTIVE We postulated that the pneumothorax rate of transthoracic needle biopsy might improve with an ipsilateral dependent position of the affected side. We tried to determine the feasibility, effectiveness, and safety of CT-guided biopsy with the patient in this position. SUBJECTS AND METHODS CT-guided needle biopsy with the patient in an ipsilateral dependent position was performed in 23 patients with 17 lung lesions (15 posterior and two anterior) and six mediastinal lesions. Fine-needle aspiration was used in all patients, and core biopsy was also used in six patients. The technical difficulty of the procedure was classified into three grades compared with a routine transthoracic needle biopsy as follows: grade I, no more difficult; grade II, somewhat more difficult; and grade III, much more difficult. RESULTS Adequate samples were obtained in 22 (96%) of 23 patients. A small asymptomatic pneumothorax occurred in two patients (8.7%). Difficulty was rated grades I, II, and III in 18 (78%), two (9%), and three (13%) procedures, respectively. Four of the five grades II and III procedures were biopsies of anterior lesions. Traversing the pleura was avoided in three of six mediastinal masses. CONCLUSION Transthoracic needle biopsy of selected lung and mediastinal lesions using an ipsilateral dependent position is feasible, effective, and safe. The role of this technique for reducing the rate of pneumothorax as a result of the biopsy requires further investigation.
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Affiliation(s)
- A M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467-2490, USA
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33
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Kaynan AM, Rozenblit AM, Figueroa KI, Hoffman SD, Cynamon J, Karwa GL, Tellis VA, Lerner SE. Use of spiral computerized tomography in lieu of angiography for preoperative assessment of living renal donors. J Urol 1999; 161:1769-75. [PMID: 10332432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
PURPOSE We evaluate whether spiral computerized tomography (CT) can be used in lieu of renal angiography for preoperative assessment of living renal donors, with special attention to multiplicity of renal vasculature. MATERIALS AND METHODS A total of 47 living renal donor candidates were evaluated with spiral CT and all but 2 underwent donor nephrectomy. Patients were divided into early and late groups because there was a learning curve with spiral CT. In the early group 18 donors underwent renal angiography as well as spiral CT and 10 underwent nephrectomy after spiral CT only. In the late group 5 had dual radiographic evaluation for ambiguities in spiral CT interpretation and 12 underwent nephrectomy after spiral CT only. Spiral CT was performed and interpreted blind to angiographic results, and vice versa. RESULTS Spiral CT identified 50 of 52 renal arteries (96%) found at surgery overall and 23 of 25 (92%) found at surgery after spiral CT only. Two accessory arteries were missed in the 10 early group donors evaluated with spiral CT only, yielding an early negative predictive value of 80%. Renal angiography identified another accessory artery missed by spiral CT in the early group. All 3 missed vessels were identified retrospectively. No arteries found at surgery were missed in the late group (negative predictive value 100%), although there were 2 false-positive results detected by spiral CT relative to renal angiography in 1 candidate renal unit. Overall accuracy to predict early renal artery division relative to surgical findings was 93% for spiral CT and 91% for renal angiography. However, early renal artery division was clinically significant for only 1 of 11 vessels found at surgery. Spiral CT demonstrated 4 anomalous venous returns and renal angiography identified none. However, spiral CT missed 2 accessory veins and identified only 1 of 2 fibromuscular dysplasia cases. Total cost for spiral CT and renal angiography was $886 and $2,905, respectively. CONCLUSIONS Spiral CT is a reasonably good alternative to renal angiography for living renal donor assessment but there is a profound learning curve for performance and interpretation. Renal angiography is still the gold standard with respect to the identification of arterial multiplicity and fibromuscular dysplasia, and it should be used adjunctively in cases with spiral CT ambiguity. Neither spiral CT nor renal angiography is ideal for the assessment of early renal artery division which is seldom an issue. The benefits of spiral CT over renal angiography are potentially lower morbidity, improved donor convenience and reduced cost.
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Affiliation(s)
- A M Kaynan
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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Rozenblit AM, Cynamon J, Maddineni S, Marin ML, Sanchez LA, Yuan J, Veith FJ. Value of CT angiography for postoperative assessment of patients with iliac artery aneurysms who have received endovascular grafts. AJR Am J Roentgenol 1998; 170:913-7. [PMID: 9530033 DOI: 10.2214/ajr.170.4.9530033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of the study was to assess the usefulness of CT angiography for follow-up of patients with iliac artery aneurysms who have undergone endovascular treatment. SUBJECTS AND METHODS Twelve patients with iliac artery aneurysms (10 true aneurysms and two pseudoaneurysms) were examined with CT angiography within 1 week of receiving transfemorally placed endovascular grafts. All patients underwent follow-up CT angiography from 3 to 30 months (mean, 11 months) later. Follow-up CT angiography at 6 months or later (mean, 14 months) was also available in 10 patients. All studies were obtained after i.v. contrast administration using 3-mm collimation, 1.6-2.0 pitch, 2-mm retrospective reconstruction, and with subsequent three-dimensional rendering and multiplanar reformation. The shape and patency of the graft, perigraft thrombosis, and the size of the aneurysm were assessed. RESULTS All grafts remained patent and without deformity. Complete thrombosis of the aneurysm was shown by initial postoperative CT angiography in 11 patients and confirmed by follow-up studies. A single case of a perigraft leak was revealed by CT angiography and confirmed by follow-up angiography. No aneurysm showed change in size at late follow-up. CONCLUSION CT angiography is an accurate method for evaluating endovascular devices. CT angiography can be used as a primary technique for follow-up of patients who have undergone endovascular repair of iliac aneurysms.
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Affiliation(s)
- A M Rozenblit
- Department of Radiology, Albert Einstein College of Medicine, Bronx, NY, USA
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