MR imaging of airway obstruction in infants and children.

Accurate diagnosis is important in the evaluation of airway disorders of infants and children. Today, multiple imaging techniques are available to evaluate the pediatric airway. In general, it is best to start with simple and readily available examinations, which may provide a diagnosis in most cases, and progress to more sophisticated studies such as MR imaging. We performed magnetic resonance (MR) imaging of 45 infants and children with symptoms of airway obstruction, 14 of 45 patient symptoms were related to masses of the airway and 31 of 45 patient symptoms were related to vascular compression.

Intraoperative gamma probe directed rib resection.

Radioguided surgery has slowly gained acceptance since the first gamma probe directed sentinel node lymph node biopsy in a patient with melanoma in 1993. We describe how the intraoperative gamma probe is used to localize a rib with abnormal uptake on the bone scan in a patient with rib pain.

Uterine fibroids: primary treatment with therapeutic embolization.

The use of transcatheter uterine artery embolization as a treatment for uterine fibroids represents a new approach to the management of this common problem. Early reports of uterine artery embolization as a treatment of symptomatic fibroids have indicated significant symptomatic improvement as well as reduction in the size of fibroids. We have been performing this procedure for two years at the Christiana Care Hospital. We describe two representative cases with clinical follow up on 12 of our patients and briefly review the literature on uterine artery embolization for uterine fibroids.

Endovascular therapy in the treatment of head and neck lesions.

Recent advances in microcatheter technology, refinements in embolic agents and improvements in navigational techniques have allowed for endovascular embolization to become an important adjunct in the treatment of vascular head and neck lesions. We describe several case reports where endovascular embolization was utilized in the treatment of such lesions.

Entanglement of guide wires by vena cava filters during central venous catheter insertion: report of three cases and a review of the literature.

Since 1993, 14 cases of central line guide wires becoming entangled with vena cava filters have been reported. We present three additional cases and review the 14 cases in the literature. Obtaining a detailed patient history is important in identifying patients with a vena cava filter. A low threshold of suspicion is needed and immediate radiograph obtained. Entangled guide wires required fluoroscopic manipulation and or retrieval of the dislodged filter. Of all reported cases, only one sustained an arrhythmia. With no signs and symptoms, conservative management of the dislodged filter is a viable option.

Unusual case of lumbar synovial cyst.

Synovial cysts are extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. To our knowledge, all the reported cases of synovial cysts in literature were posterolateral in location (1-4). This case report describes the previously unreported midline location of the synovial cyst in the spinal canal and to increase the level of awareness of diagnosing these lesions in a central location, especially in light of the evaluation of lumbar radiculopathy.