Eoin C Kavanagh

Mater Misericordiae University Hospital, Dublin, Leinster, Ireland

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Publications (95)203.58 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The study sought to determine the frequency of nonthromboembolic imaging abnormalities in pregnant women referred for computed tomography pulmonary arteriography (CTPA). CTPA studies on 100 consecutive pregnant women performed over a 5-year period were reviewed independently by 2 radiologists, with conflicts resolved by consensus. Age range was 18-43 years (mean 28 years). The presence or absence of pulmonary embolism and of nonthromboembolic imaging abnormalities was recorded. These were graded as A if the abnormalities were thought to provide potential alternative explanations for acute symptoms, B if findings were incidental that required clinical or radiologic follow-up, and C if the findings did not require further action. Pulmonary embolism was seen in 5 women. In 2 of these additional findings of consolidation and infarction were seen. Ninety-five women did not have pulmonary embolism. Eleven women (12%) had grade A abnormalities; 6 cases of consolidation, 2 cases of lobar collapse, and 3 cases of heart failure with pleural effusions. One woman had a grade B abnormality due to the presence of pulmonary nodules. Ten women had incidental grade C abnormalities. Pulmonary embolism occurs in 5% of pregnant women referred for CTPA. In pregnant women without embolism on CTPA, potential alternative causes for patient symptoms are seen on CT in 12% of cases. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.
    Canadian Association of Radiologists Journal 02/2015; 66(1):24-9. DOI:10.1016/j.carj.2014.11.006 · 0.58 Impact Factor
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    ABSTRACT: Objective To (a) evaluate the feasibility of MR epidurography (MRE) and (b) assess the distribution of injectate using two different volumes at caudal epidural steroid injection. Materials and methods Twenty patients who were referred with symptomatic low back pain for caudal epidural steroid injection were assigned to have either 10 ml (9/20) or 20 ml (11/20) of injectate administered. Gadolinium was included in the injection. The patients proceeded to MRI where sagittal and coronal T1-weighted fat-saturated sequences were acquired and reviewed in the mid-sagittal and right and left parasagittal views at the level of the exit foramina. Results Gadolinium was observed at or above the L3/4 disc level in all 11 patients who received 20 ml (100 %), compared with only five of nine patients who received 10 ml (56 %). Injectate was seen to the L4 nerve root level in all 11 patients who received 20 ml (100 %) but only four out of nine patients who received 10 ml (44 %), not even reaching the L5 nerve root level in four further of these nine patients (44 %). Overall, there was a trend to visualize gadolinium at higher levels of the epidural space with higher volumes injected. Conclusions Firstly, MR epidurography is a safe technique that allows excellent visualization of the distribution of gadolinium in the epidural space following injection via the caudal hiatus. Secondly, a volume of 10 ml is unlikely to treat L5/S1 disease in almost half of patients at caudal epidural steroid injection and at least 20 ml of injectate is likely required for any medication to reach the desired level.
    Skeletal Radiology 08/2014; 44(4). DOI:10.1007/s00256-014-1963-x · 1.74 Impact Factor
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    ABSTRACT: Calcium pyrophosphate dihydrate and basic calcium phosphate (BCP) crystals are the most common calcium-containing crystals associated with rheumatic disease. Clinical manifestations of calcium crystal deposition include acute or chronic inflammatory and degenerative arthritides and certain forms of periarthritis. The intra-articular presence of BCP crystals correlates with the degree of radiographic degeneration. Calcium crystal deposition contributes directly to joint degeneration. Vascular calcification is caused by the deposition of calcium hydroxyapatite crystals in the arterial intima. These deposits may contribute to local inflammation and promote further calcification, thus aggravating the atherosclerotic process. Calcium crystal deposition results in substantial structural consequence in humans.
    Rheumatic diseases clinics of North America 05/2014; 40(2):311-328. DOI:10.1016/j.rdc.2014.01.007 · 2.59 Impact Factor
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    ABSTRACT: We hypothesized that serum lipids, which experimental data suggest may be key initiators of carotid plaque inflammation, would be associated with plaque inflammation on (18)fluorodeoxyglucose (FDG)-PET in patients with acutely symptomatic carotid stenosis. In this cohort study, consecutive patients with acute symptomatic internal carotid artery (ICA) stenosis (≥50%) underwent carotid PET-CT. We quantified plaque FDG uptake as follows: (1) average maximum standardized uptake values (SUVmax) across 10 regions of interest (ROI); (2) highest single ROI SUV measure (SUVROImax); (3) averaged mean SUV across 10 ROIs (SUVmean). Sixty-one patients were included. Plaque inflammatory FDG SUVmax was associated with increasing tertiles of low-density lipoprotein (LDL) (trend p = 0.004), total cholesterol (p = 0.009), and triglycerides (p = 0.01), and with lower high-density lipoprotein (HDL) (p = 0.005). When analyzed as a continuous variable, LDL was associated with symptomatic ICA SUVmean (Spearman rho 0.44, p = 0.009), SUVROImax (rho 0.33, p = 0.01), and SUVmax (rho 0.35, p = 0.06). Total cholesterol was associated with SUVmean (rho 0.33, p = 0.009), with trends for SUVmax (rho 0.24, p = 0.059) and SUVROImax (rho 0.23, p = 0.08). Triglycerides were associated with SUVmax (rho 0.32, p = 0.01) and SUVROImax (rho 0.35, p = 0.005). HDL was associated with lower SUVmax (rho -0.37, p = 0.004) and SUVROImax (rho -0.44, p = 0.0004). On multivariable linear regression analysis adjusting for age, sex, degree of carotid stenosis, statins, and smoking, LDL (p = 0.008) and total cholesterol (p = 0.04) were independently associated with SUVmax. Serum LDL and total cholesterol were associated with acutely symptomatic carotid plaque FDG uptake, supporting experimental data suggesting lipids may promote plaque inflammation, mediating rupture and clinical events.
    Neurology 04/2014; 82(19). DOI:10.1212/WNL.0000000000000408 · 8.30 Impact Factor
  • Circulation Cardiovascular Imaging 03/2014; 7(2):409-411. DOI:10.1161/CIRCIMAGING.113.001290 · 5.80 Impact Factor
  • Headache The Journal of Head and Face Pain 02/2014; 54(4). DOI:10.1111/head.12298 · 2.94 Impact Factor
  • Aoife Kilcoyne, Eoin C Kavanagh
    The spine journal: official journal of the North American Spine Society 01/2014; 14(6). DOI:10.1016/j.spinee.2013.12.024 · 2.90 Impact Factor
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    ABSTRACT: Ipilimumab has been shown to improve overall survival in patients with metastatic melanoma; however, complete responses (CRs) are uncommon. Immune-related side effects usually involve the skin or gastrointestinal tract. Neurologic events occur less frequently but are well described. We report the case of a 58-year-old man with metastatic melanoma who commenced ipilimumab post spinal decompression and radiation. He developed a colitis post cycle 2 and ipilimumab was discontinued. Imaging, however, documented a radiological CR. 8 weeks later, he developed paraplegia and a myelitis despite an ongoing radiological CR. Steroid use resulted in some improvement radiologically, without clinical improvement. We report myelitis with consequent paraplegia as a potential neurological immune-related side effect of ipilimumab. We further describe a patient with a CR after 2 cycles of ipilimumab in the setting of radiation. © 2014 S. Karger GmbH, Freiburg.
    01/2014; 37(12):757-60. DOI:10.1159/000368316
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    ABSTRACT: Nontraumatic spinal intradural extramedullary hematomas are extremely rare. When they occur, they can rapidly lead to spinal cord or cauda equina compression and have devastating consequences. The aim here was to report a case of this rare phenomenon and discuss the etiology, imaging, management, and outcome of intradural hematomas. We describe the case of a 76-year-old man on warfarin therapy who presented with severe lower back pain and flaccid paraparesis. Blood tests revealed an international normalized ratio of 6.0. A magnetic resonance imaging result suggested an intradural hematoma extending from L1 to L4 and compressing the spinal cord and cauda equina. Emergency surgical decompression revealed an extensive intradural extramedullary hematoma, which was evacuated. The patient showed only minor neurologic improvement 6 months postoperatively. Coagulopathy-induced spinal hemorrhage should be included in the differential diagnosis for patients presenting with signs of acute spinal cord compression.
    Journal of Emergency Medicine 08/2013; 45(5). DOI:10.1016/j.jemermed.2013.04.048 · 1.18 Impact Factor
  • Journal of neurology, neurosurgery, and psychiatry 08/2013; 85(2). DOI:10.1136/jnnp-2013-305845 · 4.87 Impact Factor
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    ABSTRACT: Lymphomas frequently occur as extranodal lesions in the head and neck, but are rarely seen in the palate. We present a case of isolated diffuse type B-cell lymphoma of the palate, which occurred in a 28-year-old man. The patient had no history of immune compromise, and he presented to the emergency department with a 7-month history of a painful, non-healing ulcerative mass in the hard and soft palate. Positron emission tomography facilitated pretreatment assessment of the extent and activity of the lesion. Histopathological and immunohistochemical analyses of biopsied tissue confirmed a diagnosis of diffuse type B-cell lymphoma. The clinical findings and therapeutic challenges in this heterogeneous group of malignancies are discussed.
    Case Reports 05/2013; 2013(may23_1). DOI:10.1136/bcr-2013-008703
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    ABSTRACT: A 25-year-old man presented with subacute spastic paraparesis. He reported 2 previous episodes of spastic paraparesis with partial recovery. Recurrent oral and genital ulceration, pustular skin eruptions, and fever coexisted. Profound motor weakness, a sensory level at T10, oral ulceration, and a pustular eruption on the anterior abdominal wall were noted. Marked neutrophilia was noted in both blood and CSF. Neuromyelitis optica-immunoglobulin G autoantibody was negative. MRI (figure) demonstrated marked inflammatory changes. IV and oral steroids, followed by 6 months of pulsed IV cyclophosphamide, resulted in marked clinical improvement. Neuro-Behçet disease lies within the clinical differential for longitudinally extensive transverse myelitis.(1,2.)
    Neurology 04/2013; 80(18):e189-90. DOI:10.1212/WNL.0b013e3182904d2e · 8.30 Impact Factor
  • Journal of Neurology 04/2013; DOI:10.1007/s00415-013-6913-3 · 3.84 Impact Factor
  • F Bolster, J Griffin, J McKenna, E Kavanagh
    The British journal of radiology 04/2013; 86(1024):20110633. DOI:10.1259/bjr.20110633 · 2.11 Impact Factor
  • T M Ryan, E C Kavanagh, P J Macmahon
    American Journal of Neuroradiology 03/2013; 34(4). DOI:10.3174/ajnr.A3544 · 3.17 Impact Factor
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    ABSTRACT: In this study, we present the case of a 74-year-old male patient who presented with a painful pretibial swelling. The patient had a history of varices of the ipsilateral leg for which he had undergone stripping and ligation. At physical examination, pretibial varices and an associated soft tissue swelling were found. Ultrasound revealed pretibial varices, one of which caused a defect on the anterior tibial cortex. Plain radiography showed a small subcortical lucency of the tibial shaft. MRI confirmed the presence of pretibial varices, one of which perforated through the anterior tibial cortex and then coursed intramedullary as an enlarged intraosseous vein. Based on these findings, the diagnosis of varices with an intraosseous venous drainage anomaly was made. The patient was subsequently successfully treated by ambulatory minisurgical phlebectomy. Knowledge and recognition of this intraosseous venous drainage anomaly, which is a rare condition, is pivotal for correct patient management. We review clinical and imaging findings, and discuss previously reported cases.
    Skeletal Radiology 02/2013; DOI:10.1007/s00256-013-1587-6 · 1.74 Impact Factor
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    ABSTRACT: In treatment and prevention of thromboembolic events, the two major classes of anticoagulants are the antiplatelet agents and the antithrombotic agents. The antithrombotic agents have traditionally been heparin and warfarin, both of which were isolated in the 1930s, and have been used effectively since becoming commercially available in treatment and thromboprophylaxis of venous thromboembolic events (VTE). Though effective, they have a narrow therapeutic window and the antithrombotic response is variable, depending on the patient, and requires regular monitoring and adjustment to maintain the necessary therapeutic range. Recently developed novel anticoagulants in the prevention and treatment of VTE are now available and are increasingly encountered in day-to-day practice. A general understanding of these agents is essential in the planning of any interventional procedure in order to optimally balance the risk of hemorrhage, during or after a procedure, with the risk of periprocedural thrombosis.
    Skeletal Radiology 01/2013; DOI:10.1007/s00256-012-1555-6 · 1.74 Impact Factor
  • The spine journal: official journal of the North American Spine Society 12/2012; 12(12). DOI:10.1016/j.spinee.2012.11.019 · 2.90 Impact Factor
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    ABSTRACT: OBJECTIVE: To review the literature regarding normal labral variants at MRI. METHODS: A systematic search was performed in PubMed/MEDLINE and Embase. For each included study, information regarding normal labral variants and findings in asymptomatic subjects was extracted. RESULTS: There were 24 studies in symptomatic patients, evaluating 822 hips. The presence of a sublabral sulcus was reported by four studies in 41 hips (5 % of all evaluated hips), occurring at all anatomical locations. There were 3 cadaver studies, investigating 32 hips and reporting no normal labral variants. There were 8 studies in asymptomatic subjects, evaluating 1,096 hips. Labral tears were reported in 213 hips (19 %); no sublabral sulci were reported. Labral shape was most commonly triangular (59-89 %), whereas rounded (11-16 %), flattened (13-37 %) and teardrop (41 %) shapes were less frequently seen. Overall methodological quality of included studies was moderate, with median total quality scores of 43 % (symptomatic patients), 71 % (cadavers) and 70 % (asymptomatic subjects). CONCLUSION: At MRI, a sublabral sulcus can be found at any anatomical location. Our results suggest that its prevalence is at least 5 % in symptomatic patients. The most common labral shape is triangular. Rounded, flattened and teardrop shapes are less frequent but are also encountered in asymptomatic subjects. KEY POINTS : • A sublabral sulcus can be detected by MRI at any anatomical site • Its prevalence is estimated to be at least 5 % in symptomatic patients • The most common shape of the hip labrum is triangular • Rounded, flattened and teardrop shapes are less frequent.
    European Radiology 12/2012; DOI:10.1007/s00330-012-2744-3 · 4.34 Impact Factor
  • Niamh M Long, Adam C Zoga, Ruben Kier, Eoin C Kavanagh
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    ABSTRACT: OBJECTIVE: We present nondisplaced talar head fractures in two patient groups. CONCLUSION: Talar head insufficiency fractures should be considered in older patients, particularly perimenopausal women. Nondisplaced talar head fractures may occur in younger patients after trauma.
    American Journal of Roentgenology 11/2012; 199(5):W613-7. DOI:10.2214/AJR.11.7313 · 2.74 Impact Factor

Publication Stats

603 Citations
203.58 Total Impact Points

Institutions

  • 2004–2015
    • Mater Misericordiae University Hospital
      • Department of Radiology
      Dublin, Leinster, Ireland
  • 2003–2014
    • Cappagh National Orthopaedic Hospital
      Dublin, Leinster, Ireland
  • 2011
    • Dana-Farber Cancer Institute
      Boston, Massachusetts, United States
  • 2008
    • Thomas Jefferson University Hospitals
      Filadelfia, Pennsylvania, United States
    • Northwestern Memorial Hospital
      • Department of Radiology
      Chicago, Illinois, United States
  • 2006–2008
    • University of Pittsburgh
      • Department of Radiology
      Pittsburgh, Pennsylvania, United States
    • Thomas Jefferson University
      • Department of Radiology
      Philadelphia, PA, United States
  • 2005–2008
    • Vancouver General Hospital
      • Department of Radiology
      Vancouver, British Columbia, Canada
  • 2007
    • UPMC
      Pittsburgh, Pennsylvania, United States