Ramin Midia

University of Iowa, Iowa City, Iowa, United States

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Publications (6)7.95 Total impact

  • M. Midia · R. Midia
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    ABSTRACT: We described a simple technique and recipe for bilateral inferior petrosal sinus sampling.Background Bilateral inferior petrosal sinus sampling (BIPSS) is the gold standard in diagnosing Cushing disease and distinguishing a central source of adrenocorticotropic hormone (ACTH) secretion (i.e., a pituitary adenoma) from an ectopic source. Catheterization of IPS is technically demanding and even an experienced interventionalist may fail in up to 30% of cases.Clinical Findings/Procedure Details1. Review contrast enhanced MRV to identify IPS venous anatomy.2. Obtain access from right common femoral and left brachial vein and place 7 French vascular sheaths. This allows easy cannulation of left internal jugular vein and two separate sample collection stations.3. Two 5 French MPA or Davis catheters are parked in mid- low internal jugular vein (IJV) and high flow micro-catheters with straight 0.0014 wires pulled back several inches from their tip are advanced back and forth several times beyond the level of the sigmoid sinus. This maneuver allows the microcatheter tip to seek and engage the IPS given its origin from the medial and superior curve of sigmoid sinus.4. If the above described “bare back selection" fails, we proceed with sweeping of the entire length of IJV with the mircocatheter and subsequently with a 5 French catheter aiming for engaging a low inserting IPS. If the later fails we proceed with cannulation of contralateral IPS using the above described steps. Once unilateral IPS catheterization is achieved we perform selective IPS venogram to identify the anatomy of the contralateral IPS and its take off from IJV.5. Subsequent to bilateral cannulation venous sampling is carried out using modified University of Pittsburgh protocol prior and after peripheral intravenous injection of desmopressin (DDAVP).Conclusion and/or Teaching PointsUsing the above described method we were able to perform 5 successful BIPSS with fluoroscopy time ranging between 5-15 minutes in the past 18 month in our center.Reference1. Deipolyi AR, et al. Bilateral inferior petrosal sinus sampling. J Neurointerv Surg 2011;4:215-18.
    No preview · Article · Apr 2013 · Journal of Vascular and Interventional Radiology
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    ABSTRACT: There are several methods for the diagnosis and evaluation of coarctation of the aorta. Digital Subtraction Angiography (DSA) is the standard detection method, though it entails complications and side-effects. The aim of the present study was to compare Computed Tomography (CT) angiography with DSA for diagnosing aortic coarctation. We performed a cross-sectional study of 15 patients (11 males and four females aged between two and 30 years) referred to Tabriz Shahid Madani Hospital and Imaging Center between August 2005 and February 2006 with suspected aortic coarctation. All patients were subjected to DSA and CT angiography for diagnosis of aortic coarctation. The mean age of the patients was 14.6 years; 11 were male (74.4%) and four (26.6%) were female. The DSA and CT angiography results were comparable in all patients in terms of diagnosis and the detection of complications, particularly cardiovascular complications. However, CT angiography was less time-consuming to perform than DSA (p < 0.0001). In conclusion, CT angiography, comparableto DSA, diagnosed coarctation of aorta in all the patients. However, CT angiography is a non-invasive, cost effective procedure that takes significantly less time to carry out than DSA. Therefore, CT angiography is recommended as an appropriate method for diagnosing the coarctation of aorta.
    No preview · Article · Jan 2011 · Pakistan Journal of Biological Sciences
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    ABSTRACT: Multiple Sclerosis (MS) begins most commonly in young adults and is characterized by multiple areas of Central Nervous System (CNS) white matter inflammation, demyelination and glial scarring. The most valuable laboratory aid for diagnosing MS is Magnetic Resonance Imaging (MRI). An advanced type of MRI that exploits molecular diffusion can detect acute and active lesions. Early diagnosis and onset of treatment help to hinder disease progression. The aim of this study was to compare the findings of conventional and Diffusion-Weighted (DW) MRI in assessing the cerebral lesions of MS patients. Thirty patients with clinically definite MS (mean age 32.76 +/- 8.79 years) and an age- and sex-matched control group of 30 healthy volunteers (mean age 32.75 +/- 9.23 years) were enrolled in this 12 month descriptive-prospective survey. Both groups were subjected to conventional and DW MRI and were compared in respect of the total number, morphology, location and the mean size of the intra-cerebral MS plaques. The sensitivities and specificities of both imaging methods in detecting these plaques were determined. The conventional method revealed significantly more plaques within the brain (p < 0.05) and showed more ovoid lesions. More lesions were detected by the conventional method in the periventricular area, centrum semiovale and corpus callosum. The minimum plaque size was significantly lower in the conventional method group. The sensitivity of both methods was 100%. The specificities of conventional and DW MRI were 86.6 and 96.6%, respectively, so DW MRI may detect lesions that are not obvious by routine methods.
    No preview · Article · Dec 2010 · Pakistan Journal of Biological Sciences
  • Zinat Miabi · Nariman Nezami · Mehran Midia · Ramin Midia
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    ABSTRACT: A 67-year-old man fell from an agricultural vehicle and struck his right eye on a protruding element. Eight hours later, he was brought to the emergency unit of an ophthalmology hospital where examiners could not find the right eye and believed it to have been completely destroyed. However, CT disclosed that the eye, apparently still intact, had been displaced into the anterior cranial fossa through a fracture in the orbital roof. This is the first documentation of such a phenomenon.
    No preview · Article · Dec 2009 · Journal of neuro-ophthalmology: the official journal of the North American Neuro-Ophthalmology Society
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    Z Miabi · M Midia · R Midia
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    ABSTRACT: Tumors of the central nervous system (CNS), occur relatively frequently during the early years of life. They are the most common solid tumors of childhood and are second only to leukemia in overall cancer incidence and account for a high proportion of deaths. In different studied performed in several countries, astrocytomas and other gliomas (combined) account for half of the CNS malignancies, followed by PNET/MB, and ependymomas, and then craniopharyngioma. We have undertaken a perspective study with 349 brain tumor patients, ranging from 0-14 years of age, throughout a five-year period (1998-2003). Who were admitted in Tabriz children hospital or were diagnosed in Tabriz Hafez imaging center, during radiological evaluation by CT. Craniopharyngioma was the most common type of tumors among patients studied in our Series, and astrocytomas was second and medulloblastoma was third common type. The Male/Female proportion of patients in total brain tumors according to our results is 1.56 and it is similar to previous studies. About medulloblastoma and ependymomas, Male/Female proportion of patients in this study is less than 1 (0.88, 0.7), but in previous series it seems to be more than 1 (about 1.4). Age-related distribution of brain tumors in children under the age 14 was similar to that of other series to some extent. Also, since the causes and risk factors of CNS cancers remain largely undetermined, we could not reach a significant relationship between the tumors and residency of patients. Hope our results make a useful for the future studies in this field, and differences obtained in this study with results of other series, can help us more and more in management and treatment strategies in brain tumors in children of our population.
    Preview · Article · Nov 2006 · Acta medica Iranica
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    ABSTRACT: The lateral tentorial sinus (LTS) has not been well described in the imaging literature. The aim of this study was to investigate the value of MR imaging in assessing the LTS, which may provide guidance for preoperative planning. Fifty-five adult patients underwent MR imaging of the brain. Four neuroradiologists evaluated the studies for delineation of the LTS and its branches. Presence of arachnoid granulation and dominance of the venous drainage also were reported. An LTS was detected in 104 of 110 lobes. The LTS in each lobe was classified as type I (candelabra) in 30 (28.8%), type II (independent veins) in 22 (21.1%), and type III (venous lakes) in 37 (35.5%); in 15 (14.4%) of the lobes, the LTS was indeterminate. LTS branches were inconsistently detected, with the exception of the vein of Labbé (VL). Five of eight branches were seen in approximately half of the cases. The VL was identified in 94 (85.4%) lobes. Among these, 53 (56.4%) were draining into the LTS and 22 (23.4%) into the transverse sinus; in 19 (20.2%) cases, the terminal portion was not visualized. The right transverse sinus was dominant in 19 (34.5%) patients and the left in 18 (32.7%); codomination was present in 18 (32.7%) cases. At least one arachnoid granulation was seen in the transverse sinus in 27 (49.1%) patients. In many instances, the LTS and VL drainage patterns were well delineated on routine MR images. For selected cases, this information may be crucial during lateral skull base surgery to avoid venous infarct.
    Full-text · Article · Sep 2004 · American Journal of Neuroradiology