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Son SY, Seo YS, Yoon JH, Hur BY, Bae JS, Kim SH. Diagnostic Performance of Rectal CT for Staging Rectal Cancer: Comparison with Rectal MRI and Histopathology. J Korean Soc Radiol 2023; 84:1290-1308. [PMID: 38107688 PMCID: PMC10721426 DOI: 10.3348/jksr.2022.0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/21/2023] [Accepted: 03/10/2023] [Indexed: 12/19/2023]
Abstract
Purpose To compare the diagnostic performance of rectal CT with that of high-resolution rectal MRI and histopathology in assessing rectal cancer. Materials and Methods Sixty-seven patients with rectal cancer who underwent rectal CT with rectal distension using sonographic gel and high-resolution MRI were enrolled in this study. The distance from the anal verge/anorectal junction, distance to the mesorectal fascia (MRF), extramural depth (EMD), extramesorectal lymph node (LN) involvement, extramural venous invasion (EMVI), and T/N stages in rectal CT/MRI were analyzed by two gastrointestinal radiologists. The CT findings of 20 patients who underwent radical surgery without concurrent chemoradiotherapy were compared using histopathology. Interclass correlations and kappa statistics were used. Results The distance from the anal verge/anorectal junction showed an excellent intraclass correlation between CT and MRI for both reviewers. For EMD, the distance to the MRF, presence of LNs, extramesorectal LN metastasis, EMVI, T stage, and intermodality kappa or weighted kappa values between CT and MRI showed excellent agreement. Among the 20 patients who underwent radical surgery, T staging, circumferential resection margin involvement, EMVI, and LN metastasis on rectal CT showed acceptable concordance rates with histopathology. Conclusion Dedicated rectal CT may be on par with rectal MRI in providing critical information to patients with rectal cancer.
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Oliveira Santos P, Caldeira JP. Lung Cancer-Related Pneumopericardium. ACTA MEDICA PORT 2022; 35:150-151. [PMID: 33588984 DOI: 10.20344/amp.13802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/27/2020] [Revised: 10/15/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Pedro Oliveira Santos
- Serviço de Radiologia. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal
| | - João Pedro Caldeira
- Serviço de Radiologia. Instituto Português de Oncologia de Lisboa Francisco Gentil. Lisboa. Portugal
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Duarte-Batista P, Hipólito Reis J, Silva J, Sequeira Lemos S, Cubas Farinha N, Marques R, Páscoa Pinheiro J, Tuna R, Antunes C, Machado MJ, Branco J, Roque D, Simão D, Simas N, Teixeira W, Felício C, Ferreira M, Rocha L, Figueiredo G, Noronha C, Pinto V, Silva F, Ferreira A, Sousa O. Reply to Letter to the Editor Concerning "HIPTCN: Prospective Observational Study of Hypocoagulated Head Trauma Patients with Normal Admission Computed Tomography Scan". ACTA MEDICA PORT 2022; 35:155-156. [PMID: 35225781 DOI: 10.20344/amp.17630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022]
Affiliation(s)
- Pedro Duarte-Batista
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - José Hipólito Reis
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - João Silva
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Samuel Sequeira Lemos
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Nuno Cubas Farinha
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Renata Marques
- Serviço de Neurocirurgia. Hospital de Braga. Braga. Portugal
| | - João Páscoa Pinheiro
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Coimbra. Coimbra. Portugal
| | - Rui Tuna
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
| | | | | | - Jessica Branco
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Diogo Roque
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Diogo Simão
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Nuno Simas
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Wilson Teixeira
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Angola
| | - Cátia Felício
- Serviço de Cirurgia Geral. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Miguel Ferreira
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Luís Rocha
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | | | - Carolina Noronha
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Vasco Pinto
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Filipe Silva
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Ana Ferreira
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
| | - Osvaldo Sousa
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
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Rozema R, Doff MHJ, El Moumni M, Boomsma MF, Spijkervet FKL, van Minnen B. Diagnostic accuracy of physical examination findings for midfacial and mandibular fractures. Injury 2021; 52:2616-2624. [PMID: 34103150 DOI: 10.1016/j.injury.2021.05.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/24/2021] [Accepted: 05/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To assess the diagnostic accuracy of physical examination findings used to identify patients at risk for midfacial or mandibular fractures. MATERIALS AND METHODS A five-year retrospective cohort was constructed from all emergency department patients with a midfacial or mandibular trauma. The sensitivity, specificity, pre-test probability, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio data was calculated for 19 and 14 physical examination findings for midfacial and mandibular fractures respectively. Computed Tomography and panoramic radiography were used as index tests. RESULTS A total of 1484 patients were identified among whom 40.4% midfacial and 33.4% mandibular fractures were diagnosed. Overall, specificity was found to be higher than sensitivity. Regarding midfacial fractures, high specificity was found for raccoon eyes, malar eminence flattening and all the findings that are related to palpation, the nasal, ocular and intra-oral assessment. Malar eminence flattening, external nasal deformity, nasal septum hematoma, change of globe position and palpable step-off had ad high positive predictive value and positive likelihood ratio. Regarding mandibular fractures high specificity was found for mouth opening restriction, auditory canal bleeding, intra-oral assessment related findings, palpable step-off, inferior alveolar nerve paresthesia, the angular compression test and chin axial pressure test. CONCLUSIONS The diagnostic accuracy of relevant physical examination findings were identified for the prediction of midfacial and mandibular fractures.
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Affiliation(s)
- Romke Rozema
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
| | - Michiel H J Doff
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands; Department of Oral and Maxillofacial Surgery, Nij Smellinghe Hospital, Drachten, Netherlands
| | - Mostafa El Moumni
- Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Frederik K L Spijkervet
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Baucke van Minnen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Duarte-Batista P, Farinha NC, Marques R, Pinheiro JP, Silva J, Tuna R, Reis JH, Antunes C, Machado MJ, Lemos SS, Branco J, Roque D, Simão D, Simas N, Teixeira W, Felício C, Ferreira M, Cunha E, Rocha L, Figueiredo G, Noronha C, Pinto V, Silva F, Ferreira A, Sousa O. HIPTCN: Prospective Observational Study of Hypocoagulated Head Trauma Patients with Normal Admission Computed Tomography Scan. ACTA MEDICA PORT 2021; 34:413-419. [PMID: 34715948 DOI: 10.20344/amp.13770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 03/23/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Our national protocol for traumatic brain injury dictates that hypocoagulated patients with mild trauma and initial tomography scan with no intracranial traumatic changes must be hospitalized for 24 hours and do a post-surveillance tomography scan. The main goal of this study was to evaluate the clinical relevance of these measures. MATERIAL AND METHODS A prospective observational study was undertaken in four hospitals. Adult hypocoagulated traumatic brain injury patients with a normal tomography scan were included. The main outcomes evaluated were rate of delayed intracranial hemorrhage, rate of admission in a neurosurgical department, rate of complications related with surveillance and rate of prolonged hospitalization due to complications. An analysis combining data from a previously published report was also done. RESULTS A total of 178 patients were included. Four patients (2.3%) had a delayed hemorrhage and three (1.7%) were hospitalized in a neurosurgery ward. No cases of symptomatic hemorrhage were identified. No surgery was needed, and all patients had their anticoagulation stopped. Complications during surveillance were reported in seven patients (3.9%), of which two required prolonged hospitalization. DISCUSSION The rate of complications related with surveillance was higher than the rate of delayed hemorrhages. The initial period of in-hospital surveillance did not convey any advantage since the management of patients was never dictated by neurological changes. Post-surveillance tomography played a role in deciding about anticoagulation suspension and prolongation of hospitalization. CONCLUSION Delayed hemorrhage is a rare event and the need for surgery even rarer. The need for in-hospital surveillance should be reassessed.
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Affiliation(s)
- Pedro Duarte-Batista
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Nuno Cubas Farinha
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Renata Marques
- Serviço de Neurocirurgia. Hospital De Braga. Braga. Portugal
| | - João Páscoa Pinheiro
- Serviço de Neurocirurgia. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal
| | - João Silva
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Rui Tuna
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
| | - José Hipólito Reis
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | | | | | - Samuel Sequeira Lemos
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Jessica Branco
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Diogo Roque
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Diogo Simão
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Nuno Simas
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Wilson Teixeira
- Serviço de Neurocirurgia. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Cátia Felício
- Serviço de Cirurgia Geral. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Portugal
| | - Miguel Ferreira
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Eduardo Cunha
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Luís Rocha
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | | | - Carolina Noronha
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Vasco Pinto
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Filipe Silva
- Serviço de Neurocirurgia. Centro Hospitalar do Porto. Porto. Portugal
| | - Ana Ferreira
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
| | - Osvaldo Sousa
- Serviço de Neurocirurgia. Centro Hospitalar de São João. Porto. Portugal
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Abolvardi M, Akhlaghian M, Hamidi Shishvan H, Dastan F. Detection of different foreign bodies in the maxillofacial region with spiral computed tomography and cone-beam computed tomography: An in vitro study. Imaging Sci Dent 2021; 50:291-298. [PMID: 33409137 PMCID: PMC7758271 DOI: 10.5624/isd.2020.50.4.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.
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Affiliation(s)
- Masoud Abolvardi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Marzieh Akhlaghian
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Hamidi Shishvan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Farivar Dastan
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
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Yoon S, Mihn DC, Song JH, Kim SA, Yim JJ. Evolution of Interferon-Gamma Release Assay Results and Submillisievert Chest CT Findings among Close Contacts of Active Pulmonary Tuberculosis Patients. Tuberc Respir Dis (Seoul) 2020; 83:283-288. [PMID: 32640768 PMCID: PMC7515678 DOI: 10.4046/trd.2020.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/07/2020] [Indexed: 11/24/2022] Open
Abstract
Background Latent tuberculosis (TB) infection among TB contacts is diagnosed using plain chest radiography and interferon-gamma release assays (IGRAs). However, plain chest radiographs often miss active TB, and the results of IGRA could fluctuate over time. The purpose of this study was to elucidate changes in the results of the serial IGRAs and in the findings of the serial submillisievert chest computed tomography (CT) scans among the close contacts of active pulmonary TB patients. Methods Patients age 20 or older with active pulmonary TB and their close contacts were invited to participate in this study. Two types of IGRA (QuantiFERON-TB Gold In-Tube assay [QFT-GIT] and the T-SPOT.TB test [T-SPOT]) and submillisievert chest CT scanning were performed at baseline and at 3 and 12 months after enrollment. Results In total, 19 close contacts participated in this study. One was diagnosed with active pulmonary TB and was excluded from further analysis. At baseline, four of 18 contacts (22.2%) showed positive results for QFT-GIT and T-SPOT; there were no discordant results. During the follow-up, transient and permanent positive or negative conversions and discordant results between the two types of IGRAs were observed in some patients. Among the 17 contacts who underwent submillisievert chest CT scanning, calcified nodules were identified in seven (41.2%), noncalcified nodules in 14 (82.4%), and bronchiectasis in four (23.5%). Some nodules disappeared over time. Conclusion The results of the QFT-GIT and T-SPOT assays and the CT images may change during 1 year of observation of close contacts of the active TB patients.
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Affiliation(s)
- Soonho Yoon
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | | | - Jin-Hwa Song
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Sung A Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Abstract
Abstract Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese and co-morbid patients. Surgeons with a specific interest in CVH repair are now frequently referring these patients for imaging, normally computed tomography scanning. This review describes what information is required from preoperative imaging and the surgical options and techniques used for CVH repair, so that radiologists understand the postoperative appearances specific to CVH and are aware of the common complications following surgery. Key Points • Complex ventral hernia (CVH) describes large abdominal wall hernias (e.g. width ≥10cm). • CVH patients are being referred increasingly for preoperative and postoperative imaging. • Imaging is pivotal to characterise preoperative morphology and quantify loss of domain. • Postoperative imaging appearances are contingent on the surgical methods used for CVH repair. • Postoperative complications are depicted easily by imaging.
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Abstract
A number of tumors and tumor-like non-neoplastic lesions with different cell types on histology occur in the skull base. A wide variety in disease and lesion appearance often complicates the process of radiological diagnosis. The main role of radiographic imaging is the detection and characterization of skull base lesions, with evaluation of the extent of invasion or preservation of adjacent critical organs. Evaluation of the skull base anatomy and surgical planning by using image guidance are also important for surgeons. Computed tomography (CT) and magnetic resonance (MR) imaging are the preferred modalities for the evaluation of skull base lesions. CT and MR are used for lesion detection, tissue characterization and assessment of neurovascular and bone involvement by the lesions. Both modalities provide useful information, one sometimes of greater value than the other. T1-weighted MR imaging is useful in detecting skull base lesions, typically surrounded by abundant fatty bone marrow. T2-weighted MR imaging is generally useful for tumor tissue characterization. CT surpasses MR imaging in evaluating intratumoral calcification and bone destruction or hyperostosis. To date, imaging features have been well-reported in individual skull base tumors; however, correct diagnosis by imaging alone still presents a challenge. Knowledge of clinical issues and awareness of variants of skull base tumors are of help in making a diagnosis. The purpose of this article is to review pertinent clinical issues, typical imaging appearances and certain imaging variations of common skull base lesions.
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Affiliation(s)
- Akira Kunimatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Natsuko Kunimatsu
- Department of Radiology, Mita Hospital, International University of Health and Welfare, Tokyo, Japan
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Chrzan R, Jurczyszyn A, Urbanik A. Whole-Body Low-Dose Computed Tomography (WBLDCT) in Assessment of Patients with Multiple Myeloma - Pilot Study and Standard Imaging Protocol Suggestion. Pol J Radiol 2017; 82:356-363. [PMID: 28740565 PMCID: PMC5505575 DOI: 10.12659/pjr.901742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 10/17/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND For decades, the main imaging tool in multiple myeloma (MM) patients was plain radiography. However, computed tomography (CT) has been included in the updated criteria of MM. The main disadvantage of CT is a considerably high radiation dose. Therefore, low-dose CT protocols could be a solution. The aim of the study was to (1) preliminarily analyse the usefulness of Whole-Body Low-Dose CT (WBLDCT) in the evaluation of patients with MM and (2) to make adjustments in the standard CT imaging protocol. MATERIAL/METHODS In 41 patients with MM, WBLDCT was performed. The following parameters were used: detector configuration - 80×0.5 mm, scanning range in a single spiral acquisition from the skull to the proximal femoral bones, tube voltage - 120 kVp, current tube time product - 86 mAs, slice thickness 1 mm. Two sets of axial images were reconstructed for bone and soft tissue assessment, respectively. Secondary coronal and sagittal reconstructions were generated. Typical MM features were analysed and qualitatively compared with radiography results. RESULTS A potentially increased sensitivity of CT, as compared to radiography, in detecting lytic foci obscured by other structures or with a small degree of destruction was seen. A potentially increased specificity of CT was found in detecting cases of small foci suspicious of lytic lesions on skull radiographs, seen as arachnoid granulations fovea in CT. The following radiation parameters were recorded: max. CTDIvol - 7.4 mGy and DLP - 660-810 mGy×cm. WBLDCT was much shorter and more convenient to patients. CONCLUSIONS WBLDCT may become a valuable part of the assessment of MM features at a much lower radiation dose compared to standard CT protocols. It has a potential ability to increase diagnostic accuracy compared to radiography.
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Affiliation(s)
- Robert Chrzan
- Department of Radiology, Jagiellonian University Medical College, Cracow, Poland
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Cracow, Poland
| | - Andrzej Urbanik
- Department of Radiology, Jagiellonian University Medical College, Cracow, Poland
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Kaur R, Singh P, Kaur N, Bhatnagar S, Dahuja A. Role of Computed Tomography (CT) in Localisation and Characterisation of Suprahyoid Neck Masses. Pol J Radiol 2017; 82:263-270. [PMID: 28580042 PMCID: PMC5439378 DOI: 10.12659/pjr.901072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/05/2016] [Indexed: 11/09/2022] Open
Abstract
Background Suprahyoid neck lesions are difficult to assess only by means of clinical inspection and therefore imaging techniques are required to precisely evaluate suprahyoid neck spaces. The aim of this study was to evaluate the distinctive role of computed tomography in the assessment of anatomical source and pathological type of masses involving the suprahyoid neck spaces. Material/Methods Sixty patients presenting with suprahyoid neck masses underwent computed tomography of the neck. The CT findings were correlated with histopathological findings and a final diagnosis was made. Results Overall, male preponderance was seen except in the case of parotid space lesions where female predominance was seen. The most common aetiology was squamous cell carcinoma and the majority of cases (30%) were seen in patients aged 41–50 years. The majority of lesions were found in the pharyngeal mucosal space (n=16) with squamous cell carcinoma being the most common pathology. In the parotid space, pleomorphic adenoma and in the prestyloid parapharyngeal space, squamous cell carcinoma were the most common lesions, respectively. In the retropharyngeal space, an equal incidence of malignant and inflammatory aetiologies was seen. Abscesses were the most common lesions in the prevertebral space. The pleomorphic adenoma was the most common benign tumour and was also the second most common tumour in the suprahyoid neck spaces. CT had an excellent correlation with histopathological findings with sensitivity of 96.4%, specificity of 100%, positive predictive value of 100% and a negative predictive value of 91.67%. Conclusions Computed tomography definitely has a major role to play in the evaluation of suprahyoid neck masses as it has an excellent correlation with post-operative histopathological diagnosis.
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Affiliation(s)
- Rashmeet Kaur
- Department of Radiology, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Paramdeep Singh
- Department of Radiology, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Navkiran Kaur
- Department of Radiology, Government Medical College and Hospital, Patiala, Punjab, India
| | - Simmi Bhatnagar
- Department of Radiology, Government Medical College and Hospital, Patiala, Punjab, India
| | - Anshul Dahuja
- Department of Orthopedics, Guru Gobind Singh Medical College and Hospital, Baba Farid University of Health Sciences, Faridkot, Punjab, India
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Das SK, Shetty SP, Sen KK. A Novel Triage Tool: Optic Nerve Sheath Diameter in Traumatic Brain Injury and its Correlation to Rotterdam Computed Tomography (CT) Scoring. Pol J Radiol 2017; 82:240-243. [PMID: 28533826 PMCID: PMC5419089 DOI: 10.12659/pjr.900196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/31/2016] [Indexed: 11/24/2022] Open
Abstract
Background Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. Material/Methods Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated. RCTS was assessed on the same CT images, bias was eliminated by blinding RCTS to ONSD measurement. Results 150 patients were included; mean age in the group was 42.94±16.7 years. ONSD in mild TBI, RCTS 2 and 3 were 3.3 mm (SD 0.39 mm) and 4.1 mm (0.047 mm), respectively. Mean ONSD in moderate and severe TBI (RCTS score 4 and above) was 4.83 mm and above, SD 0.4 mm. Mean ONSD correlated with occurrence of diffuse cerebral oedema, presence of subdural and extradural hematoma; however in isolation there was no statistical significance. Conclusions Higher ONSD was observed in patients with moderate and severe TBI, correlating with admission RCTS of 4 and above. Subsequent increase in ONSD was also found with increase in RCTS. ONSD could serve as an initial triage tool in the emergency department as well as a method of determining the need for sequential CT in patients with mild TBI.
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Affiliation(s)
- Sudha Kiran Das
- Department of Radiodiagnosis and Imaging, JSS Medical College and Hospital (JSS University), Mysore, Karnataka, India
| | - Sachin P Shetty
- Department of Radiodiagnosis and Imaging, JSS Medical College and Hospital (JSS University), Mysore, Karnataka, India
| | - Kamal Kumar Sen
- Department of Radiodiagnosis and Imaging, JSS Medical College and Hospital (JSS University), Mysore, Karnataka, India
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13
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Gradzik M, Niemczyk M, Gołębiowski M, Pączek L. Diagnostic Imaging of Autosomal Dominant Polycystic Kidney Disease. Pol J Radiol 2016; 81:441-453. [PMID: 27733888 PMCID: PMC5031169 DOI: 10.12659/pjr.894482] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 02/19/2016] [Indexed: 12/21/2022] Open
Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic disorders caused by a single gene mutation. The disease usually manifests itself at the age of 30-40 years and is characterized by formation of renal cysts along with the enlargement of kidneys and deterioration of their function, eventually leading to renal insufficiency. Imaging studies (sonography, computed tomography, magnetic resonance imaging) play an important role in the diagnostics of the disease, the monitoring of its progression, and the detection of complications. Imaging is also helpful in detecting extrarenal manifestations of ADPKD, most significant of which include intracranial aneurysms and cystic liver diseases.
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Affiliation(s)
- Monika Gradzik
- Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Niemczyk
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Marek Gołębiowski
- Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Leszek Pączek
- Department of Immunology, Transplant Medicine and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
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Gossner J. Intramammary Findings on CT of the Chest - a Review of Normal Anatomy and Possible Findings. Pol J Radiol 2016; 81:415-421. [PMID: 28058068 PMCID: PMC5181571 DOI: 10.12659/pjr.896312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 01/31/2016] [Indexed: 01/10/2023] Open
Abstract
Computed tomography (CT) is a frequently performed examination in women of all ages. In all thoracic CT examinations of the chest at least parts of the breasts are included. Therefore incidental breast pathology may be observed. It has been suggested that one out of 250 women undergoing chest CT will show a malignant incidental breast lesion. Given the high number of performed chest CT examinations, this contributes to a significant number of malignancies. In this review, after a brief discussion of the value of computed tomography in breast imaging, normal and pathologic findings are discussed to create awareness of this potential “black box” on chest CT.
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Affiliation(s)
- Johannes Gossner
- Department of Clinical Radiology, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
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15
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Sobiecka A, Bekiesińska-Figatowska M, Rutkowska M, Latos T, Walecki J. Clinically Unjustified Diagnostic Imaging - a Worrisome Tendency in Today's Medical Practice. Pol J Radiol 2016; 81:325-30. [PMID: 27471577 PMCID: PMC4946391 DOI: 10.12659/pjr.896847] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 11/27/2015] [Indexed: 11/20/2022] Open
Abstract
Background The purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily. Material/Methods Three radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification. Results 73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details. Conclusions In our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher.
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Affiliation(s)
- Aleksandra Sobiecka
- Department of Diagnostic Radiology, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland
| | | | - Milena Rutkowska
- Warsaw School of Economics, Collegium of Socio-Economics, Warsaw, Poland
| | - Tomasz Latos
- Department of Radiology and Diagnostic Imaging, Medical Centre for Postgraduate Education, Professor Adam Gruca's Clinical Hospital, Otwock, Poland
| | - Jerzy Walecki
- Department of Diagnostic Radiology, Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland; Department of Radiology and Diagnostic Imaging, Medical Centre for Postgraduate Education, Professor Adam Gruca's Clinical Hospital, Otwock, Poland
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16
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Karagöz E, Özel D, Özkan F, Özel BD, Özer Ö, Coşkun ZÜ. Effectiveness of Computed Tomography Guided Percutaneous Radiofrequency Ablation Therapy for Osteoid Osteoma: Initial Results and Review of the Literature. Pol J Radiol 2016; 81:295-300. [PMID: 27429671 PMCID: PMC4920061 DOI: 10.12659/pjr.896475] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/13/2015] [Indexed: 11/09/2022] Open
Abstract
Background The aim of this retrospective study is to determine our experience of technique success rate, complications and clinical results in long term follow up for computed tomography (CT)-guided radiofrequency ablation [RA] therapy for osteoid osteoma (OO). Material/Methods We performed RA therapy to 18 patients with OO referred to interventional radiology from other clinics primarily from orthopedics; between January 2011 to May 2014. Daytime and nighttime pain intensity of 18 patients was noted according to visual analog scale (VAS). After procedure pain intensity was compared with before one. We also discussed other factors can affect it. Results All procedures were completed technically successful for all patients [100%]. We did not experience any major complication or mortality. However we had 3 minor complications. Pain came back in 1 patient after 5 months from procedure and it was considered as recurrence. Dramatic pain intensity fall was seen in patients after procedure, both daytime and nighttime. However we did not find and statistically significant change in comparison of pain intensity reduce and time needed to return back to routine life when using patients demographic data and lesion size. Conclusions CT guided RA therapy of OO is minimally invasive, effective and secure procedure.
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Affiliation(s)
- Erdal Karagöz
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Deniz Özel
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Fuat Özkan
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Betül Duran Özel
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Özgur Özer
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
| | - Zafer Ünsal Coşkun
- Department of Radiology, Okmeydani Education and Research Hospital, Istanbul, Turkey
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17
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Abstract
BACKGROUND Rapunzel syndrome is a rare and unique form of trichobezoar, in which a cast of hairs is formed in the stomach with its 'tail' extending up to varying lengths into the small bowel. Almost all cases described in literature are of 'classic' and more common form of Rapunzel. Sometimes however, the tail of bezoar is broken into smaller fragments. There is not much literature available on this rarer subset of Rapunzel syndrome. CASE REPORT In this report we present the ultrasound (USG) and CT findings of a case of Rapunzel syndrome in which the tail had broken into five separate fragments. The patient presented clinically with intestinal obstruction due to the impaction of the distal- most fragment in the ileum. CONCLUSIONS Our case highlights the fact that although USG features may be suggestive, a careful evaluation of CT images is essential for a confidant preoperative diagnosis of Rapunzel syndrome. In cases of this syndrome with a broken tail, CT is essential for precise count and localization of the separated fragments to ensure their complete removal at the time of surgery. We also propose to name the fragments of the broken tail as 'bezoarlets'. This word aptly describes the tail fragments as it suggests their origin from the larger gastric bezoar and the suffix 'lets' conveys they are smaller in size.
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Affiliation(s)
- Narvir S. Chauhan
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Satish Kumar
- Department of Surgery, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Rohit Bhoil
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
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Ghareep AN, Alkuwari M, Willington F, Szmigielski W. Kawasaki Disease: Diagnosis and Follow-Up by CT Coronary Angiography with the Use of 128-Slice Dual Source Dual Energy Scanner. A Case Report. Pol J Radiol 2015; 80:526-8. [PMID: 26688702 PMCID: PMC4671404 DOI: 10.12659/pjr.894680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/29/2015] [Indexed: 12/18/2022] Open
Abstract
Background Kawasaki Disease (KD) is a rare acute febrile illness due to multi-organ vasculitis. It most often affects children under five years of age. Coronary artery aneurysms are seen in about 25% of children with KD. Selective invasive coronary angiography was considered to be the gold standard for diagnosis and follow-up of coronary artery aneurysms, thrombosis and stenosis in patients with KD. Echocardiography is a non-invasive tool for imaging of this condition but it does have some limitations. Recently, a high-quality multislice CT coronary angiography has been advocated in the diagnosis of KD. Case Report We report a case of a 5-year-old boy who was diagnosed with Kawasaki disease and followed up by CT coronary angiography, which provided required excellent imaging findings in the terms of the number, size and location of coronary aneurysms. Conclusions Based on imaging results of our case it can be stated that high-quality CT coronary angiography with the use of multi-slice dual source ultra-fast scanner can be considered a better and safer non-invasive diagnostic tool, an alternative to invasive catheter selective coronary angiography in the diagnosis and long-term follow-up of patients with KD, especially when echocardiographic images are limited or technically challenging.
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Affiliation(s)
- Abdel-Naser Ghareep
- Clinical Imaging Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maryam Alkuwari
- Clinical Imaging Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Francis Willington
- Clinical Imaging Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Wojciech Szmigielski
- Clinical Imaging Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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19
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Sood D, Bhoil R, Sharma M, Garg S, Sharma S. In Response to the Article "CT of Hepatic Sarcoidosis: Small Nodular Lesions Simulating Metastatic Disease". Pol J Radiol, 2015; 80: 178-180. Pol J Radiol 2015; 80:374-5. [PMID: 26300998 PMCID: PMC4523067 DOI: 10.12659/pjr.894624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 05/25/2015] [Indexed: 11/23/2022] Open
Affiliation(s)
- Dinesh Sood
- Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Shimla, India
| | - Rohit Bhoil
- Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Shimla, India
| | - Manika Sharma
- Department of Pathology, Indira Gandhi Medical College, Shimla, India
| | - Swati Garg
- Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Shimla, India
| | - Samriti Sharma
- Department of Radiodiagnosis, Dr. Rajendra Prasad Government Medical College, Shimla, India
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20
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Sood D, Mistry KA, Chadha V, Sharma S, Morey PD, Suthar PP, Patel DG. Membranous IVC Obstruction Presenting with Antegrade/Retrograde Respiratory Flow in the Intrahepatic Segment in Doppler Imaging and Prostatic and Urethral Congestion. Pol J Radiol 2015; 80:350-5. [PMID: 26191114 PMCID: PMC4501637 DOI: 10.12659/pjr.894408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 05/06/2015] [Indexed: 12/01/2022] Open
Abstract
Background Obstruction of the inferior vena cava (IVC) is infrequent, membranous obstruction of the IVC (MOIVC) being one of its rare causes. Early diagnosis is important, as it can lead to hepatic congestion, cirrhosis and Budd-Chiari syndrome (BCS) and can predispose to development of hepatocellular carcinoma (HCC) in severe cases. Case Report We report a case of membranous IVC obstruction at the junction of hepatic and suprahepatic segments in a young male with extensive collateralization and venous aneurysms. Unique findings involved antegrade and retrograde flow during respiration in the upper part of intrahepatic IVC proximal to a large collateral vein as well as prostatic and urethral congestion leading to intermittent urinary hesitancy, which have not yet been described in such cases. Conclusions MOIVC is a rare cause of IVC obstruction with typical radiological features. Early diagnosis and management is required due to risk of cirrhosis and HCC. Antegrade and retrograde flow may be seen in incomplete MOIVC above the level of a large collateral vein and it may lead to prostatic and urethral congestion.
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Affiliation(s)
- Dinesh Sood
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Kewal A Mistry
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Veenal Chadha
- Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, India
| | - Sarthak Sharma
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Parikshit D Morey
- Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India
| | - Pokhraj P Suthar
- Department of Radiology, Baroda Medical College, Vadodara, India
| | - Dhruv G Patel
- Department of Cardiology, Saint Francis Hospital, Hartford, CT, U.S.A
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21
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Anderson B, Sabat S, Agarwal A, Thamburaj K. Diffuse Subarachnoid Hemorrhage Secondary to Cerebral Venous Sinus Thrombosis. Pol J Radiol 2015; 80:286-9. [PMID: 26097524 PMCID: PMC4456986 DOI: 10.12659/pjr.894122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 04/01/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Aneurysmal rupture accounts for the majority of nontraumatic subarachnoid hemorrhage (SAH). Increasingly recognized is the occurrence of nontraumatic convexity SAH unaccounted for by aneurysmal rupture. CASE REPORT These presentations require consideration of rare but clinically significant sources of SAH. We report a patient presenting with prolonged mild headaches and acute onset of seizure like activity found to have diffuse subarachnoid hemorrhage and extensive dural venous sinus thrombosis involving the superior sagittal sinus and right transverse-sigmoid sinuses. CONCLUSIONS There are few reported cases of SAH secondary to dural sinus thrombosis; however most of these are convexity hemorrhage. Sinus thrombosis presenting as diffuse SAH is extremely rare, as is showcased in this report.
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Affiliation(s)
- Brian Anderson
- Department of Neurosurgery, Penn State University, Hershey, PA, U.S.A
| | | | - Amit Agarwal
- Department of Radiology, Penn State University, Hershey, PA, U.S.A
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22
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Abstract
BACKGROUND Thyrolipomas seem to be a rare occurrence and until now their prevalence has only been reported in two studies. Because of the known significant geographic variations of thyroid disease, generalizability of these findings is uncertain as well as the management of found thyrolipomas. MATERIAL/METHODS Retrospective study of 107 computed tomography scans of the chest of a European inpatient population. A literature review was performed and considerations for pragmatic management were proposed. RESULTS Thyrolipomas were found in 2.8% of patients. All thyrolipomas were smaller than 15 mm. In all patients these were incidental findings unrelated to patients symptoms. No secondary signs of malignancy could be detected. CONCLUSIONS Thyrolipomas are a common finding on cross sectional imaging. Like in this study they seem to be incidental findings lacking clinical relevance. Because of the rare possibility of an thyroid cancer with inclusion of mature fat, sonographic follow-up of incidentally discovered thyrolipomas larger than 15 mm should be suggested.
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Affiliation(s)
- Johannes Gossner
- Department of Clinical Radiology, Evangelisches Krankenhaus Göttingen-Weende, Göttingen, Germany
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23
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Akar Ö, Yaldiz C, Özdemir N, Yaman O, Dalbayrak S. Isolated Transverse Clivus Fracture without Neurodeficit: Case Report and Review of Literature. Pol J Radiol 2015; 80:151-4. [PMID: 25848439 PMCID: PMC4370353 DOI: 10.12659/pjr.893027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 11/27/2014] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Clivus is a bony surface in the posterior cranial fossa, serving as the support of the brainstem and thus neighboring important structures because of its location. Skull base fractures that cannot be shown by conventional radiography can be clearly imaged by high-resolution bone window computed tomography. CASE REPORT A 44 years-old male referred to the emergency department because of a traffic accident in the car. His only complaint was a severe neckache. His X-ray examination showed no pathology. The computed tomographic examination showed no parenchymal pathology, but a isolated transverse fracture in the clivus. CONCLUSIONS The computed tomographic examination showed isolated transverse fracture in the clivus our case presented in this paper is the first case of transverse clivus fracture without additional cranial bone fracture and neurologic deficit in the literature.
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Affiliation(s)
- Ömer Akar
- Department of Neurosurgery, Necip Fazıl State Hospital, Kahramanmaras, Turkey
| | - Can Yaldiz
- Departmant of Neurosurgery, Sakarya University Training and Research Hospital, Sakarya, Turkey
| | - Nail Özdemir
- Clinic of Neurosurgery, Specialist in Neurosurgery, Tepecik Education and Training Hospital, İzmir, Turkey
| | - Onur Yaman
- Department of Neurosurgery, University of Koç, Istanbul, Turkey
| | - Sedat Dalbayrak
- Department of Neurosurgery, Neurospinal Academy, Istanbul, Turkey
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24
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Arora R. Fibrolamellar hepatocellular carcinoma presenting as obstructive jaundice: uncommon presentation of a rare entity. Pol J Radiol 2015; 80:168-71. [PMID: 25866594 PMCID: PMC4386441 DOI: 10.12659/pjr.893039] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 12/04/2014] [Indexed: 01/20/2023] Open
Abstract
Background Fibrolamellar hepatocellular carcinoma is a rare primary malignant liver tumor, significantly different from generic hepatocellular carcinoma with distinct demographics, risk factors, imaging features, histopathology and prognosis. Case Report Unlike conventional hepatocellular carcinoma, it presents in young individuals with no preexisting hepatitis or cirrhosis and does not cause elevation of serum alpha feto proteins in most cases. This paper presents a case report of this rare tumor in a young female with an unusual clinical manifestation of obstructive jaundice (which has not been reported so far) along with a review of its imaging and pathological features, with treatment options. Conclusions Fibrolamellar HCC is a rare variant of classic HCC with different epidemiology, risk factors, clinical manifestations, radiological, pathological and prognostic features. Therefore, it is important to be familiar with the entity for its early diagnosis and management.
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Affiliation(s)
- Richa Arora
- Department of Radiology, Nizams Institute of Medical Sciences, Hyderabad, India
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25
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Olchowy C, Łasecki M, Inglot M, Zaleska-Dorobisz U. Case Report of Fire Eater's Pneumonia in Adolescent Female Patient - Evolution of Radiologic Findings. Pol J Radiol 2015; 80:18-21. [PMID: 25593634 PMCID: PMC4293316 DOI: 10.12659/pjr.892227] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 09/05/2014] [Indexed: 11/09/2022] Open
Abstract
Background We present a case of a 16-year-old girl with fire-eater’s pneumonia (hydrocarbon pneumonitis). The goal of this report was to assess evolution of radiological findings. Case Report The reported case was unique because that was the first completely described case of fire-eater’s pneumonia reported in an under-aged person. Moreover, this disease is very rare even in adults and only a few scientific reports can be found, mostly because of a small occupational group. Conclusions The aim of this report was to show that the problem of fire-eater’s pneumonia can occur in under-aged patients and should be taken into consideration in case of severe pneumonia. Another objective was to point out that chest radiograph is not sufficient to depict the evolution of radiological manifestations.
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Affiliation(s)
- Cyprian Olchowy
- Department of Radiology, Wrocław University of Medicine, Wrocław, Poland
| | - Mateusz Łasecki
- Department of Radiology, Wrocław University of Medicine, Wrocław, Poland
| | - Marcin Inglot
- Department of Radiology, Wrocław University of Medicine, Wrocław, Poland
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26
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Kim H, Cha SI, Shin KM, Lim JK, Oh S, Kim MJ, Lee YD, Kim M, Lee J, Kim CH. Clinical relevance of bronchial anthracofibrosis in patients with chronic obstructive pulmonary disease exacerbation. Tuberc Respir Dis (Seoul) 2014; 77:124-31. [PMID: 25309607 PMCID: PMC4192310 DOI: 10.4046/trd.2014.77.3.124] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 07/01/2014] [Accepted: 07/03/2014] [Indexed: 12/21/2022] Open
Abstract
Background Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. Methods A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. Results Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. Conclusion Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.
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Affiliation(s)
- Hyera Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Seung-Ick Cha
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kyung-Min Shin
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae-Kwang Lim
- Department of Radiology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Serim Oh
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Min Jung Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yong Dae Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Miyoung Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jaehee Lee
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Chang-Ho Kim
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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27
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Mayoral ÉE, Schultz R, Rosemberg S, Suzuki L, de Oliveira LAN, Kay FU. Thanatophoric dysplasia: case report of an autopsy complemented by postmortem computed tomographic study. Autops Case Rep 2014; 4:35-41. [PMID: 28580325 PMCID: PMC5448300 DOI: 10.4322/acr.2014.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 06/19/2014] [Indexed: 12/27/2022] Open
Abstract
Thanatophoric dysplasia (TD) is one of the most common lethal skeletal dysplasias, which was first designated as thanatophoric dwarfism and described in 1967. The authors report a case of a Caucasian girl with TD, born to a 31-year-old woman without comorbidities. The newborn presented respiratory distress immediately after delivery, progressing to death in less than 2 hours. An autopsy was carried out after postmortem tomographic examination. The autopsy findings depicted extensive malformations of the skeletal system and the brain. The aim of this report is to discuss the pathogenesis and correlate the morphologic features of TD that were disclosed at the tomography and the autopsy.
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Affiliation(s)
- Éber Emanuel Mayoral
- Pathological Anatomical Division - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP, Brazil
| | - Regina Schultz
- Pathological Anatomical Division - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP, Brazil
| | - Sérgio Rosemberg
- Department of Pathology - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP, Brazil
| | - Lisa Suzuki
- Institute of Child - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP, Brazil
| | | | - Fernando Uliana Kay
- Institute of Child - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP, Brazil
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Adibi A, Shahbazi A. Automatic bolus tracking versus fixed time-delay technique in biphasic multidetector computed tomography of the abdomen. Iran J Radiol 2014; 11:e4617. [PMID: 24693300 PMCID: PMC3955856 DOI: 10.5812/iranjradiol.4617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 08/14/2012] [Accepted: 10/13/2012] [Indexed: 11/16/2022]
Abstract
Background Bolus tracking can individualize time delay for the start of scans in spiral computed tomography (CT). Objectives We compared automatic bolus tracking method with fixed time-delay technique in biphasic contrast enhancement during multidetector CT of abdomen. Patients and Methods Adult patients referred for spiral CT of the abdomen were randomized into two groups; in group 1, the arterial and portal phases of spiral scans were started 25 s and 55 s after the start of contrast material administration; in group 2, using the automatic bolus tracking software, repetitive monitoring scans were performed within the lumen of the descending aorta as the region of interest with the threshold of starting the diagnostic scans as 60 HU. The contrast enhancement of the aorta, liver, and spleen were compared between the groups. Results Forty-eight patients (23 males, 25 females, mean age=56.4±13.5 years) were included. The contrast enhancement of the aorta, liver, and spleen at the arterial phase was similar between the two groups (P>0.05). Regarding the portal phase, the aorta and spleen were more enhanced in the bolus-tracking group (P<0.001). The bolus tracking provided more homogeneous contrast enhancement among different patients than the fixed time-delay technique in the liver at portal phase, but not at the arterial phase. Conclusions The automatic bolus-tracking method, results in higher contrast enhancement of the aorta and spleen at the portal phase, but has no effect on liver enhancement. However, bolus tracking is associated with reduced variability for liver enhancement among different patients.
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Affiliation(s)
- Atoosa Adibi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Shahbazi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Abstract
After over one decade development, cone beam computed tomography (CBCT) has been widely accepted for clinical application in almost every field of dentistry. Meanwhile, the radiation dose of CBCT to patient has also caused broad concern. According to the literature, the effective radiation doses of CBCTs in nowadays market fall into a considerably wide range that is from 19 µSv to 1073 µSv and closely related to the imaging detector, field of view, and voxel sizes used for scanning. To deeply understand the potential risk from CBCT, this report also reviewed the effective doses from literatures on intra-oral radiograph, panoramic radiograph, lateral and posteroanterior cephalometric radiograph, multi-slice CT, and so on. The protection effect of thyroid collar and leaded glasses were also reviewed.
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Affiliation(s)
- Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
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Rezaeetalab F, Farrokh D, Zandiee B. Multiplanar Reconstructed Thoracic CT Bronchoscopy in Endobronchial Tuberculosis. Iran J Radiol 2013; 9:234-6. [PMID: 23408658 PMCID: PMC3569560 DOI: 10.5812/iranjradiol.8726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 07/25/2012] [Accepted: 08/01/2012] [Indexed: 12/29/2022]
Affiliation(s)
- Fariba Rezaeetalab
- Department of Pulmonary Medicine, Lung Diseases and TB Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Corresponding author: Fariba Rezaeetalab, Department of Pulmonary Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Tel.: +98-5118598818, Fax: +98-5118598818, E-mail:
| | - Donya Farrokh
- Department of Radiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behrouz Zandiee
- Department of Radiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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Basarslan F, Bayarogulları H, Tutanc M, Arica V, Yilmaz C, Davran R. Intrathoracic rib associated with pulmonary collapse in a pediatric patient. Iran J Radiol 2013; 9:220-2. [PMID: 23408171 PMCID: PMC3569556 DOI: 10.5812/iranjradiol.8608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Revised: 06/30/2012] [Accepted: 07/16/2012] [Indexed: 11/23/2022]
Abstract
The ribs are essential structures of the osseous thorax that provide certain significant information and aid interpretation of radiologic images in daily routine practice. Intrathoracic rib is a rare congenital anomaly that is usually discovered incidentally, but may cause in vain interventions in case of being unaware. We herein report an intrathoracic rib in a girl whose chest X-ray was strange enough to obtain a spiral computed tomography (CT) scanning for a definitive diagnosis afterwards.
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Affiliation(s)
- Fatmagul Basarslan
- Department of Pediatrics, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
- Corresponding author: Fatmagul Basarslan, Faculty of Medicine, Mustafa Kemal University, Department of Pediatrics, Hatay, Turkey. Tel.: +90-3262291000/2827, Fax: +90-326245505, E-mail:
| | - Hanifi Bayarogulları
- Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Murat Tutanc
- Department of Pediatrics, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Vefik Arica
- Department of Pediatrics, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Cahide Yilmaz
- Department of Pediatrics, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
| | - Ramazan Davran
- Department of Radiology, Research Hospital, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey
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Yerli H, Aydin E, Avci S, Haberal N, Oto S. Focal Amyloidosis of the Orbit Presenting as a Mass: MRI and CT Features. Iran J Radiol 2011; 8:241-4. [PMID: 23329948 PMCID: PMC3522366 DOI: 10.5812/iranjradiol.4555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 07/23/2011] [Accepted: 08/01/2011] [Indexed: 11/16/2022]
Abstract
Focal orbital amyloidosis is a rare entity and little is known about its magnetic resonance imaging (MRI) features. In this case report, imaging features of a case of focal orbital amyloidosis presenting as a mass have been documented together with its histopathological findings. On MRI, a well-defined mass was seen as isointense with rectus muscle on T1-weighted images and heterogeneously hypointense on T2-weighted images. Punctuate calcifications were observed on the computerized tomography (CT) examination.
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Affiliation(s)
- Hasan Yerli
- Department of Radiology, Zubeyde Hanim Practice and Research Center, Baskent University, Izmir, Turkey
- Corresponding author: Hasan Yerli, Department of Radiology, Zubeyde Hanim Practice and Research Center, Baskent University, 6371 Sk. No: 34 Bostanli/Karsiyaka, Zip Code: 35590, Izmir, Turkey. Tel.: +90-2323305230, Fax: +90-2323369421, E-mail:
| | - Erdinc Aydin
- Department of Otolaryngology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Suat Avci
- Department of Otolaryngology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Nihan Haberal
- Department of Pathology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Sibel Oto
- Department of Ophthalmology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Yoon MA, Lee JM, Kim SH, Lee JY, Han JK, Choi BI, Kim SW, Jang JJ. Primary biliary lymphoma mimicking cholangiocarcinoma: a characteristic feature of discrepant CT and direct cholangiography findings. J Korean Med Sci 2009; 24:956-9. [PMID: 19794999 PMCID: PMC2752784 DOI: 10.3346/jkms.2009.24.5.956] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Accepted: 06/22/2009] [Indexed: 12/04/2022] Open
Abstract
Primary non-Hodgkin's lymphoma arising from the bile duct is extremely rare and the reported imaging features do not differ from those of cholangiocarcinoma of the bile duct. We report a case of a patient with extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT), who presented with obstructive jaundice and describe the distinctive radiologic features that may suggest the correct preoperative diagnosis of primary lymphoma of the bile duct. Primary MALT lymphoma of the extrahepatic bile duct should be considered in the differential diagnosis when there is a mismatch in imaging findings on computed tomography or magnetic resonance imaging and cholangiography.
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MESH Headings
- Bile Duct Neoplasms/complications
- Bile Duct Neoplasms/diagnosis
- Bile Duct Neoplasms/diagnostic imaging
- Bile Ducts, Extrahepatic
- Cholangiocarcinoma/diagnosis
- Cholangiography
- Diagnosis, Differential
- Humans
- Jaundice, Obstructive/complications
- Jaundice, Obstructive/diagnosis
- Lymphoma, B-Cell, Marginal Zone/complications
- Lymphoma, B-Cell, Marginal Zone/diagnosis
- Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Tomography, X-Ray Computed
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Affiliation(s)
- Min A Yoon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Se Hyung Kim
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Young Lee
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung Ihn Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sun-Whe Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Ja-June Jang
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
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