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Kim Y, Hwang J, Hong SS, Kim HJ, Chang YW, Sung J, Nickel D. Clinical Feasibility of High-Resolution Contrast-Enhanced Dynamic T1-Weighted Magnetic Resonance Imaging of the Upper Abdomen Using Compressed Sensing. J Comput Assist Tomogr 2021; 45:669-677. [PMID: 34546676 DOI: 10.1097/rct.0000000000001221] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the clinical feasibility of high-resolution contrast-enhanced dynamic T1-weighted imaging (T1WI) using compressed sensing (CS) in magnetic resonance imaging. METHODS This study retrospectively included 35 patients who underwent dynamic T1WI using volumetric interpolated breath-hold examination (VIBE) with CS reconstruction (CS-VIBE) and 35 patients with conventional VIBE for comparison. Two observers assessed the liver and pancreas edges, hepatic artery, motion artifacts, and overall image quality. Quantitative analysis was performed by measuring signal intensity and image noise. RESULTS The results showed that CS-VIBE achieved significantly better anatomic delineation of the liver and pancreas edges and hepatic artery clarity than VIBE (P < 0.001). There were no significant differences in motion artifacts in dynamic phases and overall image quality. The signal intensities and INs of CS-VIBE were higher than VIBE. CONCLUSIONS High-resolution dynamic T1WI using CS provides better anatomic delineation with comparable or better overall image quality than conventional VIBE.
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Affiliation(s)
- Yeonsoo Kim
- From the Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Jiyoung Hwang
- From the Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Seong Sook Hong
- From the Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Hyun-Joo Kim
- From the Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - Yun-Woo Chang
- From the Department of Radiology, Soonchunhyang University College of Medicine, Seoul Hospital
| | - JaeKon Sung
- Siemens Healthineers Ltd, Seoul, Republic of Korea
| | - Dominik Nickel
- Application Development, Siemens Healthcare GmbH, Erlangen, Germany
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Davidson JR, Uus A, Matthew J, Egloff AM, Deprez M, Yardley I, De Coppi P, David A, Carmichael J, Rutherford MA. Fetal body MRI and its application to fetal and neonatal treatment: an illustrative review. Lancet Child Adolesc Health 2021; 5:447-458. [PMID: 33721554 PMCID: PMC7614154 DOI: 10.1016/s2352-4642(20)30313-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 12/14/2022]
Abstract
This Review depicts the evolving role of MRI in the diagnosis and prognostication of anomalies of the fetal body, here including head and neck, thorax, abdomen and spine. A review of the current literature on the latest developments in antenatal imaging for diagnosis and prognostication of congenital anomalies is coupled with illustrative cases in true radiological planes with viewable three-dimensional video models that show the potential of post-acquisition reconstruction protocols. We discuss the benefits and limitations of fetal MRI, from anomaly detection, to classification and prognostication, and defines the role of imaging in the decision to proceed to fetal intervention, across the breadth of included conditions. We also consider the current capabilities of ultrasound and explore how MRI and ultrasound can complement each other in the future of fetal imaging.
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Affiliation(s)
- Joseph R Davidson
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
| | - Alena Uus
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Jacqueline Matthew
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Alexia M Egloff
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Maria Deprez
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Iain Yardley
- Paediatric Surgery, Evelina London Children's Hospital, London, UK
| | - Paolo De Coppi
- UCL Great Ormond Street Institute of Child Health, University College London, London, UK; Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, London, UK; Katholieke Universiteit Leuven, Leuven, Belgium
| | - Anna David
- Prenatal Cell and Gene Therapy, Elizabeth Garrett Anderson Institute of Women's Health, University College London, London, UK; Fetal Medicine Unit, University College London, London, UK
| | - Jim Carmichael
- Paediatric Radiology, Evelina London Children's Hospital, London, UK
| | - Mary A Rutherford
- Stem Cells and Regenerative Medicine; Perinatal Imaging, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
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Deo KB, Gautam S, Awale L, Yadav TN, Pradhan A, Pandit N. Cystic Ileal Gastrointestinal Stromal Tumor Masquerading as Metastatic Adnexal Carcinoma. J Gastrointest Cancer 2021; 51:1053-1056. [PMID: 32303996 DOI: 10.1007/s12029-020-00403-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Kunal Bikram Deo
- Department of Surgery, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.
| | - Sujan Gautam
- Department of Surgery, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Laligen Awale
- Department of Surgery, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Tek Narayan Yadav
- Department of Surgery, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Anju Pradhan
- Department of Pathology, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Narendra Pandit
- Department of Surgery, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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Abstract
RATIONALE Leiomyomatosis peritonealis disseminata (LPD) is a rare benign lesion primarily consisting of smooth muscle cells, which mostly affects premenopausal females. Here, we reported 3 females with LPD (age, 40-48 years) admitted for pelvic masses. PATIENT CONCERNS All 3 LPD cases received laparoscopic uterine fibroid morcellation at 3, 8, and 14 years ago, respectively. Two cases were admitted for pelvic masses. One case was admitted for recurrent fibroids with pollakiuria. DIAGNOSES LPD was considered in 2 cases preoperation according to imaging examination, and one of them received ultrasound-guided biopsy of the lesion in the right lobe of the liver. One case was considered as recurrent fibroids preoperation. After surgery, all cases were pathologically diagnosed as LPD consisting of benign smooth muscle cells. INTERVENTIONS A total abdominal hysterectomy, salpingo-oophorectomy, and debulking was performed for all 3 cases. Intraoperative exploration revealed that the fibroids distributed in the mesentery (3 cases), broad ligament (1 case), omentum (1 case), liver (1 case), and rectus abdominis (1 case). OUTCOMES No recurrence was found during postoperative following-up (5-12 months). LESIONS Preoperative diagnosis of LPD is presented as a challenge due to unspecific clinical manifestations. Its diagnosis mainly depends on histopathologic evaluation. Surgery still is the primary treatment for LPD. For patients without reproductive desire, total abdominal hysterectomy, salpingo-oophorectomy, and debulking can be performed, and the affected tissue should be removed as much as possible based on the risk assessment.
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Beer L, Sahin H, Bateman NW, Blazic I, Vargas HA, Veeraraghavan H, Kirby J, Fevrier-Sullivan B, Freymann JB, Jaffe CC, Brenton J, Miccó M, Nougaret S, Darcy KM, Maxwell GL, Conrads TP, Huang E, Sala E. Integration of proteomics with CT-based qualitative and radiomic features in high-grade serous ovarian cancer patients: an exploratory analysis. Eur Radiol 2020; 30:4306-4316. [PMID: 32253542 PMCID: PMC7338824 DOI: 10.1007/s00330-020-06755-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/21/2020] [Accepted: 02/17/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the association between CT imaging traits and texture metrics with proteomic data in patients with high-grade serous ovarian cancer (HGSOC). METHODS This retrospective, hypothesis-generating study included 20 patients with HGSOC prior to primary cytoreductive surgery. Two readers independently assessed the contrast-enhanced computed tomography (CT) images and extracted 33 imaging traits, with a third reader adjudicating in the event of a disagreement. In addition, all sites of suspected HGSOC were manually segmented texture features which were computed from each tumor site. Three texture features that represented intra- and inter-site tumor heterogeneity were used for analysis. An integrated analysis of transcriptomic and proteomic data identified proteins with conserved expression between primary tumor sites and metastasis. Correlations between protein abundance and various CT imaging traits and texture features were assessed using the Kendall tau rank correlation coefficient and the Mann-Whitney U test, whereas the area under the receiver operating characteristic curve (AUC) was reported as a metric of the strength and the direction of the association. P values < 0.05 were considered significant. RESULTS Four proteins were associated with CT-based imaging traits, with the strongest correlation observed between the CRIP2 protein and disease in the mesentery (p < 0.001, AUC = 0.05). The abundance of three proteins was associated with texture features that represented intra-and inter-site tumor heterogeneity, with the strongest negative correlation between the CKB protein and cluster dissimilarity (p = 0.047, τ = 0.326). CONCLUSION This study provides the first insights into the potential associations between standard-of-care CT imaging traits and texture measures of intra- and inter-site heterogeneity, and the abundance of several proteins. KEY POINTS • CT-based texture features of intra- and inter-site tumor heterogeneity correlate with the abundance of several proteins in patients with HGSOC. • CT imaging traits correlate with protein abundance in patients with HGSOC.
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MESH Headings
- Abdominal Cavity/diagnostic imaging
- Adaptor Proteins, Signal Transducing/metabolism
- Aged
- Aged, 80 and over
- Aldehyde Oxidoreductases/metabolism
- Antigens, Neoplasm/metabolism
- Carcinoma, Ovarian Epithelial/diagnostic imaging
- Carcinoma, Ovarian Epithelial/metabolism
- Carcinoma, Ovarian Epithelial/secondary
- Cytokines/metabolism
- Female
- Gene Expression Profiling
- Glucose-6-Phosphate Isomerase/metabolism
- Humans
- LIM Domain Proteins/metabolism
- Mesentery/diagnostic imaging
- Middle Aged
- Neoplasm Grading
- Neoplasm Proteins/metabolism
- Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging
- Neoplasms, Cystic, Mucinous, and Serous/metabolism
- Neoplasms, Cystic, Mucinous, and Serous/secondary
- Omentum/diagnostic imaging
- Ovarian Neoplasms/diagnostic imaging
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/pathology
- Peritoneal Neoplasms/diagnostic imaging
- Peritoneal Neoplasms/metabolism
- Peritoneal Neoplasms/secondary
- Pilot Projects
- Proteomics
- ROC Curve
- Retrospective Studies
- Tomography, X-Ray Computed/methods
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Affiliation(s)
- Lucian Beer
- Department of Radiology, Cancer Research UK Cambridge Center, Cambridge, CB2 0QQ, UK
| | - Hilal Sahin
- Department of Radiology, Cancer Research UK Cambridge Center, Cambridge, CB2 0QQ, UK
| | - Nicholas W Bateman
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center of Excellence, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- The John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
| | - Ivana Blazic
- Department of Radiology, Clinical Hospital Center Zemun, Vukova 9, Belgrade, 11080, Serbia
| | - Hebert Alberto Vargas
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Harini Veeraraghavan
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Justin Kirby
- Cancer Imaging Informatics Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - Brenda Fevrier-Sullivan
- Cancer Imaging Informatics Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - John B Freymann
- Cancer Imaging Informatics Lab, Frederick National Laboratory for Cancer Research, Frederick, MD, USA
| | - C Carl Jaffe
- Department of Radiology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - James Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, Cambridgeshire, UK
- Cancer Research UK Cambridge Centre, Cambridge, Cambridgeshire, UK
| | - Maura Miccó
- Dipartimento Diagnostica per Immagini, Radiologia Diagnostica e Interventistica Generale, Area Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
| | - Stephanie Nougaret
- Department of Radiology, Montpellier Cancer Institute, INSERM, University of Montpellier, Montpellier, France
| | - Kathleen M Darcy
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center of Excellence, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- The John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
| | - G Larry Maxwell
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center of Excellence, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- The John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- Department of Obstetrics and Gynecology, Inova Fairfax Medical Campus, 3300 Gallows Rd., Falls Church, VA, 22042, USA
| | - Thomas P Conrads
- Department of Obstetrics and Gynecology, Gynecologic Cancer Center of Excellence, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- The John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Uniformed Services University, 8901 Wisconsin Avenue, Bethesda, MD, 20889, USA
- Department of Obstetrics and Gynecology, Inova Fairfax Medical Campus, 3300 Gallows Rd., Falls Church, VA, 22042, USA
- Inova Center for Personalized Health, Inova Schar Cancer Institute, 3300 Gallows Rd., Falls Church, VA, 22042, USA
| | - Erich Huang
- Biometric Research Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, NIH, Rockville, MD, 20850, USA
| | - Evis Sala
- Department of Radiology, Cancer Research UK Cambridge Center, Cambridge, CB2 0QQ, UK.
- Department of Radiology, University of Cambridge, Box 218, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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Kabakchiev CM, Zur Linden AR, Singh A, Beaufrère HH. Effects of intra-abdominal pressure on laparoscopic working space in domestic rabbits ( Oryctolagus cuniculus). Am J Vet Res 2020; 81:77-83. [PMID: 31887092 DOI: 10.2460/ajvr.81.1.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effects of 3 intra-abdominal pressures (IAPs) on pneumoperitoneal (laparoscopic working space) volume in domestic rabbits (Oryctolagus cuniculus). ANIMALS 6 female New Zealand White rabbits. PROCEDURES A Latin-square design was used to randomly allocate sequences of 3 IAPs (4, 8, and 12 mm Hg) to each rabbit in a crossover study. Rabbits were anesthetized, subumbilical cannulae were placed, and CT scans were performed to obtain baseline measurements. Each IAP was achieved with CO2 insufflation and maintained for ≥ 15 minutes; CT scans were performed with rabbits in dorsal, left lateral oblique, and right lateral oblique recumbency. The abdomen was desufflated for 5 minutes between treatments (the 3 IAPs). Pneumoperitoneal volumes were calculated from CT measurements with 3-D medical imaging software. Mixed linear regression models evaluated effects of IAP, rabbit position, and treatment order on working space volume. RESULTS Mean working space volume at an IAP of 8 mm Hg was significantly greater (a 19% increase) than that at 4 mm Hg, and was significantly greater (a 6.9% increase) at 12 mm Hg than that at 8 mm Hg. Treatment order, but not rabbit position, also had a significant effect on working space. Minor adverse effects reported in other species were observed in some rabbits. CONCLUSIONS AND CLINICAL RELEVANCE A nonlinear increase in abdominal working space was observed with increasing IAP. Depending on the type of procedure and visual access requirements, IAPs > 8 mm Hg may not provide a clinically important benefit for laparoscopy in rabbits.
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Siddique K, Sipra ZS. Periportal Plexiform Neurofibromatosis; a rare intra-abdominal manifestation of NF1. J PAK MED ASSOC 2020; 70:557-558. [PMID: 32207449] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Periportal Plexiform Neurofibromatosis (PPNF) is a rare visceral manifestation of Neurofibromatosis Type 1 (NF1) or Von Recklinghausen disease. Neurofibromas are the most common lesions in NF1. We present a case of a young female diagnosed with NF1 who initially presented with hard abdominal mass. Contrast enhanced CT revealed the unusual lintrahepatic periportal plexiform neurofibromatosis in addition to a typical large retroperitoneal lumbar neurofibroma.
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Barba E, Sánchez B, Burri E, Accarino A, Monclus E, Navazo I, Guarner F, Margolles A, Azpiroz F. Abdominal distension after eating lettuce: The role of intestinal gas evaluated in vitro and by abdominal CT imaging. Neurogastroenterol Motil 2019; 31:e13703. [PMID: 31402544 PMCID: PMC6899808 DOI: 10.1111/nmo.13703] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Some patients complain that eating lettuce, gives them gas and abdominal distention. Our aim was to determine to what extent the patients' assertion is sustained by evidence. METHODS An in vitro study measured the amount of gas produced during the process of fermentation by a preparation of human colonic microbiota (n = 3) of predigested lettuce, as compared to beans, a high gas-releasing substrate, to meat, a low gas-releasing substrate, and to a nutrient-free negative control. A clinical study in patients complaining of abdominal distention after eating lettuce (n = 12) measured the amount of intestinal gas and the morphometric configuration of the abdominal cavity in abdominal CT scans during an episode of lettuce-induced distension as compared to basal conditions. KEY RESULTS Gas production by microbiota fermentation of lettuce in vitro was similar to that of meat (P = .44), lower than that of beans (by 78 ± 15%; P < .001) and higher than with the nutrient-free control (by 25 ± 19%; P = .05). Patients complaining of abdominal distension after eating lettuce exhibited an increase in girth (35 ± 3 mm larger than basal; P < .001) without significant increase in colonic gas content (39 ± 4 mL increase; P = .071); abdominal distension was related to a descent of the diaphragm (by 7 ± 3 mm; P = .027) with redistribution of normal abdominal contents. CONCLUSION AND INFERENCES Lettuce is a low gas-releasing substrate for microbiota fermentation and lettuce-induced abdominal distension is produced by an uncoordinated activity of the abdominal walls. Correction of the somatic response might be more effective than the current dietary restriction strategy.
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Affiliation(s)
- Elizabeth Barba
- Digestive System Research UnitUniversity Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)BarcelonaSpain
- Departament de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Borja Sánchez
- Departamento de Microbiología y BioquímicaInstituto de Productos Lácteos de Asturias (IPLA), Consejo Superior de Investigaciones Científicas, Asturias (CSIC)VillaviciosaSpain
- Instituto de Investigación Sanitaria del Principado de Asturias–ISPAOviedoSpain
| | | | - Anna Accarino
- Digestive System Research UnitUniversity Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)BarcelonaSpain
- Departament de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Eva Monclus
- Departamento de Lenguajes y Sistemas InformáticosUniversidad Politécnica de CatalunyaBarcelonaSpain
| | - Isabel Navazo
- Departamento de Lenguajes y Sistemas InformáticosUniversidad Politécnica de CatalunyaBarcelonaSpain
| | - Francisco Guarner
- Digestive System Research UnitUniversity Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)BarcelonaSpain
- Departament de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
| | - Abelardo Margolles
- Departamento de Microbiología y BioquímicaInstituto de Productos Lácteos de Asturias (IPLA), Consejo Superior de Investigaciones Científicas, Asturias (CSIC)VillaviciosaSpain
- Instituto de Investigación Sanitaria del Principado de Asturias–ISPAOviedoSpain
| | - Fernando Azpiroz
- Digestive System Research UnitUniversity Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)BarcelonaSpain
- Departament de MedicinaUniversitat Autònoma de BarcelonaBellaterraSpain
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Gilligan LA, Dillman JR, Tkach JA, Xanthakos SA, Gill JK, Trout AT. Magnetic resonance imaging T1 relaxation times for the liver, pancreas and spleen in healthy children at 1.5 and 3 tesla. Pediatr Radiol 2019; 49:1018-1024. [PMID: 31049609 DOI: 10.1007/s00247-019-04411-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/12/2019] [Accepted: 04/11/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND T1 relaxation time is a potential magnetic resonance imaging (MRI) biomarker for fibrosis and inflammation of the solid abdominal organs. However, normal T1 relaxation times of the solid abdominal organs have not been defined for children. OBJECTIVE The purpose of this study was to measure T1 relaxation times of the liver, pancreas and spleen in healthy children. MATERIALS AND METHODS This was an institutional review board-approved study of a convenience sample of prospectively recruited, healthy children ages 7 to 17 years undergoing research abdominal MRI (1.5 or 3 T) as part of a larger research study between February 2018 and October 2018. For the current study, T1 mapping was performed with a Modified Look-Locker sequence covering the upper abdomen. A single reviewer placed freehand regions of interest on the T1 parametric maps in the liver, pancreas and spleen, inclusive of as much parenchyma as possible. Student's t-tests and linear regression were used to compare T1 values by age and gender. RESULTS Thirty-two participants were included (16 female:16 male; mean age: 12.2±3.1 years; n=16 at 1.5 T). Median T1 relaxation times (ms) per organ were liver: 581±64 (1.5 T), 783±88 (3 T); pancreas: 576±55 (1.5 T), 730±30 (3 T), and spleen: 1,172±71 (1.5 T), 1,356±87 (3 T). T1 values were not statistically significantly different between males and females. At both 1.5 and 3 T field strengths, linear regression showed no significant association between age and T1 values for the liver, pancreas and spleen. CONCLUSION We report normal T1 relaxation times for the liver, pancreas and spleen at 1.5 and 3 T in a cohort of healthy children.
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Affiliation(s)
- Leah A Gilligan
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA
| | - Jonathan R Dillman
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jean A Tkach
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA
| | - Stavra A Xanthakos
- Department of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jacqueline K Gill
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA
| | - Andrew T Trout
- Department of Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5031, Cincinnati, OH, 45229, USA.
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Shinar S, Berger H, De Souza LR, Ray JG. Difference in Visceral Adipose Tissue in Pregnancy and Postpartum and Related Changes in Maternal Insulin Resistance. J Ultrasound Med 2019; 38:667-673. [PMID: 30171627 DOI: 10.1002/jum.14737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To measure the difference between first-trimester and postpartum visceral adipose tissue (VAT), the agreement of this difference with change in body mass index, and whether a difference in VAT is associated with insulin resistance or glucose mishandling. METHODS Prospective study of 93 women with singleton pregnancies without a history of diabetes. Visceral adipose tissue depth was sonographically assessed at 11 to 14 weeks and at 6 to 12 weeks postpartum. Metabolic measures, sampled at 24 to 28 weeks and 6 to 12 weeks postpartum, included homeostatic model assessment of insulin resistance, insulin sensitivity index composite, and area under the 75-g oral glucose tolerance test curve. RESULTS First-trimester VAT depth explained only 37% (95% confidence interval [CI], 22-52) of the variation in postpartum VAT depth. There was limited agreement between the net change in postpartum minus first-trimester VAT depth and that same net change for body mass index (Cohen's kappa, 0.26; 95% CI, 0.05-0.47). Those with a net gain in VAT depth demonstrated poorer insulin sensitivity index postpartum than women with a net regression in VAT depth-a difference of -2.0 (95% CI, -3.3 to -0.69). CONCLUSION Sonographic assessment of postpartum VAT is feasible and may provide insight to metabolic changes between pregnancy and postpartum, beyond body mass index.
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Affiliation(s)
- Shiri Shinar
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
| | - Howard Berger
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
| | - Leanne R De Souza
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Joel G Ray
- Department of Obstetrics and Gynecology, St. Michael's Hospital, Toronto, ON, Canada
- Keenan Research Centre for Biomedical Science of St. Michael's Hospital, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
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Fatima K. Intraabdominal Gossypibomas with variable CT appearance: A case report. J PAK MED ASSOC 2019; 69:123-126. [PMID: 30623927] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A retained surgical sponge or gossypiboma is a rare and an underreported complication occurring most commonly after abdominal surgeries. The clinical presentation as well as the time of presentation is variable with about one third of patients being asymptomatic. The diagnosis is challenging because of marked variation in the presentation and imaging plays a crucial role in diagnosis. We report a 30-year old Asian woman with prior history of Caesarean section who presented with persistent abdominal pain since surgery and underwent imaging in December 2012. The case is interesting as she had two intraabdominal gossypibomas with different appearances on computerized tomography. One was suggested to be a retained foreign body while the other was initially misinterpreted as a solid ovarian mass. However, on ultrasound, both lesions showed similar appearance and the left lower abdominal solid mass was also suggested to be a retained foreign body which was then confirmed on laparotomy.
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12
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Mahmoud N, Collins T, Hostettler A, Soler L, Doignon C, Montiel JMM. Live Tracking and Dense Reconstruction for Handheld Monocular Endoscopy. IEEE Trans Med Imaging 2019; 38:79-89. [PMID: 30010552 DOI: 10.1109/tmi.2018.2856109] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Contemporary endoscopic simultaneous localization and mapping (SLAM) methods accurately compute endoscope poses; however, they only provide a sparse 3-D reconstruction that poorly describes the surgical scene. We propose a novel dense SLAM method whose qualities are: 1) monocular, requiring only RGB images of a handheld monocular endoscope; 2) fast, providing endoscope positional tracking and 3-D scene reconstruction, running in parallel threads; 3) dense, yielding an accurate dense reconstruction; 4) robust, to the severe illumination changes, poor texture and small deformations that are typical in endoscopy; and 5) self-contained, without needing any fiducials nor external tracking devices and, therefore, it can be smoothly integrated into the surgical workflow. It works as follows. First, accurate cluster frame poses are estimated using the sparse SLAM feature matches. The system segments clusters of video frames according to parallax criteria. Next, dense matches between cluster frames are computed in parallel by a variational approach that combines zero mean normalized cross correlation and a gradient Huber norm regularizer. This combination copes with challenging lighting and textures at an affordable time budget on a modern GPU. It can outperform pure stereo reconstructions, because the frames cluster can provide larger parallax from the endoscope's motion. We provide an extensive experimental validation on real sequences of the porcine abdominal cavity, both in-vivo and ex-vivo. We also show a qualitative evaluation on human liver. In addition, we show a comparison with the other dense SLAM methods showing the performance gain in terms of accuracy, density, and computation time.
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13
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Liu DN, Li ZW, Wang HY, Zhao M, Zhao W, Hao CY. Use of 18F-FDG-PET/CT for Retroperitoneal/Intra-Abdominal Soft Tissue Sarcomas. Contrast Media Mol Imaging 2018; 2018:2601281. [PMID: 30065620 PMCID: PMC6051286 DOI: 10.1155/2018/2601281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/24/2018] [Indexed: 12/16/2022]
Abstract
Rationale To assess the diagnostic value of 18F-FDG-PET/CT for different retroperitoneal soft tissue sarcomas (STS) and other similar tumors. To analyze the predictive value of 18F-FDG-PET/CT for histological grade and main prognostic factors. Methods 195 patients with 44 different diseases have been included. Relationship between SUVmax, Clinical, pathological, and prognostic information has been analyzed. Results Malignant tumors do not show higher SUVmax than benign ones (P=0.443). We divided all 44 different diseases into two groups; SUVmax of group 1 is significantly higher than group 2 (P ≤ 0.001). The ROC curve suggests 4.35 is the cutoff value to distinguish groups 1 and 2 (sensitivity = 0.789; specificity = 0.736). SUVmax correlates with Ki-67 index, mitotic count, vascular resection, histological grade, and recurrent STS without considering pathological diagnosis (P=0.001, P=0.012, P=0.002, P ≤ 0.001, and P=0.037, resp.). Conclusion 18F-FDG-PET/CT cannot simply distinguish malignant and benign tumors in retroperitoneal/intra-abdominal cavity; however, the SUVmax of malignant tumors, inflammatory pseudotumor, and PPGL group is higher than the SUVmax of benign tumors, lymph node metastasis, hematoma, and low malignant STS group. Guidance of "SUVmax location" may be helpful for biopsy and pathology dissection.
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Affiliation(s)
- Dao-ning Liu
- Sarcoma Center, Peking University Cancer Hospital & Institute, Beijing, China
| | - Zhong-wu Li
- Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Hai-yue Wang
- Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Min Zhao
- Department of Pathology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Zhao
- Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Chun-yi Hao
- Sarcoma Center, Peking University Cancer Hospital & Institute, Beijing, China
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Abstract
Secondary peritonitis accounts for 1% of urgent or emergent hospital admissions and is the second leading cause of sepsis in patients in intensive care units globally. Overall mortality is 6%, but mortality rises to 35% in patients who develop severe sepsis. Despite the dramatic growth in the availability and use of imaging and laboratory tests, the rapid diagnosis and early management of peritonitis remains a challenge for physicians in emergency medicine, surgery, and critical care. In this article, we review the pathophysiology of peritonitis and its potential progression to sepsis, discuss the utility and limitations of the physical examination and laboratory and radiographic tests, and present a paradigm for the management of secondary peritonitis.
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Affiliation(s)
- James T Ross
- Department of Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Michael A Matthay
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Hobart W Harris
- Department of Surgery, University of California, San Francisco, San Francisco, CA 94143, USA
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Ma L, Zhang L, Zhuang Y, Ding Y, Chen J. A rare case report of ovarian juvenile granulosa cell tumor with massive ascites as the first sign, and review of literature: Case report and review of literature. Medicine (Baltimore) 2018; 97:e10916. [PMID: 29923976 PMCID: PMC6023667 DOI: 10.1097/md.0000000000010916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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] [Indexed: 12/19/2022] Open
Abstract
RATIONALE Massive ascites as the first sign of ovarian juvenile granulosa cell tumor (JGCT) in an adolescent is an extremely rare, and its clinical features and treatment methods have not been well described. PATIENT CONCERNS The clinical characteristics, diagnosis, and treatment methods in a 19-year-old girl who presented with massive abdominal distention and ascites was retrospectively reviewed. Abdominopelvic ultrasonography showed a large amount of ascites. The nature of ascites was exudate. All tumor markers were normal, but ascites and serum tumor CA125 levels were significantly increased. Abdominal CT showed left attachment area teratoma and right attachment area capsule solid change. DIAGNOSES Histological and immunohistochemical results were compatible with JGCT. Based on the FIGO classification, the patient with only malignant ascites was categorized into stage IC. INTERVENTIONS The patient underwent mass resection with salpingoophorectomy. Following the operation, she received 6 courses of adjuvant chemotherapy with Nedaplatin and Paclitaxel liposome. OUTCOMES The patient was followed up postoperatively for 6 months to date without recurrence. LESSONS We should be highly vigilant the JGCT with massive ascites as the first clinical manifestation.
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Affiliation(s)
- Liang Ma
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Liwen Zhang
- Department of Pediatrics, the Second People's Hospital of Changzhou, Affiliate Hospital of NanJing medical University, Changzhou, Jiangsu, China
| | - Yun Zhuang
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Yanbo Ding
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
| | - Jianping Chen
- Department of Digestive Disease, The First People's Hospital of Changzhou, The Third Affiliated Hospital of Soochow University
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16
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Janssen Lok M, Miyake H, Hock A, Daneman A, Pierro A, Offringa M. Value of abdominal ultrasound in management of necrotizing enterocolitis: a systematic review and meta-analysis. Pediatr Surg Int 2018; 34:589-612. [PMID: 29721677 DOI: 10.1007/s00383-018-4259-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2018] [Indexed: 01/04/2023]
Abstract
PURPOSE Necrotizing enterocolitis (NEC) remains a life-threatening disease among infants in the NICU. Early diagnosis and careful monitoring are essential to improve outcomes. Abdominal ultrasound (AUS) seems a promising addition to current diagnostic modalities, but its clinical utility is uncertain. The aim of this study was to identify AUS features associated with definite NEC (i.e. Bell stage ≥ II), failed medical treatment, surgery, and death. METHODS Embase, MEDLINE, Web of Science and CINAHL databases were searched for studies that addressed any NEC-related AUS feature in relation to any of the four outcomes. After critical appraisal of relevant study methods, meta-analyses were conducted using a random-effect model. RESULTS 15 out of 1215 studies were included. All AUS features had sensitivities below 70% and specificities largely above 80% for diagnosing definite NEC; several AUS features were significantly associated with failed medical treatment and surgery. Substantial heterogeneity, poor reporting quality and uncertain risk of bias were found. CONCLUSIONS While clear associations of AUS features with failed medical treatment exist and AUS may detect definite NEC, substantial heterogeneity, poor reporting quality and an uncertain risk of bias impair the use of AUS for clinical decision making. A prospective, well-designed validation study is needed.
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Affiliation(s)
- Maarten Janssen Lok
- Division of Pediatric Surgery, Amalia Children's Hospital Radboudumc, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
- Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Hiromu Miyake
- Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Alison Hock
- Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Alan Daneman
- Division of Radiology, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Agostino Pierro
- Division of General and Thoracic Surgery, The Hospital for Sick Children, University of Toronto, 1526-555 University Avenue, Toronto, ON, M5G 1X8, Canada.
| | - Martin Offringa
- Division of Neonatology and Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, University of Toronto, 686 Bay Street, Toronto, ON, M5G 0A4, Canada
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17
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Jalalzadeh M, Ghadiani MH. Kidney Failure Due to Abdominal Compartment Syndrome Following Snakebite. Iran J Kidney Dis 2017; 11:66-69. [PMID: 28174355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 08/17/2016] [Accepted: 09/04/2016] [Indexed: 06/06/2023]
Abstract
Treatment of snakebite complications is challenging, as it is difficult to distinguish what kind of antivenins should be used. Kidney failure as a result of rhabdomyolysis or hemolysis may happen due to accumulated fluids that increase the pressure in the abdomen. This case report describes acute kidney failure probably due to intra-abdominal hypertension following an unknown bite.
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Affiliation(s)
- Mojgan Jalalzadeh
- Department of Nephrology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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18
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Bua-ngam C, Waeosak P, Wedsart B, Treesit T, Chansanti O, Panpikoon T, Tapaneeyakorn J. Predicting Factors for Failure of Percutaneous Drainage of Postoperative Intra-Abdominal Collection. J Med Assoc Thai 2017; 100:111-118. [PMID: 29911778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine the predictive factors for failure of percutaneous drainage (PD) of postoperative intra-abdominal collection, to better select the patients who might benefit from PD. MATERIAL AND METHOD From September 2011 to February 2013, the authors reviewed 42 patients with symptomatic postoperative intra-abdominal collection who had received PD at Ramathibodi Hospital. The PD was considered as failure when clinical sepsis persisted or subsequent surgery was needed. Univariate analysis was used to examine the relationships between failure of PD and the collection and drainage-related variables. RESULTS The success rate of PD in the present study was 80%. No major complication was detected. The overall mortality was 12%. Univariate analysis showed that the presence of biliary fistula (p = 0.012), subhepatic location (p = 0.040) and the drainage catheter size of 12F (p = 0.002) were significant predictive variables for failure of PD. CONCLUSION Image-guided PD of postoperative intra-abdominal collection was found to be a safe and effective procedure with few complications. Initial recognition of biliary fistula in the collection at subhepatic region or in patients underwent hepatobiliary surgery was the important prognostic factor for unsuccessful PD. These patients may be more beneficial for initial surgical drainage.
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19
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Munden MM, Wai S, DiStefano MC, Zhang W. Limited Abdominal Sonography for Evaluation of Children With Right Lower Quadrant Pain. J Ultrasound Med 2017; 36:183-186. [PMID: 27925670 DOI: 10.7863/ultra.16.01102] [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] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 04/04/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To determine whether a complete abdominal sonographic examination is necessary in the evaluation of children with right lower quadrant pain that is suspicious for appendicitis in the emergency department and whether performing a limited, more-focused study would miss clinically important disease. METHODS With Institutional Review Board approval, a retrospective study was performed of 704 patients, from ages 5-19 years, presenting to the emergency department with right lower quadrant pain that was suspicious for appendicitis who underwent a complete abdominal sonographic examination. Data were extracted from the complete abdominal sonographic examination to see whether abnormalities were noted in the pancreas, spleen, and left kidney. Patients' medical charts were reviewed to see whether any positive findings in these organs were clinically important. RESULTS Of the 65 studies with a finding that would have been missed with a limited study, only 6 were found to be clinically important. Of those, 5 were managed medically and 1 surgically. The chance of missing a potentially important finding using a limited study with our group of patients was 65 of 704 patients (9.2%), with a 95% confidence interval of 7.2% to 11.7%. The chance of missing an abnormality that was clinically important was 6 of 704 patients (0.85%), with a 95% confidence interval of 0.35% to 1.94%. CONCLUSIONS In children older than 5 years with abdominal pain that is suspicious for appendicitis, performing only a limited abdominal sonographic examination that excludes the pancreas, left kidney, and spleen will yield a miss rate for clinically important disease that is acceptably low to justify the savings of examination time.
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Affiliation(s)
| | - Shannon Wai
- Rady Children's Hospital, San Diego, California, USA
| | | | - Wei Zhang
- Texas Children's Hospital, Houston, Texas, USA
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20
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Patil AR, Nandikoor S, De Marco J, Bhat R, Shivakumar S, Mallrajapatna G. Disorders of the lymphatic system of the abdomen. Clin Radiol 2016; 71:941-952. [PMID: 27450410 DOI: 10.1016/j.crad.2016.06.116] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/22/2016] [Accepted: 06/27/2016] [Indexed: 12/31/2022]
Abstract
The lymphatic system of the abdomen comprises of the cisterna chyli, its major and minor lymphatic tributaries, and lymph nodes. Disorders of the lymphatic system of the abdomen are rarely encountered and consist of primary and secondary types. Abdominal lymphangiomas constitute the majority and have characteristic imaging features. Complicated lymphangiomas may pose a diagnostic dilemma. Generalised systemic lymphangiomatosis is a rare condition and affects major organs with a poor prognosis. Retroperitoneal lymphangiectasia in the appropriate setting might predict underlying infection, such as filariasis. Other acquired conditions include iatrogenic or treatment-induced chylocoele. Chylous ascites can be secondary to multiple causes and can be confirmed by biochemical testing and lymphangiogram in appropriate settings.
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Affiliation(s)
- A R Patil
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India.
| | - S Nandikoor
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - J De Marco
- Department of Radiology, Morristown Medical Center, Morristown, NJ, USA
| | - R Bhat
- Surgical Gastroenterology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - S Shivakumar
- Pathology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
| | - G Mallrajapatna
- Departments of Radiology, Apollo Hospitals, Bannerghatta Road, Bangalore, India
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21
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Ioffe IV, Lesnoy VV. [CORRECTION OF ENTERAL INSUFFICIENCY SYNDROME IN PATIENTS, SUFFERING DIFFUSE PERITONITIS]. Klin Khir 2016:15-17. [PMID: 27244910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The results of treatment of 65 patients, suffering diffuse peritonitis, were analyzed. For the abdominal cavity sanation and intestinal decontamination the adopted selective bacteriophages (polyvalent pyobacteriophage, intesti-bacteriophage, and the coliproteus one) were applied. The abdominal cavity state was estimated while doing a programmed relaparotomy. Bacteriologic investigation of exudate, excreted along nasointestinal probe, and of peritoneal exudate was conducted. The intestinal motor-evacuation function restoration was estimated in accordance to data of ultrasonographic investigation. Application of the procedure proposed have promoted earlier restoration of intestinal motor and the barrier functions, and elimination of enteral insufficiency syndrome.
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22
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Bolukbas FF, Bolukbas C, Furuncuoglu Y, Tabandeh B, Saglam FY, Iyigun G, Orug T, Ozcan A, Yapicier O. Large abdominal cystic masses: Report of seven cases. J PAK MED ASSOC 2016; 66:226-228. [PMID: 26819176] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Cystic abdominal tumours are encountered quite often and are diagnosed more frequently due to the availability of better imaging possibilities. Presentation of huge cysts has become rare as most of them are diagnosed and treated early. But we still have patients with enlarged abdominal cysts; majority with cases of serous cystadenomas of the ovary. Absolute diagnosis is only possible with laparotomy and histopathological findings. In this report, seven patients with enlarged gynaecological or mesenteric cystic masses and gastroenterological symptoms are reported. Four of these cases were serous cystadenoma, two were mucinous cystadenoma and one was a paratubal cyst. Gynaecological tumours and mesenteric cysts should not be missed in female patients showing gastrointestinal symptoms.
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Affiliation(s)
- Filiz Fusun Bolukbas
- Department of Gastroenterology, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Cengiz Bolukbas
- Department of Gastroenterology, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Yavuz Furuncuoglu
- Department of Internal Medicine, Medicalpark Goztepe Hospital, Istanbul, Turkey
| | - Babek Tabandeh
- Department of General Surgery, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Filiz Yarimcam Saglam
- Departments of Medical Microbiology, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Gokmen Iyigun
- Department of Obstetrics and Gynaecology, Medicalpark Goztepe Hospital, Istanbul, Turkey
| | - Taner Orug
- Department of General Surgery, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Ali Ozcan
- Department of Obstetrics and Gynecology, Medicalpark Gaziantep Hospital, Gaziantep, Turkey
| | - Ozlem Yapicier
- Departments of Pathology, Bahcesehir University, School of Medicine, Istanbul, Turkey
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Niaz A, Ahmad AH, Saeed MA, Sabir O, Tarif N. IgG4-related retroperitoneal fibrosis: A case report and review of literature. J PAK MED ASSOC 2016; 66:220-222. [PMID: 26819174] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Idiopathic Retroperitoneal fibrosis is a rare clinical condition recently identified as an autoimmune process related to Immunoglobulin G4 (IgG4) deposition. Herein we report a case of a 46 year old male presenting with 4 months history of backache, fever, flank pain and leg swelling for 2 weeks. Investigations revealed acute kidney injury diagnosed as a result of bilateral ureteric obstruction. This was later confirmed to be retroperitoneal fibrosis on CT scan and biopsy. Histopathology was consistent with IgG4 related disease. Treatment with immunosuppressive agents showed reduction in the fibrosis and normalization of the kidney functions. We discuss the IgG4 related retroperitoneal fibrosis in detail along with its varied presentations.
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Affiliation(s)
- Azra Niaz
- Department of Medicine, Division of Nephrology, Fatima Memorial Hospital, Nur International University, Lahore, Pakistan
| | - Asad Hayat Ahmad
- Department of Pathology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan
| | - Muhammed Ahmad Saeed
- Department of Urology, Fatima Memorial Hospital, Nur International University, Lahore, Pakistan
| | - Omer Sabir
- Department of Medicine, Division of Nephrology, Fatima Memorial Hospital, Nur International University, Lahore, Pakistan
| | - Nauman Tarif
- Department of Medicine, Division of Nephrology, Fatima Memorial Hospital, Nur International University, Lahore, Pakistan
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24
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Gryglewski A, Kuta M, Pasternak A, Opach Z, Walocha J, Richter P. Hiatal hernia with upside-down stomach. Management of acute incarceration: case presentation and review of literature. Folia Med Cracov 2016; 56:61-66. [PMID: 28275272] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Upside-down stomach (UDS) represents the rarest type of hiatal hernia (<5%) and is characterized by herniation of the entire stomach or most gastric portions into the posterior mediastinum. We present here a very rare complication of such a condition which is incarceration of upside-down stomach. A 54 year-old female was admitted to the emergency department presenting signs of acute epigastric pain radiating into thorax. Computed tomography revealed a giant hiatal hernia with incarceration of the gastric trunk. Immediate operation for reduction of the incarcerated stomach and repair of the hiatal defect was performed. The patient was discharged without any complication and was followed up at the surgical outpatient department. The presented case confirms that differentiation of an acute epigastric or intrathoracic pain in adults should always exclude presence of hiatal hernia which in case of incarceration should be treated by prompt surgical management.
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Affiliation(s)
- Andrzej Gryglewski
- Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, Kraków, Poland.
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25
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Chaplygina YV, Gubar AS. [REGULARITIES OF VARIABILITY OF LIVER LINEAR DIMENSIONS IN DIFFERENT ANATOMICAL VARIANTS OF ORGAN POSITION IN THE ABDOMINAL CAVITY]. Morfologiia 2016; 150:65-71. [PMID: 30136831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A large variety of anatomic variants of liver positions and shapes results in a significant variability of the data of its linear dimension determination, which may be the reason for misinterpretation of the information regarding the size of the organ as a whole and of its individual segments, in particular. In this work the analysis was performed of the linear dimensions of the liver, its right and the left lobes measured during spiral computed tomography (SCT), taking into account the anatomic variability of the position of the organ, in 193 individuals of both sexes of juvenile and first period of mature age without pathology of the liver and cardiovascular system. Besides the traditionally distinguished variants of the position of the organ in the abdominal cavity, in part of the individuals examined the combined displacement of the organ relative to the sagittal and frontal planes was noted. It was demonstrated that in combined displacement of the liver in two planes, linear parameters of this organ were extremely changeable and approached the extreme variants of the anatomic variability. The dependence of traditionally measured linear parameters of the liver from the anatomic variant of organ position in the abdominal cavity was studied. The data obtained suggest that the interpretation of SCT results without consideration of the anatomic variant of organ position may lead to erroneous judgments about the size of the liver and its individual parts.
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26
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Stuk MV, Osokin YA, Kondrat'ev EV, Varlamov AV, Karmazanovskiy GG. [Contrast-enhanced computed tomography is the required minimum in the diagnosis of abdominal and retroperitoneal space-occupying lesions]. Vestn Rentgenol Radiol 2016; 97:33-40. [PMID: 27192771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE to determine the advantages of contrast-enhanced computed tomography (CT) over contrast-free studies in the differential diagnosis of hepatic, renal, and pancreatic space-occupying lesions. MATERIAL AND METHODS. A team of experienced radiologists retrospectively used CT data of patients with different space-occupying lesions of the abdomen and retroperitoneal space (liver, kidney, and pancreas). RESULTS The diagnostic value of CT of the liver, kidney, and pancreas substantially decreases without using radiopaque contrast agents; at the same time not only the differential diagnosis, but also visualization of some neoplasms are frequently impossible. CONCLUSION The potential benefit of contrast-enhanced CT virtually always outweighs the risks associated with the injection of a contrast agent.
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27
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Matkevich EI, Sinitsyn VE, Mershina EA. [Comparative survey of radiation doses to patients in computed tomography in a federal hospital]. Vestn Rentgenol Radiol 2016; 97:41-47. [PMID: 27192772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE to analyze radiation exposure due to computed tomography (CT) of brain, chest, abdomen and pelvis in a large multi-field federal hospital and feasibility of low-dose CT-examinations. MATERIAL AND METHODS Retrospective analysis was performed using data from electronic patient records and PACS from a single multi-field hospital. Data were obtained from 1626 records of patients (794 men, 832 women; age range 17-93) scanned with 3 MDCT during one year. CT-examinations of good quality were selected, volumetric CT dose index (CTDI) and dose-length product (DLP) were collected for each of them. The effective doses (ED) were calculated using the normalized coefficients according to Russian Guidance. RESULTS. Number and structure of CT-examinations for the years 2012-2014 in a multi-field hospital were analyzed. The mean effective dose (M ± m) values with/without contrast medium (respectively), according to anatomical areas were as follows: brain--2.34 ± 0.03/3, 52 ± 0.23, chest--4.83 ± 0.11/11.02 ± 0.82, abdomen-pelvis--9.81 ± 0.40/36.6 ± 1.17, chest-abdomen-pelvis - 12.41 ± 0.79/35.63 ± 1.81 mSv. CONCLUSION. Results of this study give an example of CT dose values and distribution in a multi-field hospital. They are compa- rable with reference levels published of other authors. This expe- rience should be expanded for creation of CT national reference values and for co-operation with international initiatives (EUROSAFE projects).
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Stets N, Chernenko V. [EXPERIENCE OF TREATMENT OF PREGNANT WOMEN WITH ACUTE SURGICAL DISEASES OF THE ABDOMINAL CAVITY]. Lik Sprava 2015:100-104. [PMID: 27089725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article describes a generalized experience in the treatment of pregnant women with acute surgical diseases of the abdominal cavity.
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Linyov KA. [SURGICAL TREATMENT MANAGEMENT OF ABDOMEN GUNSHOT INJURIES]. Klin Khir 2015:26-29. [PMID: 26591213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The medical records of 100 patients with gunshot abdomen injuries were analysed. The damaging nature of the projectile, the nature of the damage and the combination with damage to other body parts were studied. The anesthesiologist--resuscitator and surgeon actions after hospitalisation of injured persons were postulated. The emergency victim examination was reduced to ultrasound and SCT. The indications for laparotomy in abdominal gunshot injuries were defined. Three most common variants of gunshot abdomen injuries were found. In surgical treatment we applied "damage control" strategy included the initial (abbreviated) operation, resuscitative therapy and final operation. The postoperative complications, couse of deaths was investigated.
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Abstract
Transmesocolic hernia is an uncommon type of internal hernia with incidence ranging from approximately 5-10%. To the best of our knowledge, this is the first reported case of a transmesocolic hernia through a gap within the descending mesocolon presenting clinically as an intestinal obstruction. A 75-year-old man was admitted with clinical features of intestinal obstruction. An abdominal X-ray showed multiple small bowel loops with air fluid levels. Contrast-enhanced CT of the abdomen revealed small bowel obstruction not only on the right, but also on the left side of the collapsed descending colon. Emergency surgery was performed. Strangulated bowel loops with gangrenous changes were resected and double-barrel ileostomy was carried out. The postoperative period was uneventful. Restoration of bowel was performed after 6 weeks. Preoperative diagnosis of bowel obstruction caused by a transmesocolic hernia remains difficult despite the currently available imaging techniques. Prompt surgery can prevent serious complications such as peritonitis and sepsis.
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Affiliation(s)
- Akshay Anand Agarwal
- Department of Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Abhinav Arun Sonkar
- Department of Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kul Ranjan Singh
- Department of Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anurag Rai
- Department of Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Mahmoudieh L, Saeedinia A, Ahmadpoor P, Temannaie Z, Parvin M, Torbati P, Mirdamadi MH, Nafar M. Nephroquiz 8: perioperative management of paraganglioma. Iran J Kidney Dis 2015; 9:259-262. [PMID: 25957432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 02/17/2015] [Indexed: 06/04/2023]
Affiliation(s)
| | - Arezoo Saeedinia
- Department of Endocrinology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kim MJ, Kim YS, Oh CS, Go JH, Lee IS, Park WK, Cho SM, Kim SK, Shin DH. Anatomical confirmation of computed tomography-based diagnosis of the atherosclerosis discovered in 17th century Korean mummy. PLoS One 2015; 10:e0119474. [PMID: 25816014 PMCID: PMC4376940 DOI: 10.1371/journal.pone.0119474] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 01/30/2015] [Indexed: 12/25/2022] Open
Abstract
In the present study on a newly discovered 17th century Korean mummy, computed tomography (CT) revealed multiple aortic calcifications within the aortic wall that were indicative of ancient atherosclerosis. The CT-based findings were confirmed by our subsequent post-factum dissection, which exhibited possible signs of the disease including ulcerated plaques, ruptured hemorrhages, and intimal thickening where the necrotic core was covered by the fibrous cap. These findings are strong indicators that the mummy suffered from aortic atherosclerosis during her lifetime. The present study is a good example of how CT images of vascular calcifications can be a useful diagnostic tool in forming at least preliminary diagnoses of ancient atherosclerosis.
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Affiliation(s)
- Myeung Ju Kim
- Department of Anatomy, Dankook University College of Medicine, Cheonan, Korea
| | - Yi-Suk Kim
- Department of Anatomy, Ewha Womans University School of Medicine, Seoul, Korea
| | - Chang Seok Oh
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Science, Seoul National University College of Medicine, Seoul, Korea
| | - Jai-Hyang Go
- Department of Pathology, Dankook University College of Medicine, Cheonan, Korea
| | - In Sun Lee
- Department of Radiology, Seoul National University Hospital, Bundang, Korea
| | - Won-Kyu Park
- Department of Wood and Paper Science, Chungbuk National University, Cheongju, Korea
| | - Seok-Min Cho
- Gaya National Research Institute of Cultural Heritage, Changwon, Korea
| | - Soon-Kwan Kim
- National Research Institute of Cultural Heritage, Cultural Heritage Science Center, Daejeon, Korea
| | - Dong Hoon Shin
- Department of Anatomy, Seoul National University College of Medicine, Seoul, Korea
- Institute of Forensic Science, Seoul National University College of Medicine, Seoul, Korea
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Vlot J, Specht PA, Wijnen RMH, van Rosmalen J, Mik EG, Bax KMA. Optimizing working space in laparoscopy: CT-measurement of the effect of neuromuscular blockade and its reversal in a porcine model. Surg Endosc 2014; 29:2210-6. [PMID: 25361652 DOI: 10.1007/s00464-014-3927-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 09/27/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The objective of this paper was to determine the effect of neuromuscular blockade (NMB) on working space in a porcine laparoscopy model. BACKGROUND Conflicting results on the effect of NMB on laparoscopic working space are found in literature. Almost all studies are limited by absence of objective assessment of working space or use surrogate outcomes. METHODS In a standardized porcine laparoscopy model, laparoscopic working-space dimensions with and without NMB were investigated in 16 animals using computed tomography at intra-abdominal pressures of 0, 5, 10, and 15 mmHg during multiple runs of abdominal insufflation. RESULTS No statistically significant effect of NMB on abdominal dimensions and laparoscopic working-space volume was found during CO2 pneumoperitoneum. In contrast, the effect of pre-stretching of the abdominal wall by a previous abdominal insufflation was found to be significant. CONCLUSIONS This experimental study confirms the results from several clinical studies that NMB does not influence laparoscopic working space. Studies dealing with working space during laparoscopy should take note of pre-stretching bias.
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Affiliation(s)
- John Vlot
- Department of Pediatric Surgery, Erasmus MC: University Medical Center, P.O Box 2060, 3000 CB, Rotterdam, The Netherlands,
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Justaniah AI, Scholz FJ, Katz DS, Scheirey CD. Perigastric appendagitis: CT and clinical features in eight patients. Clin Radiol 2014; 69:e531-7. [PMID: 25278036 DOI: 10.1016/j.crad.2014.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 08/11/2014] [Accepted: 08/22/2014] [Indexed: 11/19/2022]
Abstract
AIM To describe perigastric appendagitis (PA) on CT as a new and distinct clinical entity to enable recognition and prevent additional unnecessary investigation or intervention. MATERIALS AND METHODS Institutional review board approval was obtained and informed consent was waived. Retrospective review of the clinical data and CT findings in eight patients with PA encountered over 10 years at one institution was performed. The English literature was reviewed and summarized. Two experienced abdominal radiologists reviewed the CT images by consensus. RESULTS Seven of eight patients had moderate to severe epigastric pain for 1–7 days. All eight patients (four men, four women; mean age 44 years, range 33–81 years) had no fever or leukocytosis. All underwent abdominal CT which showed ovoid fat inflammation along the course of the perigastric ligaments (gastrohepatic, gastrosplenic, and falciform). Two had gastric wall thickening. Although the inflammation was correctly described, the specific diagnosis was not made on initial interpretation in five patients. Subsequently, they underwent further diagnostic testing [an upper gastrointestinal examination and hepatobiliary iminodiacetic acid (HIDA) cholescintigraphy, an upper endoscopy and MRI examination, HIDA cholescintigraphy, another CT, and an MRI examination, respectively]. The HIDA cholescintigraphy, upper GI examination, and upper endoscopy examinations were normal. No repeated examination was performed on the other three patients. Pain resolved spontaneously in all within two days. CONCLUSION Perigastric appendagitis can present with an acute abdomen, which is safely managed conservatively if diagnosed correctly. Radiologists should be aware of the entity to avoid unnecessary intervention, and recognize the CT findings of ovoid fat inflammation in the distribution of the perigastric ligaments.
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35
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Ukhal' MI, Ukhal' EM, Kvasha AN. [Differential diagnosis and treatment of complex renal cysts detected by ultrasound screening of the abdominal cavity organs]. Urologiia 2014:34-35. [PMID: 24956669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Ultrasound screening of the abdominal cavity organs was performed in 98 patients, and renal cysts were revealed in 31 patientsare. 11 (26,6%) of 31 patients had renal cysts with complex structure. In 4 patients, complex cysts were located in parapelvic zone, in 7 patients - in different parts of the renal parenchyma. Pharmaco-Doppler sonography and computed tomography with bolus contrast enhancement in 7 patients with complex parenchymal cysts had revealed indirect signs of a malignant process - septums, thickening of the walls of cysts and septums, foci of calcination, increased blood circulation in the thickened renal cyst walls, venous stasis on the periphery of cysts and renal medulla, increasing the density of the thickened walls. Results of morphological studies have confirmed the presence of a malignant process in 5 of these 7 patients. In 4 patients with parapelvic cysts malignant process in ectomized layers was not revealed.
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36
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Khripun AI, Salikov AV, Priamikov AD, Mironkov AB, Alimov AN, Latonov VV, Abashin MV, Guseva TV. [Modern approach to diagnosis and treatment of acute mesenteric ischemia]. Khirurgiia (Mosk) 2014:36-42. [PMID: 25042189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It was proposed the medical and diagnostic tactic in patients with acute mesenteric ischemia on basis of efficiency results of modern laboratory markers and instrumental methods. Positive laboratory D-dimer-test with computed tomography of abdominal organs or abdominal aorta and its branches CT-angiography led to diagnose thrombosis or embolism of mesenteric arteries at early terms and to reduce preoperative period. The authors presented the variant of isolated endovascular intervention in case of superior mesenteric artery thrombosis. This technique may be regarded as the method of choice in the treatment of patients with acute mesenteric ischemia.
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37
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Ermolov AS, Lebedev AG, Levitskj VD, Yarcev PA, Makedonskaya TP, Selina IE, Shavrina NV, Kirsanov II, Vodyasov AV, Ugol'nikova ED. Postoperative small intestine intussusception in adults. Khirurgiia (Mosk) 2014:62-69. [PMID: 25589320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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38
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Saffouri GB, Wittich CM. 83-year-old man with abdominal swelling and lower extremity edema. Mayo Clin Proc 2013; 88:e115-8. [PMID: 24079694 DOI: 10.1016/j.mayocp.2013.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 03/13/2013] [Accepted: 03/15/2013] [Indexed: 10/26/2022]
Affiliation(s)
- George B Saffouri
- Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN
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39
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Pongpornsup S, Eksamutchai P, Teerasamit W. Differentiating between abdominal tuberculous lymphadenopathy and lymphoma using multidetector computed tomography (MDCT). J Med Assoc Thai 2013; 96:1175-1182. [PMID: 24163994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To evaluate the specific computed tomography (CT) imaging criteria for differentiating abdominal tuberculous lymphadenopathy from lymphoma by using abdominal multidetector computed tomography (MDCT). MATERIAL AND METHOD A retrospective review of 31 patients with abdominal tuberculous lymphadenopathy and 85 patients with untreated lymphoma was conducted from abdominal CT scan reports in a single center; Siriraj Hospital, Mahidol University, Bangkok Thailand. CT scan was independently reviewed by two expert radiologists who were blinded to the patient's history, treatment outcome, and final diagnosis. The anatomical site, anatomical distribution, CT enhancement patterns, size of lymphadenopathy, amount and density of ascites, abdominal solid organ involvement, bowel involvement, and lung involvement were recorded RESULTS MDCT showed that abdominal tuberculous lymphadenopathy involved predominately the mesenteric, upper and lower para-aortic, periportal, and pancreaticoduodenal regions. Untreated lymphoma affected mainly the upper and lower para-aortic, iliac, periportal, pancreaticoduodenal, and gastrohepatic regions. Mesenteric and periportal lymph nodes were involved more often in patients with abdominal tuberculous lymphadenopathy than in those with untreated lymphoma (p = 0.04). Iliac and inguinal lymph nodes were involved more often in patients with lymphoma than in those with tuberculosis (p = 0.01). Anatomical distributions were significantly different between the two groups (p< 0.01): confluence distribution was noted more often in tuberculous lymphadenopathy. The enhancement patterns had significant difference between the two groups. Peripheral enhancement was seen significantly more often in tuberculous lymphadenopathy, whereas homogeneous enhancement was found more often in lymphoma. The maximum size of enlarged lymph nodes also showed statistical difference between two groups by using t-test (p = 0.01). The mean diameters were 2.95 cm in tuberculous lymphadenopathy and 4.10 cm in lymphoma. Ascites was found significantly more often in tuberculous lymphadenopathy than in lymphoma (p = 0.03). However; the attenuation of ascites on pre-contrast images did not show statistical difference. Small bowel and large bowel thickening were demonstrated more often in tuberculous lymphadenopathy than lymphoma (p < 0.01, p = 0.01), which mostly showed target sign enhancement in tuberculosis and homogeneous enhancement in lymphoma. The presence of hepatomegaly and splenomegaly were not different between the two groups. The diagnostic interpretations of two readers showed high sensitivity (93.5%) and high specificity (98.8% by reader 1 and 97.6% by reader 2). CONCLUSION The present study indicates that the anatomical site, anatomical distribution, enhancement patterns, and size of lymphadenopathy, persistent ascites, and small and large bowel involvement seen on contrast-enhanced MDCT is useful in differentiating between tuberculosis and untreated lymphomas.
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Affiliation(s)
- Sopa Pongpornsup
- Department of Diagnostic Radiology Faculty of Medicine Siriraj Hospital Mahidol University, Bangkok, Thailand.
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40
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Chao CT. Radiologic intra-abdominal opacity indicating an injection granuloma. Intern Med 2013; 52:2015. [PMID: 23995010 DOI: 10.2169/internalmedicine.52.0816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Chia-Ter Chao
- Department of Traumatology, National Taiwan University Hospital, Taiwan
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41
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Coskun A, Eliyatkın N, Yıldırım M, Top OE, Vardar E, Erkan N. Completely free and mobile intra-abdominal tumor. Surgery 2012; 155:350-2. [PMID: 23270969 DOI: 10.1016/j.surg.2012.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 10/22/2012] [Indexed: 11/19/2022]
Affiliation(s)
- Ali Coskun
- Department of General Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
| | - Nuket Eliyatkın
- Department of Pathology, Izmir Training and Research Hospital, Izmir, Turkey
| | - Mehmet Yıldırım
- Department of General Surgery, Izmir Training and Research Hospital, Izmir, Turkey
| | - Omer Erdinc Top
- Department of Pathology, Izmir Training and Research Hospital, Izmir, Turkey
| | - Enver Vardar
- Department of Pathology, Izmir Training and Research Hospital, Izmir, Turkey
| | - Nazif Erkan
- Department of General Surgery, Izmir Training and Research Hospital, Izmir, Turkey
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Pinho DF, Kulkarni NM, Krishnaraj A, Kalva SP, Sahani DV. Initial experience with single-source dual-energy CT abdominal angiography and comparison with single-energy CT angiography: image quality, enhancement, diagnosis and radiation dose. Eur Radiol 2012; 23:351-9. [PMID: 22918562 DOI: 10.1007/s00330-012-2624-x] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 06/24/2012] [Accepted: 06/28/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Daniella F Pinho
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA 02114, USA.
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Abstract
Assessment of patient dose attributed to multislice computed tomography (CT) examination. A questionnaire method was developed and used in recording the patient dose and scanning parameters for the head, chest, abdomen and lumbar spine examinations. The patient doses due to brain, chest and abdomen examination were above the international diagnostic reference levels (DRLs) by factors of between one and four. The study demonstrated that the use of multislice CT elevates patient radiation dose, justifying the need for local optimised scanning protocols and the use of institutional DRL for dose management without affecting diagnostic image quality.
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Affiliation(s)
- G K Korir
- Department of Physics and Applied Physics, University of Massachusetts Lowell, One University Ave., Lowell, MA 01854, USA.
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Zarb F, McEntee M, Rainford L. Maltese CT doses for commonly performed examinations demonstrate alignment with published DRLs across Europe. Radiat Prot Dosimetry 2012; 150:198-206. [PMID: 21993803 DOI: 10.1093/rpd/ncr393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This work recommends dose reference levels (DRLs) for abdomen, chest and head computerised tomography (CT) examinations in Malta as the first step towards national CT dose optimisation. Third quartiles volume CT dose index values for abdomen: 12.1 mGy, chest: 13.1 mGy and head: 41 mGy and third quartile dose-length product values for abdomen: 539.4, chest: 492 and head: 736 mGy cm(-1) are recommended as Maltese DRLs derived from this first Maltese CT dose survey. These values compare well with DRLs of other European countries indicating that CT scanning in Malta is consistent with standards of good practice. Further work to minimise dose without affecting image quality and extending the establishment of DRLs for other CT examinations is recommended.
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Affiliation(s)
- Francis Zarb
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta.
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45
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Vasil'eva MA. [Comparative capacities of radiation studies in the diagnosis of circumscribed peritonitis in case of duodenal microperforation at different stages of emergency medical care]. Vestn Rentgenol Radiol 2012:20-23. [PMID: 22997742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The results of ultrasound (US) and X-ray studies were retrospectively studied in the diagnosis of circumscribed peritonitis in case of microperforation from duodenal ulcers at different stages of emergency medical care. Analysis of the findings has demonstrated that on admission and in its first hours the most effective diagnostic method is plain radiography that enables free gas accumulation to be found under the diaphragm and US study is of low informative value. Repeat targeted US study using expert-class scanners, with the well stated task based on clinical laboratory findings, is a high-informative diagnostic technique for circumscribed peritonitis in case of duodenal perforations.
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Shen X, Zhang W, Wang PJ. [CT manifestation of abdomen and its pathology of patients with chronic schistosomiasis]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2012; 24:200-202. [PMID: 22799169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To understand the abdominal CT manifestation and its pathology of patients with chronic schistosomiasis. METHODS The plain + enhanced CT scanning was performed in 42 patients with chronic schistosomiasis, and their tissues of biopsy and surgical resection were examined pathologically. RESULTS Among the 42 patients, schistosomiasis cirrhosis of liver was found in 36 cases, left lobe enlarged was found in 21 cases, and calcification was found in 32 cases. Portal vein and its tributaries calcification were found in 14 patients, and one of them was accompanied with transplanted hepatocellular carcinoma, 12 patients with stones in gallbladder, and 5 patients with ascites. Among the 19 patients with splenomegaly, 7 patients were accompanied with calcification. Intestinal wall thickening with linear and tram-like calcification was seen in 21 cases. Descending colon, sigmoidcolon, and rectum calcifications were found in 8 cases, and rectosigmoid calcification was found in 9 cases, rectum calcification was seen in 2 cases, and 2 patients were accompanied with colon carcinoma. The pathological examination showed fibrosis and calcified ova in liver, large intestine and gallbladder of the patients, but there were no ova in spleen. CONCLUSION Abdominal CT manifestation of patients with chronic schistosomiasis presents the damage of multiple organs in abdomen, and various calcifications are the main image characteristics.
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Affiliation(s)
- Xing Shen
- Department of Radiology, Kunshan Traditional Chinese Medicine Hospital, Kunshan 215300, China
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47
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Ye Y, Yang Z, Li H, Deng W, Li Y, Guo Y. [MDCT features and anatomic-pathological basis of the diseases in central thoracic-abdominal junctional region]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2012; 29:35-44. [PMID: 22404003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This paper is to determine relationship between MDCT features and anatomic-pathology of the diseases in central thoracic-abdominal junctional region. 3 cadavers were cut transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. 93 patients with diseases in central thoracic-abdominal junctional zone were scanned with MDCT. The correlation between MDCT features of the diseases in central thoracic-abdominal junctional region and the anatomic-pathology of the diseases in this region was evaluated. On cadaver sections, central thoracic-abdominal junctional region was an area between anterior chest wall and dorsal spine in vertical direction. The region was separated into upper and lower sections by diaphragm. The upper section mainly contains heart and pericardium, while the lower contains broad ligament and left lobe of liver. The hiatus of diaphragm are vena caval foramen, esophageal foramen and aortic foramen in anterior-posterior turn. In the present study, 23 patients had portal hypertension, 18 had dissection of aorta, 8 got diseases in inferior vena cava, 9 had lymphoma, 12 got diseases in multiple vertebrae, 7 had lower thoracic esophageal carcinoma accompanied with metastasis in upper abdominal lymph nodes, 9 had carcinoma of abdominal esophagus and/or gastric cardia, 4 had esophageal hiatal hernia and 3 patients had neurogenic tumor in posterior mediastinum and/or superior spatium retroperitoneale. The MDCT features and distribution of the diseases in central thoracic-abdominal junctional region influence the anatomic-pathology characteristics in this region.
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Affiliation(s)
- Yilan Ye
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China
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Li X, Zhang W, Song T, Sun C, Shen Y. Primitive neuroectodermal tumor arising in the abdominopelvic region: CT features and pathology characteristics. ACTA ACUST UNITED AC 2012; 36:590-5. [PMID: 20959975 DOI: 10.1007/s00261-010-9655-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We analyze the computed tomography (CT) findings of a peripheral primitive neuroectodermal tumor (pPNET) arising in the abdominopelvic cavity and to improve understanding of the CT images of the tumor. MATERIALS AND METHODS Twelve cases of pPNET confirmed by histopathology were analyzed retrospectively. Image characteristics of CT scanning were analyzed and compared with the pathology of the tumors. RESULTS There were 8 males and 4 females with mean age of 34.5 years. Unenhanced CT images showed large heterogeneous and ill-defined or well-defined masses with multiple patchy hypodense areas. The average diameter was 9.8 cm (range 4.0-17.2 cm). Contrast-enhanced CT images showed variable heterogeneous contrast enhancement with multiple non-enhancement areas. 3 cases revealed metastasis and 4 cases invaded into adjacent organs. Pathology showed areas of degeneration and necrosis in all tumors. Cluster of differentiation 99 and neurone specific enolase were detected positive in 11 and 12 cases, respectively. CONCLUSIONS In conclusion, pPNET in the abdominopelvic cavity likely affects young adults with a slight male preponderance and tend to be large and aggressive. Although CT findings are nonspecific and variable, a large ill-defined or well-defined heterogeneous mass with multiple patchy hypodense areas reflecting their cystic degeneration and necrosis on pathology examination may suggest the diagnosis of pPNET.
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Affiliation(s)
- Xinchun Li
- Department of Radiology, The First Affiliated Hospital of Guangzhou Medical College, People's Republic of China
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Ignat'ev RO, Bataev SM. [Extraperitoneal ligation herniorraphy by the acute infectious diseases of the abdominal cavity in children]. Khirurgiia (Mosk) 2012:69-72. [PMID: 23258363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Surgery on the reason of the "acute abdomen" in children often reveals the persisting vaginal peritoneal defects, which further lead to hernia formation. 23 children (aged 4-15 years) were operated on the acute uncomplicated appendicitis (n=10), acute mesadenitis (n=3), appendicular local and pelvioperitonitis (n=9) and ovary apoplexia (n=1). Inguinal hernia was revealed in all patients during laparoscopy. After videoendoscopic sanation of the abdomen and appendectomy (if it was necessary) the extraperitoneal ligation herniorraphy in author's modification was performed. The were no cases of abdominal complications as well as hernia recurrence among the treated patients.
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Rodoman GV, Shalaeva TI, Sosikova NL. [The miniinvasive treatment of the aseptic fluid collections by the acute necrotizing pancreatitis]. Khirurgiia (Mosk) 2012:43-48. [PMID: 22678536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The study aimed to state the indications to punctures and draining of the aseptic fluid collections by the acute necrotizing pancreatitis. Data of 82 patients were analyzed. The miniinvasive treatment proved to be preferable to the conservative treatment only in cases of the internal organs compression. Punctures and draining didn't provide the decrease of septic complications and pseudocyst formation. Poor result of miniinvasive procedures predict the high risk of pseudocyst formation.
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