RESUMEN

During the coronavirus disease 2019 (COVID-19) pandemic, reports of vaccine-induced myocarditis, particularly messenger ribonucleic acid (mRNA)-based myocarditis, were widely spread. This case series describes various cases of COVID-19 vaccine-induced myocarditis confirmed by cardiac magnetic resonance imaging (MRI), including those who were administered rare protein-based vaccines. Eleven patients comprising eight males and three females with suspected myocarditis underwent cardiac MRI at Taichung Veterans General Hospital between October 2021 and May 2022. The median age of the patients was 33.5 years old (range: 22-57 years). The onset of myocarditis was mainly observed following mRNA vaccine inoculation. One patient received the MVC-COV1901 vaccine, a unique protein-based COVID-19 vaccine in Taiwan, and met the 2018 Lake Louise Criteria for the diagnosis of myocarditis, confirmed by cardiac MRI. Most patients reported chest discomfort after receiving various vaccine types. Among four patients with reduced left ventricular ejection fraction (LVEF), two showed LVEF restoration during the follow-up period, and the other two were lost to follow-up. Cardiac MRI characterizes myocardial features such as edema, inflammation, and fibrosis, and has been proven to diagnose myocarditis accurately with a sensitivity of 87.5% and a specificity of 96.2% according to the 2018 Lake Louise criteria. This diagnosis was achieved without invasive procedures such as endomyocardial biopsy or coronary angiography.

Asunto(s)

COVID-19 , Miocarditis , Masculino , Femenino , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Miocarditis/diagnóstico por imagen , Miocarditis/etiología , Vacunas contra la COVID-19/efectos adversos , Miocardio/patología , Volumen Sistólico , Taiwán , Medios de Contraste , Función Ventricular Izquierda , Imagen por Resonancia Magnética/métodos

RESUMEN

Breast magnetic resonance imaging (MRI) is currently a widely used clinical examination tool. Recently, MR diffusion-related technologies, such as intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI), have been extensively studied by breast cancer researchers and gradually adopted in clinical practice. In this study, we explored automatic tumor detection by IVIM-DWI. We considered the acquired IVIM-DWI data as a hyperspectral image cube and used a well-known hyperspectral subpixel target detection technique: constrained energy minimization (CEM). Two extended CEM methods-kernel CEM (K-CEM) and iterative CEM (I-CEM)-were employed to detect breast tumors. The K-means and fuzzy C-means clustering algorithms were also evaluated. The quantitative measurement results were compared to dynamic contrast-enhanced T1-MR imaging as ground truth. All four methods were successful in detecting tumors for all the patients studied. The clustering methods were found to be faster, but the CEM methods demonstrated better performance according to both the Dice and Jaccard metrics. These unsupervised tumor detection methods have the advantage of potentially eliminating operator variability. The quantitative results can be measured by using ADC, signal attenuation slope, D*, D, and PF parameters to classify tumors of mass, non-mass, cyst, and fibroadenoma types.

RESUMEN

Breast cancer is a main cause of disease and death for women globally. Because of the limitations of traditional mammography and ultrasonography, magnetic resonance imaging (MRI) has gradually become an important radiological method for breast cancer assessment over the past decades. MRI is free of the problems related to radiation exposure and provides excellent image resolution and contrast. However, a disadvantage is the injection of contrast agent, which is toxic for some patients (such as patients with chronic renal disease or pregnant and lactating women). Recent findings of gadolinium deposits in the brain are also a concern. To address these issues, this paper develops an intravoxel incoherent motion- (IVIM-) MRI-based histogram analysis approach, which takes advantage of several hyperspectral techniques, such as the band expansion process (BEP), to expand a multispectral image to hyperspectral images and create an automatic target generation process (ATGP). After automatically finding suspected targets, further detection was attained by using kernel constrained energy minimization (KCEM). A decision tree and histogram analysis were applied to classify breast tissue via quantitative analysis for detected lesions, which were used to distinguish between three categories of breast tissue: malignant tumors (i.e., central and peripheral zone), cysts, and normal breast tissues. The experimental results demonstrated that the proposed IVIM-MRI-based histogram analysis approach can effectively differentiate between these three breast tissue types.

Asunto(s)

Neoplasias de la Mama/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Medios de Contraste/uso terapéutico , Femenino , Humanos , Imagenología Tridimensional/métodos , Mamografía/métodos

RESUMEN

In this study, we aimed to evaluate whether patients with left to right shunt coronary artery fistula (LRSCAF) are predisposed to developing pulmonary hypertension and right ventricular dysfunction compared with healthy individuals. The value of cardiac CT findings in determining the necessity of intervention for these patients was investigated. We retrospectively studied 19 patients with LRSCAF and 19 healthy patients. Several parameters were observed on cardiac CT by two radiologists, including pulmonary trunk diameter (PA diameter), right ventricular diameter (RVD), left ventricular diameter (LVD), RVD/LVD ratio, septal bowing and CT score of right ventricular dysfunction (CSRVD). Data from both groups were compared. The inter- and intra-observer variabilities and correlations were examined. The disease group was further divided into intervention (n = 9) and non-intervention (n = 10) groups, and their data were compared. All cardiac CT findings showed significant intra- and inter-observer correlation without significant variability. Mann-Whitney U tests and χ(2) analysis showed that PA diameter, RVD/LVD ratio acquired from two observers, and CSRVD were higher in the disease group than in the control group (all P values < 0.05 for χ(2) and almost all P values < 0.05 for Mann-Whitney U). The RVD/LVD ratio and CSRVD were higher in the intervention group than in the non-intervention group (all P values < 0.05). Receiver operating curve analysis identified RVD/LVD = 1.036 and CSRVD = 3.5 as the best cut-off values to determine the necessity of further intervention. Patients with LRSCAF are more predisposed to pulmonary hypertension and right ventricular dysfunction compared with the normal population. RVD/LVD > 1.0 and CSRVD ≥ 4.0 may determine the necessity of intervention for patients with LRSCAF.

Asunto(s)

Presión Arterial , Angiografía por Tomografía Computarizada , Angiografía Coronaria/métodos , Anomalías de los Vasos Coronarios/diagnóstico por imagen , Hipertensión Pulmonar/diagnóstico por imagen , Tomografía Computarizada Multidetector , Arteria Pulmonar/diagnóstico por imagen , Fístula Vascular/diagnóstico por imagen , Disfunción Ventricular Derecha/diagnóstico por imagen , Función Ventricular Derecha , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Distribución de Chi-Cuadrado , Anomalías de los Vasos Coronarios/complicaciones , Anomalías de los Vasos Coronarios/fisiopatología , Femenino , Humanos , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/fisiopatología , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Pronóstico , Arteria Pulmonar/fisiopatología , Curva ROC , Reproducibilidad de los Resultados , Estudios Retrospectivos , Factores de Riesgo , Fístula Vascular/complicaciones , Fístula Vascular/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/etiología , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Derecha/etiología , Disfunción Ventricular Derecha/fisiopatología , Función Ventricular Izquierda

RESUMEN

In this study, a semi-automatic breast segmentation method was proposed on the basis of the rib shadow to extract breast regions from 3-D automated whole-breast ultrasound (ABUS) images. The density results were correlated with breast density values acquired with 3-D magnetic resonance imaging (MRI). MRI images of 46 breasts were collected from 23 women without a history of breast disease. Each subject also underwent ABUS. We used Otsu's thresholding method on ABUS images to obtain local rib shadow information, which was combined with the global rib shadow information (extracted from all slice projections) and integrated with the anatomy's breast tissue structure to determine the chest wall line. The fuzzy C-means classifier was used to extract the fibroglandular tissues from the acquired images. Whole-breast volume (WBV) and breast percentage density (BPD) were calculated in both modalities. Linear regression was used to compute the correlation of density results between the two modalities. The consistency of density measurement was also analyzed on the basis of intra- and inter-operator variation. There was a high correlation of density results between MRI and ABUS (R(2) = 0.798 for WBV, R(2) = 0.825 for PBD). The mean WBV from ABUS images was slightly smaller than the mean WBV from MR images (MRI: 342.24 ± 128.08 cm(3), ABUS: 325.47 ± 136.16 cm(3), p < 0.05). In addition, the BPD calculated from MR images was smaller than the BPD from ABUS images (MRI: 24.71 ± 15.16%, ABUS: 28.90 ± 17.73%, p < 0.05). The intra-operator and inter-operator variant analysis results indicated that there was no statistically significant difference in breast density measurement variation between the two modalities. Our results revealed a high correlation in WBV and BPD between MRI and ABUS. Our study suggests that ABUS provides breast density information useful in the assessment of breast health.

Asunto(s)

Densidad de la Mama/fisiología , Mama/diagnóstico por imagen , Mama/fisiología , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Ultrasonografía Mamaria/métodos , Algoritmos , Densitometría/métodos , Femenino , Lógica Difusa , Humanos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Aprendizaje Automático , Reconocimiento de Normas Patrones Automatizadas/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad

RESUMEN

A tumor-mapping algorithm was proposed to identify the same regions in different passes of automated breast ultrasound (ABUS). A total of 53 abnormal passes with 41 biopsy-proven tumors and 13 normal passes were collected. After computer-aided tumor detection, a mapping pair was composed of a detected region in one pass and another region in another pass. Location criteria, including the radial position as on a clock, the relative distance and the distance to the nipple, were used to extract mapping pairs with close regions. Quantitative intensity, morphology, texture and location features were then combined in a classifier for further classification. The performance of the classifier achieved a mapping rate of 80.39% (41/51), with an error rate of 5.97% (4/67). The trade-offs between the mapping and error rates were evaluated, and Az = 0.9094 was obtained. The proposed tumor-mapping algorithm was capable of automatically providing location correspondence information that would be helpful in reviews of ABUS examinations.

Asunto(s)

Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/patología , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional/métodos , Reconocimiento de Normas Patrones Automatizadas/métodos , Ultrasonografía Mamaria/métodos , Adulto , Anciano , Algoritmos , Estudios de Factibilidad , Femenino , Humanos , Aumento de la Imagen/métodos , Aprendizaje Automático , Persona de Mediana Edad , Estadificación de Neoplasias , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Técnica de Sustracción , Carga Tumoral

Asunto(s)

Fístula Arterio-Arterial/cirugía , Procedimientos Quirúrgicos Cardíacos , Vasos Coronarios/cirugía , Arteria Pulmonar/cirugía , Fístula Arterio-Arterial/diagnóstico , Angiografía Coronaria/métodos , Vasos Coronarios/diagnóstico por imagen , Ecocardiografía Doppler en Color , Femenino , Humanos , Ligadura , Persona de Mediana Edad , Tomografía Computarizada Multidetector , Valor Predictivo de las Pruebas , Arteria Pulmonar/diagnóstico por imagen , Resultado del Tratamiento

RESUMEN

UNLABELLED: A 59 year-old previously healthy male was admitted to the hospital with fever reportedly several days in duration. His physical examination was unremarkable at first. Pneumonia was initially diagnosed, but acute pulmonary edema with a new grade III to and fro murmur developed 1 week later. Transesophageal echocardiography (TEE) disclosed a pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF). Subsequent consultation with a cardiovascular surgeon resulted in a repaired aorta with otherwise uneventful results. P-MAIVF is a very rare complication of prosthetic aortic valve (AV) infective endocarditis, and even in native AV. Therefore a careful and through physical examination of patients and early TEE examination are essential in this rare complication of infective endocarditis. KEY WORDS: Echocardiography; Infective endocarditis; Mitral-aortic intervalvular fibrosa; Pseudoaneurysm.

Asunto(s)

Fuga Anastomótica/cirugía , Bioprótesis , Implantación de Prótesis de Válvulas Cardíacas/efectos adversos , Dispositivo Oclusor Septal/efectos adversos , Anciano , Fuga Anastomótica/diagnóstico por imagen , Remoción de Dispositivos/métodos , Estudios de Seguimiento , Implantación de Prótesis de Válvulas Cardíacas/métodos , Humanos , Masculino , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/cirugía , Tomografía Computarizada Multidetector/métodos , Falla de Prótesis , Reoperación/métodos , Medición de Riesgo , Resultado del Tratamiento , Ultrasonografía

RESUMEN

The purpose of the technical note is to introduce the complex coil assisted coil embolization method in the treatment of intracranial small aneurysm, in order to enhance the safety of the procedure. The first microcatheter was navigated into the aneurysm sac and the ultrasoft coil was used as the embolization coil. If the embolizations coil could not stay within the aneurysm sac smoothly, such as coil herniation into parent artery during the delivery process. The second microcatheter would be navigated to the aneurysm level in the parent artery. Another complex coil was delivered within the parent artery via the second microcatheter to provide the neck bridge effect in order to enhance the stability of embolization coil. Besides, the protection coil will not disturb the parent artery flow. While the embolization coil was put into the aneurysm sac smoothly under the help of complex protective coil, the protective coil was then withdrawn gently. We use the most magnified view, dual-plane approach simultaneously to observe the stability of embolization coil. The embolization coil would be detached without any evidence of coil motion or vibration. The new method could provide the physiological protective method, without leaving any protective device such as stent within the parent artery.

RESUMEN

A 58-year-old man with acute type B aortic dissection presented with right lower limb cyanosis, mesenteric ischemia, and acute renal failure. He was treated with extraanatomic right axillofemoral bypass surgery alone, recovered completely from renal, mesenteric, and lower extremity malperfusion shortly thereafter, and lived free of symptoms for the following year. Follow-up computed tomography angiograms documented adequate expansion of the true aortic lumen and good perfusion of visceral organs. Thus, managing such patients with coexisting visceral and extremity malperfusion may be accomplished with axillofemoral bypass exclusively, which can relieve ischemia of upstream abdominal organs and downstream lower extremities effectively and durably.

Asunto(s)

Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/cirugía , Arteria Axilar/cirugía , Arteria Femoral/cirugía , Anastomosis Quirúrgica , Disección Aórtica/clasificación , Aneurisma de la Aorta Torácica/clasificación , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Vasculares/métodos

RESUMEN

Systemic and fatal arterial air embolism during the computed tomography (CT) scan is rarely reported in English-based literature. Iatrogenic air embolism happening during the CT scan is often related to the injector, usually venous air embolism and asymptomatic. We report one fatal and extensive systemic arterial air embolism because of one error that happened during a brain CT scan. The mechanism is different from the reported cases in the literature. The possible mechanism and pathogenesis are well discussed to alert clinicians and prevent the recurrence of such complication.

Asunto(s)

Embolia Aérea/etiología , Tomografía Computarizada por Rayos X/efectos adversos , Adulto , Resultado Fatal , Femenino , Humanos

RESUMEN

With the increased availability of multi-detector row CT, indirect CT venography has become an important non-invasive image modality for patients with suspected deep vein thrombosis. Use of indirect CT venography can not only diagnose/exclude deep vein thrombosis, but can also determine if there are other anomalies or diseases which might contribute to the patient's symptoms. In this pictorial essay, we introduce the scanning protocol, post-processing techniques, and interpretation algorithm used in widely available 64 multi-detector row technology. We discuss several cases, including deep vein thrombosis in acute and chronic stages, anatomic variation, vena cava filter, and collateral veins. Lastly, we consider alternative diagnoses including varicose veins, infection, prosthesis failure of arthroplasty, traumatic vessel injury, and other musculoskeletal conditions. Radiologists should be familiar with the comprehensive interpretation of indirect CT venography to facilitate differential diagnosis and further treatment decision.

Asunto(s)

Flebografía/métodos , Interpretación de Imagen Radiográfica Asistida por Computador , Tomografía Computarizada por Rayos X , Trombosis de la Vena/diagnóstico por imagen , Algoritmos , Diagnóstico Diferencial , Humanos , Valor Predictivo de las Pruebas

RESUMEN

OBJECTIVE: Patent arteriovenous fistula (AVF) is related to better prognosis and quality of life for patients on long-term dialysis. When AVF dysfunction is suspected, MDCT is a good noninvasive tool for evaluating the entire AVF structure and determining reversible conditions for treatment. The aim of this article is to introduce the scanning and interpretation techniques and to illustrate the conditions related to early and late fistula failures. CONCLUSION: MDCT is a fast, noninvasive, and accurate technique for diagnosing AVF complications. Radiologists familiar with these techniques can help to improve the prognosis and quality of life for hemodialysis patients.

Asunto(s)

Brazo/irrigación sanguínea , Brazo/diagnóstico por imagen , Derivación Arteriovenosa Quirúrgica , Fallo Renal Crónico/terapia , Complicaciones Posoperatorias/diagnóstico por imagen , Diálisis Renal , Tomografía Computarizada por Rayos X , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Calidad de Vida , Terapia Recuperativa

RESUMEN

Recently, CT pulmonary angiography (CTPA), especially performed with multi-detector row CT, has become a key imaging modality for pulmonary embolism. However, CTPA that was performed under clinical suspicion of pulmonary embolism has been shown to lead to high prevalence of alternative diagnosis, up to 25.4%. A comprehensive evaluation of pulmonary and extrapulmonary abnormalities including cardiovascular lesions is critical in proper diagnosis and patient care. Radiologists should be familiar with the comprehensive interpretation of CTPA to facilitate differential diagnosis and further treatment decision.

Asunto(s)

Arteria Pulmonar/diagnóstico por imagen , Embolia Pulmonar/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Errores Diagnósticos/prevención & control , Femenino , Humanos , Hallazgos Incidentales , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Embolia Pulmonar/terapia , Interpretación de Imagen Radiográfica Asistida por Computador , Adulto Joven

RESUMEN

BACKGROUND: To evaluate the safety and protective effect of relative undersized coil with loose coil core in the clinical dilemma condition--very small (43.0 mm) ruptured intracranial aneurysm. METHODS: We studied 12 patients (4 men, 8 women) who had suffered from acute ruptured small intracranial aneurysms (2-3 mm in size, with SAH presentation). All subjects underwent a single coil embolization procedure. An undersized coil (equivalent to the neck size or 0.5 mm smaller than the aneurysm diameter) was chosen as the embolizer. Based on the postembolization angiogram, subjects were divided into 2 groups. One was labeled as the initial complete obliteration group (NR) and the other as the incomplete obliteration group (SR). Fisher exact test and the Wilcoxon rank sum test were used to for statistical analysis. RESULTS: The technical success rate was 100% without any procedure-related complication. The follow-up interval ranged from 6 to 32 months. No episode of rebleeding or coil migration could be defined in the admissive and following period. Loose coil core were seen in all patients. The total recurrent rate was 8.3% (1/12); only one patient suffered from recurrent lesion in SR group. CONCLUSION: The preliminary result showed that under-sized coil packing with loose coil core could provide the protective effect and prevent from further rebleeding for very small ruptured aneurysms. It should be considered as an alternative option in the treatment of acute ruptured very small aneurysms when other conventional strategies are not feasible.

Asunto(s)

Prótesis Vascular/estadística & datos numéricos , Embolización Terapéutica/instrumentación , Embolización Terapéutica/métodos , Aneurisma Intracraneal/terapia , Hemorragia Subaracnoidea/terapia , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Angiografía de Substracción Digital , Prótesis Vascular/tendencias , Arterias Cerebrales/diagnóstico por imagen , Arterias Cerebrales/patología , Protocolos Clínicos , Femenino , Escala de Consecuencias de Glasgow , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/patología , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Cuidados Posoperatorios , Prevención Secundaria , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Subaracnoidea/patología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento

RESUMEN

OBJECTIVE: CT-guided core biopsy is playing an increasing role in the diagnosis of benign disease, cellular differentiation, somatic mutation analysis, and molecular fingerprint analysis. CONCLUSION: In this article, we summarize the basic concepts, protocols, and techniques that we use for CT-guided core biopsy of lung lesions to assist radiologists in obtaining diagnostic specimens while reducing preventable complications.

Asunto(s)

Biopsia con Aguja/métodos , Enfermedades Pulmonares/patología , Radiografía Intervencional , Tomografía Computarizada por Rayos X , Diagnóstico Diferencial , Humanos , Enfermedades Pulmonares/diagnóstico por imagen

RESUMEN

Subdural hematoma (SDH) of the spine following intracranial hemorrhage is extremely rare. We present a 35-year-old woman who suffered from headache and dizziness initially, and then lower back pain, lower limb weakness and paraparesis gradually developed within 1-2 weeks. Magnetic resonance imaging revealed intracranial and spinal SDH. No vascular abnormality was seen by brain and spinal angiography. Platelet count, prothrombin time, activated partial thromboplastin time, and inflammatory markers, including C-reactive protein, were normal. A diagnosis of spontaneous spinal and intracranial SDH was then confirmed surgically. Postoperative recovery was uneventful.

Asunto(s)

Hematoma Subdural Agudo/complicaciones , Hematoma Subdural Espinal/etiología , Adulto , Drenaje/métodos , Femenino , Estudios de Seguimiento , Hematoma Subdural Agudo/diagnóstico , Hematoma Subdural Agudo/cirugía , Hematoma Subdural Espinal/diagnóstico , Hematoma Subdural Espinal/cirugía , Humanos , Imagen por Resonancia Magnética

RESUMEN

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are specific, generally Kit (CD117)-positive, mesenchymal tumors of the gastrointestinal tract encompassing a majority of tumors previously considered gastrointestinal smooth muscle tumors. Our aim was to characterize the computed tomographic findings and predict malignant risk from computed tomography for the evaluation of GISTs. METHODS: The computed tomographic images of 39 patients with pathologically and immunohistochemically proven GISTs were reviewed by 2 radiologists, and the final interpretations were reached by consensus. Images were assessed for the size, contour, growth pattern, boundary, degree of enhancement, and necrosis of the tumors. The presence of calcification within the lesions, abdominal lymphadenopathy, ascites, and bowel obstruction were also recorded. Categorical variables were compared using Fishers exact test. Univariate and multivariate logistic regression analyses were used for selection of significant predictors of high-risk malignancy. In addition, the relationships between computed tomographic features and tumor size were assessed by means of nonparametric univariate analysis with the MannWhitney U test and KruskalWallis test. RESULTS: Both old age and larger tumor size (>or= 5 cm) were statistically significant in the univariate logistic analysis for high-risk malignant tumors (p < 0.25). However, in multivariate logistic regression, only larger tumor size (>or= 5 cm) was found to have final statistical significance for high-risk malignant GISTs (p < 0.05). In addition, more exophytic growth pattern (p < 0.01), more lobulated appearance (p < 0.01), good enhancement (p < 0.05),and more necrosis (p < 0.01) of masses were more often observed in larger GISTs than small ones on computed tomography. CONCLUSION: Larger tumor size (>or= 5 cm) was found to have a predictive value with respect to high-risk malignant GISTs.

Asunto(s)

Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Tumores del Estroma Gastrointestinal/etiología , Tumores del Estroma Gastrointestinal/patología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores de Riesgo

RESUMEN

Trisomy 18 syndrome is the second most common multiple malformation syndrome. The incidence is about 0.3 per 100 newborn babies. More than 130 different abnormalities have been noted in the literature on patients with the trisomy 18 syndrome. Trisomy 18 includes a broad spectrum of anomalies and malformations, among which we found Dandy-Walker malformation (DWM) rarely mentioned. DWM is estimated to occur in approximately 1 in 25,000 to 30,000 live births. The major components of DWM are the following: partial or complete absence of the cerebellar vermis, a posterior fossa cyst continuous with the fourth ventricle, and hydrocephalus. Although DWM has been associated with many chromosomal abnormalities and genetic syndromes in live birth, trisomy 18 with DWM is a rare condition. Here we present a female newborn with intrauterine growth retardation and multiple congenital abnormalities including: craniofacial anomaly, tracheoesophageal fistula, esophageal atresia, absent radius and thumb, short ulna, clenched hands, ventricular septal defect, coarctation of the aorta, patent ductus arteriosus, Meckel's diverticulum, ectopic pancreas in the ileum, and DWM. Her chromosome karyotype was 47,XX,+18. This is a case of Trisomy 18 with multiple rare malformations.

Asunto(s)

Anomalías Múltiples/patología , Cromosomas Humanos Par 18 , Síndrome de Dandy-Walker/patología , Trisomía , Femenino , Humanos , Recién Nacido , Ultrasonografía Prenatal