RESUMEN
OBJECTIVE: To introduce a new grading system of lumbar central canal stenosis, evaluate its reliabilities, and compare it to the cross-sectional area and anterior-posterior diameter of the dural sac. MATERIALS AND METHODS: Lumbar central canal stenosis is defined as obliteration of the anterior CSF space in front of the cauda equina. Four musculoskeletal radiologists independently graded lumbar central canal stenosis by this new grading system based on separation degree of the cauda equina on T2-weighted axial images (grade 0 = no lumbar stenosis without obliteration of anterior CSF space; grade 1 = mild stenosis with separation of all cauda equina; grade 2 = moderate stenosis with some cauda equina aggregated; and grade 3 = severe stenosis with none of the cauda equina separated) in 81 patients to determine inter- and intra-reader reliability. One radiologist measured cross-sectional areas and anterior-posterior diameters and compared these to lumbar central canal stenosis grades. RESULTS: Inter-reader reliabilities were substantial to almost perfect (ICC reliability = 0.730-0.953). Intra-reader reliability was almost perfect (kappa value = 0.863-0.900). Cross-sectional areas and anterior-posterior diameters were different according to grades at all levels (p = 0.000-0.049), except between grades 2 and 3 of L2-3. At L5-S1, only anterior-posterior diameter was different between grades 0 and 1 (p = 0.005) and between grades 0 and 2 (p = 0.022). CONCLUSIONS: This new grading system may be helpful to clinicians for simple and practical evaluation of lumbar central canal stenosis and for communicating with each other.
Asunto(s)
Vértebras Lumbares , Imagen por Resonancia Magnética/métodos , Estenosis Espinal/patología , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Emphysematous infections of the abdomen and pelvis are potentially life-threatening conditions that require aggressive medical and surgical management. Therefore, early radiographic detection of emphysematous infections is important in management. Emphysematous cholecystitis is a rare and severe form of acute cholecystitis caused by gas-forming organisms. Emphysematous pancreatitis is a rare form of pancreatitis with gas in pancreatic parenchyma. We report a rare case of simultaneous occurrence of emphysematous cholecystitis and emphysematous pancreatitis.
Asunto(s)
Colecistitis/diagnóstico por imagen , Colecistitis/etiología , Enfisema/complicaciones , Enfisema/diagnóstico por imagen , Pancreatitis/diagnóstico por imagen , Pancreatitis/etiología , Tomografía Computarizada por Rayos X/métodos , Anciano de 80 o más Años , Diagnóstico Diferencial , Humanos , MasculinoAsunto(s)
Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/secundario , Diagnóstico por Imagen/métodos , Neoplasias Renales/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/secundario , Humanos , Neoplasias Renales/cirugía , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Hemorrhagic fever with renal syndrome (HFRS) is an acute viral disease characterized by fever, hemorrhage and renal failure. Among the various hemorrhagic complications of HFRS, spontaneous rupture of the kidney and perirenal hematoma are very rare findings. We report here on a case of HFRS complicated by massive perirenal hematoma, and this was treated with transcatheter arterial embolization.