RESUMEN
Extrauterine adenomyomas are rare tumors that present as uterus-like masses. Uterine adenomyomas can show interval changes according to hormone status. However, interval changes in imaging studies have not been reported in adenomyomas. We report a rare case of an extrauterine adenomyoma showing unique interval changes in magnetic resonance imaging.
Asunto(s)
Adenomioma/diagnóstico , Imagen por Resonancia Magnética , Neoplasias Pélvicas/diagnóstico , Adulto , Femenino , HumanosRESUMEN
Hilar cholangiocarcinoma is associated with a dismal prognosis; however, curative resection may offer a chance of cure. Various factors should be considered in the surgical planning for curative resection. These factors include extent of bile duct involvement, relationship between portal vein and tumor involvement, diffuse hepatoduodenal ligament infiltration, vascular invasion, lymph node metastasis, peritoneal seeding, and hepatic volume. Using high-quality volume data from multidetector-row computed tomography (MDCT) and adequate postprocessing images, radiologists can provide various types of information, imperative for curative resection of a hilar cholangiocarcinoma. This review illustrates the role of MDCT in the preoperative workup of hilar cholangiocarcinoma.
Asunto(s)
Neoplasias de los Conductos Biliares/diagnóstico por imagen , Conductos Biliares Intrahepáticos/diagnóstico por imagen , Colangiocarcinoma/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Conductos Biliares Intrahepáticos/patología , Conductos Biliares Intrahepáticos/cirugía , Colangiocarcinoma/patología , Colangiocarcinoma/cirugía , Medios de Contraste , Humanos , Metástasis Linfática , Imagen por Resonancia Magnética , Invasividad Neoplásica , Siembra Neoplásica , Cuidados Preoperatorios , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
The purpose of this study was to assess the computed tomography (CT) and ultrasonography (US) findings from cases of exophytic adenocarcinoma of the stomach (EAS) and to determine their value in distinguishing between an EAS and a malignant gastrointestinal stromal tumor (MST). US and CT findings of EAS and MST were assessed retrospectively. Antral location, thickening of the gastric wall adjacent to an exogastric mass, lymph node enlargement, and discordant images between US and CT are typical of EAS cases and allow distinction between cases of EAS and MST.
Asunto(s)
Adenocarcinoma/diagnóstico , Tumores del Estroma Gastrointestinal/diagnóstico , Neoplasias Gástricas/diagnóstico , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía/métodos , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Our objective is to describe the CT features of exophytic hepatic tumors those may pose a diagnostic challenge because of the uncertainty of tumor origin. The beak sign and the feeding artery of a tumor are useful diagnostic indicators of exophytic hepatic tumors. Two- or three-dimensional reformation images are also helpful for diagnosis. The CT features of exophytic hepatic tumors are similar to those of the usual intrahepatic tumors except for their location.
Asunto(s)
Neoplasias Hepáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Medios de Contraste , Diagnóstico Diferencial , Humanos , Neoplasias Hepáticas/patología , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
OBJECTIVE: The purpose of this article is to illustrate the varied CT appearances of serous cystadenoma of the pancreas and of masses that mimic serous cystadenoma. CONCLUSION: Serous cystadenomas of the pancreas have a wide range of CT findings. Familiarity with the varied CT appearances and awareness of the diagnostic limitations of CT are important for accurate diagnosis and management of serous cystadenoma of the pancreas.
Asunto(s)
Cistoadenoma/diagnóstico por imagen , Aumento de la Imagen/métodos , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Niño , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Most pancreatic pseudocysts are common complications of acute or chronic pancreatitis. They usually occur within the pancreas or in peripancreatic tissues, and are visualized as round or oval fluid collections with thin or thick walls on computed tomography (CT) scans. However, pancreatic pseudocysts are often combined with various complications, e.g., various organ involvements, infection, hemorrhage with pseudoaneurysm formation, rupture with fistula formation, or gastrointestinal or biliary obstruction, which may necessitate prompt intervention or surgery. This review illustrates the CT appearances of various complications associated with pancreatic pseudocysts.
Asunto(s)
Seudoquiste Pancreático/complicaciones , Seudoquiste Pancreático/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Colestasis/diagnóstico por imagen , Colestasis/etiología , Hemorragia/diagnóstico por imagen , Hemorragia/etiología , Humanos , Infecciones/diagnóstico por imagen , Infecciones/etiología , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Interpretación de Imagen Radiográfica Asistida por Computador , Radiografía Intervencional , Rotura EspontáneaRESUMEN
OBJECTIVE: The purpose of this study was to evaluate the feasibility of transrectal ultrasonography (TRUS) and color Doppler ultrasonography (CDUS) in differentiating malignant from benign distal ureteral obstructions. METHODS: Our study group consisted of 16 malignant distal ureteral obstructions and 12 benign distal ureteral obstructions. The 16 malignant distal ureteral obstructions were transitional cell carcinomas involving the distal ureter. The 12 benign distal ureteral obstructions consisted of benign strictures (n = 4), ureteral edema after stone passage (n = 3), tuberculosis (n = 2), a fibroepithelial polyp (n = 1), amyloidosis (n = 1), and a hematoma (n = 1). Findings from gray scale transabdominal ultrasonography, gray scale TRUS, CDUS, and duplex Doppler imaging were retrospectively evaluated. RESULTS: Gray scale transabdominal ultrasonography and TRUS showed no specific difference between malignant and benign distal ureteral obstructions. On CDUS, malignant distal ureteral obstructions showed dotlike blood flow in 5, moderately increased blood flow in 9, and markedly increased blood flow in 2; and benign distal ureteral obstructions showed absence of blood flow in 5 and dotlike blood flow in 7. Flow spectra could be obtained in 12 malignant distal ureteral obstructions, and they showed arterial waveforms. Duplex Doppler imaging was not tried in 4 malignant distal ureteral obstructions. In 7 benign distal ureteral obstructions with dotlike blood flow, flow spectra could not be obtained. CONCLUSIONS: Moderately or markedly increased blood flow within a ureteral mass on CDUS and an arterial waveform within a ureteral mass on duplex Doppler imaging may be helpful in differentiating malignant from benign distal ureteral obstructions.
Asunto(s)
Ultrasonografía Doppler en Color/métodos , Neoplasias Ureterales/diagnóstico por imagen , Adulto , Anciano , Diagnóstico Diferencial , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recto , Estudios Retrospectivos , Neoplasias Ureterales/patologíaRESUMEN
The purpose of this study was to describe radiologic anatomy of the superior mesenteric vein (SMV) and to evaluate branching patterns of the first jejunal trunk on axial CT images and multi-detector row CT (MDCT) venography in adults. Two hundred and twenty consecutive patients who underwent abdominal CT examinations were enrolled in this study. Appearance of the SMV, branching patterns of the first jejunal trunk, and drainage site of the inferior mesenteric vein (IMV) were assessed on axial CT images and MDCT venography. The SMV and first jejunal trunk were identified in all patients. A single trunk of the SMV was present in 95% (210/220) and absent in 5% (10/220). First jejunal trunk crossed dorsal to the superior mesenteric artery (SMA) towards the left abdomen in 64% (141/220) and first jejunal trunk crossed ventral to the SMA in 19% (41/220). First jejunal trunk crossed dorsal to the SMA and abruptly turned towards the right abdomen in 17% (38/220). Among these 38 patients, biliary-enteric bypass surgery (n = 9) and large hematoma in left abdomen (n = 1) were present. The IMV was identified in 213 patients and was observed to drain into splenic vein in 112 patients (53%), SMV in 67 (31%), splenoportal confluence in 26 (12%), and first jejunal trunk in 8 (4%). In conclusion, the first jejunal trunk, abruptly turning toward the right abdomen, may be an anatomic variant or indirect finding of biliary-enteric anastomosis. The IMV may drain into the first jejunal trunk as well as splenic vein, splenoportal confluence, and SMV.
Asunto(s)
Yeyuno/irrigación sanguínea , Venas Mesentéricas/diagnóstico por imagen , Flebografía/métodos , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodosRESUMEN
OBJECTIVE: The purpose of this study was to compare the feasibility of transrectal ultrasonography (TRUS) and color Doppler ultrasonography (CDUS) with transabdominal ultrasonography (TAUS) for the diagnosis of transitional cell carcinoma (TCC) involving the distal ureter. METHODS: Our study group consisted of 12 patients having TCC involving the distal ureter who had undergone TAUS and TRUS. Verification of the TCC involving the distal ureter was made by surgery (n = 9) or urine cytologic examination combined with the imaging findings (n = 3). The gray scale images of TAUS and TRUS were retrospectively evaluated to determine whether the ureteral mass was visualized. The CDUS findings were compared with the T stage, the histopathologic grade, and the mean microvessel density of histopathologically proved distal ureteral TCCs (n = 8). RESULTS: Transabdominal ultrasonography showed hypoechoic ureteral dilatation in 6 patients, a ureteral mass in 5, and anechoic ureteral dilatation in 1. Transrectal ultrasonography showed a ureteral mass in all 12 patients. Color Doppler ultrasonography could show blood flow in the ureteral mass in all patients. The tumor vascularity on CDUS showed no statistically significant relationship with the T stage, the histopathologic grade, and the mean microvessel density. CONCLUSIONS: Compared with TAUS, TRUS seems to improve the ability to detect TCC involving the distal ureter. In conjunction with TRUS, CDUS shows blood flow in the ureteral mass, and this may be helpful for the diagnosis of TCC involving the distal ureter.
Asunto(s)
Carcinoma de Células Transicionales/diagnóstico por imagen , Ultrasonografía Doppler en Color/métodos , Neoplasias Ureterales/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Transicionales/patología , Femenino , Humanos , Persona de Mediana Edad , Recto/diagnóstico por imagen , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad , Método Simple Ciego , Neoplasias Ureterales/patologíaRESUMEN
OBJECTIVE: We prospectively evaluated transabdominal and transvaginal sonographic findings of patients with pelvic congestion syndrome and compared them with those of healthy volunteers. SUBJECTS AND METHODS. We examined 32 patients with pelvic congestion syndrome and 35 control subjects. Using transabdominal sonography, we evaluated the ovarian veins for diameter and flow direction, presence of pelvic varicocele, diameter of the pelvic veins, change of the duplex waveform during the Valsalva's maneuver, volume of the uterus, and presence of polycystic changes in the ovaries. We compared and statistically analyzed each parameter in the pelvic congestion syndrome group and in the control group. RESULTS: The mean (+/- SD) diameter of the left ovarian vein was 0.79 +/- 0.23 cm in the pelvic congestion syndrome group and 0.49 +/- 0.15 cm in the control group (p = 0.000). Reversed caudal flow in the left ovarian vein was present in 22 of 22 patients and in four of 16 control subjects. Pelvic varicoceles were present in all patients with pelvic congestion syndrome and in six control subjects. The mean diameter of the left pelvic vein was 0.68 +/- 0.21 cm in the pelvic congestion syndrome group and 0.42 +/- 0.19 cm in the control group; the mean diameter of the right pelvic vein was 0.64 +/- 0.24 cm in the pelvic congestion syndrome group and 0.35 +/- 0.14 cm in the control group (p = 0.000). Polycystic changes of the ovary were present in 13 patients with pelvic congestion syndrome (40.6%) and four control subjects (11.4%). CONCLUSION: Sonographic findings of pelvic congestion syndrome were dilated left ovarian vein with reversed caudal flow, presence of varicocele, dilated arcuate veins crossing the uterine myometrium, polycystic changes of the ovary, and variable duplex waveform during the Valsalva's maneuver. Combined transabdominal and transvaginal sonography are potentially useful as a noninvasive screening tool for determining which patients with chronic pelvic pain may benefit from selective ovarian venography and transcatheter embolization.
Asunto(s)
Ovario/irrigación sanguínea , Dolor Pélvico/diagnóstico por imagen , Pelvis/irrigación sanguínea , Ultrasonografía Doppler/métodos , Enfermedades Vasculares/diagnóstico por imagen , Adulto , Estudios de Casos y Controles , Embolización Terapéutica , Femenino , Humanos , Persona de Mediana Edad , Dolor Pélvico/terapia , Enfermedades Vasculares/terapiaRESUMEN
We report here on a case of extrahepatic biliary cystadenoma arising from the common hepatic duct. A 42-year-old woman was evaluated by us to find the cause of her jaundice. Ultrasonography and CT showed a cystic dilatation of the common hepatic duct and also marked dilatation of the intrahepatic duct. Direct cholangiography demonstrated a large filling defect between the left hepatic duct and the common hepatic duct; dilatation of the intrahepatic duct was also demonstrated. Following excision of the cystic mass, it was pathologically confirmed as a unilocular biliary mucinous cystadenoma arising from the common hepatic duct.
Asunto(s)
Neoplasias de los Conductos Biliares/diagnóstico , Quiste del Colédoco/diagnóstico , Cistoadenoma/diagnóstico , Conducto Hepático Común/patología , Adulto , Pancreatocolangiografía por Resonancia Magnética , Diagnóstico Diferencial , Femenino , Conducto Hepático Común/diagnóstico por imagen , Humanos , Tomografía Computarizada por Rayos X , Ultrasonografía IntervencionalRESUMEN
Focal nodular hyperplasia (FNH) is characterized by the presence a central scar with radiating fibrous septa. Our case had a capsular retraction, which was the result of an extension of the central scar to the surface. In addition, a hypointense scar on the T2-weighted image and a minimal enhancing central scar on the enhanced T1-weighted image, which was due to dense, sclerotic collagenous tissue, were observed. We report the first case of FNH with a capsular retraction.
Asunto(s)
Hiperplasia Nodular Focal/patología , Hígado/patología , Adulto , Femenino , Humanos , Imagen por Resonancia MagnéticaRESUMEN
Sonograms in 131 patients with rectal carcinoma confirmed with surgery or endoscopic biopsy were included in this 7-year study. Rectal carcinoma was detected in 121 (92%) of 131 patients. Seventeen patients had a hypoechoic mass in the rectum, and 104 patients showed rectal wall thickening (mean, 12 mm). One hundred seven (97%) rectal carcinomas were detected in 110 patients with clinically suspected rectal carcinoma, and 14 (67%) rectal carcinomas were detected in 21 patients who underwent routine sonographic examination without information about rectal carcinoma. There were 19 hepatic metastases and 12 lymph node metastases. A few cases invaded to the adjacent organs, such as the uterus, seminal vesicle, ovary, or prostate. Rectal carcinoma can be detected by meticulous examination of the rectal wall during routine abdominal sonography in patients with suspected rectal carcinoma.