RESUMEN
PURPOSE: To evaluate failing hemodialysis fistula complications using 16-detector MDCTA, and to assess the accuracies of different 3D planes. MATERIALS AND METHODS: Thirty patients (16 men, 14 women, aged 27-79 years) were referred for hemodialysis access dysfunction. Thirty-one MDCTA exams were done prior to fistulography. For MDCTA, contrast was administered (2mL/kg at 5mL/s) via a peripheral vein in the contralateral arm. Axial MIP, coronal MIP, and VRT images were constructed. Venous complications were evaluated on axial source images, on each 3D plane, and on all-planes together. Results were analyzed using McNemar test. RESULTS: Axial MIP, VRT and all-planes evaluations were most sensitive for fistula site detection (93%). Coronal MIP had the highest sensitivity, specificity and accuracy (35%, 96%, and 85%, respectively) for detecting venous stenosis. VRT and all-planes had the highest sensitivity and accuracy for detecting aneurysms (100%). All-planes and axial MIP were most sensitive for detecting venous occlusion (61% and 54%). Comparisons of detection frequencies for each venous pathology between the five categories of MDCTA revealed no significant differences (P>0.05). MDCTA additionally showed 3 partially thrombosed aneurysms, 4 anastomosis site stenosis and 12 arterial complications. CONCLUSION: MDCTA overall gives low sensitivity for detection of central vein stenosis and moderate sensitivity for occlusion. For most pathology, all-planes evaluation of MDCTA gives highest sensitivity and accuracy rates when compared to other planes. For venous stenosis and occlusion, MDCTA should be considered when ultrasonography and fistulography are inconclusive. MDCTA is helpful in identifying aneurysms, collaterals, partial venous thromboses and additional arterial, anastomosis site pathologies.
Asunto(s)
Angiografía/métodos , Derivación Arteriovenosa Quirúrgica/efectos adversos , Oclusión de Injerto Vascular/diagnóstico por imagen , Oclusión de Injerto Vascular/etiología , Imagenología Tridimensional/métodos , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Diálisis Renal/efectos adversos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Diálisis Renal/instrumentación , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
Jejuno-jejunal invagination caused by metastatic renal cell carcinoma is a rare entity in the literature. We report a case of metastatic renal cell carcinoma that led to jejuno-jejunal invagination, which was diagnosed by multidedector CT examination.
Asunto(s)
Carcinoma de Células Renales/secundario , Intususcepción/etiología , Neoplasias del Yeyuno/secundario , Neoplasias Renales , Carcinoma de Células Renales/diagnóstico por imagen , Humanos , Intususcepción/diagnóstico por imagen , Neoplasias del Yeyuno/diagnóstico por imagen , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
A case of a 48-year-old woman with hydatid disease of the breast is presented. The ultrasound and mammogram findings are shown and an uncommon ultrasound appearance of hydatid cyst in the breast is discussed.
Asunto(s)
Enfermedades de la Mama , Equinococosis , Enfermedades de la Mama/diagnóstico por imagen , Equinococosis/diagnóstico por imagen , Femenino , Humanos , Mamografía , Persona de Mediana Edad , Ultrasonografía MamariaRESUMEN
Solid-pseudopapillary tumour of the pancreas is a rare benign or low-grade malignant epithelial tumour; its association with pancreatic dorsal agenesis has been reported only once before. We present the radiological and histological findings of a case of pancreatic solid-pseudopapillary tumour associated with total pancreatic dorsal agenesis. A 49-year-old woman presented with abdominal pain radiating to the back for several months. Radiological findings showed absence of the dorsal pancreas and an 8 cm x 6 cm diameter tumour arising from the head of the pancreas. She underwent successful complete resection of the tumour. Histopathology revealed a diagnosis of solid-pseudopapillary tumour.
Asunto(s)
Páncreas/anomalías , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Dolor de Espalda/diagnóstico por imagen , Dolor de Espalda/etiología , Dolor de Espalda/cirugía , Femenino , Humanos , Persona de Mediana Edad , Páncreas/diagnóstico por imagen , Pancreatectomía , Neoplasias Pancreáticas/complicaciones , Neoplasias Pancreáticas/cirugía , Intensificación de Imagen RadiográficaRESUMEN
OBJECTIVE: To determine the incidence of abnormal hepatic vein Doppler waveform in patients with diffuse fatty infiltration of the liver (FIL). MATERIALS AND METHODS: In this prospective study, 40 patients with diffuse FIL and 50 normal healthy adults who served as control group underwent hepatic vein (HV) Doppler ultrasonography. The patients with the diagnosis of FIL were 23 men (57.5%) and 17 women aged 30-62 years (mean age +/- S.D., 42 +/- 12 years). Subjects in the control group were 27 men (54%) and 23 women aged 34-65 years (mean age +/- S.D., 45 +/- 14 years). The diagnosis of FIL was confirmed with computed tomography density measurements. The waveforms of HV were classified into three groups: regular triphasic waveform, biphasic waveform without a reverse flow, and monophasic or flat waveform. Etiological factors for FIL were diabetes mellitus (DM), hyperlipidemia and obesity (body mass index > 25). Serum lipid profile was obtained from all the patients with FIL. RESULTS: Seventeen of the 40 patients (43%) with FIL had an abnormal HV Doppler waveform, whereas only one of the 50 (2%) healthy subjects had an abnormal waveform. The difference in the distribution of normal Doppler waveform pattern between the patients and the control group was significant (P < 0.001). No differences were found in the behaviour of the hepatic vein Doppler waveform in relation to the different etiologic factors for FIL (P > 0.05). There was not any correlation between the degree of fat infiltration and the hepatic vein waveform pattern (P = 0.60). CONCLUSION: Patients with fatty liver has a high rate of an abnormal hepatic vein Doppler waveform pattern which can be biphasic or monophasic. We could not find a relation between the etiological factors for FIL and the occurrence of an abnormal HV Doppler waveform.
Asunto(s)
Hígado Graso/diagnóstico , Venas Hepáticas/diagnóstico por imagen , Ultrasonografía Doppler Dúplex/métodos , Adulto , Anciano , Electrocardiografía/métodos , Hígado Graso/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Estudios Prospectivos , Valores de Referencia , Factores de Riesgo , Tomografía Computarizada por Rayos X/métodosRESUMEN
OBJECTIVE: The aim of this study was to determine the role that hemodialysis (HD) plays in radiologically assessed osteoarthritis (OA) of the hand, knee, and hip. MATERIALS AND METHODS: Eighty patients who had been on regular HD for at least 2 years were included. Anterior-posterior radiographs of the pelvis, weight-bearing knees, and hands and wrists of each patient were examined. Bone mineral density (BMD) of spine, femur, and forearm was measured. RESULTS: Radiologic assessment of the 80 patients' hands showed that 41 individuals had osteopenia, 12 had midphalangeal subperiosteal resorption, 11 had cystic bone lesions, eight had bone erosion, four had osteophytic lesions, and three had subchondral sclerosis. Bone erosion in the hands was significantly associated with HD duration, forearm T score, and serum parathyroid hormone level. Radiologically, OA was demonstrated in eight knee and ten hip joints. Minimum joint space in the tibiofemoral compartment correlated with body mass index, and minimum joint space in the hip correlated with age. The mean BMD measurements at all three sites studied in the HD patients were low. Only the duration of HD significantly correlated with forearm BMD. CONCLUSION: Osteoarticular complications are common in HD patients.
Asunto(s)
Densidad Ósea , Enfermedades Óseas/diagnóstico por imagen , Fallo Renal Crónico/terapia , Osteoartritis de la Cadera/diagnóstico por imagen , Osteoartritis de la Rodilla/diagnóstico por imagen , Diálisis Renal/efectos adversos , Adulto , Anciano , Artrografía , Densidad Ósea/fisiología , Enfermedades Óseas/epidemiología , Enfermedades Óseas/etiología , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/etiología , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/epidemiología , Resorción Ósea/etiología , Huesos/diagnóstico por imagen , Femenino , Humanos , Articulaciones/patología , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/epidemiología , Masculino , Persona de Mediana Edad , Osteoartritis de la Cadera/epidemiología , Osteoartritis de la Cadera/etiología , Osteoartritis de la Rodilla/epidemiología , Osteoartritis de la Rodilla/etiología , Prevalencia , Factores de Riesgo , Turquía/epidemiologíaAsunto(s)
Arterias Carótidas/patología , Fallo Renal Crónico/patología , Túnica Íntima/patología , Túnica Media/patología , Disfunción Ventricular Izquierda/fisiopatología , Función Ventricular Izquierda/fisiología , Adolescente , Presión Sanguínea , Niño , Ecocardiografía , Ecocardiografía Doppler en Color , Femenino , Pruebas de Función Cardíaca , Humanos , Fallo Renal Crónico/sangre , Fallo Renal Crónico/complicaciones , Masculino , Válvula Mitral/fisiología , Válvula Mitral/fisiopatología , Valores de Referencia , Disfunción Ventricular Izquierda/epidemiologíaAsunto(s)
Trasplante de Hígado/fisiología , Hígado/diagnóstico por imagen , Biopsia con Aguja , Estudios de Seguimiento , Rechazo de Injerto/patología , Humanos , Fallo Hepático/cirugía , Pruebas de Función Hepática , Trasplante de Hígado/patología , Cintigrafía , Factores de Tiempo , Trasplante HeterotópicoRESUMEN
We describe a 25-week-old female fetus of consanguineous parents with ultrasonographic findings of increased echogenicity of lungs mimicking CAM (cystic adenomatoid malformation) type III, olygohydramnios and fetal ascites. A therapeutic abortion was performed and unilateral cryptophthalmos, laryngeal atresia and bilateral syndactyly of the hands and feet were observed at post-mortem. These findings confirmed the diagnosis of Fraser syndrome after abortion.
Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Ascitis/etiología , Malformación Adenomatoide Quística Congénita del Pulmón/diagnóstico por imagen , Enfermedades Fetales/diagnóstico por imagen , Laringe/anomalías , Oligohidramnios/diagnóstico por imagen , Diagnóstico Diferencial , Anomalías del Ojo/diagnóstico por imagen , Femenino , Edad Gestacional , Humanos , Sindactilia/diagnóstico por imagen , Síndrome , Ultrasonografía PrenatalRESUMEN
PURPOSE: To evaluate thoracic CT findings of long-term hemodialysis patients. MATERIAL AND METHODS: Thoracic CT findings of 117 uremic patients (61 men, 56 women) with complaints of cough, dyspnea, low-grade pyrexia, malaise, weight loss, and profuse perspiration were retrospectively documented. RESULTS: Atelectasis (60%), cardiomegaly (60%), pleural effusion (51%), vascular congestion (44%), parenchymal consolidation (38%), parenchymal scarring-fibrosis (31%), and lymphadenopathy (29%) were the most common CT findings in the thoraces of the long-term hemodialysis patients. Staphylococcus aureus was detected in 13 patients (11%) who had parenchymal infiltration. Thoracic tuberculosis was identified in 15 patients (13%), 11 of these cases being confined to the lung parenchyma, 3 to the pleura, and 1 involving the pleura and pericardium. CONCLUSION: In patients under long-term hemodialysis treatment, parenchymal consolidation, secondary to infectious agents such as S. aureus and Mycobacterium tuberculosis, is the most important CT finding since these lesions can be detected and treated successfully if they are considered as etiologic factors early on.
Asunto(s)
Fallo Renal Crónico/terapia , Diálisis Renal , Enfermedades Torácicas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Femenino , Humanos , Fallo Renal Crónico/complicaciones , Masculino , Persona de Mediana Edad , Neumonía Estafilocócica/diagnóstico por imagen , Estudios Retrospectivos , Enfermedades Torácicas/complicaciones , Factores de Tiempo , Tuberculosis Pulmonar/diagnóstico por imagenAsunto(s)
Ciclosporina/efectos adversos , Rechazo de Injerto/diagnóstico , Trasplante de Riñón/patología , Imagen por Resonancia Magnética , Adolescente , Adulto , Medios de Contraste , Diagnóstico Diferencial , Femenino , Gadolinio DTPA , Rechazo de Injerto/patología , Humanos , Inmunosupresores/efectos adversos , Trasplante de Riñón/inmunología , Masculino , Persona de Mediana EdadRESUMEN
In this report we present the CT findings of two non-gestational, extragonadal choriocarcinomas, one arising within the stomach and one in the pancreas. These are rare tumours and a pancreatic primary site has not been previously described.
Asunto(s)
Coriocarcinoma/diagnóstico por imagen , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Gástricas/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Antineoplásicos/uso terapéutico , Biopsia , Coriocarcinoma/tratamiento farmacológico , Coriocarcinoma/secundario , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/patología , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patologíaAsunto(s)
Densidad Ósea/fisiología , Trasplante de Riñón/fisiología , Absorciometría de Fotón , Adolescente , Adulto , Quimioterapia Combinada , Durapatita/análisis , Femenino , Rechazo de Injerto/tratamiento farmacológico , Rechazo de Injerto/epidemiología , Humanos , Hiperparatiroidismo/etiología , Hiperparatiroidismo/fisiopatología , Terapia de Inmunosupresión/métodos , Inmunosupresores/uso terapéutico , Enfermedades Renales/clasificación , Enfermedades Renales/cirugía , Fallo Renal Crónico/complicaciones , Masculino , Persona de Mediana EdadAsunto(s)
Angioplastia Coronaria con Balón , Fístula Arteriovenosa/terapia , Derivación Arteriovenosa Quirúrgica/efectos adversos , Fallo Renal Crónico/terapia , Diálisis Renal , Adulto , Anciano , Fístula Arteriovenosa/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Stents , Resultado del TratamientoAsunto(s)
Composición Corporal/fisiología , Trasplante de Riñón/fisiología , Tejido Adiposo/anatomía & histología , Adolescente , Adulto , Quimioterapia Combinada , Rechazo de Injerto/tratamiento farmacológico , Humanos , Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Persona de Mediana Edad , Estudios Prospectivos , Diálisis RenalRESUMEN
They grey scale ultrasound features of liver hydatid disease have been evaluated on 65 surgically proven cysts in 38 patients. The majority of cysts showed the well-known ultrasound pattern of simple cysts. However, a minority of lesions were either multicystic or gave the appearance of a cyst within a cyst. Occasionally cysts showed a feature which we have called "the ultrasonographic water lily sign". Hydatid sand was also occasionally seen in the most dependent portion of hydatid cysts. We have noted that if a hydatid cyst becomes secondarily infected these typical ultrasound patterns are lost and the ultrasound diagnosis may then become more difficult.