RESUMEN
Due to the close proximity of arteries and veins in the superior mediastinum and upper extremities, T2* shortening effects of the gadolinium within the central veins may cause artifactual vascular stenosis (susceptibility artifact) on arterial-phase MR angiographic images of the major branches of the aortic arch. We report a case of artifactual stenosis isolated to the origin of the left common carotid artery on arterial-phase MR angiography, secondary to susceptibility artifact from non-diluted gadolinium in the adjacent brachiocephalic vein. The cause of the artifact, its identification and prevention is reviewed.
Asunto(s)
Artefactos , Estenosis Carotídea/patología , Medios de Contraste , Gadolinio DTPA , Angiografía por Resonancia Magnética , Adulto , Arteria Carótida Común , Gadolinio , Humanos , Inyecciones Intravenosas , MasculinoRESUMEN
Fibrous pseudotumors of the testicular tunics and paratesticular soft tissue are uncommon lesions. They typically arise as painless scrotal masses that may be associated with a hydrocele or history of trauma or infection. Although these lesions are clinically worrisome for a malignant neoplasm, they are thought to be reactive in nature, since they are composed of dense fibrous tissue with interspersed bland fibroblasts and myofibroblasts and mixed inflammatory cells. Once excised, these lesions behave in a benign fashion. Typically, these masses are multinodular, but in rare cases they are diffuse, bandlike myofibroblastic proliferations that encase the testis and are termed fibromatous periorchitis. Herein, we describe a 57-year-old man with a diffuse fibrous pseudotumor/fibromatous periorchitis that encased the left testis and adnexa and arose in close apposition to an inflamed hydrocele.
Asunto(s)
Fibroma/diagnóstico , Neoplasias de Anexos y Apéndices de Piel/diagnóstico , Orquitis/complicaciones , Neoplasias de los Tejidos Blandos/diagnóstico , Hidrocele Testicular/patología , Neoplasias Testiculares/diagnóstico , Testículo/patología , Fibroma/etiología , Fibroma/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de Anexos y Apéndices de Piel/etiología , Neoplasias de Anexos y Apéndices de Piel/patología , Orquitis/patología , Neoplasias de los Tejidos Blandos/etiología , Neoplasias de los Tejidos Blandos/patología , Hidrocele Testicular/complicaciones , Neoplasias Testiculares/etiología , Neoplasias Testiculares/patologíaRESUMEN
PURPOSE: To determine changes in examination patterns and effectiveness of care since the introduction of unenhanced helical computed tomography (CT) for examination of patients presenting to the emergency department (ED) with symptoms of urinary tract calculi (UTC). MATERIALS AND METHODS: Hospital clinical and radiology information systems were used to retrospectively identify patients presenting with UTC symptoms from January to December 1997 (before introduction of unenhanced CT) and from January to December 1999 (after introduction of unenhanced CT). Chart abstraction was used to confirm the identification of patients with presenting symptoms suggestive of UTC and assess patient outcomes. Two hundred sixty-five patients presented before (1997) and 602 after (1999) unenhanced CT was introduced. Distributions of dichotomous variables were compared between the 1997 and 1999 groups by using logistic regression. Means were compared between the groups by using analysis of variance and mean total numbers of imaging studies by using Poisson regression. RESULTS: Total number of imaging studies increased by 26.7% per patient visit (P <.001). Rates of admission following the initial ED visit (13.7% in 1997 vs 13.4% in 1999), as well as percentage of patients who subsequently returned to the ED (12.0% in 1997 vs 13.7% in 1999) or subsequently were admitted to the hospital (4.5% in 1997 vs 5.3% in 1999) in the month following the initial ED visit, were similar between the two groups. Unsuspected unenhanced CT findings that could affect acute patient care were observed at 5.9% of examinations. CONCLUSION: Use of imaging for suspected UTC has increased markedly since the introduction of unenhanced CT, with little effect on acute care of patients in the ED.