RESUMEN
OBJECTIVES: The study aims to compare retrospectively three clinically applied methods for the diagnostic performance of cystic renal masses (CRMs) by contrast-enhanced ultrasound (CEUS) and contrast-enhanced computer tomography (CECT) with Bosniak classification system. METHODS: A total of 52 cases of Bosniak II-IV CRMs in 49 consecutive patients were diagnosed from January 2013 to July 2022 and their data were analyzed. All patients had been subjected to CEUS and CECT simultaneously. Pathological diagnoses and masses stability were used as standard references to determine whether lesions were malignant or benign. Then 49 CRMs only with pathologic results were classified into group 1 and 2. RESULTS: A total of 52 CRMs in 49 enrolled patients were classified into 8 category II, 16 category IIF, 15 category III, and 13 category IV by CEUS (EFSUMB 2020), 10 category II, 13 category IIF, 16 category III, and 13 category IV by CEUS (V2019), while 15 category II, 9 category IIF, 13 category III, and 15 category IV by CECT (V2019). Pathological results and masses stability longer than 5 years follow-up performed substantially for CEUS (EFSUMB 2020), CEUS (V2019), and CECT (V2019) (kappa values were 0.696, 0.735, and 0.696, respectively). Among 49 pathologic approving CRMs, wall/septation thickness ≥4 mm, wall/septation thickness, presence of enhancing nodule and the diameter were found to be statistically significant for malignancy. Twenty-two malignant masses were correctly diagnosed by CEUS (V2019), while 21 malignant masses were both correctly diagnosed by CEUS (EFSUMB 2020) and CECT (V2019), and 1 mass was misdiagnosed. CONCLUSIONS: Bosniak classification of EFSUMB 2020 version might be as accurate as version 2019 CEUS and version 2019 CECT in diagnosing CRMs, and CEUS is found to have an excellent safety profile in dealing with clinical works.
Asunto(s)
Enfermedades Renales Quísticas , Neoplasias Renales , Humanos , Estudios Retrospectivos , Riñón/patología , Tomografía Computarizada por Rayos X/métodos , Neoplasias Renales/diagnóstico por imagen , Ultrasonografía/métodos , Computadores , Enfermedades Renales Quísticas/diagnóstico por imagen , Medios de ContrasteRESUMEN
It is controversial whether there is a different risk of recurrence between two histological subtypes in craniopharyngioma (CP) patients. Some reported that adamantinomatous craniopharyngioma (ACP) had a higher risk of recurrence than papillary craniopharyngioma (PCP), but others reported that there is no significant difference between them. So, we conducted this systematic review and meta-analysis to determine the association between the histological subtype of CP and the rate of recurrence. A comprehensive literature search was undertaken in PubMed, EMBASE, and Web of Science for all English articles published up to November 2020. Recurrence data stratified by ACP and PCP were extracted from studies meeting inclusion criteria. A pooled analysis of the association between the histological subtype of craniopharyngioma and rates of recurrence was performed. Thirteen articles containing 974 patients were included. When stratified by two pathological subtypes, the total recurrence rate of ACP was 26.0% and PCP was 14.1%, which showed ACP associated with a higher risk of tumor recurrence than PCP (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.36, 3.30, P = 0.00). This is the first meta-analysis focusing on histological subtypes of CP. PCP associates with a lower risk of recurrence than ACP, indicating that ACP could act as one of recurrence risk factors for CP patients. Nevertheless, large sample size and well-designed multicenter studies in which the other clinical variables are controlled to determine the histological subtype of CP as an independent recurrence risk factor are needed.
Asunto(s)
Craneofaringioma , Neoplasias Hipofisarias , Craneofaringioma/epidemiología , Craneofaringioma/cirugía , Humanos , Neoplasias Hipofisarias/epidemiología , Neoplasias Hipofisarias/cirugíaRESUMEN
Purpose: To report a rare complication that Onyx gel blocked the MCA trunk and branches unexpectedly during AVM embolism and our strategy to rescue. Material and methods: A 16 years old otherwise healthy girl hold a left side Spetzler - Martin grade III fronto-temporal AVM, during embolization, the L-MCA and its branches were blocked by Onyx completely, the patient was transferred to the operating room to extract the Onyx gel immediately. Result: After totally 10 arterotomies, all the Onyx gel were removed. 8 hours after occlusion, all arteries were then seen to pulsate. Conclusion: Iatrogenic MCA full-length acute occlusion is a rare and severe complication during AVM embolism. Carefully identify the feeding arteries, micro-catheter angiography before Onyx gel injection and balloon-assisted embolism could probably prevent it. Surgical operation to extract onyx gel and re-canalize MCA was recommended, AVM should be resect if possible.