RESUMO
PURPOSE: To determine adrenal gland enhancement with manganese (II) N,N' dipyridoxylethylenediamine-N,N'-diacetate 5,5'bis(phosphate) (DPDP) at magnetic resonance imaging. MATERIALS AND METHODS: After phase III trials, fat-suppressed, motion-compensated, T1-weighted spin-echo images (repetition time, 500 msec; echo time, 12 msec) of 13 consecutive patients were obtained at 1.5 T at one site, prior to and approximately 30 minutes after intravenous administration of 5 mumol/kg Mn-DPDP. Images were analyzed visually and by means of region-of-interest measurements, normalized to spleen. With data added from three more sites, enhancement of three adrenal adenomas and two metastases was analyzed. RESULTS: Twenty-five of 26 adrenal glands were depicted on MR images, and all showed enhancement. Mean adrenal enhancement (38%) was comparable to mean enhancement of liver (46%), pancreas (25%), and renal cortex (58%). Adrenal cortex and medulla could not be distinguished in nonenhanced or enhanced images. All three adrenal adenomas enhanced by more than 40%, but the metastases did not enhance. CONCLUSION: Functioning adrenal tissue (glands and at least some adenomas) are enhanced with Mn-DPDP.
Assuntos
Adenoma/diagnóstico , Neoplasias das Glândulas Suprarrenais/diagnóstico , Glândulas Suprarrenais/patologia , Meios de Contraste , Ácido Edético/análogos & derivados , Imageamento por Ressonância Magnética/métodos , Fosfato de Piridoxal/análogos & derivados , Neoplasias das Glândulas Suprarrenais/secundário , Feminino , Humanos , Fígado/patologia , Cirrose Hepática/diagnóstico , Hepatopatias/diagnóstico , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To determine guidelines for biopsy in men with normal prostate-specific antigen (PSA) levels and suspected prostate cancer. MATERIALS AND METHODS: The clinical-sonographic features of 91 lesions of reduced echogenicity in 83 men with normal PSA levels who underwent transrectal ultrasound-guided biopsy were analyzed. RESULTS: Sixteen men (19%) had cancer, two with bilateral foci, and four had prostatic intraepithelial neoplasia (PIN). Fourteen of 47 discrete hypoechoic lesions yielded cancer or PIN versus only five of 44 ill-defined vaguely hypoechoic lesions (P = .03). Fifteen of 18 malignant lesions exceeded 1 cm in longest dimension. In 47 men, sonographic and digital rectal examination (DRE) findings corresponded; 17 (36%) had cancer or PIN. By contrast, of 36 patients with differing sonographic and DRE findings, only three (8%) had malignancy at biopsy (P < .01). CONCLUSION: Predictors of malignancy at sonography of the peripheral prostate gland in men with normal PSA levels include (a) lesion size, (b) degree and focality of hypoechogenicity, and (c) correspondence with the site of DRE abnormality.
Assuntos
Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Exame Físico , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Estudos Prospectivos , Próstata/diagnóstico por imagem , Próstata/patologia , Prostatite/diagnóstico por imagem , Prostatite/patologia , Estudos Retrospectivos , Ultrassonografia de IntervençãoRESUMO
A survey of nonacademic community hospitals was conducted to ascertain the degree of control radiologists have of 38 selected imaging or imaging-related interventional procedures. Responses from 187 hospitals showed that community hospital radiologists totally controlled or strongly dominated almost half of these procedures, including all computed tomographic and magnetic resonance imaging studies, bone radiography, breast needle localization, emergency department radiography, arthrography, obstetric ultrasound (US), renal and peripheral angioplasty, percutaneous abscess and biliary drainage, percutaneous nephrostomy, cerebral angiography, and interventional neuroangiography. Radiologists dominated in prostate and vascular US, myelography, urethrography, cardiac nuclear medicine, percutaneous lung biopsy, ureteral stent placement, and pulmonary angiography, but there was also significant participation in these studies by nonradiologists. Radiologists and nonradiologists had roughly equivalent roles in hysterosalpingography, peripheral atherectomy and laser angioplasty, and percutaneous inferior vena cava filter placement. Nonradiologists dominated in echocardiography, endoscopic retrograde cholangiopancreatography, biliary and kidney stone lithotripsy, percutaneous gastrostomy, coronary angiography and angioplasty, and pediatric angiocardiography.