Çavuşoğlu M, Ciliz DS, Duran S
… +1 more, Elverici E
JBR-BTR
· 2014 · PMID 25786289
Most of the spinal cord lipomas reported in the literature are intradural extramedullary, and true intramedullary lipomas are very rare. We present a case of intramedullary spinal cord lipoma of the cervico-thoracic regi...Most of the spinal cord lipomas reported in the literature are intradural extramedullary, and true intramedullary lipomas are very rare. We present a case of intramedullary spinal cord lipoma of the cervico-thoracic region with extensions over many spinal segments. Magnetic resonance (MR) examination showed an intramedullary lipoma of the cervico-thoracic spinal cord of both high T1 and T2-weighted signal intensity and suppression on fat saturation sequence. MR imaging assessment is critical in the detection of intramedullary lipomas which may present without any neurological deficit at an early stage. Early diagnosis may lead to prevention of the irreversible deterioration of neurological functions.
PURPOSE: To evaluate the effectiveness of WB-MRI for the detection of primary and metastatic lesions in comparison to PET-CT in patients with newly diagnosed malignancies MATERIAL AND METHODS: In this prospective study,...PURPOSE: To evaluate the effectiveness of WB-MRI for the detection of primary and metastatic lesions in comparison to PET-CT in patients with newly diagnosed malignancies MATERIAL AND METHODS: In this prospective study, 36 patients were evaluated between August 2008 and October 2012. The findings of WB-MRI (DWI and fat saturated T2 weighted images) were compared to the findings of PET-CT re- garding the primary lesions and metastasis. Sensitivity, specificity, positive and negative predictive values were calculated. To assess the aggreement between PET-CT and WB-MRI, kappa analysis was performed. RESULTS: The sensitivity, specificity, positive and negative predictive values for WB-DWI for the detection of primary and metastatic lesions in comparison to PET-CT were 96%, 89%, 97% and 84%, respectively. These are calculated as 96%, 56%, 90% and 77%, for fat-saturated T2W images. According to kappa analysis, the agreement between PET-CT and WB-DWI was excellent (χ = 0.83), but between PET-CT and fat-saturated T2 weighted images, it was moderate (χ = 0.58). CONCLUSION: Providing both morphogical and functional data, WB-MRI with DWI is emerging as a promising alternative imaging tool in the evaluation of cancer patients and may become complementary to PET-CT in several clinical applications.
OBJECTIVE: Superficial venous insufficiency is a common problem associated with varicose veins which, if untreated, may progress to venous ulceration. Endovenous laser ablation (EVLA) is a new, minimally invasive method...OBJECTIVE: Superficial venous insufficiency is a common problem associated with varicose veins which, if untreated, may progress to venous ulceration. Endovenous laser ablation (EVLA) is a new, minimally invasive method for management of superficial venous insufficiency and varicose veins. The aim of this study was to demonstrate the effectiveness of 980 nm EVLA for treatment of symptomatic saphenous venous insufficiency and to present its early outcomes. METHODS: Thirty-eight great saphenous veins and 5 small saphenous veins in 40 patients with saphenofemoral reflux were treated with 980 nm diode endovenous laser equipment. The diameter and length of the vein treated, total laser energy and energy density (Joules/cm) delivered were recorded. To determine the severity of the venous disease Venous Clinical Severity Score (VCSS) and Visual Analogue Scale (VAS) were used. Patients were followed up for 6 months after the procedure. Complications were recorded prospectively. RESULTS: Forty-three saphenous veins in 40 patients were treated. The mean age of the patients was 39.9 (range 21-72) years. The mean diameter and length of the veins were 4.9 mm (range, 3.5 to 8.5 mm) and 30.2 cm (range, 16 to 50 cm), respectively. At 6 months follow-up, total occlusion rate was 95.4% (41/43), and recanalization rate was 4.6%. Significant decrease was observed for VCSS and VAS scores after the procedure. No major complication was detected. CONCLUSION: EVLA treatment for superficial venous insufficiency is safe and can be carried out under local anaesthesia in an outpatient setting with good patient satisfaction and low complication rates.
OBJECTIVE: This study aims to assess whether a comparison of the Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery can help detect steal syndromes at the level of native dialysis fist...OBJECTIVE: This study aims to assess whether a comparison of the Doppler flow measurements of the ulnar artery and of the postanastomotic radial artery can help detect steal syndromes at the level of native dialysis fistulas of the wrist. PATIENTS AND METHODS: We have prospectively analyzed 35 distal radiocephalic arteriovenous fistulas presenting with postanastomotic radial artery Doppler inversion of flow. The flows of the ulnar artery and of the postanastomotic radial artery have been measured and compared. Subsequent clinical examination to detect any sign of ischemia at the hand level was performed and the results of medical imaging were confronted with the clinical data. RESULTS: A steal syndrome was discovered in a total of 6 patients (17%), 4 patients out of 23 displaying an ulnar flow lower than the postanastomotic radial one and 2 patients among 12 with an ulnar flow higher than the radial one. Sensitivity, specificity, positive predictive value and negative predictive value of the test were 67%, 34%, 17% and 83%, respectively. Paradoxically, the mean intensity of ulnar flow deficiency has been measured at 40% among true positive patients and at 70% among false positive ones. We have not been able to identify any difference, be it in terms of systolic upstroke time, maximum systolic speed, telediastolic speed or in terms of global architecture of the curves between the Doppler waveforms of 4 true positive and 4 false positive patients. CONCLUSION: The comparative Doppler study of the flows of the ulnar and postanastomotic radial arteries does not enable us to detect steal syndromes at the level of wrist dialysis fistulas. Hence we consider that a systematic study of the postanastomotic radial artery flow, during routine Doppler examination of distal dialysis fistulas, proves superfluous.
PURPOSE: Studies encompassing the views and aspirations of general practitioners (GPs) concerning the radiology report are rare. We present the results of a large-scale survey among GPs in Flanders, Belgium, and examine...PURPOSE: Studies encompassing the views and aspirations of general practitioners (GPs) concerning the radiology report are rare. We present the results of a large-scale survey among GPs in Flanders, Belgium, and examine its implications for the communication between radiologists and GPs. MATERIALS AND METHODS: GPs were invited by e-mail to participate in a survey on the radiology report. Respondents could state their degree of agreement with 46 statements. Besides that, they could freely make suggestions to improve the report. Quantitative results were examined to determine majority convictions. Free text suggestions were searched for motives and convictions. RESULTS: Of 1323 GPs invited, 282 completed forms were prepared for analysis. 96.8% considered the report an indispensable tool. 85.5% were satisfied with it. Itemized reporting of complex examinations was favoured by a very large majority. 83 GPs (29.4%) made suggestions for improvement. Much emphasis was put upon the clinical role of the radiologist. The need to mark key images, to mention meaningful normal findings, to structure the report and to facilitate communication was also frequently mentioned. CONCLUSION: GPs expect the radiologist to think as a clinician and offer clinical answers. An automated electronic information chain may contribute to realize this objective but direct communication should always remain possible.
We report the case of a 28-year-old man who presented at the emergency department with recent left painful scrotal swelling, without history of genitourinary infection or trauma. On physical examination, left scrotal swe...We report the case of a 28-year-old man who presented at the emergency department with recent left painful scrotal swelling, without history of genitourinary infection or trauma. On physical examination, left scrotal swelling with nodular palpation was noted. Contrast enhanced sonography demonstrated nodular vascularized thickening of the tunica vaginalis. Surgical exploration revealed multiples solid nodules of the vaginal wall, with, at frozen section analysis, fibroblastic tissue, vessels and chronic inflammation without malignity, suggestive of fibrous pseudotumor of the tunica vaginalis. We discuss the sonographic aspect of this rare entity and the difficulty to establish a diagno- sis of benignity without surgical exploration.
We report the CT, surgical and histopathologic findings of a rare case of Hepatic Angiosarcoma (HAS) diagnosed in a 85-year old women 65 years afterThorotrast (Th232) exposure for angiography. At the early arterial phase...We report the CT, surgical and histopathologic findings of a rare case of Hepatic Angiosarcoma (HAS) diagnosed in a 85-year old women 65 years afterThorotrast (Th232) exposure for angiography. At the early arterial phase of dynamic MDCT, peripheral curvilinear and central nodular puddling of contrast produced in the 8 cm tumor.Then progressive contrast filling of the tumor was observed on the delayed scans. Associated pathognomonic signs related to previous Th232 exposure were also found comprising diffuse intrahepatic reticular bands of calcifications, numerous calcified epigastric lymph nodes and a calcified shrunken spleen. Emergency laparotomy was performed because of associated hemoperitoneum. With a delay of 65 years afterThorotrast exposure, this historical case probably represents, to our knowledge, the most delayed presentation of Th232 related HAS ever published.
BACKGROUND: Spinal intradural arachnoid cyst is a rare lesion, sometimes acquired. PURPOSE: To describe the appearance and later spontaneous disappearence of a lumbar intradural arachnoid cyst, following perineural corti...BACKGROUND: Spinal intradural arachnoid cyst is a rare lesion, sometimes acquired. PURPOSE: To describe the appearance and later spontaneous disappearence of a lumbar intradural arachnoid cyst, following perineural corticoid injections. METHOD: Review of the clinical data and imaging, with final spontaneous return to initial state. DISCUSSION: Atypical intradural arachnoid cysts can be related to perineural injections and can cause symptoms of spinal stenosis. Its spontaneous vanishing is a very rare event, up to now unreported.
Primary undifferentiated embryonal sarcoma (UES) of the liver is a highly malignant mesenchymal origin tumor and has a peak incidence between the ages of 6 and 10 years. We hereby report a case of primary UES of the live...Primary undifferentiated embryonal sarcoma (UES) of the liver is a highly malignant mesenchymal origin tumor and has a peak incidence between the ages of 6 and 10 years. We hereby report a case of primary UES of the liver in a 7-year-old male patient who initially was misdiagnosed and treated as hydatid cyst of the liver. The tumor was occupying almost the entire right lobe of the liver and had a mostly cystic appearance with some solid components in it. Because hydatid disease is endemic in this region, it can often lead to misdiagnosis. The correct diagnosis was established after a biopsy and following neo-adjuvant chemotherapy the patient underwent a successful right hepatic lobectomy with complete resection of the tumor. The patient also received adjuvant chemotherapy and is currently disease-free in the present six month period. Primary UES of the liver has a predominantly solid appearance on US in contrast to its mostly cystic appearance on CT and MRI. These paradoxical imaging findings should be kept in mind in order to be able to distinguish this rare tumor from other entities, especially hydatid cyst. Thus, early diagnosis and prompt surgical resection of these tumors together with adjuvant and/or neo-adjuvant chemotherapy can provide complete remission.
We present a case of angioleiomyoma, a benign angiomatous soft tissue tumor in a 52-year-old patient. We empha- size that small nodular tumors showing hypervascularity on MRI or ultrasound may be malignant and should be...We present a case of angioleiomyoma, a benign angiomatous soft tissue tumor in a 52-year-old patient. We empha- size that small nodular tumors showing hypervascularity on MRI or ultrasound may be malignant and should be treated with tumor excision.
Postpartum ovarian vein thrombosis (POVT) is a rare cause of right fossa pain but the diagnosis should be considered in the clinical setting of persistent fever and lower quadrant tenderness in the postpartum period. Alt...Postpartum ovarian vein thrombosis (POVT) is a rare cause of right fossa pain but the diagnosis should be considered in the clinical setting of persistent fever and lower quadrant tenderness in the postpartum period. Although ultrasound is the initial step in the diagnostic work-up right fossa pain, it is often limited by overlying bowel gas and an enlarged puerperal uterus. Therefore, most authors recommend Computed Tomography (CT) as the imaging technique of choice to confirm the clinical suspicion of POVT. Because Magnetic Resonance Imaging (MRI) is less readily available, it is rarely performed for this indication. However, MRI allows not only to make the diagnosis as accurate as CT, but moreover it provides 2 important advantages in compared to CT. First, it avoids ionizing radiation. Secondly, the use of diffusion weighted imaging (DWI) may obviate the administration of intravenous contrast.
Small bowel angioedema induced by angiotensin converting enzyme (ACE) inhibitors is a rare and often-unrecog- nized condition that presents with transient abdominal pain, nausea and vomiting. We report a case diagnosed i...Small bowel angioedema induced by angiotensin converting enzyme (ACE) inhibitors is a rare and often-unrecog- nized condition that presents with transient abdominal pain, nausea and vomiting. We report a case diagnosed in a 36 year-old female. Ultrasound and CT showed segmental small bowel wall thickening and straightening associated with marked submucosal edema and ascites. Laboratory tests only revealed mild leukocytosis. The patient improved spontaneously.