1,720,985 research outputs found
MAGNETIC RESONANCE (MRI) AND COMPUTED TOMOGRAPHY (CT) FOR CHOLANGIOCARCINOMA
High quality cross-sectional Multidetector Computed Tomography and/or Magnetic Resonance Imaging play an important role in diagnosis, localization, and staging and planning of the optimal management of cholangiocarcinoma. Correct imaging helps to localize the tumor to either the intrahepatic, the perihilar or the distal bile ducts, each of which requires different management. It accurately stages the disease, identifying the presence of significant nodal and distant metastasis or major vascular encasement of the portal vein or the hepatic arteries, or depicts extensive involvement of the hepatic duct reaching up to second-order biliary radicals. It also helps to identify the extent of local tumor invasion, which has a major impact on management.
This chapter presents the spectrum of appearances of cholangiocarcinomas at cross-sectional imaging and examines the possibilities of imaging modalities in the proper stage classification of bile duct tumors according to the recent staging systems
MANUALE DI DIAGNOSTICA PER IMMAGINI PER IL CORSO DI LAUREA IN MEDICINA E CHIRURGIA. DIAGNOSTICA PER IMMAGINI DEL FEGATO, DELLA MILZA, DEL PERITONEO E MESENTERE. 2°edizione CAPITOLO 8 - 10 - 13
1) DIAGNOSTICA PER IMMAGINI DEL FEGATO di R. Golfieri, M. Renzulli, A. Cappelli (Capitolo 8 pag.157-218): Nello studio della patologia epatica hanno un ruolo essenziale l'ecografia (US) completata da eco-color Doppler (ECD) e da mdc (ecocontrastografia), la TC, la RM e la colangio-RM. La scintigrafia e l'angiografia hanno un ruolo in settori ben definiti. 2) DIAGNOSTICA PER IMMAGINI DELLA MILZA di R. Golfieri, A. Cappelli (Capitolo 10 pag. 245-270): II compito principale delle metodiche di imaging è quello di: determinare il volume splenico, individuare eventuali lesioni focali, fornire una definizione nosografia delle splenomegalie, associate o meno a ipersplenismo e riconoscere la rottura della milza secondo i gradi di gravità 3) DIAGNOSTICA PER IMMAGINI DEL PERITONEO E MESENTERE di R. Golfieri, V. Orsini, B. Corcioni (Capitolo 13 pag. 319-2342
An unusual case of right retrocaval ureter associated with ipsilateral ureterocele
A 36-year-old man with right flank pain presented to our institution. Intravenous urography showed mild dilatation of the right pyelocaliceal system and large filling defect in the vesical lumen. Computed tomography revealed the right kidney to be smaller than the left, and with chronic pyelonephritis. The right ureter passed behind the inferior vena cava at the level of the pelvic-ureteral junction. The middle and lower ureter was dilated above a large ureterocele. Cystourethrography showed right vesicoureteral reflux. The patient underwent a resection of the ureterocele with reimplantation of the ureter. Follow-up at 3 months demonstrated resolution of the dilatation of the right ureter. © 2012 Elsevier Inc
Liver collision lesion: inflammatory hepatocellular adenoma within focal nodular hyperplasia
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Dynamic FDG PET/CT on bladder paraganglioma: A case report
Paraganglioma (PGL) is characterized by equivocal clinical manifestations and arriving to a suspicion might be challenging. Nevertheless, diagnostic imaging and nuclear medicine are a fundamental part of the diagnosis and management of this particular neuroendocrine tumor (NET). We herein report a rare case of bladder paraganglioma with unusual onset and typical PET/CT characteristics that led to its recognition
PI-RADS version 2.1 for the evaluation of transition zone lesions: a practical guide for radiologists
Multiparametric magnetic resonance imaging has been established as the most accurate non-invasive diagnostic imaging tool for detecting prostate cancer (PCa) in both the peripheral zone and the transition zone (TZ) using the PI-RADS (Prostate Imaging Reporting and Data System) version 2.1 released in 2019 as a guideline to reporting. Transition zone PCa remains the most difficult to diagnose due to a markedly heterogeneous background and a wide variety of atypical imaging presentations as well as other anatomical and pathological processes mimicking PCa. The aim of this paper was to present a spectrum of PCa in the TZ, as a guide for radiologists
3D FIESTA pulse sequence for assessing renal artery stenosis: is it a reliable application in unenhanced magnetic resonance angiography?
Results: A total of 186 renal arteries were assessed; 36 had RAS ≥ 50 % demonstrated by CE-MRA. Ten patients underwent DSA, for a total evaluation of 22 arteries. Sensitivity, specificity, NPV, PPV, and accuracy of 3D FIESTA were 91.7 %, 100 %, 98 %, 100 %, and 98 %, respectively, as compared to CE-MRA, and 88.2 %, 100 %, 71.4 %, 100 %, and 91 %, respectively, as compared to DSA. The area under the ROC curve (AUC) of 3D FIESTA as compared to CE-MRA and DSA was 0.958 and 0.941, respectively.Conclusions: Our study demonstrated the capability of the 3D FIESTA sequence in evaluating RAS, with high-quality images and good diagnostic accuracy.Key Points: • The 3D FIESTA sequence provides a robust evaluation of RAS.• The 3D FIESTA sequence allows non-invasive evaluation of the renal arteries.• The 3D FIESTA sequence could be a useful tool in evaluating RAS.Methods: We retrospectively analysed 79 patients referred for suspected RAS, examined by 3D FIESTA and contrast-enhanced magnetic resonance angiography (CE-MRA), using a 1.5T whole-body scanner. Image quality was assessed as well as the presence and grade of RAS. Patients with RAS ≥ 50 % were evaluated for possible digital subtraction angiography (DSA). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of 3D FIESTA were calculated with ROC analysis using CE-MRA and DSA as the standard of reference.Objectives: To assess the capability of the three-dimensional (3D) Fast Imaging Employing Steady-State Acquisition (FIESTA) sequence in evaluating renal artery stenosis (RAS)
Ectopic Prostatic Tissue May Cause Hydroureteronephrosis
A 60-year-old man with left flank pain, fever, and nausea underwent an abdominal ultrasound and showed left hydroureteronephrosis without urinary calculi. Computed tomography urography showed moderate left hydroureteronephrosis and a hypodense paravesical mass of 1.7 cm with mild contrast enhancement just below the ipsilateral ureterovesical junction. Contrast-enhanced magnetic resonance imaging showed a 48 cc prostate and confirmed a roundish mass, protruding into the bladder, hyperintense on T2-weighted images, hypointense on T1-weighted images, and with mild inhomogeneous contrast enhancement. Cystoscopy with cold cup biopsy was carried out. Histologic analysis revealed the presence of ectopic prostatic tissue with no evidence of malignancy
Multidetector CT urography in urogenital tuberculosis: use of reformatted images for the assessment of the radiological findings. A pictorial essay
Urogenital tuberculosis (UGTB) is the most common form of extrapulmonary TB and is responsible for a destructive inflammation of the renal parenchyma and urinary tract often leading to the loss of kidney function. For these reasons, the early diagnosis of this disease, once considered disappeared in developed countries, is very important to establish a prompt and efficient treatment. However, the subtle and non-specific symptoms, often represented by recurrent and persistent lower urinary tract symptoms, can confound and delay the diagnosis. Therefore, an adequate and comprehensive imaging study is necessary in patients with persistent urinary tract infections not responding to the antibiotics and can suggest the hypothesis although bacteriological and/or histologic analysis is required for a definitive diagnosis. In the past years, intravenous urography (IVU) has allowed a comprehensive study of the urinary excretory tract, promoting the knowledge of the radiological findings of this disease. Nowadays, computed tomography urography (CTU), with the implementation of multidetector (MD) technology, has replaced IVU in all its indications; the MDCTU improves the assessment of renal and urinary tract lesions using reformatted images [such as multiplanar reconstruction (MPR) and maximum intensity projection (MIP)]. Therefore, our paper aims to provide a guide for radiologist for searching the classic signs of UGTB on MDCTU, encouraging the use of the MPR and MIP reformatted images
ET‐1 plasma levels and scleral rigidity as risk factors in neovascular age‐related macular degeneration
Purpose
To study the ocular blood flow, the corneal biomechanics, the scleral rigidity and the endothelin-1 (ET-1) plasma levels in patients with neovascular age-related macular degeneration (ARMD).
Methods
We enrolled 20 patients with ARMD and 20 age-matched control patients. Retrobulbar blood flow was examined by Colour Doppler Aplio 500 (Toshiba Medical System, Tokyo, Japan). Peak systolic velocity (PSV) and resistivity index (RI) was measured from ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary arteries (PCA’s). The corneal hysteresis CH and the corneal resistance force (CRF) values were achieved by Ocular Response Analyzer (ORA). Scleral rigidity (E) was determined by using Friedenwald nomograms. ET-1 plasma levels were determined using a specific radioimmunoassay (Sigma-Aldrich, Merck, Germany).
Results
We found a statistically significant difference in the CRF between patients with ARMD and control subjects (ARMD 11.23 ± 1.30 vs. Controls 9.82 ± 1.37; p<0.0025) was found. The CH index between patients with ARMD and control subjects was not statistically significant (ARMD 10.15 ± 1.25 vs. Controls 10.02 ± 1.70; p<0.617). With CDI in PCA’s we found PSV (ARMD 12.37 ± 2.80 cm/sec vs. Controls 15.44 ± 3.59 cm/sec; p<0.0063); RI (ARMD 0.80 ± 0.03 vs Controls 0.74 ± 0.02; p<0.0001). The E had a significant increase in ARMD group (ARMD 0.0358 ± 0.004 vs. Controls 0.0328 ± 0.004; p<0.008) as well as ET-1 plasma levels (ARMD 2.060 ± 0.276 vs. Controls 1.492 ± 0.0.560; p<0.001). Finally, in ARMD we found that the decrease of PSV and the increase of RI in PCA’s was correlated with the ET-1 plasma levels (PSV r-0.615; p<0.0039 and r 0.764; p<0.0001) and not with the values of E, CH and CRF.
Conclusions
Our data indicate that patients with neovascular ARMD had a significant increase of RI in all vessels examined with increased corneal CRF index, scleral rigidity values and ET-1 plasma levels. The decreased blood flow in APC’s was correlated to the increase of ET-1 plasma levels. These data indicate that elevated plasma ET-1 and not the scleral rigidity may be an important risk factor in the development of neovascular ARMD
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