1,720,976 research outputs found
Low-fat angiomyolipoma of the liver studied with contrast-enhanced ultrasound and multidetector computed tomography.
No full textWe report the case of a 30-year-old woman with persistent pain at the right hypochondrium, relapsing fever, and normal serum tests. Ultrasound showed a hyperechoic inhomogeneous mass; following sulfur hexafluoride injection, uniform enhancement at 14-16s and rapid wash-out at 26s was found. Multidetector computed tomography showed an inhomogeneously hypodense mass, with no detectable negative density values, characterized by inhomogeneous enhancement at the arterial phase and wash-out at the portal phase. Histopathology demonstrated a hepithelioid angiomyolipoma with a poor fatty component. This diagnosis should always be considered in the presence of a very rapid wash-out after intravenous contrast injection. However, a hepatocellular carcinoma cannot be excluded and the final diagnosis of low-fat angiomyolipoma must be pathologically proved based on immunohistochemistry
Liver metastases on serial contrast-enhanced multidetector computed tomography examinations: was the detection possible on previous examinations?
No full textOBJECTIVE: To verify the earliest detectability of liver metastases in patients who underwent serial multidetector computed tomography (MDCT) examinations. METHODS: We selected 12 patients with known primary cancer who underwent 4 or more contrast-enhanced, 4-detector MDCTs. When metastases had been reported, an evaluation of the preceding MDCT was done to define whether the lesion was detectable, detectable only by minimal signs, undetectable, or detected but misdiagnosed as a benign lesion (MBL). RESULTS: Eighty-eight lesions were analyzed. Evaluating the preceding examination, we defined detectable (n= 8), detectable only by minimal signs (n= 5), undetectable (n= 74), and MBL (n= 1). The group with minimal signs was composed of 4 small hypodense foci and 1 calcification. The MBL was a non-Hodgkin lesion first misdiagnosed as a hemangioma. CONCLUSION: Approximately 15% of liver metastases were prospectively missed, 9% of them being retrospectively detectable, 6% being retrospectively visible as minimal signs, whereas only 1% of liver metastases were misdiagnosed as a benign lesion. Copyright (copyright) 2006 by Lippincott Williams & Wilkins
The masticator space. Value of computed tomography and magnetic resonance imaging in localisation and characterisation of lesions
Full text linkAim of the study was to assess the different roles of magnetic resonance imaging and computed tomography in the evaluation of anatomical origin and pathological nature of lesions involving the masticator space. Overall 41 cases (31 computed tomography and 14 magnetic resonance imaging) of lesions involving masticator space were retrospectively reviewed by two experienced radiologists in consensus. Reference standards were histopathological results and clinical-radiological follow-up after one year. Both computed tomography and magnetic resonance imaging were performed with and without intravenous injection of contrast. Computed tomography and magnetic resonance imaging were correct in identifying the space of origin of lesions respectively in 96% and 92% of cases. Computed tomography correctly diagnosed the nature of lesions in 81% of cases and magnetic resonance imaging in 93% of cases; computed tomography and magnetic resonance imaging correctly characterized, respectively, 88% and 100% of malignant lesions and, respectively, 73% and 83% of benign lesions. In conclusion both computed tomography and magnetic resonance imaging were effective in the identification of the origin of non-extensive lesions involving masticator space. Computed tomography was more precise in depicting lesions originating from masticator space, while magnetic resonance imaging was more correct in depicting lesions originating from contiguous spaces and involving secondarily the masticator space. Magnetic resonance imaging should always be preferred to characterise lesions, nevertheless computed tomography should be chosen in cases with suspected inflammatory involvement of mandible bone
Salivary glands imaging
No full textLa diagnostica per immagini per le ghiandole salivari può avvalersi di diverse modalità, quali l’ecografia (ultrasonography, US), la tomografia computerizzata (TC), la risonanza magnetica (RM), la sialografia e la scintigrafia. L’obiettivo di questa review è quello di illustrare il ruolo della diagnostica per immagini nella valutazione delle patologie a carico delle ghiandole salivari. La US rappresenta solitamente l’indagine di prima scelta nelle sospette sialolitiasi. Come seconda scelta può anche essere utilizzata la TC, che ha un’elevata accuratezza nel rilevare la presenza di calcoli e che permette di distinguere più accuratamente, rispetto alla US, i calcoli multipli da un unico calcolo di grandi dimensioni. La TC è anche importante per valutare la presenza di masse a livello delle ghiandole salivari , associate a processi di tipo ostruttivo o infiammatorio. Negli altri casi la RM rappresenta l’indagine di scelta, dal momento che è la tecnica più affidabile per dimostrare la presenza di un’invasione perinervosa, meningea e a livello della base del cranio. La sialografia convenzionale è utile per studiare le infezioni croniche, i tumori e i calcoli, ma è una tecnica invasiva gravata da inconvenienti e da complicanze. La scintigrafia ha potenzialmente la capacità di fornire simultaneamente informazioni di tipo morfologico e funzionale, di conseguenza le sue indicazioni cliniche principali sono rappresentate dalla valutazione della funzionalità delle ghiandole salivari e dell’escrezione della saliva in caso di patologie autoimmunitarie o dopo irradiazione dei distretti cefalici e del collo. Questa tecnica di diagnostica per immagini può anche essere di aiuto per la diagnosi del tumore di Warthin, ed è specialmente utile nel paziente più anziano con controindicazioni chirurgiche o nei pazienti con masse parotidee multipleSeveral modalities are available for salivary gland imaging, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), sialography and scintigraphy. The aim of this review was to illustrate the role of imaging in evaluating salivary gland diseases. US is usually the first-line technique in suspected sialolithiasis. Secondly, also CT may be used. It has demonstrated a high accuracy in detecting the presence of calculi and it is more accurate than US in distinguishing multiple clusters of stones from single large stone. CT is also important in the evaluation of salivary glands masses associated with obstructive or inflammatory process; in the other cases MRI is the technique of choice, as it allows to better detect perineural, meningeal and skull base invasion. Conventional sialography is useful in case of chronic infections, tumours and calculi but is an invasive technique burdened by drawbacks and complications. To obtain simultaneously morphologic and functional information scintigraphy is a solution: its main clinical indications consist in evaluation of salivary glands function and salivary excretion in autoimmune disease or after irradiation of head and neck district. This imaging method may also help to diagnose Warthin's tumour and it is especially useful in elderly patients with surgical contain- dications or in oatients with multinle carotid masses
Safety of unprotected carotid artery stent placement in symptomatic and asymptomatic patients : a retrospective analysis of 30-day combined adverse outcomes
No full textPURPOSE: To retrospectively evaluate the outcome of carotid artery stent placement (CAS) without the use of embolic protection devices (EPDs) in a large cohort of patients. MATERIALS AND METHODS: Institutional review board approval and informed consent from all patients were obtained. Preprocedure color Doppler ultrasonography (US), magnetic resonance (MR) imaging, or computed tomography (CT) were used to evaluate stenosis severity (70% or greater). Clinical findings and combined 30-day complication rates in 400 patients (289 men, 111 women; mean age, 73 years +/- 8 [standard deviation]) who underwent unprotected CAS for asymptomatic (n = 156; 39%) or symptomatic (n = 244, 61%) stenoses were analyzed. Follow-up at 30 days included neurologic evaluation and color Doppler US. RESULTS: Self-expanding stents were successfully deployed in 397 of 400 (99.25%) patients. Among the 397 patients, nine (2.27%) major complications (all in patients with prior symptoms) had occurred at 30 days, including three (0.76%) major (all in patients who had stopped antiplatelet prophylaxis) and six (1.5%) minor strokes--three intraprocedural and three delayed. Minor complications included 16 (4%) transient ischemic attacks, four in asymptomatic and 12 in symptomatic patients. The 30-day combined adverse outcomes (transient ischemic attack, ipsilateral stroke, death) were significantly correlated with prior presence of symptoms (symptomatic, 8.6%; asymptomatic, 2.6%; P < .03). CONCLUSION: Stent placement without EPD was performed with a high technical success rate. For asymptomatic patients, the combined 30-day adverse-outcomes rate was within the limits recommended by the American Heart Association for carotid endarterectomy and compared favorably with results reported for CAS with EPD. When a transient ischemic attack is excluded, the 30-day combined death and stroke rate among patients with prior symptoms also compared favorably with published results
Common carotid artery pseudoaneurysm after neck dissection : colour Doppler ultrasound and multidetector computed tomography findings
No full textCommon carotid artery pseudoaneurysm is a rare disease, which has been previously unreported in association with neck dissection. We describe the Doppler ultrasound and multidetector computed tomography (CT) findings of a case of carotid pseudoaneurysm, one month after pharyngolaryngectomy with bilateral neck dissection. Multidetector CT confirmed the diagnosis made on the basis of Doppler ultrasound; the high image quality of axial and three-dimensional reconstructions avoided the need for pre-operative conventional angiography. In the presence of a pulsatile cervical mass after neck surgery, pseudoaneurysm of the carotid artery should be included in the differential diagnosis, and multidetector CT can be the sole pre-operative diagnostic imaging modality
- …
