130,386 research outputs found
Earlier appearance of the ossification centre of the femoral head in breast fed versus formula fed infants.
No full textLeucodistrofia metacromatica e poliposi colecisti: una rara associazione
No full textGallbladder polyposis is a rare and poorly described condition in the pediatric literature. We report the case of one
6-year-old girl with metachromatic leukodystrophy and with incidental evidence of gallbladder polyposis
ultrasound. The presented case highlights the importance of the association of cholecistic polyposis with various
syndromes including metachromatic leukodystrophy
Whole-body magnetic resonance for staging and response assessment of lymphoma in a pregnant woman treated with antenatal chemotherapy
No full textA 32-year-old pregnant female presented with bilateral supraclavicular swelling, diffuse itching and right shoulder pain. After lymph nodal biopsy, a diagnosis of nodular sclerosis Hodgkin's lymphoma was obtained. A multidisciplinary team decided to start chemotherapy before the delivery, and whole-body MRI was used to stage the disease and evaluate the response after antenatal chemotherapy. This case shows that whole-body MRI is an attractive procedure that avoids radiation exposure and contrast administration, and enables staging and follow-up of a pregnant patient without risk to the fetus
Carotid artery stenting in patients with brain meningioma.
No full textThe association between carotid artery stenosis and brain meningioma is rather rare. Indeed, data in literature about this association are scarce and potential risks of carotid artery stenting using different protection devices are not known. We describe the endovascular treatment of severe carotid stenosis in two patients with intracranial meningioma
Carotid artery stenting in patients with brain meningioma
No full textThe association between carotid artery stenosis and brain Meningioma is rather rare. Indeed, data in literature about this association are scarce and potential risks of carotid artery stenting using different protection devices are not knowm. We describe the endovascular treatment of severe carotid stenosis in two patients with intracranial maningioma
A wire-loop technique for implantation of an iliac branched device in a patient with previous surgery for a ruptured abdominal aortic aneurysm
No full textWe described a modified technique for implanting a bridging stent-graft into an iliac branched device. A 79-year-old male who had received aortobiiliac synthetic graft surgery for a ruptured abdominal aortic aneurysm six months earlier was admitted to our unit for treatment of a left common iliac aneurysm involving the origin of the hypogastric artery. A standard technique was unsuccessful at implanting the bridging stent-graft, and therefore a wire-loop guidewire over the graft bifurcation was used to stabilize the contralateral sheaths and to complete the implantation. © Turkish Society of Radiology 2012
What the Young Physician Should Know About May-Thurner Syndrome
No full textMay-Thurner syndrome (MTS) is an anatomically variable condition resulting in compression of the left common iliac vein between the right common iliac artery and the underlying spine with subsequent development of a left deep vein thrombosis (DVT). Although this syndrome is rare, its true prevalence is likely underestimated. Mainly, clinical symptoms and signs include, but are not limited to, pain, swelling, venous stasis ulcers, skin pigmentation changes and post-thrombotic syndrome. Correct treatment is not well established and is based on clinical presentation. Staged thrombolysis with/without prophylactic retrievable inferior vena cava filter placement followed by angioplasty/stenting of the left iliac vein appears to be the best option in MTS patients with extensive DVT. The aim of this review is to present in a simple and didactic form all variable clinical presentations of MTS and to outline possible management within the current guidelines
Chest pain due to pinch-offsyndrome: Radiological findings and endovascular rescue
No full textPort-a-cath is widely used as a route for administration of drugs in hematology and oncology patients and, recently, has been adapted also for hemodialysis patients. Major complications include infection, thrombosis, arrhythmia, and embolization. The Pinch-off-syndrome (POS) means the clavicle and the first rib compress the long-term central venous catheter. The reported incidence rate ranges from 1.4% to 4.1%. This syndrome can be recognized on chest radiography by observing a thinning of the catheter lumen through the passage between the clavicle and the first rib. Catheter fracture is a rare but potentially life-threatening complication that must be recognized and treated promptly. Management of dislodged ports includes percutaneous transcatheter retrieval, open thoracotomy retrieval and oral anticoagulant therapy. Among these techniques, percutaneous transcatheter retrieval is an easy, safe and efficient method. We report the successful percutaneous endovascular retrieval of dislodged intracardiac catheter, separated from its port, in a 58 year-old male patient who presented with chest pain
Ruolo della RM whole body nell’identificazione di reperti incidentali in pazienti con linfoma.
No full textScopo:
Il dibattito in merito ai reperti incidentali sta divenendo emergente in molti settori radiologici, quali l’ambico cardiaco,
addominale, neurologico, senologico, pediatrico, soprattutto con metodiche quali la RM e la TC.
Lo scopo del nostro studio è stato di valutare l’utilità della Risonanza Magnetica Whole Body (RM-WB) nell’identificazione di
reperti incidentali in pazienti con linfoma.
Materiali e metodi:
Sono state revisionate le RM-WB eseguite su 114 pazienti (65 maschi; età mediana 45,2 anni, range 15-86) con diagnosi
istologica di linfoma (47 Hodgkin, 67 Non-Hodgkin). I reperti incidentali sono stati classificati in tre classi: non significativi
(classe 1), moderatamente significativi (classe 2), significativi (classe 3). Un test Chi quadro (χ2) è stato utilizzato per
valutare la significatività statistica delle differenze nella frequenza dei reperti incidentali sulla base di età (≤ 50 e > 50 anni),
sesso ed istologia.
Risultati:
Sono stati individuati uno o più reperti incidentali nelle RM-WB eseguite in 91/114 pazienti (79,8%). I reperti incidentali più
frequenti sono stati di classe 1 (43%). In 7 pazienti (6,1%) sono stati riscontrati reperti incidentali di rilevanza clinica
maggiore (classe 3), che hanno richiesto approfondimento diagnostico o immediato trattamento. I reperti incidentali sono
stati più frequenti nei pazienti oltre i 50 anni con una differenza statisticamente significativa rispetto a pazienti ≤ 50 anni (χ2
= 8,42, p < 0,05), mentre non sono state trovate differenze statisticamente significative legate a sesso (χ2 = 0,17, p > 0,05)
ed istologia (χ2 = 0,24, p > 0,05).
Le figure 1, 2 e 3 mostrano alcuni casi rappresentativi del nostro studio.
Conclusioni:
In letteratura, parecchi studi hanno analizzato i reperti incidentali in RM-WB, effettuate sulla popolazione sana [1,2]. Il nostro
lavoro è il primo che ricerca reperti incidentali in pazienti con noto linfoma e sottoposti a RM-WB.
Ci sono molti vantaggi clinici, sociali ed economici associati alla diagnosi dei reperti incidentali: in primo luogo, la diagnosi
precoce di una malattia porta ad un suo tempestivo trattamento con miglioramento della prognosi; in secondo luogo, la
diagnosi precoce occasionale di molte malattie riduce i costi per il sistema sanitario nazionale; alcuni di questi
reperti risultano essere molto utili nel caso di intervento chirurgico; infine, una valutazione approfondita delle caratteristiche
cliniche dei pazienti fornisce dei dati utili ai fini della prognosi.
Tuttavia, esistono conseguenze negative quali ad esempio il riscontro di un numero considerevole di lesioni accidentali, non
caratterizzabili con precisione con le sole immagini RM-WB, con la conseguente possibilità si sovrastimare un reperto
sospetto.
E’ fondamentale pertanto trovare un equilibrio tra i benefici associati ad una diagnosi precoce ed i rischi di sottoporre il
paziente ad ulteriori indagini non necessarie.
Nel nostro studio la percentuale dei reperti occasionali (79.8%), simile alle percentuali precedentemente riportate in
analoghi studi [3,4], cresce all’aumentare dell’età dei pazienti e non è dipendente dal sesso.
La RM-WB è una tecnica promettente che evita l’esposizione a radiazioni ionizzanti e la somministrazione di mezzo di
contrasto e consente di individuare reperti incidentali, offrendo la possibilità di ottenere una diagnosi precoce di patologie
asintomatiche anche clinicamente rilevanti.
Informazioni Personali:
Dr. Domenico Albano, MD, Dipartimento di Scienze Radiologiche, Di.Bi.Med., Università di Palermo, Via del Vespro 27, 90127
Palermo, Italia
Note Bibliografiche:
1. Cieszanowski A, Maj E, Kulisiewicz P et al (2014) Non-contrast-enhanced whole-body magnetic resonance imaging in the
general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects.
PLoS One 26;9:e107840
2. Lo GG, Ai V, Au-Yeung KM, Chan JK, Li KW, Chien D (2008) Magnetic resonance whole body imaging at 3 Tesla: feasibility
and findings in a cohort of asymptomatic medical doctors. Hong Kong Med J 14:90-96
3. Cieszanowski A, Maj E, Kulisiewicz P et al (2014) Non-contrast-enhanced whole-body magnetic resonance imaging in the
general population: the incidence of abnormal findings in patients 50 years old and younger compared to older subjects.
PLoS One 26;9:e107840
4. Lo GG, Ai V, Au-Yeung KM, Chan JK, Li KW, Chien D (2008) Magnetic resonance whole body imaging at 3 Tesla: feasibility
and findings in a cohort of asymptomatic medical doctors. Hong Kong Med J 14:90-9
A wire-loop technique for implantation of an iliac branched device in a patient with previous surgery for a ruptured abdominal aortic aneurysm.
No full textWe described a modified technique for implanting a bridging stent-graft into an iliac branched device. A 79-year-old male who had received aortobiiliac synthetic graft surgery for a ruptured abdominal aortic aneurysm six months earlier was admitted to our unit for treatment of a left common iliac aneurysm involving the origin of the hypogastric artery. A standard technique was unsuccessful at implanting the bridging stent-graft, and therefore a wire-loop guidewire over the graft bifurcation was used to stabilize the contralateral sheaths and to complete the implantation
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