Case report: isolated neurofibrosarcoma of the liver: US, CT and MR findings.

Neurofibrosarcomas are rare neoplasms usually associated with von Recklinghausen's disease. In this paper we describe ultrasound (US), computed tomography (CT) and magnetic resonance (MR) appearances of an unusual isolated neurofibrosarcoma of the liver.

US imaging and color Doppler in patients undergoing inhibitory therapy with calcitriol for secondary hyperparathyroidism.

The aim of this study was to evaluate the changes in volume, structure, and flow pattern of parathyroid glands in uremic patients with secondary hyperparathyroidism treated with long-term intravenous calcitriol (CTL) therapy. Ultrasonography was used to follow-up volume changes occurring in 18 enlarged glands in 11 patients during an 18-month period; in 6 of these cases, 11 glands were followed-up also with color-Doppler to monitor variations in flow pattern. Vascularization was classified using three grades: grade 0 = no color signal; grade I = vessels covering less than 50 % of glandular cross-sectional area; grade II = vascular signals covering more than 50 % of glandular cross-sectional area. No significant changes in volume were demonstrated during the 18 months of follow-up. On the contrary, significant decrease in flow was observed with almost complete disappearance of color-Doppler signals. This finding related well with the observed decrease in parathormone blood levels. Lack of volume changes during medical therapy demonstrates the inability of US alone to monitor the effect of this treatment on the parathyroid glands. Conversely, the observed intraglandular flow reduction indicates the possibility to use color Doppler to monitor the effects of CLT in uremic hemodialyzed patients with secondary hyperparathyroidism. This imaging procedure can be proposed for follow-up of the response of the parathyroid glands to therapy.

[Nephrogenic adenoma after kidney transplantation]. / Nephrogenes Adenom nach Nierentransplantation.

We report five cases of nephrogenic adenoma that arose several years after cadaver kidney transplantation. Cystoscopy was performed in all patients because of gross haematuria and revealed multifocal tumorous lesions in all parts of the bladder. On admission to of hospital graft function was satisfactory in all patients. There were three female and two male patients. In all patients the therapeutic procedure consisted of transurethral resection. Only very small lesions were fulgurated. Postoperatively an indwelling catheter was left in place for 2-4 days, and after a check on kidney parameters and immunosuppressive therapy all patients were discharged. Postoperative management consisted in cystoscopy every 3 months in the first year and then every 6 months. Though the etiology of nephrogenic adenoma remains unclear, mechanical traumatization and recurrent urinary tract infection seem to be the most important factors in its development.

[Evaluation of rheumatoid arthritis of the knee with Doppler color]. / Valutazione dell'artrite reumatoide del ginocchio con color Doppler.

Color-Doppler US was used to study the vascularization of the synovial membrane and of the periarticular tissues of the knee in 14 normal subjects and 15 patients with active rheumatoid arthritis. The normal subjects exhibited few spot signals within the connectival spaces surrounding the knee and adjacent to the femoral condyles and to the tibial plates. The signals were mostly arterial and impedance was high because of the absence of inversion of diastole. A hypervascular pattern was detected in 13/15 patients with rheumatoid arthritis as a result of hyperemia associated with inflammation and synovial neoangiogenesis. In these patients, the signals came mostly from the synovial pannus and the soft tissues surrounding the joint. Spectral analysis detected both venous and arterial waveforms with lower resistance than normal (resistive index ranging 0.65 to 0.76). After local treatment, both venous and low-impedance arterial signals were no longer detectable in 4/9 patients with clinical remission. In conclusion, color-Doppler US can support gray-scale US in the assessment of joint inflammation in rheumatoid arthritis patients. Vascular findings seem to correlate well with local symptoms. Color-Doppler US could make a useful tool for monitoring the clinical activity of the disease in selected joints.