RESUMO
PURPOSE: Musculoskeletal disorders are among the most disabling comorbidities in patients with acromegaly. This study examined muscle and bone quality in patients with acromegaly. METHODS: Thirty-three patients with acromegaly and nineteen age- and body mass index-matched healthy controls were included in the study. Body composition was determined using dual-energy X-ray absorptiometry. The participants underwent abdominal magnetic resonance imaging (MRI) for cross-sectional evaluation of muscle area and vertebral MRI proton density fat fraction (MRI-PDFF). Muscular strength was measured using hand grip strength (HGS). Skeletal muscle quality (SMQ) was classified as weak, low, or normal, according to HGS/ASM (appendicular skeletal muscle mass) ratio. RESULTS: Groups had similar lean tissues, total body fat ratios, and total abdominal muscle areas. Acromegalic patients had lower pelvic BMD (p = 0.012) and higher vertebral MRI-PDFF (p = 0.014), while total and spine bone mineral densities (BMD) were similar between the groups. The SMQ score rate was normal only 57.5% in the acromegaly group, and 94.7% of the controls had a normal SMQ score (p = 0.01). Subgroup analysis showed that patients with active acromegaly (AA) had higher lean tissue and lower body fat ratios than controlled acromegaly (CA) and control groups. Vertebral MRI-PDFF was higher in the CA group than that in the AA and control groups (p = 0.022 and p = 0.001, respectively). The proportion of participants with normal SMQ was lower in the AA and CA groups than that in the control group (p = 0.012 and p = 0.013, respectively). CONCLUSION: Acromegalic patients had reduced SMQ and pelvic BMD, but greater vertebral MRI-PDFF. Although lean tissue increases in AA, this does not affect SMQ. Therefore, increased vertebral MRI-PDFF in controlled acromegalic patients may be due to ectopic adiposity.
Assuntos
Acromegalia , Humanos , Acromegalia/complicações , Acromegalia/diagnóstico por imagem , Acromegalia/patologia , Força da Mão , Estudos Transversais , Coluna Vertebral , Densidade Óssea/fisiologia , Músculo Esquelético/diagnóstico por imagemRESUMO
PURPOSE: To describe the technique of DE MDCT colonoscopy and to assess its feasibility. MATERIALS AND METHODS: 8 patients were scanned with DSCT with a DE scan protocol and dose modulation software. Analysis was performed using dedicated DE software. Prone non-contrast images and DE supine images after contrast injection were obtained. RESULTS: DE colonoscopic images were successfully obtained in 7 patients, but the FOV did not cover all colonic segments in 1 patient, thus resulting in a technical success rate was 87.5 %. Streak artifacts were present in the pelvic region in 2 patients. Virtual unenhanced images and iodine map images were obtained for all patients. In 1 patient a polypoid non-enhancing structure was noted on the iodine map, and conventional colonoscopy revealed impacted stool. Enhancing rectal cancer in 1 patient was correctly shown on the iodine map. Iodine maps helped to differentiate stool fragments/retained fluid by the absence of enhancement when compared to prone CT images. The major advantage of DE colonoscopy was the lack of misregistration. CONCLUSION: DE MDCT colonoscopy is technically feasible and may obviate the need for unenhanced prone images. It may be possible to perform noncathartic DECT colonoscopy. The major limitation is the limited FOV of tube B. The dose should be optimized to reduce streak artifacts in the pelvic region.
Assuntos
Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Colonografia Tomográfica Computadorizada/métodos , Programas de Rastreamento/métodos , Intensificação de Imagem Radiográfica/métodos , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Software , Tomografia Computadorizada Espiral/métodos , Artefatos , Colonoscopia , Meios de Contraste/administração & dosagem , Estudos de Viabilidade , Impacção Fecal/diagnóstico por imagem , Feminino , Humanos , Iodo , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Sensibilidade e Especificidade , Avaliação da Tecnologia BiomédicaRESUMO
Prostate cancer most often metastases to bones and regional lymph nodes. Disseminated metastasis to distant lymph nodes is very rare. We report a case presenting with generalized lymphadenopathy and related left leg edema without any urinary symptoms and finally diagnosed as prostate cancer.
Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Ósseas/secundário , Edema/diagnóstico , Perna (Membro)/diagnóstico por imagem , Neoplasias Pulmonares/secundário , Doenças Linfáticas/diagnóstico , Neoplasias da Próstata/diagnóstico , Abdome/diagnóstico por imagem , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Idoso , Antineoplásicos Hormonais/uso terapêutico , Biópsia , Exame de Medula Óssea , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/tratamento farmacológico , Meios de Contraste , Diagnóstico Diferencial , Edema/etiologia , Evolução Fatal , Gosserrelina/uso terapêutico , Humanos , Neoplasias Pulmonares/diagnóstico , Doenças Linfáticas/tratamento farmacológico , Doenças Linfáticas/etiologia , Metástase Linfática , Masculino , Pelve/diagnóstico por imagem , Próstata/diagnóstico por imagem , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Intensificação de Imagem Radiográfica , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler em CoresRESUMO
Multidetector CT is becoming an alternative method for the diagnosis of coronary artery anomalies. We present the multidetector coronary CT angiography findings from a patient with right coronary artery duplication. Two separate right coronary arteries originating from the right aortic sinus were observed. Their anatomical course was well depicted, and atherosclerosis was excluded based on the CT angiography findings.
Assuntos
Anomalias dos Vasos Coronários/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Tomografia Computadorizada por Raios X/métodos , Angiografia Coronária/métodos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Multidetector computed tomography (MDCT) is a useful technique for imaging the inferior mesenteric vein. The aim of the present review was to discuss the normal anatomy and the pathologies of the inferior mesenteric vein, including partial or total thrombosis secondary to inflammation (pyophlebitis) and malignancy, occlusion, dilatation and reversed flow, which are rarely encountered. Optimal reconstruction techniques are also discussed. The pathologies of the inferior mesenteric vein can be clearly demonstrated using MDCT using curved-planar reformatted multiplanar reconstruction (MPR) and minimum intensity projection (MIP) images.
Assuntos
Oclusão Vascular Mesentérica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Trombose Venosa/diagnóstico por imagem , Idoso , Criança , Meios de Contraste , Feminino , Humanos , Hipertensão Portal/complicações , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Cirrose Hepática/complicações , Masculino , Oclusão Vascular Mesentérica/patologia , Veias Mesentéricas/anatomia & histologia , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/patologia , Pessoa de Meia-Idade , Trombose Venosa/patologiaRESUMO
Benign hemorrhagic adrenal cysts are a cause of subdiaphragmatic mass in the fetus and neonate with Beckwith-Wiedemann syndrome. Characteristic imaging features on ultrasonography, color Doppler, and magnetic resonance imaging help differentiate adrenal hemorrhage from neonatal neuroblastoma and help avoid unnecessary surgery in these patients. Bilateral adrenal hemorrhage is self-limiting, and spontaneous resolution is the usual outcome. This report presents this rare condition with prenatal ultrasonographic and magnetic resonance imaging findings and reviews the differential diagnosis of neonatal adrenal masses.
Assuntos
Doenças das Glândulas Suprarrenais/embriologia , Síndrome de Beckwith-Wiedemann/embriologia , Cistos/embriologia , Hemorragia/embriologia , Imageamento por Ressonância Magnética , Doenças das Glândulas Suprarrenais/diagnóstico , Doenças das Glândulas Suprarrenais/diagnóstico por imagem , Síndrome de Beckwith-Wiedemann/diagnóstico , Síndrome de Beckwith-Wiedemann/diagnóstico por imagem , Cistos/diagnóstico por imagem , Feminino , Hemorragia/diagnóstico , Hemorragia/diagnóstico por imagem , Humanos , Gravidez , Diagnóstico Pré-Natal , UltrassonografiaRESUMO
Primary extragenital leiomyosarcoma is rarely found in pelvic localization. A 33-year-old multiparous woman who had recurrent low-grade leiomyosarcoma presented with the complaints of dyspareunia, pelvic pain and gait disturbance. Her past medical history revealed she had been subjected to maximal excision of a paravaginal mass by using vaginal and suprapubic transverse incision three years before. The pathology report showed that she had leiomyoma. Three years after the initial surgery, a paravaginal fixed mass was observed at the initial tumor bed and removed by the perineal approach. The histological examination of the specimen revealed a low grade leiomyosarcoma. She was discharged from hospital without any complications.
Assuntos
Leiomiossarcoma/diagnóstico , Recidiva Local de Neoplasia/diagnóstico , Neoplasias Peritoneais/diagnóstico , Neoplasias Vaginais/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Leiomiossarcoma/diagnóstico por imagem , Leiomiossarcoma/patologia , Leiomiossarcoma/cirurgia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/secundário , Recidiva Local de Neoplasia/cirurgia , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias Vaginais/diagnóstico por imagem , Neoplasias Vaginais/secundário , Neoplasias Vaginais/cirurgiaRESUMO
Intrahepatic portosystemic venous shunt, considered to be a rare disease, can lead to hepatic encephalopathy. With recent advances in diagnostic imaging techniques, the number of reports of intrahepatic portosystemic venous shunts identified incidentally in patients without symptoms are increasing. We report an intrahepatic portosystemic venous shunt that was diagnosed incidentally by real-time ultrasound and colour Doppler imaging, including the use of three-dimensional ultrasound using minimum intensity projections and power Doppler.
Assuntos
Veias Hepáticas/anormalidades , Veia Porta/anormalidades , Fístula Vascular/diagnóstico por imagem , Adulto , Feminino , Veias Hepáticas/diagnóstico por imagem , Humanos , Imageamento Tridimensional/métodos , Achados Incidentais , Veia Porta/diagnóstico por imagem , Ultrassonografia Doppler em Cores/métodosRESUMO
The Klippel-Trenaunay syndrome (KTS) is a rare anomaly characterized by naevus, soft tissue hypertrophy and varicosities which is mainly unknown etiology. Associated deep venous system abnormalities have been reported with KTS. Here, a 4-year-old-boy with KTS was reported, because of the associated popliteal vein, common femoral vein with its deep and superficial branches, and external iliac vein agenesis. The originality of the presented case is that we have never observed such a case before.
Assuntos
Veia Femoral/anormalidades , Veia Ilíaca/anormalidades , Síndrome de Klippel-Trenaunay-Weber/diagnóstico , Pré-Escolar , Veia Femoral/diagnóstico por imagem , Humanos , Veia Ilíaca/diagnóstico por imagem , Perna (Membro)/irrigação sanguínea , Perna (Membro)/diagnóstico por imagem , Masculino , Flebografia , Ultrassonografia Doppler em CoresRESUMO
We report a unique case of exacerbation of renal lymphangiomatosis during pregnancy which was managed percutaneously until delivery. Renal lymphangiomatosis is a very rare benign disorder that might cause abdominal pain and rarely hypertension and hematuria. Surgical treatment options may result in nephrectomy. Percutaneous drainage of symptomatic renal lymphangiomas should be viewed as an efficient therapeutic option particularly when surgery is contraindicated.
Assuntos
Neoplasias Renais/terapia , Linfangioma Cístico/terapia , Nefrostomia Percutânea , Complicações Neoplásicas na Gravidez/terapia , Adulto , Diagnóstico Diferencial , Drenagem , Feminino , Humanos , Neoplasias Renais/diagnóstico , Linfangioma Cístico/diagnóstico , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Tomografia Computadorizada por Raios X , UltrassonografiaAssuntos
Granuloma de Células Plasmáticas/diagnóstico por imagem , Hepatopatias/diagnóstico por imagem , Doenças Peritoneais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Criança , Diagnóstico Diferencial , Feminino , Granuloma de Células Plasmáticas/patologia , Humanos , Hepatopatias/patologia , Doenças Peritoneais/patologiaRESUMO
Primary ovarian malignant lymphomas are rarely encountered in children. We present herein the unusual case of an 11-month-old female infant with primary bilateral non-Hodgkin's lymphoma of the ovaries who was treated by bilateral salpingo-oophorectomy followed by chemotherapy. The clinicopathological features of this rare entity are discussed, focusing special emphasis on the diagnostic and therapeutic strategies.
Assuntos
Linfoma não Hodgkin/patologia , Neoplasias Ovarianas/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Tubas Uterinas/cirurgia , Feminino , Humanos , Lactente , Linfoma não Hodgkin/cirurgia , Neoplasias Ovarianas/cirurgia , OvariectomiaRESUMO
This article presents a case of leiomyosarcomatosis with widespread lesions involving the soft tissues and the most unlikely organs such as thyroid and salivary glands, pancreas, ligamentum teres, bladder wall, and bones without lymph node or distant metastasis. The CT and US findings of this rare phenomenon are discussed with regard to the literature.
Assuntos
Neoplasias Ósseas/diagnóstico , Leiomiossarcoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Tomografia Computadorizada por Raios X , Ultrassonografia , Idoso , Biópsia por Agulha , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Musculares/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Língua/diagnósticoRESUMO
We report a case of neuroblastoma in a patient who had no involvement of the spermatic cord at diagnosis but who developed spermatic cord metastasis 2 months later. The metastasis appeared on sonography as a hypoechoic, highly vascular, fusiform, hard, 14x10x7 mm mass located in the right inguinal canal and extending into the scrotum. The diagnosis of spermatic cord metastasis was confirmed by resection and histopathologic examination. We recommend that the scrotum and spermatic cord be evaluated by high-resolution sonography in children with neuroblastoma, both at the time of diagnosis and during follow-up.
Assuntos
Neoplasias dos Genitais Masculinos/secundário , Neuroblastoma/secundário , Cordão Espermático/diagnóstico por imagem , Pré-Escolar , Diagnóstico Diferencial , Neoplasias dos Genitais Masculinos/diagnóstico por imagem , Neoplasias dos Genitais Masculinos/patologia , Humanos , Masculino , Neuroblastoma/diagnóstico por imagem , Escroto/diagnóstico por imagem , Escroto/patologia , Cordão Espermático/patologia , UltrassonografiaRESUMO
Duplication of the gallbladder, a rare congenital anomaly, is important in clinical practice because it may cause some clinical, surgical, and diagnostic problems. We present imaging findings of a double gallbladder including coronal reformatted computed tomographic sections, to our knowledge not previously presented, and discuss the radiologic signs that may be helpful in diagnosis. We also present another case of a double gallbladder in which only one gallbladder was imaged 10 years after cholecystectomy.
Assuntos
Vesícula Biliar/anormalidades , Idoso , Colecistografia , Diagnóstico Diferencial , Anormalidades do Sistema Digestório/diagnóstico , Vesícula Biliar/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
OBJECTIVE: To determine the interobserver and intraobserver variations in sonographic measurement of thyroid volume in children. DESIGN: Thyroid volumes of 30 healthy children were measured by three separate observers. Additionally each observer measured thyroid volumes of ten separate children three times. METHODS: The data were used to assess intraobserver and interobserver variations in measurement of thyroid volume. Interobserver and intraobserver variations in measuring each diameter of the thyroid gland were also determined. The effect of thyroid size on interobserver and intraobserver variations was analyzed. RESULTS: Intraobserver variation in measurement of thyroid volume was 8.4+/-6.7% (mean+/-s. d.). Interobserver variation was 13.3+/-8.2%. The widest interobserver variation was encountered in determining the craniocaudal diameter of the thyroid gland. No correlation was found between thyroid volume and interobserver variation (r=-0.12, P=0.27), whereas a slight but statistically significant correlation was found between thyroid volume and intraobserver variation (r=-0.26, P=0.012). CONCLUSION: Significant interobserver and intraobserver variation occurs in sonographic measurement of thyroid volume in children.
Assuntos
Glândula Tireoide/diagnóstico por imagem , Adolescente , Envelhecimento , Criança , Humanos , Variações Dependentes do Observador , Valores de Referência , Glândula Tireoide/anatomia & histologia , Glândula Tireoide/crescimento & desenvolvimento , UltrassonografiaRESUMO
OBJECTIVE: The purpose of this study was to determine the diagnostic value of diuretic duplex Doppler sonography in distinguishing between obstructive and nonobstructive hydronephrosis in children by calculating the resistive indices (RI) before and after administration of furosemide. MATERIAL AND METHODS: We prospectively evaluated 28 kidneys (2 solitary) in 15 patients with unilateral or bilateral neonatal hydronephrosis. All patients underwent diuretic renography and duplex Doppler sonography before and after administration of furosemide. RESULTS: According to the half-time drainage patterns at diuretic renography, 13 kidneys were classified as nonobstructed and 15 as obstructed. At baseline, the mean RI values of nonobstructed and obstructed kidneys were not significantly different (0.66 and 0.64, respectively). Ten minutes after the injection of furosemide, the mean RI values of the nonobstructed and obstructed kidneys were 0.68 and 0.70, respectively. The increase in RI over the baseline 10 min after the diuretic injection was statistically significant (p<0.00001) in the obstructed kidneys. CONCLUSION: The baseline RI value of 0.70 is not a definite value for distinguishing obstructed from nonobstructed systems. An increase in RI of at least 10% over the baseline seems to be a more reliable criterion, especially when it is used in conjunction with diuretic renography.
Assuntos
Diuréticos , Furosemida , Hidronefrose/diagnóstico por imagem , Ultrassonografia Doppler Dupla , Pré-Escolar , Feminino , Humanos , Hidronefrose/epidemiologia , Rim/diagnóstico por imagem , Masculino , Valor Preditivo dos Testes , Renografia por Radioisótopo , Compostos Radiofarmacêuticos , Sensibilidade e Especificidade , Pentetato de Tecnécio Tc 99mRESUMO
Ascariasis is a well-known cause of acute cholangitis and cholecystitis; however, very rarely do worms penetrate and colonize the liver parenchyma. Here we present the unique radiological demonstration (US, CT and ERCP) of hepatobiliary ascariasis in which worm was first alive in the parenchyma of the liver and subsequently died and formed liver abscess.
Assuntos
Ascaríase/diagnóstico , Doenças do Ducto Colédoco/diagnóstico , Diagnóstico por Imagem , Hepatopatias Parasitárias/diagnóstico , Idoso , Colangiopancreatografia Retrógrada Endoscópica , Feminino , Seguimentos , Humanos , Abscesso Hepático/diagnóstico , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
A small, fibrotic, and even calcified spleen is the hallmark of homozygote sickle cell disease in adults. Such a condition is very rare in sickle-thalassemia and, to our knowledge, not previously reported in a sickle cell trait. We report two heterozygote sickle cell siblings with splenic calcifications, one sickle cell trait and one sickle-beta+-thalassemia, without any history suggestive of splenic vasooclusive-infarctive crisis.
Assuntos
Calcinose/etiologia , Traço Falciforme/complicações , Esplenopatias/etiologia , Talassemia beta/complicações , Adulto , Calcinose/diagnóstico , Heterozigoto , Humanos , Masculino , Traço Falciforme/genética , Esplenopatias/diagnóstico , Tomografia Computadorizada por Raios X , Talassemia beta/genéticaRESUMO
Benign cystic peritoneal mesothelioma (BCPM) is a rare tumor, primarily affecting young women; approximately 130 cases have been described mainly in the pathological and surgical literature. We present imaging findings of a giant BCPM in a male patient and discuss the radiological differential diagnosis with a brief review of the literature.