RESUMO
Nineteen patients with middle and lower rectal carcinomas were operated on, with abdominoperineal resection in 10 patients, lower anterior resection with coloanal anastomosis in 6 patients, and colorectal anastomosis in 3 patients. The distance of the lower margin of the tumor to insertion of the levator ani on the rectal wall was correctly evaluated by computed tomography in 12 (63%) of 19 patients and by magnetic resonance imaging in 13 (68%) of 19 patients, while digital examination correctly assessed the distance in 15 (79%) of 19 patients. Computed tomography and magnetic resonance imaging were unable to assess extension through the rectal wall. No significant difference was observed between computed tomography and magnetic resonance imaging in assessing extension to the perivesical fat, adjacent organs, pelvic side wall, or lymph nodes. According to the TNM classification, magnetic resonance imaging correctly staged 74% (14/19) of carcinomas, while computed tomography correctly staged 68% (13/19).
Assuntos
Imageamento por Ressonância Magnética , Cuidados Pré-Operatórios , Neoplasias Retais/diagnóstico , Tomografia Computadorizada por Raios X , Idoso , Estudos de Avaliação como Assunto , Feminino , Humanos , Metástase Linfática , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Estudos Prospectivos , Neoplasias Retais/patologia , Reto/diagnóstico por imagem , Reto/patologia , Tomografia Computadorizada por Raios X/instrumentação , Tomografia Computadorizada por Raios X/métodosRESUMO
MRI findings in three cases of pseudomyxoma peritonei, in two cases associated with visceral invasion, are described. MR imaging using the same morphologic criteria as described in ultrasonography and CT suggested the diagnosis in all three cases. In T 1 weighted images (SE 400/28 ms) the hypointensity of signals of both implants and mucoid ascites was found to approach that of muscle tissue. In T 2 weighted images (SE 1600/40, 80, 120 ms), however, there was general hyperintensity of signals, which was more pronounced in mucoid ascites than in implants, and which approached signal intensities of water. Invasion of the viscera was very well depicted in all cases.
Assuntos
Imageamento por Ressonância Magnética , Pseudomixoma Peritoneal/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
The case is reported of a man of 48 with known longstanding gross cardiomegaly which was completely asymptomatic. Angiocardiography and coronary arteriography showed dilatation of the right side of the heart, and especially of the auricle. In addition, the ventricle was separated from the diphragm by a transparent non-fluid area. At operation, gross dilatation of the right atrium was confirmed, but no causative lesion could be found; there was also marked lipomatosis which involved particularly the area beneath the right ventricle. It is difficult to classify this most unusual case as either a classical dilatation of the right atrium, idiopathic or secondary, or as a cardiac lipoma or lipomatosis.
Assuntos
Cardiomegalia/etiologia , Cardiopatias/complicações , Neoplasias Cardíacas/complicações , Lipomatose/complicações , Pericárdio , Angiocardiografia , Cardiomegalia/diagnóstico por imagem , Dilatação Patológica/complicações , Átrios do Coração , Neoplasias Cardíacas/patologia , Ventrículos do Coração , Humanos , Lipomatose/patologia , Masculino , Pessoa de Meia-Idade , Pericárdio/patologiaRESUMO
The preoperative CT scan of 4 patients who had surgery for endometrioid adenocarcinoma of the ovaries were studied retrospectively and the results correlated to operative and pathological findings. 1) All tumors were bilateral. 2) Uterine involvement was diagnosed in 1 out of 3 cases. 3) Fallopian tubes involvement was present in 3 cases but was never seen on CT scan. 4) Ascites and peritoneal metastasis were correctly diagnosed in 2 out of 3 cases.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
A multicentric form of Castleman's disease is described, this being a rare affection for which CT image characteristics have not, to our knowledge, been reported. Two cases of localized and one case of multicentric Castleman's disease are reported, and differential characters of these two forms with common histology: angio-follicular lymphoid hyperplasia, outlined. The localized form is found mainly in the mediastinum in young patients and follows a favorable course with recovery after exeresis. The diffuse form develops in later life and presents with severe systemic signs and a marked biological inflammatory syndrome Glands and viscera are affected and its course is grave, with mostly fatal relapses. Angiography suggests diagnosis when images show hypervascular lesions in lymph glands. CT scan imaging with contrast is very suggestive when glandular lesions are present that take up contrast strongly. This appearance should always raise the possibility of Castleman's disease.
Assuntos
Hiperplasia do Linfonodo Gigante/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Hiperplasia do Linfonodo Gigante/diagnóstico , Feminino , Humanos , Doenças Linfáticas/etiologia , Masculino , Fatores de TempoRESUMO
Twenty-one patients with middle and low rectal carcinomas have been operated by abdominoperineal resection (APR) in 11 patients, and low anterior resection (LAR) with coloanal anastomosis in 7 and colorectal anastomosis in 3. The distance of the lower margin of the tumor to insertion of the levator ani on the rectal wall was correctly evaluated by CT in 15 of 21 cases (71%) and by MR in 14 of 21 (67%) while digital examination correctly assessed the distance in 17 of 21 (81%). CT and MR were unable to assess extension through the rectal wall. No significant discordance was observed between CT and MR in assessing extension to the perivesical fat, adjacent organs, pelvic side wall or lymphnodes. According to the TNM classification, MR correctly staged 76% (16 of 21) of patients while CT correctly staged 71% (15 of 21).
Assuntos
Adenocarcinoma/diagnóstico , Adenoma/diagnóstico , Imageamento por Ressonância Magnética , Neoplasias Retais/diagnóstico , Tomografia Computadorizada por Raios X , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenoma/diagnóstico por imagem , Adenoma/patologia , Idoso , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/patologiaRESUMO
155 patients with 210 ovarian tumours were examined pre-operatively by CT from December 1984 to February 1988. 27 patients had dermoid cysts, unilateral in 25 cases and bilateral in 2 cases. These cystic teratomas were benign in 26 patients. In one case, malignant transformation occurred. CT detected 29/29 tumours (100%). Presence of fat (26/29, 90%), calcification (20/29, 69%), Rokitansky protuberance (25/29, 86%), tufts of hair (20/29, 69%), or fat fluid level (4/29, 14%), allowed to make a definite diagnosis in 28/29 cases (96%). These findings and especially demonstration of fat, appeared to be specific for dermoid cysts in our series. The diagnosis of torsion of the cyst associated with torsion of the adnexa was made in 2 patients. No abdomino-pelvic extension occurred in 26/26 patients presenting with a benign dermoid cyst and CT correctly diagnosed the lymph node and hepatic spread in the single case of cancer.
Assuntos
Cisto Dermoide/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Calcinose/diagnóstico por imagem , Cistadenoma/diagnóstico por imagem , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico por imagemRESUMO
56 patients with bladder carcinoma were examined by magnetic resonance in the pre-operative staging. In 40 patients where total cystectomy with enterocystoplasty and pelvic node dissection were performed, a good correlation with surgical and pathologic findings was obtained. MR examination using T1 (TR 400 ms, TE 28 ms) and T2 (TR 1,200-1,600 ms, TE 40 80 120 ms) weighted images in different planes where performed after biopsy of the bladder tumor through endoscopy and within 1 or 2 weeks before surgery. Neoplasms were characterized by site, size and growth pattern. Extension through the deep muscle of the bladder wall was correctly identified in 95% with a sensitivity of 95% and a specificity of 95%. Extension through perivesical fat was assessed accurately in 85% with a sensitivity of 66% and a specificity of 100%. Accuracy in evaluating invasion of adjacent organs was 85%, sensitivity 44%, specificity 96%. Lymphadenopathy has been accurately assessed in 97.5% with a sensitivity of 83% and a specificity of 100%. MR correctly staged the tumor according to TNM classification in 24/40 (60%) patients, overestimated the extension in 3/40 (7.5%) and underestimated the extension in 13/40 (32.5%).
Assuntos
Carcinoma de Células de Transição/patologia , Imageamento por Ressonância Magnética , Neoplasias da Bexiga Urinária/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de NeoplasiasAssuntos
Próteses Valvulares Cardíacas/efeitos adversos , Adulto , Anticoagulantes/uso terapêutico , Valva Aórtica/cirurgia , Constrição , Feminino , Humanos , Embolia e Trombose Intracraniana/etiologia , Masculino , Valva Mitral/cirurgia , Fonocardiografia , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Prognóstico , Trombose/complicações , Valva Tricúspide/cirurgiaAssuntos
Sequestro Broncopulmonar/diagnóstico , Auscultação Cardíaca , Angiomatose/diagnóstico , Aortografia , Fístula Arteriovenosa/diagnóstico , Broncografia , Sequestro Broncopulmonar/diagnóstico por imagem , Sequestro Broncopulmonar/patologia , Criança , Diagnóstico Diferencial , Eletrocardiografia , Feminino , Humanos , Pulmão/irrigação sanguínea , Masculino , Fonocardiografia , Pneumonectomia , Cintilografia , ToracoscopiaAssuntos
Embolia Pulmonar/diagnóstico por imagem , Angiografia/métodos , Bloqueio de Ramo/complicações , Cateterismo/efeitos adversos , Meios de Contraste/efeitos adversos , Humanos , Infarto do Miocárdio/complicações , Flebografia/métodos , Embolia Pulmonar/complicações , Cintilografia , Tomografia Computadorizada por Raios XRESUMO
The mechanisms leading to traumatic injuries of the heart and coronary arteries and the typical lesions found are analyzed in light of experience with a total of 21 cases from several centers. The indications for angiography are discussed. Early angiography may be used for the emergency verification of a valvular, coronary, or myocardial rupture after intensive treatment has stabilized the patient's condition; in such situations the relative indications for angiography versus immediate surgery must be determined. Delayed angiography may be used in the more usual situations in which clear, persistent anomalies of a clinical, electric, or radiologic nature are observed.
Assuntos
Angiografia , Vasos Coronários/lesões , Traumatismos Cardíacos/diagnóstico por imagem , Ferimentos não Penetrantes/diagnóstico por imagem , Angiografia Coronária , Valvas Cardíacas/diagnóstico por imagem , Valvas Cardíacas/lesões , RupturaRESUMO
Selective adrenal phlebography with measurement of hormone levels was used to investigate the majority of 58 cases of primary hyperaldosteronism. The authors stress the importance of pre-operative diagnosis of the lesion as surgery is indicated for adenomas only, and because of their small size they are often missed in adrenal scintigrams and on manual exploration during operation. They are in agreement with most other authors that adrenal phlebography is the most valid investigation, as it gives a precise diagnosis of the lesion in 92% of cases. The angiographic findings in the most common lesions are described, the difficulty in diagnosing peripheral small adenomas stressed, and the problems associated with the diagnosis of nodular hyperplasias outlined. They also underline the fundamental importance of selective hormone levels measurement, as these results are of equal value to those of the images themselves.
Assuntos
Glândulas Suprarrenais/diagnóstico por imagem , Hiperaldosteronismo/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Adolescente , Neoplasias do Córtex Suprarrenal/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Glândulas Suprarrenais/patologia , Adulto , Idoso , Aldosterona/sangue , Angiografia , Feminino , Humanos , Hiperaldosteronismo/etiologia , Hiperplasia/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , FlebografiaRESUMO
The intraspinal venous stasis, described by ABOULKER as the cause of numerous myelopathies, is due to the addition of multiple venous abnormalities, demonstrated by cavospinal phlebography. The venae cavae and their major affluents and the prespinal system (lumbar and ascending lumbar veins, azygos, hemi-azygos, right superior intercostal and vertebral veins) are explored by catheterization. Cavo-spinal phlebography reveals multiple obstacles and the resulting stasis in the intraspinal plexus.