RESUMO
Intrathoracic extramedullary haematopoiesis occurring as a complication of osteopetrosis is uncommon. The combination of classic plain film and CT findings should suggest the diagnosis, which can be non-invasively confirmed with bone marrow scintigraphy.
Assuntos
Hematopoese Extramedular , Osteopetrose/complicações , Tomografia Computadorizada por Raios X , Idoso , Idoso de 80 Anos ou mais , Humanos , MasculinoRESUMO
The case report of an 88-year-old woman with dextroversion and acute anterior wall myocardial infarction is presented. The patient, who had been diagnosed with dextrocardia 3 years prior to this admission, presented with right-sided chest pain. Coronary angiography demonstrated an 80% proximal left anterior descending artery stenosis which was successfully stented. A cardiac MRI was performed to exclude a left atrial thrombus after an inconclusive echocardiogram. The MRI demonstrated findings consistent with dextroversion, with delayed contrast-enhanced viability sequences confirming a near transmural anterior wall myocardial infarct. To our knowledge, this is the first report illustrating the cardiac MRI findings in such a case.
Assuntos
Dextrocardia , Imagem Cinética por Ressonância Magnética , Infarto do Miocárdio/diagnóstico , Situs Inversus , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Fígado/anormalidades , Baço/anormalidadesRESUMO
The emerging technology of CT fluoroscopy (CTF) represents the first opportunity for real-time CT guidance in non-vascular intervention. As with any new technology, its efficacy requires validation before widespread application can be advocated. A review of our initial experience is presented with particular attention to room, procedure and fluoroscopy time savings, complication rates and dosimetry. Computed tomography fluoroscopy is useful for pulmonary, pelvic, retroperitoneal and other deep organ lesions that are not easily accessible by other modalities. Computed tomography fluoroscopy decreases procedure time by at least a factor of 2 compared with conventional CT (C-CT) guidance, resulting in improved throughput in a busy interventional CT department. Accurate targeting of small lesions, previously considered inaccessible, can also be achieved with CTF. Exposure to the physician's hands can be reduced to a level that is acceptable to the International Commission on Radiological Protection guidelines.