RESUMO
Mangafodipir trisodium (Teslascan) is a hepatobiliary contrast agent that provides noninvasive opacification of the bile ducts. Using this contrast medium combined with a T1-weighted gradient echo enhanced sequence provides functional imaging of the bile ducts. Second-intention MRI was obtained after the usual morphological study of the bile ducts using heavily T2-weighted sequences (SS-FSE Te eff long and SS FSE Te eff short). This method can detect many biliary duct anomalies: biliary leakage in the postoperative context, mapping of bile ducts and the gallbladder in the search for anatomical variants, analysis of biliodigestive or biliobiliary anastomoses, or a dynamic study of bile secretion and excretion. Opacification of the bile ducts has only been possible until now with invasive tests aggravated by a certain co-morbidity rate and their functional study using biliary scintigraphy limited by mediocre spatial resolution. This new possibility provides access not only to morphological imaging, but also to functional imaging with excellent spatial resolution.
Assuntos
Doenças Biliares/diagnóstico , Meios de Contraste , Ácido Edético/análogos & derivados , Doenças da Vesícula Biliar/diagnóstico , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Manganês , Fosfato de Piridoxal/análogos & derivados , Adulto , Idoso , Anastomose Cirúrgica/efeitos adversos , Doenças dos Ductos Biliares/diagnóstico , Ductos Biliares Intra-Hepáticos/anatomia & histologia , Cisto do Colédoco/diagnóstico , Imagem Ecoplanar/métodos , Feminino , Humanos , Imageamento Tridimensional/métodos , Transplante de Fígado/efeitos adversos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Fatores de TempoRESUMO
The objective of the CT-enteroclysis is to distend the entire small intestine equally and sufficiently using a nasojejunal probe and an enteroclysis catheter for administration of a neutral opacifying agent. Today this is the best radiological method available to explore the small intestine because of its good spatial resolution and the rapidity of the exam. It is a high-performance exam when searching for transmural and extramural pathologies, in particular small tumoral lesions. It remains less effective in the exploration of anomalies of the lumen's mucosal lining, contrary to videocapsule endoscopy and the double-balloon enteroscope. It has been recognized that the CT-enteroclysis is a high-performance examination that should replace the small-bowel follow-through exam. However, there are undeniable disadvantages: higher does of radiation, patient discomfort during placement of the enteroclysis catheter, false-positive results, long interpretation time, and the impossibility of exploring the endoluminal aspect of the intestinal mucosal lining. All radiologists should therefore become familiar with the problems involved with this exam and its signs and patterns, which are illustrated in this pictorial review.
Assuntos
Neoplasias Duodenais/diagnóstico por imagem , Neoplasias do Íleo/diagnóstico por imagem , Neoplasias do Jejuno/diagnóstico por imagem , Tomografia Computadorizada por Raios X , HumanosRESUMO
Knowledge of the histological features of different components of a liver lesion greatly assists radiologists because it provides understanding of the correspondingimaging features. The imaging characteristics of lesions depend on variations of the extracellular architecture, mainly surrounding stromal tissue. Until histological imaging techniques become available, cellular analysis relies on optical microscopy and immunohistochemistry. Recent advances in imaging techniques now provide additional information on lesions due to improved spatial, temporal and contrast resolution. Correct interpretation of these imaging features should improve diagnosis.
Assuntos
Diagnóstico por Imagem , Hepatopatias/diagnóstico , Fígado/patologia , Calcinose/diagnóstico , Calcinose/patologia , Meios de Contraste , Cistos/diagnóstico , Cistos/patologia , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/patologia , Hemorragia/diagnóstico , Hemorragia/patologia , Humanos , Aumento da Imagem/métodos , Imuno-Histoquímica , Fígado/irrigação sanguínea , Abscesso Hepático/diagnóstico , Abscesso Hepático/patologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/patologia , Hepatopatias/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Imageamento por Ressonância Magnética , Microscopia , Neovascularização Patológica/diagnóstico , Neovascularização Patológica/patologia , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
We report the case of a 28 year-old female, who gave birth seven weeks previously, presenting with a pulmonary artery leiomyosarcoma discovered on a thoracic CT performed for clinical suspicion of pulmonary embolism. This case presents two major points of interest: on the first hand, it is a particular context (young post-partum patient), with classic symptoms of routine pulmonary embolism. On the other hand, the exam clearly demonstrates tumor enhancement, which is characteristic but rarely described.
Assuntos
Leiomiossarcoma/diagnóstico por imagem , Artéria Pulmonar , Tomografia Computadorizada por Raios X , Neoplasias Vasculares/diagnóstico por imagem , Adulto , Feminino , Humanos , Período Pós-PartoRESUMO
Arrhythmogenic cardiomyopathy of the right ventricle is characterized by replacement of right myocardial cells by fibro-fatty tissue and arrhythmias. The authors present two cases where EKG gated multislice CT was valuable. In one case, comprehensive evaluation of extensive ventricular dysplasia complicated by intraventricular thrombus was achieved whereas accurate evaluation of the ventricular wall process was possible in another case.
Assuntos
Displasia Arritmogênica Ventricular Direita/diagnóstico , Eletrocardiografia , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Meckel's diverticulum is a persistent embryonic remnant occurring in 2% of the general population. As an "ileal appendix", it is usually clinically silent and only discovered at the time of complications: inflammation, hemorrhage, obstruction, tumor. The preoperative diagnosis is rarely made because of the non specific nature of the symptomatology and only about 10% of complicated cases are diagnosed at imaging. Complications from Meckel's diverticulum should always be considered in patients presenting with an acute abdomen, especially in young adults.
Assuntos
Divertículo Ileal/complicações , Divertículo Ileal/diagnóstico por imagem , Humanos , RadiografiaRESUMO
Twenty-five per cent of obstructions in patients 70 years and over could be caused by gallstone ileus. Due to the variable clinical symptomatology, diagnosis can be delayed and results in poorer outcome than expected for this benign pathology. Early CT evaluation improves the accuracy of diagnosis. Based on a review of twelve cases, the typical imaging features and pitfalls will be reviewed.
Assuntos
Obstrução Duodenal/diagnóstico por imagem , Cálculos Biliares/diagnóstico por imagem , Doenças do Íleo/diagnóstico por imagem , Íleus/diagnóstico por imagem , Doenças do Jejuno/diagnóstico por imagem , Tomografia Computadorizada Espiral , Idoso , Fístula Biliar/diagnóstico por imagem , Diagnóstico Diferencial , Obstrução Duodenal/etiologia , Feminino , Humanos , Doenças do Íleo/etiologia , Íleus/etiologia , Fístula Intestinal/diagnóstico por imagem , Doenças do Jejuno/etiologia , Masculino , Sensibilidade e EspecificidadeRESUMO
The Authors report a rare case of Meckel's diverticulum complicated by diverticulitis and a small bowel obstruction due to enteroliths, associated to a paracecal internal hernia. Computed tomography was useful for surgical planning.
Assuntos
Cálculos/diagnóstico , Doenças do Ceco/diagnóstico , Diverticulite/diagnóstico , Doenças do Íleo/etiologia , Obstrução Intestinal/etiologia , Imageamento por Ressonância Magnética , Divertículo Ileal/diagnóstico , Anastomose Cirúrgica , Cálculos/patologia , Cálculos/cirurgia , Doenças do Ceco/patologia , Doenças do Ceco/cirurgia , Ceco/patologia , Ceco/cirurgia , Diagnóstico Diferencial , Diverticulite/patologia , Diverticulite/cirurgia , Hérnia Ventral/diagnóstico , Hérnia Ventral/patologia , Hérnia Ventral/cirurgia , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/patologia , Doenças do Íleo/cirurgia , Íleo/patologia , Íleo/cirurgia , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/patologia , Obstrução Intestinal/cirurgia , Masculino , Divertículo Ileal/patologia , Divertículo Ileal/cirurgia , Pessoa de Meia-IdadeRESUMO
Most inflammatory, infectious or tumoral diseases of the bowel and abdominal organs may secondarily involve the peritoneum which acts as a mirror of the diseases. Multidetector CT allows breathhold acquisitions through the abdomen and pelvis providing high spatial and contrast resolution imaging at all phases of contrast distribution as well as MPR and 3D capabilities.