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INTRODUCTION: We evaluated chest X-ray and clinical findings of patients with lower respiratory tract infection due to influenza H5N1 and presented the radiological findings and clinical course of the infection. MATERIALS AND METHODS: Between December 2005 and February 2006, eight hospitalized patients (median age 10, 5-15 years) with avian-flu were evaluated in this study. All patients were evaluated with chest X-ray and four of them with CT scan. Post mortem pathological characterization were also available for three of the patients. RESULTS: A rapidly progressive pneumonia with high mortality rate was observed especially for cases with late admission. The major radiologic abnormalities were extensive pneumonic infiltration with segmental and multifocal distribution, mostly located in lower zones of the lung. No pleural effusion and hilar lymphadenopathy was noted. CONCLUSION: Avian flu may be presented as rapidly progressive pneumonia. The chest radiography has an important role in diagnosis and should be obtained daily because of rapid change of the findings that may necessitate prompt action.
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Subtipo H5N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Adolescente , Niño , Preescolar , Femenino , Humanos , Gripe Humana/mortalidad , Gripe Humana/patología , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Neumonía Viral/mortalidad , Neumonía Viral/patología , Tomografía Computarizada por Rayos XRESUMEN
We aimed to determine the degree and extent of parenchymal abnormalities on pulmo-CT in patients with emphysema. The study group consisted of 29 patients (18 male, 11 female; mean age 57.9+/-13). The diagnosis was based on clinical symptoms, pulmonary function tests (PFT) values, and chest CT findings. All of the patients CT scans were obtained during suspended deep inspiration from the apices to the costophrenic angles. The mean lung attenuation (MLD) and parenchymal abnormalities related to emphysema were quantitatively calculated with tables, histograms and graphics at the whole lung. The lung density measurements revealed a mean density of -898.48+/-51.37 HU in patients with emphysema and -825.1+/-25.5 HU in control group. In addition, mean percentage of subthreshold attenuation values was found as 12.03+/-15.75 and 1.07+/-0.83 in patients with emphysema and control group, respectively. Compared with control group, the patients with emphysema had a significantly lower inspiratory MLD (p<0.05). Additionally, statistically significant correlations were seen between the MLD and percentage of subthreshold values (r=0.44, p<0.05). In contrast, there was poor correlation between PFT measurements and the subthreshold values. In conclusion, pulmo-CT is a quick, simple method for quantitative confirmation of the presence of parenchymal abnormalities of lung as mosaic attenuation and should be used in combination with other radiological methods and PFT as it gives additional information to routine examinations in patients with emphysema.
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Interpretación de Imagen Asistida por Computador/métodos , Enfisema Pulmonar/diagnóstico por imagen , Enfisema Pulmonar/fisiopatología , Tomografía Computarizada por Rayos X , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfisema Pulmonar/diagnóstico , TurquíaRESUMEN
OBJECTIVE: This study aimed to investigate the localization of the lipoma, as well as associated intracranial and extracranial lesions in 14 patients immediately following hospital admission. The pathological findings from the neurological examinations of these patients are also investigated. METHODS: Fourteen patients who were admitted to our clinic with a variety of symptoms and diagnosed with intracranial lipoma were included in the study. Problems presented upon admission, neurological findings, and other existing system abnormalities were evaluated. Localization of the lipomas and accompanying pathologies were determined by using computerised tomography and magnetic resonance imaging. RESULTS: The most frequent reasons for admission of patients with intracranial lipomas were: headache 7 (50%), trauma 3 (21.5%), epilepsy 3 (21.5%) and one with symptoms due to the local mass effect of tumor (7%). Although the pericallosal region is accepted as the region where lipomas commonly occur, this study found the most frequent occurrence in the quadrigeminal cistern. Intracranial lipoma calcification was only evident in 1 of the 14 patients. In addition, contrary to the expectations, intracranial and extracranial lesions accompanying lipomas were rare. All patients received systematic treatment. CONCLUSION: This study showed that intracranial lipomas are more frequent in the quadrigeminal region of the brain; most are asymptomatic, generally caught incidentally; and accompanying intracranial and extracranial pathologies are less common than expected.
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Neoplasias Encefálicas/diagnóstico , Lipoma/diagnóstico , Adolescente , Adulto , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/rehabilitación , Calcinosis/complicaciones , Calcinosis/patología , Epilepsia/diagnóstico , Epilepsia/etiología , Femenino , Cefalea/diagnóstico , Cefalea/etiología , Hospitalización , Humanos , Lactante , Lipoma/complicaciones , Lipoma/rehabilitación , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVES: Rhinolithiasis is the presence of mineralized and calcareous formations located in the nasal cavity. They have rare occurrence and can be easily confused with infection or obstruction of upper airways. If they are undetected for a long time, they may grow large enough to cause of nasal obstruction, mimicking sinusitis. Seven cases of rhinolithiasis were presented, and their diagnosis was made by rigid endoscopic nasal examination. Also computerized tomography scan was used to describe the size and site of the rhinoliths accurately. Our purpose was to determine the role of rigid nasal endoscopy in the diagnosis and the treatment of rhinolithiasis. METHODS: In this study, seven cases of rhinolithiasis, who were diagnosed and treated by rigid nasal endoscopy were presented. RESULTS: Between January 2000 and November 2004, seven cases (four males and three females; age ranged from 8 to 45 years) with rhinolithiasis were diagnosed. The most frequent symptoms were nasal obstruction with purulent rhinorhea, nasal and oral malodor. As complementary examinations, computerized tomography and simple X-ray of paranasal sinuses were used to locate and measure the dimension of calcareous mass, and to reveal possible invasion of the adjacent structures. The removal of rhinolithiasis was done with rigid nasal endoscopy under topical anesthesia in six cases and general anesthesia in one case. CONCLUSION: Rhinolithiasis is a rare condition but must always be suspected in patients with long standing nasal obstruction, nasal and oral malodor, purulent rhinorrhea and chronic headache.
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Endoscopía/métodos , Litiasis/diagnóstico , Litiasis/cirugía , Enfermedades Nasales/diagnóstico , Enfermedades Nasales/cirugía , Adolescente , Adulto , Niño , Epistaxis/etiología , Femenino , Cefalea/etiología , Humanos , Masculino , Persona de Mediana Edad , Moco/metabolismo , Cavidad Nasal/patología , Cavidad Nasal/cirugía , Obstrucción Nasal/etiología , Odorantes , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
A 26-year-old woman in the 28th week of pregnancy presented with a primary cerebral hydatid cyst manifesting as deteriorating consciousness and weakness in the left arm and leg. Cranial computed tomography revealed an intracranial hydatid cyst. The cyst was surgically removed and albendazole was administered. The patient had a spontaneous vaginal term delivery and no problem was observed in the mother or child. No primary focus was found in the lungs, liver, and other organs. Hydatid cyst is still an important disease. Intracranial hydatid cyst without primary foci in organs such as the liver and lungs is very rare. Primary cerebral hydatid cyst during pregnancy can be successfully treated by surgical and medical intervention.
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Albendazol/uso terapéutico , Antiprotozoarios/uso terapéutico , Encéfalo/patología , Encéfalo/cirugía , Equinococosis , Complicaciones del Embarazo , Adulto , Equinococosis/tratamiento farmacológico , Equinococosis/parasitología , Equinococosis/cirugía , Femenino , Humanos , EmbarazoRESUMEN
We describe herein the use of MR fluoroscopic guidance in the drainage of abscess cavities. We percutaneously drained 12 brain abscesses in 11 patients. A 0.3T open MR imaging system was used. Sixteen drainages were performed in 12 abscesses. Repeat drainage was needed in three recurrences and one residual lesion. No serious complications were seen. MR fluoroscopy-guided percutaneous brain abscess drainage in an open MR imaging system is feasible.
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Absceso Encefálico/diagnóstico , Absceso Encefálico/terapia , Imagen por Resonancia Magnética , Succión/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Fluoroscopía , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: The aim of the study is to investigate the efficacy of the magnetic resonance fluoroscopy in the diagnosis and staging of the pelvic prolapse. MATERIALS AND METHODS: The study consisted of 46 patients who were known to have pelvic prolapses from their vaginal examination. Thirty women who underwent vaginal exam and shown not have pelvic prolapse were selected as a control group. Firstly, pelvic sagittal FSE T2 weighted images of all the women were acquired in 0.3 T open MR equipment than sagittal MR-fluoroscopic images using spoiled gradient echo sequences were obtained during pelvic strain. Physical examination and MR-fluoroscopic findings were compared. The relationship between the stages of prolapse established by both of the methods was evaluated statistically with Pearson's correlation analysis. RESULTS: Physical examination and MR findings were very concordant in the diagnosis of pelvic prolapse and statistical correlations in the stages of prolapse were established between both of the methods (P<0.01 for anterior and middle comportment, P<0.05 for posterior comportment). CONCLUSION: We conclude that MR-fluoroscopy is a non-invasive, easily applied, dynamic useful method without contrast agent in the diagnosis and staging of pelvic organ prolapse.
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Imagen por Resonancia Magnética/métodos , Rectocele/diagnóstico , Enfermedades de la Vejiga Urinaria/diagnóstico , Prolapso Uterino/diagnóstico , Adulto , Femenino , Humanos , Aumento de la Imagen/métodos , Persona de Mediana Edad , Examen Físico , Prolapso , Rectocele/clasificación , Enfermedades de la Vejiga Urinaria/clasificación , Prolapso Uterino/clasificaciónRESUMEN
A previously healthy 30-day-old girl presented with seizures, irritability and inability to sleep for three days. Vitamin K was not given just after birth. She was lethargic. A multifocal clonic seizure was evident during examination. Anisocoria was diagnosed on eye examination. Brain magnetic resonance imaging showed intracerebral hemorrhage, ventricular dilatation, and hematoma in the left temporofrontal region extending to the hypothalamus. Central diabetes insipidus was diagnosed by water deprivation due to dehydration and hypernatremia, and then desmopressin was added to phenobarbital. The possible mechanism of central diabetes insipidus in our patient is damage of vasopressin pathway resulting from compression of hemorrhage. An operation of ventriculoperitoneal shunt was also performed due to hydrocephalus. While she was symptom-free except for neurological sequel during routine control examinations after discharging from hospital, the parents said that she died, most probably from bronchopneumonia, at the age of 7.5 months. In conclusion, we emphasize that prophylactic vitamin K should be administrated to all babies just after birth, and infants with intracranial hemorrhage should carefully be monitored for central diabetes insipidus.
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Diabetes Insípida Neurogénica/complicaciones , Hemorragias Intracraneales/etiología , Deficiencia de Vitamina K/complicaciones , Anisocoria/diagnóstico , Anisocoria/etiología , Encéfalo/patología , Encéfalo/cirugía , Diabetes Insípida Neurogénica/diagnóstico , Femenino , Humanos , Hidrocefalia/etiología , Hidrocefalia/cirugía , Recién Nacido , Hemorragias Intracraneales/diagnóstico , Imagen por Resonancia Magnética , Convulsiones/diagnóstico , Convulsiones/etiología , Resultado del TratamientoRESUMEN
Osteonecrosis is an uncommon complication of acute lymphoblastic leukemia. One of the risk factor is high-dose corticosteroid therapy. The highest incidence of osteonecrosis is observed in children 9 to 18 years old at diagnosis and it is a rare condition below 5 years of age. We describe a 4 year-old child with acute lymphoblastic leukemia and complaints of progressive bone pain and walking difficulty who developed osteonecrosis and bone fracture after two remission induction chemotherapy.
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INTRODUCTION: The purpose of this study was to determine the increase in diaphragmatic excursion of patients with chronic obstructive pulmonary disease (COPD) treated with theophylline by MR-fluoroscopy which is an innovative method to demonstrate effectiveness of this treatment. MATERIALS AND METHODS: Investigations were performed on a 0.3 T open MR unit. MR-fluoroscopy images of 30 patients with COPD were obtained before and after theophylline treatment. Diaphragmatic movement values were recorded for evaluation. RESULTS: The response of the diaphragmatic movement in COPD patients treated with theophylline was evaluated by MR-fluoroscopy and an increase of 48% in diaphragmatic contractility was determined after the treatment. The increase in contractility was found to be parallel with respiratory function tests and clinical status. CONCLUSION: Diaphragmatic movement and response to the medical therapy in patients with COPD can be evaluated by MR-fluoroscopy method which can allow accurate measurements.
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Diafragma/efectos de los fármacos , Imagen por Resonancia Magnética , Parasimpatolíticos/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Teofilina/uso terapéutico , Adulto , Anciano , Espiración/efectos de los fármacos , Femenino , Volumen Espiratorio Forzado/efectos de los fármacos , Humanos , Inhalación/efectos de los fármacos , Masculino , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Respiración/efectos de los fármacos , Mecánica Respiratoria/efectos de los fármacos , Espirometría , Capacidad Vital/efectos de los fármacosRESUMEN
PURPOSE: The purpose of this study was to assess the patterns of contrast enhancement of hepatic hemangiomas on gadolinium-enhanced MR fluoroscopy imaging prospectively. METHOD: Investigation was performed on a 0.3-T open MR unit. Gadolinium-enhanced MR fluoroscopy images were obtained in 24 patients with 28 hepatic hemangiomas. Each MR fluoroscopy image was obtained in 2 s and MR fluoroscopy lasted for 10-25 min for each investigation. RESULTS: Three patterns of contrast enhancement were observed in 24 patients on MR fluoroscopy images. Four small lesions were not detected on MR fluoroscopy images. Uniform enhancement was seen in nine lesions (29%), peripheral nodular enhancement progressing centripetally to uniform enhancement was seen in nine lesions (29%), and peripheral nodular enhancement with persistent central hypointensity was seen in six lesions (22%). CONCLUSION: Enhanced MR fluoroscopy technique could obtain dynamic images of hepatic hemangiomas. It can be suggested as a useful technique for the showing of enhancement of hepatic hemangiomas, keeping in mind its low sensitivity in the diagnosis of small hemangiomas.
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Hemangioma Cavernoso/diagnóstico , Neoplasias Hepáticas/diagnóstico , Imagen por Resonancia Magnética/métodos , Adulto , Anciano , Medios de Contraste , Femenino , Fluoroscopía , Humanos , Aumento de la Imagen , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadRESUMEN
OBJECTIVE: The purpose of this study was to compare the diagnostic efficacy conventional MRI and MR arthrography (MRA) in the diagnosis of chondromalacia patella (CP) on a low-field open magnet system (LFOMS), correlated with arthroscopy. SUBJECTS AND METHODS: Forty-two patients (50 knees) with pain in the anterior part of the knee were prospectively examined with LFOMS, including T1-weighted, proton density-weighted and T2-weighted sequences. All were also examined T1-weighted MRI after intraarticular injection of dilue gadopentetate dimeglumine. Two observers, who reached a consensus interpretation, evaluated each imaging technique independently. Thirty-six of the 50 facets examined had chondromalacia shown by arthroscopy, which was used as the standard of reference. The sensitivity, specificity and accuracy of each imaging technique in the diagnosis of each stage of CP were determined and compared by using the McNemar two-tailed analysis. RESULTS: Arthroscopy showed that 16 facets were normal. Four (30%) of 13 grade 1 lesions were detected with T1. Four lesions (30%) with T2 and three lesions (23%) with proton-weighted images were detected. Seven (53%) of 13 grade 1 lesions were detected with MRA. Grade 2 abnormalities were diagnosed in two (33%) of six facets with proton density-weighted pulse sequences, two (33%) of six facets with T1-weighted pulse sequences, in three (50%) of six facets with T2-weighted pulse sequences, in five (83%) of six facets with MRA sequences. Grade 3 abnormalities were diagnosed in three (71%) of seven facets with proton density- and T1-weighted images, five (71%) of seven facets with T2-weighted pulse sequences, six (85%) of seven facets with MRA sequences. Grade 4 CP was detected with equal sensitivity with T1-, proton density- and T2-weighted pulse sequences, all showing seven (87%) of the eight lesions. MRA again showed these findings in all eight patients. All imaging techniques were insensitive to grade 1 lesions and highly sensitive to grade 4 lesion, so that no significant difference among the techniques could be shown. CONCLUSION: All imaging technique studied had high specificity and accuracy in the detection and grading of CP; however, MRA was more sensitive than T1-weighted and proton density-weighted MR imaging on a LFOMS. Although the arthrographic techniques were not significantly better than T2-weighted imaging, the number of false-positive diagnosis was greatest with T2-weighted MRI.
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Artrografía , Neoplasias Óseas/diagnóstico , Condroma/diagnóstico , Imagen por Resonancia Magnética , Rótula/diagnóstico por imagen , Rótula/patología , Adulto , Artrografía/métodos , Cartílago Articular/diagnóstico por imagen , Cartílago Articular/patología , Medios de Contraste , Reacciones Falso Positivas , Femenino , Humanos , Rodilla/diagnóstico por imagen , Rodilla/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Prospectivos , Sensibilidad y EspecificidadRESUMEN
We report a case of a 23-year-old man with a cardiac hydatid cyst involving the left ventricle wall. The diagnosis of the cyst was obtained by magnetic resonance (MR) imaging. He was operated on for cardiac hydatid cyst using enucleation and capitonnage procedure under extracorporeal circulation. Histopathologic study confirmed hydatid cyst diagnosis.
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Cardiomiopatías/diagnóstico , Equinococosis/diagnóstico , Adulto , Cardiomiopatías/cirugía , Equinococosis/cirugía , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
Agenesis of the sphenoid sinuses is a very rarely encountered anatomic variation. Findings on magnetic resonance imaging can mislead the radiologist and clinician. Therefore, the gold standard for diagnosis is computed tomography (CT) of the paranasal sinuses. We present the case of a 28-year-old man who was admitted to our hospital with a 3-month history of headache. CT of the paranasal sinuses revealed isolated bilateral sphenoid sinus agenesis.
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Imagen por Resonancia Magnética , Seno Esfenoidal/anomalías , Tomografía Computarizada por Rayos X , Adulto , Cefalea/etiología , Humanos , Masculino , Seno Esfenoidal/diagnóstico por imagen , Seno Esfenoidal/patologíaRESUMEN
AIM: To evaluate the role of perioperative freezing in the management of surgical procedures in patients with malignant renal masses. MATERIALS AND METHODS: The study group consisted of 17 patients diagnosed with renal masses who underwent nephron-sparing surgery. The group included 5 females and 12 males aged from 44 to 68 years (mean = 54.6). The mean mass size was 5.5 cm. Mass locations were as follows: 9 were in the lower pole, 4 were in the mid-pole, and 6 were in the upper pole. Perioperative freezing was not carried out. The patients were followed-up in a period ranging from 3 months to 7 years. RESULTS: Tumor pathology was reported as renal cell carcinoma in all cases, and surgical margins were negative in all of them. One patient died after 1 year because of tumor metastasis. In another patient, the tumor reoccurred in the same kidney and a radical nephrectomy was performed. Other patients were followed without recurrence. CONCLUSION: Imaging of the renal vascular system and freezing during surgery is not necessary for nephron-sparing surgery for renal cell carcinoma; however, we should be careful in terms of capsule invasion because of tumor recurrence.
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Carcinoma de Células Renales/cirugía , Secciones por Congelación , Neoplasias Renales/cirugía , Nefronas/cirugía , Adulto , Anciano , Carcinoma de Células Renales/patología , Femenino , Humanos , Neoplasias Renales/patología , Masculino , Persona de Mediana Edad , Atención PerioperativaRESUMEN
A 21-year-old female patient admitted to the emergency department complaining of left side pain. Hypovolemic shock, which was probably caused by retroperitoneal bleeding from left sided renal angiomyolipoma, was developed. Abdominal computed tomography showed multiple fat containing lesions in different, regions including right bladder wall, lower pole of left kidney, and right kidney. Some lesions compatible with tuberous sclerosis such as angiofibromas, Shagreen patches, myocardial, and brain hamartomas were also detected. Bladder wall mass showing intra- and extravesical extensions was seen at exploration. We removed the tumor completely preserving bladder trigone. Angiomyolipoma located at lower pole of left kidney was also removed. Diagnosis of bladder angiomyolipoma was confirmed by the immunohistochemical examination. Recurrent or residual mass was not detected at the three-months-follow-up. We report the first case of bladder angiomyolipoma confirmed by histopathologically as a tuberous sclerosis.
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PURPOSE: To compare the results of microsurgical and naked eye varicocelectomy in patients with grade 3 varicocele. MATERIALS AND METHODS: This study was conducted on 84 patients with grade 3 varicocele, between 2007 and 2009. Patients were randomized into two groups, equal in number. Thereafter, microsurgical varicocelectomy was performed in the first group, while the other group underwent naked eye varicocelectomy. Groups were compared in terms of operation duration, number of ligated internal and external spermatic veins, early and late postoperative complications, and postoperative color Doppler ultrasonography findings. Parametric and nonparametric values were compared using Student's t test and Chi-Square test, respectively. RESULTS: The mean duration of surgery was 19 ± 2.3 minutes (range, 12 to 25 minutes) in the naked eye surgery group and 43 ± 3.9 minutes (range, 25 to 75 minutes) in the microsurgery group (P = .008). The number of ligated internal and external spermatic veins, the incidence of early and late postoperative complications, and color Doppler ultrasonography findings were not significantly different between the two groups (P = .12, P = .09, P = .17, and P = .22, respectively). CONCLUSION: In patients with grade 3 varicocele, microsurgery and naked eye surgical methods proved similar results in terms of success and complications. Because the operation time of the classical varicocelectomy is significantly shorter, it may be preferred in this subset of patients.
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Microcirugia , Varicocele/cirugía , Humanos , Masculino , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Procedimientos Quirúrgicos Vasculares/métodos , Adulto JovenRESUMEN
PURPOSE: The aim of this study was cerebrospinal flow quantification in the cerebral aqueduct using cine phase-contrast magnetic resonance imaging (MRI) technique in both sexes and five different age groups to provide normative data. MATERIALS AND METHODS: Sixty subjects with no cerebral pathology were included in this study. Subjects were divided into five age groups: < or =14 years, 15-24 years, 25-34 years, 35-44 years, and > or =45 years. Phase, rephase, and magnitude images were acquired by 1.5 T MR unit at the level of cerebral aqueduct with spoiled gradient echo through-plane, which is a cine phase-contrast sequence. At this level, peak flow velocity (cm/s), average flow rate (cm/ s), average flow (L/min), volumes in cranial and caudal directions (mL), and net volumes (mL) were studied. RESULTS: There was a statistically significant difference in peak flow between the age group of < or =14 years and the older age groups. There were no statistically significant differences in average velocity, cranial and caudal volume, net volume, and average flow parameters among different age groups. Statistically significant differences were not detected in flow parameters between sexes. CONCLUSION: When using cine-phase contrast MRI in the cerebral aqueduct, only the peak velocity showed a statistically significant difference between age groups; it was higher in subjects aged < or =14 years than those in older age groups. When performing age-dependent clinical studies including adolescents, this should be taken into consideration.
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Acueducto del Mesencéfalo/fisiología , Líquido Cefalorraquídeo/fisiología , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Envejecimiento/fisiología , Acueducto del Mesencéfalo/crecimiento & desarrollo , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Caracteres SexualesRESUMEN
BACKGROUND: Velopharyngeal insufficiency (VPI) expresses the structural and neuromuscular disorder of soft palate and pharyngeal walls inhibiting the normal functions of velopharyngeal (VP) sphincter mechanism. In this study, efficacy of dynamic magnetic resonance imaging in the diagnosis of VPI is investigated. MATERIALS AND METHODS: A total of 32 cases, 16 controls and 16 cleft palates, were included in this study. T1 fast spin echo-weighted imaging during rest, dynamic investigations with True-fast imaging with steady-state precession sequence during /sss/ and /mmm/ phonations were performed. RESULTS: During /sss/ phonation, complete closure was observed in the control group, whereas mean VP opening was 4.11 cm2 preoperatively and 0.21 cm2 postoperatively in the cleft palate group. In the postoperative period, only 3 patients did not have complete closure. In the second operations, performed 6 months later, only muscle repair was done. All 3 had complete closure. CONCLUSIONS: In cleft palate cases with delayed diagnosis, appropriate application of muscle repair will be sufficient for anatomic repair of VPI without any extra procedures. In addition, dynamic magnetic resonance imaging is an objective, noninvasive, reliable, and effective modality that may be used in the diagnosis and treatment of VPI without any extra investigations.
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Imagen por Resonancia Magnética/métodos , Fonación , Insuficiencia Velofaríngea/patología , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Fisura del Paladar/complicaciones , Femenino , Humanos , Masculino , Úvula/patología , Insuficiencia Velofaríngea/etiología , Insuficiencia Velofaríngea/cirugíaRESUMEN
A 14-year-old female with autoimmune hemolytic anemia (AIHA) developed an acute hemolytic crisis with acute renal failure under conventional treatment with corticosteroids. Because of the life-threatening situation, we decided to start pulse dose methylprednisolone and also hemodialysis with a femoral catheter placement was performed. Fifteen days after initiating of dialysis subfebrile fever was developed, followed within 2 days with a left hemiparesis. Brain magnetic resonance imaging (MRI) revealed multiple intracerebral abscesses. The clinical picture worsened and the patient died before scheduled surgery for the abscesses.