RESUMO
Acute bleeding is a rare and potentially life-threatening complication of a Parathyroid Adenoma described in just a few cases in literature. We describe the case of a healthy 53-years-old female patient without prior history of parathyroid pathology who presented with acute onset of neck and mediastinal hemorrhage. Ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) combined with laboratory tests led to the diagnosis of a bleeding Parathyroid adenoma. This case is presented to sensitize both Radiologists and Clinicians about this rare presentation that should be put into differential diagnosis of acute neck swelling and pain.
RESUMO
PURPOSE: This study was done to evaluate the possibility of reducing the dose of ionising radiation by using dual-source dual-energy computed tomography (CT) in patients undergoing CT angiography of the aorta to search for endoleaks after endovascular aneurysm repair (EVAR). MATERIALS AND METHODS: One hundred and forty-eight patients (117 M, 31 F; mean age 75 ± 6.5) underwent 171 CT angiography scans for follow-up after EVAR. For each patient we performed a triple-phase acquisition protocol consisting of a nonenhanced phase, an arterial phase and a delayed phase; the latter acquired in dual energy. Two radiologists jointly evaluated the nonenhanced, arterial and delayed phase, and a third radiologist evaluated only the delayed phase and its virtual noncontrast (VNC) reconstruction. Moreover, we compared the cumulative effective doses of the triple-phase acquisition with the dual-energy acquisition. RESULTS: We detected 34 endoleaks (19.8 %), with 100 % agreement between the triple-phase and dual-energy acquisitions. The effective dose of dual-energy acquisition performed during the delayed phase was 61.7 % lower than that of the triple-phase acquisition. CONCLUSIONS: A dual-energy CT scan acquired during the delayed phase and its VNC reconstruction allow detection of endoleaks with a substantial reduction of effective dose and a complete diagnostic agreement with a triple-phase acquisition protocol.