Assuntos
Diagnóstico por Imagem , Hepatopatias/diagnóstico , Neoplasias Hepáticas/diagnóstico , Adulto , Criança , Diagnóstico Diferencial , Humanos , Fígado/patologia , Hepatopatias/patologia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , UltrassonografiaAssuntos
Diagnóstico por Imagem , Neoplasias Hepáticas/secundário , Diagnóstico Diferencial , Humanos , Fígado/patologia , Hepatopatias/diagnóstico , Neoplasias Hepáticas/diagnóstico , Imageamento por Ressonância Magnética , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Abdominal hernias are a common clinical problem. The main types of abdominal hernias are external or abdominal wall hernias, which involve protrusion of abdominal contents through a defect in the abdominal wall; internal hernias, which involve protrusion of viscera through the peritoneum or mesentery and into a compartment in the abdominal cavity; and diaphragmatic hernias, which involve protrusion of abdominal contents into the chest. Clinical diagnosis of abdominal hernias can be difficult. However, plain radiography, radiography performed after administration of barium, and computed tomography allow evaluation of suspected abdominal hernias and detection of those that are clinically occult. The anatomic location of the hernia, the contents, and complications such as incarceration, bowel obstruction, volvulus, and strangulation can be demonstrated with radiologic examination. Occasionally, complications such as neoplasms or inflammatory conditions can be identified in the hernial contents. With abdominal imaging modalities, a variety of abdominal hernias can be confidently diagnosed.
Assuntos
Hérnia Ventral/diagnóstico por imagem , Criança , Feminino , Hérnia Diafragmática/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Secondary involvement of the gastrointestinal tract by malignancies is encountered frequently. It usually reflects a poor prognosis because it is often multicentric and associated with metastases in other organs. Any therapy is usually palliative. Because of this, conventional barium studies or CT is sufficient for diagnosis and can obviate further studies.
Assuntos
Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/secundário , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/secundário , Humanos , Metástase Linfática , Tomografia Computadorizada por Raios XRESUMO
Computed tomography (CT) is an excellent imaging modality for demonstrating the size, shape, and position of the spleen, as well as for depicting intrasplenic pathologic features. However, it has limited value in the diagnosis of splenic involvement by lymphoma. Greater accuracy in diagnosing splenic lymphoma may be obtained by demonstrating adenopathy in the splenic hilum or by showing focal splenic defects, in addition to splenomegaly. In discussing the normal anatomy of the spleen, congenital variations (eg, accessory spleen, polysplenia, asplenia, and wandering spleen), and acquired abnormalities such as those resulting from trauma, infection, infarction, cysts, and neoplasms, this article provides evidence that CT is valuable in showing a wide variety of splenic variations and abnormalities while simultaneously allowing evaluation of the remaining intraabdominal structures. The cases presented demonstrate both the value and limitations of CT in the examination of patients with congenital and acquired abnormalities of the spleen.
Assuntos
Baço/anormalidades , Baço/diagnóstico por imagem , Esplenopatias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Humanos , Neoplasias Esplênicas/diagnóstico por imagemRESUMO
The presence of gas within the bowel wall is an uncommon condition that is typically first diagnosed by the radiologist. Although it is often seen on abdominal radiographs, computed tomography is more sensitive in demonstrating pneumatosis and its complications. There is a spectrum of disease states that produce this abnormality, ranging from the innocuous to the fatal. Its radiographic appearance is variable, particularly the location, extent, severity, and presence of pneumoperitoneum or portal venous gas. None of these imaging characteristics can be considered pathognomonic for the underlying cause of the pneumatosis. The radiologist must be aware of the different conditions associated with this entity, as well as their variable appearances.
Assuntos
Pneumatose Cistoide Intestinal/diagnóstico por imagem , Humanos , Pneumatose Cistoide Intestinal/etiologia , Pneumatose Cistoide Intestinal/patologia , Tomografia Computadorizada por Raios XRESUMO
Endorectal sonography initially was developed for evaluation of the prostate and now has been adapted for evaluation of rectal and perirectal disease. We used endorectal sonography to evaluate a spectrum of diseases, including primary and recurrent rectal carcinoma, metastases, villous adenoma, leiomyosarcoma, endometriosis, sacrococcygeal teratoma, chordoma, retroperitoneal cystic hamartoma, pelvic lipomatosis, diverticulitis, and perirectal abscess. The technique has been useful in localization of perirectal abscesses and in sonographically guided biopsy of perirectal masses. Knowledge of normal sonographic anatomy of the rectum is essential in the evaluation of rectal and perirectal disease. In this essay, we describe the technique of endorectal sonography and illustrate the sonographic findings in a variety of diseases.
Assuntos
Neoplasias Pélvicas/diagnóstico por imagem , Doenças Retais/diagnóstico por imagem , Abscesso/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Cistos/diagnóstico por imagem , Endometriose/diagnóstico por imagem , Humanos , Leiomiossarcoma/diagnóstico por imagem , Lipomatose/diagnóstico por imagem , Masculino , Melanoma/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Ultrassonografia/métodosRESUMO
Angioimmunoblastic lymphadenopathy (AILD) is a rare disorder characterized by lymphadenopathy, constitutional symptoms, skin rashes, and a variety of hematologic disorders. Its occurrence in the colon is rare. Late in the disease, immunosuppression occurs, and there is an increased risk of malignant transformation. We present a case of AILD of the colon with eventual transformation into malignant lymphoma.
Assuntos
Doenças do Colo/diagnóstico por imagem , Neoplasias do Colo/patologia , Linfadenopatia Imunoblástica/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/patologia , Colo/patologia , Doenças do Colo/patologia , Feminino , Humanos , Linfadenopatia Imunoblástica/patologia , Pessoa de Meia-Idade , RadiografiaRESUMO
The development of malignancies in renal transplant recipients is well documented. Typically, these are cutaneous tumors or lymphomas. During the past 5 years, we have encountered six patients with documented carcinomas of the gastrointestinal tract, which developed after these patients received renal transplants. These carcinomas developed at an average of 10 years (range 2-16 years) after renal transplantation. There were three carcinomas of the colon, and one each of the esophagus, stomach, and anal canal. In many instances, the patients had examinations prior to transplantation which were normal. Several surveys of transplant recipients indicate there is an increased incidence of gastrointestinal tract malignancies after transplantation. These studies also recommend that screening of the gastrointestinal tract in long-term transplant recipients be performed. Since these patients are often imaged in the radiology department, radiologists must be aware of this possible complication.
Assuntos
Adenocarcinoma/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Gastrointestinais/epidemiologia , Transplante de Rim , Adenocarcinoma/diagnóstico por imagem , Carcinoma de Células Escamosas/diagnóstico por imagem , Feminino , Neoplasias Gastrointestinais/diagnóstico por imagem , Humanos , Terapia de Imunossupressão/efeitos adversos , Incidência , Masculino , Pessoa de Meia-Idade , Radiografia , Fatores de TempoRESUMO
Collagenous colitis (CC) is characterized clinically by a chronic, watery diarrhea. Pathologically, there is a chronic lymphocytic infiltrate with abnormal thickening of the subepithelial collagen layer. This disease occurs predominantly in females, and is more frequent in the elderly. Previous clinical studies suggest that radiographic examination of the colon is of no value in this condition. We reviewed five cases of CC all of whom had colon examination within 2 weeks of the biopsy. Two of our patients showed evidence of mucosal granularity and irregularity of the rectosigmoid on double-contrast barium enema (DCBE). One patient had nodularity of the rectal wall on single-contrast colon examination. Two patients had no inflammatory changes evident on colon examination. These radiographic changes are nonspecific and may be seen in other forms of colitis, particularly ulcerative colitis and nonspecific proctitis.
Assuntos
Colite/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sulfato de Bário , Biópsia , Colite/patologia , Colágeno , Colonoscopia , Enema , Feminino , Humanos , Mucosa Intestinal/patologia , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
The preoperative computed tomographic (CT) scans of 14 patients with biopsy-proven primary adenocarcinoma of the cecum were reviewed to assess clinical presentation, CT findings, and value of staging by CT. The correlation of CT evidence for tumor invasion beyond the bowel wall with histopathology had predictive value of negative examination of 33% with sensitivity of 78%. More importantly, the correlation of metastatic nodal involvement by CT had predictive value of negative examination of 22% with sensitivity of only 12%. Of chief concern was the involvement of pericolic and mesenteric nodal chains that were not discernible by CT. Computed tomographic tumor staging was accurate in 57% of cases and upgraded in 43%. This study concludes that, although predictive values of positive CT examination are high, CT tends to underestimate disease extent.
Assuntos
Adenocarcinoma/diagnóstico por imagem , Neoplasias do Ceco/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Ceco/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Cuidados Pré-Operatórios , Estudos RetrospectivosRESUMO
In a retrospective study of 14 cases of duodenal neoplasms evaluated by computed tomography (CT), there were four primary adenocarcinomas of the duodenum, one lymphoma, five metastatic carcinomas, two duodenal lipomas, one villous adenoma, and one leiomyoma. The CT findings were diagnostic in patients with duodenal lipomas. In 11 cases, a primary origin of the mass was clearly identifiable in the duodenum. Thickening of the bowel wall, tumor necrosis, ulceration, and intraluminal defects were common. The relationship of the masses to adjacent structures was clearly shown on CT scans. Extraluminal extent of the lesion was noted on CT scans in seven patients; however, at surgery only four of six were found to have extramural disease. The presence of adenopathy, liver metastases, and vascular and mesenteric invasion were also demonstrated on CT scans. Twelve patients underwent upper gastrointestinal tract series. A duodenal abnormality was seen in all 12 patients, but the extramural extent and distant metastatic involvement could not be seen on these examinations. CT scans allowed the accurate staging of eight of ten malignant lesions and thus helped in the management of duodenal tumors.