Dual-energy computed tomography in supporting prostatic artery embolization for benign prostatic hyperplasia.

Objective: Our study aims to evaluate the value of 256-slice dual-energy computed tomography (DECT) in supporting prostatic artery embolization (PAE) under digital subtraction angiography (DSA) for benign prostatic hyperplasia (BPH). Methods: The study was conducted on 88 patients who underwent PAE to treat BPH from January 2022 to November 2023. Of these, 38 patients who had PAE without DECT were placed in group 1, while the other 50 patients with pre-interventional DECT were assigned to group 2. The results of DECT imaging of the prostate artery (PA) were compared with the results of DSA imaging. Test for statistically significant differences between the variables of the two research groups using the T - student test and Mann-Whitney test algorithms with p < 0.05 corresponding to a 95% confidence interval. The data were analyzed according to medical statistical methods using SPSS 20.0 software. Results: DECT can detect the PA origin in 96.1% of cases, identify atherosclerosis at the root of the artery with a sensitivity of 66.7% and a specificity of 89.5%, and present anastomosis with a sensitivity of 72.7% and a specificity of 72.2%. There is no statistically significant difference in PA diameter on DECT compared to DSA with 95% confidence. Group 2 used DECT for 3D rendering of the PA before PAE had procedure time reduced by 25.8%, fluoroscopy time reduced by 23.2%, dose-area product (DAP) reduced by 25.6%, contrast medium volume reduced by 33.1% compared to group 1 not using DECT, statistically significant with 95% confidence. Conclusion: DECT is a valuable method for planning before PAE to treat BPH. 3D rendering DECT of PA provides anatomical information that minimizes procedure time, fluoroscopy time, dose-area product, and contrast medium volume.

Prostatic artery embolization via inferior epigastric collateral in chronic total occlusion of the anterior division of the left internal iliac artery.

Prostatic artery embolization (PAE) is one of the new treatment therapies for lower urinary tract symptoms in male patients with benign prostatic hyperplasia. PAE is considered a minimally invasive option besides other famous traditional therapies such as transurethral resection of the prostate (TURP) and open surgery. Additionally, PAE has a specific advantage in managing the elderly group and underlying health conditions like anticoagulation. In this article, we presented the case of an 83-year-old male patient who has chronic urinary retention due to benign prostatic hyperplasia, left coronary artery stent placement, and long-term anticoagulation. The preinterventional computed tomography angiography showed chronic total occlusion of the anterior division of the left internal iliac artery. Bilateral PAE was performed successfully, and his urinary symptoms were significantly improved. Computed tomography allows for the accurate detection of prostatic anatomy and facilitates planning prostatic artery embolization.

Magnetic resonance imaging characteristics of glioblastoma of the optic pathway during adulthood.

Glioma has been previously known as the most common adult brain tumor. Glioma of the optic pathway is predominated by low-grade neoplasms. High-grade glioma in adults is extremely rare. In this study, we present the case of a 46-year-old male patient who developed glioblastoma of the optic chiasm extending along the optic tract. This study aims to discuss several common differential diagnoses of nontumor diffuse lesions in the optic pathway and their clinical symptoms and magnetic resonance imaging findings, which could help navigate management.

Appendiceal hemorrhage: An uncommon cause of lower gastrointestinal tract bleeding and intraluminal contrast extravasation.

Lower gastrointestinal tract bleeds due to appendiceal hemorrhage are extremely rare. This emergency condition requires a multidisciplinary approach to not only give a prompt diagnosis and exclude differential diagnosis but also crucial to proceed with proper intervention and cause of bleeding. In this paper, we report a case of appendiceal hemorrhage in a young male patient who presented with lower gastrointestinal bleeding. The patient was diagnosed with appendiceal hemorrhage by an abdominal computed tomography scan and gastrointestinal tract endoscopy. Postsurgical follow-up was uneventful, and the histopathology confirmed hemorrhagic and no typical inflammatory signs. It suggested that although appendiceal hemorrhage was rare, this condition should be considered one of the causes of lower gastrointestinal bleeding.