RESUMEN
Image-guided transrectal drainage is an effective treatment option for many deep pelvic abscesses in children. Currently, a variety of imaging and catheter techniques are used to access and drain these abscesses. The present report describes an approach for introducing the transrectal catheter by using transabdominal ultrasound guidance to direct transrectal advancement of an Amplatz dilator with coaxial placement of the metal cannula and inner trocar from a pigtail catheter set, followed by placement of the pigtail catheter via Seldinger technique. This approach eliminates some of the limitations of other transrectal techniques. The present report describes a single-institutional experience with this technique in 13 patients.
Asunto(s)
Absceso Abdominal/terapia , Cateterismo/instrumentación , Catéteres , Dilatación/instrumentación , Drenaje/instrumentación , Absceso Abdominal/diagnóstico por imagen , Adolescente , Cateterismo/efectos adversos , Niño , Dilatación/efectos adversos , Drenaje/efectos adversos , Diseño de Equipo , Femenino , Humanos , Masculino , Ohio , Pelvis , Radiografía Intervencional , Recto , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía IntervencionalRESUMEN
OBJECTIVE: To determine if Gadolinium-based enhanced Magnetic Resonance Imaging (GdMRI) can be used to predict sensorineural hearing loss (SNHL) in pediatric patients diagnosed with bacterial meningitis. STUDY: Design: Retrospective chart review. SETTING: Primary Children's Hospital, Salt Lake City, Utah. SUBJECTS: and Methods: We studied forty-two pediatric patients diagnosed with bacterial meningitis who underwent brain GdMRI during their index hospital admission and for whom ear specific audiometric data were available (August 2008-July 2018). A pediatric neuroradiologist, blinded to both disease and audiometric data, rated cochlear enhancement of each GdMRI (0-3; none to markedly enhanced). RESULTS: Ear specific MRI scores were statistically significantly related to ear specific hearing outcomes (p < 0.01). SNHL occurred in 19 out of 82 ears (12 out of 42 patients; 2 ears were excluded due to pre-existing SNHL in one ear and inability to read the GdMRI on the other ear). Ten of 19 ears (53%) that developed SNHL showed mild/moderate/marked enhancement (MRI score of 1, 2, or 3 respectively). Fifty-three of the 63 unaffected ears (84%) showed no enhancement (MRI score of 0). Ten of 13 (77%) ears that developed severe to profound SNHL showed mild/moderate/marked enhancement. GdMRI was 58% sensitive and 84% specific in predicting which ears would develop SNHL. GdMRI was 77% sensitive and 84% specific in identifying severe to profound SNHL. CONCLUSION: Our study demonstrates that GdMRI is a promising tool for predicting specifically severe-profound hearing loss in pediatric patients following bacterial meningitis infection.
Asunto(s)
Pérdida Auditiva Sensorineural , Meningitis Bacterianas , Niño , Medios de Contraste , Gadolinio , Pérdida Auditiva Sensorineural/diagnóstico por imagen , Pérdida Auditiva Sensorineural/etiología , Humanos , Imagen por Resonancia Magnética , Estudios RetrospectivosRESUMEN
OBJECTIVE: The development of a C-arm cone-beam CT unit coupled with flat detectors has markedly increased anatomic visualization capabilities for interventional radiology procedures. We present technology in which fluoroscopy and 3D imaging from a cone-beam CT-flat-detector C-arm unit are combined with an integrated tracking and navigation system. A description of the technology and representative clinical cases are presented. CONCLUSION: This new combination further increases interventional radiologic capabilities because it provides real-time procedural evaluation and tracking.
Asunto(s)
Cementos para Huesos/uso terapéutico , Imagenología Tridimensional/métodos , Intensificación de Imagen Radiográfica/métodos , Radiografía Intervencional/métodos , Tomografía Computarizada por Rayos X/métodos , Vertebroplastia/métodos , Adolescente , Niño , Femenino , Humanos , Inyecciones/métodos , MasculinoRESUMEN
OBJECTIVE: We describe the MRI appearance of five cases of chondral delamination of the knee. CONCLUSION: Chondral delamination injuries of the knee show increased linear signal abnormality at the junction of the articular cartilage and subchondral bone on T2-weighted (fast spin-echo) images of the knee. Identifying and treating these lesions results in an improved prognosis for patients with this injury.