RESUMEN
AIM: The aim of this study was to assess the density of the segmental branches of the middle cerebral artery (MCA) quantitatively as a predictor of acute ischemic stroke in patients without definitive infarct findings at cerebral parenchyma by non-contrast computed tomography (CT). CLINICAL RATIONALE FOR THE STUDY: The clinical rationale for the study is to evaluate if the measurement of Sylvian fissure dot sign (SDS) would help early management of patients with stroke at the emergency department. METHODS: Computed tomography scans of 101 patients admitted to the emergency department with stroke symptoms and/or signs were included in the study, retrospectively. In the patient group, the quantitative density of the segmental branches of the MCA in the Sylvian fissure was measured on the affected side and the contralateral side. RESULTS: Quantitative density of SDS was significantly higher on the ischemic side of the brain. Receiver operating characteristic (ROC) analysis showed a cut-off value of 38.5 Hounsfield units (HU) as a predictor for acute ischemic stroke, with a sensitivity and specificity of 79% and 92%, respectively. CONCLUSION: Quantitative density of SDS on the affected side in patients without definitive cerebral infarct findings of parenchyma can be used in the emergency room as an objective predictor sign for the diagnosis of acute ischemic stroke. Considering this finding in the differential diagnosis of acute stroke patients in the emergency room has the potential to improve their clinical management, particularly for the patients without early parenchymal and vascular signs of stroke.
RESUMEN
OBJECTIVES: The aim of this prospective study is to investigate the central nervous system involvement in Crimean-Congo haemorrhagic fever (CCHF) with magnetic resonance imaging (MRI) in conjunction with clinical and laboratory findings. METHODS: Between July 2015 and August 2016, 36 patients with CCHF were undergone brain MRI including SWI. Two MRIs, one at the time of admission and the second in the convalescent period, were performed for each patient in order to see if there is any sign of central nervous system (CNS) involvement, especially in terms of intracranial haemorrhage or viral encephalitis. Clinical severity scoring was also done and laboratory findings were noted in order to correlate with clinical and imaging findings. RESULTS: None of the 36 patients showed any MRI findings of an acute intracranial event during the course of the disease. There was a significant difference between mild cases and moderate cases in terms of some laboratory parameters (p < 0.05). CONCLUSIONS: Although CCHF is a highly lethal disease which involves multiple organs and systems, CNS involvement seems to be extremely rare in mild and moderate cases. KEY POINTS: ⢠MRI is the imaging method of choice to diagnose microbleeds and encephalitis ⢠Although CCHF causes multisystem bleeding, intracranial haemorrhage seems to be very rare ⢠CNS complications are uncommon, even in the setting of suggestive symptoms ⢠Death usually results from extracranial bleeding and multiorgan failure ⢠Severity scoring is associated with some laboratory abnormalities in CCHF.
Asunto(s)
Encéfalo/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Fiebre Hemorrágica de Crimea/diagnóstico por imagen , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Encéfalo/patología , Hemorragia Cerebral/diagnóstico por imagen , Encefalitis Viral/diagnóstico por imagen , Femenino , Virus de la Fiebre Hemorrágica de Crimea-Congo , Fiebre Hemorrágica de Crimea/patología , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
The jugulodigastric (JD) and juguloomohyoid (JO) lymph nodes are levels II and III cervical lymph nodes corresponding to the upper and middle internal jugular chains, respectively. The aim of this study is to delineate the sonographic properties of these two nodes, which are commonly encountered in routine neck sonography, in subjects with normal neck ultrasound findings. Atypical findings can make it difficult to differentiate benign from malignant lymph nodes. The JD and JO lymph nodes of 126 subjects were examined by ultrasonography, and size, shape, presence of echogenic hilus and Doppler activity were recorded. Among the lymph nodes examined, 31.6% were not elliptical. Proportionally more of the JO than the JD nodes were round; there was a significant difference in roundness index between them (P < 0.05). An echogenic hilus was demonstrated in 223 of the 252 JD nodes and in 161 of the 252 JO nodes. Significantly more of the lymph nodes with roundness index <2 lacked a visible echogenic hilus. There was a positive correlation between the visibility of an echogenic hilus and Doppler activity. Normal jugulodigastric and juguloomohyoid lymph nodes are relatively prominent in the upper and middle jugular chains, respectively. Awareness of variations in the sonographic appearance of these nodes could preclude unnecessary procedures. Clin. Anat. 29:943-948, 2016. © 2016 Wiley Periodicals, Inc.
Asunto(s)
Ganglios Linfáticos/diagnóstico por imagen , Cuello/diagnóstico por imagen , Ultrasonografía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Adulto JovenRESUMEN
BACKGROUND AND AIM: Cerebral hemiatrophy (CHA) is a congenital or acquired loss of volume in one hemisphere of the brain. The MR findings of the affected hemisphere have been a subject of many studies, however, the contralateral hemisphere has not been investigated. There is, in fact, an integrity between two hemispheres of the brain through transverse connection fibers. The aim of this study is to investigate the changes in the contralateral hemisphere in CHA. MATERIALS AND METHODS: Apparent diffusion coefficient (ADC) values were measured in deep gray and white matter areas in the normal-appearing contralateral hemisphere in 23 patients with CHA, in order to get in vivo information about a possible Wallerian degeneration or microstructural changes. Results were compared with the control group. RESULTS: Normal ADC values were encountered in the contralateral hemisphere in all (100%) CHA patients. The difference between the ADC values of gray and white matter in CHA patients and the control group was not statistically significant. CONCLUSION: Normal ADC values in the contralateral hemisphere in CHA patients suggests a compensatory mechanism restricting Wallerian degeneration or diffusion alteration.
Asunto(s)
Encéfalo/diagnóstico por imagen , Imagen de Difusión por Resonancia Magnética/métodos , Degeneración Walleriana/diagnóstico por imagen , Adolescente , Adulto , Atrofia/diagnóstico por imagen , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
Meningiomas are tumors that originate from the arachnoid cell and the majority are benign and grade I tumors according to World Health Organization. Chordoid meningioma is an uncommon variant of meningioma and corresponds to grade II tumor in the World Health Organization Classification of Tumors of the Nervous System 2007 because of its more aggressive behavior and increased likelihood of recurrence. A 75-year-old female was referred to the neurosurgery department complaining of headache, syncope, and seizure. Radiological examination revealed a mass lesion in the neighbourhood of the frontal lobe that destructed bone and was associated with peritumoral edema. The patient underwent surgery. The tumor was totally excised with the dura beneath. Histopathological examination showed that the tumor was composed of clusters and cords of small polygonal cells with fine chromatin and eosinophilic vacuolated cytoplasm embedded in a myxoid matrix, and also focal whorls of spindle-shaped cells. Two mitoses were seen in 10 high power fields. Vascular proliferation was observed in some tumoral areas. Bone invasion was present. Immunohistochemical analysis of the tumor cells revealed widespread strong membranous and cytoplasmic expression of epithelial membrane antigen. The Ki67 labeling index was 6-8%. All of these findings were consistent with a diagnosis of chordoid meningioma, the neoplasm was identified as grade II based on the World Health Organization Classification, 2007. In this report we present a case of chordoid meningioma without classical radiological findings of meningioma with areas of vascular proliferation that mimicked glial tumors at histopathologic examination.
Asunto(s)
Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/patología , Meningioma/diagnóstico , Meningioma/patología , Anciano , Biomarcadores de Tumor/análisis , Diagnóstico Diferencial , Femenino , Glioma/diagnóstico , Humanos , InmunohistoquímicaRESUMEN
INTRODUCTION: Cerebral small vessel disease (CSVD) and multiple sclerosis (MS) both harbor multiple, T2-hyperintense white matter lesions on conventional magnetic resonance imaging (MRI).We aimed to determine the microstructural changes via diffusion-weighted imaging (DWI) in normal appearing thalami. We hypothesized that the apparent diffusion coefficient (ADC) values would be different in CSVD and MS, since the extent of arterial involvement is different in these two diseases. METHODS: DWI was performed for 50 patients with CSVD and 35 patients with MS along with gender- and age-matched controls whose conventional MRI revealed normal findings. DWI was done with 1.5 Tesla MR devices using echo planar imaging (EPI) for b = 0, 1000 s/mm(2). ADC values were obtained from the thalami which appeared normal on T2-weighted and FLAIR images. Standard oval regions of interest (ROIs) of 0.5 cm(2) which were oriented parallel to the long axis of the thalamus were used for this purpose. RESULTS: The mean ADC value of the thalamus was (0.99 ± 0.16) × 10(-3) mm(2)/s in patients with CSVD, whereas the mean ADC value was (0.78 ± 0.06) × 10(-3) mm(2)/s in the control group. The mean ADC value was significantly higher in patients with CSVD compared to the controls (p < 0.001). The mean ADC values of the thalamus were (0.78 ± 0.08) × 10(-3) mm(2)/s in MS patients, and (0.75 ± 0.08) × 10(-3) mm(2)/s in the control group, which are not significantly different (p > 0.05). CONCLUSION: Our study revealed a difference in the diffusion of the thalami between CSVD and MS. DWI may aid in the radiological disease differentiation.
Asunto(s)
Enfermedades de los Pequeños Vasos Cerebrales/diagnóstico , Imagen de Difusión por Resonancia Magnética/métodos , Esclerosis Múltiple/diagnóstico , Tálamo/patología , Adulto , Anciano , Estudios de Casos y Controles , Enfermedades de los Pequeños Vasos Cerebrales/patología , Medios de Contraste , Diagnóstico Diferencial , Femenino , Humanos , Interpretación de Imagen Asistida por Computador , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/patología , Estudios ProspectivosRESUMEN
OBJECTIVE: To analyze and classify normal MRI tectum length and colliculus dimensions according to age and gender. METHODS: Tectum length and colliculus diameters were measured on the T1 midsagittal and axial cranial MR images in the radiology archive of 532 (344 women, 188 men) patients aged 37.36+/-21.49 (range: 4-91) years old on average, and with no disorders affecting the mesencephalic tectum. All 532 patients underwent clinical MR imaging of the cranium at the MRI Unit of Sivas Numune Hospital and Sivas Cumhuriyet University Hospital, Sivas, Turkey between February and December 2011. RESULTS: Although there was a positive linear correlation between tectum length and age, there was a negative correlation between the anteroposterior diameter of the colliculus superior and colliculus inferior and age (p<0.01). While tectum length (M3) increases with age, the anteroposterior diameter of the colliculus superior and inferior (M1 and M2) decreased (p<0.01). The colliculi were larger, and the tectum was longer in men. Although there was no difference in size between right and left superior colliculi, the left colliculus inferior was larger than the right one. CONCLUSION: In addition to the fact that normal mesencephalic tectum dimensions provide information on the brain development of individuals, they may also be beneficial for the detection and treatment of related pathologies.
Asunto(s)
Colículos Inferiores/anatomía & histología , Imagen por Resonancia Magnética/normas , Estándares de Referencia , Colículos Superiores/anatomía & histología , Techo del Mesencéfalo/anatomía & histología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Factores Sexuales , Adulto JovenRESUMEN
BACKGROUND: Arachnoid cysts are congenital fluid-filled compartments within the cerebrospinal fluid cisterns and cerebral fissures. They most commonly occur sporadically, and familial occurrence has rarely been reported. In this study, we showed the first genetic linkage in the literature in a pure intracranial arachnoid cyst family with autosomal recessive trait. METHODS: We identified an intracranial arachnoid cyst family in southern Turkey whose six of seven offspring had intracranial arachnoid cysts in different localizations, and collected venous blood from seven offspring of the family. Whole-genome linkage analysis was performed in all offspring. RESULTS: A theorical maximum logarithm of the odds score of 4.6 was identified at chromosome 6q22.31-23.2. This result shows strong genetic linkage to this locus. CONCLUSIONS: We present the first genetic linkage analysis result in a pure intracranial arachnoid cyst family in literature. Further investigation of this linkage area can reveal a causative gene causing the intracranial arachnoid cyst phenotype and can illuminate the pathogenesis of this disease.
Asunto(s)
Quistes Aracnoideos/genética , Aberraciones Cromosómicas , Cromosomas Humanos Par 6/genética , Genes Recesivos , Adulto , Quistes Aracnoideos/diagnóstico , Niño , Consanguinidad , Variaciones en el Número de Copia de ADN/genética , Femenino , Frecuencia de los Genes/genética , Ligamiento Genético/genética , Genotipo , Homocigoto , Humanos , Imagen por Resonancia Magnética , Masculino , Linaje , Fenotipo , Polimorfismo de Nucleótido Simple/genética , TurquíaRESUMEN
A 21-year-old woman was admitted due to altered mental status and hypothermia. The patient had a diagnosis of neuromyelitis optica (NMO) for 12 years and she was positive for serum anti-aquaporin 4 antibody. On admission, physical examination revealed coma with decerebration rigidity and poikilothermia. Magnetic resonance images of the brain revealed widespread, gadolinium enhancing lesions in the periventricular areas and the diencephalic structures. Laboratory investigations revealed hyponatremia and hypothyroidism. The patient was treated with high dose steroids. Both symptomatic and asymptomatic brain lesions may develop in patients with NMO. However, poikilothermia has not been reported in patients with NMO before.
Asunto(s)
Regulación de la Temperatura Corporal/fisiología , Encéfalo/patología , Trastornos de la Conciencia/complicaciones , Neuromielitis Óptica/complicaciones , Neuromielitis Óptica/patología , Trastornos de la Sensación/etiología , Femenino , Humanos , Imagen por Resonancia Magnética , Adulto JovenRESUMEN
We report a case with recurrent, transient attacks of slurred speech, weakness, and numbness of the right half of the face and the right arm without seizure activity, accompanied by headache and double vision. Neurologic examination revealed bilateral papilledema and right abducens palsy. Brain magnetic resonance imaging revealed thrombosis of the dural venous sinuses and the cortical veins, with no evidence of parenchymal lesion. Homozygous mutations were found for methylenetetrahydrofolate reductase (MTHFR) A1298C and MTHFR CG677T. Anticoagulation with heparin and warfarin resulted in prompt cessation of the transient attacks, as well as the signs and symptoms of increased intracranial pressure. This report documents that, although rare, transient ischemic attacks can result from cerebral venous thrombosis.
Asunto(s)
Ataque Isquémico Transitorio/enzimología , Ataque Isquémico Transitorio/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Mutación Puntual/genética , Trombosis de los Senos Intracraneales/enzimología , Trombosis de los Senos Intracraneales/genética , Venas Cerebrales/diagnóstico por imagen , Venas Cerebrales/patología , Venas Cerebrales/fisiopatología , Diagnóstico Diferencial , Homocigoto , Humanos , Ataque Isquémico Transitorio/diagnóstico , Masculino , Metilenotetrahidrofolato Reductasa (NADPH2)/deficiencia , Radiografía , Trombosis de los Senos Intracraneales/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: The objective of this study is the classification of the thickness of diploe and dimensions of cranium at different points of cranium in men and women according to age groups. MATERIAL AND METHOD: In the radiology archive, measurements were made at different points in magnetic resonance (MR) images of 305 (188 females and 117 males) patients, the average ages of whom were 40.98±20.44 (age range: 4-90) and who had no disorder of the bones. To determine diploe thickness, midfrontal, back and front bregma, lambda, opisthocranion and euryon points were used in the measurement. As for the determination of cranial volume, distances between glabella-opisthocranion, basion-vertex, basion-opisthion, euryon-euryon, nasion-basion, nasion-bregma, bregma-lambda and lambda-opisthocranion were measured. The data were loaded to Statistical Package for the Social Sciences (SPSS) 16.0 program. T-test, Mann-Whitney U, Pearson correlation coefficient and Kruskal-Wallis variance analysis were used in the statistical assessment. Results with a p value smaller than 0.05 were accepted as significant. RESULTS: There was a statistically significant positive correlation between age and diploe thickness in all measurement points. The diploe thickness was also increased with age (p<0.05). In all points, average diploe thickness was higher in age 61 and over than the other groups (p<0.001). At the same time, diploe thickness in parietal bones was lower than frontal and occipital bones in both sexes. According to craniometric results cranium in males was bigger (p<0.001). While the distance between glabella-opisthocranion increased in both sexes aged 61 and over, basion-vertex height decreased in women in the same group (p<0.05). Interestingly, there was no meaningful statistical difference among age groups in terms of maximum cranial width (p>0.05). Foramen magnum length decreased related to age in both men and women (p<0.001). CONCLUSION: These results related to diploe thickness and cranium dimension may be leading in the determination of sex and age; surgical interventions to the cranium and bone graft choice may increase the reliability of the operation.
Asunto(s)
Cefalometría , Imagen por Resonancia Magnética , Cráneo/anatomía & histología , Adolescente , Adulto , Determinación de la Edad por el Esqueleto , Anciano , Anciano de 80 o más Años , Envejecimiento , Niño , Preescolar , Femenino , Antropología Forense , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Determinación del Sexo por el Esqueleto , Turquía , Adulto JovenAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Glioblastoma/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/administración & dosificación , Bevacizumab , Neoplasias Encefálicas/patología , Dacarbazina/administración & dosificación , Dacarbazina/análogos & derivados , Femenino , Glioblastoma/patología , Humanos , Imagen por Resonancia Magnética , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Pronóstico , Inducción de Remisión , TemozolomidaRESUMEN
Cerebral venous thrombosis rarely develops after lumbar puncture and spinal anesthesia with accidental dural puncture, however, occurrence of isolated cortical vein thrombosis after epidural anesthesia is extremely rare. We report three cases who developed postural headache and isolated cortical vein thrombosis after epidural anesthesia. We postulate that intracranial hypotension is the cause of compensatory venous dilatation and resultant thrombosis.
Asunto(s)
Anestesia Epidural/efectos adversos , Venas Cerebrales , Trombosis Intracraneal/complicaciones , Adulto , Encéfalo/irrigación sanguínea , Encéfalo/patología , Venas Cerebrales/patología , Femenino , Humanos , Trombosis Intracraneal/diagnóstico , Trombosis Intracraneal/patología , Imagen por Resonancia Magnética , Masculino , Cefalea Pospunción de la Duramadre/complicaciones , Cefalea Pospunción de la Duramadre/diagnóstico , Cefalea Pospunción de la Duramadre/patología , Adulto JovenAsunto(s)
Daño Encefálico Crónico/patología , Dislexia/patología , Enfermedad de Hashimoto/patología , Agrafia/complicaciones , Agrafia/patología , Agrafia/psicología , Encéfalo/patología , Daño Encefálico Crónico/complicaciones , Daño Encefálico Crónico/psicología , Dislexia/complicaciones , Dislexia/psicología , Femenino , Enfermedad de Hashimoto/complicaciones , Enfermedad de Hashimoto/psicología , Cefalea/complicaciones , Humanos , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Persona de Mediana Edad , Cintigrafía , Pruebas de Función de la Tiroides , Glándula Tiroides/diagnóstico por imagenRESUMEN
The cerebral vessels are innervated by sympathetic, parasympathetic, and sensory nerves. A sensory innervation of the cerebral vessels originating in the trigeminal ganglion has been described in a number of species by several investigations. It has been shown that the electrical stimulation of the trigeminal ganglion causes an increase of cerebral cortical blood flow (CCoBF). The aim of the present study was to determine the effects of dental electrical stimulation the CCoBF in rabbits. A stimulating electrode was located in the upper right incisor tooth of rabbits and trigeminal ganglion was stimulated orthodromically via the infraorbital nerve. Variations in the cortical CCoBF were evaluated by laser-Doppler flowmetry. In experiment group, CCoBF increased together with the beginning of electrical stimulation (5 V, 0.5-ms impulse duration, square-shaped, 10-Hz frequency). The right and left hemisphere CCoBF values of stimulation period at 15s, 30s, 45s, 60s, 75s, and 90s were significantly higher than those of baseline and 105 and 120s (p < 0.05). The maximum increase in right and left CCoBF was 15.6% and 15.1% respectively. In post-stimulation period, the right CCoBF decreased gradually and returned to the baseline values at 120 s. In experiment groups, the CCoBF values of right hemisphere were comparable that of left hemisphereL (p > 0.05). This study demonstrated that the electrical stimulation of the trigeminal nerve's infraorbital branch via dental pulp increases the cortical right and left CCoBF under physiological conditions.
Asunto(s)
Circulación Cerebrovascular/fisiología , Incisivo/fisiología , Animales , Presión Sanguínea/fisiología , Pulpa Dental/fisiología , Estimulación Eléctrica , Femenino , Lateralidad Funcional/fisiología , Concentración de Iones de Hidrógeno , Incisivo/inervación , Flujometría por Láser-Doppler , Masculino , Consumo de Oxígeno/efectos de los fármacos , ConejosRESUMEN
Popliteal artery entrapment syndrome (PAES) is a disorder of the young age group characterized by ischemia of the lower extremities due to an abnormal association between the popliteal artery and adjacent musculotendinous structures. Several underlying anatomical abnormalities causing this syndrome are described and classified. In this study, we present an unusual case of PAES along with multidetector computed tomographic angiography findings.
Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Arteriopatías Oclusivas/complicaciones , Isquemia/etiología , Músculo Esquelético/diagnóstico por imagen , Anomalías Musculoesqueléticas/diagnóstico por imagen , Arteria Poplítea/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Malformaciones Vasculares/diagnóstico por imagen , Anomalías Múltiples/cirugía , Adulto , Arteriopatías Oclusivas/diagnóstico por imagen , Arteriopatías Oclusivas/etiología , Arteriopatías Oclusivas/cirugía , Femenino , Humanos , Isquemia/diagnóstico por imagen , Isquemia/cirugía , Músculo Esquelético/anomalías , Músculo Esquelético/cirugía , Anomalías Musculoesqueléticas/complicaciones , Anomalías Musculoesqueléticas/cirugía , Arteria Poplítea/anomalías , Arteria Poplítea/cirugía , Síndrome , Resultado del Tratamiento , Malformaciones Vasculares/complicaciones , Malformaciones Vasculares/cirugíaRESUMEN
OBJECTIVE: We wanted to compare the efficacies of 95% ethanol and 20% hypertonic saline (HS) sclerotherapies that were performed in a single session under CT guidance for the management of simple renal cysts. MATERIALS AND METHODS: A prospective series of 74 consecutive patients (average age: 57.6 +/- 8.1 years) with simple renal cysts were enrolled in this study. They were randomized into two groups and 95% ethanol or 20% HS, respectively, corresponding to 25% of the aspiration volume, was injected. Treatment success was determined six months later with follow-up clinical evaluation and performing ultrasonography. RESULTS: The sclerotherapy was accepted as technically successful without major complications in all except two patients who were excluded because of a communication between the simple renal cyst and the pelvicalyceal collecting system. Thirty-six patients in the ethanol group received sclerotherapy with 95% ethanol and 36 patients in the HS group underwent sclerotherapy with 20% HS. The complete regression ratio of the ethanol group was significantly higher (94% versus 72%, respectively) than that of the HS group. There was one patient with partial regression in each group. The failure ratio of the ethanol group was significantly lower (3% versus 25%, respectively) than that of the HS group. CONCLUSION: Ethanol sclerotherapy under CT guidance is a successful and safe procedure and it can be used for the treatment of simple renal cysts. Sclerotherapy with 95% ethanol is more effective than 20% HS sclerotherapy. Sclerotherapy with HS may be an option for patients preferring to undergo a less painful treatment procedure.
Asunto(s)
Etanol/uso terapéutico , Enfermedades Renales Quísticas/tratamiento farmacológico , Soluciones Esclerosantes/uso terapéutico , Escleroterapia/métodos , Tomografía Computarizada por Rayos X/métodos , Adulto , Anciano , Etanol/administración & dosificación , Femenino , Estudios de Seguimiento , Humanos , Riñón/diagnóstico por imagen , Riñón/efectos de los fármacos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Solución Salina Hipertónica/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/efectos adversos , Resultado del Tratamiento , UltrasonografíaRESUMEN
A previously healthy 14-year-old girl presented with a 1-year history of abdominal pain that had worsened during the past 4 days. She had a right lower abdominal mass that was initially diagnosed as an ovarian tumor. MR imaging revealed a unilaterally enlarged and partially torted left polycystic ovary. Polycystic ovary is a common cause of increased ovarian volume in women of reproductive age. It is characterized by numerous small peripherally located follicles and increased stroma. It may mimic a neoplasm and lead to difficulties in diagnosis. In this case report, we discuss the unusual MR imaging findings and the pitfalls in diagnosis.
Asunto(s)
Imagen por Resonancia Magnética , Neoplasias Ováricas/diagnóstico , Síndrome del Ovario Poliquístico/diagnóstico , Adolescente , Diagnóstico Diferencial , Femenino , HumanosAsunto(s)
Equinococosis/cirugía , Antebrazo/parasitología , Músculo Esquelético/parasitología , Adulto , Animales , Biopsia con Aguja/métodos , Equinococosis/diagnóstico por imagen , Femenino , Antebrazo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Músculo Esquelético/diagnóstico por imagen , RadiografíaRESUMEN
It is well known that ceftriaxone leads to pseudolithiasis in some patients. Clinical and experimental studies also suggest that situations causing gallbladder dysfunction, such as fasting, may have a role for the development of pseudolithiasis. In this study, we prospectively evaluated the incidence and clinical importance of pseudolithiasis in paediatric surgical patients receiving ceftriaxone treatment, who often had to fast in the post-operative period. Fifty children who were given ceftriaxone were evaluated by serial abdominal sonograms. Of those, 13 (26%) developed biliary pathology. Comparison of the patients with or without pseudolithiasis revealed no significant difference with respect to age, sex, duration of the treatment and starvation variables. After cessation of the treatment, pseudolithiasis resolved spontaneously within a short period. The incidence of pseudolithiasis is not affected by fasting.