ABSTRACT
PURPOSE: To illustrate that residual normal pituitary gland may show hyperintense signal on T1-weighted image after medical treatment of pituitary prolactinoma. MATERIAL: and methods. Three patients treated with bromocriptine for a prolactinoma and showing hyperintense signal of the residual normal pituitary tissue on T1-weighted images were studied. In all patients, measurements of the anterior pituitary gland signal (APGS) and the temporal lobe white matter signal (TLWMS) were obtained by a "region of interest" (ROI) on coronal T1-weighted images. The APGS/TLWMS ratios were calculated and compared to those of a control group of 30 normal subjects. RESULTS: In the three patients, the measurements obtained by ROI confirmed the visual impression of high signal of the residual normal pituitary tissue. Ratios were ranging from 1.15 to 1.21, while they were ranging, in the control group from 0.92 to 1.09. CONCLUSION: In patients with prolactin-secreting adenoma seen after medical treatment, high signal of the residual normal pituitary tissue can be observed, probably due to cellular hyperactivity as it can be noticed during some physiological states. This pattern has to be differentiated from other pituitary abnormalities demonstrating T1 hyperintensity such as hemorrhagic changes of a prolactinoma.
Subject(s)
Magnetic Resonance Imaging , Pituitary Gland, Anterior/pathology , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/drug therapy , Prolactinoma/diagnosis , Prolactinoma/drug therapy , Adult , Bromocriptine/therapeutic use , Drug Monitoring , Female , Humans , Pituitary Neoplasms/blood , Prolactin/antagonists & inhibitors , Prolactin/blood , Prolactinoma/blood , Retrospective Studies , Treatment OutcomeABSTRACT
We present the case of a patient who experienced residual ischemic symptoms and invalidating chronic pain after an injury where three fingers of his left hand were sliced off by a chain saw. He underwent 5 stellate ganglion RF neurolysis over a two year period, followed by progressive and complete pain relief. We will underscore the value of CT guidance during needle placement and the efficacy of RF neurolysis.
Subject(s)
Amputation, Traumatic/complications , Electrosurgery , Finger Injuries/complications , Pain/surgery , Stellate Ganglion/surgery , Adult , Follow-Up Studies , Humans , Male , Pain/etiology , Radiography, Interventional , Stellate Ganglion/diagnostic imaging , Time FactorsABSTRACT
Gas-containing gallstones are well-known in vitro. The typical triradiate arrangement of fissures filled with gas, first described on abdominal plain films, was named by Meyers the "Mercedes-Benz" sign. This sign is absent of the recent literature. We report a case where gas was the only CT sign suggesting the presence of gallstones in the gallbladder.