Unusual Presentation of Prostate Cancer: A Case Report.

Prostate cancer is the second-most common malignancy in males. Despite more frequently metastasizing to the bone, regional lymph nodes, and liver, the brain can also be affected. These metastases can simulate meningiomas, making the diagnosis more difficult. Here, we report the case of a 62-year-old male with a sudden onset of confusion and dysarthria with spontaneous resolution but amnesia for the event. On a neurological exam, the patient had left exophthalmos and palpebral ptosis. He was referred to the emergency room, where he underwent a cranioencephalic CT, which revealed a left anterior temporal lesion with adjacent edema suggestive of meningioma, later confirmed by an MRI. Due to the worsening of the symptoms and an increase in the size of the lesion, total resection was proposed. The anatomopathological study revealed a poorly differentiated carcinoma. To study the primary tumor, a CT of the thorax, abdomen, and pelvis; a spine MRI; and a complementary study with prostate-specific antigen were requested. These studies revealed a prostate adenocarcinoma with brain and bone metastases. After the diagnosis, the patient underwent hormone therapy, chemotherapy, and palliative radiotherapy.

Spontaneous splenoazygos shunt in a patient with portal hypertension: an exceedingly rare occurrence

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Spontaneous splenoazygos shunt in a patient with portal hypertension: an exceedingly rare occurrence.

We present a case of a spontaneous splenoazygos shunt in a patient with liver cirrhosis and portal hypertension, detected by abdominal magnetic resonance imaging. Multiplanar reconstruction demonstrated communication of the splenic vein with the azygos vein that was dilated with a winding course along the mediastinum. This pathway for decompression of the portal vein is an exceedingly rare occurrence.

Infectious and Inflammatory Diseases of the Urinary Tract: Role of MR Imaging.

Urinary tract infection (UTI) is among the most common of bacterial infections. Imaging studies are only required in cases of complicated UTIs. Ultrasound remains the first-line imaging method; however, CT is the gold standard for evaluation of UTIs. MR imaging's improved contrast resolution and absence of ionizing radiation may recommend its use for assessment of lower UTIs. Furthermore, MR imaging performs with diagnostic accuracy at least similar to CT in complicated UTIs, except for the identification of calculi and emphysematous pyelonephritis. In this article, the role of MR imaging for the evaluation of infectious and inflammatory disease processes of the urinary tract is reviewed.

Magnetic resonance imaging ancillary features used in Liver Imaging Reporting and Data System: An illustrative review.

Hepatocellular carcinoma (HCC) usually develops in the setting of chronic liver disease. In the adequate clinical context, both multiphasic contrast-enhanced CT and magnetic resonance imaging are non-invasive modalities that allow accurate diagnosis and staging of HCC, although the latter demonstrates greater sensitivity and specificity. Imaging criteria for HCC diagnosis rely on hemodynamic features such as hyperenhancement in the arterial phase and washout in the portal or equilibrium phase. However, imaging performance drops considerably for small (< 20 mm) nodules because their tendency to exhibit atypical enhancement patterns. In order to improve accuracy in the diagnosis and staging of HCC, particularly in cases of atypical nodules, ancillary features, i.e., imaging characteristics that modify the likelihood of HCC, have been described and incorporated into clinical reports, especially in Liver Imaging Reporting and Data System. In this paper, ancillary imaging features will be reviewed and illustrated.

Transition from screen-film to computed radiography in a paediatric hospital: the missing link towards optimisation.

In paediatrics, the risks associated with ionising radiation should be a major concern, due to children's higher susceptibility to radiation effects. Measure entrance skin dose (ESD) in chest and pelvis X-ray projections and compare the results with the 'European guidelines on quality criteria for diagnostic radiographer images in paediatrics' in order to optimise radiological practice. ESD values were obtained using an ionisation chamber Diamentor M4 KDK (PTW) in 429 children, who underwent chest X-ray or pelvis X-ray in a Computed Radiography system. In the first phase of the study, data were collected according to protocols used in the department; in a second phase different tube voltage values were used according to patient weight. A third phase was carried out, only for chest X-ray, using the exposure parameters of phase 2, plus activating lateral ionisation chamber. Three paediatric radiologists blindly assessed image quality of chest X-ray, using a validated assessment available in the 'European guidelines on quality criteria for diagnostic radiographer images in paediatrics'. Considering all the patients submitted to chest X-ray, the average ESD was 0.22, 0.16 and 0.08 mGy, for phases 1, 2 and 3, respectively. For pelvis X-ray, the average ESD decreased from 1.18 mGy in phase 1 to 0.78 mGy in phase 2. Dose optimisation was achieved. ESD was reduced 63.6 and 33.9 % in chest and pelvis X-ray, respectively.