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1.
Braz. j. oral sci ; 20: e219912, jan.-dez. 2021. ilus
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1254429

RESUMEN

Aim: Evaluation of the reliability of 3D computed tomography (3D-CT) in the diagnosis of mandibular fractures. Methods: A cross-sectional, quantitative and qualitative study was carried out, through the application of a questionnaire for 70 professionals in the area of Oral and Maxillofacial Surgery and Radiology. 3D-CT images of mandibular fractures were delivered to the interviewees along with a questionnaire. Participants answered about the number of traces, the region and the type of fracture. The correct diagnosis, that is, the expected answer, was based on the reports of a specialist in oral and maxillofacial radiology after viewing the images in the axial, sagittal and coronal sections. The resulting data from the interviewees was compared with the expected answer and then, the data was analyzed statistically. Results: In the sample 56.9% were between 22 and 30 years old, 52.8% were oral and maxillofacial surgeons (OMF), 34.7% were residents in OMF surgery and 12.5% OMF radiologists. Each professional answered 15 questions (related to five patients) and 50.8% of the total of these was answered correctly. Specialists in Oral and Maxillofacial Surgery and Traumatology correctly answered 53.9%. Interviewees with experience between 6 and 10 years correctly answered 58.2%. In identifying fracture traces, 46.1% of the questions were answered correctly. In terms of location, 5.6% of interviewees answered wrongly while 14.2% answered wrongly regarding classification. Conclusion: 3D computed tomography did not prove to be a reliable image for diagnosing mandibular fractures when used alone. This made necessary an association with axial, sagittal and coronal tomographic sections


Asunto(s)
Humanos , Masculino , Femenino , Diagnóstico por Imagen , Tomografía Computarizada por Rayos X , Encuestas y Cuestionarios , Imagenología Tridimensional , Fracturas Mandibulares
2.
Ann Palliat Med ; 10(8): 8797-8807, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34488368

RESUMEN

BACKGROUND: CSF rhinorrhea is a type of CSF leakage caused by an aseptic abnormal passage between the subarachnoid space and the adjacent sinus and nasal cavity due to a cranial dural defect. At present, the value of computed tomography cisternography (CTC) in locating CSF rhinorrhea has been widely recognized, and magnetic resonance hydrography (MRH), as a heavy T2-weighted water imaging, plays a pivotal role in showing the location of the leak. In this paper, we retrospectively summarize the imaging manifestations seen at our hospital of patients with clinically confirmed CSF rhinorrhea at the skull base and evaluate the diagnostic value of different imaging methods in the localization of CSF rhinorrhea by means of preoperative imaging analysis using CTC and MRH. METHODS: Fifty-five patients with CSF rhinorrhea admitted to our department from October 2016 to January 2021 were retrospectively analyzed. The patients' conventional CT, CTC, and MRH imaging data were compared, and the location of the leak determined preoperatively matched the location of the leak found during surgery. Moreover, there was no recurrence during the follow-up period of 4 months to 3 years. RESULTS: There were statistically significant differences between the diagnostic positivity rate of CTC and spiral CT (χ2=16.755, P<0.00), and between the diagnostic positivity rate of cranial MRH and spiral CT (χ2=6.338, 6.338=0.01), and no statistically significant difference between the diagnostic positivity rate of CTC and cranial MRH (χ2=2.625, P=0.1). CONCLUSIONS: The combined use of imaging techniques has important practical significance for the proper treatment and prognostic evaluation of CSF rhinorrhea. CTC has the highest positive rate for the diagnosis of CSF rhinorrhea, followed by MRH, while spiral CT is safer. CTC and MRH can promote the diagnostic rate in determining the location of CSF rhinorrhea, and selective combined application can be an important guide to surgery.


Asunto(s)
Rinorrea de Líquido Cefalorraquídeo , Rinorrea , Rinorrea de Líquido Cefalorraquídeo/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
3.
Neurol India ; 69(4): 874-878, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34507404

RESUMEN

Context: Plain computed tomography (CT) of the brain is an important first-line investigation of choice in an acute neurologic setup. Unless clinically suspected concealed areas like the confluence of venous sinuses often go unnoticed. Diagnosing anemia, thrombosis, or polycythemia correlating the CT attenuation values might prove to be fruitful in early patient management where the mode of varied clinical presentations causes a clinical dilemma. Aims: 1) To determine the objective correlation between CT attenuation of the cerebral venous sinus and hemoglobin (Hb) as well as hematocrit (HCT) value and 2) to detect anemia from measuring venous sinus attenuation. Methods and Materials: An exploratory study design of 200 patients, who had plain CT of the head and Hb and HCT levels obtained within 24 h of the scan. Statistical Analysis Used: Two-tailed unpaired t-test was used to test the difference between two independent samples. Correlation and regression analyses were used to assess the correlation between two quantitative variables. Results: A significant correlation was observed between the Hb-Hounsfield unit (HU) and HCT-HU. The simple linear regression model revealed that HU (P value < 0.001) was significantly correlated with Hb and the regression model was, Hb = 2.1 + 0.2 × HU. Similarly, HU (P value < 0.001) was significantly correlated with HCT and regression model was HCT = 6.2 + 0.7 × HU. Conclusions: Objective attenuation values of dural sinuses on plain CT can be positively correlated with Hb and HCT values. Considering the cutoff of 35.5 HU, we were able to show the specificity of 100% for the detection of anemia.


Asunto(s)
Anemia , Senos Craneales , Anemia/diagnóstico por imagen , Encéfalo , Senos Craneales/diagnóstico por imagen , Hematócrito , Humanos , Tomografía Computarizada por Rayos X
4.
Neurol India ; 69(4): 925-930, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34507414

RESUMEN

Background: Screw diameters are currently available based on the literature available for the Western population. No data are available in such a large number of patients for the Indian population. Objective: The aim of this study was to define the average pedicle size available and to determine the angulation for placement of screws for C2 pedicle in the Indian population. We also try to determine the pedicle screw diameter which can be used universally in most Indian patients, considering the pedicle dimensions. Material and Methods: Retrospective morphometric analysis of CT scans of 247 patients (152 M, 95 F) was done to calculate the C2 pedicle width (PW), pedicle height (PH), pedicle length (PL), pedicle transverse angle (PTA) and the craniocaudal angulation (CCA) of the C2 pedicle. Results: Mean PW in females was 5.3 mm and in males it was 5.9 mm. This difference was statistically significant. The mean PH in the study population was 8.9 mm, while the mean PL was 29.7 mm. The mean PTA was 40.0 degrees and the CCA was 28.4 degrees. Conclusion: This is a morphometric analysis of the C2 pedicle which provides information for the surgeons to determine the safe site of entry and trajectory for the screw implantation. We conclude that a screw diameter of 2.7 mm can be safely implanted in a vast majority of the patient population.


Asunto(s)
Tornillos Pediculares , Vértebras Cervicales , Femenino , Humanos , Masculino , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
5.
J Med Case Rep ; 15(1): 466, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34507615

RESUMEN

BACKGROUND: Troponin levels can be elevated in various diseases other than acute myocardial infarction, including sepsis. In diseases without myocardial necrosis, the elevated troponin levels are relatively low and normalize quickly. CASE PRESENTATION: A 61-year-old Japanese man with impaired consciousness was transported to our hospital. He was diagnosed as having pneumonia and septic shock. His condition was severe, but his clinical course was good. However, his troponin level remained extremely high during admission; on the second day, it was higher than the measurable range. We consulted a cardiologist and performed echocardiography and myocardial perfusion scintigraphy but found no new ischemic changes. CONCLUSION: In septic shock, troponin levels can be extremely high, which can persist even after recovery, as in very large myocardial infarctions.


Asunto(s)
Sepsis , Choque Séptico , Ecocardiografía , Humanos , Masculino , Persona de Mediana Edad , Sepsis/diagnóstico , Tomografía Computarizada por Rayos X , Troponina
6.
JNMA J Nepal Med Assoc ; 59(233): 77-80, 2021 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-34508461

RESUMEN

Medulloepithelioma is a rare childhood embryonal tumor arising from the non-pigmented ciliary epithelium of the pars plicata. We report a case of an 11-year-old male who presented with painless loss of vision of the right eye for the last three years and progressively increasing mass on the superior aspect of the globe for the last three months. On ocular examination, a firm, non-tender mass of 4cm x 3cm was noted in the superior aspect of the globe. CT-Scan of the orbit was suggestive of a foreign body with a haemorrhage or infection. The patient underwent enucleation with minimal manipulation. Histopathological examination of the enucleated globe revealed medulloepithelioma. The intraocular medulloepithelioma presentation is often late and masquerading, which may lead to extraocular extension and metastasis and ultimately unfavorable prognosis.


Asunto(s)
Neoplasias Encefálicas , Tumores Neuroectodérmicos Primitivos , Neoplasias de la Úvea , Niño , Cuerpo Ciliar/diagnóstico por imagen , Cuerpo Ciliar/cirugía , Humanos , Masculino , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagen , Tumores Neuroectodérmicos Primitivos/cirugía , Tomografía Computarizada por Rayos X , Neoplasias de la Úvea/diagnóstico , Neoplasias de la Úvea/cirugía
7.
JNMA J Nepal Med Assoc ; 59(240): 757-759, 2021 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-34508466

RESUMEN

INTRODUCTION: Evan's index is useful to objectively see if ventricles size is abnormal especially in borderline cases of hydrocephalus. Studying ventricular size in CT scan is essential in every pathology of the brain. Use of objective parameters to define hydrocephalus helps us not only to diagnose a case but also follow up the case following treatment. The aim of this study was to find out the mean even index among patients visiting the department of radiology of a tertiary care hospital. METHODS: A descriptive cross-sectional study was conducted at a tertiary care hospital from 1st january 2020 to 31st December 2020. Ethical clearance was obtained from the Institutional Review Committee of Upendra Devkota Memorial Neurological and Allied Sciences (reference number: 116/2021). Computed tomography scans were done for various reasons in the hospital over a one year period and reported normal by the radiologists were included in the study. Convenient sampling was done. Statistical analysis was done using Statistical Package for the Social Sciences. Point estimate at 95% Confidence Interval was calculated along with mean and standard deviation for continuous data. RESULTS: In this study, among the 216 cases, the mean Evan's index was found to be 0.20±0.04. CONCLUSIONS: The mean evan's index in our study population was lower than the normal cut-off value.


Asunto(s)
Radiología , Tomografía Computarizada por Rayos X , Estudios Transversales , Humanos , Nepal , Centros de Atención Terciaria
8.
JNMA J Nepal Med Assoc ; 59(239): 712-715, 2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34508506

RESUMEN

There is hardly any report of reinfection due to coronavirus disease 2019 (COVID-19) in medical professionals from Nepal. We report a case of a 32-year-old doctor with COVID-19 reinfection. Symptoms during the first infection were mild. After one month, he was reinfected and developed diarrhea as well as a continuous high fever. His d-dimer and ferritin were much increased. Computed tomography chest showed bilateral lymph nodes, minimal pleural effusion, and scattered linear fibrosis. After discharge, his depression and myalgia persisted for one month. During reinfection, his symptoms were more severe and cost of treatment was almost eight times his monthly salary and he could not work for six weeks. Possible reasons for severe reinfection and differential diagnoses like cytokine storm, multisystem inflammatory syndrome, reactivation of COVID-19, and infection due to new variants were discussed. Whether infected or vaccinated or not, all should take recommended vaccination and primary-preventive as well as health-promotive measures.


Asunto(s)
COVID-19 , Médicos , Adulto , Humanos , Masculino , Reinfección , SARS-CoV-2 , Tomografía Computarizada por Rayos X
9.
J Med Case Rep ; 15(1): 452, 2021 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-34509175

RESUMEN

BACKGROUND: Impaction of foreign body is a common condition presented to ear, nose, and throat department among Asian population. The commonest foreign body seen among this population has been documented as fish bone. Fish bone can migrate to lateral neck space or related organs around the neck and chest. By presenting this case report, we aim to emphasize the importance of taking proper history and make clinicians aware of the possibility of a fish bone migrating into different spaces. This will help to prevent diagnosis delay leading to complications due to migrated fish bone. CASE PRESENTATION: A 50-year-old female Sinhalese patient presented to ear, nose, and throat department with right-sided neck pain for 2 days, who had a history of suspected fish bone impaction a few days ago that subsided without any investigations or treatments. She did not have any symptoms related to throat, and neck examination showed mild swelling and tenderness. Computer tomography revealed a migrated fish bone into the lateral neck close to carotid artery, and the fish bone was removed by neck exploration under general anesthesia without any complications. CONCLUSION: In conclusion, migrated fish bone should be suspected if patient is having persistent symptoms mainly in the neck without having difficulty swallowing and who gives a history of fish bone impaction and having negative laryngoscopic examination. Proper history taking is very important in the assessment of these patients to prevent misdiagnosis of the condition. Clinicians should aware that migrated fish bones are not uncommon and that early suspicion can prevent later diagnosis and complications.


Asunto(s)
Cuerpos Extraños , Migración de Cuerpo Extraño , Animales , Femenino , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/cirugía , Humanos , Persona de Mediana Edad , Cuello/diagnóstico por imagen , Alimentos Marinos , Tomografía Computarizada por Rayos X
10.
Zhonghua Yi Xue Za Zhi ; 101(34): 2717-2722, 2021 Sep 14.
Artículo en Chino | MEDLINE | ID: mdl-34510879

RESUMEN

Objective: To evaluate the diagnostic efficacy of combined diagnostic model based on extreme gradient boosting (XGBoost) algorithm to determine the pathological grading of gastric neuroendocrine neoplasms (NENs). Methods: A total of 81 gastric NENs patients in the First Affiliated Hospital of Zhengzhou University confirmed by definite pathological grading from August 2012 to December 2019 were enrolled. The data of clinical and CT findings were collected. The number of lesions, tumor location, shape, lymph node metastasis, thickness, longitude of tumor and CT values in arterial and venous phase were analyzed. ITK-SNAP software and Python 2.1.0 PyRadiomics software were used to perform the image preprocessing and radiomics features extraction from segmented images. XGBoost algorithm was used to build the CT findings model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model. The diagnostic efficacy of CT imaging model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model were evaluated by accuracy, mean squared error (MSE) and mean absolute error (MAE). Results: The subjects were 28.0 to 78.0 (58.6+10.7) years old, including 56 males (69.1%). The number of lesions, tumor location, shape, lymph node metastasis, thickness and longitude of tumor between G1/G2 and G3 patients showed statistic significances (all P values<0.05), while there were no differences in CT values in arterial and venous phase (both P values>0.05). Six most important features in the combined diagnostic model were A_logarithm_glcm_Imc1, P_squareroot_glcm_Maximum Probability, thickness, longitude, A_wavelet-HHL_glrlm_GrayLevelNonUniformity and P_wavelet-LLL_ngtdm_Contrast, respectively. The accuracy of CT findings model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model were 81.8%, 86.0%, 87.8% and 91.0%, respectively; with MSE were 539.41, 490.08, 429.99 and 371.92, respectively; and MAE were 16.72, 15.25, 14.23 and 12.33, respectively. The MAE value of the combined diagnostic model was lower than those of CT findings model and radiomics model in arterial phase (P<0.001 and 0.004, respectively), while no statistically difference was detected compared to radiomics model in venous phase (P=0.111). Conclusion: The combined diagnostic model based on XGBoost algorithm have a good diagnostic efficiency for the pathological grading of gastric NENs.


Asunto(s)
Tumores Neuroendocrinos , Neoplasias Gástricas , Adulto , Anciano , Algoritmos , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Tumores Neuroendocrinos/diagnóstico por imagen , Tomografía Computarizada por Rayos X
11.
Nihon Shokakibyo Gakkai Zasshi ; 118(9): 884-889, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-34511556

RESUMEN

A 60-year-old male patient had alcoholic chronic pancreatitis. Three months prior, he had undergone an exchange of pancreatic duct stents. In December 201X-1, magnetic resonance imaging and computed tomography (CT) scan results showed a caput pancreatic mass and common bile duct dilatation. We considered that it was because of chronic pancreatitis and decided to follow up by imaging studies. Further, in March 201X, a CT scan result revealed worsening of the mass and bile duct dilation. We assessed the mass by endoscopic ultrasound and fine-needle aspiration. Histological findings revealed to an interstitial tissue infiltrated by several neutrophils and plasma cells and abscess-forming inflammation like sulfur granule. The mass was improved by antibiotic administration for 6 months.


Asunto(s)
Actinomicosis , Neoplasias Pancreáticas , Actinomicosis/diagnóstico por imagen , Actinomicosis/tratamiento farmacológico , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico , Endosonografía , Humanos , Masculino , Persona de Mediana Edad , Conductos Pancreáticos , Tomografía Computarizada por Rayos X
12.
Sensors (Basel) ; 21(17)2021 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-34502769

RESUMEN

Since the appearance of the COVID-19 pandemic (at the end of 2019, Wuhan, China), the recognition of COVID-19 with medical imaging has become an active research topic for the machine learning and computer vision community. This paper is based on the results obtained from the 2021 COVID-19 SPGC challenge, which aims to classify volumetric CT scans into normal, COVID-19, or community-acquired pneumonia (Cap) classes. To this end, we proposed a deep-learning-based approach (CNR-IEMN) that consists of two main stages. In the first stage, we trained four deep learning architectures with a multi-tasks strategy for slice-level classification. In the second stage, we used the previously trained models with an XG-boost classifier to classify the whole CT scan into normal, COVID-19, or Cap classes. Our approach achieved a good result on the validation set, with an overall accuracy of 87.75% and 96.36%, 52.63%, and 95.83% sensitivities for COVID-19, Cap, and normal, respectively. On the other hand, our approach achieved fifth place on the three test datasets of SPGC in the COVID-19 challenge, where our approach achieved the best result for COVID-19 sensitivity. In addition, our approach achieved second place on two of the three testing sets.


Asunto(s)
COVID-19 , Aprendizaje Profundo , Humanos , Pandemias , SARS-CoV-2 , Tomografía Computarizada por Rayos X
13.
J Med Case Rep ; 15(1): 461, 2021 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-34503570

RESUMEN

INTRODUCTION: We report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation. CASE PRESENTATION: An otherwise healthy 44-year-old white male from Egypt presented to the hospital with severe epigastric pain and over ten attacks of nonprojectile vomiting (first, gastric content, then bilious). Acute pancreatitis was suspected and confirmed by serum amylase, serum lipase, and computed tomography scan that showed mild diffuse enlargement of the pancreas. The patient did not have any risk factor for acute pancreatitis, and extensive investigations did not reveal a clear etiology. Given a potential occupational exposure, a nasopharyngeal swab for polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was done, which was positive despite the absence of the typical symptoms of severe acute respiratory syndrome coronavirus 2 such as fever and respiratory symptoms. The patient was managed conservatively. For pancreatitis, he was kept nil per os for 2 days and received intravenous lactated Ringer's (10 ml per kg per hour), nalbuphine, alpha chymotrypsin, omeprazole, and cyclizine lactate. For severe acute respiratory syndrome coronavirus 2, he received a 5-day course of intravenous azithromycin (500 mg per day). He improved quickly and was discharged by the fifth day. We know that abdominal pain is not a rare symptom of severe acute respiratory syndrome coronavirus 2, and we also know that elevated levels of serum amylase and lipase were reported in severe acute respiratory syndrome coronavirus-2 patients, especially those with severe symptoms. However, the association between severe acute respiratory syndrome coronavirus-2 infection and idiopathic acute pancreatitis is rare and has been reported only a few times. CONCLUSION: We believe further studies should be conducted to determine the extent of pancreatic involvement in severe acute respiratory syndrome coronavirus-2 patients and the possible causality between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis. We reviewed the literature regarding the association between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis patients. Published data suggest that severe acute respiratory syndrome coronavirus 2 possibly could be a risk factor for acute pancreatitis.


Asunto(s)
COVID-19 , Pancreatitis , Enfermedad Aguda , Adulto , Humanos , Masculino , Pancreatitis/diagnóstico , Pancreatitis/etiología , SARS-CoV-2 , Tomografía Computarizada por Rayos X
14.
Rozhl Chir ; 100(5): 243-245, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34465105

RESUMEN

INTRODUCTION: Pulmonary hernias are rare conditions, most are the results of an injury or previous thoracic surgery. CASE REPORT: We present a case of a 48-year-old woman injured in a car accident. The examination in the trauma centre revealed a chest injury with herniation of the lung parenchyma into the chest wall and fractures of long bones of lower limbs. Initially, an osteosynthesis of the left femur and the right tibia fracture were performed. The patient underwent a subsequent surgery to repair the pulmonary hernia. CONCLUSION: A pulmonary hernia is diagnosed either directly during a clinical examination or by imaging. A sovereign diagnostic method is a computed tomography. The method of treatment is a surgical repair with primary suture of the chest wall defect or implantation of a mesh to repair the pulmonary hernia.


Asunto(s)
Traumatismos Torácicos , Pared Torácica , Femenino , Hernia/diagnóstico por imagen , Hernia/etiología , Humanos , Pulmón , Persona de Mediana Edad , Traumatismos Torácicos/complicaciones , Traumatismos Torácicos/diagnóstico por imagen , Traumatismos Torácicos/cirugía , Tomografía Computarizada por Rayos X
15.
Rozhl Chir ; 100(7): 357-360, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34465113

RESUMEN

INTRODUCTION: Primary retroperitoneal mucinous cystadenoma (PRMC) and its malignant variant - cystadenocarcinoma are extremely rare tumors known only from case studies and reviews. PRMC is a cystic tumor of the retroperitoneum, which remains asymptomatic for a long time and can reach significant proportions. It occurs mainly in women. CASE REPORT: We present the case of a 38-year-old healthy woman with diagnosed resistance in the right mesogastrium during a c-section. The delivery was terminated without a surgical intervention. The above mentioned resistance was examined further by ultrasound, computed tomography and magnetic resonance imaging. All imaging examinations showed a solid - cystic bilocular expansion, which looked like a mesenteric cyst in the right paracolic area. The patient was asymptomatic at all times, with only a palpable resistance of the abdominal wall. In November 2020, the patient underwent an elective surgery - extirpation of the cystic tumor and prophylactic appendectomy. The operation was performed classically, via midline laparotomy without perioperative perforation of the cystic tumor and without complications in the postoperative period. The histopathological examination showed a malignant variant of PRMC. So far, the patient remains free of any problems and is followed at the department of oncology. CONCLUSION: The goal of treatment is to achieve complete surgical removal of the tumor without its perioperative perforation. Due to the rare occurrence of the disease, there are no guidelines for the diagnosis and treatment of PRMC. Precisely because PRMC is a rare tumor, it should be part of the differential diagnosis of cystic tumors of the retroperitoneum, especially when young women are concerned.


Asunto(s)
Cistadenocarcinoma Mucinoso , Cistoadenoma Mucinoso , Neoplasias Retroperitoneales , Adulto , Cistadenocarcinoma Mucinoso/diagnóstico por imagen , Cistadenocarcinoma Mucinoso/cirugía , Femenino , Humanos , Imagen por Resonancia Magnética , Embarazo , Neoplasias Retroperitoneales/diagnóstico por imagen , Neoplasias Retroperitoneales/cirugía , Tomografía Computarizada por Rayos X
16.
Rozhl Chir ; 100(6): 278-283, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34465117

RESUMEN

INTRODUCTION: The exact location of the original tumor should be known for a targeted increase in the dose to the tumor bed after breast cancer surgery. Therefore, at our site, we perform CT examinations of patients in the radiation position before breast cancer surgery. METHODS: Preoperative native CT scans were performed in the patients in the planning position for radiotherapy; these data were fused with standard planning CT for boost irradiation. We evaluated whether the tumor was accurately identifiable in preoperative CT scans. We also contoured one irradiation volume in the standard planning CT scans and the other in the fusion CT scans with preoperative examination, and compared these volumes. RESULTS: Out of the total number of 554 patients, we were able to identify the exact location of the breast tumor in 463 cases (83.6 %). In a group of 50 randomly selected patients, the clinical target volume for the boost dose to the postlumpectomy cavity was changed in 20 patients (40%) - decreased in 9 cases (18%) and increased in 11 cases (22%). CONCLUSION: As shown by the results of our study, preoperative CT in the planning position can be used in patients with confirmed breast cancer. This method allows us to more accurately locate the tumor bed and thus more accurately draw the target volume for boost irradiation. We confirmed that preoperative CT had an impact on the size of the target volume.


Asunto(s)
Neoplasias de la Mama , Mama , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Femenino , Humanos , Mastectomía Segmentaria , Tomografía Computarizada por Rayos X
17.
Rev Peru Med Exp Salud Publica ; 38(2): 206-213, 2021.
Artículo en Español, Inglés | MEDLINE | ID: mdl-34468566

RESUMEN

OBJECTIVES: To determine chest CT findings associated with severity and mortality in patients with COVID-19 from the Hospital Nacional Edgardo Rebagliati Martins (HNERM) and propose cut-off values for a tomographic severity score (TSS). MATERIALS AND METHODS: A retrospective cohort study was conducted in 254 patients with COVID-19 who underwent chest CT as part of their initial evaluation at the emergency room; they were classified according to clinical severity. Main tomographic findings were described. A multivariate analysis with logistic regression was carried out to determine association with clinical severity, the Cox model was used to evaluate mortality, and ROC curves were elaborated to assess cutoff values for the TSS. RESULTS: CT findings associated with clinical severity were the following: diffuse pattern (OR: 3.23, 95% CI: 1.46-7.14), crazy-paving pattern (OR: 2.48; 95% CI: 1.08-5.68), and high TSS value (OR: 1.73; 95% CI: 1.49-2.02). The crazy-paving pattern (HR: 1.78; 95% CI: 1.03-3.06) and a high TSS value (HR: 1.33; 95% CI: 1.20-1.48) were found to be associated with mortality. A value of 7 in the TSS showed a sensibility of 94.4% and a specificity of 100% for moderate disease, and a value of 13 showed a sensibility of 84.9% and a specificity of 70.6% for severe disease. CONCLUSIONS: The diffuse pattern is associated with higher clinical severity. The crazy-paving pattern and a high TSS value are associated with higher clinical severity and mortality. We propose TSS cutoff values of 7 and 13 for moderate and severe disease, respectively.


Asunto(s)
COVID-19 , Humanos , Pulmón , Estudios Retrospectivos , SARS-CoV-2 , Tomografía Computarizada por Rayos X
18.
Saudi Med J ; 42(9): 981-985, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34470836

RESUMEN

OBJECTIVES: To investigate the ethmoid infundibulum (EI) and maxillary sinus natural ostium (MSNO) dimensions in normal sinuses of the Asian population; identified variation between sides, gender, and age groups; and to assess the effects of such variation on the measurements. METHODS: We assessed EI dimension and MSNO diameter in computed tomography (CT) scans of the normal paranasal sinus of 100 patients who underwent trans-sphenoid endoscopic surgery. We compared demographic data and multiple anatomical variations. RESULTS: The gap difference in EI length between the right and left sides significantly differed from 0 (0.47±1.38 mm). We found wider EI in people aged ≥60 years (2.44±0.59 mm), compared to people aged <60 years (2.25±0.31 mm). Ethmoid infundibulum length was greater among individuals with Haller cells (8.84±1.56 mm) than in individuals without them (7.92±1.47 mm). Furthermore, MSNO diameter was greater with accessory ostium (3.48±0.77 mm versus 3.02±0.72 mm, presence versus accessory ostium absence). CONCLUSION: Multiple factors may affect EI and MSNO dimensions. Ethmoid infundibulum length differed between both sides. Ethmoid infundibulum width differed between individuals aged ≥60 years and individuals aged <60 years. Haller cells and accessory ostium presence were associated with significant differences in those measurements.


Asunto(s)
Endoscopía , Seno Maxilar , Humanos , Seno Maxilar/diagnóstico por imagen , Hipófisis , Tomografía Computarizada por Rayos X
19.
Anticancer Res ; 41(9): 4417-4422, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34475063

RESUMEN

BACKGROUND/AIM: Ovarian carcinoma is the fifth leading cause of cancer-related deaths in women in the United States. Serous papillary carcinoma is the most common histological type of ovarian carcinoma that often goes undetected until it has spread within the pelvis and abdomen leading to poor prognosis. Translation of next-generation sequencing (NGS) technology into personalized medicine and identification of new potential targets for therapeutic applications may be helpful. CASE REPORT: We report a case of a 59-year-old female who initially presented in the emergency department with increasing abdominal girth, and bloating. Computed tomography showed ascites and omental and pelvic masses. Fine needle biopsy of the omental mass showed high-grade papillary adenocarcinoma consistent with high-grade ovarian serous carcinoma. She was treated with chemotherapy followed by debulking surgery. Primary ovarian serous carcinoma and synchronous primary fallopian tube serous carcinoma with multiple leiomyomas were identified in the surgical specimen. Pleural biopsy was also positive for carcinoma. NGS and programmed death-ligand 1 (PD-L1) expression testing were performed in the ovarian serous carcinoma. The results showed mutations of breast cancer type 1 (BRCA1) and type 2 (BRCA2), tumor protein p53 (TP53) (c.524G>A at pR175H), and heat shock protein 90 alpha family class B member 1 (HSP90AB1) (p.R456C), as well as low RNA expression score of PD-L1. CONCLUSION: Identification of these mutations and PD-L1 abnormality at the diagnosis of ovarian carcinoma may shed light for clinicians to provide targeted therapy with poly (ADP-ribose) polymerase (PARP) inhibitors and immune checkpoint inhibitors for ovarian serous carcinoma. This is the first documented case of ovarian serous carcinoma to have found a HSP90AB1 (p.R456C) mutation.


Asunto(s)
Cistadenocarcinoma Seroso/genética , Neoplasias de las Trompas Uterinas/genética , Proteínas HSP90 de Choque Térmico/genética , Leiomiomatosis/genética , Neoplasias Primarias Múltiples/genética , Neoplasias Ováricas/genética , Biopsia con Aguja Fina , Cistadenocarcinoma Seroso/tratamiento farmacológico , Cistadenocarcinoma Seroso/cirugía , Procedimientos Quirúrgicos de Citorreducción , Quimioterapia , Neoplasias de las Trompas Uterinas/tratamiento farmacológico , Neoplasias de las Trompas Uterinas/cirugía , Femenino , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Leiomiomatosis/tratamiento farmacológico , Leiomiomatosis/patología , Leiomiomatosis/cirugía , Persona de Mediana Edad , Mutación , Neoplasias Primarias Múltiples/tratamiento farmacológico , Neoplasias Primarias Múltiples/cirugía , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/cirugía , Análisis de Secuencia de ADN , Tomografía Computarizada por Rayos X , Estados Unidos
20.
Anticancer Res ; 41(9): 4479-4482, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34475072

RESUMEN

BACKGROUND/AIM: This study determined whether computed tomography (CT) is an appropriate means by which to differentiate non-invasive and minimally invasive forms of pulmonary adenocarcinoma from the invasive variant. PATIENTS AND METHODS: A total of 64 patients (38 men and 26 women, aged 42-76, mean age 64), who underwent surgery for pulmonary adenocarcinoma and a chest CT no less than 1 month before surgery, were included in the study. Lesions exhibiting ground glass opacity or ground glass opacity with a solid component of 5 mm or smaller, were defined as minimally invasive or non-invasive adenocarcinomas. CT findings were correlated with histopathological examination. RESULTS: Distinguishing minimally invasive and non-invasive adenocarcinoma from invasive adenocarcinoma using CT was achieved with a sensitivity of 77.7%, a specificity of 97.8%, a positive predictive value of 93.3%, and a negative predictive value of 91.8%. CONCLUSION: CT can be useful in assessing the degree of invasiveness of pulmonary adenocarcinoma and is a potential tool for the individualization of treatment.


Asunto(s)
Adenocarcinoma del Pulmón/patología , Adenocarcinoma del Pulmón/cirugía , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/cirugía , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Adenocarcinoma del Pulmón/diagnóstico por imagen , Adulto , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Medicina de Precisión , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X
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