RESUMO
PURPOSE: The aim of this study is to describe the role of imaging in the medical care of Lemierre Syndrome and to describe its US, CT and MRI features. PATIENTS AND METHODS: Files of patients diagnosed with Lemierre Syndrome between 2005 and 2011 at CHUV hospital have been analysed retrospectively to define its imaging semiology. RESULTS: IJV thrombosis was demonstrated by US, CT and MRI. Septic pulmonary emboli were detected by CT. Complications of the Lemierre Syndrome were depicted by MR and CT. CONCLUSION: US, CT or MR evidence of IJV thrombosis and chest CT suggestive of septic emboli, should lead the physician to diagnose Lemierre Syndrome, which in case of insufficient therapy can lead to death.
But: Déterminer le rôle de l'imagerie dans la prise en charge du Syndrome de Lemierre, de décrire les caractéristiques radiologiques de cette maladie rare mais potentiellement mortelle. Patients et méthode: Analyse rétrospective des dossiers de patients diagnostiqués au CHUV avec un Syndrome de Lemierre entre 2005 et 2011 pour en définir une sémiologie spécifique. Résultats: Démonstration d'une thrombose de la VJI par l'US, le CT et l'IRM. Mise en évidence d'emboles septiques au CT. Description des complications du Syndrome de Lemierre par CT et IRM. Conclusion: La mise en évidence à l'US, au CT ou à l'IRM d'une thrombose de la VJI et la présence d'emboles septiques pulmonaires au CT devrait mener au diagnostic de Syndrome de Lemierre et permettre de traiter agressivement cette infection qui peut mener au décès du patient.
Assuntos
Diagnóstico por Imagem , Síndrome de Lemierre/diagnóstico , Adolescente , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Infecções por Fusobacterium/diagnóstico , Fusobacterium necrophorum , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Faringite/diagnóstico , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
First and second branchial arch syndromes (BAS) manifest as combined tissue deficiencies and hypoplasias of the face, external ear, middle ear and maxillary and mandibular arches. They represent the second most common craniofacial malformation after cleft lip and palate. Extended knowledge of the embryology and anatomy of each branchial arch derivative is mandatory for the diagnosis and grading of different BAS lesions and in the follow-up of postoperative patients. In recent years, many new complex surgical approaches and procedures have been designed by maxillofacial surgeons to treat extensive maxillary, mandibular and external and internal ear deformations. The purpose of this review is to evaluate the role of different imaging modalities (orthopantomogram (OPG), lateral and posteroanterior cephalometric radiographs, CT and MRI) in the diagnosis of a wide spectrum of first and second BAS, including hemifacial microsomia, mandibulofacial dysostosis, branchio-oto-renal syndrome, Pierre Robin sequence and Nager acrofacial dysostosis. Additionally, we aim to emphasize the importance of the systematic use of a multimodality imaging approach to facilitate the precise grading of these syndromes, as well as the preoperative planning of different reconstructive surgical procedures and their follow-up during treatment.
Assuntos
Região Branquial/anormalidades , Região Branquial/diagnóstico por imagem , Anormalidades Craniofaciais/diagnóstico por imagem , Adolescente , Síndrome Brânquio-Otorrenal/diagnóstico por imagem , Síndrome Brânquio-Otorrenal/cirurgia , Cefalometria , Criança , Pré-Escolar , Anormalidades Craniofaciais/cirurgia , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/cirurgia , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Disostose Mandibulofacial/diagnóstico por imagem , Disostose Mandibulofacial/cirurgia , Síndrome de Pierre Robin/diagnóstico por imagem , Síndrome de Pierre Robin/cirurgia , Radiografia PanorâmicaRESUMO
Fetal magnetic resonance imaging has become a useful noninvasive modality to examine the human fetus in case of suspicious sonography. Normally, central nervous system structures of the fetus in utero indicate the need for further evaluation. Fast T(2)-weighted sequences are used, which minimize artifacts and allow high contrast between different structures. Cases in which a diaphragmatic hernia was diagnosed via ultrasound will be shown in the magnetic resonance images of the fetuses in this study.