RESUMO
OBJECTIVE: Faecal incontinence often persists after surgery for rectal prolapse. Multiple mechanisms have been proposed as responsible, however, anal sphincter integrity has only been studied in a handful of cases. This study assesses the incidence of ultrasound detected anal sphincter tears in patients with rectal prolapse and faecal incontinence. METHODS: Retrospective search of medical records at Flinders Medical Centre over a 7-year period to identify patients with full thickness rectal prolapse and faecal incontinence who had undergone endosonographical imaging of the anal sphincter complex. Anal manometry and pudendal nerve terminal motor latency studies were also included. RESULTS: Twenty-one patients were identified (1 male, 20 female) of median age 67.5 years. Fifteen (71%) subjects had an abnormality in the anal sphincter complex on endoanal ultrasound. Of these, the defects in 4 (19%) patients were isolated to the internal sphincter, 3 (14%) to the external sphincter and in the remaining 8 (38%) subjects, defects were found in both internal and external sphincters. The degree of sphincteric defect was variable but at least 6 (29%) of the study group had full-length external sphincter tears. In the 19 patients studied, anal manometry revealed reduced basal and squeeze pressures in the majority. Delayed pudendal nerve terminal motor latency was evident in 9 of 18 patients studied. CONCLUSION: Anal sphincter tears are common in patients presenting with rectal prolapse and faecal incontinence. The faecal incontinence associated with prolapse appears to be multifactorial in aetiology. Anal sphincter defects are likely to contribute to persistent faecal incontinence or recurrence following rectal prolapse. Endoanal ultrasound derived knowledge of anal sphincter injury may guide surgical management in problematic cases.
Assuntos
Canal Anal/lesões , Incontinência Fecal/etiologia , Prolapso Retal/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Canal Anal/diagnóstico por imagem , Endossonografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RupturaRESUMO
This paper highlights the importance of cavernous haemangiomas as clinically significant lesions and the role of imaging, particularly MRI, in suggesting the diagnosis. An understanding of the pathology of these lesions helps to explain the features demonstrated by imaging techniques.
Assuntos
Neoplasias Encefálicas/diagnóstico , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico , Adulto , Neoplasias Encefálicas/patologia , Hemangioma Cavernoso do Sistema Nervoso Central/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios XRESUMO
This review summarizes important pathological lesions of the lung that typically present radiographically with an 'alveolar pattern'. For each entity, the latest findings as to its pathogenesis, aetiology and pathology are reviewed in the introductory remarks. We then present the typical radiological appearances alongside macroscopic and microscopic pathological photographs. It is hoped that the parallel presentation of radiological image with the pathology will enhance the understanding of the diverse range of diseases the aevolar pattern comprises.
Assuntos
Pneumopatias/patologia , Alvéolos Pulmonares/patologia , Diagnóstico Diferencial , Humanos , Pneumopatias/diagnóstico por imagem , Alvéolos Pulmonares/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The imaging findings of a case of meningioangiomatosis with pathologic correlation are presented.
Assuntos
Angiomatose/diagnóstico , Meninges/patologia , Adolescente , Angiomatose/patologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Meninges/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
We describe a 4-year-old girl with an inflammatory pseudotumour of the pancreas, which was preceded by varicella-zoster infection. Inflammatory pseudotumour may involve a variety of tissues, the lungs and liver being typical sites of predilection. Imaging and laboratory tests are nonspecific, and for this reason the diagnosis of inflammatory pseudotumour is rarely made prior to surgery. These benign but locally aggressive masses simulate malignancy in the majority of cases. Inflammatory pseudotumour should, therefore, be considered when a mass arises in an unusual location in the paediatric age group.
Assuntos
Varicela/complicações , Granuloma de Células Plasmáticas/virologia , Herpesvirus Humano 3/isolamento & purificação , Pancreatopatias/virologia , Pré-Escolar , Feminino , Granuloma de Células Plasmáticas/patologia , Granuloma de Células Plasmáticas/cirurgia , Humanos , Pancreatopatias/patologia , Pancreatopatias/cirurgia , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: To examine shoulder appearances at magnetic resonance (MR) imaging in long-term dialysis recipients. MATERIALS AND METHODS: Twenty-two chronic dialysis recipients underwent 1.0-T MR imaging with a combination of T1-, T2-, and T2*-weighted sequences. Rotator cuff tendon thickening was graded as present or absent by a musculoskeletal radiologist, who also measured the supraspinatus and subscapularis tendon thicknesses with electronic calipers. The long-axis dimension and location of focal osseous lesions, in addition to their T1, T2, and T2* signal intensities, were noted. RESULTS: Supraspinatus (n = 9) and subscapularis (n = 10) tendon thickening was frequently observed. Six (27%) of the 22 patients had combined thickening of the supraspinatus and subscapularis tendons without substantial involvement of the infraspinatus or teres minor tendons. These patients had undergone dialysis longer (median, 19.2 years; range, 16.3-22.8 years) than had the other patients (median, 11.7 years; range, 5.8-19.3 years; P: =.004). The 29 intraosseous lesions had high, intermediate, and low T2 signal intensity in six (21%), nine (31%), and 14 (48%) instances, respectively. CONCLUSION: Supraspinatus and/or subscapularis tendon thickening is common in chronic dialysis recipients. Bone lesions in such patients are of variable T2 signal intensity and usually subchondral or adjacent to the greater tuberosity.
Assuntos
Imageamento por Ressonância Magnética , Diálise Renal , Articulação do Ombro/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Artropatias/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Manguito Rotador/patologia , Tendões/patologia , Fatores de TempoRESUMO
The anatomical basis of the primary empty sella turcica is illustrated to emphasize that it represents a normal variant and not pathology.
Assuntos
Síndrome da Sela Vazia/diagnóstico por imagem , Síndrome da Sela Vazia/patologia , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To determine the prevalence of neurological and magnetic resonance imaging (MRI) abnormalities in a well defined population of unselected patients with primary Sjögren's syndrome (SS) and age and sex matched healthy patients. METHODS: Thirty patients with SS and 29 age and sex matched controls were examined by a neurologist and subsequently underwent MRI scanning with a 1.0 Tesla Siemens Impact MR scanner. Scans were graded by a neuroradiologist blinded to the clinical status of each subject. The number and location of white matter lesions > 3 mm in long axis (to exclude non-specific perivascular changes) were recorded for each subject. RESULTS: There was a significant increase in lesions detected by MRI in SS patients versus controls (p = 0.02) including deep white matter lesions (p = 0.03) and subcortical white matter lesions (p = 0.02). The presence of white matter lesions did not correlate with serum IgG or rheumatoid factor levels, or with presence of anticardiolipin antibodies. No subjects had symptoms or signs of serious neurological disease including multiple sclerosis, and corpus callosal lesions commonly seen in multiple sclerosis were notably absent in this study. CONCLUSION: Cerebral white matter lesions detected by MRI are more frequent in patients with primary SS than control subjects, yet do not appear to be associated with significant clinical manifestations. Although the pathological nature of these lesions is yet to be defined, their presence should not be over-interpreted.
Assuntos
Encéfalo/patologia , Fibras Nervosas Mielinizadas/patologia , Síndrome de Sjogren/patologia , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Imunoglobulina G/sangue , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fator Reumatoide/sangue , Fatores Sexuais , Síndrome de Sjogren/sangueRESUMO
Cavernous haemangiomas confined to the epidural space are rare and are therefore infrequently considered in the differential diagnosis of spinal epidural masses. In order to draw attention to this diagnosis, a case in which an epidural cavernous haemangioma simulates a lateral/foraminal disc protrusion is presented.
Assuntos
Hemangioma Cavernoso/diagnóstico , Adulto , Diagnóstico Diferencial , Espaço Epidural , Feminino , Hemangioma Cavernoso/cirurgia , Humanos , Deslocamento do Disco Intervertebral/diagnóstico , Vértebras Lombares , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
Blood, cerebrospinal fluid, and extracellular fluid of the parenchyma form the fluid compartments of the brain with three interfaces between--the blood-brain interface, the CSF-brain interface, and the blood-CSF interface. These and other issues are discussed in this article.
Assuntos
Meios de Contraste , Aumento da Imagem , Imageamento por Ressonância Magnética , Intensificação de Imagem Radiográfica , Tomografia Computadorizada por Raios X , Sangue , Barreira Hematoencefálica , Encéfalo/anatomia & histologia , Encéfalo/diagnóstico por imagem , Líquido Cefalorraquidiano , Plexo Corióideo/anatomia & histologia , Plexo Corióideo/diagnóstico por imagem , Espaço Extracelular , Humanos , IodoAssuntos
Barreira Hematoencefálica/efeitos dos fármacos , Meios de Contraste/toxicidade , Testes de Toxicidade , Animais , Arabinose/toxicidade , Relação Dose-Resposta a Droga , Extravasamento de Materiais Terapêuticos e Diagnósticos , Iohexol/análogos & derivados , Iohexol/toxicidade , Concentração Osmolar , Coelhos , Ácidos Tri-Iodobenzoicos/toxicidadeAssuntos
Barreira Hematoencefálica/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Meios de Contraste/toxicidade , Compostos Heterocíclicos/toxicidade , Imageamento por Ressonância Magnética , Compostos Organometálicos/toxicidade , Ácido Pentético/análogos & derivados , Animais , Arabinose/farmacologia , Meios de Contraste/farmacocinética , Eletroencefalografia/efeitos dos fármacos , Gadolínio , Gadolínio DTPA , Compostos Heterocíclicos/farmacocinética , Compostos Organometálicos/farmacocinética , Ácido Pentético/farmacocinética , Ácido Pentético/toxicidade , Coelhos , Convulsões/induzido quimicamenteRESUMO
Spinal intradural arachnoid cysts are seen most frequently in the thoracic region, particularly near the midline posteriorly. A thoracic intradural arachnoid cyst in this typical location is reported, with the additional unusual finding of herniation of the spinal cord through an anterior defect in the dura matter. The MRI findings are described.
Assuntos
Cistos Aracnóideos/diagnóstico , Dura-Máter , Imageamento por Ressonância Magnética , Mielografia , Compressão da Medula Espinal/diagnóstico , Adulto , Cistos Aracnóideos/patologia , Cistos Aracnóideos/cirurgia , Diagnóstico Diferencial , Dura-Máter/patologia , Dura-Máter/cirurgia , Feminino , Seguimentos , Humanos , Exame Neurológico , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação , Espinha Bífida Oculta/diagnóstico , Espinha Bífida Oculta/cirurgia , Compressão da Medula Espinal/patologia , Compressão da Medula Espinal/cirurgiaRESUMO
In a patient with celiac disease, folate and iron deficiency, and epilepsy, CT over a 4-month period showed parietoocipital calcifications in the corticomedullary junctions. The calcification was progressive, but it and the seizures stabilized after institution of a gluten-free diet and iron and folic acid supplements.