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1.
Ultrasound Q ; 38(2): 185-190, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33394995

RESUMO

ABSTRACT: Mesenteric panniculitis (MP) is a rare, benign, and nonspecific chronic fibrosing inflammation of the mesenteric adipose tissue. Abdominal pain is the most frequent presentation.The objective was to recognize ultrasound (US) features in MP. A retrospective 9-year review of computed tomography- (CT) or US-diagnosed cases of MP recorded in the radiology department was performed. The inclusion criteria included an US recorded in PACS imaging data base within 10 days before CT, to compare and evaluate the correlation of MP diagnosis.The prevalence of MP on CT was 2.8%. The 120 selected patients had an abdominal US 10 days before CT. Male-to-female ratio was 4:1. Fifty-three percent of MP was suggested by US. The US finding was increased volume with fatty mass in the mesentery root (98%). The fatty mesenteric mass had oval shape or convex anterior border in 94%, central abdominal location in 91%, and focal mesenteric increased echogenicity in 95%. Lateral bowel loop displacement was observed in 59%. Detection of lymph nodes was less frequent (55%).In conclusion, MP is an entity to be considered in the differential diagnosis of abdominal pain. Knowledge and recognition of the US findings of MP and central abdominal compression may improve detection during the abdominal US examination.


Assuntos
Paniculite Peritoneal , Dor Abdominal , Feminino , Humanos , Masculino , Mesentério/diagnóstico por imagem , Mesentério/patologia , Paniculite Peritoneal/diagnóstico por imagem , Paniculite Peritoneal/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia
2.
Rev. méd. Chile ; 149(12)dic. 2021.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1389415

RESUMO

Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers "fully agree" and "partially agree" was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.

3.
Rev Med Chil ; 149(3): 464-468, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479326

RESUMO

Small intestine neuroendocrine tumors (NET-SI) are relatively rare neoplasms. If encountered, the most common location is the ileum. Symptoms are usually non-specific, delaying the tumors diagnosis. NET-SI are often small in size and can be challenging to recognize on imaging studies. However, they have a tendency to induce a pronounced fibrotic reaction in the mesentery, often accompanied by large calcified mesenteric adenopathies. In some cases, the fibrotic reaction can produce rare complications, such as intestinal obstruction or vascular congestion with occasional secondary ischemia. This case report presents a 79-year-old male with a partial small bowel obstruction caused by a fibrotic reaction and mesenteric adenopathies of a well-differentiated neuroendocrine tumor of the ileum. The patient also presented multiple peritoneal metastases at diagnosis. Characteristic imaging findings of the tumor, allowed an accurate and early diagnosis. Once the acute episode was resolved, the diagnosis was confirmed with an image guided biopsy.


Assuntos
Neoplasias Intestinais , Obstrução Intestinal , Tumores Neuroendócrinos , Idoso , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Intestino Delgado/diagnóstico por imagem , Linfonodos , Masculino , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagem
4.
Int J Surg Case Rep ; 84: 106131, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34182434

RESUMO

INTRODUCTION: This neoplasm of the pancreas is an uncommon entity, with a frequency of 0.3-2.7% of all pancreatic tumors and even more so the finding of a synchronous lesion of the same histological lineage. For this reason, we report the atypical presentation of a SPNPs through a clinical case, review of the literature and a classification proposal, from the quantitative point of view. CASE PRESENTATION: 21-year-old patient, with incidental finding of two pancreatic tumors. Surgery included a pyloric preserving pancreatoduodenectomy with pancreatojejunostomy, distal pancreatectomy and central pancreas was preserved. The patient presents low output pancreatic fistula and nosocomial infection, treated with antibiotic therapy, being discharged 29 days after the intervention. Pathological and immunohistochemical analysis consistent with two SPNP. DISCUSSION: Its diagnosis is confirmed with the histological study and two synchronic SPNP are a rare entity and for this, or multiple lesions, an attempt should be made of a conservative resection of the parenchyma to minimize pancreatic insufficiency in a frequently young population, and always look for R0 resection, due to its uncertain behavior. CONCLUSION: Bifocal SPNP is rare and for this it is utility classify this entity -from the quantitative point of view- into unifocal, bifocal and multifocal for future medical research.

5.
J Comput Assist Tomogr ; 45(3): 352-358, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33797437

RESUMO

ABSTRACT: The COVID-19 pandemic presents an ongoing global health threat. The SARS-CoV-2 is known to cause substantial pulmonary disease, and most of the current radiological publications are dedicated to describing and characterizing these findings. However, studies regarding imaging findings in the abdomen and pelvis of infected patients are still very limited. The aim of this review is to discuss the most frequent abdominal manifestations based on the current literature and representative images from our local experience.


Assuntos
Abdome/diagnóstico por imagem , COVID-19/complicações , Pelve/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Abdome/virologia , COVID-19/diagnóstico por imagem , Feminino , Humanos , Masculino , Tomografia Computadorizada Multidetectores/métodos , Pelve/virologia
6.
Rev. argent. radiol ; 85(3): 68-74, abr. 2021. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1356973

RESUMO

Resumen La prevalencia global de diabetes mellitus (DM) aumenta cada año y, con ella, sus complicaciones. La afección del pie relacionada con DM se ha convertido en una de las principales causas de morbilidad y discapacidad. Los hallazgos más frecuentes son las alteraciones cutáneas y musculares, la arterioesclerosis y el edema óseo. Las complicaciones son la osteomielitis y la neuroartropatía, siendo causas importantes de amputación. El estudio imagenológico se inicia con radiografía (Rx), que permite descartar anomalías óseas y articulares, presencia de cuerpos extraños o alteraciones del tejido blando. Después de la Rx, la resonancia magnética (RM) es la modalidad de elección para la evaluación de la osteomielitis e infección de tejidos blandos del pie. Aunque esas afecciones comparten algunas características clínicas y de imagen con otros trastornos, el conocimiento de sus hallazgos distintivos permite al radiólogo contribuir al diagnóstico oportuno y correcto, con el fin de proporcionar al clínico información adecuada.


Abstract The global prevalence of Diabetes Mellitus (DM) tends to increase over the years, along with its complications. Diabetes related foot disease has become one of the leading causes of morbidity and disability. The most frequent findings are skin and muscle disorders, arteriosclerosis and bone marrow edema. Complications are osteomyelitis and neuroarthropathy, being important causes of amputation. The imaging study begins with radiography, which allows to rule out bone and joint abnormalities, presence of foreign bodies or soft tissue alterations. After radiography, magnetic resonance imaging (MRI) is the chosen modality to study osteomyelitis and soft tissue infection of the foot. Although these conditions share some clinical and imaging characteristics with other disorders, to know the distinctive findings allows the radiologist to contribute to get a timely and correct diagnosis, providing as well an appropriate information to the clinician.

7.
Rev. méd. Chile ; 149(3): 464-468, mar. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1389459

RESUMO

Small intestine neuroendocrine tumors (NET-SI) are relatively rare neoplasms. If encountered, the most common location is the ileum. Symptoms are usually non-specific, delaying the tumors diagnosis. NET-SI are often small in size and can be challenging to recognize on imaging studies. However, they have a tendency to induce a pronounced fibrotic reaction in the mesentery, often accompanied by large calcified mesenteric adenopathies. In some cases, the fibrotic reaction can produce rare complications, such as intestinal obstruction or vascular congestion with occasional secondary ischemia. This case report presents a 79-year-old male with a partial small bowel obstruction caused by a fibrotic reaction and mesenteric adenopathies of a well-differentiated neuroendocrine tumor of the ileum. The patient also presented multiple peritoneal metastases at diagnosis. Characteristic imaging findings of the tumor, allowed an accurate and early diagnosis. Once the acute episode was resolved, the diagnosis was confirmed with an image guided biopsy.


Assuntos
Humanos , Masculino , Idoso , Tumores Neuroendócrinos/complicações , Tumores Neuroendócrinos/diagnóstico por imagem , Neoplasias Intestinais , Obstrução Intestinal/etiologia , Obstrução Intestinal/diagnóstico por imagem , Intestino Delgado , Linfonodos
8.
Rev. chil. obstet. ginecol. (En línea) ; 86(1): 33-41, feb. 2021. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1388628

RESUMO

OBJETIVO: Evaluar concordancia de sitios de hallazgos de endometriosis profunda encontrados por RM y laparoscopia. MATERIALES Y MÉTODOS: Estudio retrospectivo, no experimental, concordancia intertécnica. Se recolectaron datos en nuestra institución de todos los informes de RM de pelvis que incluyeran la palabra "endometriosis", entre mayo de 2015 y abril de 2018 (36 meses), identificando 339 registros. Se establecieron criterios de inclusión. De los 339 registros, 62 pacientes fueron excluidas por cirugía antes de la RM. Otras 243 pacientes fueron excluidas porque no presentaban registro de protocolo quirúrgico posterior a la RM. 34 pacientes cumplieron los criterios de inclusión del estudio, lo que equivale al 10% de las RM estudiadas. Se revisaron las ubicaciones de los implantes endometriósicos informados en RM y se correlacionaron con los hallazgos encontrados en la cirugía. Se confecciono tabla para identificar la presencia/ausencia de implantes en las ubicaciones descritas en la literatura. Análisis estadístico mediante software Stata, aplicando kappa ponderada con intervalo de confianza de 95%. RESULTADOS: El promedio de edad de las pacientes llevadas a cirugía fue de 38 años. Los lugares con correlación moderada-importante (0.41-0.80) correspondieron a útero, recto-sigmoides, ovario, vagina y fondos de saco. CONCLUSIÓN: La RM de Pelvis es fundamental en la evaluación de pacientes con endometriosis en las que se plantea un manejo quirúrgico, con el objetivo de caracterizar la ubicación, forma y número de lesiones, y así lograr un satisfactorio tratamiento laparoscópico.


OBJECTIVE: To assess inter-observer reliability of sites of deep endometriosis findings found by MRI and laparoscopy. MATERIALS AND METHODS: Retrospective, non-experimental study, inter-observer reliability. Data were collected at our institution from all pelvic MRI reports that included the word "endometriosis", between May 2015 and April 2018 (36 months), identifying 339 records. The following were established as inclusion criteria. Of the 339 records, 62 patients were excluded for surgery prior to MRI. Another 243 patients were excluded because they had no record of the surgical protocol after the MRI. 34 patients met the study inclusion criteria, equivalent to 10% of the MRIs studied. The locations of the endometrial implants reported on MRI were reviewed and correlated with the findings found in the surgery. A table was prepared to identify the presence / absence of implants in the locations described in the literature. Statistical analysis using Stata software, applying weighted kappa with a 95% confidence interval. RESULTS: The average age of the patients undergoing surgery was 38 years. The places with a moderate-important correlation (0.41-0.80) corresponded to the uterus, recto-sigmoid, ovary, vagina, and recto-uterine pouch. CONCLUSION: Pelvic MRI is essential in the evaluation of patients with endometriosis in whom surgical management is proposed, in order to characterize the location, shape and number of lesions, and thus achieve satisfactory laparoscopic treatment.


Assuntos
Humanos , Feminino , Adulto , Imageamento por Ressonância Magnética , Laparoscopia , Endometriose/cirurgia , Endometriose/diagnóstico por imagem , Intervalos de Confiança , Estudos Retrospectivos
9.
Rev. chil. obstet. ginecol. (En línea) ; 86(1): 81-90, feb. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388634

RESUMO

INTRODUCCIÓN: La endometriosis afecta hasta un 10-15% de las mujeres jóvenes. Se define como tejido endometrial funcional fuera de la cavidad uterina y su presentación clásica es la dismenorrea. La variedad profunda afecta a un 1-2% y las localizaciones más frecuentes son el peritoneo pélvico, ovarios, ligamentos útero-sacros y septum recto-vaginal; sin embargo, puede presentarse de forma muy infrecuente como implantes aislados localizados en relación al nervio ciático. El diagnóstico habitualmente es complejo y tardío, dado que los síntomas son inespecíficos y el examen físico puede ser indistinguible de otras etiologías. El estudio imagenológico de elección para la endometriosis profunda es la resonancia magnética (RM) de pelvis ya que una adecuada localización pre-quirúrgica de las lesiones es fundamental. CASO CLÍNICO: Paciente de sexo femenino de 46 años, con tres años de dolor pélvico, dismenorrea y dispareunia. El síntoma cardinal fue dolor ciático progresivo, con déficit motor y alteraciones sensitivas, los cuales se exacerbaban durante la menstruación y no presentaban respuesta al tratamiento farmacológico. En la RM se identifica nódulo sólido sospechoso de endometriosis en relación al nervio ciático derecho. El caso es evaluado por un comité multidisciplinario y se realiza cirugía laparoscópica. El diagnóstico de sospecha es confirmado histológicamente. La paciente presenta buena recuperación post-quirúrgica y cese completo de los síntomas descritos. DISCUSIÓN: La endometriosis profunda presenta un reto diagnóstico y habitualmente es tardío. Este caso presenta el resultado exitoso de una buena sospecha clínica, un estudio imagenológico completo y la resolución con una técnica quirúrgica compleja.


INTRODUCTION: Endometriosis is a disease that affects 10-15% of young women. It is characterized as functional endometrial tissue outside the uterine cavity. The most common form of presentation is dysmenorrhea. Deep endometriosis affects 1-2% of the patients, and is frequently located in the pelvic peritoneum, ovaries, utero-sacral ligaments and recto-vaginal septum. The isolated endometriosis of the sciatic nerve is a very uncommon presentation of this disease. Late diagnosis is frequent, mainly because the symptoms are non-specific, and the physical examination may be indistinguishable from other etiologies. The imaging study of choice is the pelvic magnetic resonance imaging (MRI) and an accurate pre-surgical location of the lesions is critical for a successful surgical outcome. CLINICAL CASE: 46-year-old female patient with 3 years of pelvic pain, dysmenorrhea and dyspareunia. The cardinal symptom was progressive sciatic pain, with motor deficit and sensory alterations. The pain was persistent despite pharmacological treatment and exacerbated during menstruation. MRI identifies a nodule located in the pelvic portion of the right sciatic nerve, suggestive of an endometriosis implant. The case was discussed by a multidisciplinary committee and laparoscopic surgery was performed. The diagnosis was confirmed with histology. The patient recovered well from surgery with significant improvement of the previously described symptoms. DISCUSSION: The diagnosis of deep endometriosis is challenging and usually delayed. This rare disease had a successful outcome, due to an early clinical suspicion, a thorough imaging study and an effective resolution with a complex surgical technique.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Nervo Isquiático/cirurgia , Nervo Isquiático/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/cirurgia , Doenças do Sistema Nervoso Periférico/diagnóstico por imagem , Endometriose/cirurgia , Endometriose/diagnóstico por imagem , Imageamento por Ressonância Magnética , Laparoscopia , Dor Pélvica/etiologia
10.
Rev Med Chil ; 149(12): 1773-1786, 2021 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-35735345

RESUMO

Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers "fully agree" and "partially agree" was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.


Assuntos
Cisto Pancreático , Neoplasias Pancreáticas , Humanos , Chile/epidemiologia , Consenso , Cisto Pancreático/diagnóstico , Cisto Pancreático/terapia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia
12.
Abdom Radiol (NY) ; 45(6): 1694-1710, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32236651

RESUMO

Deep invasive gastrointestinal endometriosis (DIGIE) is a frequent and severe presentation of endometriosis. Although most cases invade the rectosigmoid colon, DIGIE can involve any portion of the gastrointestinal tract from the stomach to the rectum, and is commonly multifocal and multicentric. Although histopathologic confirmation with surgery remains the gold standard for diagnosis, ultrasound (US) and magnetic resonance imaging (MRI) are the key non-invasive imaging modalities for initial assessment. US may be preferred as a screening study because of its easy availability and low-cost. Pelvic MRI and magnetic resonance enterography (MRE) provide substantial advantages for disease mapping in the pre-operative period, particularly in extensive bowel endometriosis. Although medical management of DIGIE with hormonal therapy can help control symptoms, disease course can be relentless and require surgical intervention. Surgical options depend on, the location; length; depth; circumference; multicentric or multifocal disease. With procedures including simple excision, fulguration of superficial lesions, shaving, disc excision, and segmental resection. A successful treatment outcome is largely dependent on good communication between the treating surgeon and the radiologist, who can provide vital information for effective surgical planning by reporting the key elements that we elaborate upon in this paper.


Assuntos
Endometriose , Colo Sigmoide , Endometriose/diagnóstico por imagem , Endometriose/cirurgia , Feminino , Trato Gastrointestinal , Humanos , Radiologistas , Reto
13.
Rev. argent. radiol ; 84(2): 55-60, abr. 2020. graf
Artigo em Espanhol | LILACS | ID: biblio-1125856

RESUMO

Resumen La pesquisa incidental de lesiones tímicas ha aumentado. Una adecuada aproximación a esas lesiones en la tomografía computada por emisión de positrones (PET-CT) es fundamental, pues se usa como parte de la mayoría de los procedimientos de planificación oncológica. Se han seleccionado casos representativos respecto de los aspectos más importantes de las imágenes de timo en PET-CT y cómo esa técnica puede contribuir a un diagnóstico preciso o a la planificación del tratamiento. Específicamente, presentamos una descripción general de las lesiones tímicas comunes y los imitadores de enfermedad, con énfasis en los hallazgos en PET-CT, incorporando también ejemplos de resonancia magnética (RM).


Abstract Incidental thymic lesion findings have increased. An adequate characterization of these lesions in positron emission computed tomography (PET-CT) is essential, since it is used as part of most oncological planning procedures. Representative cases have been selected regarding the most important aspects of thymus imaging in PET-CT and how this technique can contribute to an accurate diagnosis or treatment planning. Specifically, we present a general description of common thymic lesions and disease mimics, with an emphasis on PET-CT findings, also incorporating examples of magnetic resonance imaging.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Timo/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Timo/fisiologia , Timo/patologia , Hiperplasia do Timo/diagnóstico por imagem , Neoplasias do Timo/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Linfoma/diagnóstico por imagem
14.
Abdom Radiol (NY) ; 45(6): 1762-1775, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30941451

RESUMO

PURPOSE: Transformation of benign endometriosis to endometriosis-associated ovarian carcinoma (EAOC) is rare; however, women with endometriosis are four times more likely to develop EAOC which can present 20 years earlier than de novo ovarian cancer. Presenting symptoms are often vague and the radiologist's role in recognizing EAOC is critical for early detection and treatment. Histopathologic evaluation remains the mainstay for definitive diagnosis. METHODS: Using a case-based approach, this article will review the sonographic, CT, and MRI features of EAOC with an emphasis on MRI. Histopathologic correlation of benign and malignant endometriosis will be reviewed. RESULTS: Multiple factors contribute to the malignant transformation of endometriosis including genetic alterations, hormonal influences, oxidative stress, and inflammation. Malignancy most often occurs in ovarian endometriomas with less common sites involving the rectovaginal septum, rectosigmoid colon, and abdominal wall scars. The most common pathologic subtypes are endometrioid adenocarcinoma and clear cell carcinoma. MRI is the most specific imaging modality for evaluating EAOC. Key MR features include solid enhancing nodules (accentuated by subtraction imaging), nodular septations, loss of T2 shading within the endometrioma, and diffusion restriction. CONCLUSIONS: EAOC is a distinct disease that affects women with benign endometriosis at younger ages than classic ovarian cancer. Understanding the imaging features of malignant transformation of endometriosis is essential for early diagnosis and timely definitive treatment.


Assuntos
Adenocarcinoma de Células Claras , Carcinoma Endometrioide , Endometriose , Neoplasias Ovarianas , Transformação Celular Neoplásica , Endometriose/diagnóstico por imagem , Feminino , Humanos , Neoplasias Ovarianas/diagnóstico por imagem
15.
Rev Med Chil ; 147(5): 663-667, 2019 May.
Artigo em Espanhol | MEDLINE | ID: mdl-31859900

RESUMO

We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.


Assuntos
Pneumonia em Organização Criptogênica/diagnóstico por imagem , Pneumonia em Organização Criptogênica/patologia , Biópsia , Pneumonia em Organização Criptogênica/tratamento farmacológico , Feminino , Glucocorticoides/uso terapêutico , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Radiografia Torácica , Tomografia Computadorizada por Raios X
16.
Rev. argent. radiol ; 83(4): 151-159, oct. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1057417

RESUMO

Resumen El colangiocarcinoma (CC) es el segundo tumor primario maligno más frecuente del hígado. La mayor incidencia se registra en Asia y su pronóstico es poco alentador. La resección quirúrgica del tumor es el único tratamiento potencialmente curativo. Sin embargo, la mayoría de los CC se diagnostican en estadios avanzados de la enfermedad y la recurrencia del tumor es común. Este trabajo pretende demostrar las características imagenológicas de los CC, su clasificación, así como también la evaluación preoperatoria por tomografía computada (TC) y resonancia magnética (RM) que el radiólogo debe realizar actualmente.


Abstract The cholangiocarcinoma (CC) is the second most common malignant primary tumor of the liver. The highest incidence is registered in Asia and its prognosis is not very encouraging. The surgical resection is the only potentially curative treatment, however most of the CCs are diagnosed in advanced stages and the tumor recurrence is frequently presented. The purpose of this study is to show the imagenologic characteristics of CC, its classification as well as the preoperative evaluation by Computed Tomography (CT) and Magnetic Resonance (MR) that the radiologist must perform currently.


Assuntos
Tumor de Klatskin , Colangiocarcinoma/diagnóstico por imagem , Ásia , Espectroscopia de Ressonância Magnética , Tomografia , Doença , Classificação , Neoplasias
17.
Rev. méd. Chile ; 147(9): 1122-1127, set. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1058654

RESUMO

Background: Spontaneous dissections of visceral arteries are rare and usually secondary to other disease. There is paucity of information about their natural course. Aim: To describe the imaging, clinical characteristics and follow-up of spontaneous visceral artery dissections diagnosed at our institution. Material and Methods: We report a series of 14 patients in whom a spontaneous dissection of a visceral artery was diagnosed on abdominal angio-CT between 2010 and 2018. Clinical features and evolution were recorded. Results: Isolated lesions of the celiac axis were the most common finding. Multiple territories were involved in 14% of cases. A dissection flap was observed in four cases, a hematoma-dissection complex in seven and an aneurysmal dilatation associated with the dissection in three. Of the 10 patients who were followed at our institution, 90% had stabilization or partial regression of the imaging findings. In the remaining case, new dissection events were observed. All cases were managed conservatively, and no death was reported. Conclusions: In this series of patients, spontaneous dissection of visceral arteries had a benign, favorable course, requiring only conservative management.


Assuntos
Humanos , Dissecção Aórtica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Artéria Celíaca/diagnóstico por imagem , Dissecação , Hematoma
18.
Rev. méd. Chile ; 147(5): 663-667, mayo 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1014276

RESUMO

We report a 64 years old female admitted with fever, cough, dyspnea and lung opacities in the chest X ray. A chest tomography scan (CTS) showed multiple-bilateral ring-shaped opacities and the reversed halo sign (RHS). The patient did not improve with antimicrobial therapy (AT). Infection and rheumatologic causes were excluded, therefore Cryptogenic organizing pneumonia (COP) was suspected with compatible percutaneous biopsy. Systemic steroids were started with a good clinical response. The patient was discharged four weeks after admission in good general conditions and practically no lungs opacities.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Pneumonia em Organização Criptogênica/patologia , Pneumonia em Organização Criptogênica/diagnóstico por imagem , Biópsia , Prednisona/uso terapêutico , Radiografia Torácica , Tomografia Computadorizada por Raios X , Pneumonia em Organização Criptogênica/tratamento farmacológico , Glucocorticoides/uso terapêutico , Pulmão/patologia , Pulmão/diagnóstico por imagem
19.
Ultrasound Q ; 35(2): 195-199, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30724869

RESUMO

Congenital variants of the gallbladder development are infrequent and sometimes represent an asymptomatic imaging finding. In this case series, we want to present multimodality imaging findings that permit the diagnosis. Ultrasound, multidetector computed tomography, and magnetic resonance images are included.The proper recognition of these infrequent congenital benign entities avoids unnecessary complementary examinations and misdiagnosis. Although ultrasound represents the most commonly used initial diagnostic tool, the increased use of magnetic resonance imaging and the wide use of multidetector computed tomography make it crucial to know how these entities are seen.A retrospective review of cases of congenital variants of gallbladder through different imaging modalities was performed in our computer archives. Representative images were selected. Agenesis, hypoplasia, septated, duplicated, intrahepatic, and left-sided gallbladder are described.Better understanding and recognition of congenital anomalies in gallbladder images will avoid misdiagnosis.


Assuntos
Diagnóstico por Imagem/métodos , Vesícula Biliar/anormalidades , Vesícula Biliar/diagnóstico por imagem , Imagem Multimodal/métodos , Humanos
20.
Rev Med Chil ; 147(9): 1122-1127, 2019 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-33625445

RESUMO

BACKGROUND: Spontaneous dissections of visceral arteries are rare and usually secondary to other disease. There is paucity of information about their natural course. AIM: To describe the imaging, clinical characteristics and follow-up of spontaneous visceral artery dissections diagnosed at our institution. MATERIAL AND METHODS: We report a series of 14 patients in whom a spontaneous dissection of a visceral artery was diagnosed on abdominal angio-CT between 2010 and 2018. Clinical features and evolution were recorded. RESULTS: Isolated lesions of the celiac axis were the most common finding. Multiple territories were involved in 14% of cases. A dissection flap was observed in four cases, a hematoma-dissection complex in seven and an aneurysmal dilatation associated with the dissection in three. Of the 10 patients who were followed at our institution, 90% had stabilization or partial regression of the imaging findings. In the remaining case, new dissection events were observed. All cases were managed conservatively, and no death was reported. CONCLUSIONS: In this series of patients, spontaneous dissection of visceral arteries had a benign, favorable course, requiring only conservative management.


Assuntos
Dissecção Aórtica , Dissecção Aórtica/diagnóstico por imagem , Artéria Celíaca/diagnóstico por imagem , Dissecação , Hematoma , Humanos , Tomografia Computadorizada por Raios X
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