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1.
Rev Assoc Med Bras (1992) ; 67(3): 418-425, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34468608

RESUMO

OBJECTIVE: The aim of this study is to evaluate the myocardium structure in patients with chest pain who were determined to have moderate and/or high risk for cardiac ischemic heart disease (IHD) but who had normal findings on conventional coronary angiography by using native cardiac magnetic resonance imaging (CMRI) T1 mapping and comparing with healthy volunteers. METHODS: A total of 50 patients and 30 healthy volunteers who underwent CMRI were included in our prospective study. Patients whose clinical findings were compatible with stable angina pectoris, with moderate and/or high risk for IHD, but whose conventional coronary angiography was normal, were our patient group. Native T1 values were measured for 17 myocardial segments (segmented based on American Heart Association recommendations) by two radiologists independently. The data obtained were statistically compared with the sample t-test. RESULTS: Myocardial native T1 values were found to be significantly prolonged in the patient group compared with the control group (p<0.05). Inter-observer reliability for native T1 value measurements of groups was high for both patient and control groups (α = 0.92 for the patient group and 0.96 for the control group). CONCLUSION: Findings suggestive of ischemia were detected by T1 mapping in the myocardium of our patients. For this reason, it is recommended that this patient group should be included in early diagnosis and close follow-up assessments for IHD.


Assuntos
Imagem Cinética por Ressonância Magnética , Miocárdio , Angiografia Coronária , Humanos , Isquemia , Estudos Prospectivos , Reprodutibilidade dos Testes , Estados Unidos
3.
Acta Radiol ; 61(6): 821-829, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31653187

RESUMO

BACKGROUND: Magnetic resonance myelography (MRM) with three-dimensional (3D) T2-weighted (T2W) turbo spin echo (TSE) sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) may be a guide to the etiology of low back pain. PURPOSE: To research the efficiency of a 3D T2W TSE SPACE MRM sequence for visualization of anatomic details of spinal nerve root at the spinal canal and lateral recess levels in the patients with low back pain. MATERIAL AND METHODS: Lumbar spinal MRM 3D T2W TSE SPACE was performed in a total of 70 patients (median age 46 years). Patients were imaged while lying in a supine position with straightened legs. According to the degree of facet arthropathy findings, patients were divided into four separate subgroups in our retrospective cross-sectional study. Spinal nerve root angle was measured within the spinal canal and at lateral recess level, and facet joint angle and lumbar lordosis measurements were measured by two radiologists, independently. RESULTS: Lumbar level was strongly negatively correlated with facet joint angle (r = -0.95) as well as nerve root angle within the spinal canal (NRASC) (r = -0.857) and at the lateral recess level (NRALR) (r = -0.947). Intracanal decline of the spinal root angle caused by spinal stenosis findings was also observed (P < 0.05). For the measurements of NRASC and NRALR, inter-observer correlation was 0.85 and 0.82 for the spinal canal and at lateral recess level, respectively. CONCLUSION: 3D T2W SPACE in NRASC and NRALR provided high resolution images for evaluation. Therefore, this method may be a qualitative guide for the clinician and the surgeon in terms of root anatomy before any intervention.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Mielografia/métodos , Canal Medular/diagnóstico por imagem , Raízes Nervosas Espinhais/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estenose Espinal/complicações , Adulto Jovem
4.
J Magn Reson Imaging ; 51(5): 1471-1477, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31665554

RESUMO

BACKGROUND: Accumulation of macrocyclic gadolinium agents in children's brains remain to be determined. PURPOSE: To demonstrate whether there is an intracranial macrocyclic gadolinium deposition after multiple contrast-enhanced MRI with gadoterate meglumine in a pediatric population. STUDY TYPE: Retrospective case-control. POPULATION: In all, 45 children (age range: 5-17 years; mean, 13.7 ± 3.4 years) for the study group and 45 healthy children (age range: 5-17 years; mean, 13.7 ± 3.4 years) for the control group. FIELD STRENGTH/SEQUENCE: T1 - and T2 -weighted axial images on a 1.5T scanner. ASSESSMENT: Children with at least three enhanced brain MRIs and an age- and sex-matched control group with an unenhanced brain MRIs were compared in terms of T1 signal intensity (SI). All patients in the study group received gadoterate meglumine intravenously (0.1 mmol/kg). SI measurements were made by drawing six regions of interest (ROIs): dentate nuclei (DN), pons, globus pallidi (GP), frontal white matter (FWM), thalamus (T), clivus, and cerebrospinal fluid (CSF) for both groups on unenhanced T1 -weighted images. STATISTICAL TESTS: Student's t-test was used for comparison of SI. The Pearson correlation was calculated for the correlation between the SI and the number of gadolinium administrations. RESULTS: A significant difference was detected between two groups for DN/CSF, pons/CSF, GP/CSF, thalamus/CSF, and FWM/CSF (P < 0.001, P < 0.001, P = 0.002, P = 0.002, P = 0.024, respectively). There was no significant difference between the two groups for clivus/CSF (P = 0.15). A good correlation between the number of gadoterate meglumine administrations and the SI for DN/CSF, pons/CSF, GP/CSF, and T/CSF (r = 0.80, r = 0.73, r = 0.91, and r = 0.90, respectively) was found. DATA CONCLUSION: A significant T1 SI increase reflecting gadolinium retention in the brain was detected for children with at least three gadoterate meglumine administrations in this series. The number of administrations correlated well with the increased SI. LEVEL OF EVIDENCE: 3 Technical Efficacy Stage: 5 J. Magn. Reson. Imaging 2020;51:1471-1477.


Assuntos
Gadolínio , Compostos Organometálicos , Adolescente , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Núcleos Cerebelares/diagnóstico por imagem , Criança , Pré-Escolar , Meios de Contraste , Gadolínio DTPA , Humanos , Imageamento por Ressonância Magnética , Meglumina/efeitos adversos , Compostos Organometálicos/efeitos adversos , Estudos Retrospectivos
5.
Can Assoc Radiol J ; 70(2): 147-155, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30955927

RESUMO

PURPOSE: We aimed to investigate the role of interfaces of exophytic solid and cystic renal masses on magnetic resonance imaging (MRI) and the added value of diffusion-weighted imaging in differentiating benign from malignant lesions. METHODS: The Institutional Review Board approved this retrospective study, and informed consent was waived. A total of 265 patients (109 [41%] women and 156 [59%] men) with a mean age of 57 ± 12 (standard deviation) years were enrolled in this study. Preoperative MRI (n = 238) examinations of patients with solid or cystic renal masses and MRI (n = 27) examinations of patients with Bosniak IIF cysts without progression were reviewed. Solid/cystic pattern, interface types and apparent diffusion coefficient (ADC) values were recorded by 2 radiologists. The diagnostic performance of combining normalized ADC values with interface sign were evaluated. RESULTS: Among 265 renal lesions (109 cystic and 156 solid), all malignant lesions (n = 192) had a round interface. No malignant lesions showed an angular interface. For prediction of benignity in cystic lesions, sensitivity (82.86% vs 56.16%), negative predictive value (92.50% vs 85.71%), and accuracy (94.50% vs 87.92%) ratios of angular interface were higher compared to all (solid plus cystic) lesions. The best normalized ADC cutoff values for predicting malignancy in lesions with round interface were as follows: for all (solid plus cystic), ≤ 0.75 (AUROC = 0.804); solid, ≤ 0.6 (AUROC = 0.819); and cystic, ≤ 0.8 (AUROC = 0.936). CONCLUSIONS: Angular interface can be a predictor of benignity for especially cystic renal masses. The evaluation of interface type with normalized ADC value can be an important clue in differential diagnosis especially in patients avoiding contrast.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Renais/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
6.
Radiol Med ; 124(6): 460-466, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30725396

RESUMO

OBJECTIVE: To investigate the effectiveness of gadoxetic acid-enhanced magnetic resonance cholangiopancreatography (CE-MRCP) and T2-weighted half-Fourier acquisition single-shot turbo spin-echo (T2W HASTE) sequences for diagnosis of cysto-biliary communication in hydatid cysts compared to surgical results. METHODS: Preoperative abdominal magnetic resonance imaging examinations of patients who underwent surgery for hepatic hydatid cysts were reviewed by two radiologists retrospectively. A total of 45 patients with hydatid cysts were included. Of 45, 27 also had CE-MRCPs. T2W HASTE sequences and CE-MRCPs were investigated separately for cysto-biliary communication. The relationship between radiological and surgical results was analyzed. The interobserver agreement was evaluated. RESULTS: Of 45 hydatid cysts, there were surgically proven 21 cysts without biliary communications and 24 cysts with biliary communications. All cysts with biliary communications were shown on T2W HASTE sequences. There was no leakage of gadoxetic acid into these cysts (n = 24). Sensitivity, specificity, negative predictive value, positive predictive value (PPV), and accuracy of diagnosis of cyst with biliary communication on T2W HASTE sequences was 100%, 63.64%, 100%, 66.67%, and 78.95%, respectively. Specificity (77.78%), PPV (87.50%), and accuracy (91.30%) were increased in ≥ 10 cm cysts. There was almost perfect interobserver agreement (K = 0.81-1.00). CONCLUSION: Leakage of gadoxetic acid inside the cyst indicates biliary communication. However, the lack of leakage does not rule out cysto-biliary communication. When biliary communication is clearly shown on T2W HASTE sequences, it should be reported as cysto-biliary communication even if there is no leakage of gadoxetic acid into the cyst on CE-MRCP.


Assuntos
Sistema Biliar/parasitologia , Colangiopancreatografia por Ressonância Magnética , Meios de Contraste/administração & dosagem , Equinococose Hepática/diagnóstico por imagem , Gadolínio DTPA/administração & dosagem , Adulto , Idoso , Sistema Biliar/diagnóstico por imagem , Diagnóstico Diferencial , Equinococose Hepática/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
7.
Clin Imaging ; 38(4): 495-498, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24651059

RESUMO

The relationship of patellofemoral congruency with chondromalacia patellae (CP) was retrospectively evaluated. Lateral patellar tilt angle (LPTA), sulcus angle (SA), trochlear depth (TD), and patella angle (PA) were measured at 301 knee magnetic resonance images and compared between groups with and without CP. In the CP group, LPTA and TD were significantly low (P<.01), SA was high (P<.01), while PA showed no difference (P>.05). The parameters were also compared between groups with mild and severe CP, and no significant difference was found (P>.05). Our results demonstrate that patellar tilt and trochlear dysplasia are related to the presence but not the degree of CP.


Assuntos
Doenças das Cartilagens/patologia , Patela/patologia , Articulação Patelofemoral/patologia , Síndrome da Dor Patelofemoral/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cartilagem/anatomia & histologia , Cartilagem/patologia , Doenças das Cartilagens/diagnóstico , Feminino , Humanos , Articulação do Joelho , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Patela/anatomia & histologia , Articulação Patelofemoral/anatomia & histologia , Síndrome da Dor Patelofemoral/diagnóstico , Estudos Retrospectivos , Adulto Jovem
8.
Surg Radiol Anat ; 35(8): 729-36, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23455362

RESUMO

PURPOSE: The aim of this study was to assess the cerebral variations and observe their frequency in the patients who have undergone angiographies with the state of the art 64-slice multidetector computed tomography (MDCT) angiography technique due to various reasons. METHODS: 500 patients (253 women, 247 men) who had CT scan in the period of April 2008 to March 2010 at Dicle University Medicine Faculty Hospital Radiology Unit were surveyed in this study. Patients who had CT scan with brain CT angio protocol were evaluated using multiplanar, maximum intensity projection (MIP) and volume rendering (VR) images in work station. RESULTS: 773 variations were totally detected among 500 patients. Variations were categorized as Willis polygon, fenestration and other variations. Frequent variations were detected at Willis polygon and posterior communicating artery (PCOA) hypoplasia was detected as the prevalent variation. CONCLUSIONS: In the present study, we have demonstrated that cerebral vascular variations are frequent and that these variations can be detected in a non-invasive manner using the MDCT angiography. The results obtained from our study may serve as preoperative guidelines for the units performing surgical procedures.


Assuntos
Artérias/anatomia & histologia , Circulação Cerebrovascular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia Cerebral , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Adulto Jovem
9.
Pediatr Cardiol ; 34(8): 1928-31, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22878809

RESUMO

A case of aberrant left pulmonary artery originating from the right pulmonary artery resembling pulmonary artery sling malformation, but without true sling formation, is presented. Anomalous left pulmonary artery was accompanied with long-segment proximal tracheal stenosis and other congenital malformations typically associated with PAS complex. The anomalous pulmonary artery passed anterior to the trachea; therefore, no true sling was formed. Because no airway compression by the aberrant left pulmonary artery was detected, the proximal tracheal stenosis was thought to be primary.


Assuntos
Artéria Pulmonar/anormalidades , Estenose Traqueal/etiologia , Malformações Vasculares/complicações , Evolução Fatal , Seguimentos , Humanos , Imageamento Tridimensional , Lactente , Tomografia Computadorizada por Raios X , Estenose Traqueal/diagnóstico , Malformações Vasculares/diagnóstico
10.
J Clin Ultrasound ; 40(5): 319-21, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22253006

RESUMO

A 20 year-old man presented with pain and swelling of the left submandibular area. Neck sonography revealed enlargement of the submandibular gland, coarsening of its echotexture with a few calculi and a multiloculated cystic lesion. Doppler sonography revealed venous flow within the cystic lesion and aneurysmal dilatation of the adjacent facial vein. CT angiography confirmed the facial vein aneurysm. We hypothesize that inflammation of the gland had weakened the wall of the adjacent facial vein, causing aneurysmal dilatation.


Assuntos
Aneurisma/etiologia , Veias Braquiocefálicas , Face/irrigação sanguínea , Doenças Vasculares Periféricas/etiologia , Sialadenite/complicações , Glândula Submandibular , Aneurisma/diagnóstico por imagem , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Doenças Vasculares Periféricas/diagnóstico por imagem , Sialadenite/diagnóstico , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Adulto Jovem
11.
Ren Fail ; 34(3): 286-90, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22251313

RESUMO

PURPOSE: Renal artery variations are important for clinical reasons. The aim of this study is to determine the originating level and variations of renal arteries with 64-channel multidetector computed tomography (MDCT). MATERIALS AND METHODS: In a university hospital, 820 patients who underwent MDCT angiography of the abdominal aorta were retrospectively evaluated. The number, early division (ED), and originating level of renal artery were evaluated retrospectively. Variations of the renal artery on both sides, the difference between the genders with variations of the renal artery, were compared with chi-square test. RESULTS: Renal artery originating from the level of L1-L2 intervertebral disc was found in 37.0% and 38.9% of patients on the right and left sides, respectively. Renal artery variations, including extrarenal artery (ERA), were found in 27% and ED in 26.7% of the patients. Significant differences were found in ED and ERA prevalence for genders (p = 0.006 and p = 0.043, respectively). The prevalence of both variations is higher in males. CONCLUSIONS: An awareness of renal vascular variations is very important for both surgeons and radiologists. In this series, renal arterial variations were found in approximately one-fourth of the study population.


Assuntos
Angiografia/métodos , Tomografia Computadorizada Multidetectores/métodos , Artéria Renal/diagnóstico por imagem , Coleta de Tecidos e Órgãos/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anastomose Cirúrgica/métodos , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Transplante de Rim/métodos , Masculino , Pessoa de Meia-Idade , Nefrectomia , Artéria Renal/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Doadores de Tecidos , Procedimentos Cirúrgicos Vasculares/métodos , Adulto Jovem
12.
Eur J Radiol ; 77(3): 392-6, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19811882

RESUMO

Fenestration is a vascular variation that begins with a common origin, then splits into two parallel luminal channels and rejoins distally. Potential association between anomalies of cerebral circulation and increased occurrence of aneurysm makes intracranial arterial fenestrations important. The planning of intracranial arterial interventions may be complicated if a fenestration occurs proximal to the site of intended treatment. This study is planned to determine the frequency of fenestrations on CT angiography and to search whether there is relationship between aneurysms and fenestrations. CT angiographies of 395 consecutive patients, performed by 64-detector CT, were retrospectively reviewed for aneurysms and fenestrations. Overall fenestration frequency, fenestration frequency in patients with and without aneurysm, and aneurysm frequency in patients with and without fenestration were searched. Demographic characteristics of patients were also compared. Overall fenestration frequency was 12.9%. Vertebrobasilar system (5.56%) and anterior communicating region (5.32%) were the two most frequent sites of fenestration. The rate of fenestrations was not significantly different between patients who had and did not have aneurysms. Mean age was significantly higher, and females were predominant in patients with aneurysms. However our results did not show significant difference in age and sex of patients with fenestrations. The frequency of fenestrations in this study is higher than in previously published radiological studies, suggesting that fenestrations are relatively common. There is no significant relationship between the frequency of aneurysms and fenestrations.


Assuntos
Artérias Cerebrais/anormalidades , Artérias Cerebrais/diagnóstico por imagem , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/epidemiologia , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/epidemiologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Angiografia Cerebral/estatística & dados numéricos , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Turquia/epidemiologia
13.
Pediatr Neurosurg ; 46(1): 54-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20516741

RESUMO

Factor X deficiency is a rare coagulation defect that can result in several hemorrhagic manifestations including central nervous system hematomas in infants and children. In this case report, we present computed tomography (CT) and magnetic resonance (MR) imaging findings of bilateral chronic subdural hematomas due to factor X deficiency. Cranial CT and MR imaging in a hypoactive 7-month-old male infant with right hemiparesis revealed bilateral chronic subdural hematomas at different stages. Laboratory findings showed a severe factor X deficiency, with a level of 0.7%. After fresh frozen plasma replacement, the patient was operated and the large hematoma on the left side evacuated. The patient recovered uneventfully and remained asymptomatic during the 1-year follow-up.


Assuntos
Craniotomia , Deficiência do Fator X/complicações , Hematoma Subdural Crônico , Índice de Gravidade de Doença , Hematoma Subdural Crônico/diagnóstico , Hematoma Subdural Crônico/etiologia , Hematoma Subdural Crônico/cirurgia , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X
14.
J Ren Care ; 36(1): 49-53, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20214709

RESUMO

Spinal tuberculosis (TB) is a rare skeletal system localisation of TB in haemodialysis patients. In this paper, a case of Pott's disease with a psoas muscle abscess is reported. The patient had been on the dialysis programme for five years and was complaining of back pain, weight loss and weakness, which were investigated. A thoracolumbar magnetic resonance imaging showed multiple paravertebral abscesses invading the psoas muscle. TB diagnosis was made by microbiological analysis of specimen, which was obtained by fine needle aspiration under computerised tomography guidance.


Assuntos
Diálise Renal , Tuberculose da Coluna Vertebral/diagnóstico , Feminino , Humanos , Hospedeiro Imunocomprometido , Falência Renal Crônica/imunologia , Falência Renal Crônica/terapia , Pessoa de Meia-Idade , Abscesso do Psoas/diagnóstico , Abscesso do Psoas/imunologia , Abscesso do Psoas/microbiologia , Tuberculose da Coluna Vertebral/imunologia
15.
Diagn Interv Radiol ; 16(2): 97-8, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19885786

RESUMO

PURPOSE: Iodinated contrast agents lead to contraction of the gallbladder. The purpose of this prospective study was to investigate whether the paramagnetic contrast agents used for magnetic resonance imaging (MRI) cause volume changes in gallbladder or not. MATERIALS AND METHODS: The gallbladder volume changes were evaluated by ultrasound just before and 15 minutes after the imaging procedure in 10 patients without any paramagnetic contrast agent administration and 36 patients in whom paramagnetic contrast agents were administered during MRI. Gallbladder volume measurements before and 15 minutes after MRI were compared with each other. RESULTS: The mean pre- and post-procedural gallbladder volumes in patients on paramagnetic contrast agents were 30.2 +/- 19.3 cm(3) and 27.8 +/- 13.5 cm(3), respectively. They were 31.8 +/- 15.0 cm(3) and 29.5 +/- 9.3 cm(3), respectively, in patients who were not administered any paramagnetic contrast agent. There were no statistically significant difference between groups, regarding pre- and post-MRI gallbladder volumes. CONCLUSION: MRI, with or without paramagnetic contrast agents, does not lead to gallbladder volume contraction. In that regard, there appears to be no need to avoid ultrasound aimed to evaluate the gallbladder after MRI examinations.


Assuntos
Vesícula Biliar/anatomia & histologia , Vesícula Biliar/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Estudos Prospectivos , Valores de Referência , Ultrassonografia , Adulto Jovem
16.
J Back Musculoskelet Rehabil ; 22(2): 121-3, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-20023340

RESUMO

We have presented a patient of 71-year-age with brucellar spondylodiscitis, involving the cervical spine, especially the C3-C4 segment. The patient had painful percussion of the cervical spine and passive mobilization of the neck, decreased range of motion, and cervical paravertebral tenderness; but no abnormalities observed on neurological examination. Wright agglutination test for brucella was positive at 1/320. Cervical localization for brucellar spondylodiscitis is an unusual case and should be detected and treated as early as possible. In endemic regions, spinal involvement of brucellosis should be considered in cases with fever, neck and low back pain.


Assuntos
Brucelose/diagnóstico , Vértebras Cervicais/microbiologia , Discite/microbiologia , Idoso , Antibacterianos/uso terapêutico , Brucelose/tratamento farmacológico , Discite/reabilitação , Doxiciclina/uso terapêutico , Combinação de Medicamentos , Quimioterapia Combinada , Terapia por Exercício , Humanos , Imageamento por Ressonância Magnética , Masculino , Rifampina/uso terapêutico , Espironolactona , Sulfonamidas
17.
Yonsei Med J ; 50(5): 721-4, 2009 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-19881980

RESUMO

Tracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause characterized by the presence of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. A simultaneous diagnosis of TO and amyloidosis is rarely reported. In this report, a case initially suspected to be asthma bronchiole that could not be treated, was radiologically diagnosed as TO, and also secondary amyloidosis is presented. A 53 years, man patient reported a 3 years history of dyspnea. Pulmonary function tests (PFTs) showed an obstructive pattern. Chest X-rays revealed right middle lobe atelectasis. FOB and CT detected nodular lesions in the trachea and in the anterior and lateral walls of the main bronchi. AA amyloidosis was confirmed by endobronchial biopsy. In the abdominal fat pad biopsy, amyloidosis was not detected. Asthma bronchiole was excluded by PFTs. This case illustrates that it is possible for TO and amyloidosis to masquerade as asthma. TO and amyloidosis should be suspected in patients of older ages with asthma and especially with poorly treated asthmatic patients. Although nodular lesions in the anterior and lateral tracheobronchial walls are typical for TO, a biopsy should be obtained to exclude amyloidosis.


Assuntos
Amiloidose/diagnóstico , Broncopatias/diagnóstico , Doenças da Traqueia/diagnóstico , Amiloidose/complicações , Amiloidose/patologia , Asma/diagnóstico , Broncopatias/complicações , Broncopatias/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Doenças da Traqueia/complicações , Doenças da Traqueia/diagnóstico por imagem
18.
Heart Surg Forum ; 11(6): E357-60, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19073532

RESUMO

A 25-year-old woman who had undergone the Blalock-Taussig shunt operation for double-outlet right ventricle (DORV) in her childhood was admitted to our hospital with mild cyanosis and dyspnea on exertion. To evaluate the precise complex anatomy of this abnormality, we carried out multidetector computed tomography (MDCT) angiography. MDCT clearly revealed both an occluded Blalock-Taussig shunt and a complex cardiac anatomy, including DORV, a doubly committed ventriculoseptal defect, pulmonary stenosis, persistent left superior vena cava, minor aortic arch anomalies, and total anomalous hepatic venous drainage. To our knowledge, our report is the first description of such a complex cardiac anatomy to be revealed with MDCT.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Cardiopatias Congênitas/diagnóstico por imagem , Ventrículos do Coração/anormalidades , Ventrículos do Coração/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Vísceras/anormalidades , Vísceras/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos
19.
J Comput Assist Tomogr ; 31(5): 728-31, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17895784

RESUMO

OBJECTIVE: We aimed to describe the clinical and multidetector computed tomography (MDCT) angiography findings of celiac, mesenteric, and renal artery entrapment by the median arcuate ligament. MATERIALS AND METHODS: Patients (n = 453) who underwent MDCT abdominal aorta angiography in a period of 3 years were retrospectively reviewed for vascular compression by median arcuate ligament known as median arcuate ligament syndrome. The MDCT examinations were performed with 16-slice (n = 292) and 64-slice scanners (n = 161). The median arcuate ligament itself and adjacent vascular branches of abdominal aorta were assessed for compression by 2 different radiologists who are experienced on MDCT angiography more than 3 years. Both axial, multiplanar reformatted images and 3-dimensional angiographies were used for interpretation. RESULTS: Twelve patients were found to have clinically significant vessel entrapments by median arcuate ligament; 6 of them with celiac artery, 4 of them with renal artery, and 2 of them with both celiac and mesenteric artery involvement. Patients with celiac and mesenteric vessel entrapments presented with epigastric pain. All patients with renal artery entrapment had resistant hypertension. The MDCT showed the proximal narrowing caused by compression of median arcuate ligament. The proximal portions of renal arteries pulled down and in toward the aorta, with mild to moderate narrowing. CONCLUSIONS: The MDCT exanimation with multiplanar images and 3-dimensional angiography is a noninvasive imaging technique that can be used with high accuracy in the diagnosis of median arcuate ligament syndrome.


Assuntos
Angiografia/métodos , Arteriopatias Oclusivas/diagnóstico por imagem , Artéria Celíaca , Ligamentos , Oclusão Vascular Mesentérica/diagnóstico por imagem , Obstrução da Artéria Renal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Imageamento Tridimensional , Iohexol/análogos & derivados , Masculino , Artéria Mesentérica Superior , Pessoa de Meia-Idade , Estudos Retrospectivos , Síndrome
20.
AJR Am J Roentgenol ; 189(3): W143-5, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17715081

RESUMO

OBJECTIVE: Our objective was to describe the technique and outcome of CT-guided injection of botulinum toxin into the diaphragmatic crus in a patient with hypertension caused by left diaphragmatic crus compression of the left renal artery. CONCLUSION: After the procedure, the patient's hypertension disappeared. We propose this technique, which directly targets inhibition of overactivity of the diaphragmatic crus, for treatment of hypertension caused by diaphragmatic compression of the renal artery as an alternative to surgery and renal artery stenting.


Assuntos
Toxinas Botulínicas Tipo A/administração & dosagem , Hipertensão Renal/diagnóstico por imagem , Hipertensão Renal/tratamento farmacológico , Radiografia Intervencionista/métodos , Obstrução da Artéria Renal/complicações , Tomografia Computadorizada por Raios X/métodos , Adulto , Feminino , Humanos , Hipertensão Renal/etiologia , Injeções Intramusculares/métodos , Obstrução da Artéria Renal/diagnóstico por imagem , Obstrução da Artéria Renal/tratamento farmacológico , Stents , Ultrassonografia
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