Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Br J Radiol ; : 20210753, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34464549

RESUMO

Adrenal hemorrhage (AH) is a rare condition. It can be traumatic or non-traumatic. Most common causes are septicemia, coagulopathy or bleeding diathesis, and underlying neoplasms. Other reported less common causes of AH are COVID-19 and neonatal stress. Clinical diagnosis of AH is challenging due to its non-specific presentation and occurrence in the setting of acute medical illness. Therefore, most cases are diagnosed incidentally on imaging. Having high clinical suspicion in the proper clinical setting for AH is crucial to avoid life-threatening adrenal insufficiency that occurs in 16-50% of patients with bilateral AH. We discuss the clinical situations that predispose to AH, review the imaging features on different imaging modalities, highlight a variety of clinical cases, imaging features that should be concerning for an underlying neoplasm, and outline the potential role of interventional radiology in management of AH.

2.
Medicine (Baltimore) ; 100(32): e26891, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397912

RESUMO

ABSTRACT: The aim of the study is to evaluate the reliability of shear wave elastography to assess the anterior and middle scalene muscles in healthy adult subjects.The study included 60 scalene muscles in 15 healthy subjects. High-resolution ultrasound and shear wave elastography were used to evaluate the anterior scalene and the middle scalene muscles. Stiffness values were measured.The mean shear elastic modulus showed the following values, right anterior scalene muscle 18.83 ±â€Š5.32 kPa, left anterior scalene muscle 21.71 ±â€Š4.8 kPa, right middle scalene muscle 12.84 ±â€Š5.2 kPa, left middle scalene muscle 19.76 ±â€Š5.30 kPa. Positive correlation was noted between the left middle scalene muscle and body mass index (P = .004). No difference in elasticity was noted between the right and left anterior scalene muscles; however, significant difference was noted between the right and left middle scalene muscles (P = .002).The results obtained in our study could be a reference point for future research considering different scalene muscle pathologies.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Músculos do Pescoço/diagnóstico por imagem , Adulto , Índice de Massa Corporal , Estudos Transversais , Elasticidade , Feminino , Voluntários Saudáveis , Humanos , Masculino , Músculos do Pescoço/fisiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
3.
AJR Am J Roentgenol ; 216(4): 927-934, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33566632

RESUMO

OBJECTIVE. The objective of this article is to discuss the anatomy, embryonic origin, normal variants, and various attachments of the ligament of Treitz. We also describe the pathologic processes that develop along the ligament of Treitz and the role of cross-sectional imaging in identifying these conditions. CONCLUSION. The ligament of Treitz, also known as the suspensory ligament of the duodenum, is an important anatomic landmark in the abdomen. It is essential that radiologists understand the anatomic attachments, normal variants, and various pathologic conditions involving the ligament of Treitz as well as the role of cross-sectional imaging in the assessment of these conditions.


Assuntos
Duodeno/diagnóstico por imagem , Ligamentos/diagnóstico por imagem , Duodeno/anatomia & histologia , Duodeno/patologia , Humanos , Jejuno/anatomia & histologia , Jejuno/diagnóstico por imagem , Jejuno/patologia , Ligamentos/anatomia & histologia , Ligamentos/patologia , Espaço Retroperitoneal/anatomia & histologia , Espaço Retroperitoneal/diagnóstico por imagem , Espaço Retroperitoneal/patologia , Tomografia Computadorizada por Raios X
4.
Curr Probl Diagn Radiol ; 50(2): 252-261, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32624297

RESUMO

The diaphragm is not only a sheet of muscle separating the abdominal and thoracic cavities: it plays an essential role in ventilation and can act as a gateway for the spread of different disease processes between the abdominal and the thoracic cavity. Careful attention to the appearance of the diaphragm on various imaging modalities is essential to ensure the accurate diagnosis of diaphragmatic disorders, which may be secondary to functional or anatomical derangements.

5.
Abdom Radiol (NY) ; 46(2): 805-817, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32949273

RESUMO

The perisplenic region is a complex anatomical area involving multiple peritoneal and subperitoneal structures, which influence the presentation and behavior of various pathologic processes. This review is a comprehensive resource for perisplenic anatomy and pathology with associated clinical presentations and imaging findings. Understanding the pathophysiologic intricacies of the perisplenic region assists the radiologist in building a helpful differential diagnosis and recognizing predictable disease patterns.


Assuntos
Peritônio , Baço , Diagnóstico Diferencial , Humanos , Baço/diagnóstico por imagem
6.
Alcohol ; 90: 45-55, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33232792

RESUMO

INTRODUCTION: Excess energy intake by spectators at a sporting event (i.e., a tailgate) might cause acute negative health effects. However, limited data exist regarding the effects of overeating and alcohol consumption on lipid metabolism and the potential to gain intrahepatic triacylglycerols (IHTG). We tested the hypothesis that overconsumption of food and alcohol would significantly increase both hepatic de novo lipogenesis (DNL) and IHTG. METHODS: Eighteen males (mean ± SD, age: 31.4 ± 7.3 years, BMI: 32.1 ± 5.9 kg/m2) were given alcoholic drinks to elevate blood alcohol for 5 h, while highly palatable food was presented. Blood samples were collected and DNL in TG-rich lipoproteins (TRL) was measured by GC/MS, IHTG was measured via MRS (n = 15), and substrate oxidation was measured via indirect calorimetry. RESULTS: Subjects consumed 5087 ± 149 kcal (191 ± 25% excess of total daily energy needs including 171 ± 24 g alcohol), which increased plasma insulin, glucose, TG, and decreased NEFA (ANOVA p ≤ 0.003 for all). Both DNL and TRL-TG increased (p < 0.001), while IHTG did not change in the group as a whole (p = 0.229). Individual subject data revealed remarkably differing responses for IHTG (nine increased, five decreased, one did not change). Despite maintaining equal breath alcohol levels, subjects with IHTG elevations exhibited higher DNL, consumed 90% less alcohol (p = 0.048), tended to consume more carbohydrates, and exhibited lower whole-body fat oxidation (not significant) compared to those whose IHTG was reduced. DISCUSSION: This study demonstrates that acute excess energy intake may have differing effects on an individual's DNL and IHTG, and dietary carbohydrate may influence DNL more than alcohol.

7.
AJR Am J Roentgenol ; 217(1): 135-140, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32845714

RESUMO

BACKGROUND. Incidental homogeneous renal masses are frequently encountered at portal venous phase CT. The American College of Radiology Incidental Findings Committee's white paper on renal masses recommends additional imaging for incidental homogeneous renal masses greater than 20 HU, but single-center data and the Bosniak classification version 2019 suggest the optimal attenuation threshold for detecting solid masses should be higher. OBJECTIVE. The purpose of this article is to determine the clinical importance of small (10-40 mm) incidentally detected homogeneous renal masses measuring 21-39 HU at portal venous phase CT. METHODS. We performed a 12-institution retrospective cohort study of adult patients who underwent portal venous phase CT for a nonrenal indication. The date of the first CT at each institution ranged from January 1, 2008, to January 1, 2014. Consecutive reports from 12,167 portal venous phase CT examinations were evaluated. Images were reviewed for 4529 CT examinations whose report described a focal renal mass. Eligible masses were 10-40 mm, well-defined, subjectively homogeneous, and 21-39 HU. Of these, masses that were shown to be solid without macroscopic fat; classified as Bosniak IIF, III, or IV; or confirmed to be malignant were considered clinically important. The reference standard was renal mass protocol CT or MRI, ultrasound of definitively benign cysts or solid masses, single-phase contrast-enhanced CT or unenhanced MRI showing no growth or morphologic change for 5 years or more, or clinical follow-up 5 years or greater. A reference standard was available for 346 masses in 300 patients. The 95% CIs were calculated using the binomial exact method. RESULTS. Eligible masses were identified in 4.2% of patients (514/12,167; 95% CI, 3.9-4.6%). Of 346 masses with a reference standard, none were clinically important (0%; 95% CI, 0-0.9%). Mean mass size was 17 mm; 72% (248/346) measured 21-30 HU, and 28% (98/346) measured 31-39 HU. CONCLUSION. Incidental small homogeneous renal masses measuring 21-39 HU at portal venous phase CT are common and highly likely benign. CLINICAL IMPACT. The change in attenuation threshold signifying the need for additional imaging from greater than 20 HU to greater than 30 HU proposed by the Bosniak classification version 2019 is supported.

8.
J Comput Assist Tomogr ; 44(6): 870-881, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33196596

RESUMO

Gastrointestinal (GI) tract and mesenteric vascular lesions can have various clinical presentations, of which GI bleeding is the most common. This collection of pathology is highly variable in etiology ranging from occlusive disease to vascular malformations to trauma to neoplasms which makes for a challenging workup and diagnosis. The advent of multiple imaging modalities and endoscopic techniques makes the diagnosis of these lesions more achievable, and familiarity with their various imaging findings can have a significant impact on patient management. In this article, we review the gamut of GI tract and mesenteric vascular lesions and their associated imaging findings.


Assuntos
Diagnóstico por Imagem/métodos , Trato Gastrointestinal/irrigação sanguínea , Trato Gastrointestinal/diagnóstico por imagem , Artérias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/diagnóstico por imagem , Neoplasias Vasculares/diagnóstico por imagem , Humanos
9.
Abdom Radiol (NY) ; 45(8): 2315-2326, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32529262

RESUMO

The peritoneum is a complex structure. Having a better understanding of this complex anatomy will enable the radiologist to accurately assess and diagnose the wide range of intra-abdominal pathologies. In this article, we review the anatomy, boundaries, and connections of Morison's pouch. In addition, we discuss the incidence and development of common pathological conditions within Morison's pouch and the role of multiple imaging modalities in assessment and diagnosis of these conditions.


Assuntos
Bolsas Cólicas , Humanos , Cavidade Peritoneal , Peritônio/diagnóstico por imagem
10.
Radiol Case Rep ; 15(7): 961-965, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32419895

RESUMO

Adrenal myelolipoma is a benign tumor of the adrenal cortex composed predominantly of fat and hematopoietic tissue. These lesions are usually asymptomatic, and most often incidentally detected on imaging. Uncommonly, they present with retroperitoneal hemorrhage, and these have been traditionally treated with emergent surgery. Although, transarterial embolization has been effectively and safely used in patients presenting with active hemorrhage from acute traumatic and nontraumatic causes, literature specifically pertaining to adrenal artery embolization is scant, perhaps due to smaller size and variability of adrenal arteries. With recent advances in endovascular techniques and imaging, there are emerging case reports and series of adrenal artery embolization in acute and nonacute settings. We report a case of spontaneous hemorrhage within an adrenal myelolipoma in a 43-year-old male patient, successfully treated with transarterial embolization, thereby avoiding major surgery. Our report adds to the growing body of literature pertaining to adrenal artery embolization.

11.
Abdom Radiol (NY) ; 45(8): 2485-2499, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32300834

RESUMO

IgG4-related disease (IgG4-RD) is a systemic, autoimmune, fibroinflammatory disease that can cause multi-organ damage. Although there have been many trials and studies since its recognition in 2003, there is still much that is unknown. Furthermore, IgG4-RD can affect any organ in the body and often has many mimics and alternative diagnoses, which can make for a challenging workup. Imaging plays a substantial role in the diagnosis of IgG4-RD and is often the first occasion where IgG4-RD comes into consideration. Thus, knowledge about the imaging findings of various manifestations of IgG4-RD can aid in the diagnosis and have a significant impact on patient management. In this article, we review the wide array of imaging findings, both typical and atypical, as well as possible mimics of IgG4-RD in the abdomen and pelvis.


Assuntos
Doenças Autoimunes , Doença Relacionada a Imunoglobulina G4 , Abdome/diagnóstico por imagem , Doenças Autoimunes/diagnóstico por imagem , Humanos , Imunoglobulina G , Doença Relacionada a Imunoglobulina G4/diagnóstico por imagem , Pelve/diagnóstico por imagem
12.
J Clin Imaging Sci ; 10: 3, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32123617

RESUMO

Chondrosarcomas are tumors consisting of osseous or cartilaginous stroma. They are not an uncommon pathology; however, primary pulmonary chondrosarcomas arising in lung parenchyma are extremely rare, with few cases published in literature. Herein, we present a case with biopsy-proven primary pulmonary chondrosarcoma after exclusion of primary origin elsewhere. In the case presented in this report, we demonstrate the clinical presentations, pulmonary function tests, and the radiological findings of this rare tumor in a young male patient. Further, we present a brief review of existing literature for patients with similar pathology.

13.
J Comput Assist Tomogr ; 44(2): 178-187, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32195796

RESUMO

Incidental adrenal lesions are found in 2% to 10% of the population. The presence and pattern of calcifications, in conjunction with other clinical and imaging features, such as soft tissue attenuation, enhancement, and laterality, can aid in narrowing a differential diagnosis, thereby preventing unnecessary biopsies and avoiding delays in management. Calcified adrenal lesions can be categorized under the clinical and laboratory headings of normal adrenal function, hyperfunctioning adrenal tissue, and adrenal insufficiency. In this review, we provide an algorithmic approach to assessing calcified adrenal nodules with correlative radiologic findings.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Glândulas Suprarrenais/diagnóstico por imagem , Humanos
14.
Skeletal Radiol ; 49(2): 321-330, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31342092

RESUMO

Plexiform neurofibromas are an uncommon variant of neurofibromas that are described as being essentially pathognomonic of neurofibromatosis type 1 (NF1). Plexiform neurofibromas in the absence of NF1 are extremely rare. We present the case of a 38-year-old woman with a large multilobulated lumbosacral mass extending into the pelvis and proximal thigh. Histopathology of a CT-guided biopsy of the mass revealed it to be a neurofibroma. The imaging findings were consistent with a plexiform subtype. Further imaging and clinical workup showed that the patient had no other identifiable neurofibromas and did not meet criteria for the diagnosis of NF1.


Assuntos
Neurofibroma Plexiforme/diagnóstico por imagem , Neurofibroma Plexiforme/patologia , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/patologia , Adulto , Feminino , Humanos , Biópsia Guiada por Imagem , Imageamento por Ressonância Magnética/métodos , Radiografia Intervencionista/métodos , Tomografia Computadorizada por Raios X/métodos
15.
Hepatology ; 72(1): 103-118, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31630414

RESUMO

BACKGROUND AND AIMS: Elevated hepatic de novo lipogenesis (DNL) is a key distinguishing characteristic of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis. In rodent models of NAFLD, treatment with a surrogate of TVB-2640, a pharmacological fatty acid synthase inhibitor, has been shown to reduce hepatic fat and other biomarkers of DNL. The purpose of this phase I clinical study was to test the effect of the TVB-2640 in obese men with certain metabolic abnormalities that put them at risk for NAFLD. APPROACH AND RESULTS: Twelve subjects (mean ± SEM, 42 ± 2 years, body mass index 37.4 ± 1.2 kg/m2 , glucose 103 ± 2 mg/dL, triacylglycerols 196 ± 27 mg/dL, and elevated liver enzymes) underwent 10 days of treatment with TVB-2640 at doses ranging from 50-150 mg/day. Food intake was controlled throughout the study. Hepatic DNL was measured before and after an oral fructose/glucose bolus using isotopic labeling with 1-13 C1 -acetate intravenous infusion, followed by measurement of labeled very low-density lipoprotein palmitate via gas chromatography mass spectometry. Substrate oxidation was measured by indirect calorimetry. Across the range of doses, fasting DNL was reduced by up to 90% (P = 0.003). Increasing plasma concentrations of TVB-2640 were associated with progressive reductions in the percent of fructose-stimulated peak fractional DNL (R2  = -0.749, P = 0.0003) and absolute DNL area under the curve 6 hours following fructose/glucose bolus (R2  = -0.554, P = 0.005). For all subjects combined, alanine aminotransferase was reduced by 15.8 ± 8.4% (P = 0.05). Substrate oxidation was unchanged, and safety monitoring revealed that the drug was well tolerated, without an increase in plasma triglycerides. Alopecia occurred in 2 subjects (reversed after stopping the drug), but otherwise no changes were observed in fasting glucose, insulin, ketones, and renal function. CONCLUSION: These data support the therapeutic potential of a fatty acid synthase inhibitor, TVB-2640 in particular, in patients with NAFLD and nonalcoholic steatohepatitis.


Assuntos
Inibidores Enzimáticos/farmacologia , Ácido Graxo Sintases/antagonistas & inibidores , Lipogênese/efeitos dos fármacos , Fígado/metabolismo , Doenças Metabólicas/metabolismo , Nitrilas/farmacologia , Piperidinas/farmacologia , Triazóis/farmacologia , Adulto , Humanos , Masculino
16.
AJR Am J Roentgenol ; 213(1): 8-16, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30973778

RESUMO

OBJECTIVE. The purposes of this article are to discuss a variety of liver masses that can present with hemorrhage, including their characteristic imaging features, and to propose a diagnostic approach. CONCLUSION. A broad spectrum of pathologic conditions can present as spontaneous hemorrhage within or surrounding the liver and may present acutely or as a chronic or incidental finding. Imaging characteristics and clinical history can often narrow the differential diagnosis and guide management.

17.
Radiol Case Rep ; 14(4): 521-525, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30906490

RESUMO

Introduction: Sclerosing Angiomatoid Nodular Transformation of the spleen is a benign vascular lesion with no known etiology. Presentation of Case: We report a new case in a symptomatic twenty-one-year old female with thrombocytopenia and a hypervascular splenic mass discovered on ultrasound. Two MRIs were performed prior to hand-assisted laparoscopic splenectomy. The specimen was sent for histopathologic analysis with confirmation of final diagnosis from an outside facility. Discussion: Sclerosing Angiomatoid Nodular Transformation of the spleen is most often discovered incidentally as a solitary splenic mass. The presence of a spoke-wheel pattern should alert the radiologist to this as a possibility. Conclusion: Ultrasound and MR imaging findings can be used to accurately diagnose cases of splenic Sclerosing Angiomatoid Nodular Transformation. Susceptibility artifact within the lesion may be directly related to the amount of iron deposition.

18.
Radiographics ; 38(7): 2051-2068, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30339518

RESUMO

The risk of developing malignancy is higher in patients with human immunodeficiency virus (HIV) infection than in non-HIV-infected patients. Several factors including immunosuppression, viral coinfection, and high-risk lifestyle choices lead to higher rates of cancer in the HIV-infected population. A subset of HIV-related malignancies are considered to be acquired immunodeficiency syndrome (AIDS)-defining malignancies, as their presence confirms the diagnosis of AIDS in an HIV-infected patient. The introduction of highly active antiretroviral therapy (HAART) has led to a significant drop in the rate of AIDS-defining malignancies, including Kaposi sarcoma, non-Hodgkin lymphoma, and invasive cervical carcinoma. However, non-AIDS-defining malignancies (eg, Hodgkin lymphoma, lung cancer, hepatocellular carcinoma, and head and neck cancers) now account for an increasing number of cancer cases diagnosed in HIV-infected patients. Although the number has decreased, AIDS-defining malignancies account for 15%-19% of all deaths in HIV-infected patients in the post-HAART era. Most HIV-related malignancies in HIV-infected patients manifest at an earlier age with a more aggressive course than that of non-HIV-related malignancies. Understanding common HIV-related malignancies and their specific imaging features is crucial for making an accurate and early diagnosis, which impacts management. Owing to the weakened immune system of HIV-infected patients, other entities such as various infections, particularly opportunistic infections, are prevalent in these patients. These processes can have confounding clinical and imaging manifestations that mimic malignancy. This article reviews the most common AIDS-defining and non-AIDS-defining malignancies, the role of imaging in their diagnosis, and the imaging mimics of malignancies in HIV-infected patients. ©RSNA, 2018.


Assuntos
Síndrome de Imunodeficiência Adquirida/complicações , Neoplasias/diagnóstico por imagem , Neoplasias/virologia , Vírus Oncogênicos/patogenicidade , Infecções Tumorais por Vírus/diagnóstico por imagem , Infecções Tumorais por Vírus/virologia , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade , Coinfecção , Diagnóstico Diferencial , Humanos
20.
Radiographics ; 38(5): 1370-1384, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30059275

RESUMO

Villous lesions are advanced adenomas that manifest most commonly in the colon; however, they can develop throughout the gastrointestinal tract. The duodenum is the most common small-bowel site of these lesions. Although in most cases these are isolated lesions that occur sporadically, patients with certain specific colorectal cancer syndromes, including familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, may develop multiple advanced adenomas. Villous lesions are important because although they are histologically benign, they may harbor dysplasia and have potential for malignancy. These characteristics make them a primary target for colorectal cancer screening with optical and virtual colonoscopy. However, these lesions can also be symptomatic and detected at diagnostic imaging when patients present for examination. They have characteristic features at a variety of imaging examinations, including barium fluoroscopy, CT, MRI, and endoscopic US. It is important for radiologists to be aware of these lesions, their potential morphologies, and their typical appearances at multimodality imaging. Although villous tumors can be detected at imaging and confirmed with biopsy, owing to limitations in identifying dysplasia and foci of malignancy with the above modalities alone and the potential for malignancy, referral for surgical resection of these lesions ultimately is required. ©RSNA, 2018.


Assuntos
Adenoma Viloso/diagnóstico por imagem , Neoplasias Gastrointestinais/diagnóstico por imagem , Imagem Multimodal , Adenoma Viloso/patologia , Neoplasias Gastrointestinais/patologia , Humanos , Síndrome
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...