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1.
Abdom Radiol (NY) ; 45(10): 3065-3080, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31190090

RESUMO

There are many different imaging features of cirrhosis, some of which are less commonly recognized. It is important that the radiologist is familiar with these features as cirrhosis can be first discovered on imaging performed for other indications, thus alerting the clinician for the need to screen for complications of cirrhosis and referral for potential treatment. This article reviews the various imaging findings of cirrhosis seen on cross-sectional imaging of the abdomen and pelvis.


Assuntos
Cirrose Hepática , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Abdome , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico por imagem , Pelve
2.
Int J Spine Surg ; 13(5): 470-473, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31741835

RESUMO

Background: Long instrumented fusions for adult deformity have a proximal junction kyphosis rate between 20% and 40%. When symptomatic, proximal junctional failure (PJF) often requires revision surgery and is associated with significant morbidity. Vertebral cement augmentation (VCA) has been used for prophylaxis against PJF but has not been previously described as treatment after onset of PJF has occurred. We describe a series of patients with PJF of long posterior spinal fusions that were treated at our institution using a novel VCA technique. Methods: Three patients with PJF above thoracolumbopelvic fusions were retrospectively reviewed following treatment with transpedicular-transdiscal VCA. The medical record was reviewed for demographic data, outcomes scores, and radiographic images. Results: Mean age was 69.3 years. Mean follow-up was 13.3 months. Mean preprocedure visual analog scale score was 8.67, and postprocedure visual analog scale score was 4.00. Mean preprocedure sagittal balance was 9.7 cm, and postprocedure sagittal balance was 5.8 cm. No patients required revision surgery for PJF in the follow-up period. Conclusions: Transpedicular-transdiscal VCA treatment for PJF is safe and may have the potential to prevent the need for revision surgery. Level of Evidence: 4.

3.
Acad Radiol ; 26(5): 686-698, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30072290

RESUMO

RATIONALE AND OBJECTIVES: Surgeons aim to restore occlusion and jaw function to baseline status for patients with mandibular fractures using either closed treatment or reduction and fixation. MATERIALS AND METHODS: Occlusion is defined as the relationship between the maxillary and mandibular teeth as they approach each other. RESULTS: Radiologists should be familiar with the goals of repair to help identify which treatment is adequate as well as to diagnose potential complications. Some of the more common complications encountered are infection, nonunion or malunion, and malocclusion. CONCLUSION: We provide a comprehensive review of both the desired and untoward CT findings after surgical repair of traumatic mandibular injuries.


Assuntos
Má Oclusão/diagnóstico por imagem , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Fixação Interna de Fraturas , Humanos , Período Pós-Operatório
4.
Lung Cancer ; 120: 1-6, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29748003

RESUMO

PURPOSE: To describe the frequency, distribution and reporting patterns of incidental findings receiving the Lung-RADS S modifier on low-dose chest computed tomography (CT) among lung cancer screening participants. METHODS: This retrospective investigation included 581 individuals who received baseline low-dose chest CT for lung cancer screening between October 2013 and June 2017 at a single center. Incidental findings resulting in assignment of Lung-RADS S modifier were recorded as were incidental abnormalities detailed within the body of the radiology report only. A subset of 60 randomly selected CTs was reviewed by a second (blinded) radiologist to evaluate inter-rater variability of Lung-RADS reporting. RESULTS: A total of 261 (45%) participants received the Lung-RADS S modifier on baseline CT with 369 incidental findings indicated as potentially clinically significant. Coronary artery calcification was most commonly reported, accounting for 182 of the 369 (49%) findings. An additional 141 incidentalomas of the same types as these 369 findings were described in reports but were not labelled with the S modifier. Therefore, as high as 69% (402 of 581) of participants could have received the S modifier if reporting was uniform. Inter-radiologist concordance of S modifier reporting in a subset of 60 participants was poor (42% agreement, kappa = 0.2). CONCLUSIONS: Incidental findings are commonly identified on chest CT for lung cancer screening, yet reporting of the S modifier within Lung-RADS is inconsistent. Specific guidelines are necessary to better define potentially clinically significant abnormalities and to improve reporting uniformity.


Assuntos
Vasos Coronários/patologia , Neoplasias Pulmonares/diagnóstico , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Calcinose , Detecção Precoce de Câncer , Feminino , Humanos , Achados Incidentais , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Tórax/patologia
5.
AJR Am J Roentgenol ; 209(4): W238-W248, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28705063

RESUMO

OBJECTIVE: The objective of this article is to describe the CT appearance of the midfacial skeleton after surgical repair of posttraumatic Le Fort, nasoorbitoethmoidal (NOE), and frontal sinus fractures. Several of the more commonly encountered complications will also be described. CONCLUSION: Surgery after midfacial trauma is aimed at restoring both form and function. Knowledge of the principal tenets of Le Fort, NOE, and frontal sinus fracture repair is vital for radiologists to accurately assess the adequacy of treatment on postoperative CT and provide meaningful reports for the surgeon.


Assuntos
Ossos Faciais/diagnóstico por imagem , Ossos Faciais/cirurgia , Fixação de Fratura , Fraturas Ósseas/tratamento farmacológico , Fraturas Ósseas/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Fraturas Cranianas/tratamento farmacológico , Fraturas Cranianas/cirurgia , Tomografia Computadorizada por Raios X , Ossos Faciais/lesões , Fixação de Fratura/métodos , Humanos
6.
J Glaucoma ; 26(6): 534-540, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28333893

RESUMO

PURPOSE: Evaluate for normative postoperative magnetic resonance imaging (MRI) characteristics of a Baerveldt Glaucoma Implant (BGI). DESIGN: Prospective case series. PARTICIPANTS: Seven subjects with uncontrolled glaucoma requiring a primary superotemporal BGI. METHODS: Subjects prospectively underwent sequential MRI orbital scans without contrast at 0 to 2 weeks, 6 to 8 weeks, and 4 to 6 months after implantation of a BGI model 103-250. Masked to the postoperative time course, a radiologist measured bleb and implant characteristics. MAIN OUTCOME MEASURES: Linear measurements of the maximum bleb height at the anterior, middle, and posterior sections of the endplate were measured. Intraocular pressure (IOP) was correlated to bleb height. RESULTS: On axial T2-weighted images, the height of fluid below and above the BGI endplate increased from the initial to the final MRI images: 0.49 mm to 1.83 mm and 0.57 mm to 1.08 mm (middle 1/3), respectively. On coronal T2-weighted images, fluid below and above the BGI endplate increased from 0.47 mm to 1.53 mm and 0.49 mm to 1.38 mm, respectively. Maximum inverse correlation between bleb height and IOP was observed at the 6 to 8 week coronal T2 images (r=-0.963, P=0.002). CONCLUSIONS: Fluid collections and endplate characteristics are easily visualized with MRI. Dynamic changes occur over the early postoperative time course. Bleb height is inversely correlated to IOP at 6 to 8 weeks, but disappears at 4 to 6 months.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma/cirurgia , Imageamento por Ressonância Magnética , Adulto , Idoso , Idoso de 80 Anos ou mais , Vesícula/diagnóstico por imagem , Vesícula/cirurgia , Feminino , Glaucoma/diagnóstico por imagem , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos
7.
J Thorac Imaging ; 32(3): 189-197, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28338536

RESUMO

PURPOSE: The aim of the study was to compare the accuracies of 4 different methods of assessing pulmonary nodule enhancement to distinguish benign from malignant solid pulmonary nodules using nondynamic contrast-enhanced dual-energy computed tomography. MATERIALS AND METHODS: Seventy-two patients (mean age, 62 y) underwent dual-energy chest computed tomography 3 minutes after intravenous contrast administration. Each of 118 pulmonary nodules (9±5.9 mm) were evaluated for enhancement by 4 methods: visual assessment, 3-dimensional automated postprocessing measurement tool, manually drawn region of interest with calculated iodine-related attenuation, and measurement of iodine concentration. The optimal cutoff for enhancement was defined as having the largest specificity among all cutoffs while maintaining 100% sensitivity. Accuracy of the methods was assessed with receiver operating characteristic curves. RESULTS: Ninety-three of 118 pulmonary nodules were benign (79%). Visual assessment of enhancement had sensitivity and specificity of 100% and 44%, respectively. For the automated 3-dimensional measurement tool, 20 HU was found to be the optimal threshold for defining enhancement, resulting in a specificity of 71% and a sensitivity of 100%, as well as an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.82-0.92). The AUC was 0.79 (95% CI, 0.73-0.85) for the measured enhancement using a manually drawn region of interest. When a threshold of 21 HU was used for defining enhancement, maximum specificity was obtained (56%) while maintaining 100% sensitivity. The AUC for measured iodine concentration was 0.79 (95% CI, 0.77-0.85). At a cutoff iodine concentration of 0.6 mg/mL, the sensitivity was 100% with a specificity of 57%. CONCLUSIONS: Although use of automated postprocessing had the highest specificity while maintaining 100% sensitivity, there were only minor clinically relevant differences between measurement techniques given that no single technique misclassified a malignant nodule as nonenhancing.


Assuntos
Neoplasias Pulmonares/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico por imagem , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Meios de Contraste , Feminino , Humanos , Imageamento Tridimensional/métodos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Intensificação de Imagem Radiográfica/métodos , Imagem Radiográfica a Partir de Emissão de Duplo Fóton/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
8.
Abdom Radiol (NY) ; 42(5): 1408-1414, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28154908

RESUMO

OBJECTIVE: The purpose of this study is to evaluate the prevalence of intra- and extrahepatic ductal dilatation in asymptomatic individuals after cholecystectomy. METHODS AND MATERIALS: This IRB-approved retrospective cohort study evaluated the prevalence of intra- and extrahepatic biliary dilation in 77 consecutive post cholecystectomy patients who had CT obtained in the portal venous phase. These were then compared to age and sex matched control patients. Two radiologists in consensus blinded to surgical history evaluated the intrahepatic ducts qualitatively for dilatation. A single radiologist using the best of three orthogonal planes measured the extrahepatic ducts. Extrahepatic ducts were considered dilated if >7 mm plus 1 mm/decade after 60 years. T tests and chi-squared tests were performed. RESULTS: Cholecystectomy patient duct patterns: normal ducts 26% (20/77); intra- and extrahepatic dilation 31.2% (24/77); intrahepatic dilation only 18.2% (14/77); extrahepatic dilation only 24.7% (19/77). Control patient duct patterns: normal ducts 88.3% (68/77); intra- and extrahepatic dilation 2.6% (2/77); intrahepatic dilation only 2.6% (2/77); extrahepatic dilation only 6.5% (5/77). All intrahepatic ductal dilatation was mild. Total intrahepatic dilation: 49.4% (cholecystectomy); 5.2% (control patients). The relative risk of intrahepatic ductal dilation in cholecystectomy patients was 9.5:1. Increased prevalence of intra- and extrahepatic dilation in cholecystectomy patients was statistically significant (p < 0.0001). Average extrahepatic duct was 7.8 mm (cholecystectomy) and 5.3 mm (control patients) (p < 0.001). CONCLUSION: Mild intrahepatic biliary dilation in the setting of cholecystectomy is very common, and if not associated with clinical or biochemical evidence of obstruction is likely of no clinical significance.


Assuntos
Ductos Biliares Intra-Hepáticos/diagnóstico por imagem , Ductos Biliares Intra-Hepáticos/patologia , Colecistectomia/efeitos adversos , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Meios de Contraste , Dilatação Patológica , Feminino , Humanos , Iohexol , Iopamidol , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
10.
AJR Am J Roentgenol ; 206(6): 1276-85, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27010378

RESUMO

OBJECTIVE: The purpose of this article is to describe both the expected and unexpected imaging features of posttraumatic defects of the orbital skeleton after surgical repair. CONCLUSION: The goal of surgery is to restore the preinjury orbital anatomy to improve function and prevent enophthalmos. Radiologists need to be cognizant of the more frequently encountered operative procedures used for orbital fracture repair, the desired goals of treatment, and common complications. This will permit accurate interpretation of postoperative CT and provide surgeons with clinically useful results.


Assuntos
Fixação de Fratura , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Complicações Pós-Operatórias/diagnóstico por imagem , Procedimentos Cirúrgicos Reconstrutivos , Tomografia Computadorizada por Raios X , Humanos , Próteses e Implantes
11.
J Comput Assist Tomogr ; 40(1): 167-71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26571059

RESUMO

OBJECTIVE: The purpose was to study the effect of low-osmolar nonionic contrast on renal length. MATERIAL AND METHODS: This study included 56 patients (4-phase renal computed tomography [CT] and 4-phase CT urogram [CTU], 19 patients each; split-phase CTU, 18 patients). Three radiologists created the best off-axis plane and renal lengths measured on a postprocessing workstation. Two-way analysis of variance with Bonferroni corrections was performed along with single-sample t tests. RESULTS: Four-phase renal CT and CTU average differences from unenhanced phases were 0.30/0.16 mm (corticomedullary), 0.88/1.33 mm (nephrographic), and 2.17/2.22 mm (delayed). The nephrographic and delayed phases were significantly different from their unenhanced phase (P < 0.01). Nonsignificant differences between the corticomedullary phase and the unenhanced phase were observed (P = 0.217, 4-phase renal CT; P = 0.232, 4-phase CTU). The split-phase CTU average difference in the enhanced phase was 1.36 mm (P < 0.001). CONCLUSION: Renal length increases 1 to 2 mm with low-osmolar nonionic contrast.


Assuntos
Meios de Contraste , Iopamidol , Rim/diagnóstico por imagem , Rim/patologia , Intensificação de Imagem Radiográfica/métodos , Tomografia Computadorizada por Raios X , Adulto , Idoso , Análise de Variância , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Reprodutibilidade dos Testes , Estudos Retrospectivos
12.
Orthopedics ; 39(1): e31-5, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26709557

RESUMO

Patient-reported outcome measures are helping clinicians to use evidence-based medicine in decision making. The use of computer-based questionnaires to gather such data may offer advantages over traditional paper-based methods. These advantages include consistent presentation, prompts for missed questions, reliable scoring, and simple and accurate transfer of information into databases without manual data entry. The authors enrolled 308 patients over a 16-month period from 3 orthopedic clinics: spine, upper extremity, and trauma. Patients were randomized to complete either electronic or paper validated outcome forms during their first visit, and they completed the opposite modality at their second visit, which was approximately 7 weeks later. For patients with upper-extremity injuries, the Penn Shoulder Score (PSS) was used. For patients with lower-extremity injuries, the Foot Function Index (FFI) was used. For patients with lumbar spine symptoms, the Oswestry Disability Index (ODI) was used. All patients also were asked to complete the 36-Item Short Form Health Survey (SF-36) Health Status Survey, version 1. The authors assessed patient satisfaction with each survey modality and determined potential advantages and disadvantages for each. No statistically significant differences were found between the paper and electronic versions for patient-reported outcome data. However, patients strongly preferred the electronic surveys. Additionally, the paper forms had significantly more missed questions for the FFI (P<.0001), ODI (P<.0001), and PSS (P=.008), and patents were significantly less likely to complete these forms (P<.0001). Future research should focus on limiting the burden on responders, individualizing forms and questions as much as possible, and offering alternative environments for completion (home or mobile platforms).


Assuntos
Medicina Baseada em Evidências/normas , Nível de Saúde , Inquéritos Epidemiológicos/métodos , Satisfação do Paciente , Ferimentos e Lesões/terapia , Adulto , Tomada de Decisões , Feminino , Humanos , Masculino
13.
AJR Am J Roentgenol ; 205(4): 797-801, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26397327

RESUMO

OBJECTIVE: The objective of this study was to determine the accuracy of renal measurement on CT in multiple imaging planes. MATERIALS AND METHODS: In this study, three board-certified radiologists retrospectively measured 110 kidneys on CT in 55 consecutive patients. Five measurement methods were used: axial, coronal single image, coronal multiimage, sagittal single image, and sagittal multiimage. The coronal database was sent to a postprocessing workstation, and each radiologist performed a maximum renal measurement using a best off-axis plane that was our reference standard. An ANOVA test with repeated measures and posthoc Bonferroni corrected t tests were performed. RESULTS: The mean differences (± standard error) compared with the reference standard method were as follows: axial, 7.7 ± 0.7 mm; coronal single image, 13.1 ± 1.4 mm; coronal multiimage, 6.4 ± 0.8 mm; sagittal single image, 6.4 ± 0.6 mm; and sagittal multiimage, 2.8 ± 0.3 mm. The reference standard measurement was larger (p < 0.001), whereas the coronal single-image measurement (p ≤ 0.006) was smaller than all other methods. The sagittal multiimage (p ≤ 0.005) was statistically significantly different from all other methods. There were no statistically significant differences among the axial, coronal multiimage, and sagittal single-image methods (p ≥ 0.088). CONCLUSION: The single-image coronal method is the least accurate, with an error of approximately 13 mm. The axial, multiimage coronal, and single-image sagittal methods underestimate renal size by approximately 6-8 mm. Multiimage sagittal is the most accurate method for measuring kidneys with an error of approximately 3 mm.


Assuntos
Rim/diagnóstico por imagem , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Iohexol , Iopamidol , Masculino , Pessoa de Meia-Idade , Padrões de Referência , Estudos Retrospectivos
14.
J Comput Assist Tomogr ; 39(6): 825-34, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26248153

RESUMO

Serum tumor markers are firmly entrenched as one of the primary tools in an oncologist's armamentarium. They can be implemented in a broad range of applications from diagnostic assistance, assessing prognosis, or guiding therapeutic decisions. However, tumor markers also have limitations, which significantly impact how they should be used. Radiologists should be familiar with the following most prevalent tumor markers, which will all be discussed here: prostate-specific antigen (prostate), carcinoembryonic antigen (colon), α-fetoprotein (hepatocellular and testicular), carbohydrate antigen 19.9 (pancreas), cancer antigen 125 (ovarian), human chorionic gonadotropin/lactic dehydrogenase (testicular), and chromogranin A (neuroendocrine). This knowledge should avoid needless intervention, enhance image interpretation, and ultimately provide optimal patient care.


Assuntos
Biomarcadores Tumorais/sangue , Diagnóstico por Imagem/métodos , Neoplasias/sangue , Neoplasias/diagnóstico , Antígeno Ca-125/sangue , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Gonadotropina Coriônica/sangue , Cromogranina A/sangue , Feminino , Humanos , Masculino , Antígeno Prostático Específico/sangue , alfa-Fetoproteínas
15.
Abdom Imaging ; 40(8): 3029-42, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26194812

RESUMO

Surgical resection of colorectal metastatic disease has increased as surgeons have adopted a more aggressive ideology. Current exclusion criteria are patients for whom a negative resection margin is not feasible or a future liver remnant (FLR) of greater than 20% is not achievable. The goal of preoperative imaging is to identify the number and distribution of liver metastases, in addition to establishing their relation to relevant intrahepatic structures. FLR can be calculated utilizing cross-sectional imaging to select out patients at risk for hepatic dysfunction after resection. MRI, specifically with gadoxetic acid contrast, is currently the preferred modality for assessment of hepatic involvement for patients with newly diagnosed colorectal cancer, to include those who have undergone neoadjuvant chemotherapy. Employment of liver-directed therapies has recently expanded and they may provide an alternative to hepatectomy in order to obtain locoregional control in poor surgical candidates or convert patients with initially unresectable disease into surgical candidates.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/secundário , Fígado/diagnóstico por imagem , Fígado/patologia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Meios de Contraste , Gadolínio DTPA , Humanos , Aumento da Imagem , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/patologia
16.
Abdom Imaging ; 40(8): 3182-90, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26205993

RESUMO

PURPOSE: To investigate the incidence of high T2 signal rims surrounding leiomyomas, evaluate if a particular T2-weighted sequence is more effective in depicting this rim, and determine if this sign is useful in differentiating pedunculated leiomyomas from other solid adnexal masses. MATERIALS AND METHODS: In this retrospective study, two radiologists evaluated 233 T2 dark pelvic masses (223 uterine leiomyomas and 10 ovarian fibromas) in 60 women (mean age 47) on Magnetic resonance imaging for the presence of a high signal rim. Three different T2-weighted sequences were reviewed independently for uterine leiomyomas: half-Fourier acquisition single-shot turbo spin echo (HASTE), SPACE, and T2 with fat saturation (T2 FS). Only T2 FS images were available for 10 fibromas. A consensus review was conducted for discrepant cases. Statistical analyses were performed using Fisher's exact test, kappa test, and ANOVA RESULTS: For 223 uterine leiomyomas, 23% (95% CI 17.8-28.9%) demonstrated a high T2 signal rim sign on T2 FS compared with 4.9% (95% CI 2.6-8.9%) for HASTE and 6.7% (95% CI 3.9-11.1%) for SPACE. The difference between the number of positive rims on T2 FS relative-HASTE and SPACE was statistically significant (p < 0.001). For ovarian fibromas, 40% (95% CI 16.9-68.8%) were classified positive for a rim sign. CONCLUSION: A high T2 signal rim sign was present for up to 23% of uterine leiomyomas and the T2 FS sequence detected this rim sign most frequently. Up to 40% of ovarian fibromas can also have a T2 rim sign and, therefore, a solid adnexal mass with a T2 rim sign cannot be assumed to represent a pedunculated leiomyoma.


Assuntos
Doenças dos Anexos/patologia , Leiomioma/patologia , Imageamento por Ressonância Magnética , Neoplasias Uterinas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Artefatos , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
17.
Radiographics ; 35(1): 221-34, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25590399

RESUMO

Ophthalmologists perform a wide array of interventions on the orbital contents. The surgical treatment of glaucoma, cataracts, retinal detachment, and ocular trauma or malignancy results in alteration of the standard anatomy, which is often readily evident at radiologic examinations. The ability to accurately recognize the various imaging manifestations after orbital surgery is critical for radiologists to avoid misdiagnosis. Of particular importance is familiarity with the numerous types of implanted devices, such as glaucoma drainage devices, orbital implants, and eyelid weights. Although knowledge of patients' surgical history is helpful, this information is often not available at the time of interpretation. Fortunately, there are characteristic posttreatment findings that enable diagnosis. The imaging features of the most commonly performed ophthalmologic procedures are highlighted, with emphasis on computed tomography and magnetic resonance (MR) imaging, because they are currently the primary modalities involved in evaluating the orbits. Glaucoma drainage devices and orbital implants after enucleation are two of the more pertinent implanted devices because their composition has substantially evolved over the past 2 decades, which affects their imaging appearance. Some devices, such as the Baerveldt Glaucoma Implant and platinum-weighted eyelid implants, may distort radiologic images. The MR imaging safety profiles of numerous implanted devices are also reported.


Assuntos
Diagnóstico por Imagem , Oftalmopatias/diagnóstico , Oftalmopatias/cirurgia , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/cirurgia , Corpos Estranhos/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Próteses e Implantes , Humanos , Implantes Orbitários , Instrumentos Cirúrgicos
18.
AJR Am J Roentgenol ; 204(2): 386-95, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25615762

RESUMO

OBJECTIVE. The purpose of this article is to highlight the most salient imaging features of retrorectal masses with regard to surgical planning, preoperative biopsy, and identification of nonneoplastic mimickers of malignancy. CONCLUSION. Retrorectal tumors are associated with high morbidity. CT and MRI aid in preoperative planning because surgical resection is the treatment of choice for both benign and malignant entities. Radiologists need to understand the operative techniques currently used for retrorectal tumors because the first attempt at excision is the best chance for complete resection and optimal outcome.


Assuntos
Neoplasias Retais/diagnóstico , Neoplasias Retais/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório , Humanos , Imageamento por Ressonância Magnética , Radiologia , Tomografia Computadorizada por Raios X
19.
Abdom Imaging ; 40(6): 2012-29, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25613332

RESUMO

Gadoxetic acid is a hepatocyte-specific magnetic resonance imaging contrast agent with the ability to detect and characterize focal liver lesions and provide structural and functional information about the hepatobiliary system. Knowledge of the pharmacokinetics of gadoxetic acid is paramount to understanding imaging protocol and lesion appearance and facilitates identification and avoidance of undesired effects with use of this intravenous contrast agent. This article reviews the utility of gadoxetic acid in liver and biliary imaging, with emphasis on the hepatobiliary phase.


Assuntos
Sistema Biliar/patologia , Meios de Contraste/farmacocinética , Gadolínio DTPA/farmacocinética , Hepatopatias/diagnóstico , Fígado/patologia , Humanos , Imageamento por Ressonância Magnética
20.
Abdom Imaging ; 40(2): 400-10, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25123077

RESUMO

PURPOSE: The radiologist can encounter benign significant imaging findings on computed tomography that can be incorrectly interpreted as neoplasm. The authors review several benign findings and demonstrate several methods to differentiate these findings from more sinister pathology. CONCLUSION: It is imperative for the radiologist to be cognizant of and how to correctly identify mimickers of pathology so that unnecessary interventions and surgeries are avoided.


Assuntos
Neoplasias Abdominais/diagnóstico por imagem , Doenças do Sistema Digestório/diagnóstico por imagem , Doenças Linfáticas/diagnóstico por imagem , Neoplasias Pélvicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doenças Vasculares/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pelve/diagnóstico por imagem , Radiografia Abdominal
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