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2.
Medicine (Baltimore) ; 98(41): e17466, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593105

RESUMO

RATIONALE: Vertebral arteriovenous fistulas (VAVFs) are depicted with anomalous connections between the vertebral artery, or its branches, and the adjacent venous system. Most VAVFs occur as a result of direct trauma during accidents, whereas others have iatrogenic origin. PATIENT CONCERNS: We report a case of 11-year-old male who presented with right limb weakness and walking instability. DIAGNOSIS: Magnetic resonance angiography as well as digital subtraction angiogram (DSA) of the neck demonstrated a right VAVF. The cervical medulla was compressed by a dilated vein in vertebral canal. The blood supply of the fistula was from the right vertebral artery, whereas drainage was via epidural and paraspinal venous plexus. INTERVENTIONS: We introduced the TransForm Occlusion Balloon Catheter into right vertebral artery, identified the VAVF, and occluded it with the balloon. OUTCOMES: We successfully obliterated the VAVF with patency of parent vertebral artery with a balloon. The symptoms of the patient were relieved after the procedure. Two years' follow-up revealed no recurrence of the fistula. The patient is currently well. LESSONS: Patency of the parent artery following obliteration a VAVF is still a challenge. Obliteration of the VAVF with a balloon while the parent vertebral artery is still patent is very possible.


Assuntos
Fístula Arteriovenosa/cirurgia , Oclusão com Balão/métodos , Artéria Vertebral/anormalidades , Angiografia Digital , Fístula Arteriovenosa/diagnóstico por imagem , Criança , Humanos , Angiografia por Ressonância Magnética , Masculino , Pescoço/irrigação sanguínea , Pescoço/diagnóstico por imagem , Resultado do Tratamento , Grau de Desobstrução Vascular , Artéria Vertebral/diagnóstico por imagem , Artéria Vertebral/cirurgia
3.
Medicine (Baltimore) ; 98(41): e17567, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593142

RESUMO

RATIONALE: Pediatric-type follicular lymphoma (PTFL) is a rare neoplasm with features that differ from those of adult-type follicular lymphoma. Compared to patients with adult-type follicular lymphoma, PTFL patients often show an excellent response. Preoperative diagnosis is challenging and, therefore, an accurate diagnosis is based on the findings of postoperative pathological examination and immunohistochemistry. PATIENT CONCERNS: A 13-year-old boy presented with a slow-growing mass on the right side of his neck. DIAGNOSES: The patient was diagnosed with PTFL based on the findings of histopathological examination and immunohistochemistry. INTERVENTION: The mass was completely resected. OUTCOMES: After 12 months of postoperative follow-up, the patient achieved good recovery without recurrence. LESSONS: The optimal treatment for PTFL has not yet been defined. However, patients with PTFL always show satisfactory prognoses, regardless of treatment strategy (targeted radiotherapy, multiagent chemotherapy, or "watch and wait" strategy). Clinically, pathological and immunohistochemical analyses are necessary in the diagnoses of PTFL cases, especially for distinguishing PTFL from reactive follicular hyperplasia, to avoid unnecessary treatment.


Assuntos
Linfoma de Células B/patologia , Linfoma Folicular/imunologia , Linfoma Folicular/patologia , Pescoço/patologia , Adolescente , Assistência ao Convalescente , Humanos , Imuno-Histoquímica/métodos , Linfoma de Células B/diagnóstico , Linfoma de Células B/imunologia , Linfoma de Células B/cirurgia , Linfoma Folicular/diagnóstico , Linfoma Folicular/cirurgia , Masculino , Pescoço/diagnóstico por imagem , Pescoço/cirurgia , Resultado do Tratamento , Ultrassonografia
5.
Ann R Coll Surg Engl ; 101(8): e178-e183, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31509000

RESUMO

Parathyromatosis is a rare entity and usually appears as a consequence of the seeding on previous parathyroid surgery which was applied for the secondary hyperparathyroidism. A 63-year-old woman presented with a history of subtotal thyroidectomy 20 years ago and parathyroidectomy due to primary hyperparathyroidism (PHPT) four years ago. Imaging methods revealed multiple parathyromatosis foci on subcutaneous tissue of the neck. En-bloc resection was performed and pathological examination confirmed the diagnosis of parathyromatosis. After an uneventful 10 months, biochemical and radiological tests revealed recurrence on bilateral thyroid lodges. En-bloc resection was performed. The patient has remained well for 24 months after the second operation and has been followed-up with normal parathormone and serum calcium values. To the best of our knowledge, this report describes the twenty-first case of parathyromatosis in PHPT setting in the literature. It should be kept in mind that parathyromatosis may recur at different sites in the neck even in patients with PHPT.


Assuntos
Coristoma/complicações , Hiperparatireoidismo Primário/etiologia , Glândulas Paratireoides , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Feminino , Humanos , Hiperparatireoidismo Primário/cirurgia , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Paratireoidectomia , Cintilografia , Recidiva , Tela Subcutânea/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia
6.
Radiologe ; 59(10): 906-911, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31444511

RESUMO

CONTEXT: Although in recent times more research has been done on interactions of metallic dental objects in magnetic resonance imaging (MRI), radiologists are often uncertain whether the objects should be removed or can be retained prior to an impending examination. On the one hand, they want to avoid unnecessary material removal which is associated with costs and potential damage of the dental object. On the other hand, they fear material-induced susceptibility artefacts will impair the diagnostic workup so that examinations will have to be repeated. The lack of information complicates adequate decision making for radiologists. AIM: The aim of this survey was to evaluate the information that is currently available to radiologists regarding orthodontic appliances of the head and neck region in the MRI and determine how to handle these situations in a radiologist's every day routine. Therefore, this study can reveal the need for further research. MATERIALS AND METHODS: The questionnaire was published in the 9/2017 issue of the journal Der Radiologe and sent as an electronic version by the BDR (Professional Association of German Radiologists) to their approximately 1800 members. In addition, the radiological institutes of 55 German university and maximum care clinics were contacted. RESULTS: In all, 74 evaluable responses were received within a period of 16 weeks, representing a response rate of 3.7%. Altogether, the participants rate the risks of a detachment or heating of orthodontic appliances as too high. The interviewed radiologists categorize the available data as insufficient and they almost unanimously (97.3%) demand a declaration requirement for the manufacturers. There is a clear need for further education (78.3%). Intraoral measurement of the magnetic permeability is considered as a useful tool to determine possible interactions with the MRI by 40.5%.


Assuntos
Imagem por Ressonância Magnética , Metais , Próteses e Implantes , Artefatos , Cabeça/diagnóstico por imagem , Humanos , Pescoço/diagnóstico por imagem , Radiologistas , Inquéritos e Questionários
7.
Medicine (Baltimore) ; 98(31): e16670, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374044

RESUMO

RATIONALE: Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth. PATIENT CONCERNS: We present a rare case of FGCC, which extended from the right neck into the superior mediastinum, and resulted in severe tracheal compression. DIAGNOSES: An FGCC was observed by ultrasonography and magnetic resonance imaging (MRI) at 27+4 weeks' gestation (WG). Fetal MRI at 35+1 WG showed that the FGCC was 3.3 × 8.2 × 7.5 cm and extended from the right neck into the superior mediastinum. Severe tracheal compression was observed and the inside diameter of the narrowest section of tracheostenosis appeared thread-like and measured only 0.1 cm. INTERVENTIONS: Cervical cyst reduction was performed prenatally under ultrasound guidance to alleviate the tracheal compression and maximize the chance of fetal survival 2 days before birth. At 36+3 WG, cesarean section was performed, and a female neonate was immediately delivered and intubated (3.5-mm tube) by an experienced anesthesiologist. Neonatal intralesional sclerotherapy and cystic component aspiration as guided by digital subtraction angiography were performed under general anesthesia. Anesthesia was maintained only with sevoflurane 3% in 2 L/min oxygen. Extubation was performed soon after surgery. OUTCOME: The neonate recovered uneventfully and was discharged 2 days postoperatively. After 140 days of follow-up, the neonate had recovered completely. LESSONS: If an FGCC is suspected by abdominal ultrasound, a fetal MRI is recommended to assess the severity of tracheal compression before birth, if feasible. An anesthesiologist should assess the risk of intubation failure at birth according to those results. If fetal severe tracheal compression is detected and it may result in inability of intubation at birth, prenatal cervical cyst reduction under ultrasound guidance may be effective for alleviating tracheal compression at birth, if feasible. This could maximize the chance of fetal survival. Improvement of fetal short- and long-term outcomes is important.


Assuntos
Fetoscopia/métodos , Hidropisia Fetal/patologia , Hidropisia Fetal/cirurgia , Linfangioma Cístico/patologia , Linfangioma Cístico/cirurgia , Pescoço/patologia , Pescoço/cirurgia , Adulto , Cesárea , Feminino , Idade Gestacional , Humanos , Hidropisia Fetal/diagnóstico por imagem , Recém-Nascido , Intubação Intratraqueal , Linfangioma Cístico/complicações , Linfangioma Cístico/diagnóstico por imagem , Imagem por Ressonância Magnética , Pescoço/diagnóstico por imagem , Pescoço/embriologia , Gravidez , Doenças da Traqueia/diagnóstico por imagem , Doenças da Traqueia/etiologia , Ultrassonografia Pré-Natal
9.
Nat Commun ; 10(1): 2966, 2019 07 04.
Artigo em Inglês | MEDLINE | ID: mdl-31273213

RESUMO

Mutations in genes encoding components of BAF (BRG1/BRM-associated factor) chromatin remodeling complexes cause neurodevelopmental disorders and tumors. The mechanisms leading to the development of these two disease entities alone or in combination remain unclear. We generated mice with a heterozygous nervous system-specific partial loss-of-function mutation in a BAF core component gene, Smarcb1. These Smarcb1 mutant mice show various brain midline abnormalities that are also found in individuals with Coffin-Siris syndrome (CSS) caused by SMARCB1, SMARCE1, and ARID1B mutations and in SMARCB1-related intellectual disability (ID) with choroid plexus hyperplasia (CPH). Analyses of the Smarcb1 mutant animals indicate that one prominent midline abnormality, corpus callosum agenesis, is due to midline glia aberrations. Our results establish a novel role of Smarcb1 in the development of the brain midline and have important clinical implications for BAF complex-related ID/neurodevelopmental disorders.


Assuntos
Anormalidades Múltiplas/genética , Agenesia do Corpo Caloso/genética , Corpo Caloso/crescimento & desenvolvimento , Face/anormalidades , Deformidades Congênitas da Mão/genética , Deficiência Intelectual/genética , Micrognatismo/genética , Pescoço/anormalidades , Proteína SMARCB1/genética , Anormalidades Múltiplas/diagnóstico por imagem , Agenesia do Corpo Caloso/diagnóstico por imagem , Agenesia do Corpo Caloso/patologia , Alelos , Animais , Criança , Pré-Escolar , Corpo Caloso/citologia , Corpo Caloso/diagnóstico por imagem , Modelos Animais de Doenças , Embrião de Mamíferos , Face/diagnóstico por imagem , Feminino , Deformidades Congênitas da Mão/diagnóstico por imagem , Humanos , Lactente , Deficiência Intelectual/diagnóstico por imagem , Mutação com Perda de Função , Imagem por Ressonância Magnética , Masculino , Camundongos , Camundongos Transgênicos , Micrognatismo/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Neuroglia/patologia , Cultura Primária de Células
11.
Clin Nucl Med ; 44(8): 657-659, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31274616

RESUMO

F-Fluoro-ethyl-choline (F-FCH) PET/CT is widely used to study patients affected by prostate cancer. However, F-FCH may be taken-up by other neoplastic diseases, infections, and non-infective inflammatory processes. While this behavior may be an opportunity to study different diseases, on the other hand, this condition brings with it the source of error in the evaluation of the images. Here we present the case of a meningeal inflammatory pseudotumor evidenced by F-FCH.


Assuntos
Granuloma de Células Plasmáticas/diagnóstico por imagem , Meninges/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Colina/análogos & derivados , Humanos , Masculino , Meninges/patologia , Pessoa de Meia-Idade , Pescoço/patologia , Neoplasias da Próstata/diagnóstico por imagem , Compostos Radiofarmacêuticos
12.
Radiol Med ; 124(9): 917-925, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31175537

RESUMO

BACKGROUND: Prenatal magnetic resonance imaging is the best tool to visualize foetal airway. OBJECTIVE: To evaluate the performance of MRI in the assessment of foetal airway status in the presence of a neck mass. MATERIALS AND METHODS: Two paediatric radiologists with 12- and 2-year experience in foetal imaging retrospectively analysed 23 foetal MRI examinations, performed between 2001 and 2016, after a second-level ultrasound suspicious for presence of a neck mass. Postnatal imaging, postoperative report, histology, autopsy, and clinical outcomes were the reference standard to calculate sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of prenatal MRI in detecting airway patency. We used the Cohen к statistics to estimate the interobserver agreement. We also assessed MRI performance in the diagnosis of the mass nature. RESULTS: We obtained data about postnatal airway status in 19 of 23 patients; prenatal MRI demonstrated a sensitivity of 9/9 [100%, 95% confidence interval (CI) 66-100%], specificity 8/10 (80%, 44-98%), accuracy 17/19 (89%, 67-99%), PPV 9/11 (82%, 48-98%), and NPV 8/8 (100%, 63-100%); the interobserver agreement was perfect. Prenatal MRI correctly identified 21 of 23 masses (к = 0.858); the interobserver agreement was almost perfect (к = 0.851). CONCLUSION: Prenatal MRI demonstrated high accuracy in assessing foetal airway status and diagnosing mass nature, allowing proper delivery planning.


Assuntos
Obstrução das Vias Respiratórias/diagnóstico por imagem , Imagem por Ressonância Magnética , Pescoço/diagnóstico por imagem , Diagnóstico Pré-Natal/métodos , Adulto , Obstrução das Vias Respiratórias/embriologia , Feminino , Humanos , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Pescoço/embriologia , Gravidez , Estudos Retrospectivos , Adulto Jovem
13.
Dentomaxillofac Radiol ; 48(7): 20180396, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31216179

RESUMO

OBJECTIVES: Cone beam CT's use (CBCT) in dentistry is increasing. Incidental findings (IFs: discoveries unrelated to the original purpose of the scan), are frequently found as a result of a large field of view. The aim of the systematic review is to analyze present literature on IFs using CBCT. METHODS AND MATERIALS: The authors searched online databases of studies and assessed the prevalence of IFs among patients undergoing head and neck CBCT scans. STROBE criteria was used to evaluate the quality of the studies. RESULTS: The original search retrieved 509 abstracts of which only 10 articles met the inclusion criteria. The sample size varied between 90 and 1000 participants. The frequency of IFs of the selected articles were 24.6-94.3%. The most common non-threatening IFs were found in the airway, such as mucous retention cyst (55.1%) and sinusitis (41.7%). Other non-threatening IFs were soft tissue calcifications such as calcified stylohyloid ligament (26.7%), calcified pineal gland (19.2%), and tonsillolith (14.3%). Threatening IFs were rare findings (1.4%). Three articles reported incidental carotid artery calcifications with a prevalence of 5.7-11.6%. Pathological findings were not common between the articles, but still relevant (2.6%). The studies had a risk of bias varying from moderate to low. CONCLUSIONS: There is a high frequency of IFs, yet not all of them require immediate medical attention. The low prevalence of threatening IFs emphasizes that CBCT should not be considered a substitution for conventional radiographs, but when used, the scans should be evaluated by a maxillofacial radiologist.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Achados Incidentais , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Cabeça/diagnóstico por imagem , Humanos , Pescoço/diagnóstico por imagem , Reprodutibilidade dos Testes
14.
Eur Arch Otorhinolaryngol ; 276(9): 2541-2547, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31218447

RESUMO

PURPOSE: Vascular injury in penetrating neck trauma predicts a poorer outcome and usually requires surgical neck exploration. Multi-detector computed tomography (MDCT) angiography is a readily available non-invasive diagnostic tool that can identify direct and indirect signs of vascular injury in stable patients. This study aims to investigate the diagnostic accuracy of radiological signs of vascular injury on MDCT, and their implications on patient management in the setting of penetrating neck trauma. METHODS: A retrospective cohort study of penetrating neck injuries (PNI) between 2012 and 2018 in a UK major trauma centre was performed. Clinical data and operative findings were compared with radiological findings on MDCT performed at the time of admission. RESULTS: 157 patients were identified with PNI in the study period, with 67 meeting inclusion criteria. The predictive value of indirect radiological signs of vascular injury alone was low, with only 12.1% of these patients having significant vascular injury found at neck exploration. However, the combined use of direct radiological signs with clinical signs resulted in a specificity of 97.7% for vascular injury. CONCLUSIONS: The use of direct and indirect radiological signs of vascular injury can increase the accuracy of diagnosis when used in conjunction with clinical signs. Combining clinical assessment and radiological investigation, specifically contrast-enhanced MDCT, improves the specificity in pre-operative assessment of potential vascular injury in PNI. MDCT is recommended in stable patients with clinical signs of vascular injury to reduce the rate of negative neck exploration.


Assuntos
Angiografia por Tomografia Computadorizada/métodos , Lesões do Pescoço , Lesões do Sistema Vascular , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Lesões do Pescoço/complicações , Lesões do Pescoço/diagnóstico , Lesões do Pescoço/epidemiologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Reino Unido/epidemiologia , Lesões do Sistema Vascular/diagnóstico , Lesões do Sistema Vascular/etiologia , Ferimentos Penetrantes/complicações , Ferimentos Penetrantes/diagnóstico
15.
J Comput Assist Tomogr ; 43(4): 533-538, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162236

RESUMO

OBJECTIVE: For research and risk factor analysis, a reproducible method quantifying atherosclerosis is necessary. Our aim was to develop a computed tomography (CT) angiography grading system to quantify atherosclerotic disease of the head and neck. METHODS: Institutional review board-approved, retrospective analysis was performed on 152 patients who underwent head/neck CT angiography. A grading scale was designed to calculate plaque burden at multiple sites with the sum referred to as atherosclerosis score. Three radiologists calculated scores with an overlap of cases to calculate the intraclass correlation coefficient. RESULTS: Without any prior training, the intraclass correlation coefficient between readers was considered fair. After a short tutorial, intraclass correlation coefficient was recalculated using separate patients, showing excellent correlation.Statistically significant positive correlation was found between atherosclerosis scale and age, hyperlipidemia, hypertension, and diabetes, but no correlation with sex or smoking status. CONCLUSIONS: A simple, visual grading scale for atherosclerosis in head/neck CT angiography was used to standardize reporting and better characterize a patient's risk of stroke.


Assuntos
Aterosclerose/diagnóstico por imagem , Angiografia por Tomografia Computadorizada/métodos , Angiografia Coronária/métodos , Cabeça , Pescoço , Adulto , Feminino , Cabeça/irrigação sanguínea , Cabeça/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/irrigação sanguínea , Pescoço/diagnóstico por imagem , Estudos Retrospectivos , Índice de Gravidade de Doença
17.
Radiol Clin North Am ; 57(4): 745-765, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31076030

RESUMO

The neck visceral space is a complex region housing several vital structures. Diagnostic imaging plays an important role in the evaluation of neck visceral injuries. Many injuries are initially missed by both clinicians and radiologists because of their infrequency and the high likelihood of other more obvious injuries. Understanding which diagnostic modality to apply at given point in the work-up; recognizing relevant clinical signs, symptoms, and injury mechanisms; and knowing pertinent direct and indirect imaging findings of injury allow radiologists to either directly render the correct diagnosis or choose the most appropriate tool for doing so.


Assuntos
Lesões do Pescoço/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Humanos , Pescoço/diagnóstico por imagem
19.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040139

RESUMO

Cutaneous metastasis from visceral malignancy is a relatively rare phenomenon. It is even rarer to have cutaneous lesions as the first mode of clinical presentation in such malignancies. The lesions are usually nodular, although they can have varied appearances. Common sites of primaries include breast, lung, colorectum, kidney, ovary, and headandneck. We report an unusual form of cutaneous metastasis in the neck, known as 'carcinoma en cuirasse', in an elderly man that subsequently led to the diagnosis of an occult gastric cancer. Our case highlights the importance of recognising cutaneous metastatic lesions early, as they may herald the diagnosis of an occult internal malignancy.


Assuntos
Adenocarcinoma/patologia , Pescoço/patologia , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Cutâneas/secundário , Neoplasias Gástricas/patologia , Adenocarcinoma/diagnóstico por imagem , Evolução Fatal , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Imagem Corporal Total
20.
Artigo em Japonês | MEDLINE | ID: mdl-31105093

RESUMO

The defectiveness of the fat suppression becomes the factor of the decrease of the quality of the diagnosis of magnetic resonance imaging. It is reported that the use of magnetic field uniformity adjuvant pad is effective for reduce poor fat suppression. The ball bullets, polystyrene balls, and polished rice are used for pad packing material, in recently, it was reported that fat suppression effect was good by the use of the small glass beads. Therefore, we tested the utility of small glass beads pad in the neck and fingers in this study. Neck and the fingers of subjects were imaged with T1-weighted image with fat suppression and T1-high resolution isotropic volume excitation image. The fat suppression effect of each image was compared with the polished rice and glass beads as material of pad used by physical, observation, and contact evaluation. In the result, satisfactory results were obtained by using glass beads, and it is suggested that fat suppression effect is improved by using glass beads as a filling material of pad in clinical study as a conclusion.


Assuntos
Tecido Adiposo , Imagem por Ressonância Magnética , Pescoço , Dedos/diagnóstico por imagem , Vidro , Humanos , Aumento da Imagem , Campos Magnéticos , Pescoço/diagnóstico por imagem
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