Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 25
Filtrar
1.
AJR Am J Roentgenol ; 215(5): 1104-1112, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32901562

RESUMO

OBJECTIVE. The purpose of this study was to investigate the diagnostic performance of semiquantitative and quantitative pharmacokinetic parameters and quantitative apparent diffusion coefficient (ADC) values obtained from prostate multiparametric MRI (mpMRI) to differentiate prostate cancer (PCa) and prostatitis objectively. MATERIALS AND METHODS. We conducted a retrospective review of patients with biopsy-proven PCa or prostatitis who underwent mpMRI study between January 2015 and February 2018. Mean ADC, forward volume transfer constant (Ktrans), reverse volume transfer constant (kep), plasma volume fraction (Vp), extravascular extracellular space volume fraction (Ve), and time to peak (TTP) values were calculated for both lesions and contralateral normal prostate tissue. Signal intensity-time curves were analyzed. Lesion-to-normal prostate tissue ratios of pharmacokinetic parameters were also calculated. The diagnostic accuracy and cutoff points of all parameters were analyzed to differentiate PCa from prostatitis. RESULTS. A total of 138 patients (94 with PCa and 44 with prostatitis) were included in the study. Statistically, ADC, quantitative pharmacokinetic parameters (Ktrans, kep, Ve, and Vp), their lesion-to-normal prostate tissue ratios, and TTP values successfully differentiated PCa and prostatitis. Surprisingly, we found that Ve values were significantly higher in prostatitis lesions. The combination of these parameters had 92.7% overall diagnostic accuracy. ADC, kep, and TTP made up the most successful combination for differential diagnosis. Analysis of the signal intensity-time curves showed mostly type 2 and type 3 enhancement curve patterns for patients with PCa. Type 3 curves were not seen in any prostatitis cases. CONCLUSION. Quantitative analysis of mpMRI differentiates PCa from prostatitis with high sensitivity and specificity, appears to have significant potential, and may improve diagnostic accuracy. In addition, evaluating these parameters does not cause any extra burden to the patients.


Assuntos
Imagem de Difusão por Ressonância Magnética , Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata/diagnóstico por imagem , Prostatite/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
2.
Diagn Interv Radiol ; 28(1): 83-91, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35142615

RESUMO

Magnetic resonance imaging-proton density fat fraction (MRI-PDFF) is an emerging quantitative imaging biomarker that accurately measures the fat fraction of tissue by correcting factors influencing magnetic resonance signal intensity. Beyond fat quantification, it also measures R2* which is a direct measure of iron concentration. The utilization of MRI-PDFF in liver diseases is well established. In the present review, we focused on applications of MRI-PDFF in different body areas including pancreas, bone, muscle, spleen, testis, visceral, and subcutaneous adipose tissue. Future studies can enable tracking of quantitative fat fraction changes in different organs simultaneously, which can be critical in understanding fat metabolism.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Prótons , Tecido Adiposo/diagnóstico por imagem , Humanos , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino
3.
Insights Imaging ; 13(1): 147, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064860

RESUMO

OBJECTIVE: To evaluate the magnetic resonance elastography (MRE)-derived liver stiffness measurement (LSM), T1 and T2 relaxation times, and hepatobiliary phase images in patients, who developed sinusoidal obstruction syndrome (SOS) after oxaliplatin-based chemotherapy. METHODS: Thirty-four patients (M/F:22/12) who underwent liver MRI-MRE and received oxaliplatin for colorectal, gastric, and pancreas cancer were included in the study. SOS was diagnosed by Gd-EOB-DTPA-enhanced MRI in 18 patients. MRE-LSM and T1-T2 maps were evaluated. Patients with SOS were grouped according to the amount of reticular hypointensity on the hepatobiliary phase images. RESULTS: The mean MRE-LSM in the patients with SOS was 3.14 ± 0.45 kPa, and the control group was 2.6 ± 0.5 kPa (p = 0.01). The mean-corrected T1 (cT1) relaxation time was 1181 ± 151 ms in the SOS group and 1032 ± 129 ms in the control group (p = 0.005). The mean T2 relaxation time was 50.29 ± 3.6 ms in the SOS group and 44 ± 3.9 ms in the control group (p = 0.01). Parenchymal stiffness values were 2.8 ± 0.22 kPa, 3 ± 0.33 kPa, and 3.65 ± 0.28 kPa in patients with mild, moderate, and advanced SOS findings, respectively (p = 0.002). Although cT1 and T2 relaxation times increased with increasing SOS severity, no statistical significance was found. CONCLUSIONS: We observed increased MRE-LSM in patients with SOS after chemotherapy compared to control group. T1 and T2 relaxation times were also useful in diagnosing SOS but were found inadequate in determining SOS severity. MRE is effective in diagnosing SOS and determining SOS severity in patients who cannot receive contrast agents, and it may be useful in the follow-up evaluation of these patients.

4.
AJR Am J Roentgenol ; 195(5): 1231-7, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20966332

RESUMO

OBJECTIVE: The purpose of this article is to evaluate the safety and efficacy of radiologic gastrostomy and gastrojejunostomy in children, with an emphasis on the comparison of single and double gastropexy. MATERIALS AND METHODS: Between January 2000 and May 2009, a total of 91 percutaneous tubes (77 gastrostomies and 14 gastrojejunostomies) were placed in 90 patients. Patients' ages ranged from 4 months to 16.5 years. Gastropexy was performed in all cases. The first 50 children underwent double gastropexy, and 40 children underwent single gastropexy. In single gastropexy, two different punctures were performed each for the anchor and the tube. Differences in the incidence of major and minor complications and tube maintenance problems between the single- and double-gastropexy groups were retrospectively analyzed by use of Fisher's exact test. RESULTS: The technical success rate was 100%. No procedure-related mortality or morbidity was detected. The overall major and minor complication rates were 4.4% and 16.7%, respectively. The mean follow-up period was 463 days. Twenty-nine tube maintenance problems were detected in 17 patients. There were four major complications (two cases of aspiration pneumonia and two site infections that required hospitalization). Minor complications occurred in 15 patients (nine localized site infections, two cases of gastroesophageal reflux, and four tube maintenance problems requiring secondary intervention). In total, 26 and 22 complications and tube maintenance problems occurred in the single- and double-gastropexy groups, respectively. No statistically significant difference was detected between the two groups in terms of complications (p > 0.005). CONCLUSION: Radiologic gastrostomy and gastrojejunostomy are safe and effective methods for long-term nutritional support in children. Single gastropexy should be performed with two different punctures for each retention suture and the tube.


Assuntos
Derivação Gástrica/métodos , Gastrostomia/métodos , Radiografia Intervencionista/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento
5.
Diagn Interv Radiol ; 12(1): 47-9, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16538584

RESUMO

Chronic pancreatitis is one of the indications for pancreatic duct stenting. The success rate of endoscopic stenting of the pancreatic duct is very high (98%). Reports of percutaneous stenting of the Wirsung's duct are very sparse. We present a case with Wirsung's duct stenosis secondary to chronic pancreatitis, which was treated by percutaneous antegrade balloon dilatation and insertion of a plastic stent. We also report on the long-term follow-up of this patient.


Assuntos
Cateterismo/métodos , Constrição Patológica/etiologia , Constrição Patológica/terapia , Pancreatite Crônica/complicações , Stents , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos , Resultado do Tratamento
6.
Insights Imaging ; 7(2): 215-22, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26883137

RESUMO

UNLABELLED: Although traumatic injuries are the cause of common splenic emergencies in the emergency room, various nontraumatic conditions may also affect the spleen with possible life-threatening results. In this pictorial review, we present imaging findings of usual and unusual splenic emergencies. It is essential to be familiar with key imaging findings and advantages of different modalities to reach a definitive diagnosis. TEACHING POINTS: • Delayed splenic rupture is commonly related to subcapsular hematoma. • Subtle haemorrhage is commonly restricted to the site of injury "sentinel clot sign". • The whorled appearance is the key imaging feature of splenic torsion.

7.
Eur J Radiol ; 55(3): 311-20, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15885958

RESUMO

Parapneumonic effusions continue to be a significant source of morbidity and mortality. Treatment at earlier stages before fibrous peel and loculations occur has a much better prognosis. Using image guidance, addition of intracavitary fibrinolytic instillation, close follow-up with drainage of residual or new collections are some of the other factors that improve prognosis. In this article, we discussed treatment strategies, percutaneous management of parapneumonic effusions, its alternatives and results.


Assuntos
Derrame Pleural/terapia , Pneumonia/complicações , Radiografia Intervencionista , Tubos Torácicos , Drenagem/métodos , Humanos , Derrame Pleural/diagnóstico , Derrame Pleural/etiologia , Cirurgia Torácica Vídeoassistida , Terapia Trombolítica , Tomografia Computadorizada por Raios X
9.
Eur J Radiol ; 43(3): 186-95, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12204401

RESUMO

Gastrostomy is a preferred method of nutrition in patients with impaired ability to eat. Although surgical gastrostomy is a well-established method and has been widely performed in the last century, beginning with early 1980s, percutaneous gastrostomy techniques, either endoscopic or radiologic, has widely gained acceptance. As percutaneous methods have been shown to be an effective, safe, easy to perform and low-cost techniques with low morbidity and mortality rates, nowadays percutaneous gastrostomy is the first method of choice in need of nutrition in patients with functioning gut. In this article authors review the technique of percutaneous radiologic gastrostomy, as well as indications, contraindications, variations of technique, ethical considerations, controversies and comparison with surgical and endoscopic methods.


Assuntos
Nutrição Enteral , Gastrostomia , Radiografia Abdominal , Radiografia Intervencionista , Contraindicações , Conteúdo Gastrointestinal , Gastrostomia/efeitos adversos , Gastrostomia/métodos , Gastrostomia/normas , Humanos , Apoio Nutricional , Fatores de Risco
10.
Eur J Radiol ; 43(3): 229-36, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12204405

RESUMO

Percutaneous cholecystostomy (PC), a technique that consists of percutaneous catheter placement in the gallbladder lumen under imaging guidance, has become an alternative to surgical cholecystostomy in recent years. Indications of PC include calculous or acalculous cholecystitis, cholangitis, biliary obstruction and opacification of biliary ducts. It also provides a potential route for stone dissolution therapy and stone extraction. Under aseptic conditions and ultrasound guidance, using local anesthesia, the procedure is carried out by using either modified Seldinger technique or trocar technique. Transhepatic or transperitoneal puncture can be performed as an access route. Several days after the procedure transcatheter cholangiography is performed to assess the patency of cystic duct, presence of gallstones and catheter position. The tract is considered mature in the absence of leakage to the peritoneal cavity, subhepatic, subcapsular, or subdiaphragmatic spaces. Response rates to PC in the literature are between the range of 56-100% as the variation of different patient population. Complications associated with PC usually occur immediately or within days and include haemorrhage, vagal reactions, sepsis, bile peritonitis, pneumothorax, perforation of the intestinal loop, secondary infection or colonisation of the gallbladder and catheter dislodgment. Late complications have been reported as catheter dislodgment and recurrent cholecystitis. PC under ultrasonographic guidance is a cost-effective, easy to perform and reliable procedure with low complication and high success rates for critically ill patients with acute cholecystitis. It is generally followed by elective cholecystectomy, if possible. However, it may be definitive treatment, especially in acalculous cholecystitis.


Assuntos
Colecistostomia/métodos , Colestase/cirurgia , Idoso , Idoso de 80 Anos ou mais , Colecistostomia/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reoperação , Fatores de Risco , Resultado do Tratamento
11.
Eur J Radiol ; 44(3): 228-31, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12468073

RESUMO

OBJECTIVE: The clinical spectrum of childhood non-Hodgkin's lymphoma (NHL) is different from that in adults, with frequent extranodal involvement. We searched the incidence and radiological appearance of the secondary involvement of the thyroid and salivary glands by ultrasonography (US) to assess its importance for staging of the disease. MATERIALS AND METHODS: We examined the thyroid, parotid and submandibulary glands of 43 children with NHL, age ranging between 9 months and 17 years, by US. RESULTS: According to US findings, involvement of the parotid gland was very common as detected in 18 of the cases with NHL (41%). It was the most common organ involved in lymphoma. Lymphomatous infiltration of the thyroid gland, with bilateral multiple focal lesions, was detected in two patients and proved by fine needle aspiration biopsy in all cases (5%). Salivary gland and thyroid involvement changed staging in three (6%) of the patients, however, the treatment plan was unchanged. CONCLUSIONS: This study shows that anatomic sites, known to be very rarely involved at the initial presentation of the disease is actually more commonly involved in childhood NHL. However, it does not cause any significant change in the treatment planning or in the survival.


Assuntos
Linfoma não Hodgkin/diagnóstico por imagem , Neoplasias das Glândulas Salivares/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos , Radiografia , Ultrassonografia
12.
Eur J Radiol ; 41(1): 26-33, 2002 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11750149

RESUMO

MATERIAL AND METHODS: Abdominal US and CT scans of 50 pediatric cystic fibrosis (CF) patients were evaluated to search for specific data that can be attributed to the involvement of the hepatobiliary system. The liver findings of the two patients who were HBs antigen carriers were excluded from the study. RESULTS: 30 out of 48 patients had at least one abnormal finding of liver on CT and/or US. Although increased echogenicity of the liver was detected in 24 of 48 patients (50%), only six of these (12%) were regarded as steatosis according to CT criteria of low attenuation values. CT and US scans both showed unique multilobular fatty pattern, described as "pseudomasses" in three patients. Increased periportal echogenicity was seen in 18 (37%) patients on US, while CT could not demonstrate any sign of increased periportal thickness. Findings of cirrhosis were present in five patients with either modalities. Lymph nodes of less than 10-15 mm in diameter were detected at the hepatico-duodenal ligament in 18 (37%) patients. Anomalies of the gallbladder (absence or microgallbladder or stone) were detected in 12 cases (24%). CONCLUSION: Although US is the most widely used modality in CF patients, CT and US correlation will help to better delineate the abnormalities between steatosis and periportal fibrosis and increase the sensitivity of the imaging methods to achieve the most accurate diagnosis.


Assuntos
Sistema Biliar/diagnóstico por imagem , Fibrose Cística/diagnóstico por imagem , Fígado/diagnóstico por imagem , Adolescente , Sistema Biliar/patologia , Criança , Pré-Escolar , Fibrose Cística/patologia , Feminino , Humanos , Lactente , Fígado/patologia , Masculino , Radiografia , Ultrassonografia
13.
Cardiovasc Intervent Radiol ; 31(5): 926-30, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18196333

RESUMO

The course of autosomal dominant polycystic kidney disease (ADPKD) is frequently complicated by infection of a cyst within a polycystic kidney, which is a diagnostic and therapeutic dilemma damaging the clinical course of patients. The aim of this study was to demonstrate the safety and efficacy of percutaneous drainage in management of infected cysts in ADPKD patients. Between May 2003 and December 2006, percutaneous drainage was performed in 16 infected renal cysts of four kidneys in three patients (two females, one male), with a mean age of 57.3 years. Cyst dimensions, total amount of drained cyst fluid, catheterization duration, isolated microorganisms, and follow-up duration were recorded. Technical, clinical success rates were 100%; the complication rate was 0%. Diameters of cysts ranged between 3 and 8 cm. Average volume of drained fluid and average duration of catheterization for one cyst were 226 ml and 9.8 days. No recurrence was encountered but one patient (no. 3), who had pyocystis in the right kidney and was treated with catheterization, referred with left flank pain due to pyocystis in her left kidney 3 months later. Follow-up durations were 35, 47, and 11 months for patients 1, 2, and 3, respectively. For patient 3, follow-up duration for the second procedure was 7 months. We conclude that percutaneous drainage with antibiotic therapy should be the initial method in management of infected cysts in ADPKD patients, with high success and low complication rates.


Assuntos
Cistite/complicações , Cistite/terapia , Cistos/terapia , Drenagem/métodos , Rim/microbiologia , Rim Policístico Autossômico Dominante/complicações , Rim Policístico Autossômico Dominante/diagnóstico , Idoso , Antibacterianos/administração & dosagem , Cateterismo Periférico/métodos , Cistite/diagnóstico por imagem , Cistos/complicações , Cistos/diagnóstico por imagem , Cistos/microbiologia , Drenagem/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Intervencionista , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia Doppler
14.
Clin Imaging ; 32(3): 192-5, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18502346

RESUMO

PURPOSE: The objective of this study is to describe the computed tomography findings of peritoneal carcinomatosis of urinary bladder cancer. MATERIAL AND METHOD: Patients with urinary bladder cancer were reviewed from patient database of our hospital, and 384 patients with urinary bladder cancer were identified. Computed tomography scans of 105 patients with urinary bladder cancer were retrospectively reviewed. Images were reviewed for presence of peritoneal implant, ascites, solid organ metastases, and retroperitoneal lymphadenopathy. Surgical history and follow-up courses of the patients were reviewed. RESULTS: Computed tomography findings of peritoneal metastases were found in eight (7.6%) patients. Peritoneal involvement was diffuse in three patients and was in the form of implantation in five patients. In two patients, liver metastases were detected; additionally, one patient had accompanying pleural implants and one patient had adrenal gland metastases. Peritoneal involvement was detected in the preoperative stage in five patients. CONCLUSION: Presence of peritoneal carcinomatosis in cancer patients is an indicator of poor prognosis. Detection of peritoneal involvement in urinary bladder cancer patients can alter treatment strategy and may prevent unnecessary aggressive surgical interventions.


Assuntos
Carcinoma de Células de Transição/secundário , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Tomografia Computadorizada por Raios X/métodos , Neoplasias da Bexiga Urinária/patologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma/diagnóstico por imagem , Carcinoma/epidemiologia , Carcinoma/patologia , Carcinoma/cirurgia , Carcinoma de Células de Transição/diagnóstico por imagem , Carcinoma de Células de Transição/cirurgia , Meios de Contraste/farmacologia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Peritoneais/epidemiologia , Neoplasias Peritoneais/cirurgia , Intensificação de Imagem Radiográfica , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia
15.
Cardiovasc Intervent Radiol ; 30(2): 237-40, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17205362

RESUMO

The aim of this study is to investigate the efficacy and long-term results of percutaneous transcatheter ethanol sclerotherapy (PTES) for postoperative pelvic lymphocele treatment. Fifty-two patients who were referred for lymphocele treatment were included in this study. Sixty lymphoceles of 52 patients were treated by percutaneous treatment with or without ethanol sclerotherapy. Lymphoceles developed in 47 and 5 patients, who underwent gynecologic malignancy operation (31 ovarian cancer, 6 cervix cancer, 10 endometrial cancer) and renal transplantation, respectively. Lymphoceles were catheterized by ultrasonography and fluoroscopy guidance using the Seldinger technique. Lymphoceles smaller than 150 mL underwent single-session ethanol sclerotherapy and the others were treated by multiple-session ethanol sclerotherapy. In 10 patients, percutaneous ethanol sclerotherapy could not be performed and they were treated only by percutaneous catheter drainage. The mean lymphocele volume was 329 mL (15-2900 mL). The mean catheterization duration was 11.8 days (1-60 days). The mean follow up time was 25.8 months (2-64 months). The initial treatment was successful in 46 out of 50 (91%) lymphoceles treated with PTES and 7 out of 10 (70%) lymphoceles treated with percutaneous catheter drainage. Minor complications (secondary infection and catheter dislodgement) were noted in seven (11.6%) patients. Recurrence developed in four and three patients who were treated by PTES and percutaneous catheter drainage, respectively. Five of these patients were treated with PTES without further recurrence. Percutaneous transcatheter ethanol sclerotherapy is an effective and reliable method for the treatment of postoperative lymphoceles.


Assuntos
Cateterismo/instrumentação , Drenagem/instrumentação , Etanol/uso terapêutico , Linfocele/terapia , Pelve/patologia , Escleroterapia/instrumentação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateterismo/efeitos adversos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Recidiva , Estudos Retrospectivos , Soluções Esclerosantes/uso terapêutico , Fatores de Tempo , Resultado do Tratamento , Turquia
16.
Cardiovasc Intervent Radiol ; 30(6): 1173-7, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17533547

RESUMO

PURPOSE: The purpose of this study is to evaluate the efficacy of palliation of malignant biliary and duodenal obstruction with combined metallic stenting under fluoroscopy guidance. MATERIALS AND METHODS: A retrospective analysis of 9 patients (6 men and 3 women) who underwent biliary and duodenal stenting was performed. The mean age of patients was 61 years (range: 42-80 years). The causes of obstruction were pancreatic carcinoma in 7 patients, cholangiocellular carcinoma in one, and duodenal carcinoma in the other. Biliary and duodenal stents were placed simultaneously in 4 patients. In other 5 patients dudodenal stents were placed after biliary stenting when the duodenal obstruction symptoms have developed. In two patients duodenal stents were advanced via transgastric approach. RESULTS: Technical success rate was 100 %. After percutaneous biliary drainage and stenting bilirubin levels decreased to normal levels in 6 patients and in remaining 3 patients mean reduction of 71% in bilirubin levels was achieved. Tumoral ingrowth occurred in one patient and percutaneous biliary restenting was performed 90 days after the initial procedure. Of the 9 patients, 6 patients were able to tolerate solid diet, whereas 2 patients could tolerate liquid diet and one patient did not show any improvement. Mean survival periods were 111 and 73 days after biliary and duodenal stenting, respectively. CONCLUSION: Combined biliary and duodenal stent placement which can be performed under fluoroscopic guidance without assistance of endoscopy is feasible and an effective method of palliation of malignant biliary and duodenal obstructions. If transoral and endoscopic approaches fail, percutaneous gastrostomy route allows duodenal stenting.


Assuntos
Colestase/terapia , Obstrução Duodenal/terapia , Cuidados Paliativos , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Sistema Biliar/complicações , Colestase/etiologia , Constrição Patológica/etiologia , Constrição Patológica/terapia , Neoplasias Duodenais/complicações , Obstrução Duodenal/etiologia , Feminino , Fluoroscopia , Humanos , Masculino , Metais , Pessoa de Meia-Idade , Neoplasias Pancreáticas/complicações , Retratamento , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
17.
Pediatr Radiol ; 37(10): 975-80, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17704914

RESUMO

BACKGROUND: There is limited experience of percutaneous biliary interventions in children although they are safe and effective procedures. OBJECTIVE: To evaluate the efficacy and safety of percutaneous management of tumoral biliary obstruction in children. MATERIALS AND METHODS: Percutaneous biliary interventions were performed in eight children (six boys, two girls) with a mean age of 10.5 years (range 4-17 years). The interventions included percutaneous biliary drainage (five patients), percutaneous biliary drainage and placement of a self-expanding metallic stent (two patients), and percutaneous cholecystostomy (one patient). All patients had signs of obstructive jaundice and two had cholangitis. RESULTS: All procedures were successful. No procedure-related mortality was observed. Bilirubin levels returned to normal in four of the eight patients. Findings of cholangitis resolved in the two affected patients after the procedure and antibiotic treatment. Two patients underwent surgery after percutaneous biliary drainage procedures. A self-expanding metallic stent was placed in two patients with malignancy and the stents remained patent until death. CONCLUSION: Percutaneous biliary interventions can be performed safely for the management of tumoral biliary obstruction in children.


Assuntos
Neoplasias dos Ductos Biliares/complicações , Neoplasias dos Ductos Biliares/cirurgia , Colecistectomia/métodos , Colestase/etiologia , Colestase/cirurgia , Stents , Adolescente , Neoplasias dos Ductos Biliares/diagnóstico , Criança , Pré-Escolar , Colecistectomia/efeitos adversos , Colestase/diagnóstico , Feminino , Humanos , Masculino , Resultado do Tratamento
18.
J Ultrasound Med ; 25(9): 1113-20; quiz 1121-3, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16929011

RESUMO

OBJECTIVE: The purpose of this study was to determine the sensitivity of renal color Doppler sonography in differentiating obstructive and nonobstructive urinary calculi in patients with acute renal colic and to compare findings with nonenhanced helical computed tomography (CT). METHODS: Sixty-five patients referred to the emergency department with acute renal colic underwent nonenhanced CT and renal resistive index (RI) measurement with color pulsed Doppler sonography within 8 to 10 hours of the onset of the symptoms. Computed tomographic evaluation was based on the detection of urolithiasis and classification according to location and the presence of obstruction. The mean RI of each kidney and the difference between the mean RI (DeltaRI) of both kidneys were calculated and compared with CT findings. RESULTS: A total of 164 stones were identified. Computed tomography revealed obstruction in 33 patients. Mean RI values for the obstructive and nonobstructive groups were 0.64 and 0.63, respectively. Mean DeltaRI values were 0.01312 and 0.01000 in the obstructive and nonobstructive groups. The differences in the mean RI and DeltaRI for the patients with and without obstruction were statistically insignificant (P = .73). No significant relationship was found between the RI values, calculus location, and degree of obstruction. CONCLUSIONS: The RI is insensitive for detection of obstruction in patients with acute renal colic, and its value in routine practice seems quite controversial.


Assuntos
Cólica/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Tomografia Computadorizada Espiral , Ultrassonografia Doppler em Cores , Obstrução Ureteral/diagnóstico por imagem , Urolitíase/diagnóstico por imagem , Doença Aguda , Adolescente , Adulto , Idoso , Criança , Cólica/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Nefropatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Obstrução Ureteral/fisiopatologia , Urolitíase/fisiopatologia
19.
Eur Radiol ; 15(8): 1727-33, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16034642

RESUMO

The objective of this study was to evaluate the efficacy of transvaginal contrast for local staging of cervical carcinoma. Fifty patients diagnosed with cervical carcinoma prospectively underwent magnetic resonance (MR) imaging before and after vaginal opacification (VO) with a mixture of 25 ml saline and 25 ml barium. T2-weighted (T2W) TSE images in axial and sagittal planes were compared before and after vaginal opacification. Dynamic T1W images in sagittal and fat-suppressed T1W images in transverse planes were also evaluated after intravenous contrast administration. Involvement of vaginal wall, lumen, and fornices; parametrium; rectum; and bladder were noted. Changes in local tumor staging and in treatment planning were also assessed after vaginal opacification. MR results were later compared with surgical pathological findings. Twenty-eight patients who went through surgical staging were included in the study. VO did not change any of the MR interpretations in 14 patients (50%). Correct staging was achieved with T2W TSE images with and without VO (in sagittal and transverse planes) in 78.5% and 50% of the patients, respectively. VO correctly lowered staging in seven and increased it in three patients compared with sagittal standard T2W images. Treatment planning was also changed in four (14%) of these patients. When overall accuracy of MR staging to indicate the appropriate treatment was evaluated, patients would have received the proper treatment in 90% and 79% of the cases when only T2W sagittal images with and without VO were evaluated, respectively. Dynamic gradient-echo images in sagittal planes and postcontrast T1W images in transverse planes evaluated with T2W series after VO, accomplished correct staging in 23 (82%) of the patients. MRI staging in early cervical cancer may be difficult and overestimated, especially if the tumor is slightly extended into the proximal vagina. Use of vaginal contrast medium is an easy, well-tolerated, and effective method to better delineate the borders of the tumor. It increases the specificity and accuracy of MR staging by showing the exact relation of the tumor with the vaginal wall and beyond.


Assuntos
Imageamento por Ressonância Magnética , Estadiamento de Neoplasias/métodos , Neoplasias do Colo do Útero/patologia , Adulto , Idoso , Meios de Contraste , Feminino , Humanos , Pessoa de Meia-Idade
20.
Pediatr Radiol ; 35(2): 155-8, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15480613

RESUMO

BACKGROUND: Simple renal cysts are rare in children and managed conservatively unless symptomatic. OBJECTIVE: To demonstrate the efficacy and long-term results of single-session ethanol sclerotherapy in symptomatic simple renal cysts in children. MATERIALS AND METHODS: Three simple renal cysts in three children (age 1, 5 and 16 years) were included in the study. Indications for treatment were flank pain (n = 1), hypertension (n = 1), and increasing cyst size and urinary tract infection (n = 1). The mean follow-up period was 5.5 years (range 3-7 years). The procedures were performed with the guidance of US and fluoroscopy and under IV sedation. After the cystogram, 95% ethanol with a volume of 40% of the cyst volume (but not more than 100 ml) was used as the sclerosing agent. RESULTS: Two cysts disappeared completely, while the volume reduction was 99% for the third cyst at the end of the first year. CT demonstrated calcification of the cyst without an enhancing soft-tissue component in the third one 7 years after sclerotherapy. After the procedures, hypertension and pain resolved without any medication. There were no complications during the procedures or during follow-up. Cytological examination was unremarkable in all patients. CONCLUSIONS: Percutaneous treatment of symptomatic simple renal cysts in children with single-session ethanol sclerotherapy is a safe, effective and minimally invasive procedure. Calcification owing to sclerotherapy can be observed on follow-up.


Assuntos
Cistos/terapia , Etanol/uso terapêutico , Nefropatias/terapia , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Adolescente , Pré-Escolar , Cistos/diagnóstico por imagem , Drenagem , Feminino , Seguimentos , Humanos , Lactente , Injeções Intralesionais , Nefropatias/diagnóstico por imagem , Masculino , Ultrassonografia
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa