Mucocele con expansión orbitaria / Mucocele with orbital expansion

El mucocele es una lesión quística benigna, que se desarrolla en el interior de los senos perinasales por la obstrucción de su drenaje natural en el curso de los procesos inflamatorios, traumas y cirugías. Se presentan tres casos con mucocele frontoetmoidal y expansión intraorbitaria, los cuales fueron atendidos en el Hospital Hermanos Ameijeiras entre los meses de febrero a diciembre del año 2013. El propósito del presente estudio es el análisis de los resultados terapéuticos obtenidos y determinar la posible influencia de la vía de abordaje utilizada sobre la efectividad terapéutica y la recidiva tumoral en cada uno de estos pacientes(AU)

Mucocele is a benign cystic lesion that emerges inside the perinasal sinuses due to the obstruction of their natural drainage in inflammatory processes, traumas and surgeries. Here are three cases with frontoethmoidal mucocele and intraorbital expansion, which were treated at Hermanos Ameijeiras hospital from February to December, 2013. The objective of this study was to analyze the therapeutic results and to determine the possible influence of the approach path on the therapeutic effectiveness and the tumor recurrence in each of the patients(AU)

Radiographic and computed tomographic anatomy of the fetlock, pastern and coffin joints of the manus of the donkey [Equus asinus]

The digit of the donkey as a draught animal is commonly susceptible to much affection. The purpose of the present study was to provide a detailed anatomic reference of radiographic and computed tomographic images in conjunction with cross and sagittal sections of the normal fetlock, pastern and coffin joints of the donkey for anatomists, surgeons and veterinary students. Eight adult donkeys of both sexes free from any joints affection were used in our study. The digit of two donkeys had undergone radiographic and computed tomographic scanning; the other donkey's specimens were used to anatomical dissection and sectional anatomy. In the computed tomography [CT] of the fetlock joint all bone structures of the joint appeared also the soft tissue structures that could be identified and evaluated on the different soft tissue window planes included the common digital extensor tendon, lateral digital extensor tendon, superficial digital flexor tendon [SDFT], deep digital flexor tendon [DDFT], straight, oblique, and cruciate distal sesamoidean and intersesamoidean ligaments. For the pastern joint the structures that can be identified including the proximal phalanx, DDFT and digital cushion. In the coffin joint the collateral sesamoidean ligament [CSL] is difficult to identify on CT images

Cierre de una fístula oroantral usando cemento óseo y un colgajo de mucosa yugal / Closure of an oroantral fistula using bone cement and a jugal mucosa flap

Una fístula oroantral es una solución de continuidad patológica entre el seno maxilar y la cavidad oral, producida frecuentemente tras una extracción dentaria, en la mayoría de los casos, del primer o segundo molar. El síntoma más común que provoca es una sinusitis aguda, que evolucionará a la cronicidad si la fístula permanece. El diagnóstico se realiza mediante endoscopia transalveolar, ortopantografía o tomografía computarizada dental. Su cierre quirúrgico es necesario cuando la fístula tiene más de 3 mm, o no sella por sí misma en 3 semanas. Existen, para ello, varias técnicas, usando distintos materiales y colgajos, cuyo fin es ocluir, tanto el defecto óseo, como el mucoso, para solucionar así a la vez la fístula y el problema sinusal(AU)

The oroantral fistula is a solution of pathological continuity between the maxillary sinus and the oral cavity, frequently produced after a teeth extraction in most of cases of the first or second molars. The commonest symptom provoked is an acute sinusitis evolving to chronicity if the fistula remains. The diagnosis is made by transalveolar, orthopantography or dental computerized tomography. Its surgical closure is necessary when the fistula has more than 3 mm or not seal by itself in three weeks. For it, there are some techniques using different materials and flaps where its objective is to occlude the bone defect as well as the mucous one thus solving the fistula and the sinus problem(AU)

Bronchiectasis in COPD patients

COPD and brochiectasis are characterized by fixed airway obstruction and chronic cough. The finding of bronchiectasis on HRCT scan in the patient with COPD may indicate the presence of more advanced airway dysfunction, frequent exacerbation and bacterial colonization. The aim of this study to evaluate the incidence of bronchiectasis on high resolution computed tomography [HRCT] scanning in patients with moderate and severe COPD, and to relate this with the presence of lower airway bacterial colonization, exacerbation frequency, severity. This study was carried out on 69 patients diagnosed with COPD. All cases were subjected to through history taking, lung function test, sputum culture, HRCT scan of the chest to diagnose bronchiectasis, All the test were performed in a stable phase. 69 COPD patients, 32 patients had moderate COPD, 37 patients had severe COPD, 33 patients [47, 8%] presented with brochiectasis, [31.3%] of the patients with moderate COPD and 62.2% of the patients with severe COPD with statistically significant difference, the more severe functional impairment [FEV1

Routinely use of computed tomography [CT] scanning in patients with abdominal pain at emergency department at King Hussein medical center. [KHMC]

To evaluate use of abdominal computed tomography in patients with abdominal pain and accuracy of diagnosis, in patients who attend the Emergency Department at KHMC. We conducted a retrospective descriptive case series of consecutive patients who received an abdominal CT scan for abdominal pain. The setting was an Emergency Department at King Hussein Medical Center, from January to September. 2011. All patients who presented to Emergency Department at King Hussein Medical Center with Abdominal pain and who received a CT scan in the ED were included. All CT scans were reviewed by a radiology specialist and all patients examined by an Emergency physicians. The number of patients that attended the emergency Department of King Hussein Medical Center during period of study with abdominal pain was [2060]. 930 [45, 1%] of those Patients underwent Abdominal CT scan for abdominal pain. Then the patients were categorized into groups according to abdominal CT scan findings. Group A: 570 [61, 2%] patients with Abnormal Abdominal CT Scan. Group B: 360 [38, 7%] patients with Normal Abdominal CT Scan. The patients with Abnormal CT scan [Group A] were classified into two subgroups: Subgroup I: [330] [57, 8%] patients had urinary tract stones. Subgroup I I: [240] [42, 1%] Patients with variable conditions. The study showed that the Use of abdominal computed tomography for Abdominal pain in emergency Department may reduce mortality and Hospitals admissions, but the use of abdominal computed tomography as a routine diagnostic tool in patients with abdominal pain is unrecompensed, unless there is an indication. The Clinical assessment remains the most important first step in evaluating patients with an Abdominal Pain to decide on when to use CT scans in patients with abdominal pain

Controle de qualidade e dosimetria em equipamentos de tomografia computadorizada / Quality control and dosimetry in computed tomography units

OBJETIVO: Avaliação de condições dos equipamentos e dosimetria em setores de tomografia computadorizada utilizando protocolos de cabeça, abdome e coluna lombar em pacientes adultos (em três equipamentos distintos) e pediátricos com até um ano e meio de vida (em um dos equipamentos avaliados). MATERIAIS E MÉTODOS: Foram estimados o índice de dose em tomografia computadorizada e a dose média em cortes múltiplos, em exames com pacientes adultos, em três distintos equipamentos. Ainda foram estimadas as doses na superfície de entrada e as doses absorvidas em exame de cabeça para pacientes adultos e pediátricos em um dos equipamentos avaliados. RESULTADOS: Foram realizados testes de controle de qualidade, mecânicos, demonstrando que os equipamentos satisfazem as especificações de uso estabelecidas pelas normas vigentes. Os resultados da dosimetria mostraram que valores de dose média em cortes múltiplos excederam em até 109,0% os valores de níveis de referência, apresentando consideráveis variações entre os equipamentos avaliados neste estudo. As doses absorvidas obtidas com protocolos pediátricos são inferiores aos de pacientes adultos, apresentando redução de até 51,0% na tireoide. CONCLUSÃO: Neste estudo foram avaliadas as condições de operação de três equipamentos tomográficos, estabelecendo quais parâmetros devem ser trabalhados para a implantação de um programa de controle de qualidade nas instituições onde esta pesquisa foi desenvolvida.

OBJECTIVE: Evaluation of equipment conditions and dosimetry in computed tomography services utilizing protocols for head, abdomen, and lumbar spine in adult patients (in three different units) and pediatric patients up to 18 months of age (in one of the units evaluated). MATERIALS AND METHODS: Computed tomography dose index and multiple-scan average dose were estimated in studies of adult patients with three different units. Additionally, entrance surface doses as well as absorbed dose were estimated in head studies for both adult and pediatric patients in a single computed tomography unit. RESULTS: Mechanical quality control tests were performed, demonstrating that computed tomography units comply with the equipment-use specifications established by the current standards. Dosimetry results have demonstrated that the multiple-scan average dose values were in excess of up to 109.0% the reference levels, presenting considerable variation amongst the computed tomography units evaluated in the present study. Absorbed doses obtained with pediatric protocols are lower than those with adult patients, presenting a reduction of up to 51.0% in the thyroid gland. CONCLUSION: The present study has analyzed the operational conditions of three computed tomography units, establishing which parameters should be set for the deployment of a quality control program in the institutions where this study was developed.

Errores neurorradiológicos frecuentes en TC y RM / Frequent neuroradiological misinterpretations in CT and MR

Se presenta una revisión de las variantes anatómicas normales más frecuentes de ver en cráneo, cerebro y espacios de líquido cefalorraquídeo, que pueden ser malinterpretradas como hallazgos patológicos llevando a la realización de estudios más complejos e innecesarios. En la mayoría de los ejemplos, las variantes anatómicas son solo visibles en TC y en otros casos son exclusivas de RM. El propósito de esta revisión es conocer las variantes más frecuentemente observadas en imágenes de RM y TC con el fin de obtener un diagnóstico acertado evitando la realización de estudios posteriores innecesarios que solo llevan a aumentar los costos en salud de nuestros pacientes.