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1.
Medisan ; 25(4)2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1340211

ABSTRACT

Introducción: El trauma torácico se encuentra entre las primeras causas de muerte, fundamentalmente en personas jóvenes. Objetivos: Caracterizar a una población operada por traumatismos torácicos según variables clinicoepidemiológicas y describir los hallazgos tomográficos posquirúrgicos. Métodos: Se llevó a cabo un estudio observacional y descriptivo de 48 pacientes atendidos en el Servicio de Radiología del Provincial Clínico-Quirúrgico Docente Saturnino Lora de Santiago de Cuba, de enero del 2016 a diciembre del 2018, a los cuales se les realizó tomografía computarizada multidetector. Resultados: Los traumas torácicos predominaron en personas jóvenes del sexo masculino, asociadas fundamentalmente a acciones violentas que provocaron traumas abiertos. La contusión pulmonar resultó ser el hallazgo tomográfico inicial más frecuente, en tanto, el neumotórax persistente y el hemotórax coagulado constituyeron los hallazgos tomográficos más influyentes en la decisión de una reintervención quirúrgica. Conclusiones: La tomografía es un medio diagnóstico que permite una descripción detallada del estado posoperatorio de los órganos afectados, con un alto valor orientativo para decidir procedimientos quirúrgicos posteriores.


Introduction: The thoracic trauma is among the first causes of death, fundamentally in young people. Objectives: To characterize a population operated due to thoracic trauma according to clinical epidemiological variables and describe the postsurgical tomographic findings. Methods: An observational and descriptive study of 48 patients assisted in the Radiology Service of Saturnino Lora Teaching Clinical Surgical Provincial Hospital was carried out in Santiago de Cuba, from January, 2016 to December, 2018, to whom a multidetector computed tomography was carried out. Results: The thoracic traumas prevailed in young male people, fundamentally associated with violent actions that caused open traumas. The lung contusion was the most frequent initial tomographic finding, as long as, the persistent pneumothorax and the coagulated hemothorax constituted the most influential tomographic findings in the decision of a surgical reintervention. Conclusions: Tomography is a diagnostic means that allows a detailed description of the postoperative state in the affected organs, with a high orientative value to decide later surgical procedures.


Subject(s)
Thoracic Injuries/surgery , Thoracic Injuries/epidemiology , Multidetector Computed Tomography , Pneumothorax/surgery , Thoracic Injuries/diagnostic imaging , Hemothorax/surgery
2.
Rev. cient. odontol ; 9(2): e056, abr.-jun. 2021. ilus, tab
Article in Spanish | LILACS, LIPECS | ID: biblio-1254595

ABSTRACT

Objetivo: Estudiar morfométricamente el complejo estilohioideo (CEH) mediante tomografía computarizada multicorte (TCM). Materiales y métodos: Investigación descriptiva, retrospectiva y transversal. La muestra estuvo conformada por 238 estudios de TCM, pertenecientes a pacientes de ambos sexos con edades entre 20 y 87 años, con indicación de tomografía para el macizo craneofacial. Se realizó la medición de la longitud del CEH en vistas laterales de reconstrucciones volumétricas en 3D. Se obtuvo la distribución de estos casos de acuerdo con edad, sexo, lateralidad, tipo de osificación y motivo de indicación del examen. Resultados: La longitud media del CEH fue de 30,66 ± 10,58 mm. Del total de la muestra, 127 (53,4%) individuos mostraron un CEH elongado; de estos, un 63,8% fueron mujeres y un 64,6% de los pacientes presentó un compromiso bilateral del complejo. La mayoría de los sujetos con un CEH elongado tenían edades comprendidas entre 30 y 59 años. El tipo de osificación encontrada con mayor frecuencia fue del tipo I (elongación continua). En cuanto al motivo de indicación del examen, la mayoría de los pacientes fueron referidos para estudio de la articulación temporomandibular. Conclusiones: La TCM es una herramienta útil en la identificación y el estudio morfométrico de la osificación del CEH, tanto en su longitud como tipo. El examen de un CEH osificado es importante para el diagnóstico diferencial de dolor cervicofacial y disfunción de la articulación temporomandibular. (AU)


Objective: tomography (MCT). Materials and methods: This was a descriptive, retrospective cross-sectional study. The sample was made up of 238 MCT studies performed in patients of both sexes between 20 to 87 years of age, with indication of tomography of the craniofacial complex. The length of the SHC was measured in lateral views of 3D volumetric reconstructions. The distribution of these cases was obtained according to age, sex, laterality, type and the reason for the examination. Results: The mean length of the SHC was 30.66 ± 10.58 mm. Of the total sample, 127 (53.4%) individuals showed an elongated SHC; of these, 63.8% were women and 64.6% of the patients presented a bilateral compromise of the complex. Most of the subjects with an elongated SHC were between 30 and 59 years old. The type of ossification most frequently found was type I (continuous elongation). Regarding the reason for the examination, most of the individuals were referred for study of the temporomandibular joint. Conclusions: MCT is a useful tool for the identification and morphometric study of ossification of the SHC, both in length and type. Examination of an ossified SHC is important for the differential diagnosis of cervico-facial pain and temporomandibular joint dysfunction. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Temporal Bone , Multidetector Computed Tomography , Hyoid Bone , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies
3.
Braz. j. med. biol. res ; 54(11): e11371, 2021. tab
Article in English | LILACS | ID: biblio-1339452

ABSTRACT

Dietary factors may influence the process of atherosclerosis and coronary artery calcification (CAC). This study assessed CAC and its association with dietary intake in asymptomatic men. We evaluated 150 asymptomatic men with mean age of 58.2±5.3 years. The dietary intake was assessed by the Food Consumption Register method. CAC was measured through multidetector computed tomography (MDCT) and assessed in accordance with the Agatston score. Modified Poisson regression model was used to estimate the effects of intake of different nutrients that are prevalent in moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals [95%CI]. An association was found between the intake of some nutrients and moderate/severe CAC. Lower carbohydrate intake (P=0.021) and higher lipid intake (P=0.006) were associated with moderate/severe CAC. After adjustment, the nutrients associated with the prevalence of moderate/severe CAC were carbohydrates (P=0.040), lipids (P=0.005), and saturated fatty acids (SFA) (P=0.013). A 1% increase in lipids and SFA intake caused an increase of 4% [95%CI: 1-7%] and 8% [95%CI: 2-14%] in the prevalence of moderate/severe CAC, respectively. A 1% increase of carbohydrate intake led to a 2% decrease in the likelihood of moderate/severe CAC [95%CI: 1-4%]. These conclusions showed that the higher intake of total lipids and SFA was associated with higher CAC scores, whereas higher carbohydrate intake was associated with lower CAC scores in asymptomatic men.


Subject(s)
Humans , Male , Middle Aged , Coronary Artery Disease/epidemiology , Coronary Artery Disease/diagnostic imaging , Atherosclerosis , Vascular Calcification/epidemiology , Vascular Calcification/diagnostic imaging , Risk Factors , Coronary Vessels/diagnostic imaging , Eating , Multidetector Computed Tomography
4.
CorSalud ; 12(4): 472-476, tab, graf
Article in Spanish | LILACS | ID: biblio-1278966

ABSTRACT

RESUMEN Las masas cardíacas constituyen un reto diagnóstico y terapéutico. Muchas veces se descubren casualmente y la evaluación confirma, finalmente, la presencia de un tumor cardíaco. Estos son neoplasias originadas en cualquier capa del corazón y se dividen en primarios y secundarios. Los primarios tienen una incidencia en autopsias de 0,001 - 0,03%, que contrasta con la frecuencia 20-40 veces mayor de los secundarios. Se presenta un paciente de 28 años de edad diagnosticado 1 año antes de adenocarcinoma de colon transverso infiltrante, en quien hace 3 meses se constató metástasis a cadena ganglionar intraabdominal y se realizó tratamiento quirúrgico más quimioterapia. Posteriormente comenzó con taquicardia y acudió a su centro de salud donde se le realizó un ecocardiograma transtorácico que constató una imagen de aspecto tumoral en ventrículo derecho. Por tomografía se demostró una masa tumoral compleja inoperable y el paciente falleció en su hogar, bajo cuidados paliativos, un mes y medio después del egreso.


ABSTRACT Cardiac masses are a diagnostic and therapeutic challenge. They are often found incidentally and assessment eventually confirms the presence of a heart tumor. They are neoplasms that originate in any layer of the heart and are divided into primary and secondary. The primary ones have a 0.001 - 0.03% incidence in autopsies, contrasting with the 20-40 times higher frequency of the secondary ones. We present the case of a 28-year-old patient diagnosed one year before with infiltrating transverse colon adenocarcinoma in whom intra-abdominal lymph node chain metastases were confirmed three months ago, receiving surgical treatment and chemotherapy. Later, he began with tachycardia and presented to his health care center where a transthoracic echocardiogram was performed, which showed a tumor-like image in the right ventricle. The CT-scan showed an unresectable complex tumor mass and the patient died at home, under palliative care, a month or so after discharge.


Subject(s)
Colonic Neoplasms , Multidetector Computed Tomography , Heart Neoplasms , Neoplasm Metastasis
6.
Rev. Asoc. Méd. Argent ; 133(2): 29-33, jun. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1119931

ABSTRACT

La Sociedad Fleishner define el signo del halo invertido o signo del atolón como un área focal redondeada con la densidad de un "vidrio esmerilado", rodeada por un anillo más o menos completo de consolidación. Este signo fue descrito inicialmente en pacientes con neumonía organizada criptogénica por Voloudaki y Kim. Ha sido descrito en: 1) enfermedades infecciosas (la paracoccidioidomicosis, la aspergilosis, la mucormicosis y virales), 2) síndromes linfoproliferativos (la granulomatosis linfomatoidea), y 3) enfermedades inflamatorias no infecciosas ni neoplásicas (el síndrome de Churg-Strauss, la neumonía intersticial no específica y la granulomatosis de Wegener).


The Fleishner Society defines the inverted halo sign or Atoll sign as a rounded focal area with a "ground glass" density, surrounded by a more or less complete ring of consolidation. This sign was initially described in patients with organizing cryptogenic pneumonia by Voloudaki and Kim. It has been described in: 1) infectious diseases (paracoccidioidomycosis, aspergillosis, mucormycosis, and virals), 2) lymphoproliferative diseases (lymphomatoid granulomatosis), and 3) non-infectious and neoplastic inflammatory diseases (Churg-Strauss syndrome, non-specific interstitial pneumonia, and Wegener's granulomatosis).


Subject(s)
Humans , Male , Middle Aged , Pneumonia, Viral/diagnosis , Coronavirus Infections/diagnosis , Multidetector Computed Tomography , Diagnostic Imaging , Polymerase Chain Reaction , Pandemics , Prodromal Symptoms , Betacoronavirus
7.
Rev. argent. radiol ; 84(2): 61-67, abr. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1125857

ABSTRACT

Resumen La inflamación de la aorta (aortitis) es una patología poco frecuente, con etiología infecciosa (pseudoaneurisma micótico, sífilis) y no infecciosa (arteritis, aortitis idiopática, espondilitis anquilosante, entre otras) de difícil diagnóstico clínico y variable pronóstico. Por esa razón, la utilización de diversos métodos por imágenes, tales como la tomografía computada multidetector (TCMD), la tomografía computada por emisión de positrones (PET-TC), la resonancia magnética (RM) y ultrasonido (US) facilitan la identificación, seguimiento y tratamiento de esa entidad. El siguiente trabajo tiene como objetivo realizar una revisión y actualización bibliográfica acerca de la aortitis y sus diversas etiologías, ejemplificando con casos de nuestra institución.


Abstract Aortic inflammation (aortitis) is a rare pathology, with infectious (fungal pseudoaneurysm, syphilis) and noninfectious etiology (arteritis, idiopathic aortitis, ankylosing spondylitis, among others), it has a difficult clinical diagnosis and a variable prognosis. The use of various imaging methods such as multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), positron emission tomography-computed tomography (PET-CT) and ultrasound (US) facilitate the identification, monitoring and treatment of this entity. The following paper aims to perform a literature review and update about aortitis and its various etiologies, exemplifying cases of our institution.


Subject(s)
Aortitis/etiology , Aortitis/diagnostic imaging , Spondylitis, Ankylosing/diagnostic imaging , Giant Cell Arteritis/diagnostic imaging , Angiography/methods , Takayasu Arteritis/etiology , Takayasu Arteritis/diagnostic imaging , Multidetector Computed Tomography/methods
8.
Rev. Asoc. Méd. Argent ; 133(1): 21-24, mar. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1097699

ABSTRACT

La isquemia mesentérica aguda (IMA) es consecuencia de la oclusión de la arteria mesentérica superior (AMS) por trombosis o embolia, y es considerada la más letal del síndrome de abdomen agudo. Se presenta el caso de paciente femenina de 69 años con clínica difusa y confirmación diagnóstica radiológica, El objetivo de este caso clínico es proporcionar una revisión bibliográfica actual del tema y facilitar la adecuada actuación ante este problema de salud de amplio compromiso sistémico, y de aparición no tan infrecuente. (AU)


Acute mesenteric ischemia (IMA) is a consequence of occlusion of the superior mesenteric artery (AMS) by thrombosis or embolism; and it is considered the most lethal of acute abdomen syndrome. The case of a 69 years old female patient with diffuse clinic and radiological diagnostic confirmation is presented. The objective of this clinical case is to provide a current bibliographic review of the topic and facilitate adequate action in the face of this health problem with a broad systemic commitment, and with no appearance so infrequent. (AU)


Subject(s)
Humans , Female , Aged , Mesenteric Artery, Superior/diagnostic imaging , Mesenteric Ischemia/diagnostic imaging , Mesenteric Vascular Occlusion/complications , Acute Disease , Mesenteric Artery, Superior/surgery , Multidetector Computed Tomography , Mesenteric Ischemia/etiology , Mesenteric Ischemia/therapy
9.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 38-46, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090545

ABSTRACT

Abstract Introduction The clinical relevance of the anatomy and variations of the anterior ethmoidal artery (AEA) is outstanding, considering its role as a landmark in endoscopic surgery, its importance in the therapy of epistaxis, and the high risks related to iatrogenic injuries. Objective To provide an anatomical description of the course and relationships of the AEA, based on direct computed-tomography (CT)-based 3D volume rendering. Methods Direct volume rendering was performed on 18 subjects who underwent (CT) with contrast medium for suspected cerebral aneurism. Results The topographical location of 36 AEAs was assessed as shown: 10 dehiscent (27.8%), 20 intracanal (55.5%), 6 incomplete canals (16.7%). Distances from important topographic landmarks are reported. Conclusion This work demonstrates that direct 3D volume rendering is a valid imaging technique for a detailed description of the anterior ethmoidal artery thus representing a useful tool for head pre-operatory assessments.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Arteries/anatomy & histology , Arteries/diagnostic imaging , Ethmoid Sinus/blood supply , Ethmoid Sinus/diagnostic imaging , Multidetector Computed Tomography/methods , Tomography, X-Ray Computed/methods , Intracranial Aneurysm/diagnostic imaging , Retrospective Studies , Skull Base/anatomy & histology , Skull Base/blood supply , Skull Base/diagnostic imaging , Contrast Media , Imaging, Three-Dimensional
10.
Rev. bras. ortop ; 55(1): 70-74, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1092675

ABSTRACT

Abstract Objective The aim of the present study is to evaluate the artery of Adamkiewicz by multidetector computed tomography angiography (MCTA) in a Brazilian population. Methods Two independent observers evaluated 86 coronary MCTA examinations. The variables studied included the identification of the artery of Adamkiewicz at its origin level, and its entry side in the spine. Results The artery of Adamkiewicz was detected in 71 (82.5%) examinations. The origin level was identified between the 9th and 11th thoracic vertebrae (T9 and T11) in 56 (79.2%) patients. In 65 (91.5%) patients, the artery was on the left side. The identification of the artery of Adamkiewicz using MCTA showed high reproducibility. Conclusions Our results were consistent with the literature regarding the identification of the artery of Adamkiewicz using MCTA, suggesting that this technique should be considered as an option to recognize this structure. In addition, we found that the distribution of the artery of Adamkiewicz in the Brazilian population is similar to that of other populations, that is, its most common origin is at the left side, between the 8th and 12th thoracic vertebrae (T8-T12).


Resumo Objetivo Avaliar a artéria de Adamkiewicz por angiotomografia computadorizada por multidetectores (ATCM) em uma população brasileira. Métodos Dois observadores independentes avaliaram 86 exames de ACTM. As variáveis estudadas incluíram a identificação da artéria de Adamkiewicz no nível de origem e o lado de entrada da artéria na coluna vertebral. Resultados A artéria de Adamkiewicz foi identificada em 71 (82,5%) exames. O nível de origem foi identificado entre a 9a e a 11a vértebras torácicas (T9 e T11) em 56 (79,2%) pacientes. Em 65 (91,5%) pacientes, a artéria foi identificada no lado esquerdo. A identificação da artéria de Adamkiewicz usando ACTM mostrou elevada reprodutibilidade. Conclusões Obtivemos resultados consistentes com os da literatura prévia quanto à identificação da artéria de Adamkiewicz utilizando angiotomografia computadorizada por multidetectores. Nossos resultados sugerem que a ATCM pode ser considerada como uma opção para identificar a artéria de Adamkiewicz. Além disso, encontramos uma distribuição da artéria de Adamkiewicz na população brasileira semelhante à de outras populações, com a artéria de Adamkiewicz originando-se mais comumente no lado esquerdo, entre a 8a e a 12a vértebras torácicas (T8-T12).


Subject(s)
Humans , Male , Female , Paraplegia , Arteries/pathology , Spinal Cord , Angiography/methods , Multidetector Computed Tomography
11.
Rev. colomb. radiol ; 31(1): 5277-5282, mar, 2020. ilus, graf
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1292765

ABSTRACT

La neumatosis intestinal es una condición que tradicionalmente se ha asociado a mal estado general, pobre pronóstico y manejo quirúrgico. No obstante, existe una forma de presentación benigna que no conlleva estas implicaciones y se denomina neumatosis cistoides. Esta entidad se caracteriza por la presencia de quistes llenos de gas en la pared intestinal, que pueden generar neumoperitoneo sin evidencia de signos de irritación peritoneal y que resuelven sin necesidad de manejo quirúrgico. El objetivo de este trabajo es realizar una revisión de la literatura acerca de la neumatosis intestinal, enfocado en el establecimiento de sus diversas etiologías y hallazgos en las diferentes modalidades diagnósticas. Debido a que las imágenes diagnósticas juegan un papel clave en el momento de definir el manejo y la necesidad de intervención quirúrgica de estos pacientes, es importante que el radiólogo conozca y pueda diferenciar los diferentes orígenes de la neumatosis intestinal en las imágenes, así como sus posibles implicaciones. Esto, asociado a una adecuada comunicación con el servicio tratante, puede ayudar a determinar la mejor forma de manejo para el paciente.


Pneumatosis intestinalis is a condition that has traditionally been associated with poor general condition, poor prognosis and surgical management. However, there is a benign form of presentation that does not carry these implications and is called Pneumatosis Cystoides. This entity, characterized by the presence of gas-filled cysts inside the intestinal wall can generate pneumoperitoneum without evidence of signs of peritoneal irritation and resolve without surgical management need. The aim of this paper is to review the literature about pneumatosis intestinalis, focused on establishing its various etiologies and findings in different diagnostic modalities. Because diagnostic images have a key role in defining the management and need for surgical intervention of these patients, it is important that the radiologist knows and differentiate the different origins of pneumatosis intestinalis in images, as well as their possible implications. Proper communication with the treating service, can help determine the best form of management for the patient


Subject(s)
Pneumoperitoneum , Pneumatosis Cystoides Intestinalis , Multidetector Computed Tomography
12.
Rev. colomb. radiol ; 31(1): 5289-5293, mar, 2020. ilus, graf
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1292792

ABSTRACT

Los lipomas constituyen la segunda causa de neoplasias benignas del colon, suelen ser asintomáticos, pero pueden manifestarse con úlceras que llevan a hemorragias o anemia ferropénica; también pueden manifestarse como obstrucción intestinal a través de una invaginación intestinal. Esta última condición rara en adultos, representa el 1 % de las causas de obstrucción intestinal en este grupo de edad; al menos el 90 % son secundarios a una condición que sirve como cabeza de invaginación o punto de partida. Se presenta el caso de un hombre de 64 años de edad con dolor abdominal, en quien los estudios de imagen establecieron el diagnóstico de invaginación ileocólica ocasionada por un lipoma colónico. Se le practicó una hemicolectomía y anastomosis ileotransversa. El estudio histopatológico confirmó el hallazgo de un lipoma colónico como punto de inicio de una invaginación.


Lipomas are the second cause of benign neoplasms of the colon. They are usually asymptomatic, but can manifest as cases of ulcers that have hemorrhages or iron deficiency anemia. They can also manifest as bowel obstruction through intussusception. This last condition is rare in adults, representing 1% of the causes of bowel obstruction in this group. Of the cases that occur, at least 90% are secondary to a condition that serves as the head of the intussusception or starting point. We present the case of a 64-year-old man with abdominal pain, in whom imaging studies established the diagnosis of ileocolic intussusception in relation to a possible colonic lipoma. He underwent surgery where a hemicolectomy and ileo-transverse anastomosis were performed. The histopathological study confirmed the finding of a colonic lipoma as the starting point of the intussusception.


Subject(s)
Lipoma , Multidetector Computed Tomography , Intestine, Large , Intussusception
13.
Rev. colomb. radiol ; 31(1): 5299-5302, mar, 2020. ilus, graf
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1292820

ABSTRACT

El secuestro pulmonar es una enfermedad congénita del tracto respiratorio que compromete el parénquima pulmonar y su vasculatura, puede dividirse en intralobar o extralobar dependiendo de su relación con la pleura visceral normal. El subtipo extralobar usualmente se diagnostica prenatalmente o en los primeros meses de vida, mientras que el intralobar se presenta en adultos jóvenes. Representa aproximadamente el 0,15-6,4 % de todas las malformaciones pulmonares congénitas y no tiene diferencias respecto al sexo con una relación 1:1. Se presenta el caso de un paciente masculino adulto medio con neumonías a repetición en quien se realizan estudios imagenológicos con hallazgos tomográficos compatibles con secuestro pulmonar intralobar en el segmento basal posterior izquierdo, con el objetivo de realizar una revisión de la literatura para plantear una discusión sobre la importancia del diagnóstico adecuado y a tiempo de esta patología. Es necesario tener una alta sospecha clínica ­se trata de una enfermedad de presentación variable­, para solicitar el estudio imagenológico más adecuado, puesto que las imágenes son las que dan el diagnóstico definitivo del secuestro pulmonar. En algunos casos, el manejo se puede realizar de manera mínimamente invasiva a cargo de radiología intervencionista, como en este caso.


Pulmonary sequestration is a congenital respiratory disease that involves the pulmonary parenchyma and its vasculature. It can be divided into intralobar or extralobar depending on its relationship with normal visceral pleura. The extralobar subtype is usually diagnosed prenatally or in the first months of life, while the intralobar occurs in young adults. It represents approximately 0.15-6.4% of all congenital lung malformations and does not show differences with respect to sex with a 1:1 ratio. We present the case of an average adult male patient with recurrent pneumonia in whom multiples imaging studies are performed, with tomographic findings compatible with intralobar pulmonary sequestration in the left posterior basal segment, with the aim of performing a literature review to raise a discussion on the importance of the proper and early diagnosis of this pathology. It is necessary to have a high clinical suspicion -it is a disease of variable presentation-, to request the most appropriate imaging study, since the images are those that give the definitive diagnosis of pulmonary sequestration. In some cases, management can be performed in a minimally invasive manner by interventional radiology, as in this case.


Subject(s)
Bronchopulmonary Sequestration , Pneumonia , Congenital Abnormalities , Multidetector Computed Tomography
14.
Rev. colomb. radiol ; 31(2): 5350-5353, jun. 2020. ilus, imag
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1343439

ABSTRACT

Los aneurismas de las arterias viscerales son relativamente poco frecuentes. El aneurisma de la arteria esplénica es el más común de este grupo, se presenta en el 60 a 70 % de los pacientes. Presentamos el caso de una paciente de 68 años de edad con factores de riesgo cardiovascular, quien consultó por un cuadro de dolor abdominal agudo, intenso, asociado a sensación de peso, y masa pulsátil al examen físico como dato representativo. Mediante angioTAC abdominal y angiografía de tronco celiaco se diagnosticó una dilatación aneurismática sacular en el segmento proximal de la arteria esplénica, la cual, por su localización y con el objetivo de preservar el bazo, fue tratada mediante cateterización selectiva y embolización del saco del aneurisma, para reducir el riesgo de ruptura y lograr un control de síntomas adecuado. A continuación, se explica brevemente la fisiopatología, diagnóstico y los beneficios de la terapia endovascular respecto a otras técnicas.


Visceral artery aneurysms are relatively rare. The splenic artery aneurysm is the most common in this group, occurring in 60 to 70% of patients. We present the case of a 68 year old patient with cardiovascular risk factors, who consulted for acute, intense abdominal pain associated with sensation of weight, and a pulsatile mass at physical examination as representative data. Diagnosis of an saccular aneurysmal dilation in the proximal segment of the splenic artery was made by abdominal angiography and celiac trunk angiography, which, due to its location and to preserve the distal flow, was treated by selective catheterization and embolization of the aneurysm sac, thus reducing risk of rupture and achieving clinical control of the patient's symptoms. The physiopathology, diagnosis, and benefits of endovascular therapy compared to other techniques are briefly explained below


Subject(s)
Aneurysm , Abdominal Pain , Embolization, Therapeutic , Multidetector Computed Tomography
15.
Rev. colomb. radiol ; 31(2): 5321-5327, jun. 2020. ilus, graf
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1292870

ABSTRACT

Introducción: En imágenes, los hallazgos del oncocitoma generalmente coinciden con el carcinoma de células renales (CCR) por lo que resulta muy poco segura su discriminación mediante imágenes. Objetivos: Evaluar el comportamiento de una muestra de oncocitoma en tomografía (TC). Métodos: Se seleccionaron retrospectivamente los pacientes con cirugía de tumor renal y diagnóstico anatomopatológico de oncocitoma, que fueron tratados entre enero de 2015 y diciembre de 2017. Se incluyeron los pacientes a quienes se les realizó TC con medio de contraste endovenoso en nuestra institución. Resultados: Del total de pacientes (n = 44), 43 tenían una lesión única renal, mientras que uno tenía tres lesiones. Del total de las lesiones (n = 47), 20 (42,55 %) fueron diagnosticadas tras una nefrectomía radical y 24 (51,10 %) fueron diagnosticadas por una nefrectomía parcial. La media de diámetro máximo fue de 36,5 mm (RIQ 22-44,25), de los cuales se agruparon en menores y mayores a 4 cm; se encontraron 22 tumores en este último grupo (47 %). De estos, en 15 tumores (31,91 %) que tenían más de 4 cm se encontró la cicatriz central. Se evidenciaron calcificaciones en 3 pacientes (6,8 %). Se encontró 1 tumor (2,1 %) con inversión de realce segmentario luego de la administración medio de contraste endovenoso. En este caso, el oncocitoma era menor a 4 cm. Conclusión: El hallazgo de una masa sólida con realce más intenso que el parénquima circundante durante la fase nefrográfica obliga a considerar al oncocitoma entre los diagnósticos diferenciales


Introduction: The imaging findings of oncocytomas usually coincide with renal cell carcinoma (RCC), which makes it difficult to discriminate them in imaging. Objective: To evaluate the imaging findings of a sample of oncocytomas in tomography (CT). Methods: We retrospectively selected patients with renal tumor surgery and oncocytoma anatomopathological diagnosis, who were treated between January 2015 and December 2017. Patients who underwent CT with intravenous contrast at our institution were included. Results: Of the total number of patients (n = 44), 43 had a single renal lesion while one patient presented 3 lesions. Of the total lesions (n = 47), 20 (42.55%) were diagnosed after a radical nephrectomy and 24 (51.10%) were diagnosed by a partial nephrectomy. The mean maximum diameter was 36.5 mm (RIQ 22-44, 25), of which they were grouped by tumor length into smaller or larger than 4 cm, with 22 tumors in this last group (47%). Of these, 15 tumors (31.91 %) that were larger than 4 cm had a central scar. Calcifications were evident in 3 patients (6.8 %). One tumor (2.1%) was found with the presence of inversion of segmental enhancement after administration of intravenous contrast. In this case, the oncocytoma was less than 4 cm. Conclusion: The finding of a solid mass with more enhancement than the surrounding parenchyma during the nephrographic phase makes it necessary to consider oncocytoma among the differential diagnoses


Subject(s)
Adenoma, Oxyphilic , Diagnosis , Multidetector Computed Tomography , Kidney Neoplasms
16.
Rev. colomb. radiol ; 31(2): 5328-5334, jun. 2020. imag, fig
Article in Spanish | LILACS, COLNAL | ID: biblio-1343284

ABSTRACT

Introducción: El uso de dosis adecuadas de radiación en pacientes pediátricos es un deber de los centros de diagnóstico médico debido a las características y retos que implica esta población. Por lo anterior, se han establecido unos niveles internacionales de referencia de dosis (DRL, del inglés dose reference level) para optimizar y comparar los protocolos de cada institución. En Colombia no se cuenta con estudios al respecto. Objetivo: Mostrar los DRL utilizados en un hospital universitario de alta complejidad en las modalidades de tomografía computarizada (TC), radiografía y fluoroscopia y compararlos con los estándares internacionales. Metodología: Estudio descriptivo retrospectivo realizado entre 2018 y 2019. Se analizaron datos de producto dosis longitud (DLP) para TC de cráneo, tórax, abdomen y TC de tórax de alta resolución (TACAR); y producto dosis área (DAP) para radiografía de tórax, abdomen, huesos y fluoroscopia por grupos etarios. Resultados: Se obtuvieron los datos de 780 pacientes: 360 radiografías, 100 de fluoroscopia y 320 tomografías. Se encontró que los niveles de referencia de dosis de radiación usados en el hospital son bajos, comparados con guías europeas de 2018 de niveles de referencia. Se describen DRL para cada estudio y grupo etario. Conclusión: Se demostró que en el hospital donde hizo el estudio los niveles de referencia de radiación en la población pediátrica son bajos. El presente trabajo puede servir como referente nacional.


Introduction: Due to the characteristics and challenges of the pediatric population regarding radiation, the use of adequate doses of radiation is a duty of medical diagnostic centers. For this reason, the Dose Reference Levels (DRL) have been established in many countries to optimize and monitor the protocols of each institution. In Colombia there are no studies in this subject. Objective: To show the DRLs used in a university hospital of high complexity in the modalities of computed tomography (CT), radiography and fluoroscopy and to compare them with international standards. Methodology: Retrospective descriptive trial between 2018 and 2019. We analyzed dose length product (DLP) data for skull, chest, abdomen, and high-resolution chest CT (HRCT); and dose area product (DAP) for chest, abdomen, bone, and fluoroscopy radiography by age groups. Results: Data were collected for a total of 780 patients. 360 x-rays, 100 fluoroscopy and 320 tomography scans. Reference levels of radiation dose used in the hospital were found to be low compared to European guidelines of 2018 reference levels. DRLs are described for each study and age group. Conclusion: It was demonstrated that at the hospital where the study was conducted, reference levels of radiation in the pediatric population are low. This work can serve as a national reference.


Subject(s)
Multidetector Computed Tomography , Radiation Dosage , Radiation Protection
17.
Rev. colomb. radiol ; 31(2): 5335-5338, jun. 2020.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1343286

ABSTRACT

Los tumores vesicales no músculo-invasivos se definen como lesiones papilares limitadas a la mucosa vesical o que invaden la lámina propia, además de los tumores de morfología plana y alto grado limitados a la mucosa (carcinoma in situ [CIS]). La confirmación diagnóstica se produce tras el análisis histológico de la muestra obtenida en la resección transuretral (RTU) de vejiga, que en los tumores Ta-T1 requiere la resección completa de todas las lesiones, incluyendo parte del músculo detrusor, lo que constituye, también, el método terapéutico. En el caso del CIS, que puede simular inflamación o no ser visible en la cistoscopia, son necesarias múltiples biopsias aleatorias de la vejiga. La perforación iatrogénica de la vejiga es el segundo evento adverso más frecuente del mencionado procedimiento; esta solución de continuidad en la pared puede dar lugar a la migración de grasa hacia el interior de la vejiga, que en las pruebas de imagen se traduce en la formación de un nivel líquido-grasa intravesical, hallazgo infrecuente, que a su vez posee un amplio diagnóstico diferencial, que abarca causas primarias, infecciosas y traumáticas, pero no previamente descrito como una complicación de la RTU. Se presenta el caso de un paciente asintomático con un nivel líquido-grasa intravesical secundario a perforación extraperitoneal de vejiga, tras la resección transuretral de un carcinoma urotelial no músculo-invasivo en la cúpula vesical.


Non-muscle-invasive bladder tumours are defined as papillary lesions limited to the bladder mucosa or invading the lamina propia, in addition to flat morphology and high-grade tumors limited to the mucosa (carcinoma in situ [CIS]). Diagnostic confirmation occurs after histological analysis of the sample obtained in the transurethral resection of the bladder (TURB), which in Ta-T1 tumours requires complete resection of all lesions, including part of the detrusor muscle, being in these cases also the therapeutic method. In the case of CIS, which may simulate inflammation or not be visible in cystoscopy, multiple random bladder biopsies are necessary (2). Iatrogenic bladder perforation is the second most frequent adverse event of this procedure; This solution of continuity in the wall can lead to the migration of fat into the bladder, which in imaging tests results in the formation of an intravesical fat-fluid level, a rare finding, which in turn has a broad differential diagnosis that covers primary, infectious and traumatic causes, but not previously described as a complication of TURB. We report the case of an asymptomatic patient with presence of intravesical fat-fluid, secondary to extra-peritoneal bladder perforation, after transurethral resection of a non-muscleinvasive urothelial carcinoma in the bladder dome.


Subject(s)
Urinary Bladder , Carcinoma, Transitional Cell , Multidetector Computed Tomography
18.
Rev. bras. cir. cardiovasc ; 35(2): 127-133, 2020. tab, graf
Article in English | LILACS | ID: biblio-1101470

ABSTRACT

Abstract Objective: To evaluate the hemodynamic performance (i.e., gradients and paravalvular leakage [PVL]) of the new and experimental Braile Inovare® Proseal. Additionally, we aimed to assess pre and postoperatively the aortic annulus and the transcatheter prosthesis using multislice computed tomography (MSCT). Methods: Patients were selected by a multidisciplinary heart team and referred for transcatheter aortic valve replacement (TAVR). MSCT was performed before and after surgery. Measurements of the aortic valve and prosthesis were conducted and correlated with the valve gradient and residual PVL. Results: Twenty-one patients were selected for the protocol. Patients had a mean age of 79 years and 38% of them were of female sex. The mean EuroSCORE II value was 12.5%±10.8. Mean gradient was reduced from 45.8±11.04 mmHg to 5.59±2.61 mmHg and there were no instances of PVL worse than mild. There were no cases of coronary obstruction or procedural death. Circularity was present in all prostheses evaluated. Circularity indexes for the prostheses were: inflow 0.05±0.03, middle third 0.04±0.02, and outflow 0.04±0.02 (P=0.08). The mean distance between the prosthesis and the left and right coronary ostia were 14.8 mm±3.3 and 17.3 mm±3, respectively. Oversizing was appropriate with a mean of 22.14%±6%. Conclusion: Braile Inovare® Proseal transcatheter device has demonstrated low gradients with low rates of PVL. Oversizing by annular measurements was adequate. MSCT was adequate to evaluate device sizing and has demonstrated preserved expansibility and circularity in the evaluated cases.


Subject(s)
Humans , Male , Female , Aged , Heart Valve Prosthesis Implantation , Transcatheter Aortic Valve Replacement , Aortic Valve , Aortic Valve Stenosis , Prosthesis Design , Stroke Volume , Cardiac Catheterization , Ventricular Function, Left , Treatment Outcome , Multidetector Computed Tomography , Hemodynamics
19.
Article in English | AIM | ID: biblio-1258617

ABSTRACT

Introduction: Time is critical in the trauma setting. Emergency computed tomography (CT) scans are usually interpreted by the attending doctor and plans to manage the patient are implemented before the formal radiological report is available. This study aims to investigate the discrepancy in interpretation of emergency whole body CT scans in trauma patients by the trauma surgeon and radiologist and to determine if the difference in trauma surgeon and radiologist interpretation of emergency trauma CT scans has an impact on patient management. Method: This prospective observational comparative study was conducted over a 6 month period (01 April­30 September 2016) at the Inkosi Albert Luthuli Central Hospital which has a level 1 trauma department. The study population comprised 62 polytrauma patients who underwent a multiphase whole body CT scans as per the trauma imaging protocol. The trauma surgeons' initial interpretation of the CT scan and radiological report were compared. All CT scans reported by the radiology registrar were reviewed by a consultant radiologist. The time from completion of the CT scan and completion of the radiological report was analysed. Results: Since the trauma surgeon accompanied the patient to radiology and reviewed the images as soon as the scan was complete, the initial interpretation of the CT was performed within 15­30 min. The median time between the CT scan completion and reporting turnaround time was 75 (16­218) min. Critical findings were missed by the trauma surgeon in 4.8% of patients (bronchial transection, abdominal aortic intimal tear and cervical spine fracture) and non-critical/incidental findings in 41.94%. The trauma surgeon correctly detected and graded visceral injury in all cases. Conclusion: There was no significant discrepancy in the critical findings on interpretation of whole body CT scans in polytrauma patients by the trauma surgeon and radiologist and therefore no negative impact on patient management from missed injury or misdiagnosis. The turnaround time for the radiology report does not allow for timeous management of the trauma patient


Subject(s)
Multidetector Computed Tomography , Multiple Trauma , Radiologists , South Africa , Trauma Centers
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