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1.
Int. j. morphol ; 38(3): 787-792, June 2020. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1098320

ABSTRACT

El bazo se localiza en el cuadrante superior izquierdo del abdomen, relacionándose posteriormente con la 9a a 11a costilla, de las que se separa por el diafragma y el receso costodiafragmático, se localiza por detrás del estómago y lateralmente al riñón izquierdo. Por alteraciones en su desarrollo pueden generarse bazos accesorios (BA), considerándose un tejido ectópico del bazo. Se consideran tejido normal, con los mismos procesos fisiológicos que el bazo principal. Con el propósito de localizar y determinar aspectos biométricos de los mismos, se realizó un estudio de corte transversal y de carácter descriptivo, sobre una muestra de 220 exámenes de TC pertenecientes a pacientes mayores de 18 años del Hospital Regional Hernán Henríquez Aravena, Temuco, Chile. Para este estudio se excluyeron toda aquellas TC con antecedentes de esplenectomía y lesiones de Bazo o peri-esplénicas. El análisis de los datos mostró una prevalencia de 32,3 % de BA, pudiendo ser de una única presencia, dos e incluso tres BA por paciente.De un total de 71 personas que tienen al menos un BA, 34 (47,89 %) fueron de sexo femenino y 37 (52,11 %) de sexo masculino. Hubo 56 pacientes (78,9 %) con un BA, 29 (40,85 %) del sexo femenino y 27 (38,03 %) del masculino; 15 (21,1 %) presentaron más de un BA, 5 (7,04 %) de sexo femenino y 10 (14,08 %) de sexo masculino, si bien se puede observar variación en la cantidad de BA según sexo, no existe una relación estadísticamente significativa entre dichas variables. La ubicación más frecuente encontrada en el plano axial fue la zona antero-medial con 59 casos (66,29 %); asimismo, en el plano sagital, la localización más frecuente fue en el polo inferior con 40 casos (44,44 %). Datos biométricos de estos BA son mostrados en Tablas. Esta información será de gran valor morfológico y médico debido a la escasa literatura existente sobre esta materia en individuos chilenos.


The spleen is located in the upper left quadrant of the abdomen, subsequently related to the 9th to 11th rib, from which it is separated by the diaphragm and the cost-diaphragmatic recess, it is located behind the stomach and laterally to the left kidney. Due to alterations in its development, accessory spleens (AS) can be generated, being considered an ectopic tissue of the spleen. The AS are considered normal tissue, with the same physiological processes as the main spleen. With the purpose of locating and determining biometric aspects of them, a cross-sectional and descriptive study was carried out on a sample of 220 CT scans belonging to patients over 18 years of age at the Hernán Henríquez Aravena Regional Hospital, Temuco, Chile. For this study, all CT scans with a history of splenectomy and spleen or peri-splenic lesions were excluded. The analysis of the data showed a prevalence of 32.3 % of AS, being able to be of a single presence, two and even three AS per patient. Of a total of 71 people who have at least one AS, 34 (47.89 %) were female and 37 (52.11 %) male. There were 56 patients (78.9 %) with a one AS, 29 (40.85 %) of the female sex and 27 (38.03 %) of the male; 15 (21.1 %) presented more than one AS, 5 (7.04 %) female and 10 (14.08 %) male, although variation in the amount of AS according to sex can be observed, no there is a statistically significant relationship between these variables. The most frequent location found in the axial plane was the anteromedial zone with 59 cases (66.29 %); also, in the sagittal plane, the most frequent location was in the lower pole with 40 cases (44.44 %). Biometric data of these AS are shown in tables. This information will be of great morphological and medical value due to the limited existing literature on this subject in Chilean individuals.


Subject(s)
Humans , Male , Female , Adult , Spleen/abnormalities , Spleen/diagnostic imaging , Tomography, X-Ray Computed , Spleen/anatomy & histology , Chile , Sex Factors , Prevalence , Cross-Sectional Studies
2.
Diagn. tratamento ; 25(2): 01-06, abr.-jun. 2020. graf, tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1115997

ABSTRACT

Contexto: A tomografia computadorizada revolucionou os estudos radiológicos convencionais. Porém, tal avanço se deu associado com o aumento das doses de radiação ionizante. A tomografia computadorizada representa 15% de todos os exames de imagem e contribui com 75% de radiação para a população. Objetivo: Estimar a dose efetiva de radiação imprimida aos pacientes durante os exames de tomografia computadorizada. Desenho e local: Estudo retrospectivo e descritivo em instituição hospitalar de nível terciário no Rio de Janeiro. Métodos: Foram selecionados 1.476 pacientes que realizaram exames de tomografia computadorizada de crânio, tórax e abdome/pelve, sem contraste endovenoso, no serviço de radiodiagnóstico do hospital no período de 1 de janeiro a 31 de março de 2018 para os exames de tórax, e no período de 1 de janeiro a 28 de fevereiro de 2018 para os exames de crânio e de abdome/pelve. Os dados foram coletados a partir do Picture Archivingand Communication System (PACS) da instituição para avaliar a dose de radiação utilizada por cada tipo de exame, por meio do cálculo das doses efetivas médias em cada tipo de exame. Resultados: As médias das doses efetivas encontradas foram de 1,57 mSv, 8,37 mSv e 12,28 mSv para os exames de crânio, tórax e abdome/pelve, respectivamente. Conclusão: O estudo verificou que os exames de crânio e abdome/pelve foram realizados com as médias das doses efetivas dentro dos valores típicos preconizados, enquanto nos exames de tórax as doses efetivas estavam acima da faixa fornecida pela Associação Americana de Física Médica (American Association of Physicists in Medicine, AAPM) (relatório # 96).


Subject(s)
Radiation Dosage , Radiation, Ionizing , Radiation Protection , Tomography, X-Ray Computed , Dosimetry
3.
Neumol. pediátr. (En línea) ; 15(2): 330-338, mayo 2020. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1099679

ABSTRACT

The CoVID-19 pandemic has impacted in a lesser extent and intensity to patients younger than 15 years. The role of different imaging studies of lung involvement has been extensively addressed, from the first cases of severe pneumonia and respiratory distress syndrome in adults. There are fewer reports of the comparative usefulness of conventional radiology, ultrasound, and computed axial tomography in children. Of those, ground glass opacities, crazy paving pattern and surrounding halo consolidation are the most characteristic. Even though none of them allows diagnostic confirmation, their correct interpretation helps in decision flows. Computed axial tomography is more accurate for defining the type and extent of lung parenchymal involvement. The role of the ultrasound in early stages in the emergency department is clearer in adults than in children, in whom there is a good correlation with chest tomography. This article addresses the different radiological patterns, their pathophysiological representation and differential diagnoses, in order to alert pediatricians of their interpretation, as well as the potential role of imaging diagnoses most frequently used in children with low acute respiratory infection.


La pandemia CoVID-19 ha impactado en una proporción e intensidad menor a los pacientes menores de 15 años. El rol de los diferentes estudios por imágenes del compromiso pulmonar ha sido extensamente abordado, desde los primeros casos de neumonías graves y síndrome de distrés respiratorio en adultos. En niños existen menos reportes de la utilidad de la radiología convencional, ecografía y tomografía axial computarizada. Sin embargo, los patrones más característicos observados en adultos se repiten en los niños. De ellos, el vidrio esmerilado, el patrón en empedrado y la consolidación con halo circundante son los más característicos. Aun cuando ninguno de ellos permite confirmación diagnóstica, su correcta interpretación ayuda en los flujos de decisiones. La tomografía axial computarizada es más certera para la definición de tipo y extensión del compromiso parenquimatoso pulmonar. El rol en los estadios tempranos en el servicio de urgencia de la ecografía es más claro en adultos que en niños, donde existe buena correlación con la tomografía de tórax. Este artículo aborda los diferentes patrones radiológicos, su representación fisiopatológica y diagnósticos diferenciales, con el objeto de apoyar a los pediatras en su interpretación, como también reconocer el rol de las técnicas de imágenes diagnósticas más frecuentemente utilizadas en niños con infección respiratoria aguda baja.


Subject(s)
Humans , Male , Infant, Newborn , Child , Pneumonia, Viral/diagnostic imaging , Coronavirus Infections/diagnostic imaging , Betacoronavirus , Radiography, Thoracic , Tomography, X-Ray Computed , Ultrasonography , Pandemics
5.
Arch. argent. pediatr ; 118(2): 102-108, abr. 2020. tab, ilus
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-1099859

ABSTRACT

Objetivos. El objetivo de este estudio fue evaluar el riesgo clínico de la apendicitis con apendicolito y su importancia al elegir las estrategias terapéuticas.Métodos. Se analizó retrospectivamente a niños con diagnóstico de apendicitis aguda entre junio de 2011 y enero de 2017. Se dividió en un grupo con apendicolito(GA) y un grupo sin apendicolito (GSA) según la presencia o no de apendicolito durante la cirugía abierta. Se revisaron y compararon la presentación clínica, de laboratorios, los resultados de la tomografía computada y los cambios patológicos.Resultados. De 163 pacientes, se incluyó a 23 (media de edad: 6,1 años) en el GA y a 140 (media de edad: 8,1 años) en el GSA. Los pacientes en el GA tuvieron una hospitalización más extensa, mayor temperatura corporal, mayor frecuencia de diarrea, signo de Blumberg, aumento del porcentaje de neutrófilos, proteína C-reactiva y mayor riesgo de perforación. La puntuación en las escalas de Alvarado (8,3 ± 1,2 frente a 7,0 ± 1,3; P < 0,05) y de respuesta inflamatoria a apendicitis (10,7 ± 1,6 frente a 7,7 ± 1,9; P < 0,05) fue mayor en el GA que en el GSA; la presencia de fiebre y apendicolito se asoció con una mayor tasa de apendicitis perforada.Conclusiones. La apendicitis pediátrica con apendicolito representa un mayor riesgo clínico y tiende a causar apendicitis complicada


Objectives. This study aims to assess the clinical risk of pediatric appendicitis with appendicolith and its guiding significance in therapeutic strategies' selection.Methods. Children diagnosed with acute appendicitis from June 2011-January 2017 were analyzed retrospectively. Patient cohort was divided to appendicolith group (AG) and non- appendicolith group (NAG) based on whether the appendicolith presents or not in the open surgery. Clinical presentations, laboratory parameters, computed tomography findings, and pathological changes were reviewed and compared between two groups. Results. Among 163 patients, 23 (meanage,6.1yearsold)weredefinedin AG and 140; mean age, 8.1 years old) in NAG. The patients in AG demonstrated prolonged length of stay (12.4 ± 5.6d vs. 8.7 ± 5.0d, P <0.05), higher body temperature (38.2 ± 0.8 °C vs. 37.3 ± 0.8 °C, P <0.05), higher frequency of diarrhea (17 % vs. 3%, P <0.05), rebound tenderness (100 % vs. 87 %, P <0.05), increased neutrophil percentage (81.4 ± 8.0 % vs. 65.3 ± 22.8 %, P <0.05), C-reactive protein (33.13 ± 10.3 mg/L vs. 23.7 ± 13.7 mg/L, P <0.05), and great risk of perforation (78 % vs. 29 %, P <0.05). Alvarado score (8.3 ± 1.2 vs. 7.0 ± 1.3, P <0.05) and AIR score (10.7 ± 1.6 vs. 7.7 ± 1.9, P <0.05) of AG, were higher than NAG he presence of fever and appendicolith was associated with a high rate of perforated appendicitis.Conclusions. Pediatric appendicitis with appendicolith has greater clinical risk and tends to causing complicated appendicitis


Subject(s)
Humans , Male , Female , Child , Appendectomy , Appendicitis/diagnostic imaging , Fecal Impaction/complications , Appendicitis/surgery , Comparative Study , Tomography, X-Ray Computed/methods , Retrospective Studies , Inflammation
6.
Int. j. morphol ; 38(2): 444-447, abr. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1056460

ABSTRACT

This study was undertaken to determine the morphometry of the piriform aperture width and height in Turkish population aged between 18-60 years. It was a retrospective study in which 200 subjects were included 106 males and 94 females, ranging from 18 up to 60 years. Subjects having brain CT in the Radiology Department. Statistical analysis were evaluated with SPSS 21.00 programme. ANOVA Test were used to determine the significance between measurements and age group. The p<0.05 value was considered as significant. The groups were divided into four groups according to age. The overall means and standard deviations of the measurements were: piriform aperture height, 45.19±2.91 mm; piriform aperture width, 24.98±2.85 mm; the golden ratio, 1.84±0.19 in males, respectively whereas, the same measurements were 42.84±2.88; 23.46±2.15 mm; 1.83±0.19 in females, respectively. Also there were an increase in piriform aperture width measurement as the age increased. These anatomical values provides more important knowledge to determine the dimensions of these structures in clinic, surgical processes.


El estudio se realizó para determinar la morfometría del ancho y la altura de la abertura piriforme en la población turca de entre 18 y 60 años. Se llevó a cabo un análisis retrospectivo en el que se incluyeron 200 sujetos 106 hombres y 94 mujeres, entre los 18 y 60 años. Sujetos con TC cerebral en el Departamento de Radiología. El análisis estadístico se evaluó con el programa SPSS 21.00. La prueba ANOVA se utilizó para determinar la importancia entre las mediciones y el grupo de edad. El valor p <0,05 se consideró significativo. La muestra se dividió en cuatro grupos según la edad. Las medias generales y las desviaciones estándar de las mediciones fueron: altura de apertura piriforme, 45,19 ± 2,91 mm; ancho de apertura piriforme, 24,98 ± 2,85 mm; la proporción áurea, 1,84 ± 0,19 en varones, mientras que las mismas medidas fueron 42,84 ± 2,88; 23,46 ± 2,15 mm; 1,83 ± 0,19 en mujeres. También hubo un aumento en la medición del ancho de apertura piriforme a medida que la edad aumentó. Estos valores anatómicos proporcionan un conocimiento más importante para determinar las dimensiones de estas estructuras en procesos clínicos y quirúrgicos.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Nasal Cavity/diagnostic imaging , Turkey , Tomography, X-Ray Computed , Retrospective Studies , Analysis of Variance , Nasal Cavity/anatomy & histology
8.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 38-46, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | 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
9.
Neumol. pediátr. (En línea) ; 15(1): 267-269, Mar. 2020. ilus
Article in English | LILACS (Americas) | ID: biblio-1088095

ABSTRACT

Presenting the case of a previously healthy eleven-year-old girl, diagnosed with septic arthritis of the left knee as a result of stabbing trauma, which subsequently develops respiratory distress and fever. Septic pulmonary embolism is diagnosed radiologically and by pathological study. Receive adequate antibiotic treatment, recovering completely. Septic pulmonary embolism, although frequently described in the adult population, is a condition rarely described in pediatric literature.


Se presenta el caso de una niña de once años previamente sana, con diagnóstico de artritis séptica de rodilla izquierda como resultado de un traumatismo punzante, que posteriormente desarrolla dificultad respiratoria y fiebre. Se diagnostica embolia pulmonar séptica documentada radiológicamente y por estudio anatomopatológico. Recibe tratamiento antibiótico adecuado, recuperándose completamente. La embolia pulmonar séptica, aunque frecuentemente descrita en población adulta, es una condición raramente descrita en la literatura pediátrica.


Subject(s)
Humans , Female , Child , Pulmonary Embolism/etiology , Arthritis, Infectious/complications , Pulmonary Embolism/drug therapy , Pulmonary Embolism/diagnostic imaging , Radiography, Thoracic , Tomography, X-Ray Computed , Sepsis , Anti-Bacterial Agents/therapeutic use
10.
Coluna/Columna ; 19(1): 30-33, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1089633

ABSTRACT

ABSTRACT Objective To describe a more accurate method for measuring the pelvic incidence angle using computed tomography, without the influence of the positioning of the pelvis in relation to the X-ray tube. Methods Thirteen CT scans of the lumbosacral region, abdomen or pelvis were randomly assessed, as all these exams include the sacrum and femoral heads. All the exams were performed in multichannel devices with six channels. The technique of overlapping images, already common in other musculoskeletal exams, such as TT-TG, was used. The centered sagittal cut of the left femoral head, the center of S1, and the right femoral head were used. From these, a fourth image was created, analogous to an X-ray of the pelvis, from which measurements were taken using the dedicated software. Results Of the thirteen exams, three were of the lumbar spine and 10 were of the total abdomen, six of them being of males.. The mean age was 56 years. The mean PI was 45°, ranging from 31 to 81 degrees. Among the women, the mean was 52° (31 to 81°) and among the men, 38° (32 to 46°). Conclusion CT can be used to calculate the PI, using the technique of overlapping images common to other musculoskeletal exams, such as TT-TG. Level of Evidence IIIB. Diagnostic study; Retrospective study.


RESUMO Objetivo Descrever um método mais preciso para medição do ângulo de incidência pélvica, utilizando a tomografia computadorizada, sem influência do posicionamento da pelve em relação à ampola de raio-x. Métodos Foram avaliados, de modo aleatório, 13 exames de TC da coluna lombossacra, abdome total ou pelve, já que englobam o sacro e as cabeças femorais. Todos os exames foram realizados em aparelhos multicanais com 6 canais. Utilizou-se a técnica de sobreposição de imagens, comum em outros exames musculoesqueléticos como TT-TG. Foi selecionado o corte sagital centrado da cabeça femoral esquerda, centro do platô de S1 e cabeça femoral direita. A partir de então, foi criada uma quarta imagem, análoga a uma radiografia da pelve, em que foram realizadas as medidas, utilizando o software dedicado. Resultados Dos 13 exames, três eram da coluna lombar e 10 do abdome total, sendo que seis eram do sexo masculino. A média de idade foi de 56 anos. A média da IP foi de 45°, variando entre 31 e 81. Entre as mulheres, a média foi de 52° (31° a 81°) e entre os homes de 38° (32° e 46°). Conclusão A TC pode ser utilizada para o cálculo da IP, utilizando a técnica de sobreposição de imagens comum em outros exames musculoesqueléticos como TT-TG. Nível de Evidência IIIB. Estudo diagnóstico. Estudo retrospectivo.


RESUMEN Objetivo Describir un método más preciso para medición del ángulo de incidencia pélvica, utilizando la tomografía computarizada, sin influencia del posicionamiento de la pelvis con relación a la ampolla de rayos x. Métodos Fueron evaluados, de modo aleatorio, 13 exámenes de TC de columna lumbosacra, abdomen total o pelvis, pues engloban el sacro y cabezas femorales. Todos los exámenes se realizaron en aparatos multicanales con seis canales. Se utilizó la técnica de superposición de imágenes, común en otros exámenes musculoesqueléticos como TT-TG. Se seleccionó el corte sagital centrado de la cabeza femoral izquierda, centro de S1 y centro de la meseta de S1 y cabeza femoral derecha. A partir de entonces, fue creada una cuarta imagen, análoga a una radiografía de la pelvis, en que fueron realizadas las medidas, utilizando el software dedicado. Resultados De los 13 exámenes, tres eran de columna lumbar y 10 de abdomen total, siendo que seis eran del sexo masculino. El promedio de edad fue de 56 años. El promedio de la IP fue de 45°, variando entre 31 y 81. Entre las mujeres, el promedio fue de 52° (31 a 81°) y entre los hombres de 38° (32 y 46°). Conclusión La TC puede ser utilizada para el cálculo de la IP, utilizando la técnica de superposición de imágenes común en otros exámenes musculoesqueléticos como TT-TG. Nivel de Evidencia IIIB. Estudio diagnóstico. Estudio retrospectivo.


Subject(s)
Humans , Scoliosis , Spine , Diagnostic Imaging , Tomography, X-Ray Computed
11.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 31-37, Jan.-Mar. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1090554

ABSTRACT

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Salivary Gland Diseases/diagnosis , Salivary Gland Diseases/pathology , Salivary Gland Diseases/therapy , Salivary Gland Diseases/epidemiology , Parotitis/epidemiology , Sialadenitis/epidemiology , Magnetic Resonance Spectroscopy , Salivary Gland Calculi/epidemiology , Tomography, X-Ray Computed , Medical Records , Incidence , Prevalence , Retrospective Studies , Longitudinal Studies , Ultrasonography , Biopsy, Fine-Needle , Germany
12.
Int. j. morphol ; 38(1): 17-22, Feb. 2020. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1056390

ABSTRACT

Thorough knowledge of splenic artery course and morphology may help clinician to provide better practice. This Study aims at finding out if there was a relationship between splenic artery tortuosity index and age, sex, Body Mass Index (BMI) and abdominal cavity diameters. Routine abdominal Computerized Tomography (CT) scan images were retrospectively analyzed for 219 patients. Splenic artery tortuosity index was calculated. Abdominal cavity diameters were measured. Age, sex, and BMI were recorded. Splenic artery straight length (x) mean was 9.41 cm (SD 1.33). Splenic artery tortuous length mean was 15.15 cm (SD 3.31). Splenic artery tortuosity index mean was 1.63 (SD 0.36). Pearson correlation coefficient for Splenic artery tortuosity index vs. age was: 0.02 (P value 0.80). Splenic artery tortuosity index for females vs. males were 1.70 vs. 1.57 (P value 0.01). Pearson correlation coefficient for Splenic artery tortuosity index vs. BMI was 0.02 (P value 0.75). Pearson correlation coefficient for Splenic artery tortuosity index vs. abdominal cavity diameters were: Anterior-Posterior (AP) diameter -0.01 (P value 0.88) and transverse diameter 0.00 (P value 0.98). There may be a relationship between splenic artery tortuosity and female sex, but not with age, BMI and abdominal cavity diameters (AP and Transverse).


El conocimiento del curso y la morfología de la arteria esplénica puede ayudar al médico a proporcionar un diagnóstico y tratamiento oportuno al paciente. Este estudio tuvo como objetivo determinar si existe una relación entre el índice de tortuosidad de la arteria esplénica y la edad, el sexo, el índice de masa corporal (IMC) y los diámetros de la cavidad abdominal. Se tomaron imágenes retrospectivas, de rutina, de 219 pacientes de tomografía computarizada (TC) abdominal. Se calculó el índice de tortuosidad de la arteria esplénica. Se midieron los diámetros de la cavidad abdominal y se registró la edad, sexo y el IMC. La media de la longitud recta de la arteria esplénica (x) fue de 9,41 cm (DE 1,33). La longitud tortuosa de la arteria esplénica fue de 15,15 cm (DE 3,31). La media del índice de tortuosidad de la arteria esplénica fue de 1,63 (DE 0,36). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica vs. edad fue: 0,02 (valor de P 0,80). El índice de tortuosidad de la arteria esplénica para las mujeres frente a los hombres fue de 1,70 frente a 1,57 (valor de P 0,01). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica versus el IMC fue de 0,02 (valor de P 0,75). El coeficiente de correlación de Pearson para el índice de tortuosidad de la arteria esplénica frente a los diámetros de la cavidad abdominal fue: diámetro anterior-posterior (AP) -0,01 (valor P 0,88) y diámetro transversal 0,00 (valor P 0,98). Puede existir una relación entre la tortuosidad de la arteria esplénica y el sexo femenino, sin embargo no se encontró relación con la edad, el IMC y los diámetros de la cavidad abdominal (AP y transversal).


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Splenic Artery/anatomy & histology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging , Splenic Artery/abnormalities , Splenic Artery/diagnostic imaging , Body Mass Index , Sex Factors , Analysis of Variance , Age Factors , Correlation of Data , Abdomen/anatomy & histology
13.
Int. j. morphol ; 38(1): 35-37, Feb. 2020. graf
Article in English | LILACS (Americas) | ID: biblio-1056393

ABSTRACT

Ectopic liver tissue is a rare developmental abnormality. It is often asymptomatic and is commonly found incidentally, during surgery or autopsy. It has been reported in various abdominal and extra-abdominal sites, most often in the gall bladder. We are reporting an incidentally found mass in the left subdiafragmatic region, diagnosed as ectopic liver in abdominal CT and intraoperatively. We aim to assess the importance of imaging examinations in the differential diagnosis of intraabdominal masses ranging from benign to malignant entities and to point out that despite the low incidence of ectopic liver, it is necessary to be aware of this diagnostic possibility.


El tejido hepático ectópico es una rara anormalidad del desarrollo. A menudo es asintomático y generalmente se encuentra de manera incidental, durante la cirugía o la autopsia. Se ha informado en varios sitios abdominales y extraabdominales, con mayor frecuencia en la vesícula biliar. Reportamos el caso de una masa encontrada en la región subdiafragmática izquierda, diagnosticada como hígado ectópico en la TC abdominal e intraoperatoriamente. Nuestro objetivo fue evaluar la importancia de los exámenes por imágenes en el diagnóstico diferencial de masas intraabdominales que incluyen masas benignas como también malignas, y señalar que a pesar de la baja incidencia de hígado ectópico, es necesario tener en cuenta esta posibilidad en el diagnóstico.


Subject(s)
Humans , Aged , Choristoma/diagnostic imaging , Abdomen/pathology , Liver/pathology , Tomography, X-Ray Computed , Abdomen/diagnostic imaging
14.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 131-135, Jan.-Feb. 2020. ilus
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1088937

ABSTRACT

A ten-month-old male Yorkshire terrier dog was evaluated via CT four months after traumatic brain injury. The head CT scan showed dilated ventricles associated with a peripheral crescent-shaped collection of blood near the right parietal bone with a mineralized area. The visceral layer of the hematoma was hyperattenuating on the native scan and showed moderate contrast enhancement after administration of intravenous iodinated contrast medium. No fractures were identified in the calvarium. These findings were compatible with acute-on-chronic calcified subdural hematoma, which have been described with more detail in humans. This is the first report to include the description of the imaging findings related to this condition using computed tomography in a dog.(AU)


Um cão Yorkshire Terrier, de 10 meses de idade, foi avaliado por tomografia computadorizada, quatro meses após lesão encefálica de origem traumática. A tomografia da cabeça demonstrou dilatação dos ventrículos associada com coleção de sangue periférico, em formato crescente, próxima ao osso parietal direito, com uma área mineralizada interna. A camada visceral do hematoma era hiperatenuante no exame pré-contraste e demonstrou moderado aumento de atenuação radiográfica após a administração de contraste iodado intravenoso. Fraturas no calvário não foram identificadas. Esses achados foram compatíveis com agudização de hematoma subdural crônico calcificado, condição que tem sido descrita com mais detalhes em humanos. Este é o primeiro relato que descreve os achados de imagem, por tomografia computadorizada, em um cão, relacionados a essa condição.(AU)


Subject(s)
Animals , Dogs , Hematoma, Subdural, Acute/veterinary , Hematoma, Subdural, Chronic/veterinary , Craniocerebral Trauma/veterinary , Tomography, X-Ray Computed/veterinary
15.
Rev. méd. Panamá ; 40(1): 44-47, ene.2020. ilus, tab
Article in Spanish | LILACS-Express | ID: biblio-1099775

ABSTRACT

El signo del halo invertido se caracteriza por una opacidad central de vidrio esmerilado rodeado por una consolidación del espacio aéreo más densa en forma de una media luna o un anillo. El signo del halo invertido se ha informado en asociación con un am­ plia gama de enfermedades pulmonares, incluidas las infecciones fúngicas pulmonares invasivas, neumonía por pneumocystis, tuberculosis, neumonía adquirida en la comuni­ dad, granulomatosis linfomatoide, granulomatosis de Wegener, neumonía lipoidea y sarcoidosis. También se observa en neoplasmas pulmonares e infarto y después de ra­ dioterapia y ablación por radiofrecuencia de neoplasias malignas pulmonares. También es conocido como signo de halo en reversa o signo del atolón.


The reversed halo sign is characterized by a central ground­glass opacity surrounded by denser air­space consolidation in the shape of a crescent or a ring. The reversed halo sign has been reported in association with a wide range of pulmonary diseases, in­ cluding invasive pulmonary fungal infections, pneumocystis pneumonia, tuberculosis, community­acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomato­ sis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and in­ farction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. It is also known as a reverse halo sign or atoll sign


Subject(s)
Tomography, X-Ray Computed , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Radiology , Acquired Immunodeficiency Syndrome , HIV
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-812981

ABSTRACT

Langerhans cell histiocytosis (LCH) is a rare and unexplained disease that can involve in any organ or system in the body and displays a variety of clinical manifestations. A 31-year-old man, who had a more than 10-year smoke history, initially presented dry cough, polydipsia and diuresis, with recurrent spontaneous pneumothorax. Pulmonary high-resolution computed tomography showed diffuse cystic and nodular lesions. Langerhans cell histiocytosis was confirmed by a transbronchial cryobiopsy. The disease is involved in the lung, pituitary, thyroid, liver, lymph node, and skin. Glucocorticoid or systemic chemotherapy is commonly used in the treatment for this disease. BRAF gene mutation inhibitor is a new direction for the treatment.


Subject(s)
Adult , Histiocytosis, Langerhans-Cell , Humans , Lung , Male , Skin , Thyroid Gland , Tomography, X-Ray Computed
17.
Article in English | WPRIM (Western Pacific) | ID: wprim-811109

ABSTRACT

PURPOSE: Appendiceal tumoral lesions can occur as benign, malignant, or borderline disease. Determination of the extent of surgery through accurate diagnosis is important in these tumoral lesions. In this study, we assessed the accuracy of preoperative CT and identified the factors affecting diagnosis.METHODS: Patients diagnosed or strongly suspected from July 2016 to June 2019 with appendiceal mucocele or mucinous neoplasm using abdominal CT were included in the study. All the patients underwent single-incision laparoscopic cecectomy with the margin of cecum secured at least 2 cm from the appendiceal base. To compare blood test results and CT findings, the patients were divided into a mucinous and a nonmucinous group according to pathology.RESULTS: The total number of patients included in this study was 54 and biopsy confirmed appendiceal mucinous neoplasms in 39 of them. With CT, the accuracy of diagnosis was 89.7%. The mean age of the mucinous group was greater than that of the nonmucinous group (P = 0.035). CT showed that the maximum diameter of appendiceal tumor in the mucinous group was greater than that in the nonmucinous group (P < 0.001). Calcification was found only in the appendix of patients in the mucinous group (P = 0.012). Multivariate analysis revealed that lager tumor diameter was a factor of diagnosis for appendiceal mucinous neoplasm.CONCLUSION: The accuracy of preoperative diagnosis of appendiceal mucinous neoplasms in this study was 89.7%. Blood test results did not provide differential diagnosis, and the larger the diameter of appendiceal tumor on CT, the more accurate the diagnosis.


Subject(s)
Appendix , Biopsy , Cecum , Diagnosis , Diagnosis, Differential , Hematologic Tests , Humans , Mucins , Mucocele , Multivariate Analysis , Pathology , Prospective Studies , Tomography, X-Ray Computed
18.
Article in English | WPRIM (Western Pacific) | ID: wprim-811106

ABSTRACT

PURPOSE: Unstable pelvic fracture with bleeding can be fatal, with a mortality rate of up to 40%. Therefore, early detection and treatment are important in unstable pelvic trauma. We investigated the early predictive factors for possible embolization in patients with hemodynamically unstable pelvic trauma.METHODS: From January 2011 to December 2013, 46 patients with shock arrived at a single hospital within 24 hours after injury. Of them, 44 patients underwent CT scan after initial resuscitation, except for 2 who were dead on arrival. Nine patients with other organ injuries were excluded. Seventeen patients underwent embolization. A single radiologist measured the width (longest length in axial view) and length (longest length in coronal view) of pelvic hematoma on CT scans. Demographic, clinical, and radiological data were reviewed retrospectively.RESULTS: Among 35 patients with hemodynamically unstable pelvic fracture, 22 (62.9%) were men. Width (P = 0.002) and length (P = 0.006) of hematoma on CT scans were significantly different between the embolization and nonembolization groups. The predictors of embolization were width of pelvic hematoma (odds ratio [OR], 1.07; P = 0.028) and female sex (OR, 10.83; P = 0.031). The cutoff value was 3.35 cm. More embolization was performed (OR, 12.00; P = 0.003) and higher mortality was observed in patients with hematoma width >3.35 cm (OR, 4.96; P = 0.048).CONCLUSION: Patients with hemodynamically unstable pelvic trauma have a high mortality rate. CT is useful for the initial identification of the need for embolization among these patients. The width of pelvic hematoma can predict possible embolization in patients with unstable pelvic trauma.


Subject(s)
Embolization, Therapeutic , Female , Fractures, Bone , Hematoma , Hemorrhage , Humans , Male , Mortality , Resuscitation , Retrospective Studies , Shock , Tomography, X-Ray Computed
19.
Article in English | WPRIM (Western Pacific) | ID: wprim-810978

ABSTRACT

OBJECTIVE: To compare the image quality of low-dose (LD) computed tomography (CT) obtained using a deep learning-based denoising algorithm (DLA) with LD CT images reconstructed with a filtered back projection (FBP) and advanced modeled iterative reconstruction (ADMIRE).MATERIALS AND METHODS: One hundred routine-dose (RD) abdominal CT studies reconstructed using FBP were used to train the DLA. Simulated CT images were made at dose levels of 13%, 25%, and 50% of the RD (DLA-1, -2, and -3) and reconstructed using FBP. We trained DLAs using the simulated CT images as input data and the RD CT images as ground truth. To test the DLA, the American College of Radiology CT phantom was used together with 18 patients who underwent abdominal LD CT. LD CT images of the phantom and patients were processed using FBP, ADMIRE, and DLAs (LD-FBP, LD-ADMIRE, and LD-DLA images, respectively). To compare the image quality, we measured the noise power spectrum and modulation transfer function (MTF) of phantom images. For patient data, we measured the mean image noise and performed qualitative image analysis. We evaluated the presence of additional artifacts in the LD-DLA images.RESULTS: LD-DLAs achieved lower noise levels than LD-FBP and LD-ADMIRE for both phantom and patient data (all p < 0.001). LD-DLAs trained with a lower radiation dose showed less image noise. However, the MTFs of the LD-DLAs were lower than those of LD-ADMIRE and LD-FBP (all p < 0.001) and decreased with decreasing training image dose. In the qualitative image analysis, the overall image quality of LD-DLAs was best for DLA-3 (50% simulated radiation dose) and not significantly different from LD-ADMIRE. There were no additional artifacts in LD-DLA images.CONCLUSION: DLAs achieved less noise than FBP and ADMIRE in LD CT images, but did not maintain spatial resolution. The DLA trained with 50% simulated radiation dose showed the best overall image quality.


Subject(s)
Artifacts , Humans , Noise , Tomography, X-Ray Computed
20.
Rev. Ciênc. Plur ; 6(2): 205-219, 2020. ilus
Article in Portuguese | LILACS (Americas), BBO | ID: biblio-1100329

ABSTRACT

Introdução:Os bifosfonatos são medicamentos que objetivam reduzir a reabsorção óssea por provocarem a apoptose de osteoclastos. Por essa razão, são frequentemente empregados em pacientes com osteoporose e no tratamento do câncer. Contudo, apesar dos benefícios associados ao tratamento com bifosfonatos, esses medicamentos vêm sendo relacionados a osteonecrose maxilo-mandibular, materializando-se como um preocupante quadro de interesse à saúde pública. Objetivo:Apresentar um caso clínico de osteonecrose mandibular associada ao uso de bifosfanato, após extração de um elemento dentário, bem como contribuir com as discussões sobre as possibilidades terapêuticas desta enfermidade.Descrição do caso:Paciente do sexo masculino,com59 anosidade, encaminhado ao serviço de Cirurgia e Traumatologia Bucomaxilofacial,dois meses após a extração do elemento dentário 45.O diagnóstico foi de Osteonecrose Maxilomandibular Relacionada a Bifosfonatos, sendo realizado,inicialmente, a remoção dos traumas existentes, como também o cuidado com a área exposta. Posteriormente,optou-se pela remoção do segmento ósseo necrótico.Conclusões:A complexafisiopatologiado tipo de osteonecrose estudadaexige dos CirurgiõesDentistas a tomada de medidas em tempo oportuno e que cause o mínimo transtorno à vida dos pacientes.Assim, deve-se avaliar o estado da lesão, havendo indicação de terapia conservadora para os achados precoces. O desbridamento cirúrgico é aconselhado para o tratamento da doença avançada e não responsiva (AU).


Introduction:Bisphosphonates are medications that aim to reduce bone resorption by causing osteoclast apoptosis. For this reason, they are often used in patients with osteoporosis and in the treatment of cancer. However, despite the benefits associated with treatment with bisphosphonates, these drugs have been linked to maxillomandibular osteonecrosis, materializing as a worrying picture of public health concern. Objective:To present a clinical case of mandibular osteonecrosis associated with the use of bisphosphateafter extraction of a dental element, as well as to contribute to the discussions about the therapeutic possibilities of this disease. Case description:Male patient, 59 years old, referred to the Buccomaxillofacial Surgery and Traumatology service, two months after extraction of the dental element 45. The diagnosis was Bisphosphonate-Related Maxillomandibular Osteonecrosis, initially performed, the removal of existing traumas, as well as care for the exposed area. Subsequently, it was decided to remove the necrotic bone segment. Conclusions: The complex pathophysiology of the type of osteonecrosis studied requires that dental surgeons take measures in a timely manner and cause the least disturbance to patients' lives. Thus, the condition of the lesion should be assessed, with an indication for conservative therapy for early findings. Surgical debridement is recommended for the treatment of advanced and unresponsive diseases (AU).


Introducción: Los bisfosfonatos son medicamentos que tienen como objetivo reducir la resorción ósea al causar apoptosis de osteoclastos. Por esta razón, a menudo se usan en pacientes con osteoporosis y en el tratamiento del cáncer. Sin embargo, a pesar de los beneficios asociados con el tratamiento con bisfosfonatos, estos medicamentos se han relacionado con la osteonecrosis maxilomandibular, materializándose como un escenario preocupante de interés para la salud pública. Objetivo: Presentar un caso clínico de osteonecrosis mandibular asociada con el uso de bisfosfanato después de la extracción de un elemento dental, así como contribuir a las discusiones sobre las posibilidades terapéuticas de esta enfermedad. Descripción del caso: un paciente masculino de 59 años fue derivado del Departamento de Traumatología y Cirugía Buccomaxilofacial después de meses de extracción dental 45. El diagnóstico era de Osteonecrosis Maxilomandibular Relacionada con Bifosfonatos, inicialmente eligiendoeliminar los traumas existente, bien como delcuidado con el área expuesta. Posteriormente, elegimos eliminar el segmento óseo necrótico.Conclusiones: La compleja fisiopatología del tipo de osteonecrosis estudiada requiere que los cirujanos dentales tomen las medidas adecuadas y causen el menor inconveniente a la vida de los pacientes. Por lo tanto, se debe evaluar el estado de la lesión, con terapia conservadora indicada para hallazgos tempranos. El desbridamiento quirúrgico se recomienda para el tratamiento de enfermedades avanzadas y que no responden (AU).


Subject(s)
Humans , Male , Middle Aged , Osteonecrosis , Diphosphonates , Bisphosphonate-Associated Osteonecrosis of the Jaw , Mandible , Brazil , Tomography, X-Ray Computed/instrumentation
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