Linfangiectasia renal bilateral / Bilateral renal lymphangiectasia

Introducción: La linfangiectasia renal es una afección infrecuente en la que existe dilatación de los vasos linfáticos renales. Usualmente es bilateral y de buen pronóstico. Objetivos: Presentar un caso de linfangiectasia renal bilateral, sus características clínicas y aspectos del diagnóstico imaginológico. Caso clínico: Paciente femenina de 59 años de edad, hipertensa controlada, que asistió a la consulta externa de urología por dolor lumbar bilateral, de moderada intensidad y coloración rojiza de la orina, ambos de forma intermitente. El examen físico general y regional fue negativo. Se confirmó microhematuria en el examen general de la orina. Los estudios de la analítica sanguínea fueron normales. El ultrasonido renal reportó pielocaliectasia bilateral moderada y quistes parapiélicos, bilaterales, a predominio izquierdo. La tomografía axial computarizada renal contrastada, reveló la presencia de formaciones hipodensas renales bilaterales, de aspecto quístico parapiélicas y en el seno renal, compatibles con linfangiectasia bilateral. La paciente ha evolucionado favorablemente. Conclusiones: La linfangiectasia renal se debe tener en cuenta en el diagnóstico deferencial de la enfermedad quística renal. Para el diagnóstico imaginológico de certeza es esencial la tomografía axial computarizada renal contrastada(AU)

Introduction: The renal linfangiectasia is an uncommon, in which dilatation of the lymphatic renal vessels exists. It is usually bilateral and of good presage. Objectives: To present a case of renal bilateral lymphangiectasia, their clinical characteristics and aspects of the imaginologic diagnosis. Clinical case: Patient feminine of 59 years of age, with controlled hypertension that attended the external consultation of Urology for lumbar bilateral pain, of moderate intensity, and reddish coloration of the urine, both in an intermittent way. The general and regional physical exam was negative. Microhematuria was confirmed in the general exam of the urine. The sanguine studies of the analytic one were all normal ones. The renal ultrasound reported bilateral moderate pielocaliectasia and parapielic cysts, with left prevalence. The renal contrasted computed tomography revealed the presence of bilateral renal hipodenses formations, of aspect cystic parapielic and in the renal sinus, and compatible with bilateral linfangiectasia. The patient has evolved favorably. Conclusions: The renal linfangiectasia it should be kept in mind in the deferential diagnosis of the cystic renal illness. For the imaginologic diagnostic of certainty it is essential the renal contrasted computed tomography(AU)

Cost-effect analysis of computed tomography in diagnosis for patients with epilepsy / 中华神经科杂志

Objective To determine the cost effect for cranial CT scans in epileptic patients.Methods The newly diagnosed epileptic patients from 1995 to 2000 were prospectively investigated by cranial CT scan in our clinic for epilepsy. The cost for finding a case of significant pathology was estimated to determine the cost effect of cranial CT scan in patients.Results 572 cases of generalized and 172 of partial epileptic patients were studied. 32% of the overall abnormalities were found by CT scan in all patients, but specific abnormalities were only found in 10% of the patients. None of 480 generalized patients without focal abnormalities in neurological and/or EEG examinations was found having clinically important abnormalities by using CT, the cost for finding a case of significant pathology was estimated to need at least 64 214 yuan. While 50% partial seizure patients having focal abnormalities in the examinations, were found having specific abnormalities by CT, the cost of finding a case of significant pathology was estimated to be 800 yuan (Cost for a CT scan about 400 yuan in our hospital).Conclusion When there is a shrinking availability of health care money, especially in developing countries, CT scan evaluation for a neurological normal patient with generalized seizures is expensive that the cost effect analysis should be taken into account.

CONCOMITANCE OF CARCINOMA AND CYST IN THE SAME KIDNEY / 解放军医学杂志

To improve the diagnosis of concomitance of cancer and cyst in the same kidney, a retrospective review of the imaging results of 10 patients with cystic renal cancers confirmed by surgery and pathologic study was performed. Excretory urography showed an avascular mass suggestive of a cyst. Ultrasonography revealed a cystic mass with thinkened and irregular walls,but it was unable to distinguish between a complicated and an extensively necrotic cancer.On CT scans,irregular cystic wall and definite early enhancement in solid component were observed.In some of the patients,there were mural nodules,septum and calcification. Some scans may show an almost cystic appearance,but one or more CT scans always showed some dense neoplastic tissue.This study indicated irregular and thickened cystic wall and septum,mural nodules and early enhancement of solid component were the characteristic findings for the CT diagnosis.This suggestive CT pattern must be particularly searched for at the base of the cyst,but may also be present in the periphery of the cyst.