ABSTRACT
Intestinal malrotation is a rare anomaly of rotation and fixation of the midgut. Left-sided appendicitis occurs in association with two types of congenital anomalies, situs inversus and intestinal malrotation. We describe a rare case of left-sided acute appendicitis with intestinal malrotation in a 14-year-old boy, in which computed tomography (CT) was useful for a preoperative diagnosis.
Subject(s)
Appendicitis/complications , Appendix/abnormalities , Situs Inversus/complications , Adolescent , Appendicitis/diagnostic imaging , Colon, Ascending/abnormalities , Duodenum/abnormalities , Humans , Jejunum/abnormalities , Male , Situs Inversus/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Adrenal myelolipoma is a benign tumor composed of fat and bone marrow tissues and is usually found incidentally. Spontaneous retroperitoneal hemorrhage from this tumor is rare. To our knowledge, there have been only 11 reported cases of ruptured adrenal myelolipoma in the literature. We report a 37-year-old female patient who underwent transcatheter arterial embolization using gelatin sponge particles for retroperitoneal hemorrhage from adrenal myelolipoma, 8x6x6 cm in size. This case, which is the second in the literature, illustrates the usefulness of embolization to achieve hemostasis prior to subsequent tumor resection.
Subject(s)
Adrenal Gland Neoplasms/complications , Embolization, Therapeutic , Hemorrhage/etiology , Hemorrhage/therapy , Myelolipoma/complications , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/diagnostic imaging , Adult , Female , Hemorrhage/diagnosis , Hemorrhage/diagnostic imaging , Humans , Magnetic Resonance Imaging , Myelolipoma/diagnosis , Myelolipoma/diagnostic imaging , Retroperitoneal Space , Rupture, Spontaneous , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: The aim of our study was to assess quantitative methods of distinguishing adenomas from malignant adrenal lesions using chemical shift fast low-angle shot MR imaging. MATERIALS AND METHODS: We assessed 102 adrenal tumors in 88 patients (27 hyperfunctioning and 44 nonhyperfunctioning adenomas, 19 metastases, nine pheochromocytomas, and three other adrenal tumors) using chemical shift MR imaging. On the chemical shift imaging, signal intensity index, calculated as [(signal intensity on in-phase imaging - signal intensity on opposed-phase imaging) / (signal intensity on in-phase imaging)] x 100%, was compared with the adrenal-to-spleen ratio, adrenal-to-muscle ratio, and adrenal-to-liver ratio for signal change on opposed-phase fast low-angle shot MR imaging. The tissues in the spleen, paraspinal muscle, and liver were reference tissues. RESULTS: The signal intensity index had several advantages over the other three parameters calculated. We found no overlap in indexes between adenomas and metastatic tumors. The accuracy in distinguishing adenomas from metastatic tumors was 100% if the cutoff value of the signal intensity index selected was 11.2-16.5%. CONCLUSION: The signal intensity index is the most reliable evaluation method for differentiating adrenal adenomas from metastatic adrenal tumors.
Subject(s)
Adenoma/pathology , Adrenal Gland Neoplasms/pathology , Adrenal Gland Neoplasms/secondary , Carcinoma/secondary , Lymphoma/pathology , Magnetic Resonance Imaging , Adult , Aged , Aged, 80 and over , Diagnosis, Differential , Female , Humans , Male , Middle Aged , ROC Curve , Reproducibility of Results , Retrospective Studies , Sensitivity and SpecificityABSTRACT
We present a 74-year-old male patient with a mobile thoracolithiasis of 1x1 cm in diameter in the left intrathoracic space that was visualized by chest radiography and CT examinations. This calcified nodule was thought to have originated from a lipoma that had arisen from the pleura or the peripheral region of the lung, or from pericardial fat, then degenerated, dropped, and entered into the intrathoracic space, where it became calcified. The central core of this nodule showed high intensity on T1- and T2-weighted MR images, suggesting that the core was a soft tissue component, probably fat.
Subject(s)
Lithiasis/diagnosis , Magnetic Resonance Imaging , Thoracic Diseases/diagnosis , Thorax/pathology , Aged , Humans , Lithiasis/diagnostic imaging , Lithiasis/pathology , Male , Radiography, Thoracic , Thoracic Diseases/diagnostic imaging , Thoracic Diseases/pathologyABSTRACT
PURPOSE: To evaluate the pancreatic duct after administration of secretin. MATERIALS AND METHODS: Single-shot turbo spin-echo T2-weighted dynamic magnetic resonance cholangiopancreatography (MRCP) was performed in 85 patients who did not have pancreatic diseases (group 1) and in 50 patients who had focal severe stenosis of the main pancreatic duct (group 2). The visualization and diameter of the pancreatic duct before and after secretin administration were assessed. RESULTS: In group 1, after secretin administration, the best visualization of the main pancreatic duct in the head, body, accessory pancreatic duct, and branch ducts was achieved in 4.7 minutes +/- 1.6 (SD), 4.8 minutes +/- 1.6, 4.6 minutes +/- 1.6, and 4.7 minutes plus minus 1.3, respectively. Improvement in the delineation of the main pancreatic duct in the head (78 [92%] patients), body (80 [94%] patients), accessory pancreatic duct (35 [41%] patients), and branch ducts (14 [16%] patients) was achieved. Overlap of fluid in the organ and the pancreatic duct was observed in 20 (24%) of 85 patients. Overlap was especially observed after 5 minutes of secretin injection. In group 2, the best visualization of the distal main pancreatic duct was achieved 4.9 minutes +/- 1.4 after secretin administration. Improvement in the delineation of the distal main pancreatic duct was achieved in 17 (85%) of 20 patients. CONCLUSION: MRCP is best performed during the first 5 minutes after secretin administration.
