ABSTRACT
PURPOSE: To compare the frequencies of parenchymal abnormalities and pleural effusions in patients with and patients without acute pulmonary embolism (PE) detected at spiral computed tomography (CT). MATERIALS AND METHODS: Contrast material-enhanced spiral CT scans obtained in 92 patients clinically suspected of having acute PE were retrospectively reviewed. The presence or absence of parenchymal abnormalities and pleural effusions was noted. The presence of filling defects consistent with central or peripheral PE was recorded. RESULTS: Twenty-eight patients had CT evidence of PE. Central emboli were evident in 27 (96%) of these patients; 23 (82%) had concomitant central and peripheral emboli, and four (14%) had only central emboli. One patient had an isolated subsegmental clot. Parenchymal abnormalities were seen in 24 (86%) patients with PE and 56 (88%) patients without PE. Atelectasis, the most common finding, was present in 20 (71%) patients with PE and 41 (64%) patients without PE. The only parenchymal abnormality significantly associated with PE was peripheral wedge-shaped opacity, which was seen in seven (25%) patients with PE and three (5%) patients without PE (odds ratio, 6.78; 95% CI = 1.60, 28.62). Pleural effusions were seen in 16 (57%) patients with PE and 36 (56%) patients without PE. In 25 (39%) patients without PE, there were additional CT findings that might suggest an alternative explanation for the acute clinical presentation. CONCLUSION: Parenchymal and pleural findings at CT are of limited value for differentiating patients with PE from those without PE.
Subject(s)
Pleural Effusion/diagnostic imaging , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed/methods , Acute Disease , Aged , Contrast Media , Female , Humans , Image Processing, Computer-Assisted , Iohexol , Male , Middle Aged , Prevalence , Pulmonary Embolism/epidemiology , Retrospective StudiesABSTRACT
The diagnostic capabilities of pancreatic imaging continue to improve with technological advancements in computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). To update the practicing radiologist, this article summarizes the current literature on pancreatic imaging, with particular emphasis on CT and US. Pertinent clinical considerations of the disease entities are included, along with illustrative material from the authors' experience.
Subject(s)
Pancreas/diagnostic imaging , Pancreatic Diseases/diagnosis , Tomography, X-Ray Computed , Diagnosis, Differential , Humans , Pancreatic Neoplasms/diagnosis , Sensitivity and Specificity , Tomography, X-Ray Computed/methods , UltrasonographyABSTRACT
Late recurrence of renal cell carcinoma (RCC), arbitrarily defined as > 10 years post nephrectomy, is rare. The longest known clinical disease-free interval of 36 years was reported by Walter and Gellespie in 1960. We report a case of recurrent RCC presenting 45 years after nephrectomy.
Subject(s)
Carcinoma, Renal Cell/epidemiology , Kidney Neoplasms/epidemiology , Neoplasm Recurrence, Local , Aged , Aged, 80 and over , Carcinoma, Renal Cell/diagnostic imaging , Disease-Free Survival , Humans , Kidney Neoplasms/diagnostic imaging , Male , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/epidemiology , Nephrectomy , Time Factors , Tomography, X-Ray ComputedABSTRACT
The authors describe a stent placement procedure for treatment of an infected ureteral leak after failure of traditional antegrade and retrograde approaches. In this procedure, a guide wire was placed across the distal ureteral segment into a urinoma with use of cystoscopic guidance. Thereafter, an antegrade approach was used to pass a wire loop snare, capture the guide wire, and withdraw it through the proximal ureter for subsequent stent passage. This approach allowed percutaneous stabilization of a ureteral leak in a patient who would have otherwise required immediate surgical repair.
