ABSTRACT
Fluid-fluid levels have been reported as an extremely infrequent and non-specific condition in many benign and malignant bone lesions. We present the first reported MRI findings of bone marrow metastasis with fluid-fluid levels from small cell neuroendocrine carcinoma of the urinary bladder to the lumbar spine. Radiologists should be aware of the MRI appearance of these extraordinary lesions in order to provide a complete differential diagnosis and to guide clinicians in adequate treatment.
Subject(s)
Bone Marrow Neoplasms/diagnosis , Bone Marrow Neoplasms/secondary , Carcinoma, Neuroendocrine/diagnosis , Carcinoma, Neuroendocrine/secondary , Urinary Bladder Neoplasms/pathology , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
AIM: To assess the diagnostic power of three-dimensional computed tomography (3D CT), axial helical computed tomography (CT) and conventional tomography in the classification of acetabular fractures by interdisciplinary review. MATERIALS AND METHODS: Receiver operating characteristics (ROCs) were assessed for two radiologists and two surgeons blinded to the presence of acetabular fractures in an animal model (a total of 62 porcine hips, 40 of them with artificial acetabular fractures). Main target parameter was the diagnostic accuracy in the classification of the artificial fractures following Judet et al. RESULTS: ROC analysis for radiologists showed A(z) values of 0.83 for 3D CT, 0.81 for axial helical CT, and 0.78 for conventional tomography; differences between the three techniques were not significant (P = 0.46-0.73). A(z) values for the surgeons were 0.87 for 3D CT, 0.68 for axial helical CT, and 0.60 for conventional tomography; 3D CT was significantly better than axial helical CT (P = 0.01) and conventional tomography (P = 0.001). The differences between axial helical CT and conventional tomography were not significant (P = 0.37). CONCLUSION: Acetabular fractures are best classified by 3D CT, followed by axial helical CT and conventional tomography when assessed by surgeons. 3D CT did not provide any additional significant benefit in the classification performed by radiologists.
Subject(s)
Acetabulum/injuries , Fractures, Bone/diagnostic imaging , Tomography, X-Ray Computed/methods , Acetabulum/diagnostic imaging , Animals , General Surgery , Models, Animal , Predictive Value of Tests , ROC Curve , Radiology , SwineABSTRACT
PURPOSE: We investigated the benefit of real-time guidance of interventional punctures by means of computed tomography fluoroscopy (CTF) compared with the conventional sequential acquisition guidance. MATERIAL AND METHODS: In a prospective randomized trial, 75 patients underwent either CTF-guided (group A, n = 50) or sequential CT-guided (group B, n = 25) punctures of thoracic (n = 29) or abdominal (n = 46) masses. CTF was performed on the CT machine (Somatom Plus 4 Power, Siemens Corp., Forchheim, Germany) equipped with the C.A.R.E. Vision application (tube voltage 120 kV, tube current 50 mA, rotational time 0.75 s, slice thickness 10 mm, 8 frames/s). RESULTS: The average procedure time showed a statistically significant difference between the two study groups (group A: 564 s, group B 795 s, P = 0.0032). The mean total mAs was 7089 mAs for the CTF and 4856 mAs for the sequential image-guided intervention, respectively. The sensitivity was 71% specificity 100% positive predictive value 100% and negative predictive value 60% for the CTF-guided puncture, and 68, 100, 100 and 50% for sequential CT, respectively. CONCLUSION: CTF guidance realizes a time-saving but increases the radiation exposure dosage.
Subject(s)
Abdominal Neoplasms/pathology , Radiography, Interventional/methods , Thoracic Neoplasms/pathology , Tomography, X-Ray Computed/methods , Abdominal Neoplasms/diagnostic imaging , Adult , Aged , Aged, 80 and over , Biopsy, Needle/methods , Female , Fluoroscopy/methods , Humans , Male , Middle Aged , Prospective Studies , Thoracic Neoplasms/diagnostic imagingABSTRACT
An 8-year-old boy presenting with intermittent haematuria and dysuria was investigated with voiding cystourethrography (VCUG), urethroscopy and perineal MRI. VCUG and urethroscopy did not provide a definitive diagnosis, while MRI clearly demonstrated a homogeneous, oval cystic lesion extending from the bulbourethral glands and slightly impressing the bulbous urethra. The patient was found to have an imperforate Cowper's syringocele. Treatment consisted of marsupialisation and the patient became symptom free. To the authors' knowledge, this is the first description of the MRI characteristics of an imperforate Cowper's syringocele in a paediatric patient.
