RESUMEN
AIM: To determine if there is a difference in the detection of labral tears and cartilage lesions using the T2-weighted sequences of magnetic resonance arthrography (MRA) only, which simulate MRA with saline alone, compared with the full examination including T1-weighted sequences. MATERIALS AND METHODS: One hundred hip MRA examinations performed at 3 T were identified retrospectively. Each study was reviewed by a musculoskeletal radiologist using either the T2-weighted sequences only (without gadolinium-based contrast agent [GBCA] effect) or the entire examination, including T1-weighted sequences (with GBCA effect). Receiver operating characteristic (ROC) curves were calculated for both groups and compared within a non-inferiority framework, using - 0.10 as the limit of non-inferiority. RESULTS: For labral tears, the difference area under the curve (AUC) was -0.004 (95% confidence interval [CI]: -0.064-0.056, p=0.90). For acetabular cartilage lesions, the difference AUC was 0.011 (95% CI: -0.073-0.096, p=0.79). For femoral cartilage lesions, the difference AUC was -0.059 (95% CI: -0.206-0.087, p=0.43). CONCLUSION: T2-weighted sequences alone were not inferior in diagnostic accuracy compared with the full examination (including T1-weighted sequences with intra-articular GBCA) in detecting acetabular cartilage lesions and labral tears. Further study with prospective comparison of saline injectate to GBCA-containing injectate may help clarify the necessity of continued GBCA use in MRA of the hip.
Asunto(s)
Cartílago Articular/patología , Gadolinio/farmacología , Articulación de la Cadera/diagnóstico por imagen , Angiografía por Resonancia Magnética/métodos , Adolescente , Adulto , Medios de Contraste/farmacología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Adulto JovenAsunto(s)
Acetábulo/lesiones , Fracturas Óseas/diagnóstico por imagen , Osteítis Deformante/diagnóstico por imagen , Anciano , Femenino , Fracturas Óseas/etiología , Humanos , Imagen por Resonancia Magnética , Osteítis Deformante/complicaciones , Osteítis Deformante/patología , Embarazo , RadiografíaRESUMEN
Magnetic resonance imaging is the method of choice for evaluating patients with a nontraumatic brachial plexopathy. Although there is a wide range of disease processes that may cause a brachial plexopathy, radiation fibrosis, primary and metastatic lung cancer, and metastatic breast cancer account for almost three-fourths of the causes. Radiation fibrosis, the most common cause in our series, may occur several months to years after the completion of therapy. Findings of radiation fibrosis include (a) thickening and diffuse enhancement of the brachial plexus without a focal mass and (b) soft-tissue changes with low signal intensity on both T1- and T2-weighted images. Lung cancer arising in the lung apex may invade the lower portion of the brachial plexus. Many tumors may metastasize to the brachial plexus, causing a brachial plexopathy. Breast cancer is the most likely to metastasize because major lymphatic drainage routes for the breast course through the apex of the axilla.
Asunto(s)
Neuropatías del Plexo Braquial/diagnóstico , Imagen por Resonancia Magnética , Adulto , Axila/inervación , Plexo Braquial/efectos de la radiación , Neuropatías del Plexo Braquial/etiología , Neoplasias de la Mama/complicaciones , Femenino , Fibrosis , Humanos , Neoplasias Pulmonares/complicaciones , Neoplasias Pulmonares/secundario , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Vaina del Nervio/complicaciones , Neoplasias del Sistema Nervioso Periférico/secundario , Traumatismos por Radiación/diagnóstico , Estudios RetrospectivosRESUMEN
BACKGROUND & AIMS: Intraductal papillary-mucinous tumor (IPMT) of the pancreatic ducts is increasingly recognized. This study investigated if clinical, imaging, or, histological features predicated outcome, formulated a treatment algorithm, and clarified relationships among IPMT, mucinous cystic neoplasms of the pancreas (MCN), and chronic pancreatitis. METHODS: The medical records, radiographs, and pathological specimens of 15 patients with IPMT (dilated main pancreatic duct or branch ducts with mucin overproduction) who were evaluated between October 1983 and January 1994 were reviewed. RESULTS: One patient had hepatic metastases. Fourteen underwent an operation (6 distal pancreatectomy, 4 total pancreatectomy, and 4 pancreaticoduodenectomy); all had dysplastic intraductal epithelium and chronic pancreatitis, whereas 3 had invasive adenocarcinoma. After a median of 25 months, 10 patients were alive; 3 of 4 with malignant and 2 of 11 with benign IPMT died (P < 0.05). Patients with or without carcinoma had similar clinical and radiographic features. A clinical diagnosis of chronic pancreatitis had been made in 9 patients with benign IMPT and in none with malignant IPMT (P < 0.05). CONCLUSIONS: IPMT is a dysplastic and likely precancerous lesion that is frequently diagnosed as chronic pancreatitis and is separate from MCN. Because it is not possible to distinguish noninvasive from invasive IPMT preoperatively, complete surgical excision of the dysplastic process is our treatment of choice whenever appropriate.
Asunto(s)
Cistoadenoma Mucinoso/patología , Conductos Pancreáticos , Neoplasias Pancreáticas/patología , Terminología como Asunto , Anciano , Anciano de 80 o más Años , Colangiopancreatografia Retrógrada Endoscópica , Cistoadenoma Mucinoso/diagnóstico por imagen , Cistoadenoma Mucinoso/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoAsunto(s)
Traumatismos en Atletas/terapia , Luxación del Hombro/terapia , Animales , Traumatismos en Atletas/diagnóstico por imagen , Traumatismos en Atletas/etiología , Tirantes , Caballos , Humanos , Masculino , Manipulación Ortopédica , Persona de Mediana Edad , Radiografía , Rango del Movimiento Articular , Luxación del Hombro/diagnóstico por imagen , Luxación del Hombro/etiología , Resultado del TratamientoRESUMEN
A 50-year-old woman with Felty's syndrome, who presented with "menopausal" symptoms, was found to have a large pelvic mass on physical exam. Computed tomography of the pelvis led to an incorrect diagnosis of malignancy, while radionuclide imaging using Tc-99m sulfur colloid confirmed the diagnosis of ectopic splenomegaly.
Asunto(s)
Coristoma/complicaciones , Síndrome de Felty/complicaciones , Neoplasias Pélvicas/complicaciones , Bazo , Coristoma/diagnóstico , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Pélvicas/diagnóstico , Esplenomegalia/diagnóstico , Azufre Coloidal Tecnecio Tc 99m , Tomografía Computarizada por Rayos XRESUMEN
Radiolabeling of Ivalon (polyvinyl alcohol sponge) particles permits localization of injected particles during embolization through the use of a portable gamma camera and provides a means to prevent potentially fatal complications such as pulmonary embolization. A more efficient technique of labeling Ivalon particles with technetium-99m sulfur colloid was developed. An increase in labeling efficiency allowed more accurate determination of the distribution of injected Ivalon particles. Scanning electron microscopy demonstrated the stability of the Ivalon particles during this new labeling process. Two patients with arteriovenous malformations underwent therapeutic embolization with radiolabeled Ivalon particles; gamma camera imaging of the lesion and chest was performed throughout the procedure.
Asunto(s)
Malformaciones Arteriovenosas/diagnóstico por imagen , Embolización Terapéutica/métodos , Marcaje Isotópico/métodos , Polivinilos/uso terapéutico , Azufre Coloidal Tecnecio Tc 99m , Adulto , Malformaciones Arteriovenosas/terapia , Niño , Embolización Terapéutica/efectos adversos , Femenino , Humanos , Pierna/irrigación sanguínea , Masculino , Microscopía Electrónica de Rastreo , Polivinilos/efectos adversos , Embolia Pulmonar/etiología , Embolia Pulmonar/prevención & control , CintigrafíaRESUMEN
Focal fatty metamorphosis of the liver is a well-recognized entity characteristically demonstrated by a nonspherical, low-density area without mass effect. We present a case of focal fatty metamorphosis of the liver that shows multiple areas of low attenuation within the liver with mass effect. Radionuclide liver-spleen scan shows multiple focal defects corresponding to the areas of fatty metamorphosis.