RESUMEN
Nasal gliomas (nasal glial heterotopia) are rare benign congenital frontonasal lesions occurring in approximately 1:20.000-40,000 live births. The diagnosis is rarely reported prenatally. Nasal gliomas are typically isolated lesions, with syndromic association being exceedingly rare. Metopic craniosynostosis can occur as an isolated abnormality or in association with multiple syndromes. This case is the first reported case of nasal glioma in association with craniosynostosis in the published literature.
Asunto(s)
Craneosinostosis/diagnóstico , Glioma/diagnóstico , Neoplasias Nasales/diagnóstico , Diagnóstico Prenatal/métodos , Craneosinostosis/complicaciones , Craneosinostosis/cirugía , Femenino , Glioma/complicaciones , Glioma/etiología , Glioma/cirugía , Humanos , Imagen por Resonancia Magnética , Neoplasias Nasales/complicaciones , Neoplasias Nasales/etiología , Neoplasias Nasales/cirugía , Embarazo , Ultrasonografía PrenatalRESUMEN
The inferior vena cava (IVC) is an essential but often overlooked structure at abdominal imaging. It is associated with a wide variety of congenital and pathologic processes and can be a source of vital information for referring clinicians. Initial evaluation of the IVC is most likely to occur at computed tomography performed for another indication. Many routine abdominal imaging protocols may result in suboptimal evaluation of the IVC; however, techniques to assist in specific evaluation of the IVC can be used. In this article, the authors review the spectrum of IVC variants and pathologic processes and the relevant findings from magnetic resonance imaging, angiography, sonography, and positron emission tomography. Embryologic development of the IVC and examples of congenital IVC variants, such as absence, duplication, left-sided location, azygous or hemiazygous continuation, and web formation, are described. The authors detail IVC involvement in Wilms tumor, leiomyosarcoma, adrenal cortical carcinoma, testicular carcinoma, hepatocellular carcinoma, renal cell carcinoma, and other neoplasms, as well as postsurgical, traumatic, and infectious entities (including filter malposition, mesocaval shunt, and septic thrombophlebitis). The implications of these entities for patient treatment and instances in which specific details should be included in the dictated radiology report are highlighted. Furthermore, the common pitfalls of IVC imaging are discussed. The information provided in this review will allow radiologists to detect and accurately characterize IVC abnormalities to guide clinical decision making and improve patient care.
Asunto(s)
Enfermedades Vasculares/diagnóstico , Vena Cava Inferior , Diagnóstico por Imagen , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Ultrasonografía , Vena Cava Inferior/anatomía & histología , Vena Cava Inferior/diagnóstico por imagenRESUMEN
An aberrant right subclavian artery can be diagnosed by PET/CT, as demonstrated in this case of a 70-y-old man undergoing PET/CT for staging of squamous cell carcinoma of the right lung. It is important to report this finding during the evaluation of oncologic patients, to prevent severe complications that may arise from various oncologic interventions.
Asunto(s)
Aneurisma/diagnóstico por imagen , Anomalías Cardiovasculares/diagnóstico por imagen , Trastornos de Deglución/diagnóstico por imagen , Imagen Multimodal , Tomografía de Emisión de Positrones , Arteria Subclavia/anomalías , Tomografía Computarizada por Rayos X , Anciano , Aneurisma/complicaciones , Anomalías Cardiovasculares/complicaciones , Trastornos de Deglución/complicaciones , Fluorodesoxiglucosa F18 , Humanos , Masculino , Arteria Subclavia/diagnóstico por imagenRESUMEN
PURPOSE: The purpose of this study was to evaluate the radiographic features of neuroendocrine carcinoma of the urinary bladder (NECB) on CT and to review the literature regarding carcinogenesis, treatment, and prognosis. METHODS: The presenting CT of patients with pathology-proven NECB were retrospectively reviewed for features including size and appearance of the bladder mass, the presence of hydronephrosis, bladder wall thickening, invasion of perivesical fat, lymph nodes, and distant metastasis. Follow-up imaging and the medical record were reviewed to determine patient treatment and overall survival. RESULTS: Sixteen patients (13 males, 3 females) were diagnosed with NECB with a mean age of 75.5 years (range 48-90). The characteristic CT appearance was a large polypoid bladder mass (average size 4.9 cm). Extension into the perivesical fat, adjacent organ involvement, and distant metastases were common. CONCLUSION: NECB is an aggressive primary neoplasm of the bladder that presents on CT as a large bladder mass with local extension into the perivesical fat, involvement of adjacent organs, and metastasis.
Asunto(s)
Carcinoma Neuroendocrino/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Neoplasias de la Vejiga Urinaria/diagnóstico por imagen , Anciano , Anciano de 80 o más Años , Carcinoma Neuroendocrino/patología , Progresión de la Enfermedad , Femenino , Humanos , Neoplasias Hepáticas , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Pronóstico , Estudios Retrospectivos , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
BACKGROUND AND PURPOSE: As potential therapies aimed at halting or slowing the decline in upper motor neuron function in patients with amyotrophic lateral sclerosis (ALS) or primary lateral sclerosis (PLS) are developed, a quantitative method for monitoring response will be necessary. Measurement of fractional anisotropy (FA) using diffusion tensor imaging (DTI) over time should parallel functional decline from upper motor neuron degeneration in these patients. PATIENTS AND METHODS: Two patients with definite ALS were imaged at 3.0 T and FA values were obtained in the corticospinal tract every 3 months for 1 year. The FA values were compared to normal age-matched controls. RESULTS: Both patients showed linear decreases in FA values over time with R(2) values ranging from 0.93 to 0.99. The decline became statistically significant over the course of the study. Qualitative decreases in anisotropy were also evident on FA maps. CONCLUSION: If these trends can be validated in greater numbers of patients, DTI may serve as an objective quantitative biomarker for disease progression in patients with upper motor neuron disease.
Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico por imagen , Esclerosis Amiotrófica Lateral/patología , Adulto , Anisotropía , Imagen de Difusión por Resonancia Magnética/métodos , Progresión de la Enfermedad , Fasciculación/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de la Neurona Motora/diagnóstico por imagen , Enfermedad de la Neurona Motora/patología , Tractos Piramidales/diagnóstico por imagen , Tractos Piramidales/fisiopatología , Radiografía , Factores de TiempoRESUMEN
We used epifluorescence microscopy and a voltage-sensitive dye, di-8-ANEPPS, to study changes in membrane potential during hypercapnia with or without synaptic blockade in chemosensory brain stem nuclei: the locus coeruleus (LC), the nucleus of the solitary tract, lateral paragigantocellularis nucleus, raphé pallidus, and raphé obscurus and, in putative nonchemosensitive nuclei, the gigantocellularis reticular nucleus and the spinotrigeminal nucleus. We studied the response to hypercapnia in LC cells to evaluate the performance characteristics of the voltage-sensitive dye. Hypercapnia depolarized many LC cells and the voltage responses to hypercapnia were diminished, but not eradicated, by synaptic blockade (there were intrinsically CO2-sensitive cells in the LC). The voltage response to hypercapnia was substantially diminished after inhibiting fast Na+ channels with tetrodotoxin. Thus action potential-related activity was responsible for most of the optical signal that we detected. We systematically examined CO2 sensitivity among cells in brain stem nuclei to test the hypothesis that CO2 sensitivity is a ubiquitous phenomenon, not restricted to nominally CO2 chemosensory nuclei. We found intrinsically CO2 sensitive neurons in all the nuclei that we examined; even the nonchemosensory nuclei had small numbers of intrinsically CO2 sensitive neurons. However, synaptic blockade significantly altered the distribution of CO2-sensitive cells in all of the nuclei so that the cellular response to CO2 in more intact preparations may be difficult to predict based on studies of intrinsic neuronal activity. Thus CO2-sensitive neurons are widely distributed in chemosensory and nonchemosensory nuclei and CO2 sensitivity is dependent on inhibitory and excitatory synaptic activity even within brain slices. Neuronal CO2 sensitivity important for the behavioral response to CO2 in intact animals will thus be determined as much by synaptic mechanisms and patterns of connectivity throughout the brain as by intrinsic CO2 sensitivity.