RESUMEN
OBJECTIVE: The aim of this study is to assess the distance between the anterior nasal spine and the sphenoidal rostrum related to the LeFort I surgery in a Turkish population sample. MATERIAL AND METHODS: We retrospectively reviewed multidetector computerized tomography (MDCT) scans of 209 patients (134 males and 75 females). The images were obtained on a 64-MDCT scanner. The imaging parameters were 0.5 × 64 mm slice thickness, 0.5/0.3 mm increment, 120 kV, 250 mAs, 0.5 sn rotation time, 0.641 pitch, and 512 matrix. The distance between the anterior nasal spine and the sphenoidal rostrum was assessed with the Vitrea 2 software program. RESULTS: The study group consisted of 134 male (mean age 57.90 ± 5.86) and 75 female (mean age 54.84 ± 4.31) patients. The distance between the anterior nasal spine and the sphenoidal rostrum was ranging between 40.4 and 70.9 mm (average 58.3 ± 5.9) in males and 45.0 and 63.2 mm in (average 55.2 ± 4.3) females. In addition, no statistically significant differences were found between genders. CONCLUSION: The results of the current study showed that after 40 mm proceeding of the ball end nasal osteotome, the surgeons must be aware of penetrating the sphenoidal rostrum.
Asunto(s)
Cefalometría/métodos , Hueso Nasal/diagnóstico por imagen , Osteotomía Le Fort/métodos , Cuidados Preoperatorios , Hueso Esfenoides/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Base del Cráneo/diagnóstico por imagen , Base del Cráneo/cirugía , TurquíaRESUMEN
OBJECTIVE: The course of the second part of the maxillary can vary among different races. The aim of this study was to evaluate the relation between the maxillary artery and the lateral pterygoid muscle in a white population sample on computed tomographic (CT) angiograms. MATERIALS AND METHODS: We retrospectively reviewed multidetector CT angiograms of 209 patients (134 men and 75 women). The images were taken using a 64-row multidetector CT scanner. The imaging parameters were 0.5 × 64-mm slice thickness, 0.5- or 0.3-mm increment, 120 kV, 250 mA s, 0.5-second rotation time, 0.641 pitch, and 512 matrix. The relationship between the pterygoid portion of the maxillary artery and the lateral pterygoid muscle was assessed on axial, sagittal, and coronal multiplanar reformatted images with the Vitrea 2 software program. RESULTS: A total of 572 maxillary arteries in 286 patients were assessed. Of these maxillary arteries, 418 (68.42%) had a superficial course to the pterygoid muscle and 132 (31.58%) had a deep course. In 165 (78.94%) of 286 patients, there was a cross-lateral symmetry of the course of the artery; that is, both vessels were superficial or deep. In 44 (21.1%) of 209 patients, an asymmetric course was observed. CONCLUSIONS: Because of the incidence of the asymmetric presentations, generalization regarding such a controversial topic should not be based on findings of cadaveric studies and each hemi head should be considered as a single entity. Therefore, advanced imaging systems are useful tools in preoperative planning and play a key role in the avoidance of hemorrhagic complications.
Asunto(s)
Angiografía/métodos , Arteria Maxilar/diagnóstico por imagen , Músculos Pterigoideos/irrigación sanguínea , Músculos Pterigoideos/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Distribución de Chi-Cuadrado , Femenino , Humanos , Modelos Logísticos , Masculino , Arteria Maxilar/anatomía & histología , Persona de Mediana Edad , Procedimientos Quirúrgicos Ortognáticos , Interpretación de Imagen Radiográfica Asistida por Computador , Estudios Retrospectivos , Programas InformáticosRESUMEN
Although neurological involvement in Behçet's disease is not so uncommon, isolated spinal cord disease is quite rare and reported to be observed in about 2% of all cases with neurological involvement. Here we report a Behçet's patient with spinal cord disease presented with anterior spinal cord syndrome. This rare syndrome is caused by hypoperfusion of the anterior spinal artery and to our knowledge has not been previously reported in patients with Behçet's disease. This report defines the characteristic clinical features of this entity and emphasizes the importance of early immunosuppressive treatment and initiation of rehabilitation.
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Síndrome de la Arteria Espinal Anterior/etiología , Síndrome de Behçet/complicaciones , Síndrome de la Arteria Espinal Anterior/diagnóstico , Síndrome de la Arteria Espinal Anterior/terapia , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/terapia , Quimioterapia Combinada , Humanos , Inmunosupresores/uso terapéutico , Imagen por Resonancia Magnética , Masculino , Modalidades de Fisioterapia , Resultado del Tratamiento , Adulto JovenRESUMEN
Congenital clefts of the larynx are rare and usually found dorsally. An anterior or ventral cleft of the larynx is extremely rare. Only a few patients with this defect have been reported in the literature. The purpose of this paper is to present a patient having an anterior and posterior laryngeal cleft together. A 20-year-old man presented with a history of dysphonia since childhood. He did not report symptoms of swallowing or respiration, and had no history of neck trauma. Findings of videolaryngoscopy showed a grossly abnormal larynx. The anterior commissure was wider than normal, and the vocal folds did not show a fusion anteriorly. There was an interarytenoid cleft posteriorly. A neck CT with 3D reconstruction demonstrated a ventral cleft or nonfusion of the thyroid cartilage with a posterior cricoid cleft. Barium swallow study was in normal limits. Since the patient did not have any problem with swallowing or respiration, no surgical intervention was planned, and the patient was put on speech therapy, which revealed improvement in voice. To our knowledge, this is the first case of a combined laryngeal cleft. The diagnosis is established by the clinical symptoms, endoscopic evaluation, and radiographic examinations including 3D and barium studies.
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Anomalías Congénitas/diagnóstico , Anomalías Congénitas/diagnóstico por imagen , Humanos , Laringoscopía , Laringe/anomalías , Laringe/diagnóstico por imagen , Masculino , Tomografía Computarizada por Rayos X , Grabación en Video , Adulto JovenRESUMEN
A giant unilateral parapharyngeal mass from the skull base to the vocal folds is presented in this case. A 20-year-old man experiencing dysphagia for 4 years was admitted, and his magnetic resonance imaging and computed tomographic scans showed a giant parapharyngeal ellipsoid mass from the left jugular foramen to the vocal folds. Its craniocaudal length was 9 cm. The left internal carotid artery was lateralized, and posterior glottic airway was narrowed by the mass. In digital subtraction angiography, 2 aberrant branches of the internal carotid artery were going inside the mass. After the excision, histopathologic evaluation showed the diagnosis, Castleman disease. This is the first case in literature presenting with the only symptom of dysphagia.
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Enfermedad de Castleman/diagnóstico , Enfermedad de Castleman/cirugía , Trastornos de Deglución/diagnóstico , Trastornos de Deglución/cirugía , Enfermedades Faríngeas/diagnóstico , Enfermedades Faríngeas/cirugía , Angiografía de Substracción Digital , Medios de Contraste , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
INTRODUCTION: The aims of this study were to determine the diagnostic value of MR urography and to compare the T2- and T1-weighted MR urography techniques in patients with urinary diversion. METHODS: We retrospectively reviewed 19 MR urograms in 14 patients (13 male and one female, 8-77 years old, mean age: 54.2) with urinary diversion. Magnetic resonance urography examinations were performed with 1.5-T MR scanners. In addition to T2- and T1-weighted MR urography techniques, conventional T1- and T2-weighted axial and coronal sequences were also obtained. Collecting systems were evaluated in five segments (right proximal and distal collecting system, left proximal and distal collecting system and conduit or reservoir). Imaging features of the urinary collecting systems were evaluated with T2- and T1-weighted MR urography images. The clinical, laboratory data and follow-up imaging findings were regarded as standard. A cross table was formed to determine sensitivity, specificity and accuracy of MR urography techniques. RESULTS: T2-weighted MR urography, T1-weighted MR urography and combination of these two techniques could demonstrate 89.01, 87.65 and 93.83% of all collecting system segments, respectively. For the detection of the pathologic urinary segments, sensitivity, specificity and accuracy were 100, 95.29 and 95.6% in T2-weighted MR urography and 100, 93.42 and 93.82% in T1-weighted MR urography, respectively. Sensitivity, specificity and accuracy were 100% in combined T2- and T1-weighted MR urography technique. CONCLUSION: Magnetic resonance urography is an effective imaging method for the evaluation of the urinary system in patients with urinary diversion. T2-weighted MR urography alone has high sensitivity, specificity and accuracy, does not require intravenous contrast medium and can be obtained in 3-5 min. However, T1-weighted MR urography may provide additional information in some cases.
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Imagen por Resonancia Magnética/métodos , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía , Derivación Urinaria/métodos , Sistema Urinario/patología , Adolescente , Adulto , Anciano , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Urografía/métodos , Adulto JovenRESUMEN
PURPOSE: To report our experience with mechanical coil embolization of pulmonary arteriovenous malformations. MATERIAL AND METHODS: Coil embolization was performed in 6 men (mean age, 21.1 years; age range, 20-23 years) with pulmonary arteriovenous malformations between 1999 and 2004. Five F Cobra catheters and various sized coils were used for embolization. Clinically, cases were followed-up every 3 months for one year and every 6 months thereafter, with a mean total follow-up period of 2.3 years. RESULTS: Complete primary occlusion was achieved in all patients. There were no complications related to the procedure and no problems were reported during follow-up period. CONCLUSION: Treatment of pulmonary arteriovenous malformation cases with coil embolization is an effective option.
Asunto(s)
Malformaciones Arteriovenosas/diagnóstico , Malformaciones Arteriovenosas/terapia , Embolización Terapéutica/métodos , Arteria Pulmonar/anomalías , Venas Pulmonares/anomalías , Adulto , Malformaciones Arteriovenosas/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Masculino , RadiografíaRESUMEN
PURPOSE: To report our experience with 10 cases of bronchial artery embolization (BAE). MATERIALS AND METHODS: The study included 18 cases (11 men and 7 women between 21 and 81 years of age, average 52 years), whose massive hemoptyses could not be controlled with conservative and bronchoscopic methods and were sent to the digital subtraction angiography unit between August 2002 and May 2004. Of these 18 cases, BAE was performed in 10 (7 men and 3 women between 21 and 78 years of age, average 54.2 years). An aortogram with a 5F pigtail catheter and a selective bronchial angiogram with a 4F glide Cobra (C2) catheter was obtained in every case. The same C2 catheters that had been used for bronchial angiography were also used for BAE in 7 cases. Hydrophilic microcatheters were additionally needed for BAE in the other 3 cases. Particles > 250 microns (polyvinyl alcohol [PVA], Embosphere microspheres), mechanical coils, or a combination of both were used for BAE. RESULTS: The etiologies of 10 cases in which BAE was performed were tuberculosis (n=3), sarcoidosis (n=3), bronchiectasis (n=2), and malignancy (n=2). Arterial bronchial pathology was also seen in the non-selective angiographic studies of 4 of the 10 BAE cases. Hemoptysis was controlled in all BAE cases in the first session. Recurrences were observed in 2 cases that were embolized with only mechanical coils during the first month follow-up and hemoptysis was again controlled with microparticle embolization with Embosphere microspheres. All 10 cases were followed- up for 1-21 months (average, 8 months). CONCLUSION: Non-selective angiographic examination alone, is not sufficient enough to detect the vascular pathology causing a massive hemoptysis. A selective study must be performed in every case. The cost of angiography can be lowered by using the same 4F glide C2 catheter for BAE. It may not be safe to use only mechanical coils in BAE cases. There is a need for studying additional cases to have more definitive conclusions.
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Arterias Bronquiales , Embolización Terapéutica/métodos , Hemoptisis/terapia , Enfermedades Pulmonares/terapia , Adulto , Anciano , Anciano de 80 o más Años , Angiografía , Femenino , Hemoptisis/diagnóstico , Hemoptisis/diagnóstico por imagen , Humanos , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana EdadRESUMEN
We present the case of a 20-year-old male with renal lymphangiectasia who presented with hypertension and hematuria. We discuss the role of magnetic resonance imaging (MRI) with gadolinium-enhanced MR urography in confirming the diagnosis, extensions of this rare benign entity, and associated conditions.
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Hematuria/diagnóstico , Hipertensión Renal/diagnóstico , Enfermedades Renales Quísticas/diagnóstico , Linfangiectasia/diagnóstico , Imagen por Resonancia Magnética/métodos , Adulto , Medios de Contraste , Hematuria/etiología , Humanos , Hipertensión Renal/etiología , Enfermedades Renales Quísticas/complicaciones , Linfangiectasia/complicaciones , MasculinoRESUMEN
PURPOSE: To report our experience with mechanical coil embolization of pulmonary arteriovenous malformations (PAVM) MATERIAL AND METHODS: Coil embolizations were performed in 6 men (mean age 21.1, age range 20-23 years) with PAVM between 1999 and 2004. Five F Cobra catheters and various size coils were used for embolization. Clinically, cases were followed in every 3 months of their first year and 6 months in the following years with a mean time of 2.3 years. RESULTS: Complete primary occlusion was achieved in all patients. There were no complications related to the procedure. No problem was reported in the follow-up period. CONCLUSION: Treatment of PAVM cases with coil embolization is a good option.