RESUMEN
SUMMARY: Hemangioendotheliomas are rare vascular tumors that can affect bone. They account for 0.5% to 1.0% of malignant primary bone tumors. Only four cases have been reported involving the temporal bone. A 5-year-old child with grade II hemangioendothelioma of the right temporal bone is presented, and the radiologic findings on different imaging studies are described. The patient was treated with preoperative endovascular embolization followed by wide surgical resection. The imaging patterns of this malignant tumor may be similar to those of a benign lesion.
Asunto(s)
Diagnóstico por Imagen , Hemangioendotelioma/diagnóstico , Hemangioma/diagnóstico , Neoplasias Craneales/diagnóstico , Hueso Temporal , Preescolar , Diagnóstico Diferencial , Femenino , Hemangioendotelioma/patología , Hemangioma/patología , Humanos , Neoplasias Craneales/patología , Hueso Temporal/patologíaAsunto(s)
Arteria Carótida Interna/anomalías , Otosclerosis/congénito , Arteria Carótida Interna/diagnóstico por imagen , Niño , Diagnóstico Diferencial , Oído Interno/diagnóstico por imagen , Oído Medio/diagnóstico por imagen , Femenino , Pérdida Auditiva Conductiva/etiología , Humanos , Otosclerosis/complicaciones , Otosclerosis/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Arachnoid cysts are intra-arachnoidal cerebrospinal fluid collections that are usually asymptomatic, however, they may become acutely symptomatic due to enlargement of the cyst or the presence of hemorrhage. MATERIALS AND METHODS: We report a case of a child presenting with a 3-week history of headaches, nausea, and vision problems. There was no history of trauma. MRI clearly demonstrated a left middle cranial fossa arachnoid cyst with associated subacute intracystic and subdural hematoma that was causing mass effect and required surgery. RESULTS: This lesion was isodense to the brain on CT. CONCLUSION: We focus on the importance of MR imaging in the differentiation of these subacute/early chronic hemorrhagic collections that may be overlooked with CT.
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Quistes Aracnoideos/diagnóstico , Encéfalo/patología , Hemorragias Intracraneales/diagnóstico , Imagen por Resonancia Magnética , Quistes Aracnoideos/complicaciones , Quistes Aracnoideos/cirugía , Niño , Diagnóstico Diferencial , Humanos , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/cirugía , Masculino , Reproducibilidad de los ResultadosRESUMEN
The imaging and pathologic features of three cases of nonlaryngeal neuroendocrine carcinoma of the head and neck are described. Neuroendocrine carcinomas represent malignant epithelial neuroendocrine neoplasms and are classified as three types: typical carcinoid (well differentiated), atypical carcinoid (moderately differentiated), and small cell neuroendocrine (poorly differentiated) carcinomas. The CT and MR imaging features of these tumors are nonspecific. Paranasal sinus neuroendocrine carcinomas showed expansion and destruction of the sinus, whereas metastatic neuroendocrine carcinomas to an intraparotid lymph node presented as a circumscribed parotid mass on CT scans.
Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Tumores Neuroendocrinos/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Magnetic resonance angiography (MRA) plays an important role in the evaluation of cerebrovascular disease. This is especially true in the diagnosis and management of cerebral vascular malformations. Both time-of-flight and phase contrast MRA techniques have proved useful for the imaging of all types of cerebral vascular malformations including AVMs, dural fistulas, cavernous malformations, and venous angiomas. The role of MRA in the evaluation of these lesions is discussed.
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Malformaciones Arteriovenosas Intracraneales/diagnóstico , Angiografía por Resonancia Magnética , Encéfalo/patología , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/diagnóstico por imagen , Angiografía Cerebral , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagen , Humanos , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Angiografía por Resonancia Magnética/métodosRESUMEN
OBJECT: The goal of this study was to evaluate gene delivery to a benign brain tumor. METHODS: A recombinant adenovirus vector bearing the Escherichia coli beta-galactosidase reporter gene was selectively injected into the vascular supply of a spontaneously occurring canine olfactory groove meningioma. The tumor and a small amount of peritumoral brain tissue were removed 5 days after viral injection and stained with X-Gal to assess gene delivery. The authors noted significant beta-galactosidase gene expression by the tumor, but not by surrounding brain tissue. No obvious viral-related cytotoxicity was noted. CONCLUSIONS: The authors found that meningiomas can be successfully transduced by adenovirus vectors by using endovascular techniques.
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Terapia Genética , Neoplasias Meníngeas/veterinaria , Meningioma/veterinaria , Adenoviridae/genética , Animales , Colorantes , ADN Recombinante/genética , Perros , Escherichia coli/genética , Hueso Etmoides/patología , Femenino , Galactósidos , Regulación Enzimológica de la Expresión Génica , Regulación Neoplásica de la Expresión Génica , Genes Reporteros/genética , Vectores Genéticos , Indoles , Inyecciones Intraarteriales , Neoplasias Meníngeas/irrigación sanguínea , Neoplasias Meníngeas/patología , Neoplasias Meníngeas/cirugía , Neoplasias Meníngeas/terapia , Meningioma/irrigación sanguínea , Meningioma/patología , Meningioma/cirugía , Meningioma/terapia , Transducción Genética , beta-Galactosidasa/genéticaRESUMEN
PURPOSE: To determine the clinical effectiveness of parent artery occlusion of the carotid or vertebral artery by means of temporary proximal flow arrest and microcoils. METHODS: Nineteen parent artery occlusions (15 carotid, four vertebral) were performed in 19 patients who successfully passed a balloon test occlusion. In these patients, endovascular occlusion of the carotid or vertebral artery was accomplished with the use of temporary proximal flow arrest and microcoils. RESULTS: All 19 parent arteries were occluded. Eighteen patients (95%) had good outcomes and one (5%) had a poor outcome. Fourteen patients (74%) had no complications and five (26%) had complications, of whom only one was left with a permanent neurologic deficit. Three (60%) of the complications were the result of delayed ischemic events after parent artery occlusion and were not predicted by balloon test occlusion. CONCLUSION: Endovascular occlusion with temporary proximal flow arrest and microcoils can be done effectively and successfully. The predictive value of the balloon test occlusion is the major complicating factor, as it is with balloon occlusion. This technique offers an additional tool that can be used for endovascular occlusion of the carotid or vertebral artery and seems to be less difficult technically. It is our primary technique for parent artery occlusion.
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Aneurisma Falso/terapia , Fístula Arteriovenosa/terapia , Arteria Carótida Interna , Seno Cavernoso , Embolización Terapéutica/instrumentación , Neoplasias de Cabeza y Cuello/terapia , Aneurisma Intracraneal/terapia , Arteria Vertebral , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aneurisma Falso/diagnóstico por imagen , Fístula Arteriovenosa/diagnóstico por imagen , Encéfalo/irrigación sanguínea , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/etiología , Arteria Carótida Interna/diagnóstico por imagen , Seno Cavernoso/diagnóstico por imagen , Angiografía Cerebral , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/etiología , Niño , Preescolar , Circulación Colateral/fisiología , Diseño de Equipo , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/irrigación sanguínea , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Arteria Vertebral/diagnóstico por imagenRESUMEN
PURPOSE: To develop a pig model of arterial thrombosis suitable for assessing different methods of thrombolysis and to use this model to compare the efficacy of intraarterial thrombolysis performed by continuous proximal urokinase infusion versus mechanical clot disruption combined with intrathrombic urokinase injection. METHODS: In a control group of five pigs, a thrombus was made in a short segment of femoral artery and observed for 2 hours to assess its stability. In a treatment group of six pigs, intraarterial thrombolysis was performed immediately after thrombus formation. Thrombolysis was accomplished by continuously infusing urokinase into the proximal leading edge of the thrombus in three pigs and by mechanical clot disruption combined with intrathrombic urokinase injection in the remaining three pigs. RESULTS: There was no spontaneous reestablishment of flow in the control group during the 2-hour observation period. In the first treatment group, no flow was observed after a 1-hour treatment period when urokinase was infused continuously into the proximal edge of the thrombus. In the second treatment group, with mechanical clot disruption and intrathrombic urokinase injection, some degree of flow was observed in all three pigs. Reestablishment of flow was more sustained and of a greater degree with the addition of systemic heparinization. CONCLUSION: This animal model could provide a useful way to evaluate and compare different methods of thrombolysis. Our results suggest that mechanical clot disruption combined with intrathrombic urokinase injection is more effective in achieving reestablishment of flow than is continuous infusion of urokinase into the proximal edge of the thrombus.
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Activadores Plasminogénicos/uso terapéutico , Terapia Trombolítica/métodos , Trombosis/tratamiento farmacológico , Activador de Plasminógeno de Tipo Uroquinasa/uso terapéutico , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Arteria Femoral , Activadores Plasminogénicos/administración & dosificación , Valores de Referencia , Porcinos , Trombectomía , Trombosis/cirugía , Resultado del Tratamiento , Activador de Plasminógeno de Tipo Uroquinasa/administración & dosificaciónRESUMEN
Thrombosis of the straight and transverse sinuses associated with a large hemorrhagic venous infarct developed in an infant with large chronic subdural fluid collections after drainage of the subdurals. CT and MR studies obtained before and after the onset of venous sinus thrombosis showed interval widening of a segment of the posterior falx between the vein of Galen and the superior sagittal sinus. MR angiography confirmed a recanalized falcine sinus.
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Síndrome del Niño Maltratado , Senos Craneales/patología , Enfermedades en Gemelos , Hematoma Subdural/diagnóstico , Enfermedades del Prematuro/diagnóstico , Trombosis de los Senos Intracraneales/diagnóstico , Infarto Cerebral/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Angiografía por Resonancia Magnética , Tomografía Computarizada por Rayos XAsunto(s)
Aneurisma/complicaciones , Enfermedades de las Arterias Carótidas/complicaciones , Medios de Contraste/efectos adversos , Embolización Terapéutica/métodos , Hemorragia/terapia , Orofaringe/patología , Dióxido de Torio/efectos adversos , Aneurisma/inducido químicamente , Enfermedades de las Arterias Carótidas/inducido químicamente , Arteria Carótida Común/patología , Embolización Terapéutica/instrumentación , Diseño de Equipo , Granuloma/inducido químicamente , Hemorragia/etiología , Humanos , Masculino , Persona de Mediana Edad , Cuello/patología , Enfermedades Faríngeas/inducido químicamente , Enfermedades Faríngeas/etiología , Enfermedades Faríngeas/terapia , Flujo Sanguíneo RegionalRESUMEN
PURPOSE: To determine the effect of proximal flow arrest on the frequency and timing of distal embolic events during occlusion of the common femoral artery with detachable coils. METHODS: Twenty-three complex fibered platinum coils were delivered into 10 common femoral arteries without proximal flow arrest. The arteries were continuously monitored for flow and embolic events by Doppler sonography during delivery and for at least 10 minutes after delivery of each coil. Thirty-four coils were delivered into 6 arteries after proximal flow arrest by inflation of a nondetachable balloon. After balloon deflation, each artery was monitored by Doppler sonography for 10 minutes. RESULTS: In the 10 arteries occluded without flow arrest, 87 events (8.7 per artery) occurred, of which 47 were embolic and 40 were indeterminate. In the 6 arteries with flow arrest, the number of emboli detected was 3 (0.5 per artery). Embolic events occurred only if there was residual flow. In those arteries that were occluded when the flow-arrest balloon was deflated, no emboli were detected. CONCLUSIONS: Proximal flow arrest virtually eliminates the risk of distal emboli during arterial occlusion with detachable fibered coils. The use of fibered coils, in conjunction with proximal flow arrest, allows for safe arterial occlusion when detachable balloons are not available or their use is not feasible.
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Velocidad del Flujo Sanguíneo/fisiología , Embolia/diagnóstico por imagen , Embolización Terapéutica/instrumentación , Procesamiento de Imagen Asistido por Computador , Ultrasonografía Doppler en Color , Animales , Perros , Arteria Femoral/diagnóstico por imagen , Factores de RiesgoRESUMEN
We report the case of a patient with a large hiatal hernia accompanied by partial gastric volvulus in whom the computed tomography (CT) findings mimic the appearances of thrombus in the inferior vena cava (IVC). To our knowledge, this has not been previously reported as a cause of "pseudothrombosis" of the IVC on CT.