RESUMEN
OBJECTIVE: Faecal incontinence often persists after surgery for rectal prolapse. Multiple mechanisms have been proposed as responsible, however, anal sphincter integrity has only been studied in a handful of cases. This study assesses the incidence of ultrasound detected anal sphincter tears in patients with rectal prolapse and faecal incontinence. METHODS: Retrospective search of medical records at Flinders Medical Centre over a 7-year period to identify patients with full thickness rectal prolapse and faecal incontinence who had undergone endosonographical imaging of the anal sphincter complex. Anal manometry and pudendal nerve terminal motor latency studies were also included. RESULTS: Twenty-one patients were identified (1 male, 20 female) of median age 67.5 years. Fifteen (71%) subjects had an abnormality in the anal sphincter complex on endoanal ultrasound. Of these, the defects in 4 (19%) patients were isolated to the internal sphincter, 3 (14%) to the external sphincter and in the remaining 8 (38%) subjects, defects were found in both internal and external sphincters. The degree of sphincteric defect was variable but at least 6 (29%) of the study group had full-length external sphincter tears. In the 19 patients studied, anal manometry revealed reduced basal and squeeze pressures in the majority. Delayed pudendal nerve terminal motor latency was evident in 9 of 18 patients studied. CONCLUSION: Anal sphincter tears are common in patients presenting with rectal prolapse and faecal incontinence. The faecal incontinence associated with prolapse appears to be multifactorial in aetiology. Anal sphincter defects are likely to contribute to persistent faecal incontinence or recurrence following rectal prolapse. Endoanal ultrasound derived knowledge of anal sphincter injury may guide surgical management in problematic cases.
Asunto(s)
Canal Anal/lesiones , Incontinencia Fecal/etiología , Prolapso Rectal/etiología , Adulto , Anciano , Anciano de 80 o más Años , Canal Anal/diagnóstico por imagen , Endosonografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , RoturaRESUMEN
This paper highlights the importance of cavernous haemangiomas as clinically significant lesions and the role of imaging, particularly MRI, in suggesting the diagnosis. An understanding of the pathology of these lesions helps to explain the features demonstrated by imaging techniques.
Asunto(s)
Neoplasias Encefálicas/diagnóstico , Hemangioma Cavernoso del Sistema Nervioso Central/diagnóstico , Adulto , Neoplasias Encefálicas/patología , Hemangioma Cavernoso del Sistema Nervioso Central/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos XRESUMEN
This review summarizes important pathological lesions of the lung that typically present radiographically with an 'alveolar pattern'. For each entity, the latest findings as to its pathogenesis, aetiology and pathology are reviewed in the introductory remarks. We then present the typical radiological appearances alongside macroscopic and microscopic pathological photographs. It is hoped that the parallel presentation of radiological image with the pathology will enhance the understanding of the diverse range of diseases the aevolar pattern comprises.
Asunto(s)
Enfermedades Pulmonares/patología , Alveolos Pulmonares/patología , Diagnóstico Diferencial , Humanos , Enfermedades Pulmonares/diagnóstico por imagen , Alveolos Pulmonares/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
We describe a 4-year-old girl with an inflammatory pseudotumour of the pancreas, which was preceded by varicella-zoster infection. Inflammatory pseudotumour may involve a variety of tissues, the lungs and liver being typical sites of predilection. Imaging and laboratory tests are nonspecific, and for this reason the diagnosis of inflammatory pseudotumour is rarely made prior to surgery. These benign but locally aggressive masses simulate malignancy in the majority of cases. Inflammatory pseudotumour should, therefore, be considered when a mass arises in an unusual location in the paediatric age group.
Asunto(s)
Varicela/complicaciones , Granuloma de Células Plasmáticas/virología , Herpesvirus Humano 3/aislamiento & purificación , Enfermedades Pancreáticas/virología , Preescolar , Femenino , Granuloma de Células Plasmáticas/patología , Granuloma de Células Plasmáticas/cirugía , Humanos , Enfermedades Pancreáticas/patología , Enfermedades Pancreáticas/cirugía , Tomografía Computarizada por Rayos XRESUMEN
The imaging findings of a case of meningioangiomatosis with pathologic correlation are presented.
Asunto(s)
Angiomatosis/diagnóstico , Meninges/patología , Adolescente , Angiomatosis/patología , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , Masculino , Meninges/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: To examine shoulder appearances at magnetic resonance (MR) imaging in long-term dialysis recipients. MATERIALS AND METHODS: Twenty-two chronic dialysis recipients underwent 1.0-T MR imaging with a combination of T1-, T2-, and T2*-weighted sequences. Rotator cuff tendon thickening was graded as present or absent by a musculoskeletal radiologist, who also measured the supraspinatus and subscapularis tendon thicknesses with electronic calipers. The long-axis dimension and location of focal osseous lesions, in addition to their T1, T2, and T2* signal intensities, were noted. RESULTS: Supraspinatus (n = 9) and subscapularis (n = 10) tendon thickening was frequently observed. Six (27%) of the 22 patients had combined thickening of the supraspinatus and subscapularis tendons without substantial involvement of the infraspinatus or teres minor tendons. These patients had undergone dialysis longer (median, 19.2 years; range, 16.3-22.8 years) than had the other patients (median, 11.7 years; range, 5.8-19.3 years; P: =.004). The 29 intraosseous lesions had high, intermediate, and low T2 signal intensity in six (21%), nine (31%), and 14 (48%) instances, respectively. CONCLUSION: Supraspinatus and/or subscapularis tendon thickening is common in chronic dialysis recipients. Bone lesions in such patients are of variable T2 signal intensity and usually subchondral or adjacent to the greater tuberosity.
Asunto(s)
Imagen por Resonancia Magnética , Diálisis Renal , Articulación del Hombro/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Artropatías/diagnóstico , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Manguito de los Rotadores/patología , Tendones/patología , Factores de TiempoRESUMEN
The anatomical basis of the primary empty sella turcica is illustrated to emphasize that it represents a normal variant and not pathology.
Asunto(s)
Síndrome de Silla Turca Vacía/diagnóstico por imagen , Síndrome de Silla Turca Vacía/patología , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To determine the prevalence of neurological and magnetic resonance imaging (MRI) abnormalities in a well defined population of unselected patients with primary Sjögren's syndrome (SS) and age and sex matched healthy patients. METHODS: Thirty patients with SS and 29 age and sex matched controls were examined by a neurologist and subsequently underwent MRI scanning with a 1.0 Tesla Siemens Impact MR scanner. Scans were graded by a neuroradiologist blinded to the clinical status of each subject. The number and location of white matter lesions > 3 mm in long axis (to exclude non-specific perivascular changes) were recorded for each subject. RESULTS: There was a significant increase in lesions detected by MRI in SS patients versus controls (p = 0.02) including deep white matter lesions (p = 0.03) and subcortical white matter lesions (p = 0.02). The presence of white matter lesions did not correlate with serum IgG or rheumatoid factor levels, or with presence of anticardiolipin antibodies. No subjects had symptoms or signs of serious neurological disease including multiple sclerosis, and corpus callosal lesions commonly seen in multiple sclerosis were notably absent in this study. CONCLUSION: Cerebral white matter lesions detected by MRI are more frequent in patients with primary SS than control subjects, yet do not appear to be associated with significant clinical manifestations. Although the pathological nature of these lesions is yet to be defined, their presence should not be over-interpreted.
Asunto(s)
Encéfalo/patología , Fibras Nerviosas Mielínicas/patología , Síndrome de Sjögren/patología , Adulto , Factores de Edad , Anciano , Femenino , Humanos , Inmunoglobulina G/sangre , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factor Reumatoide/sangre , Factores Sexuales , Síndrome de Sjögren/sangreRESUMEN
Cavernous haemangiomas confined to the epidural space are rare and are therefore infrequently considered in the differential diagnosis of spinal epidural masses. In order to draw attention to this diagnosis, a case in which an epidural cavernous haemangioma simulates a lateral/foraminal disc protrusion is presented.
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Hemangioma Cavernoso/diagnóstico , Adulto , Diagnóstico Diferencial , Espacio Epidural , Femenino , Hemangioma Cavernoso/cirugía , Humanos , Desplazamiento del Disco Intervertebral/diagnóstico , Vértebras Lumbares , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos XRESUMEN
Blood, cerebrospinal fluid, and extracellular fluid of the parenchyma form the fluid compartments of the brain with three interfaces between--the blood-brain interface, the CSF-brain interface, and the blood-CSF interface. These and other issues are discussed in this article.
Asunto(s)
Medios de Contraste , Aumento de la Imagen , Imagen por Resonancia Magnética , Intensificación de Imagen Radiográfica , Tomografía Computarizada por Rayos X , Sangre , Barrera Hematoencefálica , Encéfalo/anatomía & histología , Encéfalo/diagnóstico por imagen , Líquido Cefalorraquídeo , Plexo Coroideo/anatomía & histología , Plexo Coroideo/diagnóstico por imagen , Espacio Extracelular , Humanos , YodoAsunto(s)
Barrera Hematoencefálica/efectos de los fármacos , Medios de Contraste/toxicidad , Pruebas de Toxicidad , Animales , Arabinosa/toxicidad , Relación Dosis-Respuesta a Droga , Extravasación de Materiales Terapéuticos y Diagnósticos , Yohexol/análogos & derivados , Yohexol/toxicidad , Concentración Osmolar , Conejos , Ácidos Triyodobenzoicos/toxicidadAsunto(s)
Barrera Hematoencefálica/efectos de los fármacos , Encéfalo/efectos de los fármacos , Medios de Contraste/toxicidad , Compuestos Heterocíclicos/toxicidad , Imagen por Resonancia Magnética , Compuestos Organometálicos/toxicidad , Ácido Pentético/análogos & derivados , Animales , Arabinosa/farmacología , Medios de Contraste/farmacocinética , Electroencefalografía/efectos de los fármacos , Gadolinio , Gadolinio DTPA , Compuestos Heterocíclicos/farmacocinética , Compuestos Organometálicos/farmacocinética , Ácido Pentético/farmacocinética , Ácido Pentético/toxicidad , Conejos , Convulsiones/inducido químicamenteRESUMEN
Spinal intradural arachnoid cysts are seen most frequently in the thoracic region, particularly near the midline posteriorly. A thoracic intradural arachnoid cyst in this typical location is reported, with the additional unusual finding of herniation of the spinal cord through an anterior defect in the dura matter. The MRI findings are described.
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Quistes Aracnoideos/diagnóstico , Duramadre , Imagen por Resonancia Magnética , Mielografía , Compresión de la Médula Espinal/diagnóstico , Adulto , Quistes Aracnoideos/patología , Quistes Aracnoideos/cirugía , Diagnóstico Diferencial , Duramadre/patología , Duramadre/cirugía , Femenino , Estudios de Seguimiento , Humanos , Examen Neurológico , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/cirugía , Reoperación , Espina Bífida Oculta/diagnóstico , Espina Bífida Oculta/cirugía , Compresión de la Médula Espinal/patología , Compresión de la Médula Espinal/cirugíaRESUMEN
In a patient with celiac disease, folate and iron deficiency, and epilepsy, CT over a 4-month period showed parietoocipital calcifications in the corticomedullary junctions. The calcification was progressive, but it and the seizures stabilized after institution of a gluten-free diet and iron and folic acid supplements.