Cystic dysplasia of the rete testis: ultrasound and magnetic resonance imaging findings.

Cystic dysplasia of the testis is a rare congenital anomaly. It presents a diagnostic challenge to the pediatrician and should be distinguished from malignant lesions. We herewith present a two-month-old boy who presented with right inguinal swelling. Detailed investigations including ultrasound and magnetic resonance imaging helped in establishing the diagnosis of cystic dysplasia. To the best of our knowledge, our case is the first case of cystic dysplasia of the rete testis in the literature, which presented as undescended testis (inguinal swelling), with no associated renal or ureteric anomalies.

Can contrast-enhanced renal MR angiography replace conventional angiography in preoperative evaluation of living renal donors?

The aim of the study was to detect if gadolinium-enhanced renal magnetic resonance angiography (MRA) can replace conventional angiography in imaging vascular anatomy in potential living renal donors and compare with surgical findings. MR imaging (MRI) and breath-hold three-dimensional gadolinium-enhanced MRA of kidneys were done for 60 consecutive patients for whom successful nephrectomy was done. MRA findings were compared with the findings of nephrectomy. MRI and MRA identified 28 out of 60 patients with normal arterial and venous anatomy, and concordance was found at surgery in 27 of these patients. Vascular anomalies were depicted on MRI in 32 patients, with concordance at surgery in 27 patients. Regarding arterial anomalies, the MRA had a sensitivity of 89.3%, a specificity of 94.0% and an accuracy of 90.8%. For venous anomalies, the sensitivity was 98.5%, specificity was 100% and accuracy was 98.6%. In conclusion, gadolinium-enhanced MRA of the kidneys can replace conventional angiography as a safe and accurate modality for the assessment of potential living renal donors.

Childhood stroke in Eastern Province, KSA: pattern, risk factors, diagnosis and outcome.

BACKGROUND AND PURPOSE: Stroke has been increasingly recognized in children in recent years, but diagnosis and management can be difficult because of the diversity of underlying risk factors, atypical presentation and the absence of a uniform treatment approach. The aim of this study was to examine risk factors, clinical presentation, imaging findings and outcomes of paediatric stroke in Eastern Province, Kingdom of Saudi Arabia (KSA). SUBJECTS AND METHODS: We evaluated 25 patients (11 boys and 14 girls) using computerized tomography scan of the brain, magnetic resonance (MR) imaging and MR angiography. Cardiac assessment, haematological tests, immunological tests, infection and metabolic screening were also performed in the patients. After discharge, the patients were monitored regularly in the neurology clinic to detect their outcomes. RESULTS: A total of 76% of the patients presented with ischaemic stroke, while the remaining 24% had haemorrhagic stroke. Sickle cell disease (SCD) was the commonest risk factor for stroke (36%) followed by non determinate causes (20%). Seizure was the commonest clinical presentation (54%) followed by haemiplegia (31%) and decreased level of consciousness (30%). Recurrence occurred in SCD patients (80%) and patients with moyamoya disease (20%). Regarding the outcome, long-term deficit was the commonest (44%), while short-term deficit and death were equal (28% each). CONCLUSION: Our study in Eastern Province, KSA, showed agreement with other studies regarding risk factors, clinical presentation, imaging features and outcomes of stroke in children, yet with some points of differences, which are as follows: (1) SCD is the commonest risk factor in our study population, while in Chinese study it was not, (2) The percentage of cardiac disorders as a risk factor in this study was less than that in the European and American studies, and (3) there was relative discrepancy regarding predictors of outcome.