RESUMO
A 23-year-old man fell on his bent left knee and developed a Segond fracture with a rupture of the anterior cruciate ligament.
Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho/complicações , Fraturas da Tíbia/complicações , Adulto , Ligamento Cruzado Anterior/patologia , Humanos , Traumatismos do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Radiografia , Ruptura , Fraturas da Tíbia/diagnóstico por imagemAssuntos
Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico por imagem , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Artéria Esplênica , Neoplasias Esplênicas/complicações , Neoplasias Esplênicas/diagnóstico por imagem , Dor Abdominal/etiologia , Doença Aguda , Idoso , Falso Aneurisma/cirurgia , Angiografia Digital , Diagnóstico Diferencial , Hemorragia Gastrointestinal/etiologia , Humanos , Linfoma Difuso de Grandes Células B/cirurgia , Masculino , Doenças Retais/etiologia , Esplenectomia , Neoplasias Esplênicas/cirurgia , Tomografia Computadorizada por Raios X , Redução de PesoRESUMO
An 81-year-old man with acute back pain had a dissection of the aorta abdominalis (type B).
Assuntos
Aneurisma da Aorta Abdominal/diagnóstico por imagem , Dissecção Aórtica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Dissecção Aórtica/complicações , Aneurisma da Aorta Abdominal/complicações , Dor nas Costas/etiologia , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
A 6-months-old-boy failed to thrive. Congenital emphysema of the left upper lobe of the lung was diagnosed, and lobectomy was performed, with good results.
Assuntos
Insuficiência de Crescimento/etiologia , Pulmão Hipertransparente/complicações , Pulmão Hipertransparente/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Lactente , Pulmão Hipertransparente/congênito , Pulmão Hipertransparente/cirurgia , Masculino , Pneumonectomia , Enfisema Pulmonar/congênito , Enfisema Pulmonar/diagnóstico por imagem , Radiografia , Resultado do TratamentoRESUMO
PURPOSE: To determine the accuracy and repeatability of ultrasonography (US) with the ellipsoid formula in calculating the renal volume. MATERIALS AND METHODS: The renal volumes in 20 volunteers aged 19-51 years were determined by using US with the ellipsoid formula and magnetic resonance (MR) imaging with the voxel-count method by two independent observers for each modality. The observers performed all measurements twice, with an interval between the first and second examinations. The voxel-count method was the reference standard. Repeatability was evaluated by calculating the SD of the difference (method of Bland and Altman). RESULTS: Renal volume was underestimated with US by 45 mL (25%) on average. A comparable underestimation was found when the ellipsoid formula was applied to MR images. This indicates that the inaccuracy of US renal volume measurements (a) occurred because the kidney does not resemble an ellipsoid and (b) was not primarily related to the imaging modality. Intra- and interobserver variations in US volume measurements were poor; the SD of the difference was 21-32 mL. For comparison, the SD of the difference in reference-standard measurements was 5-10 mL. CONCLUSION: Use of US with the ellipsoid formula is not appropriate for accurate and reproducible calculation of renal volume.
Assuntos
Rim/anatomia & histologia , Rim/diagnóstico por imagem , Imageamento por Ressonância Magnética , Adulto , Antropometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valores de Referência , Reprodutibilidade dos Testes , UltrassonografiaRESUMO
In this in vitro study, the accuracy and repeatability of magnetic resonance imaging (MRI) and ultrasound (US) in assessing renal length and volume were determined. US and MR images of 20 cadaver pig kidneys were obtained twice and evaluated by two observers for each modality. The fluid displacement method provided the "gold standard." Renal volumes were calculated from the US and MR images using the ellipsoid formula. Additional volume calculations after segmentation of the kidney on MR images were done using the voxel-count method. Volumes calculated with the ellipsoid formula resulted in an average of 24% underestimation (range 5%-48%) of the renal volume for both US and MRI. With the voxel-count method, no significant deviation from the true renal volume was encountered. Repeatability was also greatest with the voxel-count method. Measuring renal length, repeatability was, again, better with MRI compared to US. For reliable calculation of renal size in vitro, MRI with use of the voxel-count method is preferred.
Assuntos
Rim/anatomia & histologia , Rim/diagnóstico por imagem , Imageamento por Ressonância Magnética , Animais , Técnicas In Vitro , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Variações Dependentes do Observador , Tamanho do Órgão , Reprodutibilidade dos Testes , Suínos , Transdutores , Ultrassonografia/instrumentação , Ultrassonografia/métodos , Ultrassonografia/estatística & dados numéricosRESUMO
PURPOSE: To define the impact of spiral computed tomographic angiography (CTA) with image reconstruction on graft selection for Transfemoral Endovascular Aneurysm Management (TEAM) by comparing it to conventional computed tomography (CT) and contrast arteriography. METHODS: Twenty-one candidates for TEAM were included. The diameters of the superior and inferior aneurysm necks and lengths between the graft attachment sites were measured using the three imaging techniques. These measurements and their consequences on graft selection were studied. RESULTS: The difference in length sizing between spiral CTA and arteriography never exceeded 1 cm; however, lengths measured by conventional CT scanning resulted in underestimation of graft length in 91% of patients. Graft diameters were chosen too small in 62% of the patients when based on arteriographic diameter measurements. A graft of similar diameter was selected by spiral CTA and conventional CT scanning in 81% of the patients, while minor oversizing by conventional CT scanning was found in 14%. CONCLUSIONS: Neither conventional CT scanning nor arteriography is adequate as a sole preoperative radiological investigation for TEAM graft sizing. Spiral CTA with image processing produces all information required for selection of the optimal graft size and should be regarded the method of first choice for this purpose.
Assuntos
Angiografia/métodos , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Prótese Vascular/normas , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/cirurgia , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Estudos ProspectivosRESUMO
This investigation evaluated patient-controlled analgesia (PCA) for subjective well-being and mood in the postoperative period in comparison with the intramuscular (im) administration of morphine given on demand. Patients scheduled for elective upper abdominal surgery were assigned at random to either PCA (n = 17) or im morphine (n = 14). The PCA group experienced significantly more pain relief and consumed more morphine than those who received im morphine. The PCA patients suffered from more fatigue and showed less vigour than the im group. Neither preoperative trait anxiety nor locus of control was associated with postoperative pain in either of the groups.