RESUMO
PURPOSE: In a retrospective study the diagnostic accuracy of computed tomography for the differentiation of benign from malignant adrenal masses in patients with extra-adrenal malignancies was evaluated. For this differentiation a new score system was tested. PATIENTS AND METHODS: Size, density, structure, and borders of adrenal masses in 60 patients with extra-adrenal tumours were analysed and scored. The single criteria and the total score values were correlated with the final diagnosis achieved either by histology or by follow-up CT examinations. RESULTS: Score values above 4 indicated always metastases and score values below 2 were benign lesions. An overlap occurred at score values between 2 and 3 resulting in an overall accuracy of 83.3%. CONCLUSION: Single CT criteria are not reliable enough to differentiate benign from malignant adrenal lesions: better results are achieved by using our scoring system.
Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/secundário , Tomografia Computadorizada por Raios X , Adenoma/patologia , Neoplasias das Glândulas Suprarrenais/patologia , Glândulas Suprarrenais/patologia , Adulto , Carcinoma Broncogênico/patologia , Diagnóstico Diferencial , Estudos de Avaliação como Assunto , Feminino , Neoplasias Gastrointestinais/patologia , Humanos , Neoplasias Pulmonares/patologia , Linfoma/patologia , Masculino , Melanoma/patologia , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
A rare (arteriolo-)capillomedullary venous anomaly of the cerebellum was examined with CT, MRI, and angiography. Unlike the usual venous angioma, this case had such extraordinary features as: infratentorial location, involvement of the whole left cerebellum, an arteriolocapillary component and a history of progressive vomiting and chronic constipation in a 7-year-old boy. CT and MRI were consistent with an extensive vascular malformation, but the actual diagnosis was reached by angiography.
Assuntos
Neoplasias Cerebelares/congênito , Cerebelo/irrigação sanguínea , Angiografia Cerebral , Hemangioma Capilar/congênito , Malformações Arteriovenosas Intracranianas/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Neoplasias Cerebelares/diagnóstico , Veias Cerebrais/anormalidades , Veias Cerebrais/patologia , Criança , Dominância Cerebral/fisiologia , Hemangioma Capilar/diagnóstico , Humanos , Masculino , Exame NeurológicoRESUMO
Gorham syndrome, also known as massive osteolysis or vanishing bone, is a rare disorder (135 cases reported) leading to extensive loss of bony matrix, replaced by proliferating thin-walled vascular channels. Three histologically proven cases of the disease are reported, including the clinical presentation and modern imaging features with CT (with 3D reconstruction) as well as T1- and T2-weighted MRI. Two cases in young women were located in the pelvis with extensive osteolysis reaching to the acetabulum. The third case in a 2-month-old boy is the youngest case ever reported and involved the humerus. The radiological appearance of the disease is discussed and the importance of the modern imaging methods debated.
Assuntos
Úmero/diagnóstico por imagem , Úmero/patologia , Imageamento por Ressonância Magnética , Osteólise Essencial/diagnóstico por imagem , Osteólise Essencial/diagnóstico , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/patologia , Tomografia Computadorizada por Raios X , Acetábulo/diagnóstico por imagem , Acetábulo/patologia , Adulto , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/patologia , Seguimentos , Humanos , Lactente , Ísquio/diagnóstico por imagem , Ísquio/patologia , Masculino , Pessoa de Meia-Idade , Osso Púbico/diagnóstico por imagem , Osso Púbico/patologia , Intensificação de Imagem Radiográfica , Fraturas do Ombro/diagnóstico por imagem , Fraturas do Ombro/patologia , Tomografia Computadorizada por Raios X/métodosRESUMO
The authors report their experience with 3D computed tomography (CT) in 23 patients with fractured os calcis (several types of fractures) in comparison to classical 2D CT. The diagnostic accuracy was not found to be improved by the three-dimensional representation. 3D CT is affected by reconstruction artifacts and strongly depends on the choice of threshold. However the 3D visualization is appreciated by the surgeons.
