RESUMO
We reviewed eight children (ten shoulders) who had suffered neonatal sepsis, after a mean follow-up of 14 years (11 to 15). The delay between the onset of symptoms and diagnosis was one day in five patients, two days in three and seven days in one. All ten shoulders were treated by aspiration, followed by arthrotomy in two. At follow-up, five of the ten shoulders had a full range of movement and the others had minimal restriction of external rotation. Shortening of 10 cm was present in one patient, while two with bilateral involvement had disproportionally short humeri. Early diagnosis and treatment favour the outcome in septic arthritis of the shoulder. With late diagnosis, deformation of the humeral head and shortening of the humerus cause marked cosmetic abnormality but negligible functional loss.
Assuntos
Artrite Infecciosa/complicações , Articulação do Ombro/microbiologia , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/cirurgia , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/etiologia , Doenças Ósseas/fisiopatologia , Estética , Seguimentos , Lâmina de Crescimento/diagnóstico por imagem , Lâmina de Crescimento/crescimento & desenvolvimento , Lâmina de Crescimento/patologia , Humanos , Úmero/diagnóstico por imagem , Úmero/crescimento & desenvolvimento , Úmero/patologia , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/patologia , Amplitude de Movimento Articular/fisiologia , Rotação , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/fisiopatologia , Articulação do Ombro/cirurgia , Sucção , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
The aim of our study was to compare the image quality of T2-weighted gradient-echo-and-spin-echo (GRASE) MRI and fast spin-echo (FSE) MRI for imaging of cervical carcinoma. In 40 patients FSE8 (TR/TE = 3400/90 ms) MRI with echo train length (ETL) of 8, GRASE (3400/90) MRI with ETL of 18, turbo factor of 6 and 3 gradient reversals, and FSE18 (2500/120) MRI with ETL of 18 were performed. Tissue contrast, subjectively rated image quality, and accuracy of tumor delineation were compared. Surgical correlation was obtained in 27 subjects. Contrast-to-noise ratios of the tumor-cervix stroma, tumor-parametrium and tumor-rectum wall interfaces were better in FSE18 than in FSE8 and GRASE (P < 0.001) but not different between FSE8 and GRASE. Subjective image quality was better in FSE18 and FSE8 than in GRASE (P < 0.02). The accuracy of tumor delineation was similar for the three different sequences. The accuracy of FSE and GRASE MRI for the delineation of cervical carcinoma is similar. Based on measurement of image quality and CNRs, however, high turbo factor FSE provides better image quality in MRI of cervical carcinoma. Whether the superior characteristics may result in better staging has to be explored in larger clinical trials.
