Endovascular Treatment of Bilateral Pulmonary Artery Stenoses and Superior Vena Cava Syndrome in a Patient with Advanced Mediastinal Fibrosis.

Vascular stenosis is a relatively uncommon and often fatal sequela of mediastinal fibrosis. There are very few reports in the medical literature of endovascular treatment for concomitant bilateral pulmonary artery stenoses and superior vena cava syndrome. We report the endovascular treatment of these conditions in a 54-year-old man, and the long-term outcome.

CT Dose Reduction Workshop: An Active Educational Experience.

PURPOSE: Improving patient safety by minimizing CT radiation dose, while maintaining diagnostic image quality, has become an important skill in diagnostic radiology. The aim of this study was to examine the value of an educational workshop for optimizing CT protocols in an academic department, and to assess its impact on resident education. METHODS: The CT Dose Reduction Workshop met monthly for 1 year, to teach and implement dose reduction strategies. Changes were made to CT protocols through group consensus while participants kept up to date with current literature. A survey was sent to 48 radiology residents and 32 attending radiologists in the department, including both participants and nonparticipants, after completion of the workshop, to assess its utility. The survey used a 5-point Likert-type scale. Average doses for a specific CT protocol before and after the workshop were compared. RESULTS: About 80% of respondents agreed or strongly agreed that the workshop was essential. Workshop participants expressed greater confidence in their knowledge of dose reduction techniques, with a mean score of 3.74 (95% confidence interval, 3.35-4.13), compared with nonparticipants, who had a mean score of 3.00 (95% confidence interval, 2.64-3.36) (P < .01). Dose reductions were established across numerous CT protocols. For instance, the average total dose-length product in renal mass protocol CT examinations decreased by 54% (P < .0001). CONCLUSIONS: A CT dose reduction workshop increases participants' confidence in knowledge of dose reduction techniques, fosters a culture of safety and quality improvement in the department, and reduces radiation dose to patients.

Hepatoblastoma Associated with Trisomy 18.

Very few reports exist in the literature regarding a possible association between trisomy 18 patients and the incidence of hepatoblastoma. Fewer reports exist on patients with multifocal hepatoblastoma. We reviewed our institutional database for the past 10 years and found three cases with this possible association to the tumor.

Congenital cystic adenomatoid malformation of the lung

La malformación adenomatoide quística congénita es una anomalía poco común, la cual debe considerarse entre las posibilidades ante el diagnóstico diferencial de la dificuldad respiratoria del neonato y de las lesiones quísticas pulmonares que se descubran en el mismo. Una vez que se establece el diagnóstico de la malformación adenomatoide, el tratamiento definitivo es quirúrgico. Se presenta el caso de una recién nacida con la malformación adenomatoide quística en el pulmón izquierdo. Tomando en consideración la posibilidad de hipoplasia del pulmón derecho, se practicó la lobectomía del lóbulo inferior izquierdo y cistectomía en el lóbulo superior izquierdo. La recuperación fue incompleta por motivo de la enfermedad residual del lóbulo superior izquierdo. Se practicó la resección del mismo y la paciente recuperó totalmente. Hemos llegado a la conclusión de que, después de valorar la función del pulmón contralateral, todo el pulmón afectado por la malformación debe ser resecado, aun cuando durante la operación un lóbulo parezca estar afectado en forma mínima