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1.
Ann Palliat Med ; 10(3): 2577-2583, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33548995

RESUMO

BACKGROUND: To explore the prognostic role of ovarian endometriosis in symptomatic adenomyosis patients underwent uterine artery embolization (UAE). METHODS: This was a retrospective, single-center study. A total of 76 patients with adenomyosis who underwent UAE in The First Affiliated Hospital of Sun Yat-sen University between May 2009 and July 2016 were enrolled in this study. These patients were divided into two groups based on whether complicated with ovarian endometriosis. After UAE, the patients were followed up for 12 months. The improvements of dysmenorrhea and menorrhagia were evaluated according to the symptom relief criteria. The improvement rates in both groups were analyzed and compared. RESULTS: Among the 76 patients with adenomyosis, 17 (22.3%) were diagnosed with OE and 59 (77.6%) were non-OE. In the OE group, all patients (17/17, 100%) had dysmenorrhea and 11 (11/17, 64.7%) had menorrhagia. In non-OE group, 57 patients (57/59, 96.6%) had dysmenorrhea and 50 (50/59, 84.7%) had menorrhagia. The improvement rates of dysmenorrhea in the two groups were 47.1% (OE group) and 86.0% (non-OE group), respectively (P<0.05). The improvement rates of menorrhagia in the two groups were 63.6% (OE group) and 84.0% (non-OE group), respectively (P=0.263). CONCLUSIONS: Patients without OE showed a lower incidence of dysmenorrhea and may have an advantage in the improvement of dysmenorrhea compared with those with OE when they underwent UAE. However, no significant difference was observed in the improvement of menorrhagia.


Assuntos
Adenomiose , Endometriose , Embolização da Artéria Uterina , Adenomiose/terapia , Endometriose/terapia , Feminino , Humanos , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento
2.
Medicine (Baltimore) ; 95(41): e5159, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27741148

RESUMO

INTRODUCTION: Meckel diverticulum (MD) is the most common congenital abnormality of gastrointestinal tract. Tough believed to occur in 2% of population, most of them remain veiled because majority are clinically asymptomatic and remain obscure in radiological examination. CLINICAL FINDINGS AND DIAGNOSIS: A 26-year-old male with episodic black colored stool since last 10 years. Tough symptomatic, diagnosis of pathological lesion, and the bleeding site could not be established with any of the sophisticated diagnostic technique. After 10 years, it was finally diagnosed as MD with careful observation of bowel loops on computed tomography enterography (CTE) where remnant of vitelline vessel and hyper-enhancing nodule are seen along the wall of diverticular loop. INTERVENTIONS AND OUTCOMES: The patient underwent robot assisted laparoscopic surgery with excision of diverticular loop. To the best of our knowledge, this robot-assistant Meckel diverculectomy is probably the first reported surgical procedure in PubMed. Follow-up for 3 month showed no complication or recurrence. CONCLUSION: Every case is unique and we must be aware and remain alert in tracing the possible morphological variation of the case. Here, we present one unique but rare feature of MD, which helped us in making diagnosis.


Assuntos
Íleo/cirurgia , Laparotomia/métodos , Divertículo Ileal/cirurgia , Robótica , Adulto , Endoscopia por Cápsula , Diagnóstico Diferencial , Humanos , Íleo/diagnóstico por imagem , Masculino , Divertículo Ileal/diagnóstico , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X
3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 15(6): 594-8, 2012 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-22736130

RESUMO

OBJECTIVE: To evaluate the efficacy and clinical significance of 64-multislice spiral computed tomography angiography(MSCTA) with image fusion for the anatomy of perigastric arteries. METHODS: A total of 53 patients underwent abdominal 64-MSCTA, among whom 26 patients with gastric cancer underwent gastrectomy. Using volume rendering techniques, computed tomography angiography(CTA) of perigastric arteries and the stomach were reconstructed respectively, and then the images were fused together. The branching pattern of the celiac trunk and the origins and courses along the stomach of the 10 perigastric arteries were assessed. The accuracy, sensitivity, and specificity of 64-MSCTA were determined based on intraoperative findings. RESULTS: CTA clearly showed the celiac trunk. The most common branching pattern of the celiac trunk was Michels type I( in 46 patients(86.8%). The anatomy of perigastric arteries and stomach could be clearly demonstrated from any angle according to image fusion. The left gastric artery and the right gastroepiploic artery were shown in 100%, the left gastroepiploic artery 94.3%(50/53), the right gastric artery 83.0%(44/53), short gastric artery 58.5%(31/53), posterior gastric artery 49.1%(26/53), the replaced left hepatic artery 15.1%(8/53). The accessory left hepatic artery, accessory left gastric artery and replaced right hepatic artery were all identified in 7.5%(4/53) patients. The accuracy of preoperative CTA in term of correctly identifying perigastric arteries ranged from 84.6% to 100%, the sensitivity 82.6% to 100%, and the specificity was 100% for all the perigastric arteries. CONCLUSIONS: 64-MSCTA can clearly reveal individual perigastric arteries. The anatomy of the stomach and perigastric arteries can be shown in vivo by fused image, and can provide guidance for gastrectomy.


Assuntos
Angiografia/métodos , Estômago/irrigação sanguínea , Tomografia Computadorizada Espiral , Adulto , Idoso , Artérias , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , Sensibilidade e Especificidade , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Adulto Jovem
4.
Abdom Imaging ; 36(1): 86-90, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20087732

RESUMO

We designed to investigate the feasibility of multi-detector row computerized tomography (CT) as a "one-stop" examination for the simultaneous preoperative evaluation of the morphology and function of living renal donors. 21 living renal donors were examined by 64-slice spiral CT with a three-phase enhancement CT scan and two inserted dynamic scans. The maximum intensity projection (MIP), multi-planar reformation (MPR), and volume reconstruction (VR) procedures were performed to compare the renal parenchyma, renal vessels, and collecting system with operational findings. The known Patlak equation was used to calculate the glomerular filtration rate (GFR); exact GFR information was acquired by single photon emission computed tomography (SPECT). Our results as following, there were 3 cases of artery variation and 3 cases of vein variation. CT findings all corresponded with the operation, and the sensitivity, positive predictive value, specialty, and negative predictive value of CT were all 100%. The r of the GFR values estimated from CT is 0.894 (left) (P < 0.001) and 0.881 (right) (P < 0.001). In conclusions, our findings demonstrate that 64-slice spiral CT may offer a "one-stop" examination to replace SPECT in the preoperative evaluation of living renal donors to simultaneously provide information regarding both anatomy and the GFR of living renal donors.


Assuntos
Transplante de Rim , Rim/diagnóstico por imagem , Doadores Vivos , Cuidados Pré-Operatórios/métodos , Artéria Renal/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Adulto , Idoso , Meios de Contraste , Estudos de Viabilidade , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Intensificação de Imagem Radiográfica/métodos , Sensibilidade e Especificidade , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adulto Jovem
5.
Zhonghua Yi Xue Za Zhi ; 91(38): 2697-701, 2011 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-22321980

RESUMO

OBJECTIVE: To explore the feasibility of multi-slice spiral computed tomography (CT) with a lower dose as one-off examination for the preoperative morphology evaluation and the quantification of unilateral renal glomerular filtration rate of living renal donors. METHODS: A total of 36 living renal donors at our hospital from May 2008 to June 2009 were examined by 64-slice spiral CT and single photon emission computed tomography (SPECT). Living renal donors were examined with a plain scan and three-phase enhancement CT scan. Also there were two inserted dynamic scans, one after the injection of contrast agent and the other between cortex and parenchymal phases. Image reconstructions were performed to observe renal parenchyma, renal vessels and collecting system. Comparisons were made with intra-operative findings. And the known Patlak equation was used simultaneously. The glomerular filtration rate (GFR) in a single kidney was calculated on CT and SPECT respectively. The GFRs of two groups were analyzed to investigate the Pearson correlation and simple linear regression between them. RESULTS: Twenty of 36 renal living donor kidneys underwent the operation, variations of morphology detected by CT were all corresponded with the operation. The GFR values estimated from CT were (42.4 ± 8.9) ml/min (left) and 43.2 ± 8.4) ml/min (right). While GFR of SPECT 47.4 ± 9.3) ml/min (left) and 48.2 ± 8.5) ml/min (right). Linear trend was found between the GFRs of CT and SPECT. Pearson's product-moment correlation coefficient r = 0.753 (left) (P < 0.01), r = 0.709 (right) (P < 0.01). These values indicated that the GFR from CT was positively correlated with the GFR from SPECT. CONCLUSION: During the preoperative evaluation, multi-slice spiral CT may provide both anatomic information and the GFR of living renal donors.


Assuntos
Rim/diagnóstico por imagem , Doadores Vivos , Tomografia Computadorizada Espiral/métodos , Adulto , Idoso , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
6.
Ai Zheng ; 25(3): 348-51, 2006 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-16536992

RESUMO

BACKGROUND & OBJECTIVE: Lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor are the most common solitary pulmonary nodules (SPN). Computed tomography (CT) is the major diagnostic examination of them. Most recent reports focused on their morphologic features on CT. The differential diagnoses are still difficult. This study was to explore their imaging features on helical incremental dynamic CT scan according to the differences of their hematal supply, and get more information for the diagnosis and differential diagnosis. METHODS: Incremental dynamic CT scan was performed on 115 cases of solitary pulmonary nodule. Of the 44 cases proved by postoperative pathology, 30 were lung carcinoma, 7 were pulmonary tuberculoma, and 7 were inflammatory pesudotumor. RESULTS: Of the 30 cases of lung carcinoma, 7 were mildly enhanced, 14 were moderately enhanced, 5 were highly enhanced, 2 were remarkably enhanced, and 7 were not enhanced; 9 had peak enhancement began at 18-28 s after injection, 17 began at 30-39 s, and 4 began at 40-44 s, with an average time of 32 s. Of the 7 cases of tuberculoma, 5 were not enhanced, and 2 were cricoid enhanced. All the 7 cases of inflammatory pesudotumor were remarkably enhanced, with the peak enhancement value of over 100 Hu in all cases; the peak enhancements began at 26 s, 28 s, 30 s, 32 s, 33 s, 110 s, and 122 s, respectively, after injection. CONCLUSION: Helical incremental dynamic CT is helpful in differential diagnoses of lung carcinoma, pulmonary tuberculoma, and inflammatory pesudotumor.


Assuntos
Granuloma de Células Plasmáticas/radioterapia , Neoplasias Pulmonares/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Tuberculoma/radioterapia , Tuberculose Pulmonar/diagnóstico por imagem , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intensificação de Imagem Radiográfica
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