RESUMO
Little is known about late changes in large arteries after radiotherapy. Much more is known about damage to other organs and tissues. The arterial changes resemble chronic, progressive atherosclerosis which may be due to a combination of periarterial fibrosis, direct damage to the arterial wall, occlusion of vasa vasorum and acceleration of naturally occurring atherosclerosis. Factors that may predispose to arterial occlusion that relate to radiotherapy include maximum tissue dose, beam energy and field size. The authors present four patients with axillary artery occlusion that occurred 10 to 27 years after mastectomy and irradiation. The axillary artery is seldom affected by segmental atherosclerotic occlusive disease. Hence, the cause of the occlusion was most likely the irradiation. All patients did well after bypass grafting.
Assuntos
Arteriopatias Oclusivas/etiologia , Artéria Axilar , Neoplasias da Mama/radioterapia , Radioterapia/efeitos adversos , Idoso , Arteriosclerose/etiologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Pessoa de Meia-Idade , Lesões por Radiação , Fatores de TempoRESUMO
Computed tomography can help in the evaluation of congenitally anomalous aortic arches and subclavian arteries. The authors discuss the role of computed tomography in the evaluation of such anomalies in seven patients.
Assuntos
Aorta Torácica/anormalidades , Artéria Subclávia/anormalidades , Adulto , Idoso , Aorta Torácica/diagnóstico por imagem , Aneurisma Aórtico/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Subclávia/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The findings at computed tomography (CT) of the adrenal glands in 58 patients are presented. Most patients (50) were referred for suspected adrenal dysfunction. In three, adrenal masses were suspected from other radiological studies. Three patients had palpable abdominal masses, and incidental adrenal metastases were found in two. Pathological findings included pheochromocytomas (nine patients), adrenocortical adenomas (six), adrenocortical carcinomas (three), metastases (two), and one example each of myelolipoma, hemorrhagic renal cyst, and probable granuloma. Of 24 adrenal masses, 23 were clearly apparent in the scans and one was suspected. The smallest tumor diagnosed was 0.5 cm in diameter. There was on false positive diagnosis of a small tumor and no known false negatives. Because of their consistent location and unusual shape and because they are usually surrounded by retroperitoneal fat, the adrenal glands are ideal organs for study by CT, a highly accurate method for detecting and excluding mass lesions that may render arteriography and venography unnecessary. Surgery was performed in five patients with tumors following localization by CT only. Limitations and potential diagnostic pitfalls in interpretation are discussed.
