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1.
Gouliamos AD Metafa A Ispanopoulou SG Stamatelopoulou F Vlahos LJ Papadimitriou JD 《European radiology》2000,10(4):583-585
We present the findings and possible causes in three cases of postoperative adrenal hematomas. In 16 cases of 45 consecutive
patients, following segmental right or left lobe hepatectomy, CT was performed in order to evaluate possible fluid collection
or other complications. In all cases imaging findings and a correlation with preoperative CT scans were done. Follow-up CT
examinations were also reviewed. In three cases solid suprarenal masses with attenuation values consistent with adrenal hematomas
were found. Preoperative scans at the same level indicated normal adrenal glands. Follow-up scans revealed the hematoma, stable
in size, for up to 12 weeks, although lower attenuation values were evident. Right adrenal hematoma is a possible postoperative
complication following hepatectomy; if it remains stable in size, it can be left alone.
Received: 29 December 1998; Revised: 25 March 1999; Accepted: 18 May 1999 相似文献
2.
Gallstone ileus: CT findings 总被引:6,自引:0,他引:6
Gallstone ileus is a rare complication of recurrent gallstone cholecystitis. The classic radiographic triad of small bowel
obstruction, pneumobilia and ectopic gallstone on abdominal plain radiograph is described with CT imaging. Because of the
better resolution of CT compared with abdominal radiography and its recent accession to emergency use, radiologists should
be aware of CT findings of gallstone ileus. We report a case in which gallstone ileus was initially diagnosed by CT.
Received: 30 July 1999; Revised: 18 October 1999; Accepted: 18 October 1999 相似文献
3.
Maleux G van Steenbergen W Stockx L Vanbeckevoort D Wilms G Marchal G 《European radiology》2000,10(7):1127-1129
We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis.
Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior
mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by
transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any
recurrent bleeding.
Received: 18 June 1999; Revised: 13 October 1999; Accepted: 15 October 1999 相似文献
4.
Purpose: To examine treatment decisions in multiple trauma patients and determine how often these decisions are based on abdominal
ultrasonography (US) findings, and how frequently these decisions are altered by subsequent computed tomographic (CT) imaging.
Methods: From August 1996 to July 1997 we prospectively performed abdominal US followed by abdominal CT in all hemodynamically stable
multiple trauma victims who did not need immediate surgery. We recorded the results from both modalities, as well as the treatment
decisions based on these results. We also noted how frequently therapy based on US results was altered by the subsequent CT
findings. Results: Treatment decisions were influenced by either US or CT in 27 of 105 patients (25.7 %). US was interpreted as normal in 76
patients (72.4 %), including 5 (6.6 %) who were subsequently found to have therapeutically significant findings on CT. US
was interpreted as abnormal in 29 (27.6 %) patients, 12 of whom (41.4 %) had their management altered by subsequent CT results.
Conclusions: Abdominal CT findings prompt changes in therapy in only a small number of stable multiple trauma patients who exhibit normal
abdominal US. On the other hand, CT may have an impact on acute therapy in a large number of patients who exhibit abnormal
US. Our results demonstrate that a diagnostic approach in hemodynamically stable patients is possible with US serving as a
decision maker to determine whether further CT imaging is needed. 相似文献
5.
Thanos L Papaioannou G Grammenou-Pomoni M Malagari K Brountzos EN Kelekis D 《European radiology》2000,10(1):105-107
A case of ruptured adrenal artery aneurysm is presented. The ultrasound, computed tomography and selective renal angiography
findings are described in detail. Aneurysms of adrenal arteries are particularly rare. Early diagnosis is important because
of their tendency towards rupture and subsequent high mortality rate.
Received: 12 November 1998; Revised: 10 March 1999; Accepted: 13 April 1999 相似文献
6.
Thoracoabdominal peripheral primitive neuroectodermal tumors in childhood: radiological features 总被引:1,自引:0,他引:1
Schulman H Newman-Heinman N Kurtzbart E Maor E Zirkin H Laufer L 《European radiology》2000,10(10):1649-1652
Peripheral primitive neuroectodermal tumors (PNET) are extremely uncommon, malignant neoplasms affecting mostly children
and young adults. We retrospectively reviewed the clinical data and radiological studies of four such cases. All cases were
pathologically proven. Plain films, US, and CT scans were used. The youngest child had a huge pelvic tumor and two adolescents
each had a chest wall (Askin) tumor. The fourth patient had a most unusual location of the PNET in the anterior mediastinum.
The CT findings are emphasized. We emphasize that the markedly abnormal CT findings are not specific for PNET.
Received: 13 February 1999; Revised: 2 July 1999; Accepted: 9 February 2000 相似文献
7.
Evaluation of CT findings for diagnosis of pleural effusions 总被引:2,自引:0,他引:2
Arenas-Jiménez J Alonso-Charterina S Sánchez-Payá J Fernández-Latorre F Gil-Sánchez S Lloret-Llorens M 《European radiology》2000,10(4):681-690
Computed tomography studies are usually used to assess patients with pleural effusions, and radiologists should be aware
of the significance of different CT findings for the diagnosis of the effusion. The purpose of this study was to evaluate
CT findings for etiological diagnosis of pleural effusions. Contrast-enhanced CT of the chest of 211 patients with pleural
effusion of definite diagnosis were evaluated. The CT images were evaluated for the presence and extent of pleural effusion,
thickening or nodules, extrapleural fat and other changes in the mediastinum or lung. The CT scans were read by two independent
observers and correlation between them was evaluated. Comparison of CT findings between benign and malignant effusions, between
exudates and transudates, and between empyemas and the other parapneumonic effusions were carried out. Kappa values for most
CT findings were > 0.85. Loculation, pleural thickening, pleural nodules, and extrapleural fat of increased density were only
present in exudative effusions. Multiple pleural nodules and nodular pleural thickening were the only pleural findings limited
to malignant pleural effusions. The signs were also more frequently seen in empyemas than in other parapneumonic effusions.
Computed tomography findings can help to distinguish between transudates and exudates. Although there is some overlap between
benign and malignant pleural effusions, pleural nodules and nodular pleural thickening were present almost exclusively in
the latter. Although differences between CT findings of empyemas and the other parapneumonic effusions exist, there is no
finding which can definitely differentiate between them.
Received: 27 January 1999; Revised: 24 June 1999; Accepted: 24 August 1999 相似文献
8.
Purpose: In blunt trauma, CT of the thorax is often performed because of the limitations of plain film chest radiography in accurately
depicting injuries to the thoracic aorta. The advent of helical CT has allowed the entire chest to be imaged more expeditiously.
We will evaluate the extent to which this ability to rapidly obtain additional images of the thorax has increased the utilization
of chest CT in blunt trauma. Methods: The radiologic records of all victims of blunt trauma who underwent total body CT (TBCT), which included abdomen, pelvis,
and chest images, in the 10 months before and 10 months after our institution acquired helical CT (HCT), were retrospectively
evaluated. Results: In the 10 months before we obtained HCT, 520 conventional CT of the abdomen and pelvis were completed, of which only 11 (2.1
%) included images of the full thorax. After HCT was instituted, 684 abdomen and pelvis CT were performed, of which 59 (8.6
%) were ordered with the entire chest. Of the 11 conventional TBCT, 6 (55 %) showed findings in the chest; in 2 of these cases
(18 %) the abnormalities were confined exclusively to the thorax. Similarly, of the 59 helical TBCT, 31 (53 %) depicted traumatic
abnormalities in the thorax, and in 23 of these cases (39 %) injuries were only within the chest. In 4 of the latter the injuries
were mediastinal hematomas, 1 of which (25 %) was confirmed angiographically to represent an aortic laceration. Conclusion: The speed and ease with which additional images can be obtained by HCT has greatly increased utilization of cross-sectional
imaging of the thorax after blunt trauma (approximately four-fold). Over half of these depict traumatic injuries. 相似文献
9.
Okamoto K Ito J Takahashi H Emura I Mori H Furusawa T Sakai K Higuchi T Tokiguchi S 《European radiology》2000,10(1):170-174
We present a case of solitary infantile myofibromatosis of the skull in a 3-month-old boy. A right parietal subcutaneous
lump was found at birth, and it increased in size over the ensuing 3 months. Surgery was performed, and a diagnosis of myofibromatosis
was confirmed histopathologically. Solitary myofibromatosis of the skull is extremely rare. The radiographical, CT, and MR
appearances, as well as histopathological findings, are described in this article.
Received: 30 December 1998; Revised: 21 April 1999; Accepted: 11 May 1999 相似文献
10.
The aim of this study was to assess radiomorphologic and clinical features of tracheal rupture due to blunt chest trauma.
From 1992 until 1998 the radiomorphologic and clinical key findings of all consecutive tracheal ruptures were retrospectively
analyzed. The study included ten patients (7 men and 3 women; mean age 35 years); all had pneumothoraces which were persistent
despite suction drainage. Seven patients developed a pneumomediastinum as well as a subcutaneous emphysema on conventional
chest X-rays. In five patients, one major hint leading to the diagnosis was a cervical emphysema, discovered on the lateral
cervical spine view. Contrast-media-enhanced thoracic CT was obtained in all ten cases and showed additional injuries (atelectasis
n = 5; lung contusion n = 4; lung laceration n = 2; hematothorax n = 2 and hematomediastinum n = 4). The definite diagnosis of tracheal rupture was made by bronchoscopy, which was obtained in all patients. Tracheal rupture
due to blunt chest trauma occurs rarely. Key findings were all provided by conventional chest X-ray. Tracheal rupture is suspected
in front of a pneumothorax, a pneumomediastinum, or a subcutaneous emphysema on lateral cervical spine and chest films. Routine
thoracic CT could also demonstrate these findings but could not confirm the definite diagnosis of an tracheal rupture except
in one case; in the other 9 cases this was done by bronchoscopy. Thus, bronchoscopy should be mandatory in all suspicious
cases of tracheal rupture and remains the gold standard.
Received: 22 February 1999; Revision received: 29 June 1999; Accepted: 1 July 1999 相似文献
11.
We present a case of concurrence of ectopic adrenal cortex with a renal cell carcinoma. The diagnosis of the accessory adrenal
tissue was made by CT-guided biopsy. With this case report, we draw attention to a specific differential diagnostic problem,
policy and to the MR characteristics of ectopic adrenal cortex.
Received: 10 August 1999; Revised: 21 October 1999; Accepted: 27 October 1999 相似文献
12.
Purpose: To compare the accuracy of spine plain films with chest and abdominal trauma CT in detection of spine fractures. Methods: The study prospectively enrolled 329 multiple trauma patients. Of these, 38 patients had both chest CT for trauma and thoracic
spine plain films, and 87 patients had both abdominal CT for trauma and lumbar spine plain films. Results: Of the fractures visible at either chest trauma CT or thoracic spine plain film examination, all were diagnosed on CT and
62 % on plain films. Of fractures visible at either abdominal trauma CT or lumbar spine plain films, 94 % were diagnosed on
CT and 67 % on plain films. The one false negative CT involved an articular process fracture, which was visible but not mentioned,
in a patient with a sacral fracture. Conclusion: Evaluation of the digital scout images and bone windows when a patient has chest and abdominal trauma CT appears to be as
accurate as thoracic and lumbar spine plain films in the evaluation of spinal trauma. 相似文献
13.
Osteogenesis imperfecta (OI) is an inherited generalized disorder of type-I collagen synthesis often associated with hearing
loss. We present a case of OI type I in which hearing loss led to examination of the temporal bone with MRI. In the osseous
otic capsule MRI demonstrated pericochlear lesions with soft tissue signal intensity and contrast enhancement. Changes similar
to otosclerosis have been described in the temporal bone of OI patients when applying CT, but reports on MRI findings do not
yet exist.
Received: 6 August 1999; Revised: 28 December 1999; Accepted: 15 February 2000 相似文献
14.
The crowned dens syndrome has been termed as acute neck pain ascribed to CPPD deposits associated with a tomographic appearance
of calcification surrounding the odontoid process. This rare entity resulting in cervical cord compression is generally seen
in older female patients. We present a 26-year-old woman with cervical cord compression due to massive calcification in the
periodontoid area and discuss the X-ray and CT findings of the disease.
Received: 8 July 1999; Revised: 24 September 1999; Accepted: 12 November 1999 相似文献
15.
Thomeer M Vanbeckevoort D Van Breuseghem I Petré C De Vuysere S Coenegrachts K Miserez M 《European radiology》2000,10(4):674-676
This article presents a case of appendicitis 7 years after open appendectomy. Together with the apparent CT findings we discuss
the current literature of this issue.
Received: 21 April 1999; Revised: 11 August 1999; Accepted: 13 August 1999 相似文献
16.
Objective: The study objective was to determine the sensitivity and specificity of a helical CT technique to screen for cervical spine
injury in a high-risk trauma population. Materials and methods: The helical CT reports for a consecutive series of 601 high-risk adult blunt trauma victims were reviewed. Findings were
confirmed using an independent reference standard, which consisted of additional cervical spine imaging (CT, MRI, or radiography),
operative findings, autopsy results or clinical outcome. Results: Sensitivity and specificity of helical CT for injury were 77/81 (95 %; 95 % confidence limits: 90–100 %) and 484/520 (93
%; 95 % confidence limits 91–95 %) respectively. Four false negative cases were comprised of three missed ligamentous injuries
and one missed fracture. False positive cases (n = 36) were mostly attributed to possible facet fracture (n = 6), possible ligamentous injury (n = 8) or technically inadequate scan (n = 6).The overall accuracy of the helical CT protocol for cervical spine injury in this population was 561/601 (93 %; 95 %
confidence limits 91–95 %). Conclusion: Helical CT has high accuracy for cervical spine injury. We believe that helical CT should be the preferred imaging strategy
in high-risk blunt trauma patients. 相似文献
17.
The aims of this article are to describe the findings of perividian tumor spread and to compare the accuracy of MRI and CT
in diagnosing perineural metastasis along the vidian nerve. Moreover, the frequency of perividian metastasis in patients with
head and neck cancer was evaluated. The CT and MR examinations of 98 consecutive untreated patients with histologically proven
head and neck cancer were retrospectively reviewed. We considered as criteria for perineural tumor spread along the vidian
nerve the following CT and MR findings: For CT (a) enlargement of the pterygoid canal, (b) erosion of its bony wall, and (c)
obliteration of its normal fatty content; and for MR (a) enlargement of the vidian nerve, (b) enhancement of the nerve, and
(c) obliteration of fat, particularly in the anterior part of the pterygoid canal. Ten patients met the selected criteria
for perineural metastasis, which was bilateral in 3 patients, with a total of 13 vidian metastases. The CT scans demonstrated
unilateral involvement of the vidian nerve in 9 patients. The MRI scans showed 13 perineural metastases. In 3 patients MR
scans demonstrated involvement of four vidian nerves that appeared normal on CT examinations. The diagnostic difference between
CT and MRI was statistically significant (Fisher's exact test; p = 0.04). Perineural spread along the vidian nerve is an event more frequent than previously reported and must be investigated
with a careful imaging technique. Although a major limitation of our study is the lack of histological proof, the MR finding
of a significant enhancement of the nerve, whether enlarged or normal in size, could be considered very suggestive of this
kind of metastatic spreading, particularly if associated with simultaneous involvement of the neighboring structures (pterygopalatine
fossa, foramen lacerum, trigeminal branches, etc.).
Received: 5 January 1999; Revision received 11 May 1999; Accepted: 17 June 1999 相似文献
18.
Omental infarction associated with right-sided heart failure 总被引:2,自引:0,他引:2
A 31-year-old man with a known congenital heart disease presented with cardial decompensation and an acute abdomen with tenderness
in the right inferior abdominal quadrant. Because infectious parameters were slightly elevated, acute appendicitis was suspected.
A CT scan showed an isolated focal infiltration of the omentum, superficial to the ascending colon, small amounts of ascites,
and dilated hepatic and mesenteric veins. Laparoscopic resection and histopathologic examination confirmed hemorrhagic omental
infarction due to thromboses of several small omental veins. This is a report on the pathogenesis, differential diagnoses,
and CT findings of omental infarction.
Received: 14 July 1999; Revised: 12 October 1999; Accepted: 4 November 1999 相似文献
19.
Demeyere A De Somer F Perdieus D Van Den Hauwe L Lemmens L Schillebeeckx J 《European radiology》2000,10(2):308-309
The CT and MRI findings in a case of chondrosarcoma of the hyoid bone are reported. Although chondrosarcoma is the second
most common primary malignant bone tumor, only 10 % of chondrosarcomas occur in the head and neck region. The hyoid bone is
a rare site of involvement with only seven cases reported previously.
Received: 19 February 1999; Revised: 19 April 1999; Accepted: 11 May 1999 相似文献
20.
Weishaupt D Hetzer FH Ruehm SG Patak MA Schmidt M Debatin JF 《European radiology》2000,10(12):1958-1964
The aim of this study was to compare the performance of 3D MRI in conjunction with an intravascular contrast agent to spiral
contrast-enhanced CT, regarding the detection of abdominal parenchymal injuries as well as peritoneal hemorrhage in an animal
model. Liver and kidney injuries were created surgically in six female pigs under general anesthesia. All pigs underwent contrast-enhanced
spiral CT and 3D MR imaging following administration of an intravascular contrast agent (NC100150 Injection). Two readers
rated their confidence independently on MR and CT data sets using a five-point scale for the presence of organ injury and
hemoperitoneum. Autopsy findings served as standard of reference. Sensitivity and specificity for MR in detecting hepatic
and renal injuries as well as hemoperitoneum was 100 %. Computed tomography was less accurate with sensitivity and specificity
values of 90 and 94 %, respectively. Receiver operating characteristics (ROC) analysis revealed a higher confidence when interpretation
was based on MR images. In an animal model 3D MR imaging in conjunction with an intravascular contrast agent proved highly
accurate in detecting and localizing parenchymal injuries to the upper abdomen as well as in detecting intraperitoneal blood
collections.
Received: 4 November 1999, Revised: 5 May 2000, Accepted: 9 May 2000 相似文献