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Mirko D’Onofrio Riccardo De Robertis Emanuele Demozzi Stefano Crosara Stefano Canestrini Roberto Pozzi Mucelli 《World journal of radiology》2014,6(4):62-71
The amount of the future liver remnant volume is fundamental for hepato-biliary surgery, representing an important potential risk-factor for the development of post-hepatectomy liver failure. Despite this, there is no uniform consensus about the amount of hepatic parenchyma that can be safely resected, nor about the modality that should be chosen for this evaluation. The pre-operative evaluation of hepatic volume, along with a precise identification of vascular and biliar anatomy and variants, are therefore necessary to reduce surgical complications, especially for extensive resections. Some studies have tried to validate imaging methods [ultrasound, computed tomography (CT), magnetic resonance imaging] for the assessment of liver volume, but there is no clear evidence about the most accurate method for this evaluation. Furthermore, this volumetric evaluation seems to have a certain degree of error, tending to overestimate the actual hepatic volume, therefore some conversion factors, which should give a more reliable evaluation of liver volume, have been proposed. It is widespread among non-radiologists the use of independent software for an off-site volumetric analysis, performed on digital imaging and communications in medicine images with their own personal computer, but very few studies have provided a validation of these methods. Moreover, while the pre-transplantation volumetric assessment is fundamental, it remains unclear whether it should be routinely performed in all patients undergoing liver resection. In this editorial the role of imaging in the estimation of liver volume is discussed, providing a review of the most recent literature and a brief personal series of correlations between liver volumes and resection specimens’ weight, in order to assess the precision of the volumetric CT evaluation. 相似文献
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The endovascular treatment of wide-necked aneurysms remains challenging. The “Y”-stenting technique has been used for stent-assisted
coil embolization of wide-necked bifurcation aneurysms. So far, this technique has been described for aneurysms of the basilar
apex or the middle cerebral artery bifurcation and only for open stent systems using the Neuroform stent. We report a 52-year-old
woman with recurrence of a wide-necked aneurysm of the anterior cerebral artery that was successfully retreated by stent-assisted
coiling using the “Y”-stenting technique with the Enterprise stent system. 相似文献
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Horseshoe lung (HL) is a rare congenital anomaly that has been classically associated with Scimitar syndrome. Very few cases have been described in the context of the VACTERL spectrum. We present a case of a newborn girl with mesocardia, tracheoesophageal fistula, and imperforated anus, who required O2 support at birth and during hospitalization. A chest CT angiography revealed a HL as an incidental finding. We suspect that HL and the VACTERL spectrum, are not separated entities but likely a further expansion of VACTERL-associated symptoms. HL might be underdiagnosed in asymptomatic patients as Chest CT angiography is not part of the routine work up for patients with VACTERL association. 相似文献
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Is selective embolization of uterine arteries a safe alternative to hysterectomy in patients with postpartum hemorrhage? 总被引:9,自引:0,他引:9
J F Deux M Bazot A F Le Blanche M Tassart A Khalil N Berkane S Uzan F Boudghène 《AJR. American journal of roentgenology》2001,177(1):145-149
OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of selective arterial embolization to control severe postpartum hemorrhage. MATERIALS AND METHODS: Twenty-five women with intractable postpartum hemorrhage underwent uterine embolization in our institution during a 6-year period. RESULTS: Angiography revealed arterial extravasation in 13 patients (52%). Sixty-nine arteries were embolized. External bleeding resolved immediately or was markedly decreased in 24 women. In one patient, embolization failed to control the bleeding, and surgical treatment was required. No major complication of embolization therapy was observed. Ten women were followed up for an average of 2 years. Menstruation resumed in all patients, and one woman became pregnant. CONCLUSION: Embolization of acute postpartum hemorrhage is a safe and effective alternative to hysterectomy. 相似文献
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《Radiography》2022,28(4):991-998
ObjectivesThe sonographer workforce in the UK is under pressure due to chronic staff shortages and increased service demands. The Health and Care Professions Council and the Society of Radiographers both advocate for the use of professional supervision to support wellbeing and development, however the use of professional supervision is not widespread within the sonographer workforce. The aim of this literature review was to explore the evidence around the use of professional supervision and how this could support sonographer wellbeing.Key findingsProfessional supervision was found to be of importance for providing emotional support which can lead to increased job satisfaction, lower levels of burnout and subsequently impact on retention of the workforce. Professional supervision supported personal development and therefore increased quality of patient care, allowing professionals to discuss evidence-based care, policies and practice development through reflection.Whilst important for emotional and professional support, this review found that there are conflicting pressures which can impact the effectiveness of supervision including the supervisory relationship itself and time and organisational pressures. Demands on the workforce made a significant impact on the availability of quality clinical supervision.ConclusionProfessional supervision has an important role in supporting the sonography workforce and enable increased wellbeing and emotional support. There are clear benefits to undertaking professional supervision to support the workforce however there are competing demands which may affect the effectiveness of professional supervision.Implications for practiceThere is limited international research on the use of professional supervision in the radiographer and sonographer workforce. There are clear benefits for supporting professional wellbeing and development under a structured professional supervision framework however within the United Kingdom there is a significant gap in the literature where further research is required. 相似文献
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Emanuela Capalbo Michela Peli Maria Lovisatti Maria Cosentino Paola Mariani Eisabetta Berti Maurizio Cariati 《La Radiologia medica》2014,119(8):572-594
Purpose
This study was performed to determine the type and incidence of complications of fine-needle aspiration biopsy (FNAB) and core biopsy (CNB) performed under computed tomography (CT) guidance to characterise lung lesions, and assess the diagnostic accuracy of the two techniques.Materials and methods
In 2009–2011, we performed 124 lung biopsies (66 CNB and 56 FNAB) on 121 patients with a mean age of 72.4 years. Exclusion criteria were pulmonary resection, pleural lesions and/or effusions, and inadequate blood-coagulation profile. All examinations were acquired after contrast-agent administration in a craniocaudal direction from the lung apex to base during a single inspiratory breath-hold, with standardised parameters. Each lesion was scanned with 13–15 slices that could be repeated whenever necessary to document the needle track and for lesion centring, by positioning a metallic marker perpendicular to the centring light to indicate the point of needle access. Unless otherwise clinically indicated, 4 h after the procedure chest radiography was performed.Results
Age was found to be a factor influencing the complications: pneumothorax in young subjects (31 %) and parenchymal haemorrhage in the elderly (30 %), with CNB but not with FNAB. We had more complications with the right lung: 50 % of pneumothorax cases in the upper lobe with CNB and 40 % of cases of haemorrhage in the lower lobe with FNAB. The anterior approach gave rise to more complications with CNB, while the posterior approach with FNAB. CNB had more complications than FNAB for lesions ≤3.5 cm (31 vs. 18 % pneumothorax), and >3.5 cm (34 vs. 9 % haemorrhage). There was no significant correlation with lesion histology, needle calibre or number of passes (probably due to the small number of procedures done with needles other than 18 G in CNB or 22 G in FNAB or involving more than one needle pass). The diagnostic accuracy of FNAB, done with a pathologist’s extemporaneous assessment of sample adequacy, was 94.83 % against 81.82. % of CNB.Conclusions
FNAB under CT guidance is subject to a lower rate of complications and, if performed in the presence of the pathologist, has a greater diagnostic accuracy compared to CNB. 相似文献10.
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OBJECTIVE: Detailed CT scans are often acquired during the radiotherapy planning process. This study was performed to determine the incidence of important benign and cancer-related CT findings on these scans. SUBJECTS AND METHODS: From December 1998 to December 2000, 162 radiotherapy patients who were to be treated curatively underwent treatment planning CT scans on a helical scanner in the radiology department at Washington Hospital, Fremont, CA. All CT scans were prospectively interpreted relative to diagnoses, and reports were dictated for the medical records. The diagnostic reports and records on all patients were reviewed to determine the incidence of previously unknown benign or cancer-related findings, the impacts of such findings on treatment, and the need for additional radiologic studies or procedures on the basis of the CT interpretations. RESULTS: Incidental benign findings were noted for 32 patients (20%). Potentially important benign findings were noted for three patients: two with aneurysms and one with a possible deep vein thrombosis. Potentially cancer-related findings were reported in 20 patients: a single liver lesion (four patients), multiple liver lesions (two patients), possible or probable lymphadenopathy (11 patients), abnormal soft tissue (one patient), a small-bowel obstruction (one patient), and a breast mass (one patient). After reviewing prior diagnostic studies and obtaining additional recommended studies, the physicians found that only three of the previously unknown findings required further investigation: two aneurysms, which did not require near-term treatment, and one metastatic neck node. CONCLUSION: Routine diagnostic interpretation of radiotherapy planning scans resulted in few important medical findings and changed patient care for less than 1% of the patients. 相似文献
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Do acute lesions of Wernicke's encephalopathy show contrast enhancement? Report of three cases and review of the literature 总被引:5,自引:1,他引:4
M. Mascalchi P. Simonelli C. Tessa F. Giangaspero P. Petruzzi L. Bosincu M. Conti G. Sechi F. Salvi 《Neuroradiology》1999,41(4):249-254
Contrast medium was given intravenously to three nonalcoholic patients who underwent MRI or CT in the acute stage of Wernicke's
encephalopathy. Pathological enhancement was not seen in one patient examined within 4 days of clinical onset, was mild in
a another 3 days after clinical deterioration and marked in a patient examined 12 days after admission. Contrast enhancement
of lesions was present in half of 12 cases of acute disease reported previously. There was a substantial overlap in the time
interval between clinical onset and contrast-enhanced CT or MRI in the groups of enhancing and nonenhancing lesions. Since
contrast enhancement may be absent in acute WE, proton-density and T 2-weighted images are more useful for diagnosis of this
reversible but potentially fatal condition.
Received: 18 December 1997 Accepted: 15 July 1998 相似文献
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Anton R. Winterstein Klaus Bohndorf Kurt Vollert Theodor Wagner Astrid Gnekow Frank W. Roemer 《Skeletal radiology》2010,39(8):827-831
Immunocompromised patients are at high risk of secondary infection associated with high morbidity. In children these complications include fungal osteomyelitis due to continuous infiltration or hematogenous spread. The case of a 4-year-old boy is presented who developed lumbalgia and thigh pain during ongoing chemotherapy for acute lymphatic leukemia. MRI revealed infarct-like lesions in the femur and L5 vertebra, which were biopsied. The histologic diagnosis was consistent with angioinvasive aspergillosis. A multifocal osseous presentation has rarely been described in children and an overview of the literature is presented. Invasive aspergillosis is a rare complication to be considered in children with MRI-detected bony lesions of infarct-like appearance. 相似文献
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Cantasdemir M Kantarci F Mihmanli I Akman C Numan F Islak C Bozkurt AK 《Cardiovascular and interventional radiology》2002,25(6):533-537
his report describes two patients with a known history of Beh?et's disease in whom massive hemoptysis developed from rupture of pulmonary artery aneurysms. The high recurrence rate of complications related to pulmonary artery aneurysms and even the aneurysms themselves due to inadequacy of medical therapy and the disadvantages of surgical treatment make these aneurysms candidates for endovascular management. The pulmonary artery aneurysms reported here were successfully treated with endovascular embolization using n-butyl cyanoacrylate. Pulmonary artery aneurysm embolization in Beh?et's disease has been reviewed in the light of relevant literature. 相似文献
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The median arcuate ligament is a tendinous arch joining the two medial borders of the diaphragm crura together. In 13-50% of asymptomatic subjects it is responsible for significant angiographic celiac trunk compression. The significance of median arcuate ligament-associated celiac artery compression has been a source of some controversy in the past literature, and the etiology remains unclear. We report here a case series from a family that was diagnosed by the use of multidetector computed tomography. The observation of this syndrome in a family suggests that the responsible anatomic relationships are congenital and may be genetically inherited. 相似文献
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INTRODUCTION: The use of vascular plug devices for the occlusion of high-flow lesions is a relatively new and successful procedure in peripheral and cardiopulmonary interventions. We report on the use and efficiency of the Amplatzer vascular plug in a small clinical series and discuss its potential for occlusion of large vessels and high-flow lesions in neurointerventions. METHODS: Between 2005 and 2007 four patients (mean age 38.5 years, range 16-62 years) were treated with the device, in three patients to achieve parent artery occlusion of the internal carotid artery, in one patient to occlude a high-flow arteriovenous fistula of the neck. The application, time to occlusion, and angiographic and clinical results and the follow-up were evaluated. RESULTS: Navigation, positioning and detachment of the device were satisfactory in all cases. No flow-related migration of the plug was seen. The cessation of flow was delayed by a mean of 10.5 min after deployment of the first device. In the procedures involving vessel sacrifice, two devices had to be deployed to achieve total occlusion. No patient experienced new neurological deficits; the 3-month follow-up revealed stable results. CONCLUSION: The Amplatzer vascular plug can be adapted for the treatment of high-flow lesions and parent artery occlusions in the head and neck. In this small series the use of the devices was uncomplicated and safe. The rigid and large delivery device and the delayed cessation of flow currently limit the device's use in neurointerventions. 相似文献
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