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81.
《Obstetrics, Gynaecology and Reproductive Medicine》2020,30(12):363-370
Radiology plays an essential role in the management of benign gynaecological conditions and includes: ultrasound; computed tomography and magnetic resonance imaging. Each modality has a different role in diagnosis, treatment selection and follow-up. This review discusses the different imaging modalities, their recommended roles in the imaging and imaging findings of common female pelvic pathology. 相似文献
82.
Enterogenous cysts are rare benign congenital tumours of the central nervous system. The aim of management is complete resection to minimise the chance of recurrence. To date, management of recurrence has favoured further surgical resection. We describe the case of a recurrent enterogenous cyst of the cervical spine, initially treated with decompression via laminectomy and fenestration. Magnetic Resonance Imaging (MRI) follow up has demonstrated spontaneous recurrence and deflation of the cyst on multiple occasions. We propose that conservative management of recurrent enterogenous cysts may be a valid management option following fenestration or partial resection of the cyst, and that recurrence may not always warrant further surgical intervention. 相似文献
83.
《Neurocirugía (Asturias, Spain)》2020,31(4):165-172
IntroductionNeuroendoscopy has become an effective and safe treatment for arachnoid cysts in the paediatric population. We review the paediatric patients with arachnoid cysts treated by neuroendoscopy in our hospital and analyse the results.Material and methodsA retrospective analysis of 20 patients operated on from 2005 to 2018. The variables assessed are: gender, age, clinical presentation, cyst site, presence of hydrocephalus and/or extra-axial collections, endoscopic procedures and complications. Procedure success is defined as an improvement in symptoms and reduction in cyst size until end of follow-up.ResultsOur series comprised 13 males and 7 females (mean age: 64.6 months, range: 4–172 months). The most frequent site was suprasellar-prepontine (7), followed by intraventricular (6), quadrigeminal (3), interhemispheric (2) and Sylvian (2).A total of 70% (14/20) of patients had hydrocephalus at diagnosis, which increased to 85% in suprasellar-prepontine cysts and 100% in quadrigeminal cysts. Only 4/14 patients with required a ventriculoperitoneal shunt (median age at diagnosis: 12.5 months). Of these 4 patients, 3 developed severe shunt overdrainage.The procedure was successful in 60% (12/20) of the patients in the series. Success by location was 57% (4/7) in suprasellar cysts, 33% (1/3) in quadrigeminal cysts, 66% (4/6) in intraventricular cysts, 100% (2/2) in interhemispheric cysts and 50% (1/2) in Sylvian cysts. Treatment thus failed in 8 cases, with a mean time to failure of 12.12 months (range: 0-45 months). A new neuroendoscopic procedure was performed in 4 of these 8 cases (success in 2/4), a ventriculoperitoneal shunt was placed in 2 cases, a cystoperitoneal shunt was placed in 1 case and the remaining case was managed conservatively. Mean follow-up time was 52.45 months (range: 3-129 months).ConclusionsNeuroendoscopy is an effective and safe treatment for arachnoid cysts in paediatric patients that also enables managing associated hydrocephalus in most cases. The choice of neuroendoscopic procedure and success rate depend on cyst location. Younger patients have been found to have a higher shunt dependency rate. In these cases, measures to prevent shunt overdrainage are recommended. 相似文献
84.
Carlos Robles-Medranda Juan I Olmos Miguel Puga-Tejada Roberto Oleas Jorge Baquerizo-Burgos Martha Arevalo-Mora Raquel Del Valle Zavala Joao Autran Nebel Daniel Calle Loffredo Hannah Pitanga-Lukashok 《World journal of gastrointestinal endoscopy》2022,14(3):129-141
BACKGROUNDCurrently, there is insufficient data about the accuracy in the diagnosing of pancreatic cystic lesions (PCLs), especially with novel endoscopic techniques such as with direct intracystic micro-forceps biopsy (mFB) and needle-based confocal laser-endomicroscopy (nCLE).AIMTo compare the accuracy of endoscopic ultrasound (EUS) and associated techniques for the detection of potentially malignant PCLs: EUS-guided fine needle aspiration (EUS-FNA), contrast-enhanced EUS (CE-EUS), EUS-guided fiberoptic probe cystoscopy (cystoscopy), mFB, and nCLE.METHODSThis was a single-center, retrospective study. We identified patients who had undergone EUS, with or without additional diagnostic techniques, and had been diagnosed with PCLs. We determined agreement among malignancy after 24-mo follow-up findings with detection of potentially malignant PCLs via the EUS-guided techniques and/or EUS-guided biopsy when available (EUS malignancy detection). RESULTSA total of 129 patients were included, with EUS performed alone in 47/129. In 82/129 patients, EUS procedures were performed with additional EUS-FNA (21/82), CE-EUS (20/82), cystoscopy (27/82), mFB (36/82), nCLE (44/82). Agreement between EUS malignancy detection and the 24-mo follow-up findings was higher when associated with additional diagnostic techniques than EUS alone [62/82 (75.6%) vs 8/47 (17%); OR 4.35, 95%CI: 2.70-7.37; P < 0.001]. The highest malignancy detection accuracy was reached when nCLE and direct intracystic mFB were both performed, with a sensitivity, specificity, positive predictive value, negative predictive value and observed agreement of 100%, 89.4%, 77.8%, 100% and 92.3%, respectively (P < 0.001 compared with EUS-alone). CONCLUSIONThe combined use of EUS-guided mFB and nCLE improves detection of potentially malignant PCLs compared with EUS-alone, EUS-FNA, CE-EUS or cystoscopy. 相似文献
85.
目的初步探讨橄榄体脑桥小脑萎缩(olivopontocerebellar atrophy,OPCA)的显微解剖结构、病因和发病机制。方法对近5年北京天坛医院神经外科28例OPCA的患者作临床、分子遗传学及影像学特征研究。结果OPCA是主要累及小脑、脑干和脊髓的进行性神经变性病。结论OPCA有遗传和散发两类,临床有多种类型和变异型。对OPCA所采用的基因诊断可以直接在DNA水平上鉴定突变基因。SCA1、SCA2、SCA7的CAG可作为基因诊断的标志。在临床上凡有小脑性共济失调,特别是以此为首发症状者,均应首选做MR检查,这对OPCA的诊断及鉴别诊断具有重要意义。 相似文献
86.
John E. Morales Arpan De Alexandra A. Miller Zhihua Chen Joseph H. McCarty 《The Journal of neuroscience》2022,42(8):1406
In the mammalian brain, perivascular astrocytes (PAs) closely juxtapose blood vessels and are postulated to have important roles in the control of vascular physiology, including regulation of the blood–brain barrier (BBB). Deciphering specific functions for PAs in BBB biology, however, has been limited by the ability to distinguish these cells from other astrocyte populations. In order to characterize selective roles for PAs in vivo, a new mouse model has been generated in which the endogenous megalencephalic leukoencephalopathy with subcortical cysts 1 (Mlc1) gene drives expression of Cre fused to a mutated estrogen ligand-binding domain (Mlc1-T2A-CreERT2). This knock-in mouse model, which we term MLCT, allows for selective identification and tracking of PAs in the postnatal brain. We also demonstrate that MLCT-mediated ablation of PAs causes severe defects in BBB integrity, resulting in premature death. PA loss results in aberrant localization of Claudin 5 and -VE-Cadherin in endothelial cell junctions as well as robust microgliosis. Collectively, these data reveal essential functions for Mlc1-expressing PAs in regulating endothelial barrier integrity in mice and indicate that primary defects in astrocytes that cause BBB breakdown may contribute to human neurologic disorders.SIGNIFICANCE STATEMENT Interlaced among the billions of neurons and glia in the mammalian brain is an elaborate network of blood vessels. Signals from the brain parenchyma control the unique permeability properties of cerebral blood vessels known as the blood–brain barrier (BBB). However, we understand very little about the relative contributions of different neural cell types in the regulation of BBB functions. Here, we show that a specific subpopulation of astrocyte is essential for control of BBB integrity, with ablation of these cells leading to defects in endothelial cell junctions, BBB breakdown, and resulting neurologic deficits. 相似文献
87.
外科治疗纵隔囊肿72例,其中支气管囊肿32例,心包囊肿11例,心包憩室3例,皮样囊肿9例,胸腺囊肿3例,食管囊肿8例及囊状淋巴管瘤6例。本病无特异性临床症状或X线表现,术前确诊困难;针吸活检可提高诊断率。作者报告了本病诊断与治疗的体会。 相似文献
88.
目的分析鞍区RaLhke囊肿的MRl表现,提高对该病的诊断水平。方法回顾性分析经手术与病理证实的24例Rathke囊肿的MRI资料,其中15例进行了动态增强扫描。结果裳肿位于鞍内1O例,鞍内向鞍上延伸14例,多呈圆形、卵圆形或哑铃形,10例正确诊断、11例误诊为垂体瘤,2例误诊为颅咽管瘤,1例误诊为蛛网膜囊肿。结论鞍区Rathke囊肿的MRI表现较典型的特点为:信号多雯,囊内有结节、壁无强化或线样强化,但部分不典型病例需密切结合临床病史与垂体瘤、颅咽管瘤鉴别。 相似文献
89.
90.