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941.
A case of vesicouterine fistula in a young woman following caesarean section is presented. The diagnosis was established
successfully using heavily T2-weighted MRI which clearly demonstrated fluid within the fistula, obviating the need for conventional
radiographic contrast examination.
Received: 21 October 1998; Revised: 27 January 1999; Accepted: 1 March 1999 相似文献
942.
Infarction of omentum and epiploic appendage: Diagnosis, epidemiology and natural history 总被引:7,自引:0,他引:7
Epiploic appendagitis and segmental omentum infarction are considered to be rare conditions, which may mimic an abdominal
surgical emergency. The purpose of our study was to describe clinical findings, US and CT appearance of infarction of an epiploic
appendage and omentum, and to determine their epidemiological characteristics and natural history. We retrospectively studied
clinical, US and CT findings at hospital admission and follow-up of all patients who were diagnosed at our institution with
epiploic appendagitis or omentum infarction between June 1988 and November 1997. We found a relatively high incidence of 40
cases: 20 patients with epiploic appendagitis, 11 with omentum infarction, and 9 in whom it was not possible to discriminate
between the both. All 40 patients recovered under conservative treatment without complications. We conclude that US and CT
features allow a reliable diagnosis, thereby obviating unnecessary surgery. Discriminating between both conditions is of no
practical relevance since treatment and prognosis are identical.
Received: 30 November 1998; Revised: 30 March 1999; Accepted: 6 September 1999 相似文献
943.
Higueras Guerrero V Torregrosa Andrés A Martí-Bonmatí L Casillas C Sanfeliu M 《European radiology》1999,9(9):1796-1799
The aim of this study was to assess the accuracy of MR in the diagnosis of synovialisation of the anterior cruciate ligament
(ACL) compared with arthroscopy. One hundred and forty-nine patients were examined with MR imaging and arthroscopy of the
knee. The MR sign used to consider a synovialised ACL consisted of hypointense fibrillar tracts, disrupted and wavily, in
its expected course. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), comparison
of proportions (McNemar test) and Kappa values for agreement between MR imaging and arthroscopy were calculated. Of the 133
(89.3 %) ligaments without synovialisation at arthroscopy, 130 accorded with the MR results. Of the 16 (10.7 %) synovialised
ligaments, 13 accorded with the MR results. Three false-positive and three false-negative MR diagnoses were identified. The
agreement between both techniques was excellent (Kappa = 0.79; p = 0.000), without differences (McNemar test; p = 1). Sensitivity was 0.81, specificity 0.98, PPV 0.98 and NPV 0.81. Magnetic resonance imaging is highly reliability for
synovialisation diagnosis. The imaging sign used to diagnose synovialised ACL (hypointense comma-like tracts in its expected
course) is reliable. As this reparative process can simulate an intact ligament, knowledge of this sign is important in diagnosing
synovialisation of ACL tears so as not to confuse it with normal ACL.
Received: 17 June 1998; Accepted: 6 August 1998 相似文献
944.
Self-expanding oesophageal metal stents for the palliation of dysphagia due to extrinsic compression
The role of self-expanding metallic stents is well established in the palliation of oesophageal stenosis and dysphagia due
to primary oesophageal malignancy. However, their role in palliation of dysphagia due to external compressive mediastinal
malignancies is not well established. The purpose of this study was to assess the efficacy of self-expanding metallic stents
in the palliation of dysphagia due to extrinsic oesophageal compression by mediastinal malignancy. Between January 1995 and
January 1998, 21 patients with oesophageal compression due to malignant mediastinal tumours underwent oesophageal stent placement
for palliation of dysphagia. Complete data were available in 17 patients (10 men and 7 women). The mean age was 63.5 years
(range 46–89 years). A total of 19 stents were placed successfully. The dysphagia grade prior to and after oesophageal stent
placement was assessed and the complications documented. Of the 17 patients, 16 reported an improvement in dysphagia. The
mean dysphagia score improved from 3.1 prior to treatment to 1.3 after treatment. In 1 patient the stent slipped during placement
and another stent was placed satisfactorily. Early complications (within 48 h) in the form of mild to moderate retrosternal
chest pain occurred in 5 patients. This was treated symptomatically. Late complications (after 48 h) in the form of bolus
impaction occurred in 2 patients. This was successfully treated with oesophagoscopy and removal of bolus. In 2 patients the
stent was overgrown by tumour and in one of these an additional stent was placed. In 1 patient incomplete closure of a tracheo-oesophageal
fistula was observed. There was no procedure- or stent-related mortality. The mean survival time of this group was 2.1 months.
Self-expanding metallic stents can be safely and effectively used in the palliation of dysphagia due to external mediastinal
malignancies.
Received: 21 October 1998; Revised: 1 February 1999; Accepted: 4 February 1999 相似文献
945.
Fibroepithelial polyps are the most frequently observed mesenchymal tumors of the renal pelvis. We report on one case of
fibroepithelial polyp of the renal pelvis with unusual CT findings of totally cystic structure with septations.
Received: 27 July 1998; Revised: 6 January 1999; Accepted: 8 February 1999 相似文献
946.
In this study, thirty-eight patients with a variety of upper abdominal diseases were examined with three-dimensional time-resolved
MR angiography (7 sec/data set). Visualisation of arterial and venous anatomy was excellent in the majority of patients. Moreover,
subtraction images could be calculated and organ perfusion could be assessed. It is concluded that this technique opens new
perspectives for a comprehensive evaluation of vascular and parenchymal disease.
Received: 14 April 1998; Revision received: 23 October 1998; Accepted: 9 November 1998 相似文献
947.
Tubular ectasia of the rete testis (TERT) is a benign entity due to dilation of the tubules of the rete testis. Most of the
time it is discovered incidentally on scrotal sonograms and may be misinterpreted as malignant. This article outlines the
diagnostic criteria of TERT, its possible causes, its incidence and its potential evolution. Recognizing this entity owing
to its characteristic clinical, sonographic and, if necessary, MRI features is important to avoid unnecessary surgery or biopsies.
Received: 4 August 1998; Revised: 15 April 1999; Accepted: 19 April 1999 相似文献
948.
Few studies related to parity address the changes in anorectal function in women. Since the majority of patients with rectal
prolapse are women, we undertook this study to assess the role of parity in the development of rectal prolapse. We retrospectively
reviewed defecography studies performed on 354 female patients over a 10-year period. Studies noting the presence of intra-anal
and external rectal prolapse (full thickness protrusion of the rectum into and through the anal sphincter) were reviewed.
Cases with intrarectal or hidden rectal prolapse, a condition of lesser clinical importance, were excluded. The obstetric
histories of the patients with rectal prolapse (n = 27) were compared to those of patients without rectal prolapse (n = 88). There was a larger proportion of nulliparous women in the rectal prolapse group than in the group without rectal prolapse,
suggesting that factors in addition to parity play a role in the development of rectal prolapse. However, parous women with
rectal prolapse had delivered significantly more children (3.3) than parous women without prolapse (2.5) (P = 0.03). The exact cause of rectal prolapse remains unclear. Childbearing appears to play a limited role in its pathogenesis
since nulliparous women are also at risk of developing rectal prolapse.
Received: 27 November 1997; Revision received: 15 April 1998; Accepted: 13 May 1998 相似文献
949.
Schneider JP Dietrich J Lieberenz S Schmidt F Sorge O Trantakis C Seifert V Kellermann S Schober R Franke P 《European radiology》1999,9(2):230-236
The purpose of our study was to evaluate the feasibility and accuracy of brain biopsies performed within a vertically opened
MR system. We worked with the interventional 0.5-T MR “SIGNA SP” (General Electric Medical Systems, Milwaukee, Wis.) with
an integrated tracking device “Flashpoint Position Encoder” (Image Guided Technologies, USA). As a holding device for this
instrument we constructed a special frame. The whole system allows an exact adjustment of an optimum biopsy direction and
guidance of the biopsy in a non-stereotactic, interactive mode in near real-time. As biopsy tools we used MR-compatible aspiration
and specially made side-cut needles (Daum, Germany; E-Z-EM, USA). We performed a prospective diagnostic brain biopsy study
in 18 patients. Guidance of the needle was carried out using gradient-echo single-slice technique. The sample was taken after
controlling the exact position of the needle tip on spin-echo images. In 12 cases an exact neuropathological diagnosis was
possible. In 6 cases of negative biopsy (4 aspiration biopsies) the samples were not representative. Our results demonstrate
the feasibility of interactive MR-guided minimally invasive brain biopsies in an open MR system. The best results were achieved
using cut needles for biopsies of contrast-enhancing lesions visible on T1-weighted gradient-echo guidance sequence.
Received: 2 February 1998; Revision received: 13 July 1998; Accepted: 2 September 1998 相似文献
950.
Pseudoaneurysm of the superficial femoral artery following accidental trauma: result of treatment by percutaneous stent-graft placement 总被引:4,自引:0,他引:4
Accidental trauma frequently involves the extremities, and can extend to involve their blood supply, causing exsanguinating
hemorrhage and pseudoaneurysm in the involved blood vessel. This is traditionally managed by surgical repair. We report a
case in which control of life-threatening hemorrhage and exclusion of a large, post-traumatic pseudoaneurysm in the superficial
femoral artery was performed by a commercially available stent-graft, without complication. This treatment method may be a
safe and effective alternative to surgery in selected patients.
Received: 10 February 1998; Revision received: 31 March 1998; Accepted: 20 April 1998 相似文献