[Magnetic resonance imaging of the transplanted kidney].
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Biomedical subjects
Publications and source records attributed to C Matos.
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We report a case of isolated superior mesenteric vein thrombosis with acute ischemic bowel disease, diagnosed early by a screening ultrasound scan of the upper abdomen and definitively assessed by computed tomography and angiography. This report stresses the contribution of cross-sectional techniques in the early diagnosis and management of venous occlusive disease of the small bowel.
A new sonographic pattern is described that has been found in eight infants having syndromes associated with malabsorption. Five infants had hepatobiliary disease and three infants had transient or permanent cow-milk intolerance. In all cases, upper abdominal sonographic examinations revealed hyperechoic tubular and round masses which, most probably, represent small bowel loops filled with malabsorbed milk. Control examinations, before hepatic failure or under corrected diet, showed absence of the pattern. It is believed by the authors that in some ambiguous cases, the finding of this pattern should direct the pediatrician toward syndromes associated with malabsorption.
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Lithiasis is usually a late complication of renal transplantation reported in approximately 1% of all renal allografts. Underlying predisposing conditions for the formation of calculi are present in almost all cases. Preexisting stones in the donor kidney have been reported once previously. The authors have observed 2 such cases, detected by routine sonography. In 1 case, stone migration into the ureter led to acute postoperative transplant failure; this complication has been reported previously.
This study was devoted to tumor differentiation in liver MR T1-weighted imaging with superparamagnetic iron oxide (SPIO). Twenty-one patients with 40 liver lesions were studied at 1.5 T. Before and at least 45 minutes after SPIO administration, turbo-field-echo (TFE) T1-weighted, TFE T1 x T2*-weighted (MXT), and fat-suppressed turbo-spin-echo T2-weighted images were acquired. A quantitative analysis was performed blindly. On TFE T1-weighted images, the signal enhancement was -33% +/- 12 for the liver, -24% +/- 2 for adenomas and focal nodular hyperplasia, +60% +/- 33 for the hemangiomas; metastases and cyst enhancement were not significant. After SPIO on TFE T1-weighted images, the hemangioma-to-liver signal ratio (149% +/- 18) was definitely higher than the mean metastasis-to-liver signal ratio (90% +/- 16). This T1-related differentiation ability lacked dramatically on TFE MXT images and, in one case, was reduced on post-SPIO TFE T1-weighted images by a long imaging delay after SPIO administration (2 hours).
PURPOSE: To assess the value of magnetic resonance angiography (MRA) in the evaluation of vascular patency after intravascular endoprosthesis placement. METHODS: Three different metallic stents (Wallstent, Strecker, Palmaz) were studied in vitro, and in vivo in six patients with spin-echo (SE) and gradient-echo (GRE) MR imaging. Time-of-flight, two-dimensional (2D) gadolinium-enhanced MRA was performed with GRE and flow-compensation technique, and reconstructed with a maximum-intensity projection (MIP) algorithm. MRA was compared to digital angiograms. RESULTS: In vitro studies demonstrated that the signal intensity (SI) within the stent differed according to the device employed, the lowest SI being observed within the Palmaz stent (p = .001). There was no difference in SI or apparent diameter of the stent according to the sequence (SE vs GRE) or length of echo time (TE). In patients, the endoprostheses recorded as a well-defined area of signal void or drop-out (p = 0.004), whereas vessels above and below the stent displayed high signal intensities. CONCLUSION: MRA does not seem as yet to be well suited for evaluating vascular patency after endoprosthesis placement, even if the Strecker and Wallstent endoprostheses provide fewer artifacts than the Palmaz stent.
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The authors report a case of simultaneously occurring neurofibroma and schwannoma of the sciatic nerve and discuss the complementary aspects of MR and US. The schwannoma was well-defined and showed distal enhancement on sonographic evaluation, whereas the neurofibroma was ill-defined; both tumors were hypoechoic. T1- and T2-weighted MR images revealed similar signal characteristics of the two tumors, but intense enhancement following administration of gadolinium-DTPA distinguished the schwannoma from the neurofibroma.
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A high incidence rate of Malaria is observed at Bolívar state (Venezuela) and, beside classic acute symptomatology, we have observed gastric symptoms like epigastralgia, anorexia, nausea and vomits. The scope of this study is to establish changes of gastric mucosa related to Plasmodium infection, using macro and microscopic technics. One hundred both sex patients with Malaria diagnosis done with thick drop technic and gastric symptomatology were studied in our department from March 1990 to February 1991. The esophagus, stomach and duodenum of all patients were evaluated with upper digestive tract endoscopy and still photographs, and biopsies of fundus, body and antrum were taken, fixed in 10% formaldehyde and stained with hematoxylin-eosine method. P. falciparum was found in 52 cases, P. vivax in 39 and 9 infected with both, most of patients complained of shivering fever, epigastralgia (76%), nausea and vomits (72%), tartness (25%) and burning pain (21%). Mucosal edema and congestion (gastritis) were the endoscopic findings in 88% of cases, usually located at antrum (67%) and fundus (33%). The microscopic findings were: mucosal edema (90%), superficial bleeding (87%), microthrombosis (60%), gastric atrophy (40%) and intestinal metaplasia (8%). Acute gastric symptomatology we have observed in patients with acute malaria my be due to microthrombosis and arteriolar occlusion, leading to ischemic changes and mucosal edema. These pathophysiological changes explain most of upper digestive tract symptoms in acute malaria, particularly when agent is P. falciparum. We have not found related papers in bibliography.
PURPOSE: To evaluate the use of postembolization gadolinium-enhanced MR imaging as a means to judge the efficacy of tumor embolization. METHODS: Fifteen patients with meningiomas were prospectively studied. The following data were evaluated for each tumor: the percentage of vascular supply to the tumor arising from the internal and external carotid arteries; the percentage of the tumor embolized as judged by angiography, by MR imaging, and by CT scanning; the estimated blood loss according to the surgeon; and histologic evidence of necrosis as seen by the neuropathologist. RESULTS: The data reveal an excellent correlation between the amount of tumor embolized as estimated by MR and both the estimated blood loss at time of surgery and the presence of histological necrosis in the specimen. CONCLUSIONS: Postembolization gadolinium-enhanced MR is an excellent means to evaluate the efficacy of an embolization and offers certain advantages over CT and angiography. One important advantage of this technique lies in the fact that it can be performed immediately postembolization.
The recent development of MRCP allowed the recognition of the potential role of Magnetic Resonance (MR) in pancreatobiliary imaging. The increasing interest on MRCP relies on its non invasiveness (there is no need for contrast media administration) and on the projectional display of the biliary and pancreatic ducts in a way similar to endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC). In addition, it offers the opportunity for dynamic analysis of biliopancreatic ducts which is useful in the assessment of subtle ductal alterations. The future of this attractive technique will depend on the demonstration of its diagnostic accuracy and on its availability. This article discusses the potential role of MRCP in the evaluation of biliary tract and pancreatic duct diseases.