[Sonographic diagnosis of a milk of calcium renal cyst].
Renal lime milk cysts are very rare. By ultrasound and computed tomography the diagnosis is easier than by normal X-rays. Presentation of a typical example.
Adult↗
Biomedical subjects
D Tscholakoff
Publications and source records attributed to D Tscholakoff.
[Mirizzi syndrome (author's transl)].
The Mirizzi syndrome consists of the trial cystic duct stone, cholecystitis and benign hepatic duct stenosis. The differentiation between intra- and extrahepatic cholestasis can be made sonographically in almost 100% of cases. In a high percentage of cases the ultrasound investigation can localise the level of the block. However, the additional use of endoscopic retrograde cholangiography (ERC) or percutaneous transhepatic cholangiography (PTC) is necessary for an exact pre-operative diagnosis. The most efficient diagnostic plan is illustrated by a case presentation of a patient with Mirizzi syndrome.
Adult↗
[Sonography of the upper abdomen in cystic fibrosis (author's transl)].
Ultrasound scans of the upper abdomen were carried out in fifty patients with cystic fibrosis (age 2 to 26 years). 38% showed an abnormal hepatic sonogram. On eight occasions it was possible to confirm these changes by a liver biopsy. In 14% there was homogenous increase in liver echoes. 22% showed an non-homogeneous liver structure due to fibrotic and cirrhotic changes and cholangitis. Four of these patients had splenomegaly due to portal hypertension. 85% of the pancreatic scans which could be evaluated showed small pancreases with high echoes. Cholelithiasis was not present in any. Sonography of the upper abdomen is the method of choice for evaluating the liver, biliary system, pancreas and spleen.
Abdomen↗
Retrocaval pseudolymphoma: clinical impact of the mirror artifact.
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Adult↗
[Ischaemic colitis (author's transl)].
Attention must be drawn to the fact that especially in elderly patients with acute onset of abdominal pain concomitant with haemorrhagic, mucous diarrhoea, ischaemic colitis must be considered in the differential diagnosis. Ischaemic colitis arises as a consequence of insufficient blood flow through the peripheral branches of the middle colic artery and inferior mesenteric artery and mostly strikes the left colonic flexure, the colon descendens or sigmoid. Because of the segmental involvement and the macroscopic appearance on X-ray and endoscopy the disease is sometimes indistinguishable from Crohn's disease or ulcerative colitis. In every day clinical life ischaemic colitis is a relatively rare phenomenon, in spite of the high incidence of arterial occlusive disease in the patients treated at this unit. The increasing frequency of ulcerative colitis in elderly patients, as reported in the literature, may be partly associated with unidentified cases of ischaemic colitis and this possibility is discussed.
Aged↗
Videofluoroscopy of the pharynx and esophagus in chronic graft-versus-host disease.
Successful allogeneic bone marrow transplantation (BMT) for hematologic disorders may be complicated by graft-versus-host-disease (GVHD). Chronic GVHD is a systemic disease, involving, among other organs, the skin, mouth, liver, and esophagus. Esophageal involvement results in mucosal inflammation, leading to submucosal fibrosis and, occasionally, formation of webs and strictures. We investigated 25 allogeneic BMT recipients (17 with and eight without chronic GVHD). All patients had a videofluoroscopic study of the pharynx and esophagus to determine the radiographic abnormalities characteristic of chronic GVHD. Oropharyngeal abnormalities (poor bolus control, pharyngeal retention, or excessive mucous secretions) were found in five patients with and three patients without GVHD. Only one patient with GVHD had a pharyngo-esophageal stricture. There was no significant difference between the two groups with regard to pharyngo-esophageal radiographic abnormalities and esophageal symptoms. Radiographic evidence of esophageal motility disorder is not specific for GVHD involvement. In the absence of specific radiographic features, endoscopy is the most accurate method for the diagnosis of esophageal involvement by GVHD.
Adult↗
Contrast MRI in multiple endocrine neoplasia type 1 (MEN) associated with renal cell carcinoma.
The radiologic work-up of a patient with multiple endocrine neoplasia type 1 (MEN 1) syndrome and multiple endocrine nodules, with coincidental renal cell carcinoma, is described. Parathyroid adenoma was differentiated from multiple thyroid nodules by gadolinium-enhanced MRI. Adrenal enlargement due to a nonfunctioning adenoma and a renal cell carcinoma next to a simple renal cortical cyst were identified by typical signal intensities on T1- (pre- and post-Gd-DPTA) and T2-weighted images. Insulinoma was visualized only retrospectively.
Adenoma↗
Comparison of Duplex sonography and color Doppler imaging in renal allograft evaluation: a prospective study.
A prospective study compared the diagnostic capability of quantitative Duplex sonography (DS) and color Doppler imaging (CDI) in 49 consecutive patients with 50 renal allografts. Sixty five DS examinations and 65 CDI examinations were performed by two independent investigators on two different machines on the same day. The resistive index (RI) was calculated and the color flow of renal arteries was observed up to the arcuate arteries. There was good correlation of RI values obtained by DS and CDI at all vascular sites. Thirty one allografts were functioning stably and 19 were in a state of dysfunction, defined by histology (n = 17). Forty allografts presented with a RI less than 0.9 and normal color flow. All five allografts with a pathologic RI greater than or equal to 0.9 showed abnormal color flow (missing flow in arcuate and/or interlobar arteries). Five allografts had a RI less than 0.9 but abnormal color flow, possibly due to atrial fibrillation, hypertension, heart failure or a combination of these. A normal color flow pattern excludes severe vascular compromise to the allograft. In addition, CDI revealed three biopsy-related vascular lesions; two of them had been missed by DS.
Adult↗
MR image contrast and relaxation times of solid tumors in the chest, abdomen, and pelvis.
A retrospective study of 121 patients with tumors in the chest, abdomen, and pelvis was made to assess the degree of contrast between solid tumors and adjacent tissue on magnetic resonance (MR) spin echo (SE) images. Tumors examined were hepatomas (five patients), liver metastases (17), hemangiomas (seven), biliary carcinomas (eight), pancreatic carcinomas (five), renal tumors (15), adrenal tumors (eight), uterine tumors (17), bladder carcinomas (five), prostatic carcinomas (13), bone tumors (six), and lung carcinomas (15). A long repetition time (TR) and a long echo time (TE) were found the most useful to delineate tumors from liver, renal tumors from kidney, lung carcinoma from lung, pelvic tumors from muscle, and uterine tumors from the myometrium. A short TR and short TE provided the best contrast between tumors and fat and bone marrow. Therefore, for detection and staging of tumors, both a sequence with short TR and short TE and one with long TR and long TE are necessary. Pancreatic carcinomas were difficult to differentiate from liver and pancreas on all SE sequences used in the study. Contrast of adrenal tumors was independent of the sequence used. Some adrenal tumors were hypointense and some similar in intensity to the kidney. Further MR characterization of the tumors was limited.
Abdominal Neoplasms↗
Hepatic penetration by duodenal ulcer: sonographic diagnosis.
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Duodenal Ulcer↗
Duplex sonography of normal renal allografts.
Thirty-five patients with normal renal allografts as well as 10 healthy volunteers with normal native kidneys were examined by duplex sonography. Blood flow measurements were performed in the main renal artery as well as in segmental, interlobar and arcuate arteries. In both groups the normal range of variation in blood flow was defined by using the resistive index (RI). Doppler wave forms and RI of main renal arteries were both similar to those of their branches. In renal allografts as well as in native kidneys the blood flow pattern showed a rapid up-slope in systole followed by a gradual down-slope in early diastole, with a persistent flow throughout diastole. In addition, there was no significant difference in the RI between allografted and native kidneys. The interobserver variability was less than 10 per cent. The mean RI was 0.68 using all data points. Vascular rejection in 11 patients could be discriminated significantly (p less than 0.001). Duplex sonography is useful in evaluating renal blood flow. This simple and non-invasive technique seems to be useful in long-term follow-up of renal allograft recipients.
Adult↗
Diagnosis of acute and chronic cardiac rejection by magnetic resonance imaging: a non-invasive in-vivo study.
To evaluate the potential usefulness for characterization of tissue and anatomical changes associated with cardiac transplantation rejection by nuclear magnetic resonance imaging (MRI), sixteen dogs underwent heterotropic cardiac transplantation with six not immunosuppressed serving as controls. Myocardial biopsy and MRI were obtained and compared on a weekly basis. Untreated allografts showed a significant increase in T2 and intensity values by MRI compared to the native heart as early as one week after transplantation. The MRI findings corresponded to the histological progression of acute rejection process in both treated and untreated groups. The linear relationship between histology and MRI was 0.72 while the correlation between T2 and the water content was 0.92. Serial gated MRI correlated with chronic anatomical changes of transplant rejection with evidence of progressive or increasing myocardial wall thickness and decrease in ventricular chamber size.
Animals↗