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At least 937 records · Page 52Linked to original sources
PubMed1981

Multimodal imaging in evaluation of two cases of adenocarcinoma of the renal pelvis.

Primary adenocarcinoma arising in the renal pelvis is a rare entity. Two cases are presented in which computed tomography (CT), ultrasound, and antegrade pyelography were performed in addition to conventional urographic methods. One patient's multifocal tumor involving several calyces was best demonstrated by ultrasound; the other patient's centrally placed pelvic mass was seen by CT. Adenocarcinomas are etiologically linked to repeated infection. Although it has been stated in previous reviews that the diagnosis of malignancy is seldom made preoperatively in these patients, the use of CT, ultrasound, and antegrade pyelography allowed the diagnosis to be made prospectively in both cases.

Adenocarcinoma↗
PubMed1997

Contrast enhancement for the abdomen and pelvis.

A "quadraphasic" imaging technique is described for imaging malignancies of the abdomen (liver, kidneys and pancreas). With this technique images are acquired during four different phases relative to the administration of contrast agent: pre-contrast (baseline), during the capillary (arterial, pre-sinusoidal) phase, during the portal (sinusoidal) phase, and during the extracellular (delayed) phase. A brief summary of the kinds of malignancy that are best imaged during each of these phases is presented. Finally, comments are presented on the use of gadolinium-based contrast media for imaging tissues of the pelvis.

Abdomen↗
PubMed2004

[Autonomic innervation of the female pelvis. Anatomic basis].

The pelvic plexus with its sympathetic (hypogastric nerves, sacral sympathetic trunk) and parasympathetic (pelvic splanchnic nerves) sources provides and distributes the autonomic nervous supply for the pelvic organs. This homogeneous autonomic nerve plate is located within and deeply to the peritoneal fold (recto-uterine in the female pelvis) lying medially to the internal iliac vessels. Autonomic nerve fibres emerge from the pelvic plexus and travel to the anterolateral aspect of the rectum and the inferolateral and posterolateral aspects of the bladder and female genital tract. In addition, pelvic organs are innervated by nerves accompanying the vessels and the ureter which penetrate the pelvic plexus. Knowledge of the topography of the pelvic plexus indicates the most common sites for iatrogenic lesions and should help us in avoiding postoperative autonomic dysfunction.

Autonomic Pathways↗
PubMed2005

["Second line" polychemotherapy in metastatic urothelial cancer of the renal pelvis. Persisting partial remission by 18 treatment cycles of gemcitabine/paclitaxel after 24 treatment cycles gemcitabine/cisplatin "stable disease"].

Moderate activity of systemic chemotherapy for advanced urothelial cancer has been reported for more than 30 years. Only with the advent of potent combination therapy in the mid-1980s have clinically significant response rates and prolonged survival been documented. Due to the small number of cases and poor prognosis, knowledge is scant about the therapeutic effect of "second-line" polychemotherapy in metastatic upper tract urothelial cancer. We report an interesting case of a 59-year-old man suffering from urothelial cancer of the renal pelvis with pulmonary, lymphogenous, and bone metastases who had an unexpected response to "second-line" chemotherapy with only 2 treatment cycles of gemcitabine/paclitaxel (partial remission) after 24 treatment cycles of gemcitabine/cisplatin in "stable disease" with progression between the therapeutic intervals.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2006

[Villous adenoma of the renal pelvis and ureter].

Villous adenomas of the urinary tract are extremely rare tumours belonging to the adenoepithelial metaplasias. They can be associated with other neoplasias, especially with carcinomas. We describe the case of an 85-year-old female patient suffering from a villous adenoma of the renal pelvis and ureter.

Adenoma, Villous↗
PubMed2001

[Therapy of carcinoma of the kidney pelvis].

Transitional cell carcinoma of the renal pelvis is relatively uncommon, and only 5% of all urothelial carcinomas occur in the renal collecting system. Invasive tumors are often aggressive in their biological behavior and show a high tendency for systemic progression. Conservative therapy should only be considered an option in patients with imperative indications (solitary functioning kidney, bilateral tumor, renal insufficiency). In some cases, organ-sparing techniques such as open resection or endourological treatment (percutaneous or by ureteroscopy) can be performed. However, nephroureterectomy with excision of a bladder cuff is considered to be the standard treatment and should be performed whenever possible.

Carcinoma, Transitional Cell↗
PubMed1999

Integration of the hand in postural reactions to sustained sideways force at the pelvis.

In order to investigate the potential hand contribution to sideways balance, sideways pushes to the right, which subjects resisted using either the lower limbs ("hip only") or the lower limbs assisted by the right upper limb ("hand and hip"), were delivered to the pelvis. Analysis of force and electromyogram recordings from the legs, arm and hand in the hand-and-hip condition showed a close co-ordination of upper and lower limbs in terms of mean latencies and amplitudes. However, trial to trial fluctuations of forces generated by the hand and leg did not correlate, suggesting parallel pathways under central co-ordinative control.

Adult↗
PubMed2002

Perforation of a central venous catheter into the pelvis of the kidney: a rare complication.

Most adverse events related to central venous catheter (CVC) use in severely ill neonates who require total parenteral nutrition (TPN) are caused by malposition of the tip of the catheter, followed by complications such as infection, sepsis, thrombosis or, rarely, perforation of the vessel. Malpositioned tip of a CVC into the renal vein followed by thrombosis is well known. We report two cases of perforation of a CVC into the renal pelvis. To prevent this complication, the value of intra- or postoperative use of fluoroscopy with injection of contrast medium through the catheter is discussed.

Catheterization, Central Venous↗
PubMed2003

The value of colour Doppler ultrasonography for identification of crossing vessels in children with pelvi-ureteric junction obstruction.

BACKGROUND: Pelvi-ureteric junction (PUJ) obstruction is caused by the presence of an aperistaltic dysplastic segment at the PUJ. Besides this intrinsic aetiology, extrinsic abnormalities, mainly crossing vessels, may be an associated factor. OBJECTIVE: To determine the reliability of colour Doppler US in the detection of crossing vessels in children with surgically proven PUJ obstruction. MATERIALS AND METHODS: Forty-eight patients (50 kidneys) with PUJ obstruction, surgically treated from 1998 to 2001, were prospectively studied by colour Doppler US prior to open pyeloplasty. There were 33 boys and 15 girls (age 2 months-12 years; median 3.5 years). There were 24 right kidneys and 26 left kidneys. The indication for surgery was according to the usual criteria. The crossing vessel was considered as present when depicted on colour Doppler US at the PUJ. RESULTS: Colour Doppler assessment of the crossing vessels was correct in all but two patients. At surgery, a crossing vessel was found in 14 kidneys (i.e. 28%). Colour Doppler US results were correlated with intra-operative findings in 50 renal units. Surgically proven vessels in 14 kidneys were identified by colour Doppler US in 13, and not shown in 1. In PUJ obstruction without a crossing vessel ( n=36), US findings were concordant in 26, discordant in 8 and inconclusive in 2 (with kidney malrotation) cases. Colour Doppler US had a sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy of 92.8%, 76.5%, 62%, 96.3% and 78%, respectively. The reliability of colour Doppler US was greatly improved with the increasing experience of the sonographer, as shown by the results of the last 2 years (26 kidneys):Se=100%, Sp=87.5%, PPV=81.8%, NPV=100%, accuracy=88.5%. CONCLUSIONS: Colour Doppler US is reliable in the detection of crossing vessels at the PUJ.

Child, Preschool↗
PubMed2004

MDCT angiography of pediatric vascular diseases of the abdomen, pelvis, and extremities.

Multi-detector-row computed tomography (MDCT) enables rapid, noninvasive, high-resolution, and three-dimensional imaging of pediatric vascular diseases. In this paper, we explore the adaptation of the MDCT angiographic principles to pediatric patients for vascular diseases of the abdomen, pelvis, and extremities. Special emphasis is placed on the practical aspects of how to perform these studies. Optimizations of scan parameters, contrast medium usage, radiation dose, and three-dimensional image processing are discussed in detail. We provide practical guidance on how to choose between MR angiography and CT angiography. Finally, we review important pediatric vascular diseases, categorized into traumatic injuries, inherited vascular diseases, congenital vascular diseases, vasculitides, and surgical planning and assessment. In each category, we discuss how CT angiography can be tailored to maximize its clinical benefits.

Adolescent↗
PubMed2000

Giant ancient schwannoma of the pelvis.

A 43-year-old man with a large ancient schwannoma of the pelvis, presenting with varicose veins, is reported. Ancient schwannoma (neurilemmoma) is a benign tumour of nerve sheath origin characterised histologically by features of severe degeneration and which rarely can grow to a large size. Malignant transformation, though reported, is extremely rare.

Adult↗
PubMedDate not supplied

Spiral CT angiography of the abdomen and pelvis: interventional applications.

Spiral CT angiography may be a useful adjunct for interventional radiologists in imaging vessels within the abdomen and pelvis. Specifically, the potential to assess abdominal aortic aneurysms preoperatively is within the realm of spiral CT angiography so long as scanners can quickly change collimation and table feed during the examination. The technique is also useful for imaging metal and nonmetal vascular grafts. The splanchnic arteries may be imaged in instances in which proximal vascular patency and course is questioned. The portal vein and its branches may be imaged prospectively with spiral CT angiography or retrospectively by postprocessing routine abdominal CT image data. The normal renal vasculature including accessory vessels may be imaged as part of preoperative evaluation for renal transplantation or for repair of ureteropelvic junction obstruction. Renal artery aneurysms may also be followed with spiral CT angiograms. Hemodynamically significant renal arterial stenoses may be detected with spiral CT angiography; grading the severity of those stenoses is within the realm of spiral CTA so long as careful attention is paid to technique.

Abdomen↗
PubMedDate not supplied

PTA and stenting of benign venous stenoses in the pelvis: long-term results.

PURPOSE: To provide follow-up data on endovascular intervention for venous stenoses in the pelvis. METHODS: Between 1985 and 1995, 35 patients presented with 42 stenoses of the pelvic veins after operative thrombectomy and creation of an arteriovenous fistula, combined with intraoperative venous angioscopy. All patients underwent angioplasty and, if unsuccessful, percutaneous insertion of an endovascular stent (n = 7). RESULTS: Angioplasty with and without endovascular stenting was technically successful in 34 of 35 patients (97%). Average length of the stenoses was 20.6 mm (range 10-90 mm), average diameter before dilation 4.1 mm (range 2-6 mm), and average diameter after dilation 10.1 mm (range 5-18 mm). Intraoperative angioscopy showed pathologic findings (intimal laceration or residual thrombotic material) in 14 patients. After an average follow-up period of 4.13 years, 24 (69%) patients had patent veins. The difference in the primary patency rate between patients with angioscopically abnormal veins (6 of 14 patients, corresponding to a patency rate of 43%) and patients with angioscopically normal veins after thrombectomy (18 of 21 patients, corresponding to a patency rate of 86%) was statistically significant (p<0.01, log rank test). CONCLUSIONS: Percutaneous transluminal angioplasty and/or stenting are good treatment modalities for pelvic vein stenosis following surgical thrombectomy. Angioscopically abnormal veins have a poorer long-term patency, regardless of the type of intervention.

Adult↗
PubMed2005

The morphometric study of the sacrospinal and sacrotuberal ligaments correlated with the morphometry of the pelvis.

Perineal neuralgias may be considered as nerve entrapment syndromes, which have been anatomically poorly studied. The pudendal nerve could be compressed between the sacrospinal and the sacrotuberal ligaments. This study tries to find a correlation between the pelvis and the lumbosacral junction morphometry, and sacrospinal and sacrotuberal ligaments morphometry. We did an anatomical study of eight anatomic specimens, and we performed the measures by using the computed tomography scanner. No correlations were found.

Cadaver↗
PubMed1999

Dynamic magnetic resonance imaging of the female pelvis: radio-anatomy and pathologic applications. Preliminary results.

Dynamic MRI of the pelvis was performed in 16 young nulliparous, normally continent women. The examinations were performed in the dorsal decubitus position. Using Turbo-Flash scans (acquisition time: 2.1 sec), sagittal images were obtained at rest and with maximal pelvic straining. The sacral promontory-subpubic (PSP) and the subpubic-subsacral axes (SPSS) measured respectively 80.5 degrees and 30 degrees in relation to the horizontal plane, without a statistically significant difference between rest and straining. A marked deformation of the posterior wall of the bladder was observed in 13 cases and the bladder neck was frontally deformed in 10 cases. With straining, the base of the bladder did not descend beyond 15 mm below the SPSS, and the cervix stayed at least 14 mm above the SPSS. These were established as the normal criteria for pelvic assessment. 20 multiparous patients (mean age 65 years), referred for urinary stress incontinence and/or prolapse, were investigated using the criteria previously established. The PSP, SPSS, and vaginal angle measured 80.95 degrees, 30.57 degrees, and 69.69 degrees respectively in relation to the horizontal. No statistically significant difference was detected between straining and rest conditions. The angle of the uterus in relation to the horizontal was 57.36 degrees at rest and 65.90 degrees in straining with a difference that was statistically significant. In six patients, the base of the bladder descended more than 1.5 cm while straining and in seven patients the cervix descended at least 1.4 cm below the SPSS while straining, both statistically significant differences. Overall, between our control and study populations, there were no significant differences between PSP and SPSS measured on straining and at rest. However, differences were detected in the vaginal angle, bladder-base position, and cervical position. These results suggest the potential substitution of MRI for colpocystography.

Aged↗
PubMed1994

[Explosive metastasis of a cancer of the kidney pelvis in analgesic kidney].

A 48-year-old male experienced sudden pain in the right flank and macrohematuria with subsequent repeated episodes of painless macrohematuria. In the radiological work-up, CT was interpreted as inflammatory enlargement of the right kidney and MRI diagnosed renal vein thrombosis. There was some suspicion that there might be a malignancy. Five months later the patient had to be admitted to the hospital, because of increasing flank pain, desiccation and general signs of inflammatory disease. Radiological changes compatible with pulmonary metastases were found. Biopsy of enlarged mediastinal lymph nodes revealed undifferentiated carcinoma. Because of the expression of Cytokeratin primary urothelial carcinoma was suspected. The patient then deteriorated rapidly. No further specific therapy could be carried out. Death was chiefly caused by respiratory insufficiency 5 months after the first episode of pain and 1 month after admission. Autopsy revealed a poorly differentiated urothelial carcinoma of the right renal pelvis, with extensive carcinomatous angiomatosis and metastases to the left kidney, lungs, and regional and mediastinal lymph nodes. Independently of the carcinoma, both kidneys also showed interstitial nephritis, papillary necrosis and capillarosclerosis, compatible with analgesic-user kidney ("phenacetin kidney") in the absence of a corresponding history.

Carcinoma, Transitional Cell↗
PubMed1996

[Fibroepithelial polyp of the kidney pelvis].

Benign fibroepithelial polyps of the renal pelvis are rare. Because of suspected malignancy in imaging procedures an ureteronephrectomy was carried out in the reported case. Histology, however, yielded no evidence of malignancy. The diagnosis of benign fibroepithelial polyp was entertained. It remains an open question whether the pathologic changes represent a hamartoma or a reactive postinflammatory process, revealing primitive myxoid stroma within the polypous portion and increasing fibrosis with diffuse submucosal involvement of the ureteral basis.

Diagnosis, Differential↗