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Background To evaluate the efficacy of antegrade insertion of the ureteric stent using pull-through technique in tight ureteric stricture that a guide-wire traversed, but a 5-F catheter could not.
Byung Moon Kim2 Email:bmoon21@hanmail.net%0A Sung Il Park1 Email:astarte@empal.com
[1] Department of Diagnostic Radiology, Kwandong University Myongji Hospital, Koyang-si, Republic of Korea ;[2] Department of Diagnostic Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Republic of Korea
2008,33,000,1,2
Endogenous Cushing’s syndrome is a relatively rare disease. Most cases being ACTH-dependent, ACTH-independent Cushing’s syndrome (AICS) is an even rarer condition [15%–20%]. In more than 95% cases the cause of AICS is unilateral adrenal enlargement caused by adenoma or carcinoma. Bilateral adrenal disease is caused by primary pigmented nodular adrenal dysplasia (PPNAD); ACTH-independent macro nodular hyperplasia (AIMAH). Only few case reports of the latter condition exist in the radiology literature, PPNAD being the commoner of two as the cause for AICS.
Ashish Verma1 Suyash Mohan1 Archna Gupta1 Email:agupta@sgpgi.ac.in
[1] Department of Radio Diagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Rae Bareily Road, Lucknow, 226 014, Uttar Pradesh, India
Leiomyosarcoma of the inferior vena cava is a rare primary tumor. We present a case of a 65-year-old man with the history of cirrhosis; non-specific symptoms. The patient underwent computed tomography; magnetic resonance imaging that revealed a leiomyosarcoma of the infrarenal portion of inferior vena cava. Clinical; imaging features, as well as the surgical technique of resection are discussed.
Spiros Delis1 Charikleia Triantopoulou2Email:chatri@mycosmos.gr Andreas Bakoyiannis1 Nikolaos Tassopoulos3 Christos Dervenis1
[1] Liver Surgery Unit, First Surgery Department, Agia Olga Hospital, Athens, Greece ;[2] CT Department, Agia Olga Hospital, Athens, Greece ;[3] Hepatology Unit, Metropolitan Hospital, Athens, Greece ;[4] 28th October Street, 9, 15452 P. Psyhiko, Athens, Greece
Surgery remains the only curative option for the treatment of pancreatic adenocarcinoma. Local tumor resectability depends on a number of factors, but most importantly, the relationship of the tumor to adjacent arterial structures. For example, surgery is rarely performed when the tumor involves the celiac axis or the superior mesenteric artery. Unexpected variant arterial anatomy or tumor involvement of aberrant arteries may complicate pancreatic surgery. The classic visceral arterial anatomy occurs in only 55%–60% of the population, with one or more variant vessels occurring in the remaining population. Knowledge of both variant; normal anatomy is essential for accurate preoperative planning. We describe here the arterial variant anatomy of the pancreas; its identification by multidetector CT imaging, with; without the aid of post-processed volume-rendered images.
Aparna Balach ran1 Email:abalach ran@di.mdacc.tmc.edu Daryle L. Darden2 Eric P. Tamm1 Silvana C. Faria1 Douglas B. Evans3 Chusilp Charnsangavej1
[1] Diagnostic Radiology, UT MD Anderson Cancer Center, 1515 Holcombe Boulevard Box 0057, Houston, TX 77030, USA ;[2] Radiologic Associates of Fredericksburg, 4718 Carr Drive, Fredericksburg, VA 22408, USA ;[3] Surgical Oncology, UT MD Anderson Cancer Center, 1515 Holcombe Boulevard Box 0444, Houston, TX 77030, USA
Since the application of cross-sectional imaging to the examination of the gastrointestinal tract, dramatic changes have occurred in the modern gastrointestinal fluoroscopic suite. Besides the great decrease in use of fluoroscopy, the types of fluoroscopic examinations requested; performed nowadays are different from those of just 2 or 3 decades ago. This paper will review the recent history; the current uses of fluoroscopy in adults at the beginning of the twenty-first century, illustrated by case images; utilization data from a large academic medical center. Fluoroscopy survives because of its unique illustration of motility in real-time, its superior detection; accurate localization of leaks in post-operative patients,; its ability to provide immediate answers; targeted examinations tailored to the individual patient.
David A. Boyajian1 Email:dboyajian@post.harvard.edu Alex er R. Margulis1
[1] Department of Radiology, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA
Degos disease is a rare idiopathic vasculopathy with multisystem involvement. We present a previously healthy 40-year-old woman who developed spontaneous small bowel infarctions; perforations 17 months after presentation with characteristic skin lesions. The abdominal CT findings of Degos disease, which have not been previously depicted in the radiology literature, are discussed.
Raghu R. Amaravadi1 Email:Raghu.r.amaravadi@lahey.org Tai M. Tran1 Rachel Altman1 Christopher D. Scheirey1
[1] Department of Diagnostic Radiology, Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805, USA
We report CT features of four cases of Eosinophilic enteritis. The disease involves the jejunum in one case, the ileum in two cases,; the colon in the remaining case. Two cases demonstrate a predominantly mucosal type of eosinophilic enteritis, while the other two cases demonstrate a predominantly subserosal type. CT findings include bowel wall thickening in four cases, bowel fold thickening in two cases, layering of the bowel wall in two cases, luminal narrowing without obstruction in three cases, an intra-luminal granuloma mimicking a huge polyp in one case, an extra-luminal irregular granuloma markedly enhancing; slightly necrosing in one case, mesenteric lymphadenopathy with peripheral rim-like enhancement; marked necrosis in one case; ascites in one case. CT findings are more characteristic of an inflammatory disease rather than of a tumor,; these findings are helpful for assessing the extent; location of the disease. Moreover, combined with its typical clinical manifestations, CT findings may lead to the correct diagnosis.
Xiangwu Zheng1 Email:zxwu111@sina.com Jianmin Cheng2 Kehua Pan1 Kaiyan Yang3 Hongqing Wang1 Enfu Wu1
[1] Department of Radiology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, People’s Republic of China ;[2] Department of Radiology, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, People’s Republic of China ;[3] Department of Pathology, The First Affiliated Hospital of Wenzhou Medical College, Wenzhou, 325000, People’s Republic of China
The purpose of this study was to describe of peritoneal manifestations of parasitic infection at CT. A broad spectrum of CT findings can be seen in the peritoneal cavity, including a varying degree of omental or mesenteric infiltration, single or multiple peritoneal mass or nodule,; peritoneal thickening or stranding. Recognition of these findings are crucial for establish an early diagnosis; helps avoid unnecessary surgery.
So Yeon Kim1 Hyun Kwon Ha1 Email:hkha@amc.seoul.kr
[1] Department of Radiology; Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-Dong, Songpa-Gu, Seoul, 138-040, South Korea
In general, gastrointestinal tract is the primary involvement site of parasites during their life cycle. In this article, we will describe amebiasis, ascariasis,; anisakiasis among the many common intestinal parasitic diseases. We will review the epidemiology, life cycles, clinical manifestations; complications,; illustrate detailed imaging findings of intestinal parasites. Recognizing features of parasitic infection is important to establish an early diagnosis that leads to prompt treatment; helps avoid unnecessary surgery.
Mi-Suk Park1Email:radpms@yumc.yonsei.ac.kr Ki Whang Kim1 Hyun Kwon Ha2 Dong Ho Lee3
[1] Department of Diagnostic Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea ;[2] Department of Radiology; Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea ;[3] Department of Diagnostic Radiology, Kyung Hee University Hospital, Seoul, South Korea ;[4] Department of Diagnostic Radiology, Severance Hospital, Seodaemun-ku, Shinchon-dong 134, Seoul, 120-752, South Korea
Parasitic infection of the biliary tree is caused by liver flukes, namely Clonorchis sinensis; Opisthorchis viverrini. These flukes reside in the peripheral small bile ducts of the liver; produce chronic inflammation of the bile duct, bile duct dilatation, mechanical obstruction,; bile duct wall thickening. On imaging, peripheral small intrahepatic bile ducts are dilated, but the large bile ducts; extrahepatic bile ducts are not dilated or slightly dilated. There is no visible caused of obstruction. Sometimes, in heavy infection, adult flukes are demonstrated on sonography, CT or MR cholangiography as small intraluminal lesions. The flukes in the gallbladder may appear as floating, small objects on sonography. Chronic infection may result in cholangiocarcinoma of the liver parenchyma or along the bile ducts. Human infection of Fasciola hepatica, a cattle flukes, may occur inadvertently,; the flukes migrate in the liver (hepatic phase); reside the bile ducts (biliary phase). Image findings in the hepatic phase present with multiple, small, clustered, necrotic cavities or abscesses in the peripheral parts of the liver, showing “tunnels; caves” sign, reflecting parasite migration in the liver parenchyma. In the biliary phase, the flukes are demonstrated in the intra-; extrahepatic bile ducts; the gallbladder as small intraluminal flat objects, sometimes moving spontaneously. Bile ducts are dilated.
Jae Hoon Lim1 Email:jhlim@smc.samsung.co.kr Eimorn Mairiang2 Geung Hwan Ahn3
[1] Department of Radiology; Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea ;[2] Department of Radiology, Khon Kaen University Medical School, Khon Kaen, Thailand ;[3] Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea