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Extravascular findings during upper limb computed tomographic angiography focusing on undiagnosed malignancy

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World Journal of Radiology 2019年第1期11卷 10-18页

作者： Romman Nourzaie Jeeban Das Hiba Abbas Narayanan Thulasidasan Panos Gkoutzios Shahzad Ilyas Leo Monzon Tarun Sabharwal Steven Moser Athanasios Diamantopoulos Department of Interventional Radiology Guys' and St.Thomas' NHS Foundation Trust

BACKGROUND Computer tomography angiography(CTA) has been an established method for diagnostic vascular disease of lower limbs. Recently, the method is widely used for diagnosis of vascular pathologies in the upper limbs too. It also has increased the possibilities of this scans being reviewed by no specially trained radiologists.This increases the risk of incidental non vascular findings to be missed or misinterpreted. The study is focusing in the frequency of extravascular incidental finding(EVIF) and highlights the importance for both the reporting radiologist and the referring physician recognizing the frequency of EVIFs.AIM To analyse the frequency of EVIF identified on computed angiography(CT) of the upper limb.METHODS A total of 1383 CT angiographic studies of the peripheral arterial system were performed between August 2015 and August 2017. All upper limb CTAs(n = 79)were retrospectively reviewed for the presence of non-vascular incidental findings within the chest, abdomen/pelvis, musculoskeletal system or head and neck. These EVIFs were subsequently grouped into 3 categories based on clinical significance. EVIFs of immediate clinical relevance were included in category A,findings considered indeterminate but most likely benign were placed in category B, while incidental findings of no clinical significance were included in category C.RESULTS Complete imaging datasets were available in 74/79(93.7%). Patientdemographics included 39(52.7%) females and 35(47.2%) males with a mean age of 59 ± 19.5 years(range 19-93 years). A total of 153 EVIFs were reported in 52 patients(70.3%). Of these, 44 EVIFs(28.7%) were found in the chest, 83(54.2%) in the abdomen, 14(9.2%) in the musculoskeletal system and 9(5.8%) in the head and neck. Thirteen EVIFs(8.4%) identified in 11 patients were noted to be of immediate clinical significance(Category A), 50 EVIFs(32.3%) were identified in20 patients and were considered indeterminate but most likely benign, while the remaining 91 EVIFs(59.5%) identified in 21 patients were dete

关键词： Extravascular incidental findings Computed angiography Upper limbs Arterial Extravascular findings

Unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis

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World Journal of Gastroenterology 2013年第25期19卷 4015-4022页

作者： Mehmet Yilmaz Sami Akbulut Koray Kutluturk Nurhan Sahin Ebru Arabaci Cengiz Ara Sezai Yilmaz Department of Surgery Liver Transplant Institute Inonu University Faculty of Medicine Department of Pathology Inonu University Faculty of Medicine

AIM: To investigate the prevalence and implications of unusual histopathological findings in appendectomy specimens from patients with suspected acute appendicitis. METHODS: The demographic and histopathological data of 1621 patients (≥ 16 years-old) who underwent appendectomy to treat an initial diagnosis of acute appendicitis between January 1999 and November 2011 were retrospectively assessed. Microscopic findings were used to classify the patients under six categories: appendix vermiformis, phlegmonous appendicitis, gan- grenous appendicitis, perforated appendicitis, supurative appendicitis, and unusual histopathologic findings. The demographic and clinicopathologic characteristics of patients with unusual histopathologic findings were evaluated in detail, and re-analysis of archived resected appendix specimens was carried out. RESULTS: A total of 912 males and 709 females, from16 to 94 years old, were included in the study and comprised 789 cases of suppurative appendicitis, 370 cases of appendix vermiformis, 243 cases of perforated gangrenous appendicitis, 53 cases of flegmaneous appendicitis, 32 cases of gangrenous appendicitis, and 134 (8.3%) cases of unusual histopathological findings. The unusual histopathological findings included fibrous obliteration (n = 62), enterobius vermicularis (n = 31), eosinophilic infiltration (n = 10), mucinous cystadenoma (n = 8), carcinoid tumor (n = 6), granulomatous inflammation (n = 5), adenocarcinoma (n = 4; one of them mucinous), and mucocele (n = 3), adenomatous polyp (n = 1), taenia sup (n = 1), ascaris lumbricoides (n = 1), appendiceal diverticula (n = 1), and B cell non-hodgkin lymphoma (n = 1). None of the 11 patients with subsequent diagnosis of tumor were suspected of cancer prior to the appendectomy. CONCLUSION: Even when the macroscopic appearance of appendectomy specimens is normal, histopathological assessment will allow early diagnosis of many unusual diseases.

关键词： Appendicitis Appendectomy specimens Histopathology Unusual findings Appendiceal malignancy

Spectrum of magnetic resonance imaging findings in congenital lumbar spinal stenosis

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World Journal of Clinical Cases 2014年第12期2卷 883-887页

作者： Theodoros Soldatos Majid Chalian Shrey Thawait Alan J Belzberg John Eng John A Carrino Avneesh Chhabra Russell H Morgan Department of Radiology and Radiological Science the Johns Hopkins Hospital Baltimore MD 21287 United States Department of Neurosurgery the Johns Hopkins Hospital Baltimore MD 21287 United States Department of Radiology and Orthopaedic Surgery University of Texas Southwestern Medical Center Dallas TX 75390-9178 United States

AIM: To investigate whether congenital lumbar spinal stenosis(CLSS) is associated with a specific degenerative changes of the lumbar spine. METHODS: The lumbar spine magnetic resonance imaging studies of 52 subjects with CLSS and 48 control subjects were retrospectively evaluated. In each examination, the five lumbar levels were assessed for the presence or absence of circumferential or shallow annular bulges, annular tears, anterior or posterior disc herniations, epidural lipomatosis, Schmorl's nodes,spondylolisthesis, pars defects, and stress reactions of the posterior vertebral elements. RESULTS: Compared to control individuals, subjects with CLSS exhibited increased incidence of circumferential and shallow annular bulges, annular tears, discherniations and spondylolisthesis(P < 0.05). CONCLUSION: CLSS is associated with increased incidence of degenerative changes in specific osseous and soft-tissue elements of the lumbar spine.

关键词： Congenital lumbar spinal stenosis Magnetic resonance imaging Imaging findings Degenerative changes Low back pain

Primary Lymphoma of Bone: Imaging findings to Improve Diagnosis of a Rarely Considered Disease Prior to Biopsy

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Open Journal of Clinical Diagnostics 2015年第3期5卷 97-106页

作者： Jamie T. Caracciolo Trevor Rose Marilyn M. Bui Department of Diagnostic Imaging Moffitt Cancer Center Tampa USA Department of Sarcoma Moffitt Cancer Center Tampa USA Department of Anatomic Pathology Moffitt Cancer Center Tampa USA

Objective: Primary lymphoma of bone (PLB) is a rare malignant bone tumor often presenting in the fifth-sixth decades involving appendicular long bones. Published radiological findings indicate that PLB typically presents as a moth-eaten osteolytic lesion with periosteal reaction, while MRI commonly demonstrates marrow infiltration with extraosseous extension. Given rarity and variable appearances, PLB may not be primarily considered prior to biopsy. Our objective was to evaluate preoperative imaging findings in effort to increase awareness and improve a perceived deficiency in preoperative diagnosis. Materials and Methods: Following IRB approval, retrospective review identified 60 patients with newly diagnosed bone lesions proven to represent PLB in accordance with WHO definition. Preoperative radiographs (n = 46), MRI (n = 33) and PET (n = 37) were independently reviewed by two radiologists. At radiography, lesions were classified: purely lytic, mixed, purely sclerotic, or occult;lytic lesions were graded utilizing Lodwick’s classification. At MRI, lesions were defined as focal or infiltrative and the presence or absence of extraosseous disease was recorded. Extraosseous masses were defined as small (1 cm) and subjectively correlated with degree of cortical destruction. At PET, lesions were recorded as FDG-avid or not. Primary radiograph reports when available (n = 33) were reviewed and exact wording of differential considerations was recorded. Results: Radiographs demonstrated mixed (n = 22), lytic (n = 15), and sclerotic (n = 8) appearances;one radiographically occult lesion was seen by MRI. Lytic lesions were graded: IB (n = 3), IC (n = 5), II (n = 4), and III (n = 3);none were IA. At MRI, 30 lesions were infiltrative and 3 were focal;11 were not associated with extraosseous extension, while 22 showed bony disease with small (n = 7) or large (n = 15) soft tissue mass. Of large masses, 13 demonstrated minimal cortical destruction. At PET, 36 demonstrated FDG uptake;one study was technically limited. Review of

关键词： Primary Lymphoma of Bone Preoperative Diagnosis Radiological findings

Imaging findings in Chest Computed Tomography: Initial Experience in a Developing Country

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Open Journal of Clinical Diagnostics 2017年第4期7卷 113-123页

作者： Adenike T. Adeniji-Sofoluwe Ademola J. Adekanmi Richard Efidi Department of Radiology College of Medicine University of Ibadan Ibadan Nigeria Department of Radiology University College Hospital Ibadan Nigeria

Background:?High resolution chest computed tomography (HRCT) is an established imaging modality that accurately assesses disease processes that are non-specific on conventional chest radiography. Chest Computed Tomography (CT) has proven invaluable in the evaluation of various diseases of the chest providing precise diagnosis that have great impact on the course of management. In this study, our aim is to evaluate the spectrum of radiological findings in all patients that had chest CTs at a tertiary health Institution in a developing Country. Method: This is a 6-year retrospective study of all patients that had Chest CT from 2009 till 2015. All patient data were retrieved and their Chest CT images reviewed and radiological findings and diagnosis documented. Results: Age range of patients was 1 - 84 years with a mean of 52.36 ± 22.9 years. Ten patients were children (12%). There were more males 53 (63.1%) than females 31 (36.9%) in the study. Referral for imaging was predominantly from internal medicine 33 (47.1%) and Surgery 27 (38.6%) departments. Most of the patients, 53 (63.1%) did not have previous chest radiographs. Consolidative changes were the most common parenchymal finding (77.4%). Few mediastinal masses were found in the study population. CT angiography constituted only 10.7% of all chest CTs done in adults. Conclusion: Few chest CT evaluations are performed compared to CTs of other parts of the body done in the same period. Chest CT is generally under-utilized even in a tertiary institution. There is a need to educate chest physicians on the role and advantages of CT use for the management of their patients.

关键词： Chest High Resolution Computed Tomography (CT) findings

Pattern of MRI findings in Patients with Low Back Pain at National Orthopaedic Hospital, Enugu Nigeria

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Journal of Biosciences and Medicines 2018年第4期6卷 85-94页

作者： Emmanuel Chino Iyidobi Benard Onyilo Obande Remigius Tochukwu Ekwunife National Orthopaedic Hospital Enugu Nigeria

BACKGROUND: Low back pain is a major cause of referral to the Spine clinic. In the adult population 50% - 90% may present with low back pain at least once in their life time. Currently, the gold standard for diagnosing the etiology of low back pain is MRI. The protocol at NOHE is to request MRI for patients whose clinical patterns are indicative for invasive intervention. OBJECTIVE: To determine the pattern of MRI findings in patients with low back pain attending spine clinic at NOHE. METHODS: This is a retrospective study of 60 MRI of adult patients with low back pain with clinical need for invasive intervention. The scan was carried out with A Basda BTI 0.35T MRI System using the standard protocol, with sagital and axial T1 and T2-weighted and STIR. Images were from Onis 2.5 digital co. limited. RESULT: Thirty five (58.3%) were males while 25 (41.7%) were females with majority aged between 40 - 59 years. About 90% of the images had disc prolapse while 73% had disc height reduction. The commonest cause of spinal canal stenosis was disc prolapse, thickened ligamentum flavum, spondylolisthesis and osteophytes. Six (10%) of the patient did not have any lesion on MRI. L4/5 was the commonest affected segment while 90% of abnormal cases had multilevel involvement. CONCLUSION: There is high yield of diagnosis with MRI scan among low back pain patients with clinical need for invasive intervention, hence an excellent navigating tool. L4/L5 disc level remains the commonest culprit.

关键词： Pattern MRI findings Low Back Pain Enugu

Sonographic findings in renal parenchymal diseases at Sudanese

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Open Journal of Radiology 2015年第4期5卷 243-249页

作者： Awadia Gareeballah Moawia Gameraddin Hago Mustafa Sultan Alshabi Fath Elerahman Alagab Jumaa Tamboul Suliman Salih Faculty of Radiological sciences and Medical Imaging Alzaeim Alazhari University Khartoum Sudan Department of Diagnostic Radiologic Technology Taibah University Madinah Saudi Arabia National Cancer Institute University of Gezira Wad Medani Sudan

Objective: The objective of this study was to assess the sonographic findings in renal parenchymal diseases using gray-scale ultrasound in order to classify these diseases. The study design was a cross-sectional one. There were 204 patients who were suspected with renal diseases. They had been scanned with ultrasound to assess the kidneys. The echogenicity, renal cortex and paren-chyma, and cortico-medullary differentiation had been evaluated. Results: The study revealed that the echogenicity of renal parenchyma and cortex increased in all types of renal parenchymal diseases. The cortico-medullary differentiation was mainly disturbed in acute parenchymal disease (69.04%), loss in chronic end-stage parenchymal disease (85%);and there was significant difference (p-value = 0.0001). Conclusion: Ultrasound provided useful and accurate diagnosis of renal parenchymal diseases. In this study, renal parenchymal diseases had been classified into acute, chronic and end-stage renal parenchymal diseases.

关键词： Renal Parenchymal Diseases Sonographic findings Sudanese

Abnormal Placental findings Associated with Non-Reassuring Fetal Monitoring and Excellent Neonatal Outcomes

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International Journal of Clinical Medicine 2011年第3期2卷 310-312页

作者： Gary Ventolini Shanthi Ramesh Sheela Barhan Ran Neiger 不详

Objective: Obstetricians, Neonatologists, and Pathologists have studied gross histological analysis of human placentas in search of specific alterations in placental functions that can be correlated with neonatal outcomes. Our study assessed the prevalence of abnormal placental findings associated with non-reassuring fetal monitoring in labor requiring emergent instrumental or cesarean delivery, followed by an excellent neonatal outcome. Study Design: One hundred consecutive emergency deliveries, instrumental or cesarean, performed due to non-reassuring fetal monitoring while in labor were retrospectively evaluated. All patients were low-risk for obstetric complications, and had a singleton, term pregnancy. They had a normal antenatal routine testing and a normal anatomy ultrasound scan at 20 to 22 weeks gestation. Results: There were 35 placentas (35%) with gross placental anomalies at the delivery triage. Additionally 7 placentas (7%) were reported to be abnormal at the pathology examination. Conclusion: The prevalence of abnormal placental findings in our studied population was 42%.

关键词： Abnormal Placental findings Excellent Neonatal Outcomes Non-Reassuring Fetal Monitoring

A Bulletinon Survey findings of China's National Population and Reproductive Health in 1997

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China Population Today 1998年第4期15卷 3-4页

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关键词： China’s findings Survey Bulletinon