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[en] Ultrasound, CAT scan, and angiographies diagnosed three cases of aneurysm of the splenic artery. The physiopathology and the most important findings are reviewed. They were all women, asymptomatic of their pathology and two of these findings were incidental. The recognition and diagnostic are vital to avoid the complications requiring in the most of the cases surgery
[en] We studied 20 patients with erectile dysfunction of vascular origin and 10 patients with psychological erectile dysfunction with Doppler ultrasound before and after injection of intra cavernous vasoactive substances. We observed that psychological erectile dysfunction, is characterized by normal vascular velocities in cavernous arteries (control group). In patients with vascular aetiology we obtained abnormal registrations that differentiated arterial from venous pathology. There was a significant difference in the diameter of the cavernous artery and the systolic flow after the injection of vasoactive substances
[en] The Mucocele of the appendix is a not very frequent entity and its diagnose pre-operative it is strange. To make diagnose in early form, it is important since lagoons of these lesions are wicked and their quick identification reduces the incidence of pseudo mixoma peritonea. Classically the diagnosis of the mucocele of the appendix is made by laparotomy when being suspected a appendicitis process inflammatory. They have been used for their diagnosis the simple badge of the abdomen, the colon for enema, the ultrasound, the computerized tomography and the gammagraphy with gallium-67 among others. This article describes a case, where the impression pre-operative diagnostic was made and in way non invasive
[en] Chagas's disease affects 7% of the Colombian population and is an uncommonly diagnosed disease due to its non-specific symptoms. In the acute phase of the disease, direct invasion of the brain can be present, with acute eningoencephalitis. In the chronic phase, there can be a residual meningoencephalitis or ischemic events related to cardiomyopathy. In acute reactivation,there is parasitaemia due to an immunosuppressed state with necrotizing meningoencephalitis and formation of cerebral masses, also called chagomas. There are no pathognomonic findings for chagomas, which consist of solitary or multiple nodular lesions, located in the white matter,basal ganglia, corpus callosum, cerebellum, brainstem or spinal cord. They present an irregular and peripheral gadolinium enhancement pattern. The main differential diagnoses include Toxoplasma gondii infection and neoplasms. This article presents a case of a 74-year-old female HIV + patient,with progressive walking impairment, presented with a corpus callosum and left periventricular white matter mass on MRI. The histological study revealed amastigotes. She had positive serum titles for Trypanosoma cruzi, confirming the diagnosis of a chagoma in a patient with AIDS.
[en] Primary sclerosing cholangitis is an uncommon chronic disease of unknown etiology characterized by inflammatory and fibrotic changes of the intra and extrahepatic bile ducts producing cholestasis that can lead to secondary biliary cirrhosis. Historically the gold standard for diagnoses of sclerosing primary cholangitis have been the endoscopic retrograde cholangiography (ERCP), it is known as a luminography due to it only shows the biliary tract, without evaluation of the hepatic parenchyma, ductal wall, hepatic hilium, among others. For this reason the magnetic cholangiography (MRC) has emerged as a new, non-invasive method that give us not only information about the biliary tract but also allows us to evaluate others structures that could be involved in the disease. Furthermore the MRC has a diagnostic performance comparable with the ERCP. We will review the general clinical and imaging features of primary sclerosing cholangitis.
[en] The aim of this study is to present our experience on bilateral and simultaneous inferior petrous sinus catheterization, on those patients with ACTH -dependent Cushing's syndrome. We describe the procedure and our results. Material and Method: A retrospective study was held between January 2003 and September 2009, including nine patients (2 men, 7 women) presenting ACTH - dependent Cushing's syndrome. Simultaneous inferior petrosal sinus catheterization was performed in all of them, sampling basal ACTH and after CRH stimulation. ACTH levels gradient in different pituitary locations and peripheral blood levels was recorded. Diagnosis was suggested when inappropriate and maintained hypercortisolemia. High urinary free cortisol levels and no response to dexamethasone suppression were detected. Eight out of nine patients had a prior negative imaging test result. Results: Inferior petrosal sinus bilateral catheterization was successfully performed in all cases, with no evidence of further complications. The results showed definitive diagnosis in all cases. In four patients ACTH levels gradient was lateralized to the left, leading to a specific surgical approach. One patient presented pituitary ACTH - secreting adenoma. Two other patients showed ectopic ACTH production, one showed suprarenal adenoma secreting ACTH and other one showed response to pituitary stimulation without side lateralisation, presenting a histological diagnosis of pituitary hyperplasia. Conclusion: Petrosal sinus catheterization is shown to be an efficient procedure to manage Cushing's syndrome differential diagnosis and to obtain specific anatomical information.
[en] Hepatic vascular diseases (HVD) are a broad spectrum of entities of low prevalence but with different clinical manifestations that may even lead to death. Its early detection and timely treatment may change the prognosis. Diagnostic imaging plays a key role and imaging findings may be typical. However, in most cases, radiologists must take into account a wide range of differential diagnosis. Computed tomography (CT) of the abdomen is one of the most useful tools for the diagnosis of HVD taking also into account the value of other imaging methods such as Doppler Ultrasound and Magnetic Resonance Imaging (MRI). HVD can be classified according to the compromised vascular structure and can be divided into venous, portal, arterial, sinusoidal and others disorders. The objective of this review is to describe the most common presentation HVD. The major imaging findings and differential diagnosis recognizing its correlation with the pathophysiological mechanisms.
[en] We report a case of a 27 year-old male with a growing post-traumatic soft-tissue mass. The diagnosis of a superficial temporal artery pseudo aneurysm was made by Doppler Ultrasound, after tomography showed non-conclusive results. In this case, this technique proved to be a low-cost and accessible approach to the initial workup in the management protocol.
[en] Nitric acid (HNO3) is a corrosive fluid that, when in contact with reducing agents, generates nitrogen oxides that are responsible for inhalation poisoning. We present two cases of poisoning from nitric acid gas inhalation resulting from occupational exposure. Imaging findings were similar in both cases, consistent with adult respiratory distress syndrome (ARDS): bilaterally diffuse alveolar opacities on the chest X-ray and a cobblestone pattern on computed tomography (CT).one of the patients died while the other evolved satisfactorily after treatment with n-acetyl cysteine and mechanical ventilation. The diagnosis of nitric acid poisoning was made on the basis of the history of exposure and the way in which the radiological findings evolved.