Journal of medical imaging and radiation oncology
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J Med Imaging Radiat Oncol · Feb 2008
Case ReportsAbdominal cerebrospinal fluid pseudocyst: a complication of ventriculoperitoneal shunts in adults.
Abdominal cerebrospinal fluid pseudocyst is an uncommon complication of using ventriculoperitoneal shunt (VPS). Although many cases have been reported in children, abdominal pseudocysts are rare in adult patients. The purpose of this article is to describe and illustrate the findings for this condition on commonly used abdominal diagnostic imaging modalities. ⋯ Plain-film radiography was carried out in one patient, ultrasound in three and CT in all six. A fluid collection close to or associated to the VPS catheter was observed in all cases. Visualization of the distal tip of the VPS within a homogeneous intraperitoneal collection is the principal diagnostic sign of an abdominal cerebrospinal fluid pseudocyst at ultrasound and CT.
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J Med Imaging Radiat Oncol · Feb 2008
ReviewInterventional radiology in the provision and maintenance of long-term central venous access.
Establishing and maintaining venous access forms an increasing proportion of the workload in interventional radiology. Several patient groups require medium-term to long-term venous catheters for a variety of purposes, including chemotherapy, long-term antimicrobials, parenteral nutrition, short-term access for haemodialysis or exhausted haemodialysis. ⋯ Venous access devices include implantable catheters (ports), tunnelled catheters and peripherally inserted central catheters, which have different functions, advantages and limitations. Imaging-guided placement is the preferred method of insertion in many institutions because of higher success rates and radiologists are well suited to address catheter complications.
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J Med Imaging Radiat Oncol · Feb 2008
Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI.
Conventional CT or MRI has low accuracy in assessing chest wall invasion in patients with peripheral lung cancer. For preoperative evaluation of chest wall invasion by peripheral lung cancer, respiratory dynamic (RD) MRI was carried out in 98 patients in whom conventional CT scan showed that the tumour was abutting the pleural surface, but there was no evidence of definite tumour invasion. We used 1.5-T MR equipment. ⋯ Pathologically, 20 patients had chest wall invasion and their RD MR was positive (sensitivity 100%). There were seven false-positive results among the 41 patients without chest wall invasion (specificity 82.9%). RD MR may improve the accuracy of conventional CT scan or MRI in the prediction of chest wall invasion of lung cancer, especially in patients in whom the results of conventional CT scan or MRI appear equivocal in the presence of a peripheral mass abutting the chest wall surface without obvious chest wall invasion.
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J Med Imaging Radiat Oncol · Feb 2008
Review Case ReportsEsthesioneuroblastoma: a case report of diffuse subdural recurrence and review of recently published studies.
Esthesioneuroblastoma is a rare malignancy arising from the olfactory epithelium. We present a case history of a 75-year-old man who presented with a Kadish stage C esthesioneuroblastoma and underwent craniofacial surgery and adjuvant radiotherapy. ⋯ The patient's condition subsequently deteriorated and he died. Given this unusual pattern of failure, we review the recent published studies regarding the natural history, treatment and outcome for this tumour.
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J Med Imaging Radiat Oncol · Feb 2008
Lymph node enlargement in pulmonary arterial hypertension due to chronic thromboembolism.
The aim of this study was to determine the prevalence and location of enlarged mediastinal and hilar lymph nodes in patients with pulmonary arterial hypertension (PAH) due to chronic pulmonary thromboembolism (CPTE) and to identify possible causes. Thoracic CT images of 85 patients (43 men and 42 women, aged 18-80 years) with PAH in whom CPTE was confirmed at surgery (n = 75) or angiography and angioscopy (n = 10) were evaluated by two thoracic radiologists to determine the presence, size and location of lymph nodes more than 1 cm in the short axis. The presence of pleural and pericardial effusions and parenchymal abnormalities were also noted. ⋯ Pleural and pericardial effusions were more common in patients with CPTE who also had lymphadenopathy than in the group with no lymphadenopathy (P < 0.05). Lymph node enlargement is common in patients with PAH caused by CPTE. The frequent association of lymphadenopathy with pleural and pericardial effusions suggest a possible pathophysiological mechanism of increased lymphatic flow caused by right heart failure.