Portal biliopathy, magnetic resonance imaging and magnetic resonance cholangiopancreatography findings: A case series

WOS: 000371242400011PubMed ID: 25216728Portal biliopathy (PB) is a rare disorder, characterized by biliary ductal and gallbladder wall abnormalities seen in patients with portal hypertension. It most commonly occurs due to idiopathic extrahepatic portal vein obstruction (EHPVO). The abnormalities consist mainly of bile duct compression, stenoses, fibrotic strictures and dilation of both extrahepatic and intrahepatic bile ducts, as well as gallbladder varices. PB may mimic cholangiocarcinoma, sclerosing cholangitis, or choledocholithiasis. Misdiagnosis can be avoided using appropriate imaging modalities to prevent complications. We present the magnetic resonance imaging (MRI) and magnetic resonance cholangiography (MRCP) features of three patients with PB

Transient hepatic attenuation differences in two patients with superior vena cava obstruction: Computed tomography findings

Karaciğerin kanlanmasındaki hemodinamiklerin bozulması sonucunda tümöral süreç ile karışan parankimal geçici kontrastlanma farklılıkları oluşabilir. Etiyolojide tümöral veya tümöral olmayan süreçler rol oynar. Superior vena kava obstrüksiyonları, geçici hepatik kontrastlanma farklılığı (GHKF) etiyolojileri arasında son derece nadir olarak karşımıza çıkar. Çalışmamızda, superior vena kava obstrüksiyonuna bağlı oluşan GHKF’nın bilgisayarlı tomografi bulguları sunulmuş ve tartışılmıştır.Radiographic appearances of transient hepatic attenuation differences (THAD) can mimic tumors. THAD can occur as a result of altered hemodynamics of the hepatic blood flow. Tumoral or non-tumoral processes can play role in the etiology. THADs that appear secondary to the obstruction of the superior vena cava are rarely seen. Herein, we present computed tomography findings of two cases with THAD secondary to superior vena cava obstruction

Frontal lobe lipoma associated with cortical dysplasia and abnormal vasculature

Intracranial lipomas (ICLs) are rare lesions, the vast majority encountered as incidental findings on imaging studies. ICLs are generally pericallosal midline lesions and thought to be asymptomatic and can be accompanied by additional intracranial congenital malformations. We describe a 17-year old male with an unusual case of ICL on the frontal lobe associated with cortical dysplasia and abnormal vasculature mimicking arteriovenous malformation on magnetic resonance images

Our experience with MR imaging of perianal fistulas

Magnetic resonance imaging (MRI) depicts infectious foci in the perianal region better than any other imaging modality. MRI allows definition of the fistula, associated abscess formation and its secondary extensions. Accurate information is necessary for surgical treatment and to obtain a decrease in the incidence of recurrence and complications. Radiologists should be familiar with anatomical and pathological findings of perianal fistulas and classify them using the MRI – based grading system. The purpose of this article was to provide an overview for evaluation of perianal fistulas, examples of various fistula types and their classification

Brachial artery thrombosis mimicking De Quervain's syndrome: A case report

WOS: 000422787600011Upper limb occlusions are rare and the clinical presentation may vary depending on the affected arteries. A detailed history and physical examination may reveal possible causes and can facilitate the differential diagnosis. It can be misdiagnosed as musculoskeletal diseases due to similar clinical manifestations. In this report, we present a case with wrist pain mimicking de Quervain's syndrome diagnosed as subacute brachial artery thrombosis due to factor II gene mutation. In conclusion, physicians should be cautious to avoid unnecessary delay in the diagnosis of thrombosis in young patients

Splenic abscess due to brucellosis: A case report and a review of the literature

WOS: 000333565100014PubMed ID: 24433982Splenic abscess due to acute brucellosis is a rare event. We report a case of multiple splenic abscesses caused by Brucella melitensis in a 45-year-old woman and review the English language literature based on a PubMed/MEDLINE search of the last 50 years. The majority of the cases published in the literature were due to B. melitensis and a splenectomy was required in half of the cases. Antibiotics alone without surgical intervention can be successful in the treatment of patients with splenic brucellosis in the early stages of the disease. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved

Spinal arteriovenous malformation: Use of intraoperative color Doppler ultrasonography guidance for surgical resection. Case report

WOS: 000345159600019PubMed ID: 25463896Spinal arteriovenous malformations (AVMs) may be associated with sensory and motor deficits, bowel or bladder dysfunction, radicular pain or deficit, and back pain. Hemorrhage can occur in the parenchyma leading to the acute onset of symptoms. Neurosurgical resection is one of the way of treatment. Several techniques including intraoperative angiography, dye-injection and the micro Doppler method have proven to be useful during the surgical resection of spinal vascular lesions. Herein, we report our experience with intraoperative ultrasonography (IOUS) and color Doppler ultrasonography guidance for visualizing a spinal cord AVM during surgery. IOUS is a time-saving and noninvasive method for intraoperative imaging of spinal AVM

Problems with the median arcuate ligament should be recognized before surgery; Its importance in pancreaticoduodenectomy

Background: Celiac artery stenosis (CAS) is a not a rare finding in the general population. The median arcuate ligament (MAL) is a fibrous arch that unites the diaphragmatic crura on either side of the aortic hiatus and, while it normally passes cranial to the origin of the celiac truncus, a low-lying ligament may lead to compression of the celiac artery and is the one of the major causes of CAS. Case Report: In this paper, we present a patient with a mass in the gastric bulbus who was diagnosed with celiac artery stenosis during the pancreaticoduodenec- tomy (PD). MAL was the cause of the celiac artery ste- nosis, determined based on the findings of preoperative computed tomography (CT). Conclusion: Although CAS is usually asymptomatic due to the collateral blood supply, it may be associated with potentially disastrous results due to ischemia of the upper abdominal organs as a result of disruption of the collateral pathways. It is especially important to recognize the presence of CAS and its etiology before interventional procedures. With the increasing use of multidetector computed tomography (MDCT), it be- comes essential for radiologists to be aware of this entity and the cross-sectional findings

Effect of radiation dose reduction on image quality in adult head CT with noise-suppressing reconstruction system with a 256 slice MDCT

WOS: 000354950100028PubMed ID: 26103494The purpose of our study was to investigate the effect of iterative reconstruction (IR) as a dose reduction system on the image quality (IQ) of the adult head computed tomography (CT) at various low-dose levels, and to identify ways of setting the amount of dose reduction. We performed two noncontrast low-dose (LD) adult head CT protocols modified by lowering the tube current with IR which were decided in the light of a group of phantom studies. Two groups of patients, each 100 underwent noncontrast head CT with LD-I and LD-II, respectively. These groups were compared with 100 consecutive standard dose (STD) adult head CT protocol in terms of quantitative and qualitative IQ. The signal-to-noise ratio (SNR) of the white matter (WM) and gray matter (GM) and contrast-to-noise ratio (CNR) values in the LD groups were higher than the STD group. The differences were statistically significant. When the STD and the LD groups were compared qualitatively, no significant differences were found in overall quality. By selecting the appropriate level of IR 34%, radiation dose reduction in adult head CT can be achieved without compromising IQ

Compression of the celiac artery by the median arcuate ligament: Multidetector computed tomography findings and characteristics

WOS: 000359964200011PubMed ID: 25896451Purpose: The prevalence of the celiac artery stenosis caused by median arcuate ligament (MAL) compression and its multidetector computed tomography (MDCT) characteristics were evaluated in patients who underwent abdominal MDCT procedures, retrospectively. Methods: Totally 1121 patients who had abdominal MDCT with arterial phase or MDCT angiography of the abdominal aorta for various indications were analyzed for celiac artery compression by the MAL. Results: Fifty (ie, 4.6%) patients showed typical MDCT features of MAL compression. Focal narrowing of the proximal celiac artery, a characteristic hooked appearance of the narrowed segment without calcification and atherosclerotic changes were diagnostic. Poststenotic dilatation was detected in 22 (44%) patients with MAL compression. The ratio of the stenosis of the celiac artery was between 35%-50% in 15 patients and 51%-80% in 35 patients. The gastroduodenal artery diameter of these patients was not significantly different from the asymptomatic control group. Conclusion: MALS is an uncommon entity but it should be kept in mind in the presence of unexplained gastrointestinal symptoms. MDCT is a minimally invasive and plays a dominant role in the diagnosis of MAL compression especially with reformatted and 3-D reconstructed images.Objet : Nous avons evalu e, de fac¸on r etrospective, le taux de pr evalence de la st enose du tronc cœliaque attribuable a une compression par le ligament arqu e m edian et les caract eristiques observ ees par tomodensitom etrie multibarrettes (TDM multibarrettes) chez des patients ayant subi des techniques d’imagerie abdominale par TDM multibarrettes. M ethodes : Au total, nous avons analys e le dossier de 1 121 patients ayant subi une TDM multibarrettes abdominale avec acquisition a la phase art erielle ou une angiographie par TDM multibarrettes de l’aorte abdominale pour divers motifs afin de d eceler une compression du tronc cœliaque par le ligament arqu e m edian. R esultats : Des caract eristiques evoquant une compression par le ligament arqu e m edian ont et e observ ees par TDM multibarrettes chez 50 patients (soit 4,6 % des patients). Le r etr ecissement focal de la partie proximale du tronc cœliaque, l’aspect recourb e caract eristique de ce tronc¸on et l’absence de calcification et de modifications ath eroscl ereuses ont permis d’ etablir le diagnostic. Une dilatation post-st enotique a et e d ecel ee chez 22 des 50 patients (44 %) qui pr esentaient une compression par le ligament arqu e m edian. Le degr e de st enose du tronc cœliaque etait de 35 a 50 % chez 15 patients, et de 51 a 80 % chez 35 patients. Chez ces patients, le diametre de l’artere gastroduod enale ne diff erait pas sur le plan statistique de celui du groupe t emoin asymptomatique. Conclusion : Le syndrome du ligament arqu e m edian n’est pas courant, mais il doit ^etre pris en consid eration en pr esence de sympt^omes gastro-intestinaux inexplicables. La TDM multibarrettes est une technique peu effractive et de premier plan pour etablir un diagnostic de compression du tronc cœliaque par le ligament arqu e m edian, notamment avec des techniques de reformatage et de reconstruction tridimensionnelle des images