Right liver lobe hypoplasia and related abnormalities

BACKGROUND: Hypoplasia and agenesis of the liver lobe is a rare abnormality. It is associated with biliary system abnormalities, high location of the right kidney, and right colon interposition. These patients are prone to gallstones, portal hypertension and possible surgical complications because of anatomical disturbance. CASE REPORT: Magnetic resonance imaging features of a rare case of hypoplasia of the right lobe of the liver in a sigmoid cancer patient are presented. CONCLUSIONS: Hypoplasia of the right liver should not be confused with liver atrophy; indeed, associations with other coexistent abnormalities are also possible. Awareness and familiarity with these anomalies are necessary to avoid fatal surgical and interventional complications

Metástases nas leptomeninges da espinal medula num doente com carcinoma de céculas escamosas do pulmão Spinal leptomeningeal metastasis in a patient with squamous cell lung cancer

As metástases nas leptomeninges da espinal medula ocorrem raramente nos tumores sólidos e o prognóstico é bastante reservado. Os adenocarcinomas e os carcinomas de pequenas células são os grupos histológicos mais envolvidos no que se refere aos tumores pulmonares. Um homem de 58 anos com história de carcinoma de células escamosas do pulmão com inversão mediastínica e metástases cerebrais apresenta lombalgias e fraqueza em ambos os membros inferiores. A RMN da coluna vertebral revelou espessamento na espinal medula e múltiplos nódulos do grupo das fibras da cauda equina. Tanto quanto sabemos, trata-se do segundo caso relatado de carcinoma pulmonar de células escamosas que apresenta metástases nas leptomeninges da espinal medula.Spinal leptomeningeal metastasis occurs rarely in solid tumors, and the prognosis is extremely poor. Adenocarcinomas and small-cell carcinomas are the most common histological type detected among lung tumors. A 58-year-old man with a history of squamous-cell lung carcinoma with mediastinal invasion and brain metastasis was examined because of his low back pain and weakness in both lower limbs. Spinal MRI revealed subpial enhancement in the spinal cord; and innumerable nodules with thickening of the cauda equina fibres. To our knowledge, this is the second reported case of squamous cell lung cancer with spinal leptomeningeal metastasis

Metástases nas leptomeninges da espinal medula num doente com carcinoma de céculas escamosas do pulmão

Resumo: As metástases nas leptomeninges da espinal medula ocorrem raramente nos tumores sólidos e o prognóstico é bastante reservado. Os adenocarcinomas e os carcinomas de pequenas células são os grupos histológicos mais envolvidos no que se refere aos tumores pulmonares. Um homem de 58 anos com história de carcinoma de células escamosas do pulmão com inversão mediastínica e metástases cerebrais apresenta lombalgias e fraqueza em ambos os membros inferiores. A RMN da coluna vertebral revelou espessamento na espinal medula e múltiplos nódulos do grupo das fibras da cauda equina. Tanto quanto sabemos, trata-se do segundo caso relatado de carcinoma pulmonar de células escamosas que apresenta metástases nas leptomeninges da espinal medula.Rev Port Pneumol 2008; XIV (6): 875-879 Abstract: Spinal leptomeningeal metastasis occurs rarely in solid tumors, and the prognosis is extremely poor. Adenocarcinomas and small-cell carcinomas are the most common histological type detected among lung tumors. A 58-year-old man with a history of squamous-cell lung carcinoma with mediastinal invasion and brain metastasis was examined because of his low back pain and weakness in both lower limbs. Spinal MRI revealed subpial enhancement in the spinal cord; and innumerable nodules with thickening of the cauda equina fibres. To our knowledge, this is the second reported case of squamous cell lung cancer with spinal leptomeningeal metastasis.Rev Port Pneumol 2008; XIV (6): 875-879 Palavras-chave: Espinal medula, leptomeninges, metástases, ressonância magnética nuclear, Key-words: Spinal, leptomeningeal, metastasis, lung cancer, magnetic resonance imagin

The Vertebral Artery Convergence to the Cervical Spine in Elders

Background: In the older population, tortuosity of the vertebral artery (VA), uncovertebral joint (UVJ) osteoarthritis, and abnormal vertebral alignment may alter the normal anatomy.Aim: We aimed to determine the anatomical variations and relationships between the cervical segment of the VA and the cervical spine with regard to ageing.Materials and methods: In this retrospective cross-sectional study, the computed tomography angiography scans of 110 subjects were reviewed. Any variations in the VA, UVJ degeneration were identified. The distance between the VA and uncinate process (UP) was measured electronically. The distance between the VA and UP were compared according to the age group (group A 65 years-old).Results: With regard to the transverse foramen, 7.2% of the cases had entering abnormalities of the VA, while in one case (0.83%), the right VA had an exiting abnormality (exiting from the C2 instead of the C1). UVJ degeneration was found to be significantly higher in the older age group (p < 0.05). Furthermore, at the C4-C7 levels, the distances between the VA and UP were significantly smaller in the older age group (p < 0.01).Conclusions: The VA-UP distance has been shown to decrease due to increasing UVJ osteoarthritis in the elderly. The convergence of the VA toward the spine occurs at the most mobile segment of the cervical spine, and this anatomical alteration may predispose temporary and/or permanent vertebral artery occlusion clinically, and be dangerous during cervical spine surgery

Interrelationship between Liver Hemodynamics and Tumor Metabolism in Liver Metastases: Diagnostic Value of Doppler Perfusion Index Revisited

It should be expected that the hepatic blood flow increase in the cases with liver metastasis. We aimed to find out if there is a correlation between Doppler parameters and hepatic metabolic activity in oncology patients. 35 patients with hepatic metastases who were identified by 18F-fluorodeoxyglucose positron emission tomography scan and assessed with Doppler ultrasound were included in this prospective study. Patients with hepatic disease, cardiac dysfunction, dehydration, history of alcoholism, intake of antihypertensive or vasoactive medication were excluded. Volume flow of the proper hepatic artery and the portal vein were measured in the hepatoduodenal ligament by Doppler sonography. Doppler perfusion index (the ratio of the hepatic artery flow to the total liver blood flow) and flow volumes of 31 age matched subjects were compared. Both flow of the proper hepatic artery and portal vein were found to be significantly higher in patients with liver metastasis. The mean Doppler perfusion index value was 0.2 ± 0.13 in hepatic metastases whereas 0.13 ± 0.05 in control group. Doppler perfusion index was significantly higher in liver metastases (p=0.008). A positive correlation was found between the maximum standardized uptake value of the liver and flow volume of the proper hepatic artery (r=0.774, p=0). Blood flow of the proper hepatic artery and Doppler perfusion index correlates with hepatic standardized uptake value. Flow measurements of the liver may become an important parameter for selecting patients for further positron emission tomography scan and following-up the response after systemic and local therapeutic procedures

Symphysis pubis distance in adults: a retrospective computed tomography study

WOS: 000253204600011PubMed ID: 18183348Background In this retrospective study, symphysis pubis (SP) distance was measured by transverse computed tomography scans. The relation between the SP distance and age, gender, number of birth and body-mass index was studied. Methods Symphysis pubis joint distances were evaluated for the patients who had undergone abdominal or pelvic computed tomography examination for other medical reasons between the dates of March and May 2007. Anterior, middle, and posterior SP joint distances were measured at transverse planes. Normal joint width in women and men was determined. The relation between obtained values, and age, gender, number of birth, as well as body-mass index was studied. Results Symphysis pubis narrows at anterior concurrently with ageing (r = -0.115; P = 0.007). Narrowing, though less, is also observed at posterior (r = -1.50 P = 0.000); however, middle part does not change (r = 0.030; P = 0.489). Number of birth and body-mass index values do not affect SP width. The widths measured at anterior and middle of the SP were significantly higher in women (P = 0.010 and P = 0.002). Conclusions Osteoarthritic changes develop in SP with ageing. However, osteoarthritis in SP, was found to be clinically and radiologically different from that in other symphyseal joints, as SP hardly ever moves, and vertically processing interpubic disc combines pelvis girdle with counterforces, and is supported by very strong ligaments and muscles. Anterior and middle part of the SP joint is wider in women, because fibrocartilaginous disc is too thick to provide the mobility

Symphysis pubis distance in adults: a retrospective computed tomography study (vol 30, pg 153, 2008)

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