PLANTAR THROMBOPHLEBITIS: MAGNETIC RESONANCE IMAGING FINDINGS

ABSTRACTObjective: Demonstrate the magnetic resonance imaging (MRI) findings in plantar thrombophlebitis. Methods: Retrospective review of twenty patients with pain in the plantar region of the foot, in which the MRI findings indicated plantar thrombophlebitis. Results: A total of fourteen men and six women, mean age 46.7 years were evaluated. Eight of these patients also underwent Doppler ultrasonography, which confirmed the thrombophlebitis. The magnetic resonance images were evaluated in consensus by two radiologists with experience in musculoskeletal radiology (more than 10 years each), showing perivascular edema in all twenty patients (100%) and muscle edema in nineteen of the twenty patients (95%). All twenty patients had intraluminal intermediate signal intensity on T2-weighted (100%) and venous ectasia was present in seventeen of the twenty cases (85%). Collateral veins were visualized in one of the twenty patients (5%). All fourteen cases (100%), in which intravenous contrast was administered, showed perivenular tissues enhancement and intraluminal filling defect. Venous ectasia, loss of compressibility and no flow on Doppler ultrasound were also observed in all eight cases examined by the method. Conclusion: MRI is a sensitive in the evaluation of plant thrombophlebitis in patients with plantar foot pain

Feasibility of CT scan studies with triple split bolus intravenous contrast medium technique and reduced radiation dose for potential kidney donors

Objective: To show that it is possible to reduce the radiation dose in the examination of potential kidney donors by splitting the contrast injection followed by a single scanning, enabling evaluation of vascular structures, renal parenchyma and collecting system/ureters, using computed tomography protocols with reduced mAs. Methods: Twenty-six potential donors were evaluated based on the following criteria: image quality, radiation dose reduction, and complications associated with the exam. The criteria were scored by two examiners, and the differences were resolved by consensus. Rresults: For each item assessed, 85 to 90% of studies were scored as very good or excellent with regards to image quality. There was excellent interobserver agreement, and there were no significant differences between the exams with low radiation dose compared to those with the conventional dose. No exam-related complications were observed. Cconclusions: The CT scan study with triple-split bolus technique and low dose is effective for reducing the dose of radiation to potential kidney donors

Acute and chronic mesenteric ischemia: MDCT findings

Mesenteric ischemia is caused by a reduction in mesenteric blood flow. It can be divided into acute and chronic, based upon the rapidity and the degree to which the blood flow is compromised. The authors retrospectively reviewed 22 cases of mesenteric ischemia, diagnosed by multidetector computed tomography (MDCT) in our service, and confirmed by surgery or clinical follow-up. The frequency of the diagnostic findings of chronic and acute mesenteric ischemia was evaluated. The improvement of three-dimensional (3D) MDCT allows accurate assessment of mesenteric vessels. Therefore, it demonstrates changes in ischemic bowel segments helpful in determining the primary cause of the disease, and can identify the complications in patients with acute and chronic mesenteric ischemia

Ultrasonographic findings in genitourinary tract malformations: a pictorial essay

Objective: To demonstrate didactically the different ultrasound findings of various congenital malformations of the genitourinary system. Methods: Twelve cases were retrospectively studied, comprising patients who presented with genitourinary tract malformations (with or without related symptoms), detected by ultrasound testing carried out with Phillips ATL / HDI – 5000 ultrasound equipment, during the period of August 2007 to June 2009 at the Imaging Department of the Hospital Israelita Albert Einstein. Rresults: Six patients were females and six were males, and ages varied from a few hours of life to 15 years and 9 months. All individuals were evaluated and accompanied by the Pediatric Radiology sector of the Hospital Israelita Albert Einstein. The study was carried out as follows: two cases of hydrocolpos, one of them a result of imperforate hymen and one a case a congenital stenosis of the ureteropyelic junction, one case of ureterocele, one case of bilateral double collection system, one case of horseshoe kidney, one case of Hutch’s diverticulum, two cases of pelvic kidney, one of them with hydronephrosis, one case of multicystic dysplastic kidney, one case of polycystic kidney (adult form), and one case of congenital megaureter. Cconclusions: The ultrasonographic study is a valuable method for the early identification, often in the uterus, of these and several other treatable anomalies of the genitourinary tract. Additionally, it also presents the advantage of not using ionizing radiation, which is very significant, especially in the pediatric age group

Tromboflebite plantar: achados em ressonância magnética Plantar thrombophlebitis: magnetic resonance imaging findings

OBJETIVO: Demonstrar os achados em ressonância magnética (RM) da tromboflebite plantar. MÉTODOS: Revisão retrospectiva de 20 pacientes com dor na região plantar nos quais os achados de ressonância magnética indicaram tromboflebite plantar. RESULTADOS: Foram avaliados 14 homens e seis mulheres, com idade média de 46,7 anos. Oito desses pacientes também foram submetidos à ultrassonografia com doppler, que confirmaram a tromboflebite. As imagens de ressonância magnética foram avaliadas em consenso por dois radiologistas com experiência em radiologia do sistema musculoesquelético (mais de 10 anos cada um), demonstrando edema perivascular em todos os 20 pacientes (100%) e edema muscular em 19 dos 20 pacientes (95%). Todos os 20 pacientes apresentavam intensidade de sinal intermediária intraluminal em T2 (100%) e ectasia venosa estava presente em 17 dos 20 casos (85%). Veias colaterais foram visualizadas em um dos 20 pacientes (5%). Todos os 14 casos (100%), nos quais o contraste intravenoso foi administrado, apresentavam realce dos tecidos perivenulares e defeito de enchimento intraluminal. Ectasia venosa, perda da compressibilidade e ausência de fluxo na ultrassonografia com doppler também foram observados em todos os oito casos examinados pelo método. CONCLUSÕES: A RM é um método sensível na avaliação de tromboflebite plantar em pacientes com dor plantar.OBJECTIVE: demonstrate the magnetic resonance imaging (MRI) findings in plantar thrombophlebitis. METHODS: Retrospective review of twenty patients with pain in the plantar region of the foot, in which the MRI findings indicated plantar thrombophlebitis. RESULTS: A total of fourteen men and six women, mean age 46.7 years were evaluated. Eight of these patients also underwent Doppler ultrasonography, which confirmed the thrombophlebitis. The magnetic resonance images were evaluated in consensus by two radiologists with experience in musculoskeletal radiology (more than 10 years each), showing perivascular edema in all twenty patients (100%) and muscle edema in nineteen of the twenty patients (95%). All twenty patients had intraluminal intermediate signal intensity on T2-weighted (100%) and venous ectasia was present in seventeen of the twenty cases (85%). Collateral veins were visualized in one of the twenty patients (5%). All fourteen cases (100%), in which intravenous contrast was administered, showed perivenular tissues enhancement and intraluminal filling defect. Venous ectasia, loss of compressibility and no flow on Doppler ultrasound were also observed in all eight cases examined by the method

Magnetic resonance imaging findings in adnexial torsion

Adnexial torsion is an unusual event, but a major cause of abdominal pain in women. It is often associated with ovarian tumor or cyst, but can occur in normal ovaries, especially in children. The twisting of adnexial structures may involve the ovary or tube, but frequently affects both. In most cases, it is unilateral, with slight predilection for the right side. In imaging findings, increased ovarian volume and adnexial masses are observed, with reduced or absent vascularization. In cases of undiagnosed or untreated complete twist, hemorrhagic necrosis may occur leading to complications; in that, peritonitis is the most frequent. Early diagnosis helps preventing irreversible damage with conservative treatment, thereby saving the ovary. Limitations in performing physical examination, possible inconclusive results in ultrasound and exposure to radiation in computed tomography makes magnetic resonance imaging a valuable tool in emergency assessment of gynecological diseases. The objective of this study was to report two confirmed cases of adnexial twist, emphasizing the contribution of magnetic resonance imaging in the diagnosis of this condition