Endovascular treatment of nutcracker syndrome : a case report

Background: The "nutcracker" syndrome is most commonly caused by arterial compression of the left renal vein between the superior mesenteric artery and the aorta. As a consequence venous blood pressure increases within the renal pelvis, ureter and gonadal veins. This compression syndrome may be treated by endovascular stent implantation into the left renal vein. Case report: A 20 year old female patient was referred to us, suffering from pain in her left side, gross proteinuria and the suspicion of "nutcracker" syndrome. Symptoms were present for the last 3 years. Angio MRI was performed and confirmed compression of the left renal vein between the aorta and the superior mesenteric artery. The patient was qualified for endovascular treatment. A self expandable metallic stent, diameter 16 x 40 mm was implanted into the left renal vein. Control venography confirmed good placement of the stent and a good immediate hemodynamic effect of the procedure. The patient remains symptom free in a 14 month follow up period. Conclusions: At present, endovascular stenting seems to be the method of choice for the treatment of the nutcracker syndrome

MRI-guided fiducial marker implantation as a method of tagging an ultrasound- and non-enhanced CT-invisible liver tumor before thermal ablation

Some liver tumors are not visible on ultrasound or non-enhanced CT (NECT) which are main modalities used in image-guided ablations. This is a report of MR-guided implantation of fiducial marker to tag a neuroendocrine tumor metastasis in a patient with renal insufficiency precluding the use of contrast – enhanced CT during ablation. The marker was well visible on NECT which allowed for precise needle placement and complete ablation which was confirmed in 12-months follow-up

The impact of studying on the hippocampal volume in medical students and its correlation with the results of the Final Medical Examination : a single-centre, prospective observational cohort study

Purpose: The hippocampus forms part of the limbic system and is involved in the learning process; it is responsible for transferring information from short-term to long-term memory. The aim of our study was to assess the effect of intensive studying on hippocampal volume and whether this correlates with exam results. Material and methods: The analysis included volunteer final-year medical students who underwent 2 volumetric 3D T1 magnetic resonance imaging scans with an interval of 20 weeks: 19 weeks before and one week after the Final Medical Examination. FreeSurfer software was used to compare the volumes of the whole hippocampus and its subfields between the 2 measurements. We assessed correlations between changes in hippocampal volume and the time students spent studying, between changes in hippocampal volume and the results of the exam, and between time spent studying and exam results. Results: Forty participants (25 women and 15 men; mean age 25 years) were included in the analysis. The right hippocampus presubiculum area increased significantly over the study period (p = 0.029), whereas the volume of the left hippocampus remained unchanged. An increase in the volume of the right hippocampus correlated with longer study time (r = 0.371 in percentage and r = 0.397 in mm3) and better LEK exam results (r = 0.441 in percentage and r = 0.456 in mm3). Conclusions: Our research confirms the role of the hippocampus, particularly the subicular complex, in the process of learning and remembering, and suggest that the plastic abilities of the hippocampus depend on the intensity of learning and translate into better skills

Radiation dose in CT-guided microwave liver tumor ablation

Introduction.Ablation is one of most important methods of liver tumor treatment. However, radiation is one of disadvantages of CT-guided procedures including ablation. The purpose of this study is to assess the factors that have impact on radiation doses during CT-guided microwave liver tumor ablation. Material and methods.Radiation doses of CT-guided liver tumor ablations were collected in 127 patients. They were then compared in terms of number of lesions, lesion size and depth, use of additional localization needles and hydrodis­section as well as tumor location. Results.The median radiation doses of ablations of multiple tumors (2348 mGy*cm) were significantly higher (p = 0.03) than those of single tumors (1784 mGy*cm). No statistically significant differences were noted when other factors (lesion size, depth, location, use of localization needles and hydrodissection) were taken into consideration. Conclusions.The number of lesions is the most important factor in terms of expected radiation doses in CT-guided microwave liver tumor ablations

Radiation dose in CT-guided microwave liver tumor ablation

Introduction.Ablation is one of most important methods of liver tumor treatment. However, radiation is one of disadvantages of CT-guided procedures including ablation. The purpose of this study is to assess the factors that have impact on radiation doses during CT-guided microwave liver tumor ablation. Material and methods.Radiation doses of CT-guided liver tumor ablations were collected in 127 patients. They were then compared in terms of number of lesions, lesion size and depth, use of additional localization needles and hydrodis­section as well as tumor location. Results.The median radiation doses of ablations of multiple tumors (2348 mGy*cm) were significantly higher (p = 0.03) than those of single tumors (1784 mGy*cm). No statistically significant differences were noted when other factors (lesion size, depth, location, use of localization needles and hydrodissection) were taken into consideration. Conclusions.The number of lesions is the most important factor in terms of expected radiation doses in CT-guided microwave liver tumor ablations

MR Imaging of Pulmonary Nodules: Detection Rate and Accuracy of Size Estimation in Comparison to Computed Tomography

<div><p>Objective</p><p>The aims of this study were to assess the sensitivity of various magnetic resonance imaging (MRI) sequences for the diagnosis of pulmonary nodules and to estimate the accuracy of MRI for the measurement of lesion size, as compared to computed tomography (CT).</p><p>Methods</p><p>Fifty patients with 113 pulmonary nodules diagnosed by CT underwent lung MRI and CT. MRI studies were performed on 1.5T scanner using the following sequences: T2-TSE, T2-SPIR, T2-STIR, T2-HASTE, T1-VIBE, and T1-out-of-phase. CT and MRI data were analyzed independently by two radiologists.</p><p>Results</p><p>The overall sensitivity of MRI for the detection of pulmonary nodules was 80.5% and according to nodule size: 57.1% for nodules ≤4mm, 75% for nodules >4-6mm, 87.5% for nodules >6-8mm and 100% for nodules >8mm. MRI sequences yielded following sensitivities: 69% (T1-VIBE), 54.9% (T2-SPIR), 48.7% (T2-TSE), 48.7% (T1-out-of-phase), 45.1% (T2-STIR), 25.7% (T2-HASTE), respectively. There was very strong agreement between the maximum diameter of pulmonary nodules measured by CT and MRI (mean difference -0.02 mm; 95% CI –1.6–1.57 mm; Bland-Altman analysis).</p><p>Conclusions</p><p>MRI yielded high sensitivity for the detection of pulmonary nodules and enabled accurate assessment of their diameter. Therefore it may be considered an alternative to CT for follow-up of some lung lesions. However, due to significant number of false positive diagnoses, it is not ready to replace CT as a tool for lung nodule detection.</p></div