Diagnostyka obrazowa jąder

Pathological lesions within the scrotum are relatively rare in imaging except for ultrasonography. The diseases presented in the paper are usually found in men at the age of 15–45, i.e. men of reproductive age, and therefore they are worth attention. Scrotal ultrasound in infertile individuals should be conducted on a routine basis owing to the fact that pathological scrotal lesions are frequently detected in this population. Malignant testicular cancers are the most common neoplasms in men at the age of 20–40. Ultrasound imaging is the method of choice characterized by the sensitivity of nearly 100% in the differentiation between intratesticular and extratesticular lesions. In the case of doubtful lesions that are not classifi ed for intra-operative verifi cation, nuclear magnetic resonance is applied. Computed tomography, however, is performed to monitor the progression of a neoplastic disease, in pelvic trauma with scrotal injury as well as in rare cases of scrotal hernias involving the ureters or a fragment of the urinary bladde

Scrotal imaging

Pathological lesions within the scrotum are relatively rare in imaging except for ultrasonography. The diseases presented in the paper are usually found in men at the age of 15–45, i.e. men of reproductive age, and therefore they are worth attention. Scrotal ultrasound in infertile individuals should be conducted on a routine basis owing to the fact that pathological scrotal lesions are frequently detected in this population. Malignant testicular cancers are the most common neoplasms in men at the age of 20–40. Ultrasound imaging is the method of choice characterized by the sensitivity of nearly 100% in the differentiation between intratesticular and extratesticular lesions. In the case of doubtful lesions that are not classifi ed for intra-operative verifi cation, nuclear magnetic resonance is applied. Computed tomography, however, is performed to monitor the progression of a neoplastic disease, in pelvic trauma with scrotal injury as well as in rare cases of scrotal hernias involving the ureters or a fragment of the urinary bladder

Diagnostyka obrazowa jąder

Pathological lesions within the scrotum are relatively rare in imaging except for ultrasonography. The diseases presented in the paper are usually found in men at the age of 15–45, i.e. men of reproductive age, and therefore they are worth attention. Scrotal ultrasound in infertile individuals should be conducted on a routine basis owing to the fact that pathological scrotal lesions are frequently detected in this population. Malignant testicular cancers are the most common neoplasms in men at the age of 20–40. Ultrasound imaging is the method of choice characterized by the sensitivity of nearly 100% in the differentiation between intratesticular and extratesticular lesions. In the case of doubtful lesions that are not classified for intra-operative verifi cation, nuclear magnetic resonance is applied. Computed tomography, however, is performed to monitor the progression of a neoplastic disease, in pelvic trauma with scrotal injury as well as in rare cases of scrotal hernias involving the ureters or a fragment of the urinary bladder.Patologiczne zmiany w obrębie worka mosznowego są stosunkowo rzadko spotykane w badaniach obrazowych, z wyjątkiem ultrasonografii. Prezentowane choroby dotyczą najczęściej grupy mężczyzn w przedziale wiekowym 15–45 lat, czyli w wieku rozrodczym, dlatego zasługują na szczególną uwagę. U niepłodnych mężczyzn badanie ultrasonograficzne moszny powinno być wykonywane rutynowo, ponieważ w tej populacji częstość wykrywania zmian patologicznych w mosznie jest bardzo wysoka. Nowotwory złośliwe jąder należą do najczęstszych nowotworów występujących u mężczyzn w wieku 20–40 lat. Metodą diagnostyczną z wyboru jest badanie ultrasonograficzne, którego czułość w różnicowaniu zmian wewnątrzjądrowych i zewnątrzjądrowych wynosi prawie 100%. W diagnostyce niejednoznacznych zmian, niekwalifikujących się do weryfikacji operacyjnej, stosowany jest magnetyczny rezonans jądrowy. Tomografię komputerową natomiast wykorzystuje się w monitorowaniu zaawansowania choroby nowotworowej, w stanach pourazowych miednicy z udziałem urazu moszny oraz w rzadkich przypadkach przepuklin mosznowych zawierających moczowody lub fragment pęcherza moczowego

Perfusion-CT--Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

PURPOSE:Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. MATERIAL AND METHODS:79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4-6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. RESULTS:Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. CONCLUSIONS:CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of developing pancreatic and/or peripancreatic necrosis already on the first day of the onset of symptoms and can be used for treatment planning and monitoring of therapy of acute pancreatitis. Early suspicion of possible pancreatic necrosis both on the basis of scores based on clinical status and laboratory tests have low predictive value

Colour perfusion maps for blood flow (BF), blood volume (BV), permeability surface (PS) and mean transit time (MTT).

<p>Colour perfusion maps for blood flow (BF), blood volume (BV), permeability surface (PS) and mean transit time (MTT).</p

ROC curves for different parts of pancreas: (A) Head of pancreas. (B) Body of pancreas. (C) Tail of pancreas.

<p>ROC curves for different parts of pancreas: (A) Head of pancreas. (B) Body of pancreas. (C) Tail of pancreas.</p

Average MTT value in patients with progression and without progression acute pancreatitis illustrated as a box-whiskers-plot graph.

<p>Average MTT value in patients with progression and without progression acute pancreatitis illustrated as a box-whiskers-plot graph.</p