[PET/CT with (18F)FDG in the initial staging of a pelvic kidney neoplasm. A case report].

We report a case of 58-year-old woman referred to our service for an (18)FFDG PET/CT study of initial staging after being diagnosed of a pelvic kidney mass consistent with malignancy. The FDG-PET showed an abnormal mass in the right kidney, a suspicious metastasis versus a second primary tumor in the cortex of the kidney and lymph node infiltration in the paracaval nodes. The histological analysis verification after exeresis of the lesions confirmed the diagnosis of renal metastases.

[Vesicosigmoid fistulas secondary to diverticulitis: helical CT diagnosis].

Colovesical fistulas are the most common type of vesicointestinal fistula and the most prevalent of these are vesicosigmoid fistulas. In our environment, diverticulitis is the most common cause, accounting for approximately one half of all cases. The literature describes different methods for the diagnosis of colovesical fistula, with computed tomography and cystography being the most useful.

Capsule endoscopy versus computed tomographic or standard angiography for the diagnosis of obscure gastrointestinal bleeding.

Background And Aims: Capsule endoscopy (CE) is superior to push enteroscopy and small bowel barium radiography in detecting the source of obscure GI bleeding. We now compared whether CE has a superior diagnostic yield than CT angiography (CTA) or standard mesenteric angiography (ANGIO) in patients with obscure GI bleeding.

Methods: From June 2004 to October 2005, consecutive patients admitted for OGIB underwent both CTA and ANGIO, followed by CE, performed blindly by independent examiners within the next 7 days.

Nutcracker or left renal vein compression phenomenon: multidetector computed tomography findings and clinical significance.

The use of multidetector computed tomography (MDCT) in routine abdominal explorations has increased the detection of the nutcracker phenomenon, defined as left renal vein (LRV) compression by adjacent anatomic structures. The embryology and anatomy of the nutcracker phenomenon are relevant as a background for the nutcracker syndrome, a rare cause of hematuria as well as other symptoms. MDCT examples of collateral renal vein circulation (gonadal, ureteric, azygous, lumbar, capsular) and aortomesenteric (anterior) and retroaortic (posterior) nutcracker phenomena in patients with no urologic complaint are shown as well as studies performed on patients with gross hematuria of uncertain origin.

Aortic stenosis: spectrum of diseases depicted at multisection CT.

Aortic stenosis, or narrowing of the aortic lumen, has many causes. It may originate in coarctation or pseudocoarctation of the aorta, midaortic dysplastic syndrome, atherosclerosis, Takayasu arteritis, aortic dissection, or various intraaortic and periaortic diseases or as a result of aortic surgical repair. The impedance of blood flow through the stenotic segment may lead to the development of various collateral arterial pathways, according to the location of stenosis.

Complications of orthotopic liver transplantation: spectrum of findings with helical CT.

Orthotopic liver transplantation has become the treatment of choice for patients with end-stage nonmalignant liver disease. The surgical techniques and immunosuppressive therapy for this procedure have improved considerably. Nevertheless, there are still significant complications, particularly those of vascular origin, which can lead to graft failure and require retransplantation unless prompt treatment is instituted.

[Computerized tomography angiography of the renal vessels].

Objective: To present the findings and discuss the diagnostic possibilities of helical CT angiography and digital substraction angiography, and to compare their capabilities to depict renal vascular anatomy (arterial and venous) and the pathological changes.

Methods: The findings obtained by the different imaging modalities of CT angiography were compared with those of digital substraction angiography in more than 2000 studies performed at our hospital.

Results: Agreement and correlation between CT angiography and digital substraction angiography, the gold standard, were found in the vast majority of the cases.

Hemoperitoneum as a first manifestation of hepatocellular carcinoma in western patients with liver cirrhosis: effectiveness of emergency treatment with transcatheter arterial embolization.

Hemoperitoneum is a well-known form of hepatocellular carcinoma presentation and represents a frequent complication in countries with a high incidence of hepatocellular carcinoma, but it is rarely seen in Western countries. Our aim was to report the results and describe the arteriographic and CT-scan characteristics in a series of seven consecutive patients. They were admitted to our hospital because of hemoperitoneum due to ruptured tumor as a first manifestation of hepatocellular carcinoma, and the rupture was effectively controlled by transcatheter arterial embolization.

Improved diagnosis of hepatic perfusion disorders: value of hepatic arterial phase imaging during helical CT.

The liver has a unique dual blood supply, which makes helical computed tomography (CT) a highly suitable technique for hepatic imaging. Helical CT allows single breath-hold scanning without motion artifacts. Because of rapid image acquisition, two-phase (hepatic arterial phase and portal venous phase) evaluation of the hepatic parenchyma is possible, improving tumor detection and tumor characterization in a single CT study.

Portomesenteric vein gas: pathologic mechanisms, CT findings, and prognosis.

Portomesenteric vein gas is a rare condition whose pathogenesis is not fully understood. Portomesenteric vein gas is most commonly caused by mesenteric ischemia but may have a variety of other causes. The primary factors that favor the development of this pathologic entity are intestinal wall alterations, bowel distention, and sepsis.

Accuracy of helical computed tomographic angiography for the diagnosis of colonic angiodysplasia.

Background & Aims: The diagnosis of colonic angiodysplasia is often challenging and relies on endoscopy or catheter angiography. We investigated whether computed tomographic angiography (CTA) contributes to the diagnosis of colonic angiodysplasia.

Methods: Twenty-eight patients with suspected bleeding from colonic angiodysplasia were prospectively evaluated.

Arteriovenous fistula secondary to iliac mycotic aneurysm: helical CT findings.

We describe the case of a 59-year-old man who presented a mycotic aneurysm of the common right iliac artery due to Streptococcus agalactiae and developed an arteriovenous fistula within the inferior vena cava secondary to spontaneous rupture of the aneurysm. The clinical syndrome, helical computed tomographic, and angiographic findings are described and discussed.

Intrahepatic arterioportal shunt: helical CT findings.

The purpose of this study was to characterize the appearance of intrahepatic arterioportal shunts (APS) on two-phase helical CT, with emphasis on the importance of the hepatic arterial-dominant phase (HAP) to demonstrate perfusion disorders. We review eight cases of APS diagnosed by helical CT in our institution from January 1996 to March 1997 and describe the CT findings that established diagnosis. Five of them were confirmed by angiography.

Renal trauma in occult ureteropelvic junction obstruction: CT findings.

The aim of this study was to present CT findings of occult ureteropelvic junction obstruction in patients with renal trauma and to describe the clinical signs and singular CT features that are characteristically observed with trauma and are relevant to management of these patients. We retrospectively reviewed 82 helical CT studies in patients with renal trauma referred to our institution. We found 13 cases of occult preexisting renal pathology, six of which were occult ureteropelvic junction obstructions.

Aortic dissection: diagnosis and follow-up with helical CT.

Acute aortic dissection is a cardiovascular emergency that requires prompt diagnosis and treatment. Helical computed tomography (CT) allows diagnosis of acute aortic dissection with a sensitivity and specificity of nearly 100%. With helical CT, a dissection involving the ascending aorta (type A in the Stanford classification) can be differentiated from one distal to the left subclavian artery (type B).

Small bowel obstruction secondary to bezoar: CT diagnosis.

Two cases of small bowel obstruction secondary to phytobezoar diagnosed by computed tomography (CT) and confirmed at surgery are presented. CT findings were dilated intestinal loops and an intraluminal mass with air bubbles retained in its interstices, resulting in a mottled appearance. We propose that definite diagnosis of small bowel bezoar can be made on the basis of these CT findings.

Duodenal schwannoma causing gastrointestinal bleeding: helical CT findings.

Neurogenic tumors of the small intestine are extremely rare and represent an unusual cause of gastrointestinal hemorrhage. We present a case of schwannoma of the fourth portion of the duodenum demonstrated by helical computed tomography. Multiplanar reconstructions showed a hypervascular tumor arising from the inferior wall of the duodenum.

CT evaluation of underlying cause in spontaneous subcapsular and perirenal hemorrhage.

We evaluated the CT scans of 13 patients with spontaneous subcapsular or perinephric hemorrhage (SPH) associated with these underlying causes: 4 angiomyolipomas, 2 renal cell carcinomas, 1 renal metastatic malignant melanoma, 1 ruptured renal artery aneurysm, 1 adrenal myelolipoma, 1 ruptured renal abscess, 2 ruptured hemorrhagic cysts, and 1 patient with undiagnosed coagulation disorder. Our objective was to ascertain whether an underlying cause of SPH was identifiable by CT, and to determine the extension of the hematomas. Computed tomography identified the hematoma in all 13 cases (sensitivity 100 %).

Spontaneous aortocaval fistula: CT findings with pathologic correlation.

We present a case of aortocaval fistula (ACF) secondary to spontaneous rupture of an atherosclerotic infrarenal aortic aneurysm into the inferior vena cava that was initially diagnosed with computed tomography (CT). This is believed to be the first report of this condition with CT demonstration of the exact site of fistula and CT-pathologic correlation. We retrospectively reviewed the CT findings of another two cases of ACF and the previous literature.

[The percutaneous dissolution treatment of gallstones. Our initial experience].

Objective: To describe our initial experience in direct contact dissolution of cholesterol gallstones with methyl-tert-butyl ether, a non surgical approach for high risk patients.

Patients: Twenty symptomatic patients were preselected. They all had radiolucent stones in functioning gallbladders.

Scintigraphy, angiography and computed tomography in unilateral hyperlucent lung due to obliterative bronchiolitis.

This study examines the value of different imaging methods in assessing the anatomic structures of unilateral hyperlucent lung due to obliterative bronchiolitis. We studied 9 patients, 5 males and 4 females, suffering from UHL (mean age 49 years). Ventilation-perfusion scan (VPS) and computed tomography (CT) of the chest were performed in all, and conventional angiography or digital substraction angiography (DSA) in 7 patients.

CT of primary bilateral adrenal lymphoma.

Two cases of bilateral primary adrenal lymphoma are presented. One case had a cystic appearance and the other a homogeneous density.

Spontaneous duodenal fistula due to hepatic hydatid cyst.

Communication of a hepatic hydatid cyst to the duodenum appears to be extremely rare. This is the first case described in the imaging literature of hepatic echinococcosis fistulized to the duodenum studied by computed tomography.

[The radiologic manifestations of bronchiolitis obliterans].

We reviewed the radiological findings in 19 patients suffering obliterans bronchiolitis, all of whom were classified as idiopathic obliterans bronchiolitis with organizing pneumonia. In most cases, above 80%, X-rays showed alveolar opacities in patches; other less frequent findings were the presence of an interstitial pattern and cavitation (10%). Radiological findings are not specific being most useful in posttreatment patient follow-up.