Home About us Contact
|
Home About us Contact | ||
|
|
||
Radiological Study (radiological + study)
Selected AbstractsThalassemia: macroscopic and radiological study of a caseINTERNATIONAL JOURNAL OF OSTEOARCHAEOLOGY, Issue 3 2007A. Lagia Abstract Differentiation of the genetic and the acquired anaemias, particularly in areas of the world where they may co-exist, has been a challenge for palaeopathologists for over 100 years. In this paper we present macroscopic and radiographic skeletal lesions that are associated with the thalassemias in a 14-year-old girl from a modern reference collection of the University of Athens. This individual is of known sex, age, cause of death, place and dates of birth and death. The case is examined in terms of epidemiology, growth, distribution and severity of lesions and differential diagnosis. The entire skeleton is affected by marrow hyperplasia: lesions of the axial skeleton are extreme, and the appendicular skeleton is severely affected as well. The odontofacial manifestations that are diagnostic of thalassemia and differentiate it from other anaemias are present and include: maxillary and mandibular hyperplasia, reduced sinuses, displacement of maxillary dental structures, overbite, and generalised osteopenia. The development of extreme bone lesions and the ,advanced' age-at-death of this individual is explained as either the result of thalassemia major under a low transfusion regimen that was the norm during her lifetime, or to a form of thalassemia intermedia that allows survival to later life at the expense of gross skeletal alterations. The present status of skeletal studies in Greece does not support the identification of a genetic anaemia in past populations. The potential contribution of the current analysis in differentiating the anaemias in antiquity is evaluated. Copyright © 2006 John Wiley & Sons, Ltd. [source] Identification and validation of risk factors for vesicourethral leaks following radical retropubic prostatectomyINTERNATIONAL JOURNAL OF UROLOGY, Issue 11 2005VINCENT J GNANAPRAGASAM Aims: To identify risk factors for anastomotic leaks at cystography following radical retropubic prostatectomy (RRP). Methods: In phase 1 the records of a 107 RRP patients were reviewed. Data collected included comorbidity, pathological factors and intra- and postoperative complications. From these, risk factors were identified that were associated with a leak at cystography. In phase 2 (n = 46) we prospectively tested if the risk factors identified could predict an anastomotic leak. Results: In phase 1 the only identifiable risk factors were that of a difficult anastamosis, an unsatisfactory intraoperative test flush and the presence of a urinary tract infection. One or more of these events were found in 17/25 (68%) of the patients who leaked (P < 0.0001). Of the eight leaks missed, five were classed as minimal and did not require repeat cystography. Within the prospective phase 2 cohort one or more risk factors were present in 7/10 (70%) of the patients who leaked. In contrast, the identified risk factors were present in only 5/36 (13.8%) of the patients who did not leak (P < 0.001). The specificity of the test was 86.1% with a sensitivity of 70%. This gave a positive predictive value of 58.3% and a negative predictive value of 91.1%. Three leaks (two minimal and one moderate) would have been missed but 31 (67.3%) patients would have avoided an unnecessary radiological study. Conclusion: Using a retrospective and prospective cohort of patients we have shown that a cystogram following RRP can be safely avoided in the absence of the identified risk factors. [source] Central facial palsy revisited: A clinical-radiological study,ANNALS OF NEUROLOGY, Issue 3 2010Luigi Cattaneo MD We investigated the pattern of volitional facial motor deficits in acute stroke patients. We assessed the strength of single facial movements and correlated it to the site of infarct classified on computed tomography scans. Exclusion criteria were previous stroke, cerebral hemorrhage, and subcortical stroke. Results showed that weakness in eyelid closure was associated with anterior cerebral artery (ACA) stroke. Weakness in lip opening was associated with middle cerebral artery (MCA) stroke. We suggest that sparing of upper facial movements in MCA stroke is due to the presence of an upper face motor representation in both the MCA and ACA territories. ANN NEUROL 2010;68:404,408 [source] Metanephric adenoma of the kidney: clinical and radiological study of nine casesBJU INTERNATIONAL, Issue 11 2009Cyrille Bastide OBJECTIVE To analyse the clinical and radiological features of metanephric adenoma (MA, a rare benign renal tumour) in nine patients, and to review previous reports. PATIENTS AND METHODS From 1992 to 2007, we identified nine patients (eight women and one man) with MA at our institution. Four patients had a radical nephrectomy and five a partial nephrectomy. Preoperative imaging was reviewed by a senior radiologist. Renal colour Doppler ultrasonography (US), abdominal computed tomography and abdominal magnetic resonance imaging were used in seven, eight and four patients, respectively. RESULTS The mean (range) age of the patients was 46.8 (19,79) years. Six tumours were discovered incidentally. Three patients were symptomatic (two with haematuria and one with polycythaemia). There was no vascular flow on colour Doppler US within the tumours. There were peripheral and/or central calcifications in six of the tumours. All the tumours were well-circumscribed with minimal enhancement after injection with non-ionic intravenous contrast or gadolinium. CONCLUSIONS Renal MA is a benign tumour occurring mainly in young and middle-aged women. Polycythaemia is associated in ,10%. Generally, MA is solid, well-circumscribed and hypovascular, often with calcifications. Based on a combination of clinical and imaging features, it might be possible to suspect the diagnosis of MA and propose a preoperative diagnostic biopsy, a partial nephrectomy or active surveillance. [source] The subdural space of the spine: A lymphatic sink?CLINICAL ANATOMY, Issue 7 2010Myodil's last message Abstract Following the radiological study of a large number of myelograms, starting over 50 years ago when the only clinical contrast medium available to show the contents of the spinal canal was an iodized oil, the author has collected a number of examples where the oil was inadvertently injected into the subdural area, rather than the intended subarachnoid space. By taking follow-up films at various intervals following the inadvertent injection, it has been possible to study the extent to which the subdural space could become visualized from a lumbar injection, the contrast medium sometimes passing to the top of the cervical region and the lower part of the sacrum. Also, the contrast passed outward along the peri-neural lymphatic sheaths or spaces of the issuing spinal nerves, where it might remain for months, and under the influence of gravity it could extend for a considerable way. It also passed into abdominal and thoracic lymph vessels and nodes. Considering the morphology, predictability, and ease with which the demonstrated subdural space fills, the author concludes that the subdural region is a true and functionally significant "space," and an important conduit or functional part of the body's lymphatic system. He also considers that it has implications for the spread or dissemination of various organisms, substances or pathological conditions, as well as being part of the normal conduit for reabsorption of CSF with implications for hydrocephalus, and with potential for misplacement of spinal anaesthetic agents. Clin. Anat. 23:829,839, 2010. © 2010 Wiley-Liss, Inc. [source] Anatomical delineation of a safety zone for drilling the internal acoustic meatus during surgery for vestibular schwanomma by retrosigmoid suboccipital approachCLINICAL ANATOMY, Issue 7 2009Tulika Gupta Abstract Drilling the internal acoustic meatus (IAM) is an important step during surgical removal of vestibular schwanommas. During this maneuver, the proximity of the jugular bulb and the saccus endolymphaticus to the IAM makes these structures prone to injury. There have been studies in the past on the relationship between a high jugular bulb (HJB) and the IAM, but there is no description of a safety area available for drilling the meatus. In the present study, measurements were made between the IAM and the nearest points on the top of the jugular bulb, the saccus endolymphaticus and the petrous ridge. The incidence of a HJB was also calculated. It was found that about 5 mm of bone could be safely drilled away from the posterior lip of the IAM without damaging either the jugular bulb or the saccus endolymphaticus in most of the cases. The incidence of HJB was found to be 38.6% with 18.1% having a very high bulb. Thus, a significant proportion of patients are likely to have a HJB. Since there are significant individual variations, a preoperative radiological study for delineation of important bony landmarks is necessary in all patients undergoing surgery for vestibular schwanommas. Clin. Anat. 22:794,799, 2009. © 2009 Wiley-Liss, Inc. [source] The gracilis muscle and its use in clinical reconstruction: An anatomical, embryological, and radiological studyCLINICAL ANATOMY, Issue 7 2008V. Macchi Abstract The gracilis muscle is used widely in reconstructive surgery, as a pedicled or as a free microsurgical flap, for soft tissue coverage or as a functioning muscle transfer. Many studies, based on cadaver dissections, have focused on the vascular anatomy of the gracilis muscle and provided different data about the number, origin, and caliber of its vascular pedicles. Computed tomographic (CT) angiography of both thighs of 40 patients (35 males and 5 females, mean age: 63 years) have been analyzed to provide a detailed anatomical description of the arterial supply of the gracilis muscle. The gracilis muscle had a mean length of 41 ± 2.1 cm. The principal pedicle enters the gracilis muscle at a mean distance (±SD) of 10 ± 1 cm from the ischiopubic attachment of the muscle. Its caliber shows a mean value of 2.5 ± 0.5 mm, and it is statistically larger when originating directly from the deep femoral artery (45%) than from its muscular branch supplying the adductors, i.e., the "artery to the adductors" (46%) (P < 0.01). A significant correlation between the caliber of the artery of the main pedicle and the volume of the gracilis muscle was found (P < 0.01). The mean number of distal accessory pedicles is 1.8 (range, 1,4,) and the artery of the first of these pedicles shows a mean caliber of 2.0 mm. There is no correlation between either the number or the caliber of the artery of the accessory pedicles and the volume of the gracilis muscle. CT angiography, providing detailed images of the muscular and vascular structures of the thigh of each patient, could be a useful preoperative study for the reconstructive surgeon. It would allow a personalized planning of a gracilis flap, reducing the risk of iatrogenic damage. Clin. Anat. 21:696,704, 2008. © 2008 Wiley-Liss, Inc. [source] Comparing the anatomical consistency of the posterior superior iliac spine to the iliac crest as reference landmarks for the lumbopelvic spine: A retrospective radiological studyCLINICAL ANATOMY, Issue 7 2007J.M. McGaugh Abstract A palpation reference line coursing between the superior-most aspect of the iliac crests has been reported to cross the L4 spinous process or L4/L5 intervertebral space in ,80% of the population. Comparable data have not been defined for the line coursing between the posterior superior iliac spines (PSIS). The purpose of this study was to compare the anatomical consistency of the PSIS to the iliac crest as landmarks used for spinal palpation. One hundred computerized tomographic images were reviewed in a three-dimensional setting. Two horizontal lines were constructed on each image: Line 1 representing the superior-most aspect of the iliac crest and Line 2 representing the inferior margin of the PSIS. The vertical distance between each horizontal line and the inferior edge of its respective spinous process were measured. The PSIS corresponded to the S2 spinous process in 81% of subjects and the iliac crest to the L4 spinous process in 59% of subjects. Distance measures suggest that the PSIS was closer to S2 versus the iliac crest to L4 (t = 6.998; P < 0.01). The PSIS crossed S2 more frequently than the iliac crest crossed L4 (,2 = 12.719, P , 0.01). The study findings support the relationship between the PSIS, and the spinous process of S2 is more consistent when compared to the iliac crest and the spinous process of L4. The PSIS reference line may be used to find S2 as a reference standard in validity and reliability palpation studies in the lower lumbar spine. Clin. Anat. 20:819,825, 2007. © 2007 Wiley-Liss, Inc. [source] | ||||||||||