Search

Objective: Malignant bladder neoplasms can cause life-threatening persistent hematuria. Selective transarterial embolization is an effective way to achieve hemostasis in such patients. The purpose of our study is to share our experience in these patients and to evaluate the short- and long-term effectiveness of this procedure. Methods: Twelve male patients with intractable hematuria due to bladder carcinoma were included in the study. A total of 17 selective transarterial embolization procedures (bilateral in 5 patients) were performed in 12 patients with microspherical particles and microcoils. Results: Complete control of bleeding was achieved in 9 patients after the procedures whereas the need for transfusion continued in 3 patients. Approximately 75% bleeding control was achieved during our average 6-month (4- to 12-month) follow-up period. After the procedure, the patients had mild complaints that lasted for a few days, such as pain (66%), fever (42%), and nausea (50%). No major complications occurred. Conclusion: Selective transarterial internal iliac artery embolization is a reliable method that can be used for the palliative treatment of intractable hematuria due to bladder carcinomas. [ABSTRACT FROM AUTHOR]

Background. Ultrasound is as a noninvasive method commonly used in the work-up of thyroid nodules. This study aimed to evaluate the usefulness of sonographic and elastosonographic parameters in the discrimination of malignancy.

Objective: Horseshoe kidney is the most common renal fusion anomaly, accounting for 90%. The study aims to explore the variations in the renal arteries of individuals with horseshoe kidney anomalies and contribute to the classification in the literature. Materials and methods: Computed tomography images of 145 individuals who had intravenous contrast-enhanced abdominal computed tomography for any reason and had horseshoe kidney anomalies were analyzed retrospectively, and the presence, origin, and number of accessory renal arteries were evaluated. Then, classification was performed according to the origin of the accessory arteries. Results: In 145 individuals, 44 different combinations of the accessory artery according to the origin and number were obtained. Most common accessory artery combination was type 2a (M1). According to our classification, 13.1% of the patients were type 1, 57.2% were type 2, 17.2% were type 3, 10.3% were type 4, and 1.4% were type 5. Conclusion: The classifications of arterial variations in horseshoe kidney anomalies did not match each other in previous studies and did not comprise all patients because they were conducted with a small number of cases. A more comprehensive new classification was created in our study according to accessory artery origins with the help of previous studies. [ABSTRACT FROM AUTHOR]

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1177/1051228405001528 Byline: Mustafa Efkan Colpan (1), Zeki Sekerci (1), Baki Hekimoglu (1), David Jeffrey Mogul (1) Keywords: Aneurysm; angiography; computerized tomography; magnetic resonance; reconstruction; thrombi Abstract: ABSTRACT Objective. Improved visualization of intraaneurysmal thrombi can contribute to understanding their impact on clinical courses and treatments. Digital subtraction angiography (DSA) demonstrates the hemodynamic portion of aneurysm domes and vasculature structures and has been considered by many to be the principal technique used for aneurysm diagnosis. An intraaneurysmal thrombus may be visualized as a filling defect on DSA, but DSA does not reliably indicate the presence of an intraaneurysmal thrombus or its details. Computerized tomography (CT) and magnetic resonance (MR) imaging may have advantages over DSA, particularly because of their capacity to visualize soft tissue. Hence, we investigated the reconstruction of MR and CT images and compared it to DSA for assessment of intraaneurysmal thrombi. Methods. Thirty-one patients with 34 aneurysms were enrolled. The entire group was examined with DSA. Sixteen cases were also examined with MR imaging; the remaining 15 were examined with CT imaging. Images of intraaneurysmal thrombi were rendered from corresponding MRI and soft tissue scans using CT. Intracranial vessels and aneurysms were defined from MR and CT angiography. Whole images were linked via imaging software for the reconstruction of vasculature structures. Images were superimposed to produce visualizations of thrombi situated in aneurysmal bodies. Results. Reconstruction of the MR and CT images clearly demonstrated the presence and details of intraaneurysmal thrombi in 9 (26.4 %) of 34 aneurysms. DSA detected only 4 (11.7 %) of the cases as a filling defect. Significant differences in thrombus visualization were observed between DSA used alone or in conjunction with either MRA (P= .02) or CTA (P= .04) images. Mean volume of thrombosed aneurysms was 3.2 [+ or -] 0.84 mL (mean [+ or -] SEM) and thrombosis volume was 0.9 [+ or -] 0.31 mL. Aneurysm and nested thrombus volumes were highly correlated (r= 0.987; P < .001). Conclusion. Intraaneurysmal thrombi were clearly visualized by computerized MR and CT image reconstruction. MR and CT were superior to DSA alone in demonstrating the presence of intra-aneurysmal thrombi. Computer-assisted 3-D visualization can be invaluable in understanding the shape and volume of intraaneurysmal thrombi, which may contribute to more accurate assessment and effective treatment of aneurysms cases. Author Affiliation: (1)From the Department of Neurosurgery, SSK Ankara Education and Research Hospital, Ankara, Turkey (MEC, ZS); Pritzker Institute of Biomedical Science & Engineering; Illinois Institute of Technology, Chicago, Illinois, USA (MEC, DM); and Department of Radiology, SSK Ankara Education and Research Hospital, Ankara, Turkey (BH). Article History: Received April 13, 2005, and in revised form August 19, 2005. Accepted for publication August 30, 2005. Article note: Address correspondence to Mustafa Efkan Colpan, MD, Pritzker Institute of Biomedical Science and Engineering, 10 West 32nd Street, E1-116, Chicago, IL, 60616. E-mail: colpan@iit.edu.

Purpose: The aim of our study was to evaluate the availability of magnetic resonance spectroscopy (MRS) for the differentiation of benign or malignant pulmonary nodules and masses.Methods: A total of 59 patients (45 male, 14 female) with pulmonary nodules and masses were included in this prospective study. MRS was applied to the pulmonary lesions of the patients and choline levels were determined. Afterwards CT-guided percutaneous needle biopsy was performed. According to the biopsy results, pulmonary lesions were benign in 25 patients and malignant in 34 patients.Results: Choline levels were significantly higher in malignant lesions compared with benign lesions (p < 0.001). When the other conditions were kept constant, the probability of malignancy significantly increased by 17.38-fold (95% CI, 3.78-79.93) in those with choline levels >1.65 µmol/g compared to those with choline levels ≤1.65 µmol/g (p < 0.001).Conclusion: MRS is a noninvasive method that can be used in the differential diagnosis of pulmonary nodules and masses. [ABSTRACT FROM AUTHOR]

Background: According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown. Purpose: To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (nonmass enhancements) sick lobe patterns, together with the histopathology results. Material and Methods: MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors. Results: The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns. Conclusion: In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations. [ABSTRACT FROM AUTHOR]