Magnetic resonance imaging and angiography is the technique of choice in the diagnosis and follow-up of cerebral venous thrombosis: Thrombosis appears as an absence of flow void on spin echo images and lack of signal in angiographic techniques. The thrombus signal intensity is different on T1 and T2 spin echo weighted images and evolves according to hemoglobin degradation. Recognition of pitfalls and artefacts related to the different magnetic resonance imaging techniques employed is essential to interpret dural venous sinus thrombosis. In this paper the imaging of 27 patients with cerebral venous thromboses is reviewed. We describe the type of signal abnormalities, the different types of clot- and flow-related artefacts, and the indirect signs of cerebral venous thrombosis.
Here we present a case of a 58 year old man referred to our hospital to undergo neck and thyroid ultrasonography (US) following palpable neck mass. US revealed a solid hypoechoic nodule in right thyroid lobe, and a solid lesion on the right laterocervical neck region with ultrasound suspicious features of neoplastic lymph node. In order to achieve a diagnosis of the neck mass and to get a proper evaluation of the thyroid nodule, we decided to perform a fine-needle aspiration (FNA) of both lesions. At cytopathologic examination the thyroid nodule appeared as benign, while cytologic sampling of the neck lesion was inadequate for a proper evaluation. Thus, we performed core needle biopsy (CNB) of the neck lesion like recently proposed for thyroid lesions; also, to definitively exclude malignancy of thyroid nodule, this also underwent CNB. Histologic report of CNB confirmed benign thyroid nodule, while the neck lesion revealed a proliferation of neuronal type consistent with schwannoma. The patient has been addressed to clinical and ultrasonographic follow-up. CNB appears as a safe and minimally-invasive approach to diagnose indeterminate neck masses and avoid unnecessary diagnostic surgery.Riassunto Presentiamo il caso di un uomo di 58 anni che si sottoponeva ad ecotomografia del collo per una massa palpabile in sede laterocervicale destra. L'esame ecotomografico ha mostrato la presenza di una lesione solida nella regione laterocervicale destra del collo, con caratteristiche ecografiche sospette per linfonodo neoplastico. Contestualmente, si riscontrava un nodulo solido ipoecogeno del lobo destro della tiroide. Allo scopo di un'ulteriore definizione diagnostica, si è pertanto deciso di procedere ad esecuzione di agoaspirato ecoguidato di entrambe le lesioni, inviando per esame citologico il materiale ottenuto. Il nodulo tiroideo ha mostrato caratteri di benignità, mentre il prelievo eseguito sulla formazione del collo non è apparso adeguato per la valutazione citologica. Abbiamo così deciso di procedere a core needle biopsy della lesione del collo, eseguendo la medesima procedura anche sul nodulo tiroideo, per una conferma diagnostica. L'esame istologico ha confermato la benignità del nodulo tiroideo e la lesione del collo è risultata una proliferazione di tipo neuronale compatibile con schwannoma. Il paziente è stato quindi indirizzato a follow-up clinico ed ecografico. In conclusione, nel caso clinico da noi presentato la core needle biopsy è apparsa una procedura sicura e mini-invasiva nell'inquadramento diagnostico di una massa del collo di incerto significato all'esame ecotomografico, senza necessità di ulteriori approcci chirurgici.
Parameters evaluated for the SRD study included: maximum observed concentration (Cmax); time to achieve Cmax (tmax); area under the concentration-time (AUCt) curve dosing interval (τ) from 0 extrapolated to infinity (AUC0-∞); AUCt from 0 to last quantifiable data point (AUC0-tz), and over dosing interval τ (AUCt1-t2); percentage of AUCtz-∞obtained from extrapolation (%AUCtz-∞); terminal elimination constant (λz) and half-life (t1/2); mean residence time after peroral administration (MRTpo); apparent clearance (CL/F) and volume of distribution (Vz/F); amount (Aet1-t2), or fraction (fet1-t2) of BI 653048 eliminated in urine from dosing interval τ; renal clearance between dosing interval τ (CLR,t1-t2); dose-normalized Cmax (Cmax, norm) and AUC0-∞ (AUC0-∞, norm).Pharmacokinetic monitoring for the MRD and LPS challenge study was performed after the first dose and again at steady state (ss).
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