We report a case of sclerosing stromal tumor of the ovary in a 30-year-old pregnant patient presenting with pelvic pain, dysuria, and metrorrhagia. Very few reports of sclerosing stromal tumor of the ovary during pregnancy have been presented. The purpose of our work is to present the findings at physical examination, ultrasonography, magnetic resonance imaging, and histopathology, to review the literature regarding this uncommon neoplasm, and to show the usefulness of magnetic resonance imaging in the assessment of pelvic masses during pregnancy.
The purpose of our work was to evaluate the volume of hippocampus-amygdala formation (HAF) in patients with anorexia nervosa (AN), being this structure a crucial target for the glucocorticoid action in the adaptative stress-response. AN patients have biochemical hypercortisolism associated to normal ACTH levels, but do not develop the characteristic clinical features of glucocorticoid hypersecretion. Furthermore, in these patients cortisol levels usually do not suppress after dexametasone challenge. Twenty AN females (aged 30.0+/-5.1) with 10.5+/-4.2 yr of disease underwent a brain magnetic resonance (MR) examination during the recovery phase; an age-matched control group (CG) of 20 healthy female volunteers was also studied. Two interleaved T1-weighted spin-echo sequences for 46 contiguous 2-mm coronal slices (pixel 0.98(2) mm) were used. The volumes of both right and left HAFs were calculated with manual contouring from the third ventricle to the Sylvian aqueduct. IGF-I, T3, gonadotropins, 24-h urine free cortisol, and BMI were obtained for both patients (on admission and on present evaluation) and CG. Mann-Whitney, Wilcoxon and Spearman tests were used. AN patients showed a significant (p=0.0001) reduction of total (right plus left) HAF volume (6.6+/-1.3 cm3) when compared with CG (8.9+/-1.1). No significant difference was found between right and left HAF in both patients and CG. In AN patients, no significant correlation was found between the HAF and all the hormonal parameters or BMIs, while a trend towards significance was observed with duration of the disease (r=-0.398; p=0.082). MR imaging demonstrated a significant volume reduction o
Our objective was to describe our technique for multislice CT cholangiography without cholangiographic contrast agent, and to present our preliminary clinical results. Thirty-seven patients with suspected biliary obstruction were studied. A multislice CT unit was used with the following technical parameters: 2.5-mm collimation; 7.5-mm/s table speed; pitch 6; 0.8-s rotation time; 300 mA; 120 kVp; 18- to 24-s scan time; scan volume ranging from the hepatic dome to below the pancreatic head; 70-s delay after injection of 150 ml of iodinated contrast agent at 4 ml/s. No biliary contrast material was given; oral iodinated contrast agent was administered to opacify bowel loops. Axial, multiplanar reformatted, and minimum intensity projection images were evaluated. The CT findings were compared with the gold standard techniques: endoscopic retrograde cholangiography (ERCP) in 30 patients, percutaneous transhepatic cholangiography in 5, and intraoperative cholangiography in 2. In 5 patients with ampullary lesions biopsy was made during ERCP, 9 underwent surgery, and 11 US-guided fine-needle aspiration. Bile ducts appeared hypodense within the surrounding enhanced structures. Regarding the site of obstruction, agreement between multislice CT and conventional cholangiography was observed in all cases. One patient presented negative findings on both CT and ERCP. In 31 of 36 (86%) patients, multislice CT cholangiography without cholangiographic contrast agent correctly assessed the cause of bile duct obstruction. Multislice CT cholangiography without cholangiographic contrast agent seems to be a promising diagnostic tool in the assessment of patients with bile duct obstruction.
Navigator-echo, 3D MR coronary angiography is a promising sequence for assessing coronary arterial stenoses, but further improvements are required for distal segments.
hCT proved to have a high diagnostic efficacy in evaluating breast tumors. Even though it involves some exposure to radiation, it should be considered in patients in whom MR is contraindicated.
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