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T Avataneo

Publications and source records attributed to T Avataneo.

35 records · Page 2Linked to original sources

[The role of adrenal computerized tomography in endocrinopathies. Primary hyperaldosteronism].

A review was made of the CT findings in a series of 15 patients with a clinical diagnosis of primary hyperaldosteronism. An adrenal tumour (diameter 11-68 mm) was observed in 13 cases. No adrenal involvement was noted in the other two. The initial diagnosis was confirmed either histologically or by means of a thorough clinical and instrumental follow-up in all 15 cases. High-resolution CT may thus be proposed as an initial examination in the diagnosis of primary aldosteronism. Its efficiency is such that venous sampling can be restricted to doubtful or negative cases.

Adenoma↗

[Computed tomography of non-functioning adrenal masses].

Incidental finding of non-functioning adrenal masses is not uncommon in patients undergoing abdominal CT. In a 4-year period, adrenal masses were detected as an accessory finding in 38 patients. The diagnosis was confirmed either histologically or in follow-up studies. This global series consists of 6 adenomas, 4 carcinomas, 1 pheochromocytoma, 1 ganglioneuroma, 23 metastases, 1 lymphoma, 1 histiocytoma, 1 myelolipoma. The Authors point out the parameters for the pathologic assessment of adrenal masses: size, contours and fine-needle biopsy appear to be the most reliable features.

Adenoma↗

[Adrenal tuberculosis in 13 patients with Addison's disease. CT findings].

A series of thirteen cases of adrenal tuberculosis with Addison's disease is presented. At the onset of disease, CT findings consisted of an enlargement of both glands, with peripheral enhancement after contrast medium was injected. The CT differential diagnosis among tubercular, metastatic and amyloidotic etiology was not possible. When the course of the illness was favourable, CT showed a generalized glandular atrophy with calcifications. In two fatal cases, the diagnosis could be made only at post-mortem examination.

Addison Disease↗

MR imaging of adrenal myelolipomas.

The magnetic resonance (MR) images in six patients with seven adrenal myelolipomas are presented. Four lesions involved the right gland, and three the left; they ranged from 3 to 12.5 cm in diameter. Magnetic resonance was able to image all lesions. Using T1-weighted sequences, three structural patterns were observed; (a) homogeneous masses with intensity equal to adjacent fat (three cases); (b) heterogeneous masses with fat intensity areas and areas similar to renal cortex (two cases); and (c) nodules quite different from fat, hypointense to the liver (two cases). On T2-weighted images, myelolipomas were slightly hypointense to fat and either hypo- or isointense to the liver. A comparison with the results of CT studies was possible in all cases, and good correlation with determination of the presence and quantity of fat density tissues within the lesions was observed. However, MR imaging did not seem to help in diagnosing adrenal myelolipoma in patients with equivocal CT findings, and needle biopsy is still needed in difficult cases.

Adrenal Gland Neoplasms↗

[Critical evaluation of preoperative instrumental staging of rectal tumors. Research on the adequate use of US, CT and MR].

Both traditional exams (rectal exploration, rectoscopy, barium enema, CEA) and advanced imaging (31 US, 40 CT and 11 MR) were performed for preoperative evaluation of rectal carcinoma in order to assess the accuracy of radiological imaging in the T and N staging. The results obtained have not been considered satisfactory and it is felt that US, CT and MR should not be employed routinely for rectal staging. Indeed accuracy of US, CT and MR is respectively 64%, 75% and 81% in the T evaluation and 64%, 70% and 64% in the N staging. In order to evaluate the effective usefulness of these three latter imaging techniques a double therapeutical choice was proposed. The first treatment option was suggested on the basis of traditional staging while a second choice was given considering US, TC and MR data also. Operatory findings subsequently allowed a definitive judgement on the influence of the different techniques on treatment selection. US has furnished useful data that could have allowed us to modify treatment in one case while in 5 other cases diagnostic error would have influenced treatment negatively. CT was useful in 5 cases while in 7 cases it would have influenced treatment choice negatively. MR would have been useful in one case and harmful in another. It is concluded that only patients with large neoplasms (stages T3 and T4) benefit from CT and MR staging with the exception of those cases that have tumors above the peritoneal fold or in strict relation with the sphincter structures. US was useful only in evaluating relations of neoplasms of the anterior rectal wall with nearby pelvic structures.

Adult↗

[Comparison of MR and CT in a radiological study of Cushing's syndrome. A report on 16 cases].

In 16 patients with high cortisol plasma levels MRI and CT investigation of adrenal gland region was performed; 13 also had the pituitary region examined. CT and MRI results in Cushing's Syndrome due to adrenal glands etiology (8 cases) are overlapping. The morphological criteria utilized consist in the radiological finding of bilateral adrenal hyperplasia or adrenal mass (adenoma, carcinoma). The great amount of retroperitoneal fat increases the normal contrast with both techniques. In the pituitary Cushing's Syndrome MRI was more sensible than CT as far as it concerns ACTH producing pituitary lesion assessment; this technique may show 5 mm diameter adenomas for their high signal intensity.

Adenoma↗

Is magnetic resonance imaging more sensitive than computed tomography in the location of corticotropin secreting pituitary adenomas?

Two cases of pituitary-dependent Cushing's syndrome are described in which the computed tomography (CT) examination was negative; as the hormone dynamic investigations were directed towards the presence of corticotropin (ACTH) secreting pituitary formations, magnetic resonance imaging (MRI) of the pituitary was performed, which evidenced the presence of such lesions; subsequent neurosurgery confirmed in both cases the location indicated by MRI. In conclusion, the higher sensitivity of MRI compared to CT in the diagnosis of ACTH secreting pituitary adenomas can be noted.

Adenoma↗

[CT and MR compared in the study of hypophysis].

Normal CT and MR anatomy was studied in two series (53 and 25 cases respectively) of young volunteers of both sexes, asymptomatic and certainly without lesions of the pituitary gland. 115 other pathological cases (73 hyperprolactinemias, 8 acromegalies, 15 Cushing syndromes, 2 hyperthyroidisms, 17 nonsecreting adenomas) were examined using both CT and MRI. Both an accurate review of the relative literature and the results of our own series prove that MR is superior to CT in diagnosing pituitary microadenomas (3.2% not diagnosed with MRI and 25.8% not diagnosed with CT), in the follow-up of prolactinomas subjected to medical therapy and in the study of extrasellar involvement of pituitary adenomas, particularly with regard to the demonstration of compression of the optic chiasma.

Adenoma↗

[Magnetic resonance in renal transplants].

The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejected or normally functioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnet, body coil, spin-echo pulse sequence (SE) and inversion-recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated.

Adolescent↗

[Magnetic resonance in the study of patients of short stature of the hypothalamo-hypophyseal origin. Report on 29 cases].

Although growth hormone (GH) deficiency is a very common cause of short stature, many cases are still diagnosed as idiopathic. Magnetic Resonance Imaging (MRI), more clearly than CT, reveals the anatomy of the hypothalamic-hypophyseal region and of the possible alterations (pituitary hypoplasia, interruption of the stalk) causing hormonal deficit. Twenty-nine patients with short stature underwent MRI examinations of the hypothalamic-pituitary region to assess the significance of the correlation between hormonal test and MR patterns. Five patients had normal variants of short stature (NVSS), 7 had multiple pituitary hormone defects (MPHD) and 17 had isolated growth hormone deficiency (IGHD). In patients with MPHD or with severe isolated growth hormone deficit MRI shows interruption of the pituitary stalk with ectopy of the neurohypophysis or a mass. In patients with less severe IGHD and in NVSS, MRI demonstrates a normal pituitary region or a slightly hypoplastic gland, the neurohypophysis being normally situated. MRI may provide an ethiological classification in short stature patients. Typical MR patterns can be demonstrated in cases of dwarfism secondary to a mass in the hypothalamic-pituitary region or to morphological changes of the pituitary stalk, while in transient GH deficit no anatomical abnormalities are observed.

Adolescent↗

[Definition of the T parameter in nasosinusal neoplasms: a CT-MR comparison].

This study was aimed at investigating the value of CT and MRI in the staging of sinonasal tumors. The authors report 22 cases of sinonasal tumors: 7 squamous cell carcinomas, 4 adenoid-cystic carcinomas, 1 mucoepidermoid carcinoma, 6 adenocarcinomas, 1 esthesioneuroblastoma, 1 osteosarcoma, 1 small-cell sarcoma and finally 1 non-Hodgkin lymphoma. No significant differences were observed between CT and MR staging: 2 T2 and 15 T4 lesions were diagnosed in the maxillary sinuses and 3 stage-II and 1 stage-III lesions in the naso-ethmoidal region. Tumor spread was similar in 20/22 cases: MRI excluded the involvement of maxillary and sphenoid sinuses in 2 cases. CT was superior in the assessment of bone destruction particularly at the base of the skull, but MRI better demonstrated intracranial spread. MRI detailed the intraorbital muscles and, in the infratemporal fossa, the pterygoid muscles better than CT. High agreement was observed between CT and histology in 5/7 cases and between MRI and histology in 6/7 cases undergoing craniofacial resection. Seventeen of 22 cases had low to intermediate signal intensity on T1-weighted, PD and T2-weighted MR images. Signal was hyperintense in 5 cases: 1 adenocarcinoma with mucinous features, 3 adenoid-cystic carcinomas and 1 esthesioneuroblastoma. In agreement with literature data, this study confirms CT as the examination of choice in staging sinonasal tumors: nonetheless, MRI yields valuable information in the cases with tumor spread to the muscles and soft tissues.

Adult↗