PURPOSE: To compare follow-up results of sclerotherapy for renal cyst using 50% acetic acid with those using 99% ethanol as sclerosing agents. METHODS: Eighty-one patients underwent sclerotherapy and 58 patients, 23 males, 35 females, aged 6-76 years, having a total of 60 cysts, were included in this study; the others were lost to follow-up. The renal cysts were diagnosed by sonography, computed tomography (CT), or magnetic resonance imaging (MRI). Sclerotherapy was performed using 50% acetic acid for 32 cysts in 31 patients and 99% ethanol for 28 cysts in 27 patients. Under fluoroscopic guidance, cystic fluid was aspirated as completely as possible. After instillation of a sclerosing agent corresponding to 11.7%-25% (4-100 ml) of the aspirated volume, the patient changed position for 20 min and then the agent was removed. Patients were followed up by sonography for a period of 1-49 months. The volume of the renal cyst after sclerotherapy was compared with that of the renal cyst calculated before sclerotherapy. Medical records were reviewed to analyze complications. RESULTS: The mean volume after sclerotherapy of the 17 cysts followed for 3-4 months in the acetic acid group was 5.1% of the initial volume, and for the 14 cysts in the ethanol group it was 10.2%. Complete regression during follow-up was shown in 21 cysts (66%) in the acetic acid group; the mean volume of these cysts before the procedure was 245 ml. The mean volume of the nine (32%) completely regressed cysts in the ethanol group was 184 ml. Mild flank pain, which occurred in three patients in each group, was the only complication and resolved the next day. CONCLUSION: Acetic acid was an effective and safe sclerosing agent for renal cysts, tending to induce faster and more complete regression than ethanol.

Acetic Acid↗

PubMedDate not supplied

Percutaneous endovascular stent-graft for iliac pseudoaneurysm following lumbar discectomy.

In a 24-year-old woman, an iliac pseudoaneurysm following lumbar discectomy was successfully treated by percutaneous placement of a self-expanding stent-graft. A postprocedural angiogram demonstrated complete exclusion of the pseudoaneurysm without leakage of contrast agent.

Adult↗

PubMedDate not supplied

Bone bruises: MR characteristics and histological correlation in the young pig.

PURPOSE: To correlate magnetic resonance (MR) signal characteristics of bone bruises with histological findings. MATERIALS AND METHODS: In 14 tibiae of young pigs, bone bruises were created in the proximal tibial metaphysis. The signal intensity seen on the MR images were correlated with histological findings. The following findings were evaluated: (a) changes of signal intensity on the tibiae; (b) changes of histology on the tibiae; and (c) changes of (a) and (b) on follow-up examinations. RESULTS: We observed three types of injuries on T1-weighted images: focal or diffuse low signal, normal signal and linear low signal intensities. Severe hemorrhagic areas showed low signal intensities on all sequences of MR imaging. Fast spin-echo (FSE) T2-weighted images showed a more distinct low signal intensity than T1-weighted images. FSE short tau inversion recovery (STIR) and FSE fat saturated (FSE-FS) T2-weighted images showed similar signal intensities with FSE T2-weighted images. FS T1-weighted enhanced images showed low signal intensities with variable enhancements. Upon histological examination, hemorrhages and edemas were prominent at the subcortical areas of the contusion sites. The areas of dense, low signal intensities in all imaging sequences showed signs of severe hemorrhage. The areas of diffuse low signal and enhanced areas showed mixed areas of hemorrhages and edemas. Follow-up MR imaging showed evolution of the processes of hemorrhages and edemas with fatty marrow changes. CONCLUSIONS: MR imaging can depict changes in the bone marrow resulting from direct injury to the bone. MR imaging is a useful tool for evaluating the evolution of bone bruises.

Animals↗

PubMedDate not supplied

Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging.

The purpose of this study was to determine the usefulness of magnetic resonance imaging (MRI) for distinguishing spinal involvement of hematopoietic malignancies (lymphoma, leukemia, and multiple myeloma) from metastasis. 62 spinal MRIs were obtained in 60 patients with hematopoietic malignancies (n = 24) and metastasis (n = 36) in clinically and pathologically proven cases. MRI findings were evaluated in each group of patients for the pattern of involvement, signal change of vertebral body, location of paraspinal mass formation, location of epidural mass formation, cortical destruction, contour change, and compression fracture. Diffuse involvements were more commonly seen in hematopoietic malignancies than in metastasis (p < 0.05). Signal change confined to anterior element was seen in 9 metastasis but was not seen in hematopoietic malignancies. Cortical destructions were more commonly seen in metastasis than in hematopoietic malignancies (p < 0.05). Other findings did not show any statistical significance in both groups. MRI findings such as diffuse involvement, posterior epidural mass formation, and cortical destruction were useful to distinguish spinal involvement of hematopoietic malignancies and metastasis.

Adolescent↗