Gaston Morillo

Comparison of CT and MR imaging in musculoskeletal neoplasms.

Magnetic resonance (MR) and CT of 50 musculoskeletal neoplasms were compared to investigate the relative values of these modalities in the assessment and staging of musculoskeletal neoplasms and to determine how often they are complementary and when they are redundant. The material included 25 benign and 25 malignant neoplasms, of which 33 were skeletal and 17 were of soft tissue origin. Magnetic resonance was superior to CT with respect to all morphologic criteria except for cortical bone destruction, calcification, ossification, and the assessment of lytic and sclerotic changes in flat bones. Magnetic resonance was found to be complementary to CT in 48% of the cases (30% malignant, 18% benign). Use of both MR and CT was considered redundant in 52% of the cases (20% malignant, 32% benign). Magnetic resonance was found to be the modality of choice for all benign and malignant soft-tissue neoplasms. Both modalities are complementary and necessary for complete evaluation of malignant skeletal tumors. Benign skeletal tumors should be considered for evaluation by CT, MR, or both on an individual case basis.

Vesicourethral Dysfunction following Cystourethropexy

AbstractWe report on 32 women referred to our institution with incontinence or voiding dysfunction after an anti-incontinence operation. Our method of investigation included simultaneous pressure-flow-sphincter electromyography, and anteroposterior and lateral fluoroscopy. The patients were classified into 3 groups with respect to normal, hyporeflexive or hyperreflexive detrusor activity. The most common reasons for failure were improper surgical indications, suture misplacement and over correction of the vesicourethral angle.

Retrocaval ureter: Report of 8 cases and the surgical management

We present 8 cases of retrocaval ureter, one of which concerns a unique periureteral venous ring formed by the persistence of the right posterior cardinal vein along with a normal vena cava. Current radiographic concepts are reviewed and the importance of inferior venacavography in the preoperative evaluation for correction of the retrocaval ureter is emphasized.

Scrotal kidney and ureter: An unusual hernia

Abstract The first case of a kidney in a scrotal hernia is reported. Scrotal hernias and upper urinary tract herniations are discussed.

Hepatic artery aneurysm simulating a cystic mass of the pancreas

Aneurysms of the hepatic artery are the second most common visceral aneurysm found in the abdomen, following those of the splenic artery (1, 2). Owing to the close relationship between the common hepatic artery and the head of the pancreas, aneurysms of this vessel may be confused with pancreatic masses during radiologic imaging. This is a case report of a patient with an hepatic artery aneurysm, the only one found in approximately 15,600 consecutive CT examinations of the upper abdomen performed at our institution in a 5-year period. He was initially misdiagnosed as having a pancreatic pseudocyst.

Review of computed tomography findings in thrombosis of the major abdominal venous pathways

Computed tomography is commonly the first diagnostic modality to detect venous thrombosis. The relatively constant location and anatomic relations of the major abdominal veins allow for their proper recognition and differentiation from other tubular structures. Whether the occlusion is secondary to blood clot or tumor extension, the vessels demonstrate a characteristic appearance. The presence of adjacent tumor mass is the single most important factor to differentiate the two types of thrombi. Invaluable aid is provided by computed tomography in the management of this clinical situation. Uncommonly, the diagnosis remains unclear and venography must be done. Selected examples of major abdominal venous thrombosis are presented.

Atypical healed stress fracture of the fibula masquerading as chronic osteomyelitis. A case report of magnetic resonance distinction.

proximal right fibula (Fig. 1). The lesion had a well-defined area of laminated periosteal reaction surrounding it. The center of the lesion contained a residue of the original bone which was narrowed probably due to the resorption. Some of the original bone was preserved and the lesion simulated a &dquo;bone within a bone&dquo; picture. Mixed areas of mottled lucencies and sclerosis were present. The radiographic differential diagnosis included a healed stress fracture, chronic osteomyelitis, and, less likely, a primary bone neoplasia. A 99mTc-phosphate bone scan showed mild increased uptake in this area. MR studies were obtained in coronal and axial planes. Tl weighted images demonstrated a homogeneously intense signal throughout the medullary cavity and the inner aspect of periosteal reaction surrounding the lesion (Fig. 2). T2 weighted images again showed increased signal from the lesion (Fig. 3). No soft tissue abnormalities were detected. Due to the uncertain radiographic appearance biopsy was performed. The pathologic specimen demonstrated normal cortical bone and no evidence of infection or tumor. (Fig. 4).

Renal cell carcinoma complicating long-term dialysis: Computed tomography-guided aspiration cytology

The diagnosis of renal cell carcinoma was established by computed tomography-guided aspiration in two small solid lesions occurring in end-stage kidneys. This represents a safe means of providing more specific information about the various lesions that specific information about the various lesions that frequently develop in chronic hemodialysis patients: complex cysts, adenoma, and renal cell carcinoma. The proposed conservative approach of simple observation of these lesions may be altered if a precise diagnosis is obtained. Computed tomography is considered the most reliable imaging modality for evaluation and guided aspiration.

Complete Trifurcation of the Urethra

AbstractThe first case of complete trifurcation of the anterior urethra is presented. The embryology, previous classifications and symptoms are discussed.

Pathologic vascularity of renal angiomyolipoma: Cast corrosion and angiographic study

Angiomyolipomas of the kidney at times have been preoperatively identified by the interlobar or interlobular artery eneurysms in the early vascular phase of renal arteriograms. A case report is presented in which a plastic cast corrosion technique was used postnephrectomy to demonstrate the presence of aneurysms identified angiographically prior to surgery. Portions of a cast corrosion model of a hypernephroma are also exhibited to compare and contrast pathologic vascular features of both types of tumors.