Paul Fornes

Multimodality imaging of melanoma metastases to the abdomen and pelvis

Disease in the abdomen and pelvis is frequent in patients with metastatic melanoma (MM). Multidetector row computed tomography is the imaging modality of choice for diagnosis and follow-up of MM. However, positron emission tomographic scan may be used as well as other newer imaging modalities, particularly for imaging of the abdominal and pelvic metastases. The aim if this exhibit is to review the distribution and features of melanoma metastases to the abdomen and pelvis as well as the role of currently available imaging modalities.

MRI and pelvic abscesses: a pictorial review

OBJECTIVE The purpose of our article was to review the magnetic resonance imaging (MRI) features of pelvic abscesses. Pelvic abscesses account for a wide range of abnormalities from various etiologies. CONCLUSION MRI is being increasingly used for pelvic exploration. Radiologists must thus be aware of their features and characteristics.

MR imaging features of nongynaecologic cystic lesions of the pelvis

OBJECTIVE The purpose of our article is to review the magnetic resonance imaging (MRI) features of nongynaecologic cystic lesions of the pelvis. CONCLUSION The rising use of MRI for pelvic exploration will result in an increase in incidental detection of pelvic cystic cysts. Pelvic cysts of non gynecologic origin are less frequent than gynecologic cysts. However, they account for a wide range of abnormalities, and radiologists must be aware of their features and characteristics.

Coarctation of the aorta: A call for early detection.

BACKGROUND: Early repair of coarctation of the aorta (COA) is associated with few perioperative complications and better long-term outcome. Therefore, early detection and treatment of COA patients is extremely desirable. The aim of this study was to review our referral system, the effectiveness of neonatal screening examination, and orient physicians about this abnormality, the mode and age of presentation, differences in presentation between cases with isolated COA, and cases associated with other cardiac lesions. PATIENTS AND METHODS: This was a retrospective study of 61 inpatients admitted to our hospital between January 1989 and December 1996, who were found to have COA. Referral data was analyzed and compared to hospital cardiac evaluation findings. RESULTS: All the patients were referred after being symptomatic, but there was no suspicion of COA in any of the cases. One of the patients was referred by a pediatrician from a private clinic, and the rest by hospital pediatricians. Femoral pulse and cardiac murmur were commented upon in only three of the referral letters. Systolic pressure gradient (SPG) between upper and lower limbs and systolic hypertension were not commented on in any of the referral letters. SPG >/=10 mm Hg and systolic hypertension were found in 100% and 58% of the patients, respectively, upon evaluation in our center. SPG in patients with COA associated with other cardiac lesions was significantly lower than in patients with isolated COA (P=0.02). CONCLUSION: Increased awareness in our primary health physicians of the importance of the neonatal screening examination and of measuring blood pressure in the limbs to detect COA early is needed. Timing of the neonatal screening examination between the third day and the third week is recommended. Systolic pressure gradient is a reliable method to detect COA, and in the lower significant range (>/=10 mm Hg) is associated with complex cardiac lesion rather than isolated COA.

Thoracic calcifications in childhood

Thoracic calcifications are found in the following locations: mediastinum, lung, pleura, cardiovascular system, and thoracic wall. The calcifications of the mediastinum include mostly inflammatory lesions and malignant neoplasms. Pulmonary calcifications are mainly inflammatory lesions and metastases of osteosarcomas. Where the cardiovascular system is concerned, the most common calcifications are those of the heart relating to tumors or surgery. Calcifications of the aortic wall and valve calcifications can be found. In the thoracic wall there are calcifications of the bone and of soft tissues. The knowledge of shape and location is very useful for the diagnosis of the underlying disease. Calcifications in the thorax are frequently manifestations of previous infectious processes. Less often, they may be due to neoplasms, metabolic disorders, or previous medical therapy.