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Mucinous cystic neoplasms (MCNs) can be of ovarian or extra-ovarian origin. They share a common pathway of development, but pathogenesis remains controversial. Case reports involving the mesentery as a primary tumour site are few ...
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Mucinous cystic neoplasms (MCNs) can be of ovarian or extra-ovarian origin. They share a common pathway of development, but pathogenesis remains controversial. Case reports involving the mesentery as a primary tumour site are few in literature. We report a case of a 48 year old female who presented with abdominal pain. Ultrasound revealed an intraabdominal cystic mass probably of adnexal in origin under radiology. On laparotomy, the mass was seen arising from the mesentery and was suspected to be a mesenteric cyst. On histopathological examination, the cyst was diagnosed to be of neoplastic nature (Mesenteric mucinous cystadenoma). MCNs of the mesentery remain asymptomatic until they attain a very large size. The awareness of this entity helps in considering this lesion in the differential diagnosis of mesenteric cysts. Complete surgical removal of the tumour without spillage is recommended, due to higher risk of recurrence and malignant transformation. The definitive diagnosis is based on histopathological examination which can exclude a borderline or malignant component, thereby helping in better patient management.
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There is no specific duplex ultrasound (DUS) criteria for the diagnosis of inferior mesenteric artery (IMA) stenosis. This study will define the optimal duplex velocity values with the best overall accuracy (OA) in detecting ≥50%...
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There is no specific duplex ultrasound (DUS) criteria for the diagnosis of inferior mesenteric artery (IMA) stenosis. This study will define the optimal duplex velocity values with the best overall accuracy (OA) in detecting ≥50% stenosis of the IMAs. Eighty-five IMAs with both DUS and mesenteric arteriography were analyzed. Eighty-five IMAs were examined: 45 were normal, 12 with <50% stenosis, eight with ≥50-69% stenosis and 15 with ≥70% stenosis (including occlusion) based on angiography. The mean peak systolic velocities (PSVs) for a normal IMA, <50% and ≥50% stenosis was 105, 215 and 392 cm/second, respectively (P < 0.0001). The most accurate PSV in detecting ≥50% stenosis was ≥250 cm/second with a sensitivity of 90%, a specificity of 96% and an OA of 95%. The most accurate end-diastolic velocity (EDV) in detecting ≥50% stenosis was ≥80% or ≥90 cm/second, with an OA of 86%, a sensitivity of 60% and a specificity of 100%. The most accurate ratio in detecting ≥50% stenosis was ≥4 or ≥4.5 with an OA of 93%. Receiver operator curves analysis showed that the PSV was not better than EDV and PSV ratio in detecting ≥50% stenosis (P = 0.1661 and 0.4568, respectively). In conclusion, specific IMA PSVs, EDVs and IMA/aortic systolic ratios can be used in detecting significant IMA stenosis with reasonable accuracy.
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Superior mesenteric artery (SMA) syndrome is caused by compression of the transverse part of the duodenum between the SMA and the aorta, where the distance between these vessels decreases with loss of mesenteric fat. It occurs mos...
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Superior mesenteric artery (SMA) syndrome is caused by compression of the transverse part of the duodenum between the SMA and the aorta, where the distance between these vessels decreases with loss of mesenteric fat. It occurs most frequently in patients with rapid weight loss. Conventionally, the diagnosis is established by digital fluoroscopy and contrast-enhanced spiral computed tomography (CT). A 17-year old woman was admitted via the emergency department with postprandial fullness, nausea, and bile stained vomiting. The initial radiological examination revealed severe gastroptosis. Fluoroscopic evaluation after barium swallowing failed due to a markedly distended stomach. The diagnosis of SMA syndrome was made by endoscopic ultrasound (EUS) using a mini-probe. EUS findings were in good agreement with the CT angiogram. A conservative trial was attempted, but symptoms remained refractory. Surgery was an alternative option and we treated the patient successfully with laparoscopic duodeno-jejunostomy.
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This report describes the use of ultrasound to diagnose right dorsal displacement of the large colon (RDDLC) in 13 horses prior to surgery. Horses had ultrasonographic examinations performed of the right lateroventral aspect of th...
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This report describes the use of ultrasound to diagnose right dorsal displacement of the large colon (RDDLC) in 13 horses prior to surgery. Horses had ultrasonographic examinations performed of the right lateroventral aspect of the abdomen upon admission to the hospital with a 2-5 MHz broadband curvilinear sector scanning transducer after alcohol was used to wet the hair. First, the caecal vessels were identified in the right flank and followed medially and cranially. Next, each intercostal space, from caudal to cranial, was scanned from dorsal to ventral evaluating for abnormally-located mesenteric vessels associated with the large colon. Abnormally-located mesenteric vessels associated with the large colon, distinct from the caecal vessels, were identified in 13 of 23 horses with a diagnosis of RDDLC obtained at exploratory laparotomy. In horses, ultrasonographic visualisation of mesenteric vessels along the right lateral abdomen, dorsal to the costochondral junction in at least 2 intercostal spaces, distinct from the caecal vessels, is consistent with a surgical diagnosis of RDDLC.
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Purpose Diagnosis of non-occlusive mesenteric ischemia (NOMI) is difficult, with diagnostic imaging being mainly performed using angiography or contrast-enhanced computed tomography. Contrast-enhanced ultrasonography (CEUS) offers...
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Purpose Diagnosis of non-occlusive mesenteric ischemia (NOMI) is difficult, with diagnostic imaging being mainly performed using angiography or contrast-enhanced computed tomography. Contrast-enhanced ultrasonography (CEUS) offers an alternative diagnostic method, although diagnosis of NOMI using CEUS is not common. In this report, we review CEUS findings in a series of patients with NOMI. Methods The records of patients diagnosed with NOMI who underwent a surgical procedure in our institution between January 2015 and February 2020 were retrospectively assessed. Grayscale ultrasonography and CEUS findings were evaluated. Results Ten patients (mean age 65 +/- 25 years, 7 men) were studied. Grayscale ultrasonography revealed bowel dilatation, the presence of intestinal pneumatosis, portal venous gas, bowel wall thickening, and no or decreased peristalsis. A CEUS finding of note was a partial lack of enhancement of the bowel wall. Conclusion In a small case series of 10 patients with surgically/histopathology confirmed NOMI, partial lack of ultrasound contrast-enhancement of the bowel wall was observed.
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Compression of the celiac artery by the diaphragmatic crura, the median arcuate ligament, or the fibrous periaortic ganglionic tissue results in a rare constellation of symptoms known as celiac artery compression syndrome (CACS).
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Objective This article reviews the relevant anatomy and physiology of the mesenteric vasculature, familiarizes the radiologist with the accepted diagnostic criteria for mesenteric artery stenosis and its role in the diagnosis of c...
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Objective This article reviews the relevant anatomy and physiology of the mesenteric vasculature, familiarizes the radiologist with the accepted diagnostic criteria for mesenteric artery stenosis and its role in the diagnosis of chronic mesenteric ischemia, describes Doppler imaging techniques, and provides protocols for the assessment and surveillance of the mesenteric vasculature before and after revascularization. It also discusses expected changes following revascularization and reviews common post-procedural complications. Results Duplex sonography plays an important role in the diagnosis and management of chronic mesenteric ischemia (CMI). Establishing a successful diagnosis is dependent upon knowledge of mesenteric arterial anatomy and physiology as well as sufficient expertise in image optimization and scanning techniques. Although there has been a trend toward utilization of other noninvasive [computed tomographic angiography (CTA), magnetic resonance angiography (MRA), and invasive (digital subtraction angiography (DSA)] imaging modalities for assessment of the mesenteric vasculature, a new era of "imaging wisely" raises legitimate concerns about the effects of ionizing radiation as well as potential effects of CT and MR contrast agents. These concerns are obviated by the use of ultrasound, and recently developed techniques, such as contrast-enhanced ultrasound and vascular applications focused on the evaluation of slow flow, have revealed the vast potential of vascular ultrasound in the evaluation of chronic mesenteric ischemia. Conclusion Duplex sonography is a cost-effective and powerful tool that can be utilized for the accurate assessment of mesenteric vascular pathology, specifically mesenteric arterial stenosis, and for the evaluation of mesenteric arterial system post revascularization.
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Superior mesenteric artery syndrome, also known as Wilkie’s syndrome, is a rare vascular disease caused by the anomalous course of the superior mesenteric artery arising from the abdominal aorta with a smaller angle than the norm...
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Superior mesenteric artery syndrome, also known as Wilkie’s syndrome, is a rare vascular disease caused by the anomalous course of the superior mesenteric artery arising from the abdominal aorta with a smaller angle than the norm (\22). The reduced angle compresses the structures situated between the aorta and the superior mesenteric artery, such as the duodenum and left renal vein; this can determine painful crises, intestinal subocclusions, and left varicocele. This syndrome can be congenital or acquired. The acquired type is more common and is generally caused by reduced perivascular fat surrounding the abdominal aorta and the superior mesenteric artery; this form is common among anorexic patients that have had a rapid weight loss. We present the case of a female patient who suffered from repeated postprandial vomiting and who lost 12 kg in 4 months. B-mode ultrasound imaging revealed evidence of a reduced angle between the aorta and the superior mesenteric artery, as found in Wilkie’s syndrome. After diagnosis, the patient followed a high-calorie diet, and 2 months later an ultrasound scan proved the restoration of the aorto-mesenteric angle as a consequence of increased perivascular fat with regression of symptoms.
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Superior mesenteric artery (SMA) dissection is a rare disease. Most of the cases are diagnosed through contrast-enhanced computed tomography. The use of emergent bedside ultrasound has been described to diagnose aortic dissection....
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Superior mesenteric artery (SMA) dissection is a rare disease. Most of the cases are diagnosed through contrast-enhanced computed tomography. The use of emergent bedside ultrasound has been described to diagnose aortic dissection. However, evidence is limited regarding the use of bedside ultrasound for diagnosing SMA dissection, which is a known risk factor for aortic dissection. We present two case reports: one case of isolated SMA dissection and one case of SMA dissection complicated with aortic dissection. Both cases were initially diagnosed through bedside ultrasound and confirmed through contrast-enhanced computed tomography.
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Abstract Typical ultrasound findings of fetal abdominal lymphangioma include thick‐walled, multiseptated anechoic masses. Although a majority of cases can be suspected promptly by ultrasound examination, the two cases presented h...
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Abstract Typical ultrasound findings of fetal abdominal lymphangioma include thick‐walled, multiseptated anechoic masses. Although a majority of cases can be suspected promptly by ultrasound examination, the two cases presented herein did not meet the standard criteria and were misleading. Both cases involved unilocular cysts without clear septations, but in retrospect were atypical findings of fetal abdominal lymphangioma. A few reports of misleading cases have been described previously; however, the precise characteristics have not been reported in detail. Therefore, in this case report, we focused predominantly upon the difficulties encountered in the prenatal diagnosis of abdominal lymphangioma based on ultrasound morphology alone.
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