Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von A... more Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von Abweichungen von der Norm mit bis zu 9% angegeben. Mit zunehmendem Einsatz der Computertomographie (CT) werden bei bis zu 5% aller (auch aus anderer Fragestellung) durchgeführten CTs pathologische Befunde im Bereich der Nebennieren gefunden. Spezifische Diagnosen, wie Myelolipome, Hämatome oder Zysten können durch ihr besonderes Verhalten in der CT gestellt werden. Früher waren Adenome ein diagnostisches Dilemma. Heute können sie korrekt durch neue Methoden (unverstärkte CT, "chemical shift" MR und "Wash-out" Kontrast CT-Analyse) erkannt werden. Da die Nebennieren eine Prädilektionsstelle für Metastasen sind, sind in letzter Zeit viele Bemühungen publiziert worden, benignes von malignem Gewebe im Bereich der Nebennieren zu differenzieren. Bei Patienten ohne bekannte maligne Erkrankung sind die meisten Läsionen der Nebennieren gutartig. Heute kann auf Grund des Verhaltens in der Bildgebung zumeist eine spezifische Diagnose erstellt werden. Obwohl heute verschiedene Arten der Bildgebung verwendet werden, spielt die CT eine zentrale Rolle in der Entdeckung und in der Differentialdiagnose von Nebennieren-Läsionen. Ziel der vorliegenden Arbeit ist es, einen Überblick über die mit CT erhebbaren Befunde bei Erkrankungen der Nebennieren zu liefern. The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases.
Our aims were to present the hepatic arterial variations that were detected with computed tomogra... more Our aims were to present the hepatic arterial variations that were detected with computed tomographic angiography (CTA) and confirmed by operation in living liver donors and to emphasize the usefulness of CTA in the assessment of hepatic arterial anatomy. The donors of 100 patients (46 women and 54 men) who had undergone a living donor liver transplantation in a (blinded) hospital between July 2004 and June 2007 were evaluated. The age of the donors ranged from 18 to 63 years (mean, 39 years). The CTA images obtained by a 16-slice multidetector CT before the transplantation procedure were retrospectively evaluated for arterial variations, and the results were compared with the results of the operation. In 59 donors (59%), classic hepatic arterial anatomy was observed. In the remaining 41 donors (41%), various arterial variations were determined. In 11 of the donors (11%), variations were not compatible with the description of Michel's classification. In all of our patients, CTA findings were confirmed with operational findings. Our complication rate was 1%. Only 1 of the patients who had undergone the transplantation developed hepatic arterial thrombus, and the remaining 99 patients had no arterial complications. The course of the vascular structures before live donor liver transplantation is essential for planning and success of the operation. Our study showed that multidetector CTA can be used successfully in hepatic artery imaging of liver transplantation donors as a noninvasive method.
Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von A... more Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von Abweichungen von der Norm mit bis zu 9% angegeben. Mit zunehmendem Einsatz der Computertomographie (CT) werden bei bis zu 5% aller (auch aus anderer Fragestellung) durchgeführten CTs pathologische Befunde im Bereich der Nebennieren gefunden. Spezifische Diagnosen, wie Myelolipome, Hämatome oder Zysten können durch ihr besonderes Verhalten in der CT gestellt werden. Früher waren Adenome ein diagnostisches Dilemma. Heute können sie korrekt durch neue Methoden (unverstärkte CT, "chemical shift" MR und "Wash-out" Kontrast CT-Analyse) erkannt werden. Da die Nebennieren eine Prädilektionsstelle für Metastasen sind, sind in letzter Zeit viele Bemühungen publiziert worden, benignes von malignem Gewebe im Bereich der Nebennieren zu differenzieren. Bei Patienten ohne bekannte maligne Erkrankung sind die meisten Läsionen der Nebennieren gutartig. Heute kann auf Grund des Verhaltens in der Bildgebung zumeist eine spezifische Diagnose erstellt werden. Obwohl heute verschiedene Arten der Bildgebung verwendet werden, spielt die CT eine zentrale Rolle in der Entdeckung und in der Differentialdiagnose von Nebennieren-Läsionen. Ziel der vorliegenden Arbeit ist es, einen Überblick über die mit CT erhebbaren Befunde bei Erkrankungen der Nebennieren zu liefern. The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases.
Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal... more Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma, often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. Different diagnostic tools have been used to define this entity, with ultrasonography (US), i.v. pyelography (IVP) and computed tomography (CT) used most commonly. We report MR urography and MR appearance of replacement lipomatosis in a 38-year-old man. We think that it combines the advantages of IVP, US and CT.
The aim of this study was to evaluate the utility of DW MRI with two different b values in identi... more The aim of this study was to evaluate the utility of DW MRI with two different b values in identifying peritoneal tumors in oncology patients. Nineteen patients with known malignancy underwent abdominal and pelvic MRI before surgery. MRI included free-breathing DWI with b values of 400 and 800 s/mm2, T1-weighted fat-suppressed spoiled gradient-echo, T2-weighted fat-saturated turbo spin-echo, and 5-min delayed gadolinium-enhanced imaging. Two observers reviewed images for peritoneal tumors at ten anatomic sites within consensus. The results of laparatomy and histopathological evaluation were compared with MRI results. Sensitivity, specificity, and accuracy of identifying peritoneal metastases were calculated for conventional MRI, combined DWI with a b value of 400 s/mm2 and conventional MRI, and combined DWI with a b value of 800 s/mm2 and conventional MRI by consensus of two observers. One-hundred and twenty-five peritoneal metastasis sites were confirmed by surgical and histopathological findings. Conventional MRI alone identified 72 peritoneal metastases (sensitivity, 0.58; specificity, 0.87; accuracy, 0.67). Combined DWI with a b value of 400 s/mm2 and conventional MRI revealed 106 peritoneal metastases (sensitivity, 0.85; specificity, 0.88; accuracy, 0.85). Finally, combined DWI with a b value of 800 s/mm2 and conventional MRI revealed 103 peritoneal metastases (sensitivity, 0.83; specificity, 0.94; accuracy, 0.86). DWI with a high b value provides complementary information that can improve the detection of peritoneal tumors when combined with conventional MRI. We recommend combined MRI and DWI with a high b value for increasing the sensitivity and accuracy of the preoperative detection of peritoneal tumors.
We describe a case of an unusual variation of the double retroaortic left renal vein discovered d... more We describe a case of an unusual variation of the double retroaortic left renal vein discovered during routine donor examination of the abdomen by multidetector computed tomography. A 53-year-old man underwent evaluation in our department as a potential renal donor for his brother who had end-stage renal failure. Multidetector computed tomography angiography showed double retroaortic left renal veins. This can increase the potential for serious morbidity and mortality in the donor. We prefer right kidney for potential donation. Multidetector computed tomography is the method of choice in the evaluation of renal donation.
Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von A... more Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von Abweichungen von der Norm mit bis zu 9% angegeben. Mit zunehmendem Einsatz der Computertomographie (CT) werden bei bis zu 5% aller (auch aus anderer Fragestellung) durchgeführten CTs pathologische Befunde im Bereich der Nebennieren gefunden. Spezifische Diagnosen, wie Myelolipome, Hämatome oder Zysten können durch ihr besonderes Verhalten in der CT gestellt werden. Früher waren Adenome ein diagnostisches Dilemma. Heute können sie korrekt durch neue Methoden (unverstärkte CT, "chemical shift" MR und "Wash-out" Kontrast CT-Analyse) erkannt werden. Da die Nebennieren eine Prädilektionsstelle für Metastasen sind, sind in letzter Zeit viele Bemühungen publiziert worden, benignes von malignem Gewebe im Bereich der Nebennieren zu differenzieren. Bei Patienten ohne bekannte maligne Erkrankung sind die meisten Läsionen der Nebennieren gutartig. Heute kann auf Grund des Verhaltens in der Bildgebung zumeist eine spezifische Diagnose erstellt werden. Obwohl heute verschiedene Arten der Bildgebung verwendet werden, spielt die CT eine zentrale Rolle in der Entdeckung und in der Differentialdiagnose von Nebennieren-Läsionen. Ziel der vorliegenden Arbeit ist es, einen Überblick über die mit CT erhebbaren Befunde bei Erkrankungen der Nebennieren zu liefern. The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases.
Our aims were to present the hepatic arterial variations that were detected with computed tomogra... more Our aims were to present the hepatic arterial variations that were detected with computed tomographic angiography (CTA) and confirmed by operation in living liver donors and to emphasize the usefulness of CTA in the assessment of hepatic arterial anatomy. The donors of 100 patients (46 women and 54 men) who had undergone a living donor liver transplantation in a (blinded) hospital between July 2004 and June 2007 were evaluated. The age of the donors ranged from 18 to 63 years (mean, 39 years). The CTA images obtained by a 16-slice multidetector CT before the transplantation procedure were retrospectively evaluated for arterial variations, and the results were compared with the results of the operation. In 59 donors (59%), classic hepatic arterial anatomy was observed. In the remaining 41 donors (41%), various arterial variations were determined. In 11 of the donors (11%), variations were not compatible with the description of Michel's classification. In all of our patients, CTA findings were confirmed with operational findings. Our complication rate was 1%. Only 1 of the patients who had undergone the transplantation developed hepatic arterial thrombus, and the remaining 99 patients had no arterial complications. The course of the vascular structures before live donor liver transplantation is essential for planning and success of the operation. Our study showed that multidetector CTA can be used successfully in hepatic artery imaging of liver transplantation donors as a noninvasive method.
Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von A... more Die Nebennieren sind ein häufiger Ort der Erkrankung. In Autopsieserien wird die Häufigkeit von Abweichungen von der Norm mit bis zu 9% angegeben. Mit zunehmendem Einsatz der Computertomographie (CT) werden bei bis zu 5% aller (auch aus anderer Fragestellung) durchgeführten CTs pathologische Befunde im Bereich der Nebennieren gefunden. Spezifische Diagnosen, wie Myelolipome, Hämatome oder Zysten können durch ihr besonderes Verhalten in der CT gestellt werden. Früher waren Adenome ein diagnostisches Dilemma. Heute können sie korrekt durch neue Methoden (unverstärkte CT, "chemical shift" MR und "Wash-out" Kontrast CT-Analyse) erkannt werden. Da die Nebennieren eine Prädilektionsstelle für Metastasen sind, sind in letzter Zeit viele Bemühungen publiziert worden, benignes von malignem Gewebe im Bereich der Nebennieren zu differenzieren. Bei Patienten ohne bekannte maligne Erkrankung sind die meisten Läsionen der Nebennieren gutartig. Heute kann auf Grund des Verhaltens in der Bildgebung zumeist eine spezifische Diagnose erstellt werden. Obwohl heute verschiedene Arten der Bildgebung verwendet werden, spielt die CT eine zentrale Rolle in der Entdeckung und in der Differentialdiagnose von Nebennieren-Läsionen. Ziel der vorliegenden Arbeit ist es, einen Überblick über die mit CT erhebbaren Befunde bei Erkrankungen der Nebennieren zu liefern. The adrenal gland is a common site of disease, with an abnormality prevalence as high as 9% in autopsy series. With the increasing use of CT, adrenal lesions are frequently found in the daily practice of radiology and are diagnosed in up to 5% of CT examinations performed for varied reasons. Imaging features on CT can establish a specific diagnosis of many of these lesions, including myelolipoma, hematoma and cysts. Once a diagnostic dilemma, now adenomas can be accurately diagnosed using unenhanced CT, chemical shift magnetic resonance imaging and CT contrast washout analysis. Because the adrenal gland is also a frequent site of metastasis, recent literature has focused on imaging characterization of adrenal masses for differentiation of adenomas from metastases. In patients without known malignancy, most adrenal lesions are benign and a specific diagnosis can now be made on the basis of imaging features. It is important to understand the prevalence of adrenal abnormalities because the gland is a common site of disorders, and the increased use of cross-sectional imaging has increased the frequency of detection of adrenal lesions. The prevalence of disease is important in predicting the risk of malignancy when an adrenal mass is discovered in a patient without known cancer. Detection of adrenal gland diseases has increased substantially with the advent and widespread use of imaging techniques. Although several imaging modalities can be used, CT has a central role in both detection and differential diagnosis of an adrenal lesion. The aim of this article is to review the CT findings of adrenal gland diseases.
Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal... more Replacement lipomatosis of the kidney is the result of severe atrophy or destruction of the renal parenchyma, often caused by calculous disease with secondary marked proliferation of renal sinus, renal hilus, and perirenal fatty tissue. Different diagnostic tools have been used to define this entity, with ultrasonography (US), i.v. pyelography (IVP) and computed tomography (CT) used most commonly. We report MR urography and MR appearance of replacement lipomatosis in a 38-year-old man. We think that it combines the advantages of IVP, US and CT.
The aim of this study was to evaluate the utility of DW MRI with two different b values in identi... more The aim of this study was to evaluate the utility of DW MRI with two different b values in identifying peritoneal tumors in oncology patients. Nineteen patients with known malignancy underwent abdominal and pelvic MRI before surgery. MRI included free-breathing DWI with b values of 400 and 800 s/mm2, T1-weighted fat-suppressed spoiled gradient-echo, T2-weighted fat-saturated turbo spin-echo, and 5-min delayed gadolinium-enhanced imaging. Two observers reviewed images for peritoneal tumors at ten anatomic sites within consensus. The results of laparatomy and histopathological evaluation were compared with MRI results. Sensitivity, specificity, and accuracy of identifying peritoneal metastases were calculated for conventional MRI, combined DWI with a b value of 400 s/mm2 and conventional MRI, and combined DWI with a b value of 800 s/mm2 and conventional MRI by consensus of two observers. One-hundred and twenty-five peritoneal metastasis sites were confirmed by surgical and histopathological findings. Conventional MRI alone identified 72 peritoneal metastases (sensitivity, 0.58; specificity, 0.87; accuracy, 0.67). Combined DWI with a b value of 400 s/mm2 and conventional MRI revealed 106 peritoneal metastases (sensitivity, 0.85; specificity, 0.88; accuracy, 0.85). Finally, combined DWI with a b value of 800 s/mm2 and conventional MRI revealed 103 peritoneal metastases (sensitivity, 0.83; specificity, 0.94; accuracy, 0.86). DWI with a high b value provides complementary information that can improve the detection of peritoneal tumors when combined with conventional MRI. We recommend combined MRI and DWI with a high b value for increasing the sensitivity and accuracy of the preoperative detection of peritoneal tumors.
We describe a case of an unusual variation of the double retroaortic left renal vein discovered d... more We describe a case of an unusual variation of the double retroaortic left renal vein discovered during routine donor examination of the abdomen by multidetector computed tomography. A 53-year-old man underwent evaluation in our department as a potential renal donor for his brother who had end-stage renal failure. Multidetector computed tomography angiography showed double retroaortic left renal veins. This can increase the potential for serious morbidity and mortality in the donor. We prefer right kidney for potential donation. Multidetector computed tomography is the method of choice in the evaluation of renal donation.
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