This Hypertension Grand Rounds shows how applying new clinical laboratory techniques helped to diagnose pheochromocytoma in a difficult case. In the setting of long-standing, sustained hypertension, the patient had a hypertensive paroxysm during anesthesia induction for surgery, leading to suspicion of a pheochromocytoma. Conventional testing, including CT scanning and fractionated ...

Ballistic imaging databases allow law enforcement to link recovered cartridge cases to other crime scenes and to firearms. The success of these databases has led many to propose that all firearms in circulation be entered into a reference ballistic image database (RBID). To assess the performance of an RBID, we ...

Adrenocorticotropic hormone (ACTH)-independent hypercortisolism accounts for 15%-20% of cases of Cushing syndrome and always arises from primary adrenal disease. Computed tomographic (CT) and magnetic resonance (MR) imaging findings in 37 patients with primary adrenal Cushing syndrome were analyzed and correlated with pathologic findings. Hyperfunctioning adenomas (n = 24), together with ...

OBJECTIVE: Many studies have suggested that Hounsfield measurements on unenhanced CT can reliably differentiate adrenal adenomas from nonadenomas using a scanner-independent threshold level. The purpose of this study was to determine whether establishment of a scanner-independent threshold for differentiation of adenomas from nonadenomas is technically feasible. MATERIALS AND METHODS: Surgically ...

We review the anatomy of the masticator space and the localization of masticator space lesions on cross-sectional imaging. The magnetic resonance imaging and computed tomography appearances of inflammatory, neoplastic, developmental and vascular masticator space lesions are discussed and illustrated. Benign processes and normal variations, which mimic masticator space pathology, are ...

PURPOSE: To investigate the frequency and significance of adrenal lesions that demonstrate heterogeneous suppression on chemical shift magnetic resonance imaging (MRI). MATERIALS AND METHODS: A retrospective search of adrenal lesions identified on MR from November 1997-July 2001 was performed. The adrenal lesions were classified as having suppression typical for an ...

Ascites is a not infrequent finding on CT. Causes of ascites include congestive heart failure, hypoalbuminemia, cirrhosis, inflammation, and neoplasm. In most cases the attenuation of ascites is that of clear fluid, measuring around 0 HU. Rarely, however, a considerably higher density of ascites is seen. This finding may be ...

Acute adrenal hemorrhage (AAH) is an extremely rare disorder, especially in adults, and may be difficult to diagnose because of its nonspecific presentation. We report a case of AAH following a sepsis, resulting in persistant adrenal insufficiency contrasting with the radiologic normalisation of the adrenals on computed tomography (CT) scan ...

We evaluated low-cost, store-and-forward telepathology interpretation of digital images of skin sections stained immunohistochemically, using immunofluorescence (IF) and immunoperoxidase (IP). The sample comprised 17 patients with skin diseases characterized by cutaneous deposition of immunoglobulins, fibrinogen or complement components. Up to 11 digital IF or IP images (median 3) were transferred ...

A 59-year-old Japanese woman, admitted for the treatment of diabetes mellitus and hypertension, was incidentally discovered to have a solid mass of 1.4 cm in diameter by CT scan with the attenuation value of 38 Hounsfield units, relatively higher for ordinary adrenal adenomas. Magnetic resonance imaging revealed no reduction of ...

BACKGROUND: Iodine 123 meta-iodobenzylguanidine (MIBG) scintigraphy has been used in patients with clinical suspicion of pheochromocytoma to confirm the nature of an adrenal or extraadrenal mass or to identify occult disease. Additionally, it may be used to identify unsuspected bilaterality or metastases in the setting of a known unilateral adrenal ...

OBJECTIVE: Attenuation values on CT of less than 10 H are considered characteristic of adrenal adenomas. Adrenal pheochromocytomas can infrequently contain fat that could result in low attenuation on CT. The purpose of our study was to determine if pheochromocytomas could be confused with adenomas by virtue of their attenuation ...

Giant adrenal myelolipoma is an uncommon entity. We present the atypical MR imaging findings of a giant adrenal myelolipoma in a patient with homozygous beta-thalassemia with histopathology correlation. The tumor showed a drop in signal on the opposed-phase images, with no evidence of macroscopic fat contents, and demonstrated very high ...

OBJECTIVE: To evaluate the relationship between lipid-rich cells of the adrenal adenoma and precontrast computed tomographic (CT) attenuation numbers in three clinical groups. MATERIALS AND METHODS: Thirty-five surgically resected adrenal adenomas were used. The clinical diagnoses of the patients included 13 cases of primary aldosteronism, 15 cases of Cushing's syndrome, ...

Use of three-dimensional (3D) volume-rendered helical computed tomography (CT) in surgical planning before laparoscopic adrenalectomy was evaluated in a retrospective study. In 35 consecutive patients before laparoscopic adrenalectomy, 3D volume-rendered CT scans were created from helical CT scans. Videotapes that showed anterior, lateral, posterior, and posterocephalic approaches were assessed retrospectively. ...

We report a case of aldosterone-producing microadenoma that was correctly diagnosed and thus treated less invasively by laparoscopic adrenalectomy. A 58-year-old woman presented with palpitation and muscular weakness. She exhibited hypertension, hypokalemia and increased aldosterone excretion with suppressed renin activity. Therefore, primary aldosteronism was suggested. Although adrenal scintigram and computed ...

PURPOSE: We validated the therapeutic efficacy of computerized tomography (CT) guided percutaneous ethanol injection (PEI) for hyperfunctioning pheochromocytoma. MATERIALS AND METHODS: Pheochromocytoma was treated with CT guided PEI in 41 patients, including 19 men and 22 women with a mean age of 42 years (range 31 to 59). Of the ...

OBJECTIVE: The objectives of this study were to compare MRI and iodine-123 ((123)I) metaiodobenzylguanidine (MIBG) scintigraphy in the detection of neuroblastoma lesions in pediatric patients and to assess the additional value of combined imaging. MATERIALS AND METHODS: Fifty MRI and 50 (123)I MIBG examinations (mean interval, 6.4 days) were analyzed ...

AIM: The aim of this study was to compare the usefulness of computed tomography (CT)-scan, magnetic resonance imaging (MRI), and fine-needle aspiration (FNA) cytology in patients with incidentally discovered adrenal masses. PATIENTS AND METHODS: Thirty-four consecutive patients (six men and 28 women, median age of 47 years, range 26-80) with ...

OBJECTIVE: The objectives of our study of patients with primary hyperaldosteronism (Conn's syndrome) were to determine whether the adrenal glands are larger in patients with bilateral adrenal hyperplasia than in those with aldosterone-producing adenomas or in healthy control subjects; and whether a CT criterion based on adrenal gland size can ...

BACKGROUND: We describe nonenhanced, early contrast-enhanced, and delayed contrast-enhanced computed tomographic (CT) features and contrast washout characteristics of lipid-poor and lipid-rich adrenal adenomas and nonadenomas to determine the role of these methods in distinguishing one type from the other. METHODS: Sixty-five patients with 77 adrenal masses (16 lipid-poor and 37 ...

BACKGROUND: We describe a retrospective analysis of the clinical presentation and imaging features in nine patients with adrenal histoplasmosis in nonimmunocompromised patients from a nonendemic region. METHODS: Clinically, a tuberculosis-like presentation in four patients and a tumor-like presentation in five patients were seen. All patients were seronegative for the human ...

PURPOSE: To evaluate a histogram analysis method for differentiating adrenal adenoma from metastasis at computed tomography (CT). MATERIALS AND METHODS: In a retrospective review of 2 years of clinical CT records, 223 adrenal adenomas in 193 patients (115 with contrast material-enhanced CT, 43 with unenhanced and enhanced CT, and 35 ...

We report a potential pitfall of 123I-metaiodobenzylguanine (MIBG) scan. Magnetic resonance imaging performed for other reasons, showed 2.5 cm tumor in the left adrenal gland. On questioning patient had episodic palpitations, flushing and hypertension suggestive of pheochromocytoma. Urinary metanephrine level was of borderline value but serum chromogranin A level was ...

This review provides current understanding of the pathophysiology of pheochromocytoma and the wide range of associated clinical manifestations that have led to earlier recognition of the disease. In addition, it reviews optimal screening methods and localization techniques that have enhanced the clinician's ability to make the diagnosis with greater certainty. ...

Chemical shift MRI is widely used for identifying adenomas, but it is not a perfect method. We determined whether combined dynamic MRI methods can lead to improved diagnostic accuracy. Fifty-seven adrenal masses were examined by chemical shift and dynamic MR imaging using 2 MR systems. The masses included 38 adenomas ...

OBJECTIVE: To audit our practice of performing ovarian and adrenal venous catheterization and sampling in hyperandrogenic women who fail to suppress their elevated androgen levels following a 48-h low-dose dexamethasone suppression test (LDDST). We considered the technical success rate of catheterization, the extra information obtained in addition to the standard ...

A case of primary adrenal carcinoma that showed a decreased signal in part of the tumor on chemical shift magnetic resonance imaging (CSI) is reported. The patient had clinical symptoms of Cushing syndrome. The tumor was a discrete right adrenal mass about 3.4 cm in largest diameter. It was surgically ...

OBJECTIVE: The aim of our study was to assess quantitative methods of distinguishing adenomas from malignant adrenal lesions using chemical shift fast low-angle shot MR imaging. MATERIALS AND METHODS: We assessed 102 adrenal tumors in 88 patients (27 hyperfunctioning and 44 nonhyperfunctioning adenomas, 19 metastases, nine pheochromocytomas, and three other ...

The aim of this study was to evaluate the sensitivity and positive predictive value (PPV) of dexamethasone-suppression norcholesterol scintigraphy (NCS), computed tomography (CT) scanning and magnetic resonance imaging (MRI) in patients with primary aldosteronism (PA) who had undergone unilateral adrenalectomy. A series of 49 patients with confirmed PA was reviewed. ...

On single-photon emission tomography (SPET) examinations with indium-111 pentetreotide, we have often observed a small "hot" spot close to the upper portion of the left kidney. While it was initially believed that this represented a tumour in the tail of the pancreas or in the left adrenal, we now understand ...

Cavernous hemangiomas of the adrenal gland are rare in clinical practice. Recently some cases have come to clinical attention as incidental findings on sonography, computed tomography (CT), or magnetic resonance imaging (MRI). With many reports regarding its CT or MRI manifestation, sonographic features of this entity have seldom been delineated. ...

RATIONALE AND OBJECTIVES: The authors performed this study to assess the usefulness of the various features of their radiology department intranet and to quantify its effect in facilitating intradepartmental information flow. MATERIALS AND METHODS: The number, length, and nature of visits to each directory on the intranet were recorded by ...

INTRODUCTION: Desmoids are rare, locally aggressive but nonmetastasizing clonal proliferations of fibroblasts that occur both sporadically and in association with familial adenomatous polyposis. Most occur in intra-abdominal sites, where they may lead to major morbidity and mortality. A proposed desmoid precursor lesion occurs in the mesentery of one-third of patients ...

Injury to the adrenal gland is often incidentally diagnosed with Computed Tomography (CT) following blunt abdominal trauma. In a high percentage of cases, it is accompanied by other intra-abdominal, retroperitoneal or intrathoracic injuries. Although not usually clinically significant, adrenal traumatic lesions can be a source of infection, as well as ...

OBJECTIVE: To determine if anemia can be predicted on unenhanced computed tomography (CT) of the thorax. METHODS: Hemoglobin and hematocrit levels were obtained within 24 hours of the unenhanced CT scan of the thorax of 200 patients. Anemia was defined as a hemoglobin level less than 140 g/L for men ...

We compared diagnoses made by a teledermatologist from digital photographs and patient histories sent from general practitioners using a store-and-forward technique and those made by another dermatologist in a face-to-face consultation with the same patients. A total of 117 patients (mean age 47 years) were referred by 18 general practitioners ...

We collected and examined the medical records from telemedicine cases dealt with by the telemedicine centre of Shanghai Hospital No. 85. This centre handles the second largest number of teleconsultations in the entire network. There were 658 telemedicine cases in total. The medical records included the patient record in 599 ...

Forty-three dogs without evidence of endocrine disease that underwent spinal or abdominal magnetic resonance imaging (MRI) for clinical reasons were studied. Because the procedures were not optimized for inclusion of the adrenal glands, they were not always visible in all planes. Eighty-five of the 86 adrenal glands were seen and ...

OBJECTIVES: With the recent widespread use of modern imaging techniques, the frequency of small low-stage renal cell carcinomas (RCC) has grown considerably, giving rise to more conservative surgical approaches. We evaluated the characteristics of adrenal involvement and the accuracy of computerized tomography (CT) in the diagnosis of RCC, defining the ...

PURPOSE: We describe the presenting features, imaging methods, prognosis of and treatment approach to adrenocortical carcinoma. MATERIALS AND METHODS: A comprehensive literature review of adrenal carcinoma was performed using PubMed and a review of current urology, oncology, radiology and pathology journals. RESULTS: The incidence of adrenocortical tumors has been reported ...

Eosinophilic fasciitis (EF) is an uncommon connective tissue disease. We report a patient with EF who presented with episodic swelling and stiffness of his legs and forearms in combination with peripheral eosinophilia. Imaging studies of the legs and forearms, including computed tomography (CT) and magnetic resonance imaging (MRI), clearly demonstrated ...

Metaiodobenzylguanidine (MIBG) scintigraphy is a well-established functional imaging method for localizing pheochromocytomas. However, the morphologic information revealed on the scintigram is often too sparse and thus, accordingly, supplemental computed tomography (CT) or magnetic resonance imaging are often performed. Recently, gamma cameras with built-in low-dose CT were introduced. The authors describe ...

Addison's disease due to adrenal lymphoma usually manifests as bilateral adrenal enlargement. We report a patient with Addsion's disease in whom the initial overt primary adrenal insufficiency was accompanied by an only slightly enlarged right adrenal gland. The 80-year-old man presented with nausea, anorexia, weight loss, and hyperpigmentation of the ...

To prefetch images in a hospital-wide picture archiving and communication system (PACS), a rule must be devised to permit accurate selection of examinations in which a patient's images are stored. We developed an inductive method to compose prefetch rules from practical data which were obtained in a hospital using a ...

BACKGROUND:Endometriosis, arising de novo, is believed to be uncommon in women who have undergone bilateral tubal ligation because the occluded tube prevents outflow of blood and menses. CASE:A woman 10-year status-post bilateral tubal ligation suffered from dysmenorrhea and menorrhagia that began within 1 year after sterilization. At the time of ...

The advent of CT and MRI imaging in the last two decades has redefined the approach and analysis of various diseases including tuberculosis. Tuberculosis afflicts hollow and solid viscera. Genitourinary, hepatobiliary and adrenal tuberculosis is uncommon in children. CT and MRI have however shown several advantages over conventional radiology and ...

The aim of this study was to investigate the prevalence of renal cortical retention (RCR) of contrast media seen on delayed CT, and nephropathy following transarterial chemoembolisation (TACE) in high-risk patients. The findings of 18 patients with abnormally high serum creatinine levels who underwent TACE were reviewed. Nephropathy was defined ...

The accurate diagnostic localization of extra-adrenal pheochromocytoma is important in the treatment of primary and metastatic tumors. In this study, we report on a case of extra-adrenal pheochromocytoma in which the tumor could not be diagnosed by 131I-metaiodobenzylguanidine (MIBG) scintigraphy but only by 123I-MIBG scintigraphy. Our patient was a 16-year ...

The postmortem findings in 274 kittens were reviewed. The kittens were grouped by age at death: perinatal (< one day), neonatal (one to 14 days), preweaning (15 to 34 days) and postweaning (35 to 112 days); 203 (74 per cent) of the kittens were postweaning and 38 (14 per cent) ...