Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
LU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2issues with a directional internal structure depending on the angle of insonation. The term is derived from the Greek riniso (meaning not the same) and tropứỊ (to turn or reflect). The phenomenon was first described in tendons [ 1,2|, but can also occur in the kidneys where the radial arrangement of Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2 nephrons and intervening tissues results in greater echogenicity from parts of the kidney where the nephrons arc perpendicular to the ultrasound beamEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
when compared to parts where the nephrons arc parallel to the ultrasound beam |3,4|. In practice, this can result in an apparent echogenic pscudotumoLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2e misinterpreted as a true echogenic renal mass, suggestive of cither angiomyoli-poina or renal cell carcinoma, and result in unnecessary additional workup and patient anxiety.Typical clinical scenarioThis pseudotumor is a technical artifact and so can potentially lx seen in any patient undergoing u Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2ltrasound of the kidneys.Differential diagnosisThe key to recognizing anisotropic renal pseudotumor at ultrasound is to compare the image with the appEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
arent masswhen the transducer is centered on the mid kidney to an image obtained when the transducer is closer to a radial alignment with the polar paLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2 addition, anisotropic renal pseudotumor typically has ill defined margins and fades gradually into the surrounding tissues, unlike a true renal mass which frequently has well-defined margins.Teaching pointrhe possibility of an anisotropic renal pscudotumor should be considered when an apparent echo Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2genic mass is seen at ultrasound in the polar parts of the kidney.REFERENCES1Fornage BL>. The hypocchok normal tendon. A pitfall. / Ultrasound Med 198Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
7: 6: 19-22.2Connolly l)J, Berman I.. McNally EC. The use of beam angulation to overcome anisotropy when viewing human tendon with high frequency lineLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2d Mflf Hioi 1988; 14: 507—SI I.IInsaru MF, Hall T|, Fishlxtck IL Identifying acoustic scattering sources in normal renal parenchyma from the anisotropy in acoustic properties. ultrasound Med Biol 1991: 17: 613-626.143PseudotumFigure 44.1 A. Longitudinal ultrasound i'nage of the right kidney obtainec Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2 during routine evaluation of d 21-week gestation pregnancy in a 29 year old woman shows an apoa’ent echogenic mass lar'ow) in the unper pole. Mote thEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
e transducer A centered on the mid-kdney.B. Longitudinal ultrasound image o' the right kidney obtained during the same study with the transducer centeLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2iously prc-Á-dea by Dr Peter CaiVfn, ưcsp149Echogenic renal cell carcinoma mimicking angiomyolipomaImaging descriptionA reported 61% (22 of 36) to 77% (24 of 31) of small renal cell carcinomas arc hypcrcchoic relative to the adjacent renal parenchyma at ultrasound, and 32% (10 of 31) are uniformly a Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2nd markedly echogenic such that they mimic angiomyolipo mas (figures 45.1 and 45.2) 11, 2|. Larger renal cell carcinomas are usually hypoechoic. GivenEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
that there is no particularly plausible reason for echogenicity to depend on tumor size, it is possible that this relationship is artifactual due to LU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2d, while small echogenic renal cell carcinomas stand out relative to the renal paren chyma and arc more likely to be detected |3].Importancerhe primary concern is that a renal cell cancer misdiagnosed as an angiomyolipoma might progress and become incurable. Based on the available evidence and given Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2 that the frequence' with which small echogenic renal masses represent renal cell carcinoma rather than angiomyolipoma is unknown, it has been suggestEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
ed that all non-calcificd echogenic renal lesions found on ultrasound need further evaluation with CT |4|. This may l>e a counsel of perfection, sinceLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2noma that was initially diagnosed as an angiomyolipoma on ultrasound. ’Illis may mean the majority of small echo genic masses are truly angiomyolipomas, or might just as well reflect the fact that small incidental renal cell carcinomas arc often indolent and arguably subctinical (6|.Typical clinical Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2 scenarioEchogenic renal masses are usually detected incidentally at ultrasound performed for unrelated reasons, and so may be encountered in any clinEbook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2
ical setting.Differential diagnosisSeveral studies have shown that some ultrasound features help in the distinction of angiomyolipoma from echogenic rLU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within ti Ebook Pearls and pitfalls in abdominal imaging (Pseudotumors, variants and other difficult diagnoses - 1st edition): Part 2nly in renal cell carcinomas (Figure 45.4) (7-9|. Unfortunately, these findings are not present in many cases, limiting their clinical utility.LU 1/1< Ù44Pseudotumor due to anisotropismImaging descriptionIn ultrasound, anisotropism refers to the different echogenicity that can occur within tiGọi ngay
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