Dr masciotra clinical case of intrahepatic cholelithiasis
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This document describes a case of intrahepatic cholelithiasis (gallstones within the liver) in a 29-year-old woman who had no symptoms. Ultrasound images showed multiple small (<1mm) hyperechoic foci distributed along the intrahepatic biliary tree in segments 6 and 7, consistent with lipid deposits. The distribution and appearance indicated it was not caused by air in the bile ducts. In young women, this condition can be caused by low phospholipid content in the bile due to genetic mutations affecting bile acid transport.
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This document provides information on esophageal atresia, including:
- Esophageal atresia is a congenital condition where the esophagus is interrupted, sometimes accompanied by a tracheoesophageal fistula.
- Classification systems help determine prognosis and appropriate timing of repair (immediate, delayed, staged). Higher risk patients with factors like low birth weight or cardiac issues may benefit from delayed or staged repair.
- Associated anomalies occur in about 50% of cases, most commonly vertebral, anorectal, cardiovascular, and renal defects.
small intestine diseases 2
The patient presented with symptoms of intestinal obstruction including abdominal pain, nausea, vomiting and abdominal distension. Physical exam revealed abdominal tenderness and laboratory tests showed signs of dehydration and inflammation. Radiographic imaging confirmed multiple dilated loops of small bowel consistent with mechanical intestinal obstruction. The obstruction was determined to be complete based on symptoms. The patient's history of previous appendectomy suggested the underlying cause was likely adhesive obstruction. Treatment involved fluid resuscitation, gastrointestinal decompression and antibiotics, with potential for surgical lysis of adhesions if symptoms did not improve.
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Enterocutaneous fistulas ppt
1. Enterocutaneous fistulas are abnormal connections between the gastrointestinal tract and skin that allow intestinal contents to drain onto the skin. They most commonly originate from the small intestine.
2. Management of enterocutaneous fistulas involves stabilization of the patient, controlling sepsis, providing adequate nutrition, defining the anatomy of the fistula, and creating a treatment plan.
3. Key steps in management include fluid resuscitation, controlling fistula output, protecting the skin, draining any abscesses, providing nutrition either enterally or parenterally, and using pharmacological agents like octreotide to help reduce output.
Enterocutaneous fistulas ppt
1. Enterocutaneous fistulas are abnormal connections between the gastrointestinal tract and skin that allow intestinal contents to drain onto the skin. They most commonly originate from the small intestine.
2. Management of enterocutaneous fistulas involves stabilization of the patient, controlling sepsis, providing adequate nutrition, defining the anatomy of the fistula, and creating a treatment plan.
3. Key steps in management include fluid resuscitation, drainage of any abscesses, nutritional support either enterally or parenterally, controlling fistula output, and investigating the cause and location of the fistula through tests such as fistulography and CT scan with contrast.
Similar to Dr masciotra clinical case of intrahepatic cholelithiasis (20)
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Esophageal atresia with or without tracheoesophageal fistula
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Dr. masciotra a clinical case of renal angiomyolipoma
A 50-year-old woman undergoing an abdominal ultrasound for breast cancer staging was found to have a renal mass. Computer tomography and magnetic resonance imaging confirmed features consistent with renal angiomyolipoma. Biopsy of the mass showed the classic microscopic pathology of angiomyolipoma, with myoid cells and mature fat tissue surrounding large vessels. Elastography found the mean stiffness of the angiomyolipoma to be similar to renal cortex but less than the renal medulla.
Dr. masciotra sonoelastography and us in the diagnosis of small thyroid pap...
Three small thyroid papillary cancers were detected in two asymptomatic women. Shear wave elastography proved reliable in identifying stiff nodules, correctly characterizing the single benign nodule as soft. While papillary cancers are usually stiff, follicular cancers can be soft. Small nodules can be cancerous, while large nodules may be benign. Ultrasonography offers multiple parameters including stiffness, standard deviation, and elasticity ratios, providing a multiparametric approach rather than relying on a single mode.
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A 51-year-old woman underwent ultrasound examination of her thyroid which revealed two nodules - a mixed 25mm nodule in the right lobe and a solid 6mm nodule in the left lobe. Various ultrasound techniques were used to analyze the nodules, including color Doppler, power Doppler, and shear wave elastography. While TIRADS analysis only slightly differed between the nodules, shear wave elastography showed the right nodule to be significantly stiffer, correctly indicating it was a follicular carcinoma based on areas of capsular invasion. Advanced ultrasound tools like shear wave elastography provide important additional information beyond traditional ultrasound in evaluating thyroid nodules.
Dr. masciotra case of the day n.1 - breast cancer
A 50-year-old woman felt a slightly painful nodule in her left breast. Comparison of mammograms from 1 year and 2 months ago showed an increase in density and volume of the nodule. Ultrasound, MRI and shear wave elastography of the breast and axilla revealed a 3 cm cancer close to the pectoral fascia and metastatic involvement of at least two axillary lymph nodes. High breast density can obscure cancers on mammography. Multiple modalities including ultrasound and MRI may be needed for screening in dense breasts. Shear wave elastography provides information on size and stiffness of cancers and lymph nodes beyond conventional ultrasound.
Dr. masciotra swe in a selection of primitive and secondary lymphnodes mali...
This is a collection of clinical cases of primary and secondary lymphodes malignancies with analysis of the information that Shear Wave Elastography can add to diagnostic workup.
Dr. masciotra shear wave elastography and more in a clinical case of multip...
This is the presentation of a clinical case of Multiple Myeloma with a thorough discussion on many aspects of the disease and on applications of Shear Wave Elastography.
Dr. masciotra breast swe clinical cases
Ultrasound gives today more informations both in morphology (through speed of sound optimisation and 3D acquisition) and in mechanical properties evaluations (it gives mean, maximum and minimum stiffness as well standard deviation in the ROI). Furthermore it's possible to draw freehand ROI, very useful to differentiate the tumor and the stiff surrounding stroma also in the C plane with 3D SWE. Here some clinical cases are presented.
Dr. masciotra speed of sound role in us studies
In this presentation dr. Masciotra shows how the speed of sound selection in US imaging does change the informations of US data, both qualitative (morphology, echogenicity, spatial and contrast resolution) and quantitative (density of vessels, stiffness map) of the tissues examined.
In questa presentazione il dr. Masciotra analizza sulle immagini di casi clinici gli effetti della scelta della velocità del suono sulla qualità delle informazioni dei dati ecografici.
Come si può vedere il parametro della velocità del suono condiziona in maniera sensibile le informazioni sia qualitative (morfologia, ecostruttura, risoluzione spaziale e di contrasto) che quantitative (densità dei vasi e proprietà meccaniche come l'elasticità) dei tessuti esaminati.
Swe on breast cancer in dense breast with considerations on tnm staging
This case shows how dense breast can hinder cancer at mammography and the important role of US and SWE elastography in situation like this.
SWE could be the most reliable tool for the measurement of the 'T' parameter of TNM staging of breast cancer, especially if performed with 3D probe.
Shear waves elastography movies compresso
The document discusses shear wave propagation in different mediums like isotropic phantoms, the liver, and brain. It shows images from ultrasound and MR elastography experiments visualizing the propagation of shear waves through these tissues at different driving frequencies, as well as the resulting elastograms estimating tissue stiffness.
Carotid and vertebral arteries cd, pd, ultrafast doppler, cimt and pulsed wav...
Carotid and vertebral arteries cd, pd, ultrafast doppler, cimt and pulsed wav...antonio pio masciotra
Ultrasound is currently the only mean to determine non-invasively:
•the elastic properties of the arterial wall material (Young's elastic modulus)
•the relationship between intima-media thickness (IMT) and elastic properties or the influence of inward or outward remodeling on arterial distensibility.
Here you find also a demonstration of UltraFast doppler technology in the study of the carotids and vertebral arteries.
UltraFast doppler acquisition lasts only a few seconds and then in postprocessing it is possible to do spectral analysis in up to 3 different vessels (or 3 different sites in the same vessel).
It automatically identifies the frames with :
1) Maximum velocities
2) Mean velocities
3) Peak sistolic velocity.
It's very fast and reliable.D. antonio pio masciotra breast cancer seen on chest ct
1) A 74-year-old woman underwent an unenhanced CT scan of the chest for cough and dyspnea that incidentally found a 3 cm solid mass in her right breast. Further imaging with mammography, ultrasound, and shear wave elastography provided details of the mass's irregular margins, infiltrating growth, and stiff mechanical properties.
2) A follow-up CT scan with contrast found the mass had a contrast enhancement pattern between Type 1 and Type 2 curves on MR, which is not highly indicative of malignancy based on kinetics. Density increments were also relatively low.
3) The CT scan also incidentally found endometrial cancer, and total body CT was done for staging. Incidental breast
Dr. masciotra liver shear wave elastography clinical cases
The document discusses liver shear wave elastography and presents several clinical cases. It provides a table comparing the liver fibrosis classification using liver biopsy and Metavir scores to the corresponding ranges measured by shear wave elastography in kilopascals and meters/second. Several images show shear wave elastography measurements of livers with conditions like steatosis, cirrhosis, and hepatocellular carcinoma. The document demonstrates using shear wave elastography to evaluate liver fibrosis in patients with hepatitis C at different stages of disease.
Pavia 2013 dr. masciotra sonoelastography of the testis
This is the slideshow of the presentation held at 3d International Meeting on Sono-Elastography in Pavia on Oct. 1st 2013 concerning both elastography of the testis and general considerations on elastography.
Queste sono le slides presentate al Terzo Meeting Internazionale di Sonoelastografia tenutosi a Pavia il 01/10/2013.
Vengono trattati sia l'elastografia del testicolo che gli aspetti più generali dell'elastografia con le sue prospettive di sviluppo.
Sono elastography meeting pavia 2011 may 29-30 - presentation of dr. masciotra
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Masciotra pavia 2012 clinical cases
This document discusses the use of breast and thyroid sonoelastography and shear wave elastography in evaluating various clinical cases. It presents case studies demonstrating how elastography can help characterize nodules, cysts, lymph nodes and tissue changes after radiation therapy. Quantitative shear wave elastography provides stiffness measurements that can help differentiate benign from malignant lesions and identify tissue abnormalities. The goal of elastography is to correctly quantify tissue elasticity and identify elasticity cut-off values to aid the diagnostic evaluation of diffuse and focal diseases.
Breast elastography
This presentation was held by dr. Antonio Pio Masciotra - italian radiologist - on Novembre 2012 at Prato.
It concerns about neoplastic tissue's elasticity and breast elastography.
Masciotra prato 2012 compresso
The document discusses the transition from morphological imaging to physiopathological imaging. It notes that in ancient Egypt, hard masses in the body were linked to disease, and in Hippocratic medicine, palpation was an essential part of examination. It states that in the 21st century, remote palpation through elastographic imaging is becoming a reality. The document also provides examples of elasticity imaging techniques for breast lesions and lymph nodes and discusses aims of quantifying tissue elasticity and identifying disease states.
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Dr masciotra clinical case of intrahepatic cholelithiasis
- 1. Antonio Pio Masciotra Campobasso – Molise – Italy Website www.masciotra.net YouTube channel https://www.youtube.com/channel/UCgCj21nKGAhR997Ia3-QegQ Intrahepatic cholelithiasis in a 29 years old woman without symptoms
- 2. 29 years old woman without symptoms
- 3. 29 years old woman without symptoms
- 4. 29 years old woman without symptoms
- 5. 29 years old woman without symptoms
- 6. 29 years old woman without symptoms
- 7. 29 years old woman without symptoms
- 8. 29 years old woman without symptoms
- 9. 29 years old woman without symptoms
- 10. 29 years old woman without symptoms
- 11. 29 years old woman without symptoms Ultrasound images of intrahepatic hyperechoic foci. In this patient we can see hyperechoic foci with diffuse topography compatible with lipid deposits along the luminal surface of the intrahepatic biliary tree , here limited to segments 6 and 7. These multiple dots, less than 1 mm in diameter, cast short echogenic trail without acoustic shadows and sometimes look like comet tails. They are typically distributed along the portal arborizations in single line (end to end or in indian file) and may be associated with intrahepatic sludge or microlithiasis casting typical acoustic shadows. In this patient gallbladder has no stones. In the slides n. 3 and 4 you can see that the images were taken with patient in supine and orthostatic positions to exclude that hyperechoic foci were due to aerobilia (in which case their distribution would have been changed, going the air upward). In a young woman like in this case we could suppose a Low phospholipid associated cholelithiasis, sometimes associated to an ABCB4 gene mutation. Phospholipids are the major carrier and solvent of cholesterol and they exert a protective effect against bile saltinduced biliary mucosa injury. Mutations in the ABCB4 gene are thought to be responsible for progressive intrahepatic cholestasis type 3 and heterozygous mutations have been also reported in patients presenting with a history of intrahepatic cholestasis of pregnancy or with a cholangiopathy referred to as anti-mitochondrial antibody (AMA) negative primary biliary cirrhosis (PBC). Defect in ABCB4 function causes the production of bile with low phospholipid content, increased lithogenicity and high detergent properties leading to bile duct luminal membrane injuries and resulting in cholestasis with increased serum GGT activity.
- 12. Antonio Pio Masciotra Campobasso – Molise – Italy Email antoniomasciotra@yahoo.it Website www.masciotra.net YouTube Channel https://www.youtube.com/ch annel/UCgCj21nKGAhR997I a3-QegQ Intrahepatic cholelithiasis in a 29 years old woman without symptoms