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Query: UMLS:C0034065 (pulmonary embolism)
14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A young woman affected by multiple sclerosis (MS) was examined by magnetic resonance (MRI) during a relapse. Three months later the patient died from acute pulmonary embolism. An imaging and quantitative MRI study was performed on the formalin-fixed brain. Finally, the left hemisphere was examined by light microscopy after histological and immunocytochemical staining. While fixation significantly reduced T1 and T2 relaxation times, MRI signal and image contrast of the fixed brain were satisfactory. Lesion distribution was very similar in corresponding MRI slices and histological sections. The post mortem MRI scan and pathological study detected several new lesions, as expected from the patient's clinical course. Thus, it was possible to evaluate the age of lesions by comparing the MRI scans. In this study, signal intensity of MS lesions varied according to their histological features, i.e. to their age.
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PMID:An in vivo and post mortem MRI study in multiple sclerosis with pathological correlation. 134 48

On the basis of one personal case of leiomyosarcoma, the various anatomicoclinical features of sarcomas of the pulmonary artery are summed up. They most often produce a picture of severe pulmonary embolism that is resistant to all treatments; the lesion most often is a hilar mass without any associated bronchoscopic abnormality. Angiograms are not always easily interpreted, and the modern imaging techniques (ultrasound, computed tomography, and above all MRI) can best lead to the preoperative diagnosis, although this lesion is unfrequent.
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PMID:[Primary sarcoma of the pulmonary artery]. 175 65

Common intracranial complications following head injury are meningitis, usually associated with a basilar skull fracture or open-depressed skull fracture; delayed hematoma; hydrocephalus; and vascular injuries. Prophylactic antibiotics are not recommended for the management of basilar skull fractures. The best means of preventing infection from open-depressed skull fractures is operative debridement and thorough irrigation, though recent evidence suggests that select cases can be safely managed without operation. Serial CT scans should be obtained in severely head-injured patients to identify delayed hematomas. CT and MRI scans obtained several weeks or months after severe head injury frequently reveal enlarged ventricles, though only a small percentage of these patients have clinical hydrocephalus. Those that do, often benefit from a shunt. Vascular injuries frequently are not detected until ischemic symptoms develop hours or days after the injury. Recommended treatment for intimal tears or dissection is full anticoagulation, but in those with cerebral contusions or other intracranial lesions, this may present an unacceptable risk for intracranial hemorrhage. Pulmonary infections frequently occur following head injury, and can be associated with admission to the ICU and intubation. A large percentage of these infections are caused by enteric gram-negative organisms, and aggressive treatment with appropriate antibiotics is necessary. Aspiration of gastric contents is common in head-injured patients and is frequently complicated by bacterial superinfection. The routine use of antacids and H2 blocking agents leads to bacterial colonization of the stomach with anaerobes and gram-negative aerobes. Thus, empiric therapy for aspiration pneumonia should include clindamycin. Sinusitis is a frequent cause of fever and leukocytosis in patients with nasotracheal or nasogastric tubes in place for several days and often subsides spontaneously with removal of the tubes. Pulmonary edema is often caused by excessive fluid administration during resuscitation of these patients, and can be avoided by monitoring central venous pressures. Pulmonary edema may also be caused by ARDS, excessive catecholamine release, or primary cardiac failure. Most of these patients will benefit from early intubation and PEEP. Pulmonary emboli most often originate from deep venous thrombi, and there is increasing evidence that prophylaxis with low-dose heparin and pulsating boots can significantly reduce the incidence of both complications. Erosive gastritis is found in the majority of severely head-injured patients and may be due to ischemia of the gastric mucosa as well as gastric hyperacidity.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Complications of head injury and their therapy. 182 50

We present a retrospective study of ten patients presenting non specific clinical manifestations in whom the diagnosis of pulmonary embolism was documented by CT scan and/or MRI. Results of CT scan and/or MRI were compared to DSA bi-selective pulmonary angiography findings. In a large number of cases, CT scan and MRI allowed the detection of the obstruction within the right and left pulmonary arteries (RPA and LPA). Although these techniques did not permit the diagnosis of peripheral clots, pulmonary infarcts were usually depicted by these two procedures. CT scan and/or MRI could be performed as first-line investigations in case of atypical clinical symptoms because of their high relevance for proximal pulmonary artery obstruction, although these two non-invasive procedures cannot indicate the aetiology of the obstruction etiology.
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PMID:[Obstruction of pulmonary arteries. Contribution of the scanner and MRI. Apropos of 10 cases]. 182 57

A wide variety of MRI techniques is available for vascular imaging, each exploiting a different property of flowing blood to achieve contrast. These include spin-echo, which has been used for the diagnosis of aortic dissection and of great vessel anomalies, as well as for the evaluation of pulmonary flow in patients with pulmonary hypertension and pulmonary embolism. Spin echo excels in detecting infection and hematoma in the tissues around grafts and vessels. Phase display imaging has proven useful in differentiating signal of slow flow from that of intravascular thrombus. Imaging of peripheral vessels can be achieved with gradient refocused sequences, which provide bright intravascular signal over a wide range of flow velocities. These sequences may be combined with subtraction strategies to eliminate the signal from stationary tissues in order to generate an angiographic image. The advent of three-dimensional MR angiographic imaging techniques provides an effective way to display peripheral vessels. Early experience implies that MR angiography will play an important role in vascular imaging in the future, provided that the signal loss from turbulent flow can be minimized.
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PMID:Current applications of magnetic resonance vascular imaging. 267 Feb 32

Although cardiac myxomas are histologically benign, they may be lethal because of their strategic position. They can mimic not only every cardiac disease but also infective, immunologic, and malignant processes. Myxomas must therefore be included in the differential diagnosis of valvular heart disease, cardiac insufficiency, cardiomegaly, bacterial endocarditis, disturbances of ventricular and supraventricular rhythm, syncope, and systemic or pulmonary embolism. The symptoms depend on the size, mobility, and location of the tumor. Echocardiography, including the transesophageal approach, is the most important means of diagnosis; CT and MRI may also be helpful. Coronary arteriography in patients over 40 years of age is generally required to rule out concomitant coronary artery disease. Surgical removal of the tumor should be performed as soon as possible; the long-term prognosis is excellent, and recurrences are rare. In follow-up examinations as well, echocardiography is essential.
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PMID:Cardiac myxomas. 861 42

This article presents an exhaustive review of MRI in the assessment of the pulmonary arteries (sequences, normal results, clinical signs of the main diseases). Its current preferential indications are: the study of the main pulmonary artery trunks (primary tumours, proximal embolism, caliber abnormalities, anatomical relations with central tumours), the assessment and post-treatment follow-up of pulmonary arterial malformations. Angio-MRI is currently being developed and, in the near future, should allow the reliable diagnosis of pulmonary embolism and will therefore be indicated alongside spiral computed tomography. MRI also allows functional assessment of the right circulation (measurements of circulatory velocity and flow rates). It should rapidly become an examination of choice in the haemodynamic follow-up of patient with pulmonary hypertension and transplant recipients and as an evaluation tool for new drugs.
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PMID:[Morphological and functional study of pulmonary arteries by MRI]. 763 21

Clinical, radiological, and histopathological features of 51 surgically treated gangliogliomas were evaluated retrospectively. The most common presenting symptoms were epileptic seizures (47 patients (92%)). Focal neurological deficits occurred in 8% of the patients. The duration of symptoms at the time of operation ranged from three months to 45 years, mean 11 years. The temporal lobe was affected in 43 patients (84%), the frontal lobe in five patients (10%), and the occipital lobe in one patient (2%). Two of the tumours (4%) were localised infratentorially. On MRI, solid tumour parts usually showed a pronounced signal increase on proton density images and a less pronounced signal increase on T2 weighted images, whereas solid components were mainly isointense on T1 weighted images. Contrast enhancement was noted in 16 of 36 patients (44%). Cystic tumour parts were found in 23 of 40 patients (57%), all characterised by signal increase on T2 weighted images and decreased T1 signals. Signal deviation of cystic tumour parts on proton density images was variable. Computed tomography was performed in 17 patients and showed hypodense lesions in 10 (59%), and calcifications in seven (41%) cases. Surgery included complete tumour removal in 44 patients (86%) and partial resection in seven (14%). In six patients (12%) there were transient postoperative complications. One patient (2%) died postoperatively due to pulmonary embolism. Histopathological examination of the surgical specimens showed low grade gangliogliomas in 49 cases (96%) and anaplastic gangliogliomas in two (4%). Control MRI of 31 patients with a mean follow up period of 16 months was uneventful in all but one case of an anaplastic ganglioglioma. In all patients in whom the ganglioglioma was associated with medically intractable seizures the operation resulted in complete relief of seizures or a noticeable improvement of the epilepsy.
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PMID:Gangliogliomas: clinical, radiological, and histopathological findings in 51 patients. 779 80

A 73-year-old man suffering from exertional dyspnea was admitted to our hospital. Transthoracic echocardiography revealed pericardial effusion. This case was diagnosed as idiopathic pericarditis from laboratory data and pathological findings of the pericardial biopsy. A right atrial mass was detected by computed tomography, transesophageal echocardiography and MRI during conservative treatment. Because of the risk of pulmonary embolism due to the presence of the right atrial mass, removal of the mass was performed. The atrial mass was diagnosed as organized thrombus by pathological examination. It was suggested that the cause of right atrial thrombus was congestion and damage of the right atrial endocardium due to idiopathic pericarditis and atrial fibrillation. This case of a right atrial thrombus associated with idiopathic pericarditis is very rare, and MRI was proven to be very useful in the differentiation of a thrombus from cardiac tumor.
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PMID:[A case of right atrial thrombus associated with idiopathic pericarditis]. 783 34

Lateral sinus thrombophlebitis (LST) is an intracranial complication of otitis media. Its incidence has markedly decreased in the era of antibiotic therapy but mortality is still high. A 13-year-old girl presented with fever, ear discharge and torticollis. On the day of admission LST was diagnosed from the clinical presentation and CT-scan. She was operated immediately and intravenous antibiotics were administered. Despite the rapid intervention, the course was protracted, with recurrent events of septic pulmonary embolism. Despite internal jugular vein ligation, fever continued and anticoagulant therapy was begun. The possibility of LST should be considered in patients with ear discharge and fever. CT-scan enables early diagnosis of LST and MRI has a role in detecting additional intracranial septal foci. Surgical intervention should be early and aggressive. The efficacy of jugular vein ligation is unclear; anticoagulant therapy should be considered.
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PMID:[Lateral sinus thrombophlebitis]. 820 May 85


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