The British journal of radiology
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Ureteric obstruction causing renal failure is a serious complication of advanced prostate cancer. Percutaneous nephrostomies (PCNs) are used to decompress the obstructed kidney(s). This study aims to identify whether bilateral PCN insertion confers any advantage over unilateral PCN insertion for patients with bilateral ureteric obstruction. ⋯ The mean survival time following PCN was 7.5 months for all patients. The data suggest that the nadir serum creatinine after PCN insertion was similar, independent of whether one or two nephrostomies were inserted. There was also little difference in the serum creatinine levels at the time of death, suggesting that survival after PCN insertion is based on the aggressiveness of the prostate cancer as opposed to the number of nephrostomies inserted.
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We report a case of traumatic extrathoracic lung herniation. This is a rare injury that is potentially life threatening. The imaging features, associated injuries and complications are discussed to facilitate rapid recognition for best patient outcome. Uniquely, we demonstrate the injury with a three-dimensional reconstructed minimum intensity projection.
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Patients undergoing radiotherapy for rectal cancer are generally treated in a prone position, with a full bladder, to reduce the volume of normal bowel in the high-dose volume. This position is difficult to maintain, and is not consistently reproducible. This study evaluates the volume of bowel and dose received in the prone and supine positions in patients undergoing pre-operative rectal cancer chemoradiation. ⋯ From 20-45 Gy, there was no significant difference in the volume of bowel irradiated with each 5 Gy increment. This study demonstrates that the volume of bowel irradiated at doses associated with bowel toxicity in concurrent chemoradiation is not significantly higher in the supine position. This position could be adopted for patients undergoing pre-operative rectal cancer chemoradiation.
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We report a case of nephrogenic systemic fibrosis involving the thighs bilaterally in a patient who received multiple MRI scans with gadolinium. A recent bone scan demonstrated uptake of radiotracer in a region that correlates with CT and dermatopathological findings.
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Central venous occlusions can be difficult to traverse using conventional catheter and wire techniques. We describe six procedures in five patients using a technique of "sharp" recanalization and subsequent line insertion. The technique was successful in all of the cases, with the line functional for a mean duration of 13 months. This technique can permit successful dialysis catheter placement in patients who have failed with traditional techniques.