Adrenal Imaging: Why, When, What, and How? Part 3. The Algorithmic Approach to Definitive Characterization of the Adrenal Incidentaloma

2011 ◽  
Vol 196 (2) ◽  
pp. W109-W111 ◽  
Author(s):  
Giles W. L. Boland
Keyword(s):  
Adrenal Incidentaloma ◽  
Algorithmic Approach ◽  
Adrenal Imaging

scholarly journals Prinsip, Teknik, dan Algoritma untuk Karakterisasi Pencitraan Lesi-Lesi Adrenal Incidentaloma

2017 ◽  
Vol 3 (1) ◽  
pp. 28-38
Author(s):  
Bambang Purwanto Utomo ◽  
Pramiadi Pramiadi
Keyword(s):  
Imaging Techniques ◽  
Correct Diagnosis ◽  
Critical Role ◽  
Adrenal Incidentaloma ◽  
Resonance Imaging ◽  
Imaging Algorithm ◽  
Adrenal Imaging ◽  
Magnetic Resonance Imaging Lesion ◽  
Imaging Algorithms

Adrenal Incidentaloma lesions are commonly detected by Computed Tomography and Magnetic Resonance Imaging. Lesion characterization is essential to predict the prognosis of the primary disease, to assess staging, and direct therapy. Imaging plays a critical role in the characterization of adrenal incidentaloma lesions. Imaging modalities have been developed forr accurately differentiating lesions by using anatomic and physiologic imaging principles and major adrenal imaging techniques currently available which include newly developed promising techniques. An imaging algorithm is provided to guide radiologists in recognizing, reporting, and managing adrenal lesions, so it leads to the appropriate test to make correct diagnosis. The purpose of this article is to discuss the principles, techniques and imaging algorithms in characterizing adrenal lesions.

scholarly journals Adrenal incidentaloma. Part 1. Computed tomography of adrenal incidentaloma: the possibilities and difficulties of differential diagnosis

2020 ◽  
Vol 92 (12) ◽  
pp. 185-194
Author(s):  
S. A. Buryakina ◽  
N. V. Tarbaeva ◽  
N. N. Volevodz ◽  
G. G. Karmazanovsky ◽  
L. D. Kovalevich ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Adrenal Gland ◽  
Correct Diagnosis ◽  
Adrenal Incidentaloma ◽  
Diagnostic Study ◽  
Specific Organ ◽  
Adequate Management ◽  
Active Can

The adrenal incidentaloma is a lesion of a different etiology and found incidentally in patients who underwent a diagnostic study not about the disease of this organ. Lesions can be both hormonally inactive and hormonally active, can arise from different zones of the adrenal gland or have non-specific organ affiliation, can be benign or malignant. Computed tomography characterization of these lesions, especially the differential diagnosis of benign and malignant, is extremely important for the correct diagnosis in order to provide adequate management of the patient. The article presents the key computed tomography criteria that allow radiologist to characterize the lesion most accurately and consider appropriate diagnosis.

Adrenal incidentaloma

2011 ◽  
pp. 781-788
Author(s):  
Massimo Terzolo
Keyword(s):  
Clinical Practice ◽  
Medical Practice ◽  
Adrenal Mass ◽  
Adrenal Incidentaloma ◽  
Specific Diagnosis ◽  
Incidental Discovery ◽  
Definition Of ◽  
Adrenal Disease ◽  
Ct And Mri

Adrenal incidentaloma is an adrenal mass that is discovered serendipitously with a radiological examination performed for indications unrelated to adrenal disease (1). The incidental discovery of an adrenal mass has become an increasingly common problem, because of the widespread use of ultrasonography, CT, and MRI in clinical practice (2, 3). These techniques have greatly improved their power of resolution over recent years, thereby increasing the possibility of detection of tiny adrenal lumps. Several factors hinder a clear characterization of the phenomenon ‘adrenal incidentaloma’, which may be considered as a byproduct of technology applied to medical practice. Adrenal incidentaloma is not a single pathological entity and the likelihood of any specific diagnosis depends both on the circumstances of discovery and the applied definition of incidentaloma. Unfortunately, published reports are inconsistent in applying inclusion and exclusion criteria for these various factors, making the results difficult to interpret. A further issue is the lack of specific clinical features of the patients carrying an adrenal incidentaloma.

Approach to the Patient with Gait Disturbance

2021 ◽  
Vol 41 (06) ◽  
pp. 717-730
Author(s):  
Christopher G. Tarolli ◽  
Karlo J. Lizarraga
Keyword(s):  
Neurological Disorders ◽  
Systematic Approach ◽  
Outpatient Visit ◽  
Chief Complaint ◽  
Algorithmic Approach ◽  
Daunting Task ◽  
Gait Dysfunction ◽  
Chief Complaints ◽  
Difficulty Walking

AbstractThe assessment of patients presenting with disorders of gait can be a daunting task for neurologists given the broad potential localization and differential diagnosis. However, gait disorders are extremely common in outpatient neurology, and all neurologists should be comfortable with the assessment, triage, and management of patients presenting with difficulty walking. Here, we aim to present a manageable framework for neurologists to approach the assessment of patients presenting with gait dysfunction. We suggest a chief complaint-based phenomenological characterization of gait, using components of the neurological history and examination to guide testing and treatment. We present the framework to mirror the outpatient visit with the patient, highlighting (1) important features of the gait history, including the most common gait-related chief complaints and common secondary (medical) causes of gait dysfunction; (2) gait physiology and a systematic approach to the gait examination allowing appropriate characterization of gait phenomenology; (3) an algorithmic approach to ancillary testing for patients with gait dysfunction based on historical and examination features; and (4) definitive and supportive therapies for the management of patients presenting with common neurological disorders of gait.

Leydigcelhyperplasie: een zeldzame oorzaak van hyperandrogenisme bij een menopauzale vrouw

2021 ◽  
Author(s):  
M. BEKAERT ◽  
H. SONNEMANS ◽  
G. PEETERS ◽  
L. KEULEN ◽  
N. WILLERS ◽  
...  
Keyword(s):  
Leydig Cell ◽  
Adrenal Incidentaloma ◽  
Rapid Onset ◽  
Pathological Examination ◽  
Bilateral Oophorectomy ◽  
Biochemical Tests ◽  
Cell Hyperplasia ◽  
Adrenal Imaging ◽  
Leydig Cell Hyperplasia ◽  
Ovarian Pathology

Leydig cell hyperplasia: an atypical cause of postmenopausal hyperandrogenism We present a case of a 64-year old postmenopausal patient with new onset hirsutism, acne and clitoromegaly. Her medical history includes a non-secreting adrenal incidentaloma. Biochemical evaluation withheld an elevated testosterone with normal dehydroepiandrosterone sulphate (DHEAS). Other adrenal biochemical tests were normal and adrenal imaging was unaltered. Imaging of the ovaries was unremarkable. Due to the normal DHEAS, ovarian etiology was suspected, for which a bilateral oophorectomy was performed. Pathological examination showed bilateral Leydig cell hyperplasia, a benign though rare cause of postmenopausal hyperandrogenism. Postmenopausal hyperandrogenism is caused by of a group of gynaecological and endocrinological disorders. In case of rapid onset and severe symptoms of hirsutism or virilization an androgen-secreting neoplastic disorder should be suspected. Normal DHEAS is suggestive for an ovarian etiology. Imaging is necessary to differentiate between adrenal and ovarian causes, though normal imaging of the ovaries does not rule out ovarian pathology. Definitive diagnosis is often based on pathological examination after oophorectomy.

scholarly journals From benign adrenal incidentaloma to adrenocortical carcinoma: an exceptional random event

2017 ◽  
Vol 176 (6) ◽  
pp. K15-K19 ◽  
Author(s):  
I Belmihoub ◽  
S Silvera ◽  
M Sibony ◽  
B Dousset ◽  
P Legmann ◽  
...  
Keyword(s):  
Ct Scan ◽  
Adrenocortical Carcinoma ◽  
Adrenal Incidentaloma ◽  
Urinary Free Cortisol ◽  
European Guidelines ◽  
First Case ◽  
Adrenal Imaging ◽  
Free Cortisol ◽  
Catecholamine Metabolites ◽  
Work Up

New European guidelines for the management of adrenal incidentalomas were recently released. One of the most novel recommendations is to stop following patients when they present a typical, small and non-secreting adenoma. We report here the case of a 71-year-old man with such an adenoma, who developed an adrenocortical carcinoma (ACC) fourteen years later, with subsequent metastases and death. Clinically, he had a normal blood pressure and no sign of hormonal hypersecretion. The hormonal work-up showed no hormone excess: urinary free cortisol level was normal, the diurnal cortisol rhythm was respected and urinary catecholamine metabolites levels were normal. Computed tomography (CT) scan showed a homogeneous lesion, with a low density. The lesion remained unchanged during the five years of follow-up. Eight years after the last CT, a large right heterogeneous adrenal mass was incidentally discovered during an ultrasound examination. On CT scan, it was a 6 cm heterogeneous tumor. On hormonal work-up, there was no secretion. The patient was operated of an adrenalectomy, and the histology described an ACC with a Weiss score at 8, with no benign contingent. To our knowledge, this is the first case of an ACC occurring in a patient with prior adrenal imaging showing a typical benign adenoma.

scholarly journals Finite Element Approximation of Variational Inequalities: An Algorithmic Approach

2018 ◽  
Vol 22 (2) ◽  
pp. 114
Author(s):  
Messaoud Boulbrachene
Keyword(s):  
Finite Element ◽  
Variational Inequalities ◽  
Finite Element Approximation ◽  
Optimal Error Estimates ◽  
Element Approximation ◽  
True Solution ◽  
Algorithmic Approach ◽  
Elliptic Variational Inequalities ◽  
Standard Finite Element Method

In this paper, we introduce a new method to analyze the convergence of the standard finite element method for elliptic variational inequalities with noncoercive operators (VI). The method consists of combining the so-called Bensoussan-Lions algorithm with the characterization of the solution, in both the continuous and discrete contexts, as fixed point of contraction. Optimal error estimates are then derived, first between the continuous algorithm and its finite element counterpart, and then between the true solution and the approximate solution.

Morphological Characterization of Mycobacteriophage R1

1974 ◽  
Vol 32 ◽  
pp. 254-255
Author(s):  
B. L. Soloff ◽  
T. A. Rado
Keyword(s):  
Carbon Source ◽  
Stationary Phase ◽  
Growth Phase ◽  
Minimal Medium ◽  
Morphological Characterization ◽  
Logarithmic Growth Phase ◽  
Complete Lysis ◽  
Lysogenic Culture ◽  
Logarithmic Growth

Mycobacteriophage R1 was originally isolated from a lysogenic culture of M. butyricum. The virus was propagated on a leucine-requiring derivative of M. smegmatis, 607 leu−, isolated by nitrosoguanidine mutagenesis of typestrain ATCC 607. Growth was accomplished in a minimal medium containing glycerol and glucose as carbon source and enriched by the addition of 80 μg/ ml L-leucine. Bacteria in early logarithmic growth phase were infected with virus at a multiplicity of 5, and incubated with aeration for 8 hours. The partially lysed suspension was diluted 1:10 in growth medium and incubated for a further 8 hours. This permitted stationary phase cells to re-enter logarithmic growth and resulted in complete lysis of the culture.

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