Radionuclide renal scan findings in a patient with iatrogenic rupture of the ureter are reported. Although the literature contains reports of the radionuclide scan in rupture of the ureter from other causes, this, to our knowledge is the first description of the scan findings in iatrogenic rupture.
Nonenhanced CT scans through the kidneys commonly show a difference in radiopacity between the inner peripelvic portion of the renal parenchyma and the more peripheral regions of the renal parenchyma. This normal observation has not been described.We reviewed 50 nonenhanced CT scans. Renal parenchyma was evaluated by both visual inspection and density measurements of inner and outer aspects of the kidneys in 38 and visual inspection only in 12. A narrower window was used to better show density differences (100 W, 35 L). We recorded the indication for the CT, history, and recent blood chemistries.The inner parenchyma was of greater radiopacity than the outer parenchyma in 35 of 50 cases by visual inspection and in all densitometry cases (38 of 38). There was no correlation with clinical history or blood chemistry.A difference in density between the inner and outer portions of the renal parenchyma is very common and will often be seen if one looks for it. We have not shown an etiology for this difference, and indeed, it may be physiological. One must be aware of this finding to avoid mistaking it for pathology.
Since 2009, the rate of nondiagnostic (ND) thyroid nodule fine-needle aspiration (FNA) has ranged from 2% to 20%. A ND result can cause further patient morbidity secondary to repeated procedures and delay in diagnosis. The use of real-time strain elastography (RTE) in determining nodule malignant risk has gained considerable focus recently. A less studied area where RTE may prove beneficial is its role in targeting areas for FNA. Our hypothesis is that FNA performed in concurrence with RTE will show a decreased rate of ND results leading to fewer repeated FNA.The Institutional Review Board approval was obtained. A retrospective review of all thyroid nodule FNA from January 1, 2011, to January 1, 2014, was performed with review of nodule size, presence of microcalcifications, vascularity, solid components, patient age, and gender. Cases were separated based if RTE was done before FNA or not. Pathology reports were reviewed to assess for specimen adequacy. Statistical comparison was performed using SAS analysis software.A total of 221 specimens were reviewed, with RTE performed on 140 cases (63.4%). Both groups were similar in demographics and previously described nodule characteristics. The ND rate when RTE was not performed was 16% (13/68) compared to 10% when RTE was performed (14/126). The difference was not found to be statistically significant, P = 0.205.The presence of an elastogram failed to demonstrate a significant decrease in ND FNA rates although these results may be secondary to study design. Further evaluation with prospective trials using larger sample size may ultimately detect increased accuracy of RTE-targeted FNA.
