Tac de silla turca

TC oidos

Las enfermedades hipofisarias, como la acromegalia y la enfermedad de Cushing, requieren un tratamiento quirúrgico o médico. En algunos tumores hipofisarios funcionantes se observa una remisión espontánea de la hipersecreción hormonal, principalmente asociada a la apoplejía o al infarto hipofisario. Comunicamos la evolución de dos pacientes mujeres mayores de 70 años en el momento del diagnóstico, con múltiples comorbilidades. En el caso 1, la acromegalia se diagnosticó a los 74 años de edad. La tomografía computarizada del sella mostró un adenoma de 10 mm. Durante su seguimiento, los niveles de IGF1 permanecieron normales. Nueve años después, una resonancia magnética (RM) mostró un adenoma de 7 mm. En el caso 2, se hizo el diagnóstico clínico y bioquímico de la enfermedad de Cushing teniendo 71 años. La RMN Sellar mostró un adenoma de 6 mm. Tres años después, el cortisol urinario se normalizó sin cambios en el adenoma en la RM. Siete años después, sigue sin signos clínicos ni bioquímicos de hipercortisolismo. En ambos casos, no se observaron signos de hemorragia en la RM.

Figura 2A Cortes coronales en resonancia nuclear magnética de silla turca al momento del diagnóstico, en el estudio sin contraste la flecha indica un nódulo de 6 mm, posterolateral izquierdo, isointenso en secuencias T1 y T2 (recuadros izquierdo y central). Después de la administración de gadolinio, se realiza escasamente al medio de contraste. La imagen hiperintensa en T1 adyacente al piso selar, corresponde a estructura vascular venosa (recuadro derecho).

3d skull tomography - clínica melendres

The challenge of evaluating and treating the patient with vertigo and dizziness lies in correctly identifying the etiology of the complaint, and the differential diagnosis is broad. It is common for physicians who evaluate these patients to use imaging tests as the first diagnostic approach to rule out central causes of the symptom.

A study of contrast-enhanced angiotomography and MRI concluded that the diagnostic and therapeutic efficacy of neuroimaging in patients with uncomplicated vertigo is extremely low [12]. Several articles do not routinely recommend it [12,13].

In this study we aim to know what profile of patients with vertigo and dizziness have neuroimaging tests performed, as well as to quantify and describe the radiological findings found. We also analyzed the cost-utility of CT and MRI in the study of these patients.

From the review of the clinical history we studied demographic variables of the patients (age, sex, country of birth) and clinical variables (psychiatric/psychological pathology and emergency room attendance due to vertigo).

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That the Social Security Institute, in accordance with the provisions of numeral 3 of Article 3 of Decree 2148 of 1992, must guarantee to its affiliates and beneficiaries the rendering of integral medical assistance services that by law correspond to it, through preventive, curative and rehabilitation actions.

That based on Paragraph 1 of Article 275 of Law 100 of 1993, the Board of Directors of the Institute is responsible for determining the rates to be applied by the Institute in the sale of health services.

That by virtue of the provisions of Article 1, Paragraph 1 of Resolution 4144 of 1999 of the Ministry of Health, while the Health Services Tariff Manual is in force, based on the Single Classification of Health Procedures (CUPS), the service providers will use, for the purpose of reporting individual records, the coding systems with which they bill the value of the services to the benefit plan administrators.