Objective To summarize the important HR-MRI manifestations of orbital disease in extraconal compartment.Methods Forty-four patients with extraconal orbital disease identified pathologically were analysed retrospectively. MRI of the orbit at 1.5 Tesla was performed with surface coil, thin slice, suitable bandwidth, small field of view (FOV) and large matrix. The analyzed criteria of imaging appearance were: location, shape,size, margins, extent, adjacent structures, and signal intensity.Results Lymphoma, hemangioma, rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon accounted for 70% of all extraconal orbital diseases. Three cases of haemangioma had round shape and clear margin; most lymphoma had irregular shape, unclear margin and big volume; while most rhabdomyosarcoma and metastasis had round shape and unclear margin. The effect of space-occupying of lymphoma was not obvious. One case of lymphangioma had high signal intensity on both T 1- and T 2-weighted images without enhancement. Melanomametastasis appeared hyperintense on T 1- weighted and hypointense on T 2-weighted images. The contrast-enhancement of haemangioma was much more prominent than others. There were characteristic of rhabdomyosarcoma, metastasis, pseudotumor, and phlegmon about their age,clinical history and examination. Conclusion Location criteria, morphological changes, MRI signal intensity, clinical history and the effect of space-occupying are very useful in the differential diagnosis of the orbital disease.

Objective To investigate HR-MR imaging characteristics of non-Hodgkin lymphomas (NHL) of the orbits in extraconal compartment. Methods The HR-MR images of 16 patients with NHL of the orbits identified pathologically were retrospectively analyzed. MRI of the orbit at a 1.5 T scanner was performed with 4-cm surface coil, thin slice, suitable bandwidth, small FOV, and large matrix. T1-weighted (before and after i.v. bolus injection of contrast medium) and fast spin-echo T2-weighted sequences were acquired in all patients. All cases were performed with fat suppression techniques. The analyzed criteria of imaging appearance included location, number, size, shape, margins, extension, adjacent structures, and signal intensity of the lesions. Results The lesions in 13 of 16 cases located in anterior part of extraconal compartment, posterior to the orbital septum, and with irregular cast shape. The other 3 patients showed diffuse lesions with infiltration in extraconal compartment and with irregular shape. Eleven lesions had the large volume above 3.0 ml, 4 lesions with medium volume ranging from 1.0 to 3.0 ml, and only one with small volume less than 1.0 ml. 13 cases had a poor-defined margin with infiltration of extraocular muscles, but without mechanical shift of the muscles. 7 patients had infiltration of eyeball, but only 3 cases with exophthalmos. Destruction of orbital bone was evident in 2 cases with diffuse lesions but never in isolated orbital lymphoma. On the T_1-weighted images, the signal intensity of the lymphoma was isointense compared with that of the muscle in all patients. The T_2-weighted fast SE images showed a hyperintense signal in 13 cases and intermediate in 3 cases. All lesions enhanced after intravenous Gd-DTPA administration, 15 cases with homogeneous enhancement, and 10 cases with reliably visible enhancement in the T_1-weighted fat-suppressed sequences. Conclusion Most NHL of the orbits in extraconal compartment have the characteristic findings on HR-MR imaging, including anterior part of extraconal compartment location, posterior to the orbital septum, irregular cast shape, large volume, poor-defined margin with infiltration but without mechanical shift of extraocular muscles, uniform signal characteristics and marked enhancement after injection of contrast medium, and without bony destruction in isolated orbital lymphoma. The understanding of HR-MRI features of orbital NHL in extraconal compartment is very useful for making the differential diagnosis with other orbital diseases.

Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.
Adolescent ; Adult ; Child ; Delivery of Health Care ; Diagnosis ; Follow-Up Studies ; Humans ; Kidney Transplantation ; Nephrology ; Renal Insufficiency, Chronic ; Survival Rate ; Transplantation ; Transplants ; Young Adult