CMIG Extra: Cases最新文献

We report a case of exophytic sigmoid colon cancer mimicking an ovarian tumor. This tumor showed submucosal growth accompanied by an extracanal cystic component. It was difficult to determine whether this tumor derived from the sigmoid colon or from the ovary by double contrast barium enema and endoscopic examination. On multidetector-row CT (MDCT), it was possible to see that this mass continued not to the gonadal vein but to the inferior mesenteric vein indicating sigmoid colon origin. In determining the origin of a pelvic mass, it is useful to evaluate the relationship between the tumor and the venous anatomy.

Global developmental delay has a significant socioeconomic impact. Early identification of the etiology can obviate further diagnostic testing. Magnetization transfer imaging and diffusion-weighted imaging were performed on 85 children with global developmental delay and 133 normally developed children as control. Conventional MRI was abnormal in all of the 41 children with congenital brain malformation, metabolic and chromosomal disorders, and vitamin B12 deficiency, 85.71% of the seven children with genetic syndrome, and 60% of the five children with history of viral encephalitis. Although magnetization transfer ratios and apparent diffusion coefficients were abnormal in these children, there was no specific pattern to aid the differential diagnosis. Eight of the 13 children with clinical suspicion of cerebral palsy had abnormal MRI findings that may help to reclassify them as having congenital malformation. All of 19 children who were eventually classified as idiopathic global developmental delay had normal MRI. The diagnostic yield of electroencephalogram, metabolic screening, cytogenetic testing, and skin/muscle biopsy was low at 62.50, 24.71, 22.22, and 19.05%, respectively.

Chondrosarcoma is a malignancy rarely encountered in the head and neck. The reported prevalence of chondrosarcoma involving the head and neck region has a range of 1–12%. In our case report, we demonstrate a chondrosarcoma of the left lower neck region by means of magnetic resonance imaging. We were not able to show its exact origin and considered the possibility of a rare extraosseous origin. It presented as a slowly growing, painless mass and showed characteristic calcification and high signal intensity on long TR, long TE sequences. It caused left jugular vein compression and left subclavian artery kinking due to mass effect. Histopathologic examination revealed a low-grade mesenchymal myxoid chondrosarcoma. In this study, we review the clinical presentation, imaging features, management, and treatment procedures of these rare tumors.

Vacuolating megalencephalic leukoencephalopathy is a recently defined entity characterized by swelling of white matter, subcortical cysts in fronto-temporal regions and slow progression of neurological symptoms that contrasts with the severity of radiological findings. We present a late follow-up of a case with vacuolating megalencephalic leukoencephalopathy. There was an improvement of the brain swelling and associated sulcal enlargement. Of notice was basal ganglia involvement which has not been described previously.

The study evaluated the feasibility of determining coronary lesion configuration, including coronary plaque, stenosis and calcification, by ECG-gated MSCT. The results were compared with the characteristics of intravascular ultrasound (IVUS). The overall sensitivity for diagnosing significant coronary stenosis was 80.2%, and the specificity was 95.6%. There were significant differences in plaque density among three groups (p<0.01). MSCT was feasible for the detection of coronary artery stenosis. And plaque composition could be clearly differentiated and classified by MSCT, which is a promising method of non-invasive risk assessment in patients with known or suspected coronary artery disease.

A 53-year-old-man demonstrated an embolism of the left middle cerebral artery, a rapid spontaneous thrombolysis and a subsequent recovery of the cerebral perfusion. These events were documented using MR angiography, perfusion-weighted MR imaging and digital subtraction angiography. The patient recovered consciousness and his symptoms of right hemiparesis and aphasia disappeared completely, representing the so-called spectacular shrinking deficit. This case provides evidence that an early spontaneous thrombolysis may recover cerebral perfusion and alleviate the symptoms of the patient.

The authors sought to compare the early MRI and CT findings in patients suffering closed head injury and to investigate the impact of imaging discrepancies on treatment management. A group of 62 patients with closed head injury and discrepancy between the apparently normal or with minor findings CT scan, and their neurological statuses were prospectively studied with MRI. Both CT and MRI were performed within the first 6 days after injury. According to the Glasgow Coma Scale (GCS), 46 patients suffered severe head injury (GCS≤8) and 16 patients moderate head injury (GCS 9–12). Four MRI sequences in various planes were applied using a 1T MR scanner. CT findings were present in 19 out of 62 patients and MRI findings in 61. Extra-axial lesions were found in 52 patients with MRI and in 16 with CT. Subarachnoid hemorrhage (SAH) was observed in 40 patients with MRI and in 12 with CT. Intraventricular hemorrhage was observed in 15 patients with MRI and in 6 with CT. Intraaxial lesions were demonstrated in 54 patients with MRI and in 17 patients with CT. MRI demonstrated diffuse axonal injuries (DAI) type I in 27 patients, type II in 32 and type III in 9 as opposed to 2, 1 and 0 patients with CT respectively. Subcortical gray matter injuries were shown in 12 patients with MRI and 4 with CT. Primary brainstem injuries were shown in 6 patients with MRI and 1 with CT. The FLAIR sequence alone, revealed 89% of the findings demonstrated by all 4 MRI sequences. No statistically significant difference on GCS versus the hemorrhagic and non-hemorrhagic nature of the lesions was found (p>0.05). In conclusion, in closed head injury patients with minor or absent CT findings and severe or moderate injury, MRI findings are almost always present and include particularly DAI lesions and SAH. These differences in favor of MRI do not alter the treatment management.

In 216 patients who underwent stereotactic irradiation (STI), MRI was performed 4–12 times for 17–29 months after STI. Frequency of new radiation-induced lesions more than 2 cm in diameter on sequential MRI following STI, and characteristics on sequential MRI findings were investigated. Ten patients displayed new lesions following STI. These patients comprised eight of 208 patients with intracranial neoplasm and two of seven patients with AVM. Lesions appeared 1–12 months after STI. The lesions appeared near primary lesions in nine patients. Contrast-enhancement was seen along the cerebral cortex in three patients. Sequential MRI is effective in detecting radiation-induced lesions following STI.