European Journal of Radiology Extra最新文献

Introduction

We describe a unique case of dural optic nerve sheath calcification with areas of parenchymal intracranial calcification.

Case history

A 74 years old Afro-Caribbean male presented with the history of puffiness under the lids associated with left ptosis. He has right eye Amblyopia. Fundus examination revealed slightly pale and more cupped left disc compared to the right optic disc. CT scan with contrast of the orbit and brain revealed dural optic sheath calcification with areas of relatively symmetrical parenchymal intracranial calcification and with normal serum investigations.

Discussion

None of the previous reported cases had brain parenchymal calcification. Our case is unique that he not only had dural optic nerve sheath calcification but also had intracranial brain parenchymal calcification.

Purpose

An endometrium cancer with liver metastasis, developing continuous and severe abdominal pain with vomiting and constipation, following phenol celiac plexus neurolysis, is described to find out if MRI can explain the reason of neurologic deficit.

Materials and methods

A 81-year-old woman with metastatic endometrium cancer underwent celiac plexus phenol neurolysis for management of severe pain at right hypochondriacal region. In spite of apparently adequate needle position, she developed transient paraplegia consistent with anterior spinal artery syndrome. At 48 h after celiac plexus block MRI was performed.

Results

In this patient, paraplegia suddenly ensued after instillation of the phenol solution, and postprocedure spinal MRI showed increased signal in the thoracic spinal cord consistent with edema. The patient was discharged 25 days after the block with clinically insignificant neurological deficit.

Conclusion

We present a case of a patient who had paraparesis after the performance of celiac plexus block (CPB). We propose that the mechanism for this rare but devastating complication is the neurotoxicity of phenol on spinal cord which may result from spasmotic effect of phenol on spinal feeding arteries. In such cases MRI, especially the short tau inversion recovery (STIR) sequence should be performed to see the acute changes in spinal cord in patients with acute developing neurologic deficit following CPB.

Noonan syndrome is an autosomal dominant condition with a wide variation in phenotypic expression. We report a case of a young man diagnosed with Noonan syndrome on the grounds of the classical PTPN-11 mutation, whose brain MRI performed for the evaluation of progressive gait-disorders showed remarkable intra-cerebral lesions.

The authors present a case of giant pelvic tumor in a 29-year-old previously healthy female. The tumor was an incidental finding during cesarean procedure after an unremarkably pregnancy. Both CT and MRI prior to surgery demonstrated a heterogeneous tumor measuring 30 cm × 16 cm × 5 cm occupying the entire pelvis and involving bilaterally both iliac and inguinal vessels. CT revealed little contrast enhancement and on MRI showed slight hypointensity signal on T1-weighted sequences and hyperintensity on T2-weighted sequences. Surgical excision was performed 2 weeks later.

On follow-up the CT a few months later there was a recurrent tumor with the same location. She undergone angiography that showed no invasion of the superior and inferior mesenteric vessels and iliac.

A pelvic MRI study was performed prior to the second surgery that showed a giant mass, from the iliac crest to the coccyx, pushing the uterus, bladder and rectum to the right, closed to gluteus muscles and along the left sacral roots without infiltrative aspects. The lesion demonstrated hypointensity on T1-weighted sequences and hyperintensity on T2-weighted images however failing to enhance with cystic-like features that are usually depicted in hemangiomas. A hypothesis of plexiform fibroma versus other fibrous tumors was then postulated. According to the imaging findings and the tumor recurrence the hypothesis of aggressive angiomyxoma considered most likely. The glass slide revision referred the differential diagnosis of cavernous hemangioma with retroperitoneal angiomyolipoma and aggressive angiomyxoma.

She undergone surgery and the pathological the final diagnosis was aggressive angiomyxoma.

We report the case of a woman whose echocardiographic findings where suspicious for an atrial septal defect. The subsequent cardiac MRI revealed the finding of a synchronous prominent persistent Eustachian valve and atrial septal aneurysm. The jet through the canal formed by the Eustachian valve and the bulging right atrial septum mimicked an atrial septal defect on Doppler mode.

Bilateral intraosseous lipoma is an unusual diagnosis. Radiological appearance depends on the stage due to evolutionary changes within the tumor. This report describes the imaging features of pathologically proven bilateral intraosseous calcaneal lipoma, showing the complete spectrum of evolutionary change, in the form of intralesional cyst, hemorrhage, fat necrosis, dystrophic calcification and woven bone formation, occurring simultaneously in the same patient.

44 year old male was admitted to hospital with chest pain. Complex coronary artery fistula drained into pulmonary artery was depicted but not clearly demonstrated with conventional angiography despite various projections. CT angiography was demonstrated that the fistula was fed by both left anterior descending (LAD) and right coronary artery (RCA) branches. A feeder aneurysm was found on a LAD branch. The fistula was associated with RCA and LAD artery via small caliber vessel web which was also associated with right ventricular outlet. 64-MDCT is superior to catheter angiography in its capability to demonstrate beyond the lumen of coronary arteries and extra-anatomical structures like fistulas.

Primary small cell carcinoma of the oesophagus is a rare condition accounting for less than 2.4% of all primary oesophageal malignancies. We present a case of primary small cell carcinoma of the oesophagus with benign appearances on contrast oesophagography.

We reported a 48-year-old lady with incidental finding of a retroperitoneal tumor during regular ultrasound examination. Computed tomography (CT) revealed a tumor in retroperitoneum with strong enhancement comparable to vascular structure. In magnetic resonance imaging (MRI), the lesion showed high signal intensity on T2 weighted imaging, indicating its nature as a vascular tumor. Pathological examination disclosed the diagnosis of glomus tumor. We have a thorough discussion about the correlation between the imaging findings and the pathological features.