European Journal of Radiology Extra最新文献

Systemic air embolism (SAE) frequently has a fatal outcome, actually for 80% in blunt trauma and 48% in penetrating ones. Several diagnosis tools can detect intracardiac and cerebral air, but should not be necessary to confirm SAE. Our observation underlines that computed-tomography is an interesting and sensitive exam enough, and can be performed also in post-mortem in case of unexplained fatal outcome of chest trauma.

Neurothekeomas are extremely rare benign tumors of nerve sheath origin. We describe MR and CT Myelogram findings of an intraspinal neurothekeoma occurring in a 49-year-old white female who presented with back pain. MR imaging showed a well-circumscribed avidly enhancing intrathecal mass at L1–L2 lumbar spine level while CT Myelogram imaging showed an intradural soft tissue density mass filling the thecal sac at L1–L2 level. Neurothekeomas mimic ependymoma, schwanoma, and paragangliomas in radiologic appearance and may be included in the differential diagnosis of soft-tissue masses of cauda equina in an adult female patient. Additionally, neurosurgeons and neuroradiologists should be familiar with the benign nature of these masses.

A female baby was admitted to our hospital with an immobilized right arm. The baby had multiple osteolytic lesions without sclerotic borders in the metaphyses and diaphyses in long bones of both arms, but she had not any mucocutaneous symptoms and signs at all.

In this case report, we discuss the differential diagnoses of neonatal multiple osteolytic lesions, and osseous and extraosseous imaging features of neonatal Langerhans cell histiocytosis (LCH).

Anomalies of the aortic root vessels may present in adulthood and are not uncommonly found. We present a case of a middle-aged man who was found to have a Kommerell's divericulum during standard vascular imaging. Vascular ring presenting for the first time in adulthood may run a benign course requiring no surgical intervention or repair.

A 23 year old female underwent laparoscopic cholecystectomy complicated by gallstone and biliary spillage into the peritoneal cavity. Six years after surgery, ectopic gallstones were identified in the pelvis on sonography and MR imaging. Identification of ectopic gallstones is imperative for the expeditious diagnosis of the etiology and cause of the patient's symptoms prior to the development of more severe complications. Clinical sequelae of dropped gallstones include abscess formation, empyema, intra-abdominal adhesions, and draining sinus formation. Delay in diagnosis and treatment is often due to lack of awareness of intraoperative events and potential complications, unusual presentation of symptoms, and unexpected site of infection.

A 27-year-old male presented to our clinic for evaluation after operation which was made for a malignancy originated from undescended testis. Operation had revealed abdominal mass located right lateral to bladder originated from right testis. There were no additional findings at operation note. Pathology of specimen was mixed germ cell tumor consisting of embryonal carcinoma, yolk sac tumor and seminoma. Radiologic evaluation ultrasonography (US) showed a solid mass posterior to the bladder with a central cystic component and a hypoechoic oval shaped solid structure on the left side of this mass. Between these masses there was a hypoechoic band like structure. Magnetic resonance imaging (MRI) confirmed the presence of these masses. Four years after operation laboratory results revealed increased AFP levels and patient had exploratory laparotomy since a pelvic mass was seen on MRI and positron emission tomography (PET). Histopathologic diagnosis of tumor was embryonal carcinoma.

We report a case of systemic arterial supply to normal segment of the lung without sequestration in a 27-year-old man with intermittent and massive hemoptysis. Multidetector-row CT scan demonstrated that dilated basal pulmonary venous branches and an aberrant artery connecting lower thoracic aorta and running toward the medial basal segment of right lung. Angiography showed a dilated aberrant artery with mild shunts to basal pulmonary venous branches connecting an anomalous pulmonary vein. Transarterial embolization of the aberrant artery was occluded by multiple 0.035-in. coils under balloon occlusion technique. Hemoptysis has been ceased after transarterial coil embolization which is useful and safe in the treatment of this rare congenital anomaly and may be alternative to surgical intervention.

Biliary cystadenoma is a rare tumor, often encountered as an incidental finding during imaging for other indications. As the lesion is considered pre-malignant, surgical management is advocated, hence a pre-operative differential diagnosis is important. Diagnosis by biopsy or fine needle aspiration (FNA) is sometimes inaccurate and carries a risk of cyst rupture and of seeding, hence imaging is a major contributor to the management decision. Traditionally, ultrasound and CT are considered the two most popular modalities in contributing to a diagnosis, with little emphasis placed on contrast-enhanced ultrasound (CEUS). Two cases are presented where CEUS clearly demonstrated vascularity within the septations of biliary cystadenomas, which could be seen in the arterial as well as porto-venous phases.

Background

Olivopontocerebellar atrophy (OPCA) is a term that encompasses an increasing number of neurodegenerative syndromes that lack a unique pathogenesis but are known to result from a disruption in the relationship between the cerebellar cortex, dentate nucleus, and the inferior olivary nuclei. OPCA can be difficult to diagnose on clinical grounds only and recent data suggests that OPCA affects 3–5 individuals in every 100,000 and may constitute almost 6% of patients diagnosed with atypical parkinsonism.

Case report

Herein, we report the case of a 36-year-old female that initially developed dysarthria and gait abnormalities and subsequently presented with progressive neurologic signs and symptoms. A routine MRI of the brain was performed and high-resolution images were taken through the entire posterior fossa which showed prominent widening of the CSF spaces in the posterior fossa, cerebellar atrophy and reduction in the size of the pons, consistent with a diagnosis of OPCA.

Conclusion

Olivopontocerebellar atrophy is challenging condition to diagnose on a clinical basis, and hence requires corroboration of clinical and physical examination findings with radiologic findings. MRI of the brain is the gold standard in assessing OPCA and is an extremely valuable imaging modality in distinguishing OPCA from other neurological disorders and allows for the precise determination of OPCA subtypes.

We report a case of a 68-year-old Chinese man who presented with Fatigue, anorexia more than half month, the body clear yellow dye for a week, liver function tests with alkaline phosphatase, alanine transferase increased, etc. Abdominal ultrasound showed extrahepatic duct dilatation. Enhanced computed tomography revealed signs of hepatic duct obstruction. Magnetic resonance imaging showed about the confluence of hepatic duct and upper common bile duct wall thickening; cholestasis common bile duct, multiple small stones in the lower; cholecystitis, elevation of the tumor markers CA19-9. At laparotomy, gallbladder, common bile duct, extrahepatic bile duct is clearly dissected out, no tumor, tumor eliminated by histologic examination.