European Journal of Radiology Extra最新文献

Amyloidosis is a heterogeneous group of diseases characterized by the presence of extracellular deposition of amyloid. We present a case of localized amyloidosis of the middle mediastinum, that was diagnosed by trans-esophageal endoscopic ultrasound (EUS)-guided biopsy, focusing on imaging features of contrast-enhanced CT, MRI including dynamic contrast-enhanced study and DWI, and integrated fluorine-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT.

Left ventricular non-compaction, which is characterized by left ventricular hypertrabeculation, is a rare congenital cardiomyopathy. The changing and progressing morphology, with different clinical manifestations, made the diagnosis difficult. Here is a case report of a middle-age woman, who had exercise intolerance for many years. Traditional echocardiography showed findings of dilated cardiomyopathy but obscure trabeculations, which was clearly seen by three-dimensional echocardiography. Subsequent cardiac magnetic resonance imaging well demonstrated the myocardial non-compaction and delayed enhancement. LVNC could be found early in a child, and also in a mid-age adult. When a patient with LVNC had progressing heart failure, the hypertrabeculation may become less prominent. The utilization of three-dimensional echocardiography and MRI would help identify such landmark findings.

Dedifferentiated liposarcoma is an aggressive soft tissue disease, with a prognosis critically depending on a timely detection of the primary and metastatic lesions. We present here a rare case of diaphragmatic metastasis from a recurrent liposarcoma of the colon, demonstrating the important contribution of FDG PET and CT imaging to disease management: FDG PET/CT imaging allowed the identification of this unusual metastatic site and a complete clinical remission by the surgical excision of the lesion. These data support the systematic inclusion of FDG PET/CT scans in the follow-up of high-grade soft tissue tumors.

Purpose

Remote cerebellar haemorrhage is a rare and poorly understood complication of neurosurgery.

Methods and results

Based on four cases and a literature review of the fifteen last years, we try to describe and analyse this complication

Conclusion

Remote cerebellar haemorrhage must be considered in patients with unexplained neurological deterioration after cerebral or spinal surgery. Even if mechanism is still unknown venous origin seems obvious. Therefore neurological examination and emergency neuroradiological imaging are needed for patient management.

The detection of an ectopic pregnancy on CT is a rare event. However with the increasing utilisation of CT in the emergency setting for the evaluation of acute abdominal pain, the inadvertent detection of an ectopic pregnancy on CT may become a more common event. Radiologists therefore need to be aware of the CT appearances of this potentially life threatening condition.

We studied 2 patients with large expansive and osteolytic lesions of the skull on CT, with characteristics suggestive of intradiploic epidermoid cysts. It was the purpose of our work to study the MR-imaging characteristic of these lesions. Both lesions proved to have the same MR-imaging characteristic than epidermoid cysts elsewhere in the intracranial compartment. The lesions were inhomogeneously hypointense on T1-weighted images, inhomogeneously hyperintense on T2-weighted images and on FLAIR, without signal attenuation. The signal intensity was high on diffusion-weighted images reflecting diffusion restriction in one patient with low ADC-value and a factor T2-shine through in the other patient with an intermediate ADC-value. The behaviour of the lesion on a CISS sequence, performed in one patient was also similar to other epidermoid cysts, but this proved less relevant at this location.

Schwannoma is a slow growing painless, benign neoplasm originating from schwanian cells of peripheral nerve sheath. A 67 years old female patient was admitted to Taif armed forces hospital complaining of left lower limb pain and swelling. The patient was provisionally diagnosed to have left lower limb deep venous thrombosis. Doppler lower limb ultrasound revealed an intra-abdominal mass of ovarian origin. Magnetic Resonant Image (MRI) of the pelvis was performed and showed a retroperitoneal large pelvic mass measuring 17 × 13 cm in the largest diameter which was well marginated.

Neurogenic appendicopathy is a condition in which abnormalities within the appendix produce symptoms that mimic acute appendicitis. It is usually difficult to differentiate between neurogenic appendicopathy and acute appendicitis from their clinical history, symptoms, laboratory findings and physical examination. We experienced two cases of neurogenic appendicopathy diagnosed from histopathologic findings, in which patients had presented with right lower abdominal pain. On Multidetector Computed Tomography, dilated appendix was depicted with uniform enhancement, associated with calcifications (or appendicolith). Inflammatory change was not so remarkable in both cases. We suspected appendiceal tumor from imaging findings in both cases and elective surgeries were performed. Pathologically, neuroma-like proliferation of nerve fibers was found, which were stained with S-100 protein in submucosal layer. The imaging features of neurogenic appendicopathy, including Computed Tomography, have not been reported in English literatures. In this article, we reported the imaging characteristics on Multidetector Computed Tomography in these two cases of neurogenic appendicopathy, correlated them with pathologic features. It is supposed to reflect its pathological change including edematous change, proliferation of collagen and nerve fibers. There has been no definitive criterion for imaging diagnosis of neurogenic appendicopathy, and further investigation is needed to evaluate for the imaging characteristics and its significance in clinical situation.

Although multicystic biliary hamartoma of the liver is a rare entity, recently several case reports have been described. The criteria proposed by Zen et al. include the presence of honeycomb-like nodules located around the hepatic capsule that are close to the hepatic falciform ligament and characteristically protrude from the liver.

In this report, we present a case of multicystic biliary hamartoma, which also features intrahepatic bile duct dilatation, and could therefore mimic a malignant neoplasm such as bile duct carcinoma. Our case highlights the potential difficulties in differentiating between multicystic biliary hamartoma and bile duct carcinomas under such circumstances.

Hepatic hemangiomas are the most common benign mesenchymal hepatic tumors. They are usually asymptomatic and most of them are discovered incidentally during an imaging test performed for various indications. However, spontaneous intratumoral bleeding or rupture is possible and usually occurs in large hemangiomas that are peripherally located. In this paper, we present a case of a patient with an asymptomatic bleeding into hepatic hemangioma. Reviewing the literature we found no reports on accidental finding of bleeding with absence of clinical symptoms. Intratumoral bleeding in hepatic hemangioma is suggested by presence of high density areas within the tumor on nonenhanced CT images and high signal intensity areas on T1-weighted MR images, best depicted on fat-suppressed sequences. Presence of typical enhancement features of hemangioma and marked high signal intensity on T2-weighted sequences in spared nonhemorrhagic areas allow the specific diagnosis. In this paper we describe changes that occur in hepatic hematomas during long follow-up period using magnetic resonance imaging.