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A rare case of chronic calcificpancreatitis with intrahepatic andsplenic pseudocysts 慢性钙化性胰腺炎合并肝内及脾假性囊肿一例
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000066
Sanjib K. Das, IpsitaAcharya, JayashreeMohanty, Sasmita Swain
Pancreatic pseudocyst is a well-defined collection of fluid rich in pancreatic enzymes which occurs as a complication of pancreatitis. They are mostly located in the head and body of the pancreas while few are found in extra-pancreatic locations like mediastinum, liver, pelvis, pleura and spleen. However intrahepatic pseudocyst is a rare complication of pancreatitis with only 34 such cases being reported in English literature till the year 2009. Around 1 in 100 cases of pancreatic pseudocyst show extension into spleen.
胰腺假性囊肿是一种明确的富含胰酶的液体集合,是胰腺炎的并发症。它们大多位于胰腺的头部和身体,而在胰腺外的位置如纵隔、肝脏、骨盆、胸膜和脾脏则很少发现。然而肝内假性囊肿是一种罕见的胰腺炎并发症,截至2009年英文文献仅报道34例。100例胰腺假性囊肿中约有1例扩展到脾脏。
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引用次数: 1
Breast Cancer Heterogeneity Analysis as Index of Response to Treatment Using MRI Images: A Review 乳腺癌异质性分析作为MRI图像治疗反应的指标:综述
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000069
M. Adoui, S. Drisis, M. A. Larhmam, Marc Lemort Mohammed Benjelloun
Purpose: Breast tumor structure contains a high degree of heterogeneity. This heterogeneity has been correlated with the level of tumor response to neoadjuvant chemotherapy. A significant number of studies using magnetic resonance imaging have looked into the quantification of intra tumor heterogeneity in breast cancer. Nevertheless, a limited number of these studies have specifi-cally looked at evaluating breast cancer heterogeneity as a biomarker of response to treatment. Methods: In this paper, several heterogeneity quantification methods, which have studied breast cancer response to treatment through MR images, will be presented. Important methodological and technological techniques using experimental design, such as histogram analysis, texture analysis and parametric response mapping (PRM), will be explored. Results: Data acquisition, the number of patients, the number of treatment cycles, and other analysis will be discussed for each presented research case. Furthermore, some proposed methods will be evaluated on our institution MRI dataset, collected between 2013 and 2016. Conclusion: This paper can be used as a guideline for investigators working on breast cancer het-erogeneity as a biomarker of response to treatment.
目的:乳腺肿瘤结构具有高度的异质性。这种异质性与肿瘤对新辅助化疗的反应水平有关。大量的研究使用磁共振成像研究了乳腺癌肿瘤内异质性的量化。然而,这些研究中有有限数量的研究专门将评估乳腺癌异质性作为对治疗反应的生物标志物。方法:本文将介绍几种异质性量化方法,这些方法通过MR图像研究了乳腺癌对治疗的反应。使用实验设计的重要方法和技术技术,如直方图分析,纹理分析和参数响应映射(PRM),将被探索。结果:数据采集,患者数量,治疗周期数,以及其他分析将讨论每个提出的研究案例。此外,我们将在2013年至2016年收集的机构MRI数据集上评估一些建议的方法。结论:本文可为研究乳腺癌异质性作为治疗反应的生物标志物提供指导。
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引用次数: 14
Cecal volvulus case report 盲肠扭转1例报告
Pub Date : 2017-01-01 DOI: 10.14303/Imaging-Medicine.1000053
S. deSilva
Cecal volvulus is a rare cause of acute abdominal pain and intestinal obstruction, which if left untreated can lead to sepsis and death. Its clinical presentation is highly variable ranging from intermittent relenting abdominal pain, to severe acute pain associated with sepsis and bowel strangulation. This is a report of a 59 year old man who presented with nonspecific signs of an intestinal obstruction. CT demonstrated a cecal volvulus, which was not suspected by the clinical team. The objective of this report is to discuss the radiological findings critical to the urgent diagnosis and treatment of this rare but life-threatening condition.
盲肠扭转是一种罕见的急性腹痛和肠梗阻的原因,如果不及时治疗,可能导致败血症和死亡。它的临床表现变化很大,从间歇性的缓和腹痛到与败血症和肠绞窄相关的严重急性疼痛。这是一个59岁的男子谁提出了非特异性迹象的肠梗阻的报告。CT显示盲肠扭转,临床小组没有怀疑。本报告的目的是讨论对这种罕见但危及生命的疾病的紧急诊断和治疗至关重要的放射学发现。
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引用次数: 0
Evaluating patients with pulmonarythromboembolism: a retrospective studyon the utilization of serum D-dimer assayand CT angiography 评价肺血栓栓塞患者:血清d -二聚体测定和CT血管造影应用的回顾性研究
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000064
A. Tobias, Anjali Agrawal ArjunKalyanpur
Background and objective: Serum D-dimer assay is an inexpensive laboratory test with a high negative predictive value, obviating the need for computed tomographic pulmonary angiography (CTPA) in patients with low clinical probability of thromboembolic disease. It has been recommended that CTPA may be performed only in patients with positive D-dimer assays and clinical suspicion of PTE (pulmonary thromboembolism), to curb unnecessary imaging and health care costs. We wanted to reassess the validity of this recommendation by looking into the D-dimer results in patients with positive PTE on CTPA. Methods: All patient records with positive PTE diagnosis on CTPA and having relevant laboratory data during one calendar year (January 01 to December 31, 2009) were selected. Serum D-dimer values of >500 ng/ml was considered abnormal. The D-dimer results among the patients who had the test performed were tabulated based on age and sex along with those without D-dimer assay in the same groups and correlated with their percentage distribution. Results: Out of a total of 98 positive PTE cases on CTPA, only 26 patients (26.5%) had a serum D-dimer assay done prior to CTPA. Of these, 20 (76.9%) had elevated values and 6 cases (23.1%) had a negative test. Negative D-dimer results varied with patient age, being highest in the 21-40 years age group. Conclusion: Overall, there seems to be more preferred use of CTPA and underutilization of serum D-dimer assay in clinical practice for suspected PTE. Secondly, negative D-dimer assay should not be used to triage patients with a high clinical index of suspicion for PTE.
背景和目的:血清d -二聚体检测是一种廉价的实验室检测,具有较高的阴性预测值,避免了对临床可能性低的血栓栓塞性疾病患者进行计算机断层肺血管造影(CTPA)的需要。建议CTPA仅适用于d -二聚体检测阳性且临床怀疑有PTE(肺血栓栓塞)的患者,以减少不必要的影像学检查和医疗费用。我们希望通过研究CTPA PTE阳性患者的d -二聚体结果来重新评估这一建议的有效性。方法:选取1年内(2009年1月1日至12月31日)所有CTPA PTE诊断阳性并有相关实验室资料的患者。血清d -二聚体值>500 ng/ml为异常。进行d -二聚体检测的患者的d -二聚体结果根据年龄和性别以及同一组中未进行d -二聚体检测的患者的d -二聚体结果制成表格,并与他们的百分比分布相关。结果:在总共98例CTPA阳性PTE病例中,只有26例(26.5%)患者在CTPA之前进行了血清d -二聚体测定。其中高发20例(76.9%),阴性6例(23.1%)。d -二聚体阴性结果因患者年龄而异,在21-40岁年龄组中最高。结论:总体而言,临床对疑似PTE患者更倾向于使用CTPA,而血清d -二聚体检测利用不足。其次,d -二聚体检测阴性不应用于临床疑似指数高的PTE患者的分诊。
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引用次数: 0
How (not) to misdiagnose focal renal lesions: lessons learned? 如何(不)误诊局灶性肾脏病变:经验教训?
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000080
L. Leão, T. Mussi, F. Yamauchi, R. Baroni
More than half of patients over the age of 50 years old may have at least one incidental renal lesion detected on imaging studies, such as ultrasonography, computed tomography or magnetic resonance imaging. Although the majority can be easily detected and correctly characterized, misdiagnoses may occur and are often related to methods limitations, inadequate imaging protocols and misinterpretation. This pictorial essay addresses recommendations on how to recognize benign and malignant renal processes that can be potentially missed or mischaracterized on imaging studies.
在50岁以上的患者中,超过一半的患者在影像学检查(如超声、计算机断层扫描或磁共振成像)中可能至少发现一种偶发性肾脏病变。虽然大多数可以很容易地发现和正确表征,但可能会发生误诊,并且通常与方法限制,不充分的成像方案和误解有关。这篇图片文章介绍了如何识别良性和恶性肾脏过程,这些过程可能在影像学研究中被遗漏或错误表征。
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引用次数: 0
MRI in pre-operative NAC vascular map 术前NAC血管图MRI
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000086
C. Francisco, S. João, B. Rita, M. Carlos, Leal de Faria Joao Abecasis Nuno
Objective: NAC’s blood supply may convey essential information for surgery planning. This study’s aim was to evaluate breast blood supply using MRI and to compare it between oncological and non-oncological subjects. The risk factors for NAC necrosis in nipple sparing mastectomy were analyzed. Methods: Breast MRI exams in one month at a single institution were evaluated. The considered inclusion criteria focused on patients with: ductal carcinoma in situ, invasive carcinoma (IC) or high-risk screening (HRS) without previous breast surgery. Subtraction reconstructions from dynamic acquisitions obtained at 60 s post-contrast administration were used. Results: 166 breasts were evaluated (12 pre op DCIS; 42 HRS; 112 pre op IC) - 71% of the NAC’s had a dominant blood supply. Tumors were localized in the upper outer quadrant (UOQ) in 46% of cases. In the NAC vascularization analysis, there was a tendency for a higher number of vessels vascularizing the NAC in the IC group (p=0.056) and there was a difference in the quadrant analysis mainly at the UOQ that had a dominant blood supply in 18% of the IC group and only 2% in the HRS (p=0.048). 16 patients performed NSM, three had NAC necrosis. The number of vessels supplying the NAC was the only factor with correlation with this outcome (p=0.01). There was not a single NAC with a dominant blood vessel from the lower outer quadrant (LOQ). Conclusion: Using MRI to pre-operatively evaluate breast blood supply is feasible without adding extra MRI time or contrast. 71% had dominant supply to the NAC, so every effort should be made to preserve it. The LOQ appears to be an optimal site for skin incisions. There is an asymmetry between cancer and HRS breasts mainly at the NAC’s level with neovascularization of that area. Patients with a single vessel supplying the NAC are at improved risk for necrosis.
目的:NAC血供可为手术规划提供重要信息。本研究的目的是利用核磁共振成像评估乳腺血液供应,并比较肿瘤和非肿瘤受试者的情况。分析保留乳头乳房切除术中NAC坏死的危险因素。方法:对一个月内在同一家机构进行的乳腺MRI检查进行评估。考虑的纳入标准集中于:导管原位癌、浸润性癌(IC)或高危筛查(HRS)患者,既往未做过乳房手术。使用对比后60秒动态采集的减法重建。结果:166个乳房被评估(12个术前DCIS;42小时;112术前IC) - 71%的NAC有优势的血液供应。46%的病例肿瘤局限于上外象限(UOQ)。在NAC血管化分析中,IC组NAC血管化的数量有增加的趋势(p=0.056),在象限分析中,差异主要在UOQ, IC组有18%的主导血液供应,而HRS只有2% (p=0.048)。NSM 16例,NAC坏死3例。NAC供血血管数量是与该结果相关的唯一因素(p=0.01)。没有一个NAC的优势血管来自下外象限(LOQ)。结论:术前应用MRI评估乳腺血供是可行的,无需增加MRI时间和造影剂。71%的公司对NAC的供应占主导地位,因此应尽一切努力保持这种供应。LOQ似乎是皮肤切口的最佳部位。癌症和HRS乳房之间的不对称主要发生在NAC水平,该区域新生血管形成。只有一条血管供应NAC的患者发生坏死的风险更高。
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引用次数: 0
Sonographic appearance of ewings sarcoma of femur: a case report 股骨尤因肉瘤的超声表现1例
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000046
N. Jain, R. Galhotra, Kavita Saggar Simran Sidhu
Ewings sarcoma is the second most common bone tumor after osteosarcoma in children and adolescents. Diagnosis of skeletal Ewings sarcoma is usually based on MRI and histopathological findings. But one should be aware of the ultrasonographic appearance of this tumor as this may aid in the initial diagnosis. We report a case of Ewings sarcoma of the femur in which a periosteal reaction, cortical destruction, and Power Doppler on sonography suggested a probable malignant diagnosis.
尤因肉瘤是儿童和青少年中仅次于骨肉瘤的第二大常见骨肿瘤。骨骼尤文氏肉瘤的诊断通常基于MRI和组织病理学结果。但应注意肿瘤的超声表现,因为这可能有助于初步诊断。我们报告一例股骨尤文氏肉瘤,其骨膜反应,皮质破坏,超声功率多普勒提示可能的恶性诊断。
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引用次数: 0
Xanthomas in familial hypercholesterolemia
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000076
L. Jhuria, Sanjay Kumar
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引用次数: 1
Cardiac amyloidosis revealed by bone scintigraphy 骨显像显示的心脏淀粉样变性
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000088
Yassir Benameura, M. Nadif, I. Ghfir, L. Oukerraj, H. Guerrouj, M. Cherti, N. B. Aouad
Planar whole-body bone scan was performed in the anterior and posterior projections 3 hrs after injection of 740 MBq (20mCi) of 99mTcHMDP (99m Technetium hydroxymethylene diphosphonate). The scanning speed was at 10-15 cm/min and the image format was 1024 × 256. Single photon emission computed tomography (SPECT-CT) was additionally performed. The bone scintigraphy showed an intense cardiac uptake corresponding to a grade 3 (intense cardiac uptake with attenuated bone uptake) and
注射740mbq (20mCi)的99mTcHMDP (99m二膦酸羟基亚甲基锝)后3小时进行全身平面骨扫描。扫描速度为10-15 cm/min,图像格式为1024 × 256。另外进行单光子发射计算机断层扫描(SPECT-CT)。骨显像显示强烈的心脏摄取对应于3级(强烈的心脏摄取与减弱的骨摄取)
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引用次数: 0
Depressed skull fracture following a baseball bat strike to the head 棒球棒击中头部后凹陷性颅骨骨折
Pub Date : 2017-01-01 DOI: 10.14303/IMAGING-MEDICINE.1000052
L. Phillips
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引用次数: 0
期刊
Imaging in Medicine
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