Journal of Clinical Imaging Science最新文献

The use of chemotherapy has revolutionized the management of cancer in the past decades. Liver toxicity is commonly observed among different types of chemotherapy drugs. The aim of this pictorial review is to illustrate radiological features of various chemotherapy-associated hepatic parenchymal changes in different imaging modalities and to demonstrate potential complications of these liver injury patterns with representative cases. Early recognition of these liver conditions allows prompt clinical action to be taken, thus optimizing management and avoiding severe complications.

Fabry disease (FD) is a rare X-linked lysosomal storage disorder. Cardiac involvement is frequent in the classic phenotype and late-onset cardiac variant of FD. It is challenging to distinguish FD cardiomyopathy from other forms of unexplained left ventricular hypertrophy, especially in those patients without extracardiac manifestations. Cardiac magnetic resonance imaging is an essential imaging modality for the quantitative and qualitative assessment of FD cardiomyopathy. It helps to monitor disease progress and allows early disease detection in the mild form or subclinical cardiac phenotypes. This review illustrates the characteristic imaging features of FD cardiomyopathy in cardiac MRI, aiming to enhance the awareness of this disease entity among the scope of unexplained cardiomyopathy and promote timely enzyme replacement therapy for patients.

Syringomyelia is a rare condition characterized by the formation of a fluid-filled cyst within the spinal cord, leading to myelopathy. In addition, the pathological enlargement of the central canal is referred to as hydromyelia or cleft-like syrinx. We present a case of idiopathic syringomyelia and hematomyelia in a 50-year-old female patient with a 5-year follow-up on her disease progression. Magnetic resonance imaging (MRI) images revealed low-signal intensity on T1 and high-signal intensity on T2, with elevated hemorrhagic signal intensity on T1 and low peripheral signal intensity on T2. A fluid-filled lesion measuring 12 × 36 mm was observed between the C7 and Th3 vertebrae, with separation from some of the detailed components. No contrast enhancement was noted following IV contrast administration. Based on the MRI findings, a diagnosis consistent with giant hemorrhagic syringomyelia was established. Subsequently, a neurosurgical intervention was performed, resulting in a reduction in the size of the syringomyelia and a moderate improvement in the patient's symptom profile.

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare diffuse parenchymal lung disease representing 3% of all interstitial lung diseases. PLCH occurs either as part of multi-system Langerhans cell histiocytosis (LCH) or an isolated disease of the lung. Isolated involvement of lungs is observed in approximately 50-70% of LCH cases and the age of onset peaks between 20 and 40 years without gender difference. Cigarette smoking is the only identified environmental risk factor. PLCH is characterized by Langerhans cell infiltrates that in general are in a bronchiolocentric distribution. Pulmonary lesions can occur after chronic systemic disease or are an initial sign of disease. The aims of this study are to (1) report five rare cases of PLCH in adults; (2) discuss the relationship of PLCH with interstitial lung fibrosis; (3) provide a concise review of PLCH epidemiology, pathophysiology, diagnosis, treatment, and prognosis to improve the knowledge of PLCH by pneumologists and internal medicine physicians.

Blunt traumatic inferior vena cava (IVC) injury is rare and presents diagnostic and therapeutic challenges. We report a case of blunt traumatic IVC injury associated with bowel perforation and spinal cord injury, successfully managed with non-operative conservative treatment. A 57-year-old woman sustained injuries in a motor vehicle collision with a seatbelt fastened. Computed tomography (CT) revealed an irregular IVC contour at the infrarenal level and a retroperitoneal hematoma, leading to the diagnosis of blunt traumatic IVC injury. Free intraperitoneal air suggested bowel perforation, and magnetic resonance imaging confirmed a C5/6 spinal cord injury. This combination of injuries may raise suspicion for a seatbelt injury pattern. The bowel perforation was surgically treated, and posterior fixation was performed for the spinal injury. Since the patient remained hemodynamically stable, conservative management was selected for the IVC injury. Follow-up CT revealed a reduction in the retroperitoneal hematoma and improvement in the IVC contour, indicating successful conservative treatment. Blunt traumatic IVC injury is rare, and some cases do not exhibit contrast media extravasation. In this case, the diagnosis was based on IVC contour abnormalities and retroperitoneal hematoma. Considering the patient's stable hemodynamics, conservative treatment was selected. Careful interpretation of CT findings is essential for diagnosing IVC injury, and appropriate clinical judgment is key to achieving successful non-operative management in selected cases.

Objectives: Congenital arteriovenous malformations (AVMs) are characterized by abnormal connections between arteries and veins, often presenting challenges in treatment due to their complex vascular structure. Endovascular therapies, including embolization techniques, have become integral in managing AVMs, yet optimal treatment strategies remain under investigation. This retrospective study aimed to evaluate the safety and efficacy of percutaneous glue embolization of n-butyl cyanoacrylate (nBCA) combined with arterial embolization in treating extracranial AVMs.

Material and methods: This retrospective study included 11 patients with extracranial AVMs who underwent percutaneous injection of nBCA glue embolization combined with arterial embolization at our institution between May 2015 and October 2023. Angiographic classification was performed using the Cho-Do vascular imaging system and the Schobinger classification system to categorize the AVMs. Treatment efficacy was assessed based on the percentage of vessel occlusion observed in angiography or imaging studies. The occurrence of major and minor complications was also evaluated.

Results: Eleven patients received 16 treatments, involving a combination of arterial and percutaneous embolization techniques. Five cases achieved complete recovery, while four cases showed significant improvement, resulting in an overall treatment success rate of 81.8%. Favorable outcomes were observed in terms of symptom alleviation and lesion occlusion. Adverse events were minimal, with transient pain and edema being the most common postoperative complaints. Only one case of mild post-operative complication occurred.

Conclusion: Percutaneous glue embolization combined with arterial embolization proves to be a safe and effective treatment modality for extracranial AVMs, with acceptable rates of complications and favorable treatment outcomes.

The spleen is a highly vascular organ susceptible to injury in blunt abdominal trauma, often leading to massive blood loss. Splenic artery embolization (SAE) has been shown to be a safe and effective nonoperative approach in cases of hemodynamically stable patients with blunt splenic trauma. SAE can be performed proximally or distally, with both approaches demonstrating similar clinical efficacy. This case report describes emergent splenic embolization for acute abdominal trauma in a liver transplant recipient. However, due to the presence of prior splenic artery ligation, a uniquely alternative route through the gastroepiploic artery was used to gain access to the spleen for embolization.

Renal replacement lipomatosis (RRL), as described by the word, is characterized by abnormal proliferation of the fatty tissue and replacement of renal parenchyma by fat with atrophy of renal parenchyma. This rare condition is mainly attributed to a long-standing disease such as lithiasis. The patient usually presents with non-specific abdominal pain of chronic duration, and imaging is necessary to confirm the diagnosis. Here, we present the case of total RRL presented at our center, diagnosed with ultrasonography, and computerized tomography of kidneys, along with contributing factors and its course of treatment.

Most primary paragangliomas of the head and neck occur in the carotid, jugular body, tympanic ventricle, and vagus nerves. Primary sellar paragangliomas are rare, and their long-term outcomes remain unknown. It is also unclear whether they can be classified as asymptomatic incidentalomas in the sellar region. A 75-year-old man who had been followed up for 15 years for an asymptomatic non-functional pituitary adenoma strongly requested surgery and underwent endoscopic transsphenoidal surgery to remove the tumor. Intraoperatively, the tumor was found to be elastic, harder than the pituitary adenoma, fibrous, and not extremely vascularized. The tumor was excised extracapsularly, although residual tumor tissue remained in the medial part of the bilateral cavernous sinuses. A histopathological assessment revealed negative epithelial markers, positive neuroendocrine markers, and partial positivity for S-100, leading to a diagnosis of paraganglioma. Cervicothoracic and abdominal computed tomography, along with spinal magnetic resonance imaging, revealed no apparent neoplastic lesions. The patient experienced no recurrence for 5 years following the resection. The majority of sellar tumors are pituitary adenomas, craniopharyngiomas, Rathke's cleft cysts, or metastatic brain tumors. Herein, we present a case of an asymptomatic primary sellar paraganglioma that was successfully resected. The case highlights that paraganglioma can be included among incidentalomas in the sellar region. Routine follow-up should generally be recommended for patients with asymptomatic sellar incidentalomas.

Ventriculoperitoneal (VP) shunts are commonly used to treat hydrocephalus by diverting cerebrospinal fluid from the ventricles to the peritoneal cavity. Migration of the VP shunt into the heart and pulmonary artery is a rare complication. Herein, we described a 67-year-old man with a VP shunt catheter that migrated through the venous system into the pulmonary circulation, highlighting early diagnosis with imaging and symptoms.