Journal of Clinical Imaging Science最新文献

Desmoplastic fibroma (DF) is an uncommon benign bone tumor that typically affects the facial bones, with cerebral cranium involvement being extremely rare. We report a unique case of DF in the parietal bone of a 28-year-old woman, notable for its rapid growth during pregnancy-a phenomenon not previously documented. The imaging features of this case also differ from all but one previously reported case. The patient underwent surgical removal, and histopathology confirmed the diagnosis of DF (collagenous fibroma). After 17 months of follow-up, no local recurrence was observed. We also provide a comprehensive review of 32 cases involving DF of the cerebral cranium, analyzing clinical features, imaging findings, treatment methods, and recurrence patterns. This case highlights the importance of considering DF in the differential diagnosis of cranial lesions, particularly in pregnant patients with rapid tumor growth. Complete surgical resection with a wide margin remains the recommended treatment to minimize recurrence risk.

Dual left anterior descending (LAD) coronary artery is a rare anatomical variant with significant clinical implications. Recognizing this variant is crucial for accurate diagnosis and effective management, particularly in the context of revascularization strategies. We present a 71-year-old male with a history of dyspnea on exertion with baseline wall motion abnormality on a transthoracic stress echocardiography irreversible after exercise. Coronary computed tomography angiography revealed a dual LAD system: The left short LAD (LAD1) originating from the left main coronary artery and the right LAD (LAD2) arising separately from the right coronary cusp, distinct from the right coronary artery ostium. Having different origins and courses, both LADs supply the LAD territory. Our case is notable for two main reasons: The rarity of this particular type of dual LAD anatomy and the unique course of the LAD2, which, to our knowledge, has not been described in any previous case report. Although rare, dual LAD coronary artery should be considered in patients with atypical short LAD. Comprehensive imaging and a thorough understanding of coronary artery variants are essential for accurate diagnosis and effective management.

Objective: The objective of this study was to evaluate complete contrast staining (CCS) of HCC during drug-eluting bead transarterial chemoembolization (DEBTACE) first session for response prediction.

Methods: Forty-one patients with solitary HCC who underwent DEBTACE were retrospectively enrolled and divided into two groups based on contrast staining of HCC using two-dimensional (2D) fluoroscopy during the first session of DEBTACE. Both groups underwent one or two sessions of DEBTACE to achieve a complete response. Responses were evaluated using the modified Response Evaluation Criteria in Solid Tumors. A comparison of the complete response between the CCS and non-CCS groups was performed, and the prediction value was studied.

Results: CCS in 2D fluoroscopy during the first session of drug-eluting bead chemoembolization was observed in 22 (53.7%) patients. Well-defined HCC and super-selective chemoembolization were significantly associated with CCS. Complete response was observed in 54.54%, 90%, and 95.45% of CCS patient groups after the first session, second session, and cumulative sessions of TACE, respectively. Complete responses were 10.52%, 29.41%, and 36.84% in the non-CCS group after the first, second, and cumulative sessions of TACE, respectively.

Conclusion: CCS of HCC using 2D fluoroscopy during DEBTACE is a predictor of a favorable response after two sessions of treatment.

Objectives: The objective of this study was to determine how often myocardial infarctions are retrospectively visible on conventional, non-gated, non-cardiac computed tomography (CT) scans. Our goal was to evaluate a cohort of patients with myocardial infarctions visible on cardiac magnetic resonance imaging (MRI) to determine how often the area of infarction was retrospectively visible by preceding, conventional CT. We also sought to evaluate how often the diagnosis of myocardial infarction was reported at the time of initial study review.

Material and methods: The Institutional Review Board approval was obtained for the creation and retrospective analysis of a database of patients undergoing cardiac MRI. We started with a cohort of 252 patients who had undergone cardiac MRI at our institution, over a 4-year period. We identified 160 patients who had a myocardial infarct visible on MRI.

Results: Of the 160 patients who had been identified as having an infarct on cardiac MRI, 54 patients had undergone a recent (within 30 days) conventional CT scan, usually done for non-cardiac indications. In addition to the review of reports, non-cardiac CT scans were also evaluated retrospectively by two experienced, cardiothoracic imaging physicians, including a radiologist and a cardiologist. In 26 of these patients (48.1%), an infarct was visible on the CT images. In 12 of these 26 cases (46.1%), the infarct was noted in the initial report. In the remaining 14 of these 26 cases (53.8%), the infarct was unrecognized at the time of initial study interpretation.

Conclusion: Our retrospective analysis demonstrates that myocardial infarctions may be frequently observed on non-gated, non-cardiac CT scans but may be underrecognized and under-reported.

Objectives: The study aimed to evaluate the relationship between maxillary sinus volume and various sinonasal anatomical variants, as detected by multi-detector computed tomography, and their associations with chronic rhinosinusitis (CRS).

Material and methods: A case-control study was conducted with 103 patients presenting with chronic sinonasal symptoms (cases) and 50 asymptomatic individuals (controls). A 128-slice computed tomography scanner was used to measure maxillary sinus volume and assess anatomical variants, such as a deviated nasal septum (DNS), concha bullosa (CB), and agger nasi cells. Exclusion criteria included previous sinonasal surgery, malignancy, craniofacial trauma, and lack of consent. Statistical analysis was performed using t-tests for continuous variables and Chi-square tests for categorical data. Receiver operating characteristic curve analysis was utilized to determine a DNS angle cutoff for predicting CRS.

Results: Anatomical variants were significantly more frequent in cases than in controls. The left-sided DNS was predominant in cases, while the right-sided DNS was more common in controls. The mean DNS deviation angle was notably larger in cases (10.84° ± 7.87) than in controls (5.55° ± 5.02). Maxillary sinus volume was significantly smaller in cases (9.69 cc on the left side and 10.23 cc on the right side) compared to controls (18.57 cc and 18.46 cc, respectively), with female patients exhibiting smaller volumes than males. Agger nasi cells were detected in 51.5% of cases versus 8.0% of controls. A strong association was found between CB and contralateral DNS. The optimal DNS deviation angle cutoff for predicting CRS was identified as 12.7°.

Conclusion: This study shows that CRS is linked to smaller maxillary sinus volumes, with males having larger sinus volumes than females. A DNS and larger deviation angles were associated with a higher risk of sinus inflammation, with angles over 12.7° predicting the onset of the condition. The presence of CB and agger nasi cells also contributed to the development of CRS.

Pulmonary sequestration is a malformation of lung tissue such that a zone of pulmonary parenchyma exists in isolation from the bronchopulmonary tree. This condition is typically treated with surgical resection, but an increasing number of sequestrations are being treated with arterial embolization. We report interventions that were performed at two institutions on patients 53-70 years old. One patient presented with chronic cough and the two other patients presented with hemoptysis. Two of the cases were managed solely by endovascular embolization of the arteries supplying the pulmonary sequestration. In one patient, embolization was performed to debulk the sequestration, followed by surgical resection. These cases suggest transcatheter embolization may be an effective treatment in adult patients with symptomatic pulmonary sequestrations.

Portal vein (PV) anomalies are rare during embryonic development, with very few cases of duplicated PVs reported. This case reveals a new PV trunk anomaly, where computed tomography venography imaging shows three portal veins. The superior mesenteric vein and inferior mesenteric vein join to form a trunk that divides into two branches: One entering the liver (PV1) and the other ascending to join the splenic vein. The splenic vein then divides into two branches in the neck of the pancreas (PV2 and PV3), both entering the liver. The three PVs vary in thickness and all enter the liver through the first hepatic portal. Understanding the normal structure and anatomy of the PV is important for successful surgical planning. This case involves three main trunks of the PV, which is an extremely rare type of PV duplication anomaly. Reporting this case aims to enhance the awareness and understanding of PV duplication anomalies among clinicians and radiologists.

Granulomatous prostatitis (GP) is a rare form of chronic prostatitis with reported incidence of 0.65-1.5%. Radiological features of GP overlap with those of prostate adenocarcinoma. The following magnetic resonance imaging characteristics can suggest the diagnosis in an appropriate clinical setting: Diffuse or focal nodular low T2 signal, high signal on diffusion-weighted imaging with corresponding low apparent diffusion coefficient signal, and post-contrast imaging with lesion enhancement or rim-enhancing in the setting of caseous necrosis or abscess formation. Even with suspicion on imaging, the overlapping imaging features with prostate adenocarcinoma necessitate biopsy for confirmatory diagnosis. Here, we report a case of a 70-year-old man with GP in the setting of prior intravesicle bacillus Calmette-Guérin administration.

Idiopathic granulomatous mastitis is a rare, chronic inflammatory disease of the breast of uncertain etiology that can mimic breast cancer. In rare instances, it may emerge secondary to trauma to the breast. We present a case of a 66-year-old woman who initially underwent a benign stereotactic core-needle biopsy of her left breast complicated by a small hematoma which initially remained unchanged mammographically and sonographically for 1 year; then, it enlarged unexpectedly at the 21-month interval follow-up prompting an ultrasound-guided biopsy revealing granulomatous mastitis.

We present a case involving a 71-year-old male with tubulocystic renal cell carcinoma (TRCC), which is a rare entity of renal neoplasm. The patient was admitted for a cystic nodule on the middle pole of the right kidney by urological ultrasound during physical examination. The nodule presented with hyperechoic on conventional ultrasonic and the enhancing intensity of thicken cystic wall at the peak phase in contrast-enhanced ultrasound was similar to that of the renal parenchyma. Findings from computed tomography angiography exhibited heterogeneously contrast enhancing tumor, and magnetic resonance imaging demonstrated hypointense on T1-weighted images (WI) and hyperintense on T2WI. Histologically, the spongy surface was composed of the typical tubular and multiloculated cystic components lined by a single layer of epithelial cells. The final pathological diagnosis was TRCC. The uneventful laparoscopic right radical nephrectomy was conducted. The patient was followed up for 12 months after discharge and no signs of local or distant metastasis were found. In conclusion, TRCC should be accurately diagnosed on the basis of comprehensive radiological and histological findings to ensure a timely surgery and better prognosis.