Journal of Clinical Imaging Science最新文献

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.

We report a case of a 73-year-old woman presenting with intracranial and extracranial meningioma with perineural spread crossing the foramen rotundum and pterygopalatine fossa, primarily along the maxillary nerve. She visited our hospital with the chief complaint of the left cheek swelling. Subsequent magnetic resonance imaging revealed a well-demarcated mass containing intracranial (cavernous sinus, Meckel's cave, and middle cranial fossa) and extracranial components (pterygopalatine fossa, orbit, nasal cavity, ethmoid and sphenoid sinuses, infratemporal fossa, and buccal space) through the foramen rotundum. A biopsy specimen was obtained from the cheek mass, and the histopathological diagnosis was meningothelial meningioma.

Point-of-care ultrasound (POCUS) has emerged as a cost-effective diagnostic tool that significantly augments physical examinations. Positioned as an extension of traditional examination methods, particularly appealing to the upcoming generation of clinicians, it holds promise in potentially replacing the stethoscope in various medical assessments and procedures. The University of Rochester is deploying 2500 POCUS machines, enhancing compliance for image storage and documentation. Halfway through our 4-year deployment plan, we will discuss our governance structure, educational initiatives, and credentialing strategies. While POCUS adoption has seen organic growth over the past decade, our aim is to implement a comprehensive strategy ensuring adherence to established protocols for image storage and documentation. At present, we have successfully deployed 789 probes, with integration across 64 departments or divisions into our IT platform. Notably, this implementation has resulted in a remarkable 116% increase in hospital charges, underscoring the tangible impact of POCUS integration. However, achieving compliance and education among established providers has proven to be challenging.

Facet joint septic arthritis is a rare; yet, severe spinal infection often misdiagnosed due to its non-specific clinical presentation and radiological mimickers. This case series illustrates various clinical presentations, imaging features, and outcomes of patients with facet joint septic arthritis. We demonstrate different disease stages to aid clinicians and radiologists in recognizing this condition. Key diagnostic pitfalls are also discussed to enhance diagnostic accuracy in clinical practice.

Radiofrequency (RF) interference artifact is a common type of magnetic resonance imaging (MRI) artifacts caused by the presence of unwanted RF field inside the scanner room. The artifact has the appearance of parallel bright lines or bands that resemble zippers, which can mimic pathology, obstruct the viewing of underlining tissues, and lower image signal-to-noise ratio, affecting the diagnostic evaluation of the image and sometimes even rendering it non-diagnostic. Due to the presence of multiple possible sources of RF interference in MRI and potential nonrelated MRI artifacts that resemble RF interference artifact, it may be difficult to effectively and timely resolve the artifact problem. The objective of this paper is to provide a review of RF interference in MRI and to offer guidance in the prompt and correct identification of the associated image artifacts as well as efficient approaches to resolve and prevent RF interference problems. This article should serve as a useful educational reference to magnetic resonance (MR) technologists and radiologists in dealing with MR image artifacts that may be caused by RF interference.