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A Case of Interrupted Aortic Arch in an Adult: An Unsuspected Cause of Uncontrolled Hypertension 一例成人主动脉弓中断病例:高血压无法控制的意外原因
Pub Date : 2024-04-20 DOI: 10.1155/2024/8691643
Abdi Dandena Dibaba, Abenezer Kebede Bekele, Selam Hagos Gebrewahd
In this paper, we describe an incidentally discovered case of interrupted aortic arch in a 28-year-old male patient with a history of long-standing poorly controlled hypertension. The patient presented to the hospital with a complaint of upper respiratory complaints and long-standing chest pain. A plain chest radiograph was requested to exclude a diagnosis of pneumonia, and the radiography spotted an incidental finding of inferior rib notching. A subsequent CT angiography was done for further characterization, and a diagnosis of interrupted aortic arch was confirmed. Therefore, although rare, IAA should be considered in adults with refractory hypertension or unexplained congestive heart failure.
本文描述了一例偶然发现的主动脉弓中断病例,患者为一名 28 岁男性,长期高血压病史控制不佳。患者入院时主诉上呼吸道不适和长期胸痛。为了排除肺炎的诊断,患者要求进行胸部平片检查,结果意外发现肋骨下凹陷。随后进行了 CT 血管造影进一步定性,确诊为主动脉弓中断。因此,IAA 虽然罕见,但对于患有难治性高血压或原因不明的充血性心力衰竭的成人患者来说,应该予以考虑。
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引用次数: 0
Hysterosalpingography and Ultrasonography Features of Herlyn-Werner-Wunderlich Syndrome Detected during Infertility Workup. 不孕症检查中发现的赫林-维尔纳-吴德立综合征的子宫输卵管造影和超声特征
Pub Date : 2024-02-19 eCollection Date: 2024-01-01 DOI: 10.1155/2024/1055130
Hidayatullah Hamidi, Bibi Hosai Balkhi

The Herlyn-Werner-Wunderlich syndrome (HWWS) is a very rare congenital anomaly of the urogenital tract. It is characterized by a combination of didelphys uterus, unilateral vaginal obstruction, and ipsilateral renal agenesis. MRI imaging is usually used for diagnosis; however, the authors present a case of HWWS diagnosed by ultrasonography (HSG) and hysterosalpingography (HSG) in a 22-year-old lady who has undergone an imaging workup of infertility.

Herlyn-Werner-Wunderlich综合征(HWWS)是一种非常罕见的先天性泌尿生殖道畸形。其特征是合并有双子宫、单侧阴道梗阻和同侧肾脏发育不全。核磁共振成像通常用于诊断;然而,作者介绍了一例通过超声波造影(HSG)和子宫输卵管造影(HSG)确诊的 HWWS,患者是一名 22 岁的女性,因不孕接受了造影检查。
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引用次数: 0
Ischemic Stroke due to Intracranial Embolization of a Pelvic Phlebolith in a Pregnant Patient Successfully Treated by Surgical Embolectomy following Attempted Endovascular Thrombectomy 一名孕妇因盆腔静脉结石栓塞导致颅内缺血性中风,尝试血管内血栓清除术后通过外科栓子切除术成功治愈
Pub Date : 2023-12-06 DOI: 10.1155/2023/1653631
Sherwin Azad, John Anson, Tamara Majic, Raisa Lev, Varoujan Kostanian
An unusual case of ischemic stroke due to calcified cerebral embolus occurring in a pregnant patient during the peripartum period is reported. The source of the embolus was suspected to be a pelvic phlebolith in origin which paradoxically embolized via a patent foramen ovale to the supraclinoid right internal carotid artery. To our knowledge, this is the first reported case of calcified cerebral embolus attributed to paradoxical embolism of a pelvic phlebolith, and we theorize that introduction of the phlebolith into the venous system may have occurred as a consequence of vascular remodeling due to pregnancy-related hemodynamic changes. Clinicians should be aware of this potential source of calcified cerebral emboli in patients with a patent foramen ovale during pregnancy. Our patient ultimately achieved an excellent outcome with surgical endarterectomy and embolectomy following an unsuccessful attempt at mechanical thrombectomy.
一个不寻常的情况下缺血性中风由于钙化脑栓塞发生在围产期妊娠患者报告。栓子的来源被怀疑是盆腔静脉结石的起源,矛盾地通过卵圆孔未闭栓塞到右颈内动脉上突。据我们所知,这是第一例因盆腔静脉结石的矛盾栓塞而导致钙化脑栓塞的报道,我们推测,静脉结石进入静脉系统可能是由于妊娠相关血流动力学改变导致血管重塑的结果。临床医生应该意识到怀孕期间卵圆孔未闭患者钙化脑栓塞的潜在来源。在机械取栓失败后,我们的患者最终通过手术动脉内膜切除术和栓塞切除术获得了良好的结果。
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引用次数: 0
Incidental Detection of a Rare Pediatric High-Grade Fibrosarcoma in a Post-traumatic Setting: The Conundrum of Intra-Abdominal Hematoma versus Neoplasia 创伤后意外发现罕见的小儿高级别纤维肉瘤:腹腔内血肿与肿瘤的难题
Pub Date : 2023-12-05 DOI: 10.1155/2023/3178778
Kamand Khalaj, Nikoo Fattahi, A. Omo-Ogboi, J. Thomas-Ogunniyi, Olanrewaju A. Ogunleye, Ashish Khanal, Larry A. Kramer
Infantile fibrosarcoma (IF) is a rare malignant fibroblastic tumor that affects infants and young children, occurring most commonly in the extremities. Here, we present a 14-year-old patient with an abdominal mass incidentally detected after a blunt injury to the abdomen. The initial trauma protocol CT revealed a high attenuation mesenteric lesion in the left central abdomen suggestive of mesenteric hematoma. However, the possibility of a solid neoplastic mass lesion could not be excluded. Further evaluation with dynamic contrast-enhanced serial MRI showed a progressive enhancing mass and excluded a hyperacute hematoma with active bleeding. The mass was resected, and histopathological examination and molecular analysis of tumor cells were consistent with a high-grade fibrosarcoma with KMT2D : BCOR fusion.
婴儿纤维肉瘤(IF)是一种罕见的影响婴儿和幼儿的恶性纤维母细胞肿瘤,最常见于四肢。在这里,我们提出一个14岁的病人,腹部钝性损伤后偶然发现一个腹部肿块。最初的创伤CT显示左中央腹部高衰减的肠系膜病变提示肠系膜血肿。然而,不能排除实性肿瘤肿块病变的可能性。进一步的动态增强系列MRI检查显示一个进行性增强的肿块,排除了伴有活动性出血的超急性血肿。切除肿块,组织病理学检查和肿瘤细胞的分子分析与KMT2D: BCOR融合的高级别纤维肉瘤一致。
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引用次数: 0
Diffuse Idiopathic Skeletal Hyperostosis Causing Progressive Dysphagia: A Case Report and Review. 弥漫性特发性骨骼肥大导致进行性吞咽困难:一例报告和回顾。
Pub Date : 2023-09-25 eCollection Date: 2023-01-01 DOI: 10.1155/2023/8853575
Farzin Davoodi, Narges Bazgir, Reza Naseri

Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a rare noninflammatory disorder impacting spinal longitudinal ligament and enthesis. The majority of DISH cases are asymptomatic or have few manifestations. Manifestations include neck pain and stiffness, stridor, breathing disturbances, and dysphagia. Case Presentation. A mid-aged man with progressive dysphagia to solid food was admitted to Loghman Hakim Hospital. In cervical X-ray, a huge ossification in the anterior longitudinal ligament was evident. Eventually, he was diagnosed with DISH. Because of coronary artery disease, conservative treatment was considered for him.

Conclusion: DISH is a rare disorder usually asymptomatic. In this case report, we present a DISH case with progressive dysphagia to solid foods.

背景:弥漫性特发性骨骼肥大(DISH)是一种罕见的影响脊柱纵韧带和端部的非炎症性疾病。大多数DISH病例是无症状的或很少有表现。症状包括颈部疼痛和僵硬、喘鸣、呼吸障碍和吞咽困难。案例介绍。Loghman Hakim医院收治了一名对固体食物有进行性吞咽困难的中年男子。在颈椎X光片中,前纵韧带有明显的巨大骨化。最终,他被诊断为DISH。由于患有冠状动脉疾病,考虑对他进行保守治疗。结论:DISH是一种罕见的无症状疾病。在本病例报告中,我们报告了一例对固体食物有进行性吞咽困难的DISH病例。
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引用次数: 0
Spontaneous Subcapsular Renal Hematoma as Cause of Hypovolemic Shock in a Chronic Hemodialysis Patient. 慢性血液透析患者自发性肾包膜下血肿引起低血容量性休克。
Pub Date : 2023-09-11 eCollection Date: 2023-01-01 DOI: 10.1155/2023/5570992
Jorge Luis Bermudez-Gonzalez, Bethsabel Rodríguez-Encinas, Ángel Miguel Beverido-Florido, Jesús Alejandro Gabutti-Thomas

Subcapsular renal hematomas may appear spontaneously in patients in chronic hemodialysis, though other causes as neoplasms, vasculitis, and infections should be excluded. Patients may present with abdominal pain and hemorrhagic shock; hence, early diagnosis is vital. Nephrectomy or renal artery embolization are suitable treatment options.

慢性血液透析患者可能自发出现肾包膜下血肿,但应排除肿瘤、血管炎和感染等其他原因。患者可能表现为腹痛和失血性休克;因此,早期诊断至关重要。肾切除术或肾动脉栓塞是合适的治疗选择。
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引用次数: 0
Primary Chest Wall Hydatid Disease: A Case Report with Multimodality Imaging Findings. 原发性胸壁包虫病:1例多模态影像学表现。
Pub Date : 2023-01-01 DOI: 10.1155/2023/5313067
Waleed Althobaity, Ayman Aldeheshi, Mnahi Bin Saeedan

Primary chest wall hydatid cyst is a very rare disease in endemic areas. This case report describes a 22-year-old male patient with a 3-year history of chronic left chest pain. He had a history of close animal contact in childhood. Chest computed tomography (CT) scan showed a left upper posterior paravertebral cystic mass with peripheral and intrinsic calcifications. Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scan showed no significant FDG uptake. Magnetic resonance imaging (MRI) showed a left paravertebral cystic mass with daughter cysts and a peripheral low T2 wall, compatible with hydatid disease. Medical treatment was started, and a follow-up MRI showed rupture of hydatid cysts. The patient underwent surgical resection, and a hydatid disease diagnosis was confirmed by histopathologic examination. During the postoperative hospital course, the patient developed pneumothorax which was successfully treated with a surgical procedure. The patient was discharged with medical treatment (albendazole). In conclusion, this case highlights the importance of considering hydatid disease in the differential diagnosis of chest wall cystic masses, especially in endemic regions, and the value of multimodality imaging in diagnosis and treatment planning.

原发性胸壁包虫病在流行地区是一种非常罕见的疾病。本病例报告描述一位22岁男性患者,有3年的慢性左胸痛病史。他童年时曾与动物有过密切接触。胸部电脑断层扫描显示左侧椎旁上后部囊性肿块伴周围及内在钙化。氟-18氟脱氧葡萄糖(F-18 FDG)正电子发射断层扫描(PET)显示没有明显的FDG摄取。磁共振成像(MRI)显示左侧椎旁囊性肿块伴子囊肿和周围低T2壁,与包虫病相符。开始治疗,随后的MRI显示包虫囊肿破裂。患者行手术切除,组织病理学检查证实为包虫病。术后住院期间,患者出现气胸,手术成功治疗。患者经药物治疗(阿苯达唑)出院。总之,本病例强调了在胸壁囊性肿物鉴别诊断中考虑包虫病的重要性,特别是在流行地区,以及多模式成像在诊断和治疗计划中的价值。
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引用次数: 0
A Worm's Tale or Why to Avoid the Raccoon Latrine: A Case of Baylisascaris procyonis Meningoencephalitis. 蠕虫的故事或为什么要避开浣熊厕所:一例贝氏蛔虫性原yonis脑膜脑炎。
Pub Date : 2022-08-21 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5199863
Adam E Goldman-Yassen, Anna Derman, Rebecca Pellett Madan, Alireza Radmanesh

The raccoon roundworm Baylisascaris procyonis (B. procyonis) may infect humans to cause severe or fatal meningoencephalitis, as well as ocular and visceral larva migrans. Young children are at greater risk for cerebral larva migrans with severe meningoencephalitis, and early empiric therapy may improve outcomes. Familiarity with characteristic brain imaging findings may prompt earlier diagnosis, particularly in the setting of CSF eosinophilia. We report a case of a 19-month-old boy who presented with truncal ataxia and was found to have peripheral and CSF eosinophilia. MRI demonstrated symmetric, confluent T2 hyperintense signal in the cerebral and cerebellar deep white mater, which helped differentiate B. procyonis meningoencephalitis from other infectious and non-infectious causes of eosinophilic meningoencephalitis. Early recognition and treatment of B. procyonis meningoencephalitis are important for improved outcomes, and careful review of neuroimaging can play a critical role in suggesting the diagnosis.

浣熊蛔虫(Baylisascaris procyonis)可感染人类,引起严重或致命的脑膜脑炎,以及眼部和内脏的幼虫迁移。幼儿发生严重脑膜脑炎脑幼虫迁移的风险较大,早期经验性治疗可改善预后。熟悉特征性脑影像学表现可能有助于早期诊断,特别是在脑脊液嗜酸性粒细胞增多的情况下。我们报告一个19个月大的男孩谁提出了躯干共济失调和被发现有周围和CSF嗜酸性粒细胞增多。MRI显示大脑和小脑深部白质对称、融合的T2高信号,有助于区分嗜酸性粒细胞性脑膜脑炎与其他感染性和非感染性原因的嗜酸性粒细胞性脑膜脑炎。早期识别和治疗原梭状芽胞杆菌脑膜脑炎对改善预后非常重要,仔细检查神经影像学对建议诊断起关键作用。
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引用次数: 1
Adult-Onset Acute Disseminated Encephalomyelitis with Epstein-Barr Virus Infection 成人发病急性播散性脑脊髓炎伴eb病毒感染
Pub Date : 2022-06-04 DOI: 10.1155/2022/6149501
Emika Murasawa, Masazumi Matsuda, Koichi Ishiyama, Tetsugaku Shinozaki, Toshiki Murata, M. Hashimoto
We present the case of a 22-year-old man who was diagnosed with tonsillitis and treated with antibiotics. Although the symptoms subsided, 1 week later, he presented with weakness in the lower limbs and was hospitalized. The weakness in the lower limbs worsened; he developed difficulty speaking and was transferred to our hospital. Laboratory tests showed a white blood cell count of 10,600/μL (24% atypical lymphocytes). Positive results were obtained for immunoglobulin M (IgM) antibody against Epstein-Barr virus (EBV) viral capsid antigen. EBV-deoxyribonucleic acid quantification in blood yielded positive results. Magnetic resonance imaging (MRI) revealed a hyperintensity in the spinal cord at the Th11 level of the lower spine on T2-weighted imaging (T2WI). In addition, T2WI and fluid-attenuated inversion recovery imaging showed hyperintense lesions on the right cerebral peduncle, bilateral thalami, posterior leg of the left internal capsule, and right corona radiata. We diagnosed acute disseminated encephalomyelitis (ADEM) with EBV and initiated steroid pulse therapy. Symptoms, along with the lesions seen on MRI, subsequently ameliorated. This case suggests that ADEM can be difficult to diagnose, but careful diagnosis is crucial since appropriate treatment is necessary to improve the symptoms.
我们提出一个22岁的男子谁被诊断为扁桃体炎和抗生素治疗的情况下。虽然症状消退,但1周后,患者出现下肢无力并住院。下肢无力加重;他出现说话困难,被转到我们医院。实验室检查显示白细胞计数10,600/μL(24%非典型淋巴细胞)。对eb病毒(EBV)衣壳抗原免疫球蛋白M (IgM)抗体检测结果阳性。血液中ebv -脱氧核糖核酸定量结果呈阳性。磁共振成像(MRI)在t2加权成像(T2WI)上显示下脊柱Th11水平脊髓高信号。此外,T2WI和液体衰减反转恢复成像显示右侧脑脚、双侧丘脑、左侧内囊后肢和右侧放射冠呈高强度病变。我们诊断急性播散性脑脊髓炎(ADEM)伴EBV并开始类固醇脉冲治疗。症状以及MRI上的病变随后得到改善。本病例提示ADEM可能难以诊断,但仔细诊断至关重要,因为需要适当的治疗来改善症状。
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引用次数: 2
Ruptured Median Raphe Cyst Mimicking a Vascular Penile Mass on Ultrasound 中缝囊肿破裂,超声显示酷似阴茎血管性肿块
Pub Date : 2022-02-28 DOI: 10.1155/2022/8899541
A. Pakray, Andrew Surro, D. Gibson, A. Tahawi
Median raphe cysts are uncommon benign cysts thought to occur due to improper fusion of the genital tubercle and can occur anywhere along the median raphe, from the glans to the anus, most commonly occurring along the ventral penile shaft. Limited information is available in the literature about the common imaging features of median raphe cysts with available reports highlighting an avascular cystic lesion. Our case demonstrates a 10-year-old male patient presenting with a ventral penile mass that demonstrated interval growth in the absence of trauma without overlying skin changes. Doppler ultrasound examination demonstrated a solid vascular mass measuring up to 1.6 cm at the ventral aspect of the penis with arterial and venous waveforms. The patient underwent elective resection of the mass which revealed a 2.0 cm inflamed glandular subtype median raphe cyst. This report demonstrates an atypical imaging presentation of an inflamed median raphe cyst, particularly that of a heterogeneous solid mass with arterial and venous blood flow on ultrasound.
中缝中间囊肿是一种罕见的良性囊肿,被认为是由于生殖器结节融合不当而发生的,可发生在从龟头到肛门的中缝中间的任何地方,最常见于阴茎腹侧。文献中关于中缝囊肿的常见影像学特征的信息有限,现有报告强调无血管囊性病变。我们的病例是一个10岁的男性患者,表现为阴茎腹侧肿块,在没有外伤的情况下表现为间隔生长,没有覆盖的皮肤变化。多普勒超声检查显示阴茎腹侧有一长达1.6 cm的实性血管肿块,呈动脉和静脉波形。患者择期切除肿块,发现一个2.0厘米的炎性腺型中缝囊肿。本文报告了一个非典型的中缝囊肿炎症的影像学表现,特别是在超声上表现为动脉和静脉血流动的非均匀固体肿块。
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引用次数: 0
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Case Reports in Radiology
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