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False-Positive 18F-FDG PET/CT Uptake in Unilateral Lactation. 单侧泌乳时18F-FDG PET/CT摄取假阳性。
Pub Date : 2020-11-28 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8850052
Joshua Wei Liang Yip, Han Loh, Chuong Bui, Veronica Chi Ken Wong, Robert Mansberg

A 31-year-old woman (7 months postpartum and lactating) with multiple sclerotic bone lesions was referred for an 18F-FDG PET/CT scan for characterization. The scan demonstrated unilateral diffuse intense FDG uptake corresponding to dense soft tissue in the right breast, likely related to secretory hyperplasia. On further questioning, it was made apparent that she had only been breastfeeding from the right breast. While the left breast also demonstrated dense soft tissue to a lesser degree, no significant FDG uptake was seen. The sclerotic bone lesions were not FDG avid, likely due to a separate non-FDG avid benign condition or bony metastases from a non-FDG avid primary malignancy. This was reinforced by the fact that subsequent investigations including serial bilateral breast ultrasound and percutaneous biopsy demonstrated no definite evidence of malignancy in the bilateral breasts. The histopathology findings of an open surgical biopsy of sclerotic lesions in the left posterior ilium were also nonspecific, favouring bone dysplasia with no evidence of malignancy.

一名31岁的女性(产后7个月,正在哺乳期)患有多发性硬化性骨病变,接受了18F-FDG PET/CT扫描以确定其特征。扫描显示单侧弥漫性强FDG摄取与右乳腺致密软组织相对应,可能与分泌性增生有关。在进一步询问后,很明显,她只从右乳房哺乳。虽然左乳也表现出较轻程度的致密软组织,但未见明显的FDG摄取。硬化性骨病变不存在FDG,可能是由于单独的非FDG良性病变或非FDG原发性恶性肿瘤的骨转移所致。随后的检查,包括双侧乳房超声和经皮活检,都没有明确的双侧乳房恶性肿瘤的证据,这一点得到了加强。左侧后髂骨硬化病变的开放性手术活检的组织病理学结果也是非特异性的,有利于骨发育不良,没有恶性肿瘤的证据。
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引用次数: 0
Internal Iliac Aneurysm Causing Hydroureteronephrosis. 髂内动脉瘤导致肾积水
Pub Date : 2020-11-12 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8857729
Tawfeeq Sangey, Sibtain Moledina

A 63-year-old presented with right lumbar pain and increased frequency of urination. Imaging revealed right internal iliac artery aneurysm causing hydroureteronephrosis and compressing the urinary bladder.

一名 63 岁的患者因右腰部疼痛和尿频而就诊。造影检查发现,右侧髂内动脉瘤导致肾积水并压迫膀胱。
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引用次数: 0
Spontaneous Retroperitoneal Hemorrhage Secondary to Chronic Celiac Axis Compression Treated with Embolization Utilizing Cone Beam CT. 锥束CT栓塞治疗慢性腹腔轴受压继发自发性腹膜后出血。
Pub Date : 2020-08-01 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2636495
Bashar Khiatah, Sam Jazayeri, Charles M Hubeny, Brian Nadav, Amanda Frugoli

Median arcuate ligament syndrome (MALS) is a rare and often misdiagnosed vascular pathology. In this paper, we discuss a 51-year-old female with MALS presenting with hypotension due to retroperitoneal hemorrhage. Currently, there is no consensus regarding the optimal treatment approach for such patients. This case report demonstrates the utility of conventional mesenteric angiography, cone beam CT with 3D reconstruction, and selective mesenteric transarterial embolization as an effective treatment approach for patients with spontaneous aneurysm rupture in MALS.

摘要正中弓状韧带综合征是一种罕见且常被误诊的血管病变。在本文中,我们讨论了一个51岁的女性肌萎缩侧索硬化症表现为低血压,由于腹膜后出血。目前,对于此类患者的最佳治疗方法尚无共识。本病例报告表明,常规肠系膜血管造影、三维重建锥形束CT和选择性经动脉栓塞是治疗自发性动脉瘤破裂MALS患者的有效方法。
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引用次数: 1
Single Procedure Saline Lavage for Treatment of Inspissated Bile. 单程序盐水灌洗治疗胆汁浓缩。
Pub Date : 2020-07-31 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8816599
Nafisa Sideeka, Raja Shaikh, Gulraiz Chaudry

Inspissated bile syndrome is a rare cause of cholestatic jaundice in infancy, occurring due to obstruction of the biliary ducts and gallbladder by biliary sludge. Traditional methods of treatment include surgical drainage or cholecystostomy drain placement. Both can be associated with complications and prolonged admission. We present 2 cases treated with a single percutaneous needle puncture of the gallbladder followed by saline lavage. Two neonates presented with cholestatic jaundice and sonographic evidence of biliary sludge and dilation of the common bile duct. Single sonographic-guided needle puncture of the gallbladder was followed by irrigation with saline. Clearing of the biliary sludge was confirmed by sonography and cholecystocholangiography. There was resolution of the cholestatic jaundice, with no complications or repeat procedures.

胆汁淤积综合征是一种罕见的婴儿胆汁淤积性黄疸的病因,发生的原因是胆管和胆囊被胆道污泥阻塞。传统的治疗方法包括手术引流或胆囊造口引流放置。两者都可能与并发症和住院时间延长有关。我们报告了2例经皮胆囊穿刺后盐水灌洗的病例。两名新生儿表现为胆汁淤积性黄疸,超声显示胆泥和胆总管扩张。超声引导下单针穿刺胆囊,盐水冲洗。胆道污泥清除经超声及胆道造影证实。胆汁淤积性黄疸消退,无并发症或重复手术。
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引用次数: 2
Congenital High Airway Obstruction Syndrome (CHAOS): No Intervention, No Survival-A Case Report and Literature Review. 先天性高气道阻塞综合征(CHAOS):无干预,无生存——一例报告及文献复习。
Pub Date : 2020-06-27 eCollection Date: 2020-01-01 DOI: 10.1155/2020/1036073
Ammar Ashraf, Ahmed Mohamed Abdelrahman, Ahmed Senna, Fatimah Alsaad

Congenital high airway obstruction syndrome (CHAOS) is complete or partial obstruction of the fetal upper airway. CHAOS is a rare and fatal condition if no perinatal intervention is done. Antenatal sonographic imaging has typical findings that can help in an early diagnosis, which is important in deciding elective termination of the pregnancy or successful planning of appropriate perinatal management.

先天性高气道阻塞综合征(CHAOS)是胎儿上气道的完全或部分阻塞。如果不进行围产期干预,混沌是一种罕见且致命的疾病。产前超声成像有典型的发现,可以帮助早期诊断,这是重要的决定选择性终止妊娠或成功计划适当的围产期管理。
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引用次数: 5
Unruptured Multiple Sinus of Valsalva Aneurysms. 未破裂的多发性Valsalva动脉瘤窦。
Pub Date : 2020-05-27 eCollection Date: 2020-01-01 DOI: 10.1155/2020/5046095
Demian J Omeh, Amgad N Makaryus

Sinus of Valsalva aneurysm (SVA) is a rare cardiac condition occurring in about 0.09% of the general population, with potential for grave complications. Unruptured sinus of Valsalva aneurysms of all three sinuses in the same patient are even more rare. There are congenital, inherited, or acquired causes. Noninvasive cross-sectional imaging modalities, consisting of color Doppler echocardiography, cardiac computed tomographic angiography (CCTA), and cardiac magnetic resonance imaging (MRI), make the diagnosis. Treatment is mainly by open surgical reconstruction. However, transcatheter techniques are gaining popularity with noninferior outcomes in selected cases. We report the diagnosis and successful management of a patient with an unusual presentation of multiple unruptured SVAs of all three sinuses, and we conducted a review of the English medical literature.

Valsalva窦性动脉瘤(SVA)是一种罕见的心脏疾病,约占总人口的0.09%,具有潜在的严重并发症。在同一患者中,所有三个鼻窦未破裂的Valsalva动脉瘤更为罕见。有先天的、遗传的或后天的原因。无创横断成像方式,包括彩色多普勒超声心动图,心脏计算机断层血管造影(CCTA)和心脏磁共振成像(MRI),做出诊断。治疗主要是开放性手术重建。然而,经导管技术在某些病例中因其良好的预后而越来越受欢迎。我们报告了一名患者的诊断和成功的治疗,他的三个鼻窦都有多个未破裂的sva,我们对英国医学文献进行了回顾。
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引用次数: 3
Rare Case of a Calcified Catheter-Related Sheath Embolizing to the Right Pulmonary Artery. 导管相关的钙化鞘栓塞右肺动脉的罕见病例。
Pub Date : 2020-05-20 eCollection Date: 2020-01-01 DOI: 10.1155/2020/8623538
Lee K Rousslang, Jonathan R Wood

Catheter-related sheaths, formerly known as "fibrin sheaths," are the most common complications of central venous catheters. Although usually harmless, they can very rarely detach from the venous wall against which they were formed and embolize with effects ranging from subclinical embolisms to death. This rare occurrence has only been described a few times in the literature to date, and to our knowledge, the embolized sheath has never been directly visualized with CT. We report the case of catheter-related sheath embolization to the right pulmonary artery in a child, as confirmed on CT.

导管相关鞘,以前称为“纤维蛋白鞘”,是中心静脉导管最常见的并发症。虽然通常是无害的,但它们很少能从形成它们的静脉壁上脱离并栓塞,其后果从亚临床栓塞到死亡不等。迄今为止,这种罕见的情况在文献中只被描述过几次,据我们所知,栓塞鞘从未在CT上直接可见过。我们报告一例导管相关鞘栓塞到右肺动脉在一个孩子,并证实了CT。
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引用次数: 7
Ganglion of the Sternoclavicular Joint: A Rare Location of an Uncommon Pediatric Mass. 胸锁关节神经节:罕见小儿肿块的罕见部位。
Pub Date : 2020-03-26 eCollection Date: 2020-01-01 DOI: 10.1155/2020/2035756
Jacob Musiol, Jacob Hansen, Jonathan Wood

This is a case of a two-year-old boy with a ganglion arising from the sternoclavicular joint. Ganglia are rare in the pediatric population, with less than 2% occurring under the age of 2 years old. Additionally, sternoclavicular joint ganglia are also exceedingly rare. The case illustrates the importance of keeping ganglion within the differential diagnosis for palpable subcutaneous masses, even in young children, especially when they are seen to connect to the joint.

这是一例两岁男孩的神经节起源于胸锁关节。神经节在儿科人群中很少见,不到2%发生在2岁以下。此外,胸锁关节神经节也极为罕见。该病例说明了在可触及的皮下肿块的鉴别诊断中保持神经节的重要性,即使在幼儿中,特别是当它们与关节相连时。
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引用次数: 0
A Degrading Potassium Tablet Mimicking Active Gastric Bleeding in a Computer Tomographic Investigation. 一种模拟胃活动性出血的降解钾片的计算机断层扫描研究。
Pub Date : 2020-03-18 eCollection Date: 2020-01-01 DOI: 10.1155/2020/9791519
J P Commandeur, A Metwaly, L Büchler, J Speiser, L Brander, A Reintam Blaser

A 54-year-old male patient was admitted to the hospital due to symptoms caused by an intramural hematoma of the descending aorta. In a contrast media-enhanced computed tomography scan performed five days after admission to evaluate dynamics of the hematoma, a hyperdense lesion was seen in the stomach. A suspicion of gastric hemorrhage was raised at the first evaluation. Because the patient's clinical condition and hemoglobin levels were stable, gastroscopy to rule out an aorto-gastric fistula or another type of bleeding was not undertaken. In the secondary evaluation of the history and images, it became clear that the hyperdense lesion mimicking bleeding in the stomach must have been caused by a degrading potassium tablet ingested by the patient five hours before the investigation.

一名54岁男性患者因降主动脉壁内血肿引起的症状入院。入院后5天进行的造影剂增强计算机断层扫描以评估血肿的动态,在胃中可见高密度病变。初次检查时怀疑胃出血。由于患者的临床状况和血红蛋白水平稳定,因此没有进行胃镜检查以排除主动脉胃瘘或其他类型的出血。在对病史和图像的二次评估中,很明显,类似胃出血的高密度病变一定是由患者在调查前5小时摄入的降解钾片引起的。
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引用次数: 3
Germ Cell Tumor with Bronchial Fistula. 生殖细胞瘤伴支气管瘘。
Pub Date : 2020-02-25 eCollection Date: 2020-01-01 DOI: 10.1155/2020/7650206
María Katherinne Flórez Leguía, Paula Camila Riveros Calvete, Paulina Ojeda, Jorge Alberto Carrillo Bayona
Germ cell tumors account for 15% of anterior mediastinum tumors. Fistulas are abnormal communications between two surfaces covered by the epithelium. A fistula can occur between the bronchial tree and the adjacent anatomical structures secondary to variable etiologies. The main clinical manifestations of bronchial fistulas include hemoptysis, purulent cough, and pneumonia, which might threaten the patient's life. Diagnosis can be established with computed tomography, which shows direct and indirect signs of a fistulous tract. We present the case of a 25-year-old patient, with an embryonic carcinoma of the mediastinum, who developed a fistula between the mediastinal mass and the bronchial tree after chemotherapy and thoracic radiotherapy. We carried out a review of the literature about the epidemiological aspects and the physiopathology and the relevant radiological findings of this pathology.
生殖细胞肿瘤占前纵隔肿瘤的15%。瘘管是上皮覆盖的两个表面之间的异常交通。瘘管可发生在支气管树和邻近解剖结构之间,继发于各种病因。支气管瘘的主要临床表现为咯血、化脓性咳嗽、肺炎等,可危及患者生命。诊断可以通过计算机断层扫描建立,它显示直接和间接的瘘道征象。我们报告一例25岁的纵隔胚胎癌患者,在化疗和胸部放疗后,纵隔肿块和支气管树之间出现瘘。我们对流行病学方面的文献、病理生理和相关的放射学结果进行了回顾。
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引用次数: 1
期刊
Case Reports in Radiology
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