Radiology Case Reports最新文献

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Accelerated brain atrophy in sickle cell anemia despite chronic exchange transfusion therapy—A case report 慢性换血治疗后镰状细胞性贫血加速脑萎缩1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-31 DOI: 10.1016/j.radcr.2025.12.044

Tales Santini PhD , Jinghang Li , Jr-Jiun Liou PhD , Sossena Wood PhD , Howard J. Aizenstein MD, PhD , Joseph Mettenburg MD, PhD , Enrico M. Novelli MD, MS , Tamer S. Ibrahim PhD , Olubusola Oluwole MD, MS

Neurovascular complications are a common and major cause of morbidity and mortality in patients with sickle cell anemia (SCA). Prior studies have demonstrated cortical thinning as well as reduced cerebral volume in children with SCA when compared to age-matched controls, but data in adults are scarce. Chronic transfusion regimens have been shown to be neuroprotective in children with SCA, but their efficacy in adults is less clear. Automated erythrocytapheresis (red blood cell exchange transfusion) is the most aggressive disease modifying-treatment in SCA, by rapidly diluting sickle hemoglobin and replacing it with normal hemoglobin. Recently, 7 Tesla (7T) MRI have allowed for precise definition and quantitation of brain structures, specifically the delineation between gray and white matter, thereby facilitating the assessment of neurodegeneration in SCA. We hereby present a case of a woman in her late 30s (at the baseline) who was monitored for a period of 6 years (baseline + 2 time points) with 7T structural imaging. The patient has SCA and a remote history of right hemispheric stroke. Despite adherence to a chronic exchange transfusion program, the patient developed accelerated gray matter with a volume loss of 1.15% per year, on average, during the 6-year period. Our case report underscores the severity of accelerated brain atrophy in SCA.

神经血管并发症是镰状细胞性贫血（SCA）患者发病和死亡的常见和主要原因。先前的研究表明，与年龄匹配的对照组相比，SCA儿童的皮质变薄以及脑容量减少，但成人的数据很少。慢性输血方案已被证明对患有SCA的儿童具有神经保护作用，但其对成人的疗效尚不清楚。通过快速稀释镰状血红蛋白并用正常血红蛋白代替，自动红细胞置换（红细胞交换输血）是SCA中最积极的疾病修饰治疗。最近，7特斯拉（7T） MRI可以精确地定义和定量大脑结构，特别是灰质和白质之间的描绘，从而促进了SCA神经退行性变的评估。我们在此报告一位30多岁（基线）的女性病例，她接受了6年（基线+ 2个时间点）的7T结构成像监测。患者有SCA和右半脑卒中的长期病史。尽管坚持了慢性换血计划，但在6年期间，患者的灰质以平均每年1.15%的体积损失加速发展。我们的病例报告强调了SCA加速脑萎缩的严重性。

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引用次数: 0

Renal cell carcinoma with local tumor extension and pulmonary tumor embolism captured on hybrid CT and F18-PSMA PET 混合CT和F18-PSMA PET显示肾细胞癌伴局部肿瘤扩展和肺肿瘤栓塞

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-31 DOI: 10.1016/j.radcr.2026.01.019

Vincent Lam MD , Adelle Thea MD , Claire Cuscaden FAANMS, FRANZCR, MBBS

A 52-year-old female presented to hospital with acute dyspnea on a background of renal cell carcinoma in remission. Initial CT imaging demonstrated a large volume of acute occlusive pulmonary emboli in segmental and subsegmental arteries. Subsequent prostate-specific membrane antigen positron emission tomography-computed tomography scan was performed identifying the occlusive emboli as tumor thrombus in the renal vein, inferior vena cava and pulmonary arteries. The use of the prostate-specific membrane antigen positron emission tomography scan assisted in the differentiation of tumor thrombus from bland thrombus—allowing for targeted treatment with immunotherapy.

一名52岁女性，因肾细胞癌缓解期的急性呼吸困难而入院。最初的CT图像显示在节段动脉和亚节段动脉有大量急性闭塞性肺栓塞。随后进行前列腺特异性膜抗原正电子发射断层扫描-计算机断层扫描，确定闭塞栓子为肾静脉，下腔静脉和肺动脉的肿瘤血栓。前列腺特异性膜抗原正电子发射断层扫描的使用有助于肿瘤血栓与平淡血栓的区分，从而允许免疫治疗的靶向治疗。

引用次数: 0

Bizarre parosteal osteochondromatous proliferation of the temporal bone: A case report 颞骨怪异骨旁软骨瘤增生1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-31 DOI: 10.1016/j.radcr.2026.01.020

Mohammed M. Kanani MS , Sara Haseli MD , Majid Chalian MD , Kelsey V. Maher MD

Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora’s lesion, is a rare benign surface bone lesion typically arising in the hands and feet. We report an unusual case involving the temporal bone in a 63-year-old woman, presenting with progressive external auditory canal obstruction and hearing-related symptoms. Imaging revealed a well-circumscribed osseous mass without corticomedullary continuity, and surgical excision with canaloplasty led to complete symptom resolution. This case expands the recognized anatomical spectrum of Bizarre parosteal osteochondromatous proliferation (BPOP) and underscores the importance of including it in the differential diagnosis of surface bone lesions in the craniofacial region, where even benign processes may result in significant functional impairment due to local anatomy.

奇异骨旁软骨瘤增生（BPOP），或诺拉病变，是一种罕见的良性表面骨病变，通常发生在手和脚。我们报告一个不寻常的病例涉及颞骨的63岁妇女，表现为进行性外耳道阻塞和听力相关症状。影像学显示一个界限清晰的骨性肿块，没有皮质-髓质连续性，手术切除与椎管成形术导致症状完全解决。本病例扩展了奇异骨旁软骨瘤增生（BPOP）的解剖学范围，并强调了将其纳入颅面区表面骨病变鉴别诊断的重要性，在颅面区，即使是良性病变也可能由于局部解剖而导致严重的功能损伤。

引用次数: 0

Right ventricular outflow tract aneurysm as an incidental finding in a patient with acute pericarditis: A case report 急性心包炎患者偶然发现右心室流出道动脉瘤1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-30 DOI: 10.1016/j.radcr.2025.12.048

Seyed Reza Tabibian MD , Faezeh Tabesh MD , Farshad Riahi MD

Right ventricular outflow tract (RVOT) aneurysms are rare, often linked to congenital defects or surgery, and their incidental detection during acute pericarditis is unreported. This case highlights the diagnostic role of imaging in atypical presentations. A 32-year-old male presented with a 2-week history of sharp, pleuritic chest pain worsened by inspiration and coughing, partially relieved by nonsteroidal anti-inflammatory drugs (NSAIDs). He had a 10 pack-year smoking history but no prior cardiac disease. Physical examination was unremarkable. Laboratory tests showed mildly elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Electrocardiography (ECG) was normal, but transthoracic echocardiography revealed a left ventricular ejection fraction (LVEF) of 40%, right ventricular enlargement, and moderate pericardial effusion. Multidetector computed tomography (MDCT) with pulmonary thromboembolism (PTE) protocol excluded PTE but incidentally identified RVOT aneurysm. Conservative management with aspirin and colchicine led to symptom resolution; at 6-month follow-up, the patient was asymptomatic with stable imaging. This incidental finding underscores MDCT’s utility in detecting coexisting structural anomalies in patients presenting with pericarditis. Conservative management is appropriate for asymptomatic cases without obstruction.

右心室流出道（RVOT）动脉瘤是罕见的，通常与先天性缺陷或手术有关，在急性心包炎中偶然发现的动脉瘤尚未报道。本病例强调了影像学在非典型表现中的诊断作用。32岁男性，有2周剧烈胸膜炎胸痛病史，吸气和咳嗽加重，非甾体抗炎药（NSAIDs）部分缓解。他有10包年的吸烟史，但没有心脏病史。体格检查无明显异常。实验室检查显示c反应蛋白（CRP）和红细胞沉降率（ESR）轻度升高。心电图（ECG）正常，但经胸超声心动图显示左心室射血分数（LVEF） 40%，右心室增大，心包有中度积液。多探测器计算机断层扫描（MDCT）与肺血栓栓塞（PTE）协议排除PTE，但偶然发现RVOT动脉瘤。阿司匹林和秋水仙碱保守治疗导致症状缓解；随访6个月，患者无症状，影像学稳定。这一偶然发现强调了MDCT在检测心包炎患者共存结构异常方面的实用性。对于无症状、无梗阻的病例，宜采用保守治疗。

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引用次数: 0

Spontaneous duodenal perforation in a neonate: A case report 新生儿自发性十二指肠穿孔1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-30 DOI: 10.1016/j.radcr.2025.12.052

Zelalem Assefa Semegn MD, Chibahew Lante Kebede MD, MPH

Neonatal duodenal perforation is an extremely rare but life-threatening surgical emergency. Reported etiologies include prematurity, necrotizing enterocolitis, distal obstruction, trauma, and sepsis; however, in rare instances, no identifiable cause is found and the condition is described as spontaneous. Early diagnosis relies heavily on radiologic imaging, particularly plain abdominal radiographs demonstrating pneumoperitoneum. We report a 2-day-old full-term female neonate who presented with progressive abdominal distension, nonbilious vomiting, and low-grade fever of one day duration. Laboratory evaluation showed leukocytosis with a high absolute neutrophil count and mildly elevated C-reactive protein; blood culture grew Klebsiella pneumoniae, for which appropriate antibiotic therapy was initiated. Supine abdominal radiography revealed massive pneumoperitoneum with classic radiologic signs, including the football sign and Rigler’s (double-wall) sign, consistent with gastrointestinal perforation. Exploratory laparotomy identified a solitary perforation on the anterior wall of the first part of the duodenum, with no evidence of distal obstruction, necrotizing enterocolitis, ischemia, or traumatic injury. The perforation was repaired by primary closure reinforced with a pedicled omental patch. Despite the presence of bacteremia, no intraoperative findings supported sepsis-related bowel necrosis, and the perforation was therefore classified as spontaneous. The neonate had an uneventful postoperative recovery. Although exceedingly rare, neonatal duodenal perforation carries significant morbidity and mortality. Prompt radiologic recognition of pneumoperitoneum and early surgical intervention are critical for favorable outcomes. This case highlights the diagnostic value of imaging and underscores the importance of carefully excluding infectious and secondary causes before labeling a duodenal perforation as spontaneous.

新生儿十二指肠穿孔是一种极为罕见但危及生命的外科急症。报道的病因包括早产、坏死性小肠结肠炎、远端梗阻、创伤和败血症；然而，在极少数情况下，没有发现明确的原因，这种情况被描述为自发的。早期诊断在很大程度上依赖于放射学成像，特别是腹部平片显示气腹。我们报告了一个2天大的足月女婴，她表现为进行性腹胀，非胆汁性呕吐和持续一天的低烧。实验室检查显示白细胞增多，中性粒细胞绝对计数高，c反应蛋白轻度升高；血培养培养出肺炎克雷伯菌，因此开始适当的抗生素治疗。仰卧位腹部x线片显示大量气腹，伴有典型的影像学征象，包括足球征和瑞格勒（双壁）征，符合胃肠道穿孔。剖腹探查发现十二指肠第一部分前壁有孤立穿孔，无远端梗阻、坏死性小肠结肠炎、缺血或创伤性损伤的证据。穿孔采用带蒂网膜补片修补。尽管存在菌血症，但术中没有发现支持败血症相关性肠坏死，因此穿孔被归类为自发性。新生儿术后恢复顺利。虽然极为罕见，但新生儿十二指肠穿孔具有显著的发病率和死亡率。气腹的及时放射学识别和早期手术干预是获得良好结果的关键。本病例强调了影像学的诊断价值，并强调了在将十二指肠穿孔标记为自发性穿孔之前仔细排除感染性和继发性原因的重要性。

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引用次数: 0

Fatty falciform ligament appendage torsion (F-FLAT): A rare cause of acute epigastric pain 脂肪镰状韧带附属物扭转（F-FLAT）：急性胃脘痛的罕见原因

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-30 DOI: 10.1016/j.radcr.2026.01.017

Hoang Minh Hieu Nguyen, Thi Hien Nguyen, Thi Song Huong Tran, Ngoc Thanh Hoang, Trong Binh Le, Thanh Thao Nguyen

Disorders related to the falciform ligament are extremely rare. We present a case of a 56-year-old woman diagnosed with fatty-falciform ligament appendage torsion (F-FLAT). F-FLAT was detected on ultrasound and confirmed by computed tomography. The patient recovered well without further treatment beyond conservative measures. F- FLAT is usually self-limiting. Precise identification on ultrasound and computed tomography is crucial to avoid unnecessary surgical procedures.

与镰状韧带相关的疾病极为罕见。我们提出一个病例56岁的妇女诊断为脂肪镰状韧带附属物扭转（F-FLAT）。超声检测F-FLAT，计算机断层扫描证实。除保守措施外，患者未接受进一步治疗，恢复良好。F- FLAT通常是自我限制的。超声和计算机断层扫描的精确识别对于避免不必要的外科手术至关重要。

引用次数: 0

Hepatic plexiform neurofibroma a rare manifestation of neurofibromatosis type 1: A case report and literature review 肝丛状神经纤维瘤是1型神经纤维瘤病的一种罕见表现：1例报告并文献复习

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-30 DOI: 10.1016/j.radcr.2025.12.011

Omar Y. Alkhaja MD, MBBS , Feras Shmeylan Alharbi MD, MBBS , Mohammed Salem Wadani MD, MBBS , Moayad Khalid Almaimani , Ahmed Aldraihem

Neurofibromatosis type 1 (NF1) is a clinical diagnosis supported by characteristic radiological multisystem manifestations. NF1 commonly presents with cutaneous, musculoskeletal, and neurological findings, while abdominopelvic involvement is less frequent. We present the case of a 7-year-old girl clinically and radiologically diagnosed with NF1 who was incidentally found to have a hepatic lesion. Further investigations confirmed a hepatic plexiform neurofibroma, a rare manifestation of NF1 with few reported cases worldwide. This report describes the patient’s neurological findings, as well as the sonographic, cross-sectional, and magnetic resonance imaging features of hepatic plexiform neurofibroma.

1型神经纤维瘤病（NF1）是一种临床诊断，具有特征性的放射学多系统表现。NF1通常表现为皮肤、肌肉骨骼和神经系统的表现，而累及腹部骨盆的情况较少见。我们提出的情况下，一个7岁的女孩临床和放射诊断为NF1谁是偶然发现有肝脏病变。进一步的调查证实了肝丛状神经纤维瘤，这是一种罕见的NF1的表现，在世界范围内报告的病例很少。本报告描述了患者的神经学表现，以及肝丛状神经纤维瘤的超声、横断面和磁共振成像特征。

引用次数: 0

A Jaw out of joint: Uncovering a rare infectious dislocation of temporo-mandibular junction: A case report 下颌关节外：发现罕见的感染性颞下颌关节脱位：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-30 DOI: 10.1016/j.radcr.2025.12.057

Nadia Mouna MD , Nawal Chyabri MD , Asmae Kasimi MD , Mostapha Yassine Tahouna MD , Mohamed Slimani MD , Hamid Ziani MD , Siham Nasri MD , Imane Kamaoui MD , Imane Skiker MD

Septic involvement of the temporomandibular joint (TMJ) resulting in dislocation is an exceptionally rare entity and is most often associated with contiguous spread from deep cervicofacial infections. Early recognition and coordinated multidisciplinary management are essential to avoid severe functional and infectious complications. We describe the case of a 48-year-old woman with a background of chronic otitis media who presented with progressive left-sided facial swelling, trismus, and local signs of inflammation. Laboratory investigations demonstrated marked inflammatory response. Contrast-enhanced computed tomography of the head and neck revealed a left parapharyngeal abscess with extension to the masticator space, complicated by dislocation of the left TMJ. The patient was treated with surgical drainage combined with broad-spectrum intravenous antibiotic therapy. Clinical outcome was favorable, with resolution of the infectious process and gradual recovery of mandibular mobility. Although rare, TMJ dislocation secondary to deep cervicofacial infection should be considered in patients presenting with facial swelling and trismus, particularly when imaging demonstrates deep neck space abscesses. Prompt imaging assessment and multidisciplinary care play a pivotal role in achieving optimal outcomes.

脓毒性颞下颌关节（TMJ）受累导致脱位是一种非常罕见的实体，最常与深层颈面感染的连续扩散有关。早期识别和协调的多学科管理对于避免严重的功能和感染并发症至关重要。我们描述的情况下，一个48岁的女性背景慢性中耳炎谁提出了进行性左侧面部肿胀，咬牙，和局部炎症的迹象。实验室检查显示明显的炎症反应。头部及颈部电脑断层造影显示左侧咽旁脓肿并延伸至咀嚼间隙，并合并左侧颞下颌关节脱位。手术引流联合广谱静脉抗生素治疗。临床结果良好，感染过程消退，下颌活动能力逐渐恢复。虽然罕见，但在出现面部肿胀和咬合的患者中，特别是当影像学显示深颈间隙脓肿时，应考虑继发于深颈面感染的TMJ脱位。及时的影像评估和多学科护理在实现最佳结果中起着关键作用。

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引用次数: 0

Risk factors and imaging features of a rudimentary horn pregnancy: A case report and literature review 早期角妊娠的危险因素和影像学特征：1例报告和文献复习

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-29 DOI: 10.1016/j.radcr.2026.01.013

Robert E. Jones MD , Zade Akras BS , Robin B. Levenson MD , Fátima Reyes MD, FACOG , Caryn R. Dutton MD, MS

A rudimentary horn is a type of congenital uterine anomaly associated with a unicornuate uterus. Rudimentary horn pregnancies (RHPs) are extremely rare and the majority of cases result in second trimester rupture necessitating emergent laparotomy with associated high maternal morbidity and delivery of a previable fetus. We report the case of a 33-year-old G5P0131 female who presented at 15 weeks and 4 days gestational age with pelvic and back pain and imaging favoring an abdominal pregnancy. The patient underwent an exploratory laparotomy with left salpingectomy and excision of an unruptured extrauterine pregnancy that was confirmed to be an RHP on pathologic examination. Postsurgery review of the imaging demonstrated several features consistent with the diagnosis of an RHP that were not initially identified. Furthermore, the patient’s medical and surgical histories were notable for several risk factors associated with congenital uterine anomalies that should have heightened the clinical suspicion for an RHP. This case emphasizes how increased familiarity with the risk factors and imaging findings associated with rudimentary horns and RHPs may lead to an earlier and more accurate diagnosis, more timely and appropriate treatment, and ultimately a reduction in maternal and fetal morbidity and mortality.

畸形角是一种先天性子宫畸形，伴有独角子宫。早期角妊娠（RHPs）极为罕见，大多数情况下导致妊娠中期破裂，需要紧急剖腹手术，并伴有高产妇发病率和早产胎儿的分娩。我们报告一例33岁的G5P0131女性，在15周4孕龄时出现骨盆和背部疼痛，影像学倾向于腹部妊娠。患者接受了探查性剖腹手术，左输卵管切除术和未破裂的子宫外妊娠切除术，病理检查证实为RHP。术后复查影像学显示了几个最初未被确定的与RHP诊断一致的特征。此外，患者的医疗和手术史值得注意的是与先天性子宫异常相关的几个危险因素，这应该提高RHP的临床怀疑。本病例强调了如何提高对危险因素的熟悉程度以及与初生角和RHPs相关的影像学发现可能导致更早和更准确的诊断，更及时和适当的治疗，并最终降低孕产妇和胎儿的发病率和死亡率。

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引用次数: 0

The role of multimodal imaging in diagnosis in the diagnosis of epididymal metastasis from prostate carcinoma: A case report 多模态影像在前列腺癌附睾转移诊断中的作用：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-29 DOI: 10.1016/j.radcr.2026.01.005

Valentina Testini MD , Laura Eusebi MD , Giuseppe Sortino MD , Mobin Safi MD , Giuseppe Guglielmi

Prostate cancer is a common malignancy in men, typically metastasizing to bones, lymph nodes, and visceral organs. Epididymal metastasis, however, is extremely rare, with a reported prevalence of less than 4% and usually identified incidentally. We report the case of a 72-year-old male with a history of high-risk prostate adenocarcinoma previously treated with radical prostatectomy. During follow-up, the patient presented with a painless right scrotal nodule and a concurrent rise in serum PSA levels. Scrotal ultrasound and contrast-enhanced ultrasound (CEUS) revealed a solid, hypervascularized lesion in the right epididymis. PSMA PET-CT confirmed intense radiotracer uptake at the same site, consistent with metastatic disease. No other distant metastases were detected. The patient was treated with hormonal therapy and monitored through imaging and PSA levels, showing partial response. This case underscores the importance of considering atypical metastatic sites in prostate cancer follow-up. Multimodal imaging, especially CEUS and PSMA PET-CT, plays a pivotal role in the detection and characterization of rare metastatic localizations.

前列腺癌是男性常见的恶性肿瘤，通常转移到骨骼、淋巴结和内脏器官。然而，附睾转移极为罕见，据报道患病率不到4%，通常是偶然发现的。我们报告的情况下，一个72岁的男性与历史的高风险前列腺腺癌先前治疗根治性前列腺切除术。在随访期间，患者表现为无痛性右阴囊结节，同时血清PSA水平升高。阴囊超声和造影增强超声（CEUS）显示右侧附睾有实性血管充血病变。PSMA PET-CT证实同一部位有强烈的放射性示踪剂摄取，与转移性疾病一致。未发现其他远处转移。患者接受激素治疗，并通过影像学和PSA水平监测，显示部分反应。这个病例强调了在前列腺癌随访中考虑非典型转移部位的重要性。多模式成像，特别是超声造影和PSMA PET-CT，在罕见转移定位的检测和表征中起着关键作用。

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