Radiology Case Reports最新文献_第10页

Shrinking hemangiomas amid advancing cirrhosis: A report of 2 cases 肝硬化进展期血管瘤萎缩2例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-13 DOI: 10.1016/j.radcr.2025.12.020

Hari Movva MD , Christo Mathew MD , Shiv Patel BS , Jimmy George MD , Vikas Burugu BS , Peeyush Bhargava MD

Hepatic hemangiomas are the most common benign tumors of the liver. They typically display stable imaging features in non-cirrhotic livers. However, in the setting of cirrhosis, their imaging appearance may change dramatically, posing notable diagnostic challenges during hepatocellular carcinoma (HCC) surveillance. The shrinkage and altered imaging characteristics of hemangiomas in cirrhotic livers likely reflect fibrotic remodeling and changes in hepatic perfusion rather than true lesion involution. We highlight how fibrotic compression, vascular redistribution, and capsular retraction may cause hemangiomas to appear smaller or display atypical features on imaging, posing a diagnostic challenge. These changes can even mimic malignancy transformation, reducing clinical confidence and leading to potential misdiagnosis. Clinicians must remain aware of these potential pitfalls to avoid unnecessary intervention, maintain appropriate management, and approximate the true progression of hemangiomas in the setting of cirrhosis. Here, we report 2 cases of hepatic hemangiomas in patients with cirrhosis that demonstrated apparent regression on serial MRI. In both cases, hemangioma size decreased over time in conjunction with advancing parenchymal fibrosis, increased nodularity, and signs of portal hypertension. Despite the reduction in size, neither patient showed imaging features concerning for malignancy, and both remained stable with respect to liver function.

肝血管瘤是肝脏最常见的良性肿瘤。它们通常在非肝硬化肝脏中显示稳定的影像学特征。然而，在肝硬化的情况下，它们的影像学表现可能会发生巨大变化，这在肝细胞癌（HCC）监测中提出了显著的诊断挑战。肝硬化肝血管瘤的缩小和影像学特征改变可能反映了纤维化重塑和肝灌注的改变，而不是真正的病变复归。我们强调如何纤维化压缩，血管重新分布，和包膜缩回可能导致血管瘤看起来更小或显示非典型特征的影像学，提出了诊断的挑战。这些变化甚至可以模拟恶性转化，降低临床信心，导致潜在的误诊。临床医生必须意识到这些潜在的陷阱，以避免不必要的干预，保持适当的管理，并在肝硬化的情况下近似血管瘤的真实进展。在此，我们报告2例肝硬化患者的肝血管瘤，在连续MRI上表现出明显的消退。在这两种情况下，血管瘤的大小随着时间的推移而减小，同时伴有实质纤维化的进展，结节性增加和门静脉高压的迹象。尽管体积减小，但两名患者均未表现出与恶性肿瘤有关的影像学特征，并且两名患者的肝功能均保持稳定。

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引用次数: 0

Ventral hernia containing a term gravid uterus: A rare challenge in surgical and obstetric management 腹疝包含妊娠期子宫：一个罕见的挑战，在外科和产科管理

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.002

José Maria Zepeda Torres MD , Juan Daniel Flores Carlos MD , Luis Osvaldo Suárez Carreón , Frida Juliette Montes Aceves MD , Gonzalo Delgado Hernández MD , Daniel Alejandro Ángel Montoya MD , Pedro Mauricio Nuñez Aviña , Oswaldo Efraín Moreno Castro MD , Julio César Cárdenas Valdéz MD , Víctor Salvador García Escoto MD , Ramón Jafit González López MD

A 28-year-old woman at 34.5 weeks of gestation presented with an incarcerated ventral hernia containing the gravid uterus and overlying skin ulceration, one year after a cesarean section. Magnetic resonance imaging revealed a large infraumbilical defect with herniation of the uterus and small bowel. Given the risk of rupture and infection, an urgent cesarean delivery followed by primary abdominal wall repair without mesh was performed. Both maternal and neonatal outcomes were favorable. Gravid uterine herniation through an incisional defect is extremely rare and requires individualized multidisciplinary management, with primary repair being a safe option in contaminated or high-risk settings.

一名28岁的妇女，妊娠34.5周，在剖宫产手术一年后出现嵌顿性腹疝，包括妊娠子宫和覆盖的皮肤溃疡。磁共振成像显示一个大的脐下缺损，子宫和小肠突出。考虑到破裂和感染的风险，我们进行了紧急剖宫产，随后进行了无补片的初级腹壁修复。产妇和新生儿预后均良好。通过切口缺陷的妊娠子宫疝是极其罕见的，需要个性化的多学科治疗，在污染或高风险环境下，初级修复是一种安全的选择。

引用次数: 0

Internal trapping for ruptured vertebral artery dissection involving the anterior spinal artery: A case report 椎动脉夹层破裂累及脊柱前动脉的内陷术：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.013

Daiki Tanabe MD , Atsushi Fujita MD, PhD , Satoshi Inoue MD, PhD , Eiji Kurihara MD, PhD , Takashi Sasayama MD, PhD

Endovascular treatment of ruptured vertebral artery dissections in the acute phase often requires consideration of the posterior inferior cerebellar artery; however, the anterior spinal artery has seldom been discussed. We report a case of ruptured vertebral artery dissection involving the origin of the anterior spinal artery that was successfully treated with internal trapping while preserving the anterior spinal artery. A 49-year-old woman in semi-comatose state was transferred to our hospital. Computed tomography revealed a diffuse subarachnoid hemorrhage. The dissected segment was located distal to the posterior inferior cerebellar artery origin, and the anterior spinal artery originated from the distal portion of the aneurysmal dilatation. The anterior spinal artery was primarily supplied by the affected side. Internal trapping of the aneurysmal segment was performed, with meticulous preservation of the anterior spinal artery origin. The patient recovered without any neurological deficits and was discharged on postoperative day 30. This case highlights the importance of careful angiographic evaluation of the anterior spinal artery when planning endovascular treatment for ruptured vertebral artery dissection. Preservation of the anterior spinal artery is critical for achieving favorable clinical outcomes.

急性期椎动脉夹层破裂的血管内治疗通常需要考虑小脑后下动脉；然而，脊髓前动脉很少被讨论。我们报告一例涉及脊髓前动脉起源的椎动脉夹层破裂，在保留脊髓前动脉的同时成功地进行了内部夹持治疗。一名处于半昏迷状态的49岁女性被转送至我院。计算机断层扫描显示弥漫性蛛网膜下腔出血。解剖节段位于小脑后下动脉起源的远端，脊髓前动脉起源于动脉瘤扩张的远端。脊髓前动脉主要由患侧供血。对动脉瘤段进行内部夹闭，并一丝不苟地保留脊髓前动脉的起源。患者恢复无任何神经功能缺损，术后第30天出院。本病例强调了在规划椎动脉夹层破裂的血管内治疗时，仔细评估脊髓前动脉血管造影的重要性。保存脊柱前动脉对于获得良好的临床结果至关重要。

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引用次数: 0

A case of telangiectatic osteosarcoma arising from the frontal bone 起源于额骨的毛细血管扩张性骨肉瘤1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.010

Akihiko Hayakawa MD , Yukari Wakabayashi MD, PhD , Masanori Ishida MD, PhD , Elly Arizono MD , Maki Tanigawa MD, PhD , Toshitaka Nagao MD, PhD , Jun Nishida MD, PhD , Kazuhiro Saito MD, PhD

Osteosarcoma of the calvarium is extremely rare, specifically of the telangiectatic subtype, which has few reported cases. Herein, we report a case of telangiectatic osteosarcoma occurring in the frontal bone of a 33-year-old man without notable family or medical history. The patient presented with a painless mass in the frontal region, and computed tomography (CT) imaging and magnetic resonance imaging (MRI) revealed a tumor destructively involving the inner and outer tables of the skull. On T1- and T2-weighted magnetic resonance imaging (MRI) images, the tumor exhibited an isointense signal similar to brain parenchyma with multiple hemorrhagic cavities internally. Furthermore, the solid component of the tumor enhanced intensely on enhanced T1-weighted image; moreover, biopsy revealed giant cells. Thus, based on imaging and biopsy findings, a preoperative diagnosis of aneurysmal bone cyst was initially suspected. However, pathological examination of the entire tumor after resection revealed atypical mitosis. Results of immunohistochemical tests revealed no H3G34W mutation, and molecular genetic analyses revealed no USP6 gene rearrangement, leading to a final diagnosis of telangiectatic osteosarcoma.

骨肉瘤的颅骨是极其罕见的，特别是毛细血管扩张亚型，其报告的病例很少。在此，我们报告一例毛细血管扩张性骨肉瘤发生在额骨33岁的男子无显著的家族或病史。患者表现为额叶无痛性肿块，计算机断层扫描（CT）和磁共振成像（MRI）显示肿瘤破坏性累及颅骨内外表。在T1和t2加权磁共振成像（MRI）图像上，肿瘤表现出类似于脑实质的等强信号，内部有多个出血性腔。在增强的t1加权图像上，肿瘤实部增强明显；此外，活检显示巨细胞。因此，根据影像学和活检结果，术前诊断动脉瘤性骨囊肿最初被怀疑。然而，整个肿瘤切除后病理检查显示非典型有丝分裂。免疫组化检测结果未发现H3G34W突变，分子遗传学分析未发现USP6基因重排，最终诊断为毛细血管扩张性骨肉瘤。

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引用次数: 0

Enhanced myometrial vascularity on MRI in a patient with retained products of conception 妊娠产物保留患者的MRI增强子宫肌血管

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.041

Derek A. Tsang BS, Erin N. Gomez MD

Secondary postpartum hemorrhage (PPH), sometimes referred to as secondary postpregnancy hemorrhage, is a potentially serious complication that arises between 24 hours and 12 weeks after delivery. Retained products of conception (RPOC) and subinvolution of the placental site are common causes, but uterine vascular anomalies such as arteriovenous malformations (AVMs) can present with similar clinical imaging findings, creating diagnostic uncertainty. Enhanced myometrial vascularity (EMV) has recently been recognized as a postpartum vascular finding that may mimic AVMs on ultrasound and magnetic resonance imaging (MRI). Because true congenital AVMs are rare, most AVM-like lesions encountered in the postpartum period likely represent acquired vascular changes or EMV, making accurate diagnosis vital for appropriate and fertility-preserving management. We present the case of a 34-year-old gravida 5 para 3 patient who developed persistent heavy vaginal bleeding following early pregnancy loss. Serial ultrasounds demonstrated a thickened, hypervascular endometrium with extension into the myometrium, raising concern for either RPOC or uterine AVM. Despite declining serum β-hCG levels, her symptoms persisted. MRI performed nearly two months after pregnancy loss revealed intrauterine enhancing material consistent with RPOC and associated EMV, favoring a diagnosis of EMV over AVM. The patient subsequently underwent successful hysteroscopic dilation and curettage, with pathology confirming RPOC and resolution of symptoms. This case highlights the diagnostic challenge and importance of differentiating EMV from uterine AVM in the evaluation of secondary PPH to avoid unnecessary invasive treatments such as embolization or hysterectomy.

继发性产后出血（PPH），有时被称为继发性妊娠后出血，是一种潜在的严重并发症，发生在分娩后24小时至12周之间。妊娠产物残留（RPOC）和胎盘部位亚内陷是常见的原因，但子宫血管异常，如动静脉畸形（AVMs）可呈现类似的临床影像学表现，造成诊断的不确定性。肌层血管增强（EMV）最近被认为是一种产后血管发现，可能在超声和磁共振成像（MRI）上模仿avm。由于真正的先天性动静脉畸形是罕见的，产后遇到的大多数动静脉样病变可能代表获得性血管改变或EMV，因此准确诊断对于适当和保留生育能力的治疗至关重要。我们提出的情况下，34岁妊娠5第3段患者谁发展持续严重阴道出血后早期妊娠流产。连续超声检查显示增厚、血管丰富的子宫内膜延伸至子宫肌层，引起对RPOC或子宫AVM的关注。尽管血清β-hCG水平下降，但她的症状持续存在。流产后近两个月的MRI显示子宫内增强物质与RPOC和相关EMV一致，有利于EMV而不是AVM的诊断。患者随后接受了成功的宫腔镜扩张和刮除，病理证实RPOC和症状缓解。本病例强调了继发性PPH的诊断挑战和区分EMV与子宫AVM的重要性，以避免不必要的侵入性治疗，如栓塞或子宫切除术。

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引用次数: 0

Spontaneous resolution of cervical calcified ligamentum flavum in a 72-year-old woman with cervical myelopathy 72岁宫颈骨髓病女性的宫颈钙化黄韧带自发消退

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.024

Mohamed Sarraj MD , Felix Diehn MD , Charles Mechas MD , Karen Truitt DO , Meera M. Dhodapkar MD, MHS , Paul Scholten MD , Ahmad Nassr MD

Ossification of the ligamentum flavum (OLF) and calcification of the ligamentum flavum (CLF) are rare disease entities in the cervical spine which may result in neurologic symptoms. A 72-year-old female patient presented with 2 months of improving left upper extremity radicular symptoms and 1 year of right hand numbness, with subtle clinical signs and symptoms of cervical myelopathy. Imaging at the time of onset of left upper extremity radicular pain demonstrated calcifications of the ligamentum flavum (CLF) resulting in cervical spinal cord compression at C3-4. A cervical spine CT obtained nearly 3 months after initial CT demonstrated complete resolution of the ligamentum flavum calcifications.Patients with CLF who demonstrate symptomatic improvement should be considered for repeat imaging to identify any radiographic evidence of resolution.

黄韧带骨化（OLF）和黄韧带钙化（CLF）是颈椎罕见的疾病实体，可导致神经系统症状。72岁女性患者，左上肢神经根症状改善2个月，右手麻木1年，临床体征和颈椎病症状轻微。左上肢神经根性疼痛发作时的影像学显示黄韧带（CLF）钙化导致C3-4处颈脊髓受压。初次CT后近3个月的颈椎CT显示黄韧带钙化完全消退。表现出症状改善的CLF患者应考虑重复影像学检查，以确定任何缓解的影像学证据。

引用次数: 0

Recurrent pneumonia unmasks congenital lobar emphysema in a 2-month-old infant: Radiological insights from a rare ICU case report 复发性肺炎暴露了2个月婴儿的先天性肺气肿：来自罕见ICU病例报告的放射学见解

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.023

Marwane El Arabi MD , Mohammed Maarad MD , Ikram Markaoui MD , Meryem Chatar MD , Mahmoud Aberkane MD , Samia Berrichi MD , Houssam Bkiyar MD, PhD

Congenital lobar emphysema (CLE) is a rare pulmonary malformation characterized by hyperinflation of 1 or more lobes due to bronchial cartilage or connective tissue abnormalities. Although typically presenting in neonates and young infants with respiratory distress, CLE may mimic more common conditions such as pneumothorax or recurrent pneumonia leading to diagnostic delays or inappropriate management. We report the case of a 2-month-old female infant admitted for recurrent respiratory infections and acute respiratory distress. The initial chest radiograph suggested a pneumothorax; however, chest CT demonstrated a giant emphysematous bulla involving the right upper lobe, causing significant mediastinal compression, consistent with CLE. The patient underwent right upper lobectomy, and histopathology confirmed emphysematous changes with chronic nonspecific inflammation and hemorrhagic remodeling. Postoperative evolution was favorable. This case illustrates the diagnostic challenges associated with CLE, particularly its potential to mimic pneumothorax and prompt inappropriate invasive procedures. Radiological evaluation—especially CT imaging—plays a pivotal role in establishing a definitive diagnosis and guiding appropriate management. Early recognition of CLE is essential to avoid misdiagnosis and ensure optimal treatment. This case underscores the importance of integrating clinical and imaging findings when evaluating infants with recurrent or unexplained respiratory symptoms.

先天性肺气肿（CLE）是一种罕见的肺部畸形，其特征是支气管软骨或结缔组织异常导致一个或多个肺叶过度膨胀。虽然通常出现在新生儿和年幼婴儿呼吸窘迫，但CLE可能模仿更常见的情况，如气胸或复发性肺炎，导致诊断延迟或处理不当。我们报告的情况下，2个月大的女婴入院复发呼吸道感染和急性呼吸窘迫。最初的胸片提示气胸；然而，胸部CT显示一个巨大的肺气肿大泡累及右上叶，造成明显的纵隔压迫，与CLE一致。患者行右上肺叶切除术，组织病理学证实肺气肿改变伴慢性非特异性炎症和出血性重塑。术后进展良好。本病例说明了与CLE相关的诊断挑战，特别是其潜在的模拟气胸和提示不适当的侵入性手术。放射学评估，特别是CT成像，在确定明确的诊断和指导适当的治疗方面起着关键作用。早期识别CLE对于避免误诊和确保最佳治疗至关重要。本病例强调了在评估有复发性或不明原因呼吸道症状的婴儿时，将临床和影像学结果结合起来的重要性。

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引用次数: 0

Pneumosinus dilatans, an uncommon clinical condition: A case report 肺窦扩张，一罕见的临床状况：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.038

VK Sundeep Nalamolu M.B.B.S, M.D , Srilatha Kavarthapu MS ENT

Pneumosinus dilatans (PSD) is an abnormal expansion of the paranasal sinus beyond the normal anatomical boundaries of the sinus and the associated bone, with normal thickness of the sinus wall. It is a rare clinical condition, with a relatively small number of cases documented in the literature. Numerous theories have been proposed to explain the etiology of PSD, of which only the ball valve mechanism and Genetic predisposition with hormonal trigger have some scientific evidence. Usually detected incidentally by imaging, however, it may present with symptoms such as swelling of the forehead (with involvement of the frontal sinus), headache, nasal block, and symptoms related to mass effect on adjacent structures. Imaging plays a major role in diagnosis, differential diagnosis, and identification of associated conditions, which is described in detail in this case report. The differential diagnosis includes hypersinus, pneumosinus, mucolcele, and benign sinus tumors. Conservative management by endoscopy is considered in asymptomatic patients, and surgical management is considered in patients with aesthetic concerns. We present a case of PSD in a 35-year-old female patient who presented with right-sided nasal obstruction and intermittent dull, nonradiating frontal headache for 3 years.

肺窦扩张（PSD）是一种鼻窦异常扩张，超出了鼻窦和相关骨的正常解剖边界，鼻窦壁厚度正常。这是一种罕见的临床疾病，文献中记载的病例相对较少。关于PSD的病因，人们提出了许多理论，其中只有球阀机制和激素触发的遗传易感性有一定的科学依据。然而，通常通过影像学偶然发现，它可能表现为前额肿胀（累及额窦）、头痛、鼻阻塞以及与肿块影响邻近结构相关的症状。影像在诊断、鉴别诊断和鉴别相关疾病中起着重要作用，这在本病例报告中有详细描述。鉴别诊断包括高鼻窦炎、气窦、粘液囊肿和良性鼻窦肿瘤。对于无症状的患者，可考虑采用内窥镜保守治疗，对于有审美问题的患者，可考虑采用手术治疗。我们报告一位35岁的女性患者的PSD病例，她表现为右侧鼻塞和间歇性钝性，非辐射性额部头痛3年。

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引用次数: 0

Multimodality imaging approach to identify hemodynamic significance of an anomalous papillary muscle insertion: A case report 多模态成像方法识别异常乳头肌插入的血流动力学意义：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.043

Som Singh MD , Omar Shaikh MD , Akshitha Yarrabothula MD , Simbo Chiadika MD

Anomalous papillary muscle insertion (APMI) has primarily been reported in the context of contributing to left ventricular outflow tract (LVOT) obstruction. However, there is a paucity of cases reporting APMI without LVOT obstruction. This case reports a 61-year-old female who presented with acute neurologic symptoms suggestive of cardioembolic stroke. Transthoracic and transesophageal echocardiography identified a mobile mass on the anterior mitral leaflet without significant valvular abnormality or LVOT obstruction. Cardiac MRI confirmed the diagnosis of APMI without dynamic obstruction and excluded thrombus or tumor. Given the lack of hemodynamic compromise, the patient was managed conservatively without surgical intervention or anticoagulation. This case highlights the utility of multimodality imaging in evaluating rare congenital cardiac anomalies. Cardiac MRI was essential in characterizing APMI and avoiding unnecessary surgical or pharmacologic intervention. The case adds to the limited literature on APMI without LVOT obstruction, particularly in the setting of stroke evaluation.

异常乳头肌插入（APMI）主要是在左心室流出道（LVOT）梗阻的背景下报道的。然而，报告APMI没有LVOT阻塞的病例很少。本病例报告一位61岁的女性，她表现出急性神经系统症状，提示心脏栓塞性中风。经胸和经食管超声心动图发现二尖瓣前小叶上有一个可移动的肿块，没有明显的瓣膜异常或LVOT阻塞。心脏MRI证实APMI无动力梗阻，排除血栓和肿瘤。鉴于缺乏血流动力学损害，患者被保守管理，没有手术干预或抗凝。本病例强调了多模态成像在评估罕见先天性心脏异常中的应用。心脏MRI在诊断APMI和避免不必要的手术或药物干预方面至关重要。该病例增加了关于无LVOT阻塞的APMI的有限文献，特别是在卒中评估方面。

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引用次数: 0

Developmental venous anomaly related to de novo cerebral cavernous malformation: Imaging findings from two cases 与新生脑海绵状血管瘤相关的发育性静脉异常：两例影像学表现

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-12 DOI: 10.1016/j.radcr.2025.12.026

Sergio Gordillo Tovar MD , Andrés Felipe Parra MD

The association between a developmental venous anomaly (DVA) and a cerebral cavernous malformation (CCM) is well-established. The development of a de novo CCM (dnCCM) adjacent to a preexisting DVA suggests that certain characteristics of the angioarchitecture of the DVA, in addition to genetic and molecular factors, play a critical role in its pathogenesis. We present the cases of two patients who were initially diagnosed with a DVA in different locations (left frontal and left occipital lobes) without evidence of a CCM in their initial imaging studies. During the follow-up, new lesions that were consistent with a dnCCM were identified adjacent to the DVA. One patient underwent surgical resection, and histopathology confirmed the CCM. Our findings support the postulate that the chronic hemodynamic alterations induced by the angioarchitecture of the DVA enable the formation of a dnCCM, as documented in the cases presented. These findings suggest that patients with a DVA who have hemodynamic risk factors may benefit from follow-up neuroimaging examinations. While our cases were monitored with standard MRI sequences, advanced techniques such as perfusion imaging might provide further insights into the hemodynamic mechanisms at play in future studies. Furthermore, we emphasize the need for longitudinal studies to establish a definitive causal relationship between DVA and dnCCM.

发育性静脉异常（DVA）与脑海绵状血管瘤（CCM）之间的关系已得到证实。在先前存在的DVA附近发生新生CCM （dnCCM）表明，除了遗传和分子因素外，DVA血管结构的某些特征在其发病机制中起关键作用。我们报告了两例患者，他们最初被诊断为不同位置的DVA（左额叶和左枕叶），在他们最初的影像学研究中没有CCM的证据。在随访期间，在DVA附近发现了与dnCCM一致的新病变。1例患者行手术切除，组织病理学证实为CCM。我们的研究结果支持这样的假设，即DVA血管结构引起的慢性血流动力学改变使dnCCM的形成成为可能，正如所提出的病例所记录的那样。这些发现表明，有血流动力学危险因素的DVA患者可能受益于随访的神经影像学检查。虽然我们的病例是用标准的MRI序列监测的，但灌注成像等先进技术可能会在未来的研究中为血液动力学机制提供进一步的见解。此外，我们强调需要纵向研究来建立DVA和dnCCM之间明确的因果关系。

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引用次数: 0