Radiology Case Reports最新文献

英文中文

Renal artery pseudoaneurysm following tumor biopsy: Delayed rupture shortly after commencing chemotherapy for malignant lymphoma 肾动脉假性动脉瘤肿瘤活检后：延迟破裂后不久开始化疗恶性淋巴瘤

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.005

Tomonori Matsuura MD, Satoru Yanagaki MD, Yuriko Kagaya MD, Tomomi Sato MD, Nozomi Satani MD, Hiroshi Fukuda MD, Takayuki Yamada MD

A woman in her 70s with a large abdominal mass was admitted to another hospital, presenting with general malaise, poor appetite, weight loss, and night sweats. Abdominal computed tomography (CT) revealed homogeneously and mildly enhancing retroperitoneal tumor extending to the renal hilum and sinus along the urinary tract, causing peripheral compression of the normal renal parenchyma. A percutaneous renal biopsy under sonographic guidance confirmed the diagnosis of diffuse large B-cell lymphoma. A follow-up CT scan performed at our hospital revealed further enlargement of the lymphoma and the presence of a postbiopsy hematoma in the posterior pararenal space; however, no renal artery pseudoaneurysm was identified at that time (12 days after the biopsy). Four days after initiating chemotherapy—corresponding to 16 days after the biopsy—the patient developed abdominal pain and gross hematuria, progressing to shock. Emergency CT revealed a hematoma within the right urinary tract and a renal artery pseudoaneurysm located in the renal sinus, coinciding with marked regression of the lymphoma. Transcatheter arterial embolization was performed, and the renal artery pseudoaneurysm was successfully embolized using microcoils.

一位70多岁的妇女，腹部肿块较大，被另一家医院收治，表现为全身不适，食欲不振，体重减轻，盗汗。腹部计算机断层扫描（CT）显示均匀且轻度增强的腹膜后肿瘤沿尿路延伸至肾门和肾窦，造成正常肾实质的外周压迫。超声引导下经皮肾活检证实弥漫性大b细胞淋巴瘤。在我院进行的后续CT扫描显示淋巴瘤进一步扩大，并在肾旁后间隙存在活检后血肿；然而，当时（活检后12天）未发现肾动脉假性动脉瘤。化疗开始后4天，即活检后16天，患者出现腹痛和肉眼血尿，进展为休克。急诊CT显示右尿路血肿和位于肾窦的肾动脉假性动脉瘤，与淋巴瘤明显消退一致。经导管动脉栓塞，微线圈成功栓塞肾动脉假性动脉瘤。

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引用次数: 0

Dynamic chest radiography for wheezing-associated acute respiratory failure: 4 case reports 动态胸片诊断喘息相关急性呼吸衰竭4例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.012

Hidemitsu Miyatake MD, PhD , Masafumi Toshimitu MD , Shina Nakano MD , Junji Shimizu MD, PhD , Yasuyuki Tsujita MD, PhD , Kohei Asada MD, PhD , Naoto Shiomi PhD

Dynamic chest radiography is a bedside, low-dose X-ray technique that captures sequential images to visualize respiratory and cardiovascular motion and to derive ventilation maps. We present a case series of 4 patients with wheezing-associated acute respiratory failure from diverse etiologies (presumed asthma exacerbation, tracheobronchomalacia, cardiogenic pulmonary edema, and endotracheal mucus plugging). In each case, dynamic chest radiography provided real-time functional information that complemented initial evaluations when conventional tests were inconclusive. It suggested diffuse airflow limitation in the presumed asthma case, demonstrated expiratory central airway collapse in tracheobronchomalacia, supported pulmonary congestion without ventilation loss in heart failure, and revealed unilateral ventilation impairment due to mucus plugging in an intubated patient. These findings informed bedside clinical decision-making. Dynamic chest radiography may serve as a practical adjunct that increases diagnostic confidence in emergency and critical care settings where rapid, noninvasive functional assessment is desirable.

动态胸部x线摄影是一种床边低剂量x线摄影技术，可捕获连续图像，以可视化呼吸和心血管运动，并获得通气图。我们报告了4例不同病因（假定为哮喘加重、气管支气管软化、心源性肺水肿和气管内粘液堵塞）的喘息相关急性呼吸衰竭患者的病例系列。在每个病例中，动态胸部x线摄影提供了实时功能信息，补充了常规检查不确定时的初步评估。在假定的哮喘病例中提示弥漫性气流限制，在气管支气管软化症中显示呼气性中央气道塌陷，在心力衰竭中支持肺充血而无通气丧失，并在插管患者中显示由于粘液堵塞引起的单侧通气障碍。这些发现为床边临床决策提供了依据。动态胸片可以作为一种实用的辅助手段，在需要快速、无创功能评估的急诊和重症监护环境中提高诊断的可信度。

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引用次数: 0

Multifocal tenosynovial giant cell tumor: A case report 多灶性腱鞘巨细胞瘤1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.050

Mohammed M. Kanani MS , Sara Haseli MD , Majid Chalian MD

Tenosynovial giant cell tumor is a rare, generally benign soft tissue lesion arising from the synovial lining of joints, bursae, or tendon sheaths. It most commonly presents as a solitary, localized mass in the small joints of the hands and feet. Diagnosis can be difficult due to clinical overlap with other soft tissue masses. Imaging and histopathologic confirmation are critical for diagnosis, while management decisions are guided by considerations of tumor extent, symptom burden, and patient preference, with close follow-up to monitor progression. Surgical excision remains the standard treatment; however, observation may be appropriate in select cases with minimal functional impairment. This case illustrates a rare presentation in a 56-year-old male with multifocal involvement of noncontiguous digits and highlights the importance of clinical awareness of unusual presentations and supporting individualized treatment planning.

腱鞘巨细胞瘤是一种罕见的，通常是良性的软组织病变，起源于关节、滑囊或肌腱鞘的滑膜衬里。它最常见的表现是手和脚小关节的孤立、局部肿块。由于临床与其他软组织肿块重叠，诊断可能很困难。影像学和组织病理学确认对诊断至关重要，而管理决策应考虑肿瘤范围、症状负担和患者偏好，并密切随访监测进展。手术切除仍然是标准的治疗方法；然而，在功能损害最小的情况下，观察可能是适当的。本病例为56岁男性，罕见的多病灶累及不连续指，强调了临床认识异常表现和支持个体化治疗计划的重要性。

引用次数: 0

Hepatic artery pseudoaneurysms: Two cases, 2 novel solutions, and a brief review of current treatments 肝动脉假性动脉瘤：两例，两种新的解决方案，并简要回顾目前的治疗方法

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.068

John Cacciatore BS, Stephanie Gonzalez BS, Kenneth Briley MD, Syed Ali MD, Maria Del Pilar Bayona Molano MD, Neal Viradia MD

Despite their rarity, hepatic artery pseudoaneurysms present a major risk to patients associated with high mortality. Effective, timely treatment is crucial. Options include percutaneous, endovascular, and surgical management. The first case involved a 68-year-old female with a fusiform pseudoaneurysm at the bifurcation of the common hepatic into the proper hepatic artery and the gastroduodenal arteries. Onyx (ev3,Plymouth,MN) was used to reconstruct the vessel lumen while angiography confirmed embolization of the pseudoaneurysm and arterial patency. Postoperatively, the Hgb stabilized with discharge 5 days later. The second case involved a 45-year-old male with nausea, emesis, pain, elevated liver function tests, and a pseudoaneurysm of the proper hepatic artery seen on imaging. Balloon occlusion was performed for 50 minutes until complete thrombosis. This method was only feasible due to the dual blood supply of the liver. Postoperatively, the abdominal pain immediately resolved and liver enzymes returned to baseline with discharge 2 days later. Being both rare and deadly, effective treatments of hepatic artery pseudoaneurysms are necessary, but novel treatments are seldom documented. Here 2 cases are described: vessel reconstruction with Onyx and Prolonged Balloon Occlusion. Both proved to be effective. Future studies should investigate additional options.

尽管罕见，但肝动脉假性动脉瘤对患者的死亡率很高。有效、及时的治疗至关重要。选择包括经皮、血管内和手术治疗。第一例患者为68岁女性，在肝总动脉与肝固有动脉及胃十二指肠动脉的分叉处有梭状假性动脉瘤。使用Onyx （ev3,Plymouth，MN）重建血管腔，同时血管造影证实假性动脉瘤栓塞和动脉通畅。术后Hgb稳定，5 d后出院。第二例患者为45岁男性，有恶心、呕吐、疼痛、肝功能升高，影像学上可见肝固有动脉假性动脉瘤。球囊闭塞50分钟直至完全血栓形成。由于肝脏有双重血供，这种方法是可行的。术后腹痛立即缓解，肝酶恢复至基线水平，2天后出院。由于肝动脉假性动脉瘤既罕见又致命，有效的治疗是必要的，但新的治疗方法很少有文献记载。这里描述了2例：血管重建与玛瑙和延长球囊闭塞。事实证明，这两种方法都很有效。未来的研究应该调查更多的选择。

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引用次数: 0

Novel inferior gluteal artery access for successful type 2 endoleak embolization enabling the access site hemostasis by manual compression: A case report 新型臀下动脉通路成功实现2型内漏栓塞，可通过手动压迫使通路部位止血：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.057

Ryo Ogawa MD , Masashi Tamura MD, PhD , Taku Fujii MD, PhD , Jitsuro Tsukada MD, PhD , Atsunori Asami MD, PhD , Kiyoshi Ohkuma MD , Seishi Nakatsuka MD, PhD , Masahiro Jinzaki MD, PhD

Direct aneurysm or superior gluteal artery puncture is an alternative approach for internal iliac artery aneurysms after endovascular aneurysm repair. A 76-year-old man underwent endovascular aneurysm repair and bilateral internal iliac artery embolization for bilateral internal and right common iliac artery aneurysms. During the follow-up, the coils in the left internal iliac artery were recanalized, resulting in type 2 endoleak and the aneurysm enlarged. As standard antegrade or collateral access was impossible, percutaneous retrograde transgluteal inferior gluteal artery access was performed above the acetabulum with the patient in the prone position, followed by successful embolization of the internal iliac artery and aneurysm sac. Access-site hemostasis was achieved via manual compression. This access just above the acetabulum enabling stable manual compression could provide a safe option.

直接动脉瘤或臀上动脉穿刺是血管内动脉瘤修复后髂内动脉瘤的另一种方法。一位76岁的男性接受了血管内动脉瘤修复术和双侧髂内动脉栓塞术治疗双侧髂内动脉和右侧髂总动脉动脉瘤。随访中，左髂内动脉线圈再通，导致2型内漏，动脉瘤增大。由于标准的顺行或侧支通路是不可能的，在患者俯卧位下，经皮经臀下动脉逆行进入髋臼上方，随后成功栓塞髂内动脉和动脉瘤囊。通过手压实现通路部位止血。该入路位于髋臼上方，可实现稳定的手动加压，是一种安全的选择。

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引用次数: 0

Chudley-McCullough syndrome: A report of a rare syndromic sensorineural hearing loss Chudley-McCullough综合征：一个罕见的综合征感音神经性听力损失的报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.006

Chaimae Ouqlani MD, Nourrelhouda Bahlouli MD, Hafsa Riache MD, Meryem Fikri PhD, Najwa Ech-cherif Kettani PhD, Mohamed Jiddane PhD, Firdaous Touarsa PhD

Chudley-McCullough syndrome (CMS) is a rare autosomal recessive disorder. It is characterized by the association of early-onset sensorineural hearing loss and typical brain malformations, in contrast with preserved or only mildly affected psychomotor development. The first cases were reported in 1997 by Chudley et al. in a brother and sister born to consanguineous parents. It was not until 2012 that Doherty et al. identified mutations in the GPSM2 gene (G-protein signaling modulator 2) as the cause of CMS. We present the case of CMS in a 3-year-old girl with bilateral sensorineural deafness and characteristic brain malformations on MRI (callosal splenium agenesis, colpocephaly, interhemispheric cyst, cerebellar dysplasia, midline polymicrogyria and gray matter heterotopia).

查德利-麦卡洛综合征（CMS）是一种罕见的常染色体隐性遗传病。它的特点是与早期发病的感觉神经性听力损失和典型的脑畸形相关联，与保留或仅轻度影响的精神运动发育相反。Chudley等人于1997年在一对近亲父母所生的兄妹中报告了首例病例。直到2012年，Doherty等人才发现GPSM2基因（g蛋白信号调节因子2）突变是导致CMS的原因。我们报告一例3岁女童的CMS，双侧感音神经性耳聋，MRI表现为特征性脑畸形（胼胝体脾发育不全，阴道畸形，半球间囊肿，小脑发育不良，中线多小回畸形和灰质异位）。

引用次数: 0

Traumatic basal ganglia hemorrhage in the pediatric population 儿童创伤性基底神经节出血

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.046

Ashley Park MD, Daniel Masri MD

Traumatic Basal Ganglia Hemorrhage has been rarely reported in the pediatric population. This case describes a 22 month old male who suffered a closed head injury following a motor vehicle accident and subsequently developed a basal ganglia hemorrhage. Unilateral basal ganglia hemorrhage with associated diffuse axonal injury in the corpus callosum and the grey white matter interface were visualized in magnetic resonance imaging and series of computed tomography. The patient was managed conservatively and discharged to a rehabilitation facility with minimal deficits. In summary, this case discusses the clinical and radiological prognosis of traumatic basal ganglia hemorrhage in the pediatric population.

外伤性基底神经节出血在儿童中很少报道。本病例描述了一名22个月大的男性，他在机动车事故后遭受闭合性头部损伤，随后发展为基底神经节出血。单侧基底节区出血伴胼胝体及灰质界面弥漫性轴索损伤。患者接受保守治疗，出院后康复设施恢复正常。总之，本病例讨论了儿童创伤性基底神经节出血的临床和影像学预后。

引用次数: 0

Retroperitoneal cavernous hemangioma: A case report with literature review 腹膜后海绵状血管瘤1例并文献复习

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-13 DOI: 10.1016/j.radcr.2025.10.049

Omer H. Ghalib PhD , Rawa Bapir PhD , Hemin A. Hassan PhD , Las L. Hussain PhD , Deari A. Ismaeil PhD , Soran H. Tahir PhD , Kayhan A. Najar BSc , Jihad I. Hama MSc , Hiwa O. Abdullah BSc , Fahmi H. Kakamad PhD

Retroperitoneal cavernous hemangiomas (RCHs) are exceedingly rare benign vascular tumors. They pose significant diagnostic challenges due to their nonspecific clinical presentations and imaging findings. This report highlights a clinically misdiagnosed case of RCH as a different retroperitoneal tumor. A 43-year-old female presented with persistent right hypochondrial pain. Imaging studies suggested a retroperitoneal mass, initially suspected to be either a gastrointestinal stromal tumor (GIST) or Schwannoma, or paraganglioma. Surgical resection of the tumor was performed, and histopathological examination confirmed the diagnosis of a cavernous hemangioma. The patient recovered well with no postoperative complications. Limited cases of RCHs have been reported in the literature. These tumors often mimic other retroperitoneal masses such as GISTs. Imaging findings are nonspecific, and definitive diagnosis typically relies on histopathological analysis. Surgical resection is the mainstay of treatment, with excellent outcomes reported across cases.

腹膜后海绵状血管瘤是一种极为罕见的良性血管瘤。由于其非特异性的临床表现和影像学表现，它们构成了重大的诊断挑战。本文报告一例临床误诊RCH为不同的腹膜后肿瘤。一名43岁女性，表现为持续性右侧疑病症疼痛。影像学检查提示腹膜后肿块，最初怀疑为胃肠道间质瘤（GIST）或神经鞘瘤或副神经节瘤。手术切除肿瘤，组织病理学检查证实了海绵状血管瘤的诊断。患者恢复良好，无术后并发症。文献中报道了有限的RCHs病例。这些肿瘤通常类似于其他腹膜后肿块，如胃肠道间质瘤。影像学表现是非特异性的，明确的诊断通常依赖于组织病理学分析。手术切除是治疗的主要方法，在所有病例中都有很好的结果。

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引用次数: 0

Orbital vaso-occlusive crisis mimicking an abscess in pediatric sickle cell disease: A diagnostic pitfall 儿童镰状细胞病中模拟脓肿的眼眶血管闭塞危象：一个诊断缺陷

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-12 DOI: 10.1016/j.radcr.2025.10.067

Daniel C. Fong BS , Wiktoria A. Gocal MD , Amal Isaiah MD, PhD, MBA

Sickle cell disease (SCD) is characterized by vaso-occlusive crises (VOC) that typically affect bones with high marrow content. Orbital involvement is rare, observed more frequently in children due to their greater marrow space and rich vascularization. Orbital VOC can clinically and radiologically mimic orbital abscesses, posing significant diagnostic challenges. We present a case of a 6-year-old boy with SCD who developed an orbital VOC initially mimicking an orbital abscess. The patient presented with 4 days of progressive right eye swelling and systemic inflammatory signs. A contrast-enhanced computed tomography demonstrated findings suggestive of subperiosteal abscess, preseptal abscess, subdural empyema, and sinusitis. Subsequent magnetic resonance imaging showed features that could represent either an orbital hematoma or abscess formation. Given the constellation of clinical and radiologic findings suggesting infection with potential intracranial extension, the patient underwent urgent surgical intervention including right craniotomy, right orbitotomy, and nasal endoscopy. Intraoperative drainage revealed dark red-brown fluid without purulence. Surgical pathology demonstrated necrotic fibrovascular tissue with brisk neovascularization, consistent with an organizing hematoma. Cultures remained negative. The final diagnosis was orbital hematoma secondary to vaso-occlusive infarction of orbital bone marrow despite the initial suspicion of an abscess. This case illustrates how orbital VOC in children with SCD can radiologically and clinically mimic an orbital abscess, necessitating a multidisciplinary evaluation to resolve the complicated diagnostic picture. It emphasizes the importance of maintaining a broad differential diagnosis in pediatric SCD patients presenting with orbital findings, particularly when systemic inflammation confounds radiologic interpretation.

镰状细胞病（SCD）的特点是血管闭塞性危机（VOC），通常影响骨髓含量高的骨骼。眼眶受累是罕见的，由于儿童的骨髓空间更大，血管丰富，在儿童中更常见。眼眶VOC可以在临床和放射学上模拟眼眶脓肿，这给诊断带来了重大挑战。我们提出一个病例6岁男孩SCD谁发展了眼眶VOC最初模仿眼眶脓肿。患者出现4天进行性右眼肿胀和全身炎症征象。对比增强计算机断层扫描显示提示骨膜下脓肿、隔膜前脓肿、硬膜下脓肿和鼻窦炎。随后的磁共振成像显示可能代表眼眶血肿或脓肿形成的特征。鉴于临床和放射学结果提示感染可能颅内延伸，患者接受了紧急手术治疗，包括右开颅、右眼窝切开和鼻内窥镜检查。术中引流显示深红褐色液体，无脓。手术病理显示坏死的纤维血管组织伴有活跃的新生血管，符合组织性血肿。文化仍然是消极的。最终诊断为眼眶血肿继发于眼眶骨髓血管闭塞性梗死，尽管最初怀疑为脓肿。本病例说明了SCD患儿眼眶VOC在放射学和临床上如何与眼眶脓肿相似，需要多学科评估来解决复杂的诊断问题。它强调了在出现眼眶病变的儿童SCD患者中保持广泛的鉴别诊断的重要性，特别是当全身性炎症与放射学解释混淆时。

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引用次数: 0

Intradural spinal capillary hemangioma mimicking thoracic meningioma 模拟胸椎脑膜瘤的脊髓硬膜内毛细血管瘤

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-11-12 DOI: 10.1016/j.radcr.2025.10.038

Katherine H Belanger MD , Carol P Geer MD , Tyler P Grande , E Andrew Stevens MD

Capillary hemangiomas are benign vascular lesions that frequently involve the soft tissues of the head and neck. Less commonly, these lesions can be found along the spinal neuroaxis. The differential diagnosis of a spinal intradural extramedullary lesion is led by meningioma and nerve sheath tumors. We present the case of a spinal capillary hemangioma mimicking a spinal meningioma and suggest this pathology should be considered in the differential diagnosis of similar lesions in the spinal intradural extramedullary space. This diagnostic consideration is important as it may impact treatment planning, surgical decision making, and complication avoidance.

毛细血管瘤是一种良性血管病变，常累及头颈部软组织。不太常见的是，这些病变可以沿着脊髓神经轴被发现。脊髓硬膜内髓外病变的鉴别诊断以脑膜瘤和神经鞘肿瘤为主。我们提出了一个脊髓毛细血管瘤模拟脊髓脑膜瘤的病例，并建议在鉴别诊断脊髓硬膜内髓外间隙类似病变时应考虑这种病理。这种诊断考虑很重要，因为它可能影响治疗计划、手术决策和并发症的避免。

引用次数: 0

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