Radiology Case Reports最新文献

英文中文

Lesser omental capillary-lymphatic-venous malformation with massive intralesional hemorrhage: A case report 小网膜毛细血管-淋巴-静脉畸形伴病灶内大出血1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-27 DOI: 10.1016/j.radcr.2025.12.058

Haruka Ogata MD, Shun Goto MD, Daiya Morita MD, Sako Tomogane MD, Masumi Nakahashi MD, PhD, Masaya Miyazaki MD, PhD

Lesser omental cystic capillary-lymphatic-venous malformation (CLVM) is a rare benign intra-abdominal vascular anomaly. We report the case of a 50-year-old female patient who was admitted to our hospital with epigastric pain. She was previously diagnosed with abdominal cystic lymphangioma. At the time of her visit to our hospital, abdominal computed tomography (CT) revealed massive intralesional hemorrhage. During tumor resection, the cystic lesion was found to originate from the lesser omentum. Histopathologically, the patient was diagnosed with CLVM instead of lymphangioma, based on the 2018 International Society for the Study of Vascular Anomalies (ISSVA) classification. Hemorrhage within the cyst may alter lesion imaging features, thereby complicating preoperative diagnosis. Preoperatively, we were unable to identify imaging features of vascular components other than the lymphatic component. In our case, the hemorrhage may have been caused by vascular structures pathologically identified within the lesion. Therefore, we speculated that previously reported cases of abdominal lymphangiomas complicated by hemorrhage may harbor combined vascular malformations had they been pathologically reclassified according to the 2018 ISSVA classification system. We report a case of lesser omentum CLVM that subsequently developed into intralesional hemorrhage, with a review of the relevant literature.

小网膜囊性毛细血管-淋巴-静脉畸形（CLVM）是一种罕见的腹腔内良性血管异常。我们报告的情况下，一个50岁的女性患者谁住进我们的医院与胃脘痛。她之前被诊断为腹腔囊性淋巴管瘤。在她来我院就诊时，腹部计算机断层扫描（CT）显示病灶内大量出血。在肿瘤切除时，发现囊性病变起源于小网膜。根据2018年国际血管异常研究学会（ISSVA）的分类，组织病理学诊断为CLVM，而不是淋巴管瘤。囊肿内出血可能改变病变的影像学特征，从而使术前诊断复杂化。术前，我们无法确定除淋巴成分外血管成分的影像学特征。在我们的病例中，出血可能是由病变内病理鉴定的血管结构引起的。因此，我们推测，如果按照2018年ISSVA分类系统进行病理重新分类，先前报道的腹腔淋巴管瘤合并出血病例可能存在合并血管畸形。我们报告一例小网膜CLVM随后发展为病灶内出血，并回顾相关文献。

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引用次数: 0

Abdominal wall desmoid tumor postcesarean section: A case report 剖宫产术后腹壁硬纤维瘤1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-27 DOI: 10.1016/j.radcr.2025.12.050

Abdallah Said Abdallah MD , Mehdi Salmane MD , Chakir Mahfoud MD , Nezha Elbahaoui PhD , Fatima Zahrae Laamrani PhD , Youssef Omor PhD , Hafid Hachi PhD , Rachida Latib PhD , Sanae Amalik PhD

Desmoid-type fibromatosis (DTF) is a rare, locally aggressive myofibroblastic neoplasm. Abdominal wall occurrences are frequently associated with antecedent surgical trauma, such as Cesarean sections, and pregnancy-related hormonal factors. The diagnosis is challenging and requires differentiation from scar endometriosis. We report the case of a 35-year-old woman presenting with a painful infraumbilical mass 4 years after her last Cesarean section. Magnetic Resonance Imaging (MRI) suggested a desmoid tumor, characterized by T2 hypointensity and fascial infiltration. Percutaneous biopsy confirmed the diagnosis, revealing nuclear beta-catenin positivity and negative hormone receptors. Following multidisciplinary assessment and in accordance with the patient's preference, a conservative management strategy using nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated, resulting in symptomatic relief. This case underscores the importance of MRI in the diagnostic workup and highlights the role of active surveillance and medical management as a viable first-line strategy for symptomatic abdominal wall DTF.

纤维瘤病是一种罕见的局部侵袭性肌纤维母细胞肿瘤。腹壁的发生通常与先前的手术创伤，如剖宫产和妊娠相关的激素因素有关。诊断具有挑战性，需要与瘢痕性子宫内膜异位症进行鉴别。我们报告的情况下，35岁的妇女提出了一个痛苦的脐下肿块4年后，她最后一次剖宫产。磁共振显示为硬纤维瘤，以T2低密度及筋膜浸润为特征。经皮活检证实了诊断，显示核β -连环蛋白阳性，激素受体阴性。在多学科评估后，根据患者的偏好，开始使用非甾体抗炎药（NSAIDs）的保守治疗策略，导致症状缓解。本病例强调了MRI在诊断检查中的重要性，并强调了积极监测和医疗管理作为有症状的腹壁DTF的可行一线策略的作用。

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引用次数: 0

Giant splenic artery pseudoaneurysm fistulizing to the colon: A case report and focused literature review 巨脾动脉假性动脉瘤致结肠瘘：1例报告及重点文献复习

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-27 DOI: 10.1016/j.radcr.2025.12.047

Tom Simon MSc , Nicolas Brassart MD

Splenic artery pseudoaneurysm (SAP) is a rare but dangerous visceral arterial lesion, and fistulization into the gastrointestinal tract is an exceptional and life-threatening complication. We report the case of a 73-year-old woman presenting with acute lower gastrointestinal bleeding caused by a giant SAP that had eroded into the splenic flexure of the colon. Proximal embolization using coils and Onyx achieved initial hemostasis. Although the patient was clinically stabilized, she later developed delayed septic and inflammatory complications requiring splenectomy, colonic resection, partial gastrectomy, and removal of the aneurysmal sac. This case, together with our focused review of published SAP fistula cases, highlights that embolization should be considered a temporizing measure when gastrointestinal fistulization is present; early surgical management remains essential to prevent severe infection and multi-organ complications.

脾动脉假性动脉瘤（SAP）是一种罕见但危险的内脏动脉病变，而进入胃肠道的瘘管是一种罕见且危及生命的并发症。我们报告的情况下，一个73岁的妇女提出急性下消化道出血引起的一个巨大的SAP已经侵蚀到结肠脾弯曲。近端栓塞使用线圈和玛瑙实现初步止血。虽然患者临床稳定，但后来出现迟发性脓毒症和炎症并发症，需要脾切除术、结肠切除术、部分胃切除术和切除动脉瘤囊。本病例，连同我们对已发表的SAP瘘病例的重点回顾，强调当存在胃肠道瘘时，栓塞应被视为一种暂时措施；早期手术治疗对于预防严重感染和多器官并发症仍然至关重要。

引用次数: 0

A case report: Acute presentation of chronic aortic dissection 慢性主动脉夹层的急性表现

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-27 DOI: 10.1016/j.radcr.2025.12.051

Abhyuday Kumar Yadav MBBS , Sumarg Simkhada MD , Bhawana Bastola MBBS , Barada Bajracharya MBBS , Sneha Shrestha MBBS , Suyesh Raj Shrestha MBBS , Bikram Yadav MBBS

Chronic aortic dissection is a rare variant of aortic dissection where dissection in a weakened aortic wall and subsequent blood flow occur over a period of 3 months or more. The underlying mechanism for chronicity and global burden of the disease is not well documented or understood. Further contributed by the overall rarity of aortic dissection, literature published on the topic is lacking. We present a case of a 83-year-old lady who presented with features of Cor Pulmonale with coexisting right hypochondrium tenderness which when further evaluated with a USG revealed an aortic aneurysm with features of dissection. Further evaluation with a CT scan revealed a Stanford type A, DeBakey type I aortic dissection with a false flap and calcific changes hinting to its chronic nature. The patient was managed for the presenting features and is under regular outpatient care for aortic dissection. Among the survivors of acute dissection/aneurysms people in their 6th and 7th decade and having a history of familial disease, dyslipidemia, arterial hypertension and aortic surgeries seem to be at higher risk of chronic dissection. Although more common in males, females seem to have worse prognosis. Various imaging modalities may be useful in diagnosis, CT being the most reliable. Intimal tears and flaps showing flow in the false lumen and calcification of the aortic wall are some positive radiological findings. Thrombus formation in the slow blood flowing false lumen with subsequent embolisation, secondary aneurysms and rupture, end organ malperfusion, pericardial tamponade may be some dreaded complications. These may be avoided by timely diagnosis and intervention that may extend the life expectancy by as much as 7 years. Chronic Aortic dissection is a rare and complicated entity that is not well understood. Various complications of the disease may be the cause of severe morbidity and mortality. Timely diagnosis and interventions such as aortic repair and/ or active surveillance are essential for a positive outcome.

慢性主动脉夹层是一种罕见的主动脉夹层变异型，在3个月或更长时间内，主动脉壁发生夹层，并伴随血流。该病的慢性和全球负担的潜在机制尚未得到很好的记录或了解。由于主动脉夹层的总体罕见性，有关该主题的文献发表较少。我们报告一位83岁的女士，她表现为肺心病的特征，并伴有右侧胁肋压痛，当进一步用超声造影评估时，发现有夹层特征的主动脉瘤。进一步的CT检查显示为Stanford a型，DeBakey I型主动脉夹层，伴有假瓣和钙化改变，提示其慢性性质。对患者的表现进行了管理，并在定期门诊治疗主动脉夹层。在急性夹层/动脉瘤的幸存者中，年龄在六、七十岁、有家族病史、血脂异常、动脉高血压和主动脉手术史的人发生慢性夹层的风险更高。虽然在男性中更常见，但女性的预后似乎更差。不同的成像方式可能有助于诊断，CT是最可靠的。内膜撕裂和皮瓣显示假腔内流动和主动脉壁钙化是一些阳性的放射表现。血液流动缓慢的假腔内血栓形成并随之栓塞、继发性动脉瘤和破裂、终末器官灌注不良、心包填塞可能是一些可怕的并发症。这些可以通过及时的诊断和干预来避免，可以延长预期寿命长达7年。慢性主动脉夹层是一种罕见而复杂的疾病，目前尚未得到很好的了解。该病的各种并发症可导致严重的发病率和死亡率。及时诊断和干预措施，如主动脉修复和/或主动监测，对于取得积极结果至关重要。

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引用次数: 0

Indications and opportunities for transsplenic access to treat portal venous and portosystemic pathology: A report of 2 cases and review of the literature 经脾入路治疗门静脉及门静脉系统病理的适应证及时机：附2例报告及文献复习

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.radcr.2025.12.053

Trinity Puno BS , Joshua Levy MD , Daniel Villegas MD , Marvi Moreno MD , Ryan Rimer MD , Brandon Chen MD

Transsplenic access has emerged as a valuable technique for portal venous interventions when conventional transjugular or transhepatic approaches are challenging due to prohibitive anatomy. We briefly summarize the literature on how transsplenic access came to be and present 2 unique cases that highlight the importance of transsplenic access in facilitating transjugular intrahepatic portosystemic shunt creation in complex portal venous disease. The first case describes a 68-year-old male cirrhotic patient with extensive acute-on-chronic portal vein thromboses in whom transsplenic access enabled portal vein thrombectomy and successful portosystemic shunt placement. The second case involves a 60-year-old female patient with chronic portal vein thrombosis and cavernous transformation, where a combined transsplenic–transhepatic “body floss” technique allowed recanalization and subsequent portosystemic shunt creation.

当传统的经颈静脉或经肝入路由于解剖学上的限制而具有挑战性时，经脾入路已成为门静脉介入治疗的一种有价值的技术。我们简要总结了关于经脾通路的文献，并提出了2个独特的病例，强调了经脾通路在促进复杂门静脉疾病中经颈静脉肝内门静脉系统分流的重要性。第一个病例描述了一个68岁的男性肝硬化患者，他有广泛的急性和慢性门静脉血栓形成，经脾通道允许门静脉血栓切除术和成功的门静脉分流放置。第二个病例涉及一名60岁的女性慢性门静脉血栓形成和海绵状病变，经脾-肝联合“体牙线”技术允许再通和随后的门静脉系统分流术。

引用次数: 0

Psoas metastasis mimicking abscess in untreated muscle-invasive bladder cancer: A diagnostic pitfall 未经治疗的肌肉浸润性膀胱癌的腰肌转移模拟脓肿：一个诊断缺陷

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.radcr.2025.12.049

Maachi Youssef MD, Bensaleh Nasseredine MD, Zaki Amine MD, Slaoui Amine MD, Karmouni Tariq MD, Koutani Abdellatif MD, Elkhader Khalid MD

Psoas involvement represents a rare clinical entity presenting significant diagnostic challenges due to nonspecific symptomatology. We report a 62-year-old male patient with muscle-invasive bladder carcinoma treated by transurethral resection of bladder tumor (TURBT) who declined radical cystectomy. Six months following initial surgical intervention, he presented with back pain, fever, and progressive clinical deterioration. Laboratory investigations demonstrated marked systemic inflammation. Computed tomography revealed recurrent bladder tumor with a 12-cm left psoas collection, initially interpreted as representing an abscess. Despite percutaneous drainage and broad-spectrum antibiotic therapy, clinical improvement remained limited. Magnetic resonance imaging demonstrated an infiltrative lesion within the psoas musculature, separated from the bladder by a preserved fat plane, consistent with skeletal muscle metastasis rather than direct tumor invasion or infectious abscess. This case illustrates the diagnostic difficulty in distinguishing abscess from malignant infiltration in advanced bladder cancer and emphasizes the critical role of magnetic resonance imaging when conventional treatment modalities fail to achieve expected clinical response.

腰大肌受累是一种罕见的临床实体，由于非特异性症状而呈现出重大的诊断挑战。我们报告一位62岁男性肌肉浸润性膀胱癌患者，经尿道膀胱肿瘤切除术（turt）治疗，他拒绝根治性膀胱切除术。术后6个月，患者出现背部疼痛、发热和进行性临床恶化。实验室检查显示明显的全身性炎症。计算机断层扫描显示复发性膀胱肿瘤伴12厘米左腰肌集合，最初解释为脓肿。尽管经皮引流和广谱抗生素治疗，临床改善仍然有限。磁共振成像显示腰大肌浸润性病变，被保存的脂肪层与膀胱分离，符合骨骼肌转移，而不是肿瘤直接侵袭或感染性脓肿。本病例说明了在晚期膀胱癌中区分脓肿和恶性浸润的诊断困难，并强调了当常规治疗方式未能达到预期的临床反应时，磁共振成像的关键作用。

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引用次数: 0

Rasmussen aneurysm: A rare complication of pulmonary tuberculosis case report 拉斯穆森动脉瘤：一罕见的肺结核并发症

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-24 DOI: 10.1016/j.radcr.2025.12.031

Harry Galuh PhD , Dian Komala Dewi MD , Pramesti Indri MD , Ferdy Ferdian MD , Shindy Octaviana MD

Rasmussen’s aneurysm is a rare but potentially fatal complication of pulmonary tuberculosis (TB), characterized by the development of a pseudoaneurysm in the pulmonary arterial system due to chronic inflammation and weakening of the vessel wall. This condition arises from tuberculous destruction of lung parenchyma, leading to erosion of adjacent pulmonary arteries and subsequent aneurysm formation. Clinically, it presents with life-threatening hemoptysis, often requiring prompt diagnosis and intervention. Imaging modalities such as contrast-enhanced computed tomography (CT) and digital subtraction angiography (DSA) play a crucial role in identifying the aneurysm and guiding treatment. Management options include transcatheter arterial embolization, which is the preferred intervention, or surgical resection in select cases. Early recognition and timely treatment of Rasmussen’s aneurysm are essential to prevent catastrophic hemorrhage and improve patient outcomes.

拉斯穆森动脉瘤（Rasmussen’s动脉瘤）是肺结核（TB）的一种罕见但可能致命的并发症，其特征是由于慢性炎症和血管壁削弱而在肺动脉系统中形成假性动脉瘤。这种疾病是由肺实质的结核性破坏引起的，导致邻近肺动脉的侵蚀和随后的动脉瘤形成。临床上，它表现为危及生命的咯血，通常需要及时诊断和干预。成像方式，如增强计算机断层扫描（CT）和数字减影血管造影（DSA）在识别动脉瘤和指导治疗方面起着至关重要的作用。治疗方案包括经导管动脉栓塞，这是首选的干预措施，或在某些情况下手术切除。早期识别和及时治疗拉斯穆森动脉瘤是必不可少的，以防止灾难性出血和改善患者的预后。

引用次数: 0

MRI as a key tool in presumptive antemortem diagnosis of rabies: A case report MRI作为狂犬病推定死前诊断的关键工具：1例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-23 DOI: 10.1016/j.radcr.2025.12.005

Ephrem Fekadu Tuji MD , Bethelhem Belachew MD , Biniyam Beyene Tabor MD , Marta Desta Woldetsadick MD , Alemayehu Bedane Worke MD

Rabies, a rapidly progressive and fatal viral encephalitis, can present a diagnostic challenge in its paralytic form, which can mimic Guillain-Barré syndrome (GBS) and delay diagnosis, especially when classic symptoms like hydrophobia and aerophobia are absent. We report the case of a 24-year-old woman with progressive bilateral leg weakness, urinary retention, and behavioral changes. She developed symptoms 1 month after a dog bite and 6 days after completing post-exposure prophylaxis (PEP), initially leading to suspicion of post vaccination Guillain-Barré syndrome (GBS) or ADEM. Despite supportive care, her condition worsened. Brain and spinal MRI revealed characteristic symmetrical T2/FLAIR hyperintensities in the bilateral basal ganglia, thalami, limbic system, brainstem, and central cervical spinal cord as seen in rabies encephalitis. This case highlights the diagnostic value of MRI in identifying rabies, particularly in atypical presentations and post-vaccination states.

狂犬病是一种快速进展和致命的病毒性脑炎，其瘫痪形式可能会给诊断带来挑战，可模拟格林-巴- 综合征（GBS），并延误诊断，特别是在没有恐水和恐空气等典型症状时。我们报告一例24岁女性进行性双侧腿无力，尿潴留和行为改变。她在狗咬伤后1个月和完成暴露后预防（PEP）后6天出现症状，最初导致怀疑接种后吉兰-巴罗综合征（GBS）或ADEM。尽管得到了支持性治疗，她的病情还是恶化了。脑和脊髓MRI显示狂犬病脑炎患者双侧基底节区、丘脑、边缘系统、脑干和中央颈脊髓特征性对称T2/FLAIR高信号。本病例强调了MRI在识别狂犬病方面的诊断价值，特别是在非典型表现和接种疫苗后状态下。

引用次数: 0

A case of successful catheter removal with ventricular septal defect occluder after accidental misplacement of left subclavian vein catheter into aortic arch 左锁骨下静脉导管误置主动脉弓后用室间隔缺损封堵器成功取管一例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-22 DOI: 10.1016/j.radcr.2025.12.062

Chuke Qiao MD , Shaojie Liu MD , Hongwei Shan MD, PhD

Abstract The subclavian vein is one of the most frequently-used approaches for central venous catheterization. However, it demands high technical skills and accurate puncture positioning. In case of accidental misplacement into the artery, it is impossible to achieve sufficient local hemostasis. Moreover, removing the catheter without assistance may lead to severe complications or even death. This paper reports a case of an elderly patient with multiple underlying diseases. After left subclavian vein catheterization accidentally entered the aortic arch, a ventricular septal defect occluder was used to successfully remove the catheter. There were no adverse clinical sequelae after the operation, providing a new solution for the accidental insertion of a catheter into an artery in noncompressible areas.

锁骨下静脉是中心静脉置管最常用的入路之一。然而，它需要很高的技术技能和准确的穿刺定位。万一意外错位进入动脉，不可能达到充分的局部止血。此外，在没有帮助的情况下拔除导管可能会导致严重的并发症甚至死亡。本文报告一例老年患者多发性基础疾病。左锁骨下静脉置管意外进入主动脉弓后，使用室间隔缺损封堵器成功取出导管。术后无不良临床后遗症，为非压缩性动脉意外置管提供了新的解决方案。

引用次数: 0

A rare site for a common tumor: Incidental hepatic lipoma detected during evaluation for perforated appendicitis 一个罕见的常见肿瘤部位：在评估穿孔性阑尾炎时发现偶然的肝脂肪瘤

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-22 DOI: 10.1016/j.radcr.2025.12.014

Lubna Rabeeh Shihada , Mahmoud Alawneh , Hamza A. Abdul-Hafez , Rahaf M. Nofal , Zaina Z.D. Najjar , Eliana Almasri , Khaled Al-ali , Mohammed A. Barakat

Hepatic lipomas are exceedingly rare benign tumors composed of mature adipose tissue, typically detected incidentally during imaging for unrelated conditions. We present the case of a 44-year-old male admitted with perforated appendicitis, during whose radiological evaluation an incidental hepatic lipoma was discovered. CT imaging confirmed a well-defined fat-containing lesion with characteristic attenuation of −80 Hounsfield Units. The patient recovered uneventfully postappendectomy, and conservative management of the asymptomatic liver lesion was adopted. The importance of our case lies in its contribution to the limited global literature on hepatic lipomas and its demonstration of how such rare entities can be encountered in routine clinical practice. By presenting detailed imaging features and discussing potential diagnostic dilemma, this case enhances awareness among clinicians and radiologists. It highlights the necessity of differentiating hepatic lipomas from other fat-containing hepatic lesions to ensure appropriate management and avoid unnecessary intervention. This case reinforces the value of incidental findings in expanding clinical knowledge.

肝脂肪瘤是由成熟脂肪组织组成的极其罕见的良性肿瘤，通常在影像学检查中偶然发现。我们提出的情况下，44岁的男性承认与穿孔阑尾炎，在其放射评估偶然发现肝脂肪瘤。CT成像证实了一个明确的含脂肪病变，特征衰减为- 80 Hounsfield单位。患者阑尾切除术后恢复平稳，对无症状肝脏病变采取保守治疗。本病例的重要性在于其对有限的全球肝脂肪瘤文献的贡献，以及其在常规临床实践中如何遇到这种罕见实体的演示。通过介绍详细的影像特征和讨论潜在的诊断困境，本病例提高了临床医生和放射科医生的认识。它强调了区分肝脂肪瘤与其他含脂肪肝脏病变的必要性，以确保适当的治疗和避免不必要的干预。这个病例强化了偶然发现在扩大临床知识方面的价值。

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引用次数: 0

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