Radiology Case Reports最新文献

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Multisystemic impact of autosomal dominant polycystic kidney disease: A case report highlighting renal, hepatic, and neurological involvement

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2025.01.021

Ibrahim Khalil MBBS , Ahmed Fahim Faiyaz MBBS , Md. Imran Hossain MBBS , Mahmuda Akter MBBS

We present a case of a 64-year-old male with Autosomal Dominant Polycystic Kidney Disease (ADPKD), characterized by systemic involvement, including renal, hepatic, and neurological complications. The patient presented with persistent micturition difficulties, hematuria, and abdominal pain, compounded by hypertension and chronic obstructive pulmonary disease. Imaging revealed bilateral renal enlargement with hemorrhagic cysts, a kidney stone, and hepatic cysts causing hepatomegaly. Neurological evaluation identified chronic and recent intracerebral hemorrhages associated with poorly controlled hypertension, underscoring ADPKD's multisystem impact. ADPKD, caused by PKD1 or PKD2 mutations, often leads to progressive renal dysfunction, hypertension, and extrarenal manifestations such as hepatic cysts and intracranial aneurysms. Advances like tolvaptan demonstrate efficacy in slowing renal disease progression, while somatostatin analogs offer promise for hepatic cyst management. This case emphasizes the necessity of a multidisciplinary approach, including strict blood pressure control, regular imaging, and pharmacological intervention, to address ADPKD's complexities and optimize patient outcomes. Early diagnosis and vigilant monitoring remain crucial for preventing complications and enhancing quality of life. This report underscores the importance of integrated care in managing ADPKD, highlighting emerging therapies and the ongoing need for personalized treatment strategies in such challenging cases.

{"title":"Multisystemic impact of autosomal dominant polycystic kidney disease: A case report highlighting renal, hepatic, and neurological involvement","authors":"Ibrahim Khalil MBBS , Ahmed Fahim Faiyaz MBBS , Md. Imran Hossain MBBS , Mahmuda Akter MBBS","doi":"10.1016/j.radcr.2025.01.021","DOIUrl":"10.1016/j.radcr.2025.01.021","url":null,"abstract":"<div><div>We present a case of a 64-year-old male with Autosomal Dominant Polycystic Kidney Disease (ADPKD), characterized by systemic involvement, including renal, hepatic, and neurological complications. The patient presented with persistent micturition difficulties, hematuria, and abdominal pain, compounded by hypertension and chronic obstructive pulmonary disease. Imaging revealed bilateral renal enlargement with hemorrhagic cysts, a kidney stone, and hepatic cysts causing hepatomegaly. Neurological evaluation identified chronic and recent intracerebral hemorrhages associated with poorly controlled hypertension, underscoring ADPKD's multisystem impact. ADPKD, caused by PKD1 or PKD2 mutations, often leads to progressive renal dysfunction, hypertension, and extrarenal manifestations such as hepatic cysts and intracranial aneurysms. Advances like tolvaptan demonstrate efficacy in slowing renal disease progression, while somatostatin analogs offer promise for hepatic cyst management. This case emphasizes the necessity of a multidisciplinary approach, including strict blood pressure control, regular imaging, and pharmacological intervention, to address ADPKD's complexities and optimize patient outcomes. Early diagnosis and vigilant monitoring remain crucial for preventing complications and enhancing quality of life. This report underscores the importance of integrated care in managing ADPKD, highlighting emerging therapies and the ongoing need for personalized treatment strategies in such challenging cases.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2093-2100"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coexistence of a right vertebral artery originating from the right common carotid artery, an aberrant right subclavian artery and a left primitive proatlantal intersegmental artery: First case report

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2025.01.047

Jinlu Yu

There are no reports of the coexistence of a right vertebral artery (VA) originating from the right common carotid artery (CCA), an aberrant right subclavian artery (SCA) and a primitive proatlantal intersegmental artery (PPIA); thus, we report such a case. A 61-year-old female presented with subarachnoid hemorrhage. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) revealed a ruptured right posterior communicating artery (PcomA) aneurysm. The PcomA aneurysm was successfully embolized, and the patient recovered well. Moreover, CTA and DSA revealed that the right VA originated from the right CCA instead of the right SCA. The right SCA was aberrant from the aorta, a PPIA originated from the left external carotid artery and extended posteriorly into the left C1 transverse foramen to connect with the left intracranial VA, and the left extracranial VA was hypoplastic. Our report contributes to the literature concerning the rare variation in the origins of larger vessels located above the aorta. In addition, in our report, the complex anatomy of the neck vessels made establishing a path to access intracranial aneurysms difficult.

{"title":"Coexistence of a right vertebral artery originating from the right common carotid artery, an aberrant right subclavian artery and a left primitive proatlantal intersegmental artery: First case report","authors":"Jinlu Yu","doi":"10.1016/j.radcr.2025.01.047","DOIUrl":"10.1016/j.radcr.2025.01.047","url":null,"abstract":"<div><div>There are no reports of the coexistence of a right vertebral artery (VA) originating from the right common carotid artery (CCA), an aberrant right subclavian artery (SCA) and a primitive proatlantal intersegmental artery (PPIA); thus, we report such a case. A 61-year-old female presented with subarachnoid hemorrhage. Computed tomography angiography (CTA) and digital subtraction angiography (DSA) revealed a ruptured right posterior communicating artery (PcomA) aneurysm. The PcomA aneurysm was successfully embolized, and the patient recovered well. Moreover, CTA and DSA revealed that the right VA originated from the right CCA instead of the right SCA. The right SCA was aberrant from the aorta, a PPIA originated from the left external carotid artery and extended posteriorly into the left C1 transverse foramen to connect with the left intracranial VA, and the left extracranial VA was hypoplastic. Our report contributes to the literature concerning the rare variation in the origins of larger vessels located above the aorta. In addition, in our report, the complex anatomy of the neck vessels made establishing a path to access intracranial aneurysms difficult.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2129-2134"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neglected adult PFAPA syndrome

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2025.01.051

Aiping Zhang, Ruifeng Zhang, Yiling Jiang, Ling Shi, Meihong Luo

Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis (PFAPA) syndrome is rarely seen in adults. The diagnosis is challenging, and the majority of cases are misdiagnosed early. Here we present a case of a 69-year-old woman with PFAPA syndrome, initially misdiagnosed as pharyngitis or lymphadenitis and received multiple antibiotic therapy without any clinical benefit. This report emphasizes the importance of early identification of the disease. Patients with periodic fever accompanied by cervical lymphadenitis, clinicians should consider the possibility of PFAPA syndrome especially when antibiotic treatment is ineffective. The case showed that colchicine could significantly prolong the interval between fever, with the longest interval reaching 8 months, which significantly improved the patient's quality of life (QOL).

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The giant within: A rare case of bilateral renal angiomyolipoma surpassing 30 cm

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2024.10.138

Hadj Hsain ihssan, Marrakchi salma, Laasri lina, Lahlou chaima, Boutaleb joud, Fenni Jamal, Ennouali Hassan

We report the case of a 36-year-old woman who presented with abdominal distension and abdominal pain. Clinical examination revealed a significant increase in abdominal volume. A comprehensive biological workup was performed, including blood tests and tumor markers, followed by an abdominal CT scan. The imaging revealed 1 large retroperitoneal masses. To establish a definitive diagnosis, an ultrasound-guided biopsy was conducted, In this review, we evaluate our case of angiomyolipoma against others that have been documented in the literature by comparing its dimensions, clinic, course of therapy, complications, and evolution.

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Cerebral hemiatrophy unveiled: An in-depth radiological perspective on the diagnosis and clinical implications of Dyke-Davidoff-Masson syndrome

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2025.01.018

Rakshanda Agrawal MBBS, Vaishali Dhawan MBBS, Pratapsingh Parihar MBBS, Anjali Kumari MBBS, Komal Mishra MBBS

Dyke-Davidoff-Masson Syndrome (DDMS) is a rare neurological condition characterized by unilateral cerebral atrophy and compensatory cranial changes. It typically presents with a constellation of clinical features, including seizures, developmental delays, and hemiparesis, resulting from early brain injury or developmental anomalies. Radiological imaging, particularly Magnetic Resonance Imaging (MRI), plays a pivotal role in diagnosing DDMS by providing detailed visualization of the structural abnormalities and associated compensatory changes. This case report details the clinical and radiological findings of an 8-year-old female presenting with recurrent seizures, developmental delay, and left-sided hemiparesis. A neurological examination revealed cognitive impairment and significant left-sided weakness. Routine laboratory investigations were unremarkable, and an electroencephalogram (EEG) demonstrated focal epileptic activity. MRI findings were characteristic of DDMS, showing marked atrophy of the right cerebral hemisphere, ex vacuo dilatation of the lateral ventricle, ipsilateral calvarial thickening, and hyper pneumatization of the right sphenoid bone and bilateral mastoid air cells. Areas of cystic encephalomalacia with surrounding gliosis were noted in the right fronto-parieto-temporal regions, suggestive of prior ischemic or hypoxic injury. This case underscores the essential role of radiological imaging in diagnosing and managing DDMS. MRI confirms the diagnosis by highlighting hallmark features and helps differentiate it from other conditions with overlapping clinical and imaging findings, such as Sturge-Weber syndrome or Rasmussen encephalitis. Early recognition and diagnosis allow for optimized therapeutic strategies, including seizure management with antiepileptic medications and physiotherapy for motor deficits. Long-term follow-up is critical to monitor disease progression and adapt treatment plans.

{"title":"Cerebral hemiatrophy unveiled: An in-depth radiological perspective on the diagnosis and clinical implications of Dyke-Davidoff-Masson syndrome","authors":"Rakshanda Agrawal MBBS, Vaishali Dhawan MBBS, Pratapsingh Parihar MBBS, Anjali Kumari MBBS, Komal Mishra MBBS","doi":"10.1016/j.radcr.2025.01.018","DOIUrl":"10.1016/j.radcr.2025.01.018","url":null,"abstract":"<div><div>Dyke-Davidoff-Masson Syndrome (DDMS) is a rare neurological condition characterized by unilateral cerebral atrophy and compensatory cranial changes. It typically presents with a constellation of clinical features, including seizures, developmental delays, and hemiparesis, resulting from early brain injury or developmental anomalies. Radiological imaging, particularly Magnetic Resonance Imaging (MRI), plays a pivotal role in diagnosing DDMS by providing detailed visualization of the structural abnormalities and associated compensatory changes. This case report details the clinical and radiological findings of an 8-year-old female presenting with recurrent seizures, developmental delay, and left-sided hemiparesis. A neurological examination revealed cognitive impairment and significant left-sided weakness. Routine laboratory investigations were unremarkable, and an electroencephalogram (EEG) demonstrated focal epileptic activity. MRI findings were characteristic of DDMS, showing marked atrophy of the right cerebral hemisphere, ex vacuo dilatation of the lateral ventricle, ipsilateral calvarial thickening, and hyper pneumatization of the right sphenoid bone and bilateral mastoid air cells. Areas of cystic encephalomalacia with surrounding gliosis were noted in the right fronto-parieto-temporal regions, suggestive of prior ischemic or hypoxic injury. This case underscores the essential role of radiological imaging in diagnosing and managing DDMS. MRI confirms the diagnosis by highlighting hallmark features and helps differentiate it from other conditions with overlapping clinical and imaging findings, such as Sturge-Weber syndrome or Rasmussen encephalitis. Early recognition and diagnosis allow for optimized therapeutic strategies, including seizure management with antiepileptic medications and physiotherapy for motor deficits. Long-term follow-up is critical to monitor disease progression and adapt treatment plans.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2101-2104"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Imaging surprise: Incidentally detected duplication of gall bladders in a case of ruptured liver abscess: A rare case report

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2025.01.016

Kaustubh Gupta MD , Priya Das MBBS , Gaurav Raj MD , Vikas Singh MS

Anatomical variations of the biliary tree are common and frequently encountered during imaging; however, anatomical variations of the gall bladder are rare. Information about such rare variant anatomy must be communicated to the surgeon beforehand due to the risk of common bile duct (CBD) and hepatic artery injury during surgery. Duplication of the gall bladder is a rare malformation and may be asymptomatic or symptomatic, with symptoms being difficult to differentiate from single gall bladder pathology. Imaging plays a pivotal role in preoperative planning.

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Isolated cardiac hydatid cyst: A rare but potentially life threatening presentation of hydatid infection

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-30 DOI: 10.1016/j.radcr.2024.12.060

Pratapsingh H. Parihar MD, Mrunali Bhosale MBBS, Ravishankar Patil MD, Devyansh Nimodia MBBS, Gahana Kataria MBBS, Manasa Suryadevara MBBS, Gaurav Mishra MDPhD

Cardiac hydatid disease which is caused by the larval form of Echinococcus granuloses is the rarest yet significant presentation which is characterized by the formation of cystic lesions within the heart. It is not as common as hepatic, pulmonary hydatidosis, hence poses a unique diagnostic challenge. It may lead to severe complications like cardiac tamponade, embolism and arrhythmias. Here we present a rare case of cardiac hydatid from central India, a 74-year-old female from central India with complaints of chest pain radiating to her left hand since a duration of 2 months. After suspecting it as pericardial and cardiac hydatid on ultrasonography; diagnosis was confirmed on CT thorax and Cardiac MRI. Both CT and MRI are helpful to precise the morphological features of the cysts as well as their location.

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Case series review illustrating the utility of SPECT/CT in enhancing reader confidence and avoiding pitfalls in interpreting 99mTc-labeled red blood cell scans

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-29 DOI: 10.1016/j.radcr.2024.12.016

Jeremy Hugh Yen-hey Lau, Koon Kiu Ng, Wai Chung Wong, Boom Ting Kung

Gastrointestinal bleeding is a common condition requiring urgent medical attention. ^99mTc-labeled red blood cell scintigraphy is a conventional nuclear medicine imaging technique which is sensitive and noninvasive for diagnosing occult gastrointestinal bleeding. However, there are pitfalls in this technique due to 2D representation in planar images and altered biodistribution in certain physiological status of the patient. The anatomical localization of single-photon emission computerized tomographycomputed tomography (SPECT/CT) can avoid these pitfalls and reduce equivocal findings in Tc99m-labeled red blood cell scintigraphy. This case series review demonstrates equivocal findings in ^99mTc-labeled red blood cell scintigraphy, with the help of SPECT/CT, were found to be possible blood pooling in vasculatures and hemolysis after blood transfusion.

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Acute soft head syndrome in sickle cell disease: A rare and under-recognized complication with diagnostic challenges

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-28 DOI: 10.1016/j.radcr.2025.01.026

Muhiddin Dervis MD. , Adil Omer MD , Christopher Karakasis MD , David Mihal MD

Acute Soft Head Syndrome (ASHS) is an exceptionally rare complication of sickle cell disease (SCD), characterized by scalp pain and swelling secondary to subgaleal hematoma formation. Distinguishing its nonspecific clinical features, which often mimic other SCD-related complications, poses a significant diagnostic challenge. Imaging plays a crucial role in differentiating ASHS from other potential diagnoses and in evaluating the presence of coexisting intracranial hemorrhage, a common complication associated with ASHS. This report presents a rare case of ASHS in a patient with SCD, highlighting the diagnostic complexities and underscoring the essential role of imaging in its evaluation and management.

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A unique case of primary central nervous system neuroblastoma mimicking as hemangiopericytoma in an adult

Q4 Medicine

Radiology Case Reports

Pub Date : 2025-01-28 DOI: 10.1016/j.radcr.2025.01.012

Srishti Singh, Neha Singh, Jyoti Baliyan

Neuroblastoma is one of the common pediatric malignancy. Its occurrence in adult patients is a rareness in itself. Intrabdominal location is the most common site of the tumor, however intracranial manifestation is a very infrequent and unusual finding. We report 1 such unique and rare case of a 25 year old, female patient, who presented with chief complaints of on and off headache, occasional vomiting and blurring of vision. Plain CT brain study followed by CEMRI brain study showed a well- defined extra axial lesion in right frontal region, showing predominantly homogenous enhancement and few non enhancing area. The lesion was causing focal erosion of right frontal bone also. Imaging differentials were concluded as hemangiopericytoma, atypical meningioma with rare possibilities of histiocytosis and dural metastases. The patient underwent right frontal craniotomy with gross excision of the mass. The final histopathological conclusion came as supratentorial neuroblastoma. Subsequent chest and abdomen radiographs and ultrasound abdomen of the patient showed no obvious evidence of any intrathoracic or intrabdominal mass or vertebral lesion. Our case, therefore, is a unique amalgamation of both rare age presentation and infrequent location for Neuroblastoma. It also emphasizes on the pertinence and relevance of correlation among imaging findings, differentials and finally the histopathological results. Although, adult primary intracranial neuroblastoma is a very rare occurrence, but a radiologist should be aware of such sparse entities which can be encountered occasionally and mimic other commoner and known intracranial aetiologies on imaging.

{"title":"A unique case of primary central nervous system neuroblastoma mimicking as hemangiopericytoma in an adult","authors":"Srishti Singh, Neha Singh, Jyoti Baliyan","doi":"10.1016/j.radcr.2025.01.012","DOIUrl":"10.1016/j.radcr.2025.01.012","url":null,"abstract":"<div><div>Neuroblastoma is one of the common pediatric malignancy. Its occurrence in adult patients is a rareness in itself. Intrabdominal location is the most common site of the tumor, however intracranial manifestation is a very infrequent and unusual finding. We report 1 such unique and rare case of a 25 year old, female patient, who presented with chief complaints of on and off headache, occasional vomiting and blurring of vision. Plain CT brain study followed by CEMRI brain study showed a well- defined extra axial lesion in right frontal region, showing predominantly homogenous enhancement and few non enhancing area. The lesion was causing focal erosion of right frontal bone also. Imaging differentials were concluded as hemangiopericytoma, atypical meningioma with rare possibilities of histiocytosis and dural metastases. The patient underwent right frontal craniotomy with gross excision of the mass. The final histopathological conclusion came as supratentorial neuroblastoma. Subsequent chest and abdomen radiographs and ultrasound abdomen of the patient showed no obvious evidence of any intrathoracic or intrabdominal mass or vertebral lesion. Our case, therefore, is a unique amalgamation of both rare age presentation and infrequent location for Neuroblastoma. It also emphasizes on the pertinence and relevance of correlation among imaging findings, differentials and finally the histopathological results. Although, adult primary intracranial neuroblastoma is a very rare occurrence, but a radiologist should be aware of such sparse entities which can be encountered occasionally and mimic other commoner and known intracranial aetiologies on imaging.</div></div>","PeriodicalId":53472,"journal":{"name":"Radiology Case Reports","volume":"20 4","pages":"Pages 2029-2034"},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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