Radiology Case Reports最新文献

英文中文

Malignant skin adnexal tumor of the finger with late metastases 手指皮肤附件恶性肿瘤伴晚期转移

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-06 DOI: 10.1016/j.radcr.2025.11.083

Mohammad Hussain Erfani MD , Surenth Nalliah MD , Idris Abdulrahman Abdullah Akreyi MD , Morten Smærup Olsen MD, PhD

Malignant cutaneous adnexal tumors (MCATs) are rare neoplasms with unpredictable metastatic behavior and limited radiologic characterization. We report a case of malignant spiradenocylindroma initially evaluated with ultrasound, which demonstrated a pear-shaped heterogeneous subcutaneous structure with slight peripheral hyperemia and a small fluid-filled component in the distal phalanx of the left third finger, interpreted as a possible post-traumatic hematoma or foreign-body reaction consistent with the clinical history. Three years later, magnetic resonance imaging (MRI) revealed an infiltrative, contrast-enhancing mass with adjacent bone destruction, confirming a malignant process. After amputation, the patient remained disease-free for 8 years before developing neurological symptoms. Brain MRI showed an unusual multilobulated cystic metastasis, and positron emission tomography combined with computed tomography (PET/CT) demonstrated metabolically active pulmonary metastases. The patient ultimately experienced a fatal outcome. This case highlights the diagnostic challenges in early presentation and underscores the potential for delayed distant metastases in MCATs while expanding the radiologic spectrum of intracranial involvement to include rare multilobulated cystic presentations.

恶性皮肤附件肿瘤（MCATs）是一种罕见的肿瘤，具有不可预测的转移行为和有限的影像学特征。我们报告一例恶性螺旋腺鞘瘤，最初通过超声评估，其表现为梨形异质皮下结构，轻度外周充血，左侧第三指远端指骨有小的充满液体的成分，解释为可能是创伤后血肿或与临床病史一致的异物反应。三年后，磁共振成像（MRI）显示浸润性，增强对比肿块，邻近骨破坏，确认恶性过程。截肢后，患者在出现神经系统症状之前保持无病8年。脑MRI显示异常的多分叶囊性转移，正电子发射断层扫描结合计算机断层扫描（PET/CT）显示代谢活跃的肺转移。病人最终经历了致命的结局。该病例强调了早期表现的诊断挑战，并强调了mcat延迟远处转移的潜力，同时扩大了颅内累及的放射谱，包括罕见的多分叶囊性表现。

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引用次数: 0

Case report: preoperative radiological suspicion of atypical meningioma: A diagnostic challenge 病例报告：术前不典型脑膜瘤的影像学怀疑：诊断上的挑战

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-06 DOI: 10.1016/j.radcr.2025.12.001

Raisa Mahmudah MD, Namira Ammarin MD, Tasiya Ocvianty MD

Atypical meningiomas represent a minority of intracranial meningiomas yet carry more aggressive biological behavior and higher recurrence rates, making preoperative differentiation essential for optimal management. We report a 56-year-old female presenting with progressive headaches, drowsiness, and vomiting, with no focal neurological deficits. Brain Magnetic Resonance Imaging (MRI) revealed a dural-based lesion at the posterior falx with cystic components, irregular margins, heterogeneous enhancement, disproportionate peritumoral edema, all suggesting atypicality. Subtotal resection followed by histopathological analysis confirmed a atypical meningioma. This case underscores the pivotal role of comprehensive MRI—including conventional sequences and advanced techniques—in identifying features of atypical meningioma even without definitive brain invasion, thereby guiding appropriate surgical planning and consideration of adjuvant therapy.

非典型脑膜瘤只占颅内脑膜瘤的一小部分，但具有更强的生物学行为和更高的复发率，因此术前鉴别对于最佳治疗至关重要。我们报告一名56岁女性，表现为进行性头痛、嗜睡和呕吐，无局灶性神经功能障碍。脑磁共振成像（MRI）显示后镰硬脑膜病变伴囊性成分，边缘不规则，非均匀强化，瘤周不成比例水肿，均提示非典型。次全切除及组织病理学分析证实为非典型脑膜瘤。该病例强调了综合mri（包括常规序列和先进技术）在识别非典型脑膜瘤特征方面的关键作用，即使没有明确的脑侵犯，从而指导适当的手术计划和考虑辅助治疗。

引用次数: 0

Interventional, surgical, and clinical management of Abernethy malformations: A case series and novel anatomic variant 阿伯内蒂畸形的介入、手术和临床治疗：一个病例系列和新的解剖变异

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-05 DOI: 10.1016/j.radcr.2025.11.085

Camden J. MacDowell MD, PhD , Rebecca Choi MD , Muhammad Hammad Malik MD , Natalie Ring MD , Natasha Dilwali MD , Wikrom Karnsakul MD , Harjit Singh MD

Abernethy malformation is a rare congenital extrahepatic portosystemic shunt resulting from the persistence of embryonic vessels in the splanchnic venous system. There are 2 known types of Abernethy malformations: type I and II; both of which involve aberrant drainage of the portal venous blood into the inferior vena cava. Here, we detail the anatomy as well as clinical, surgical, and interventional management of 4 patients with Abernethy malformations. In addition, we detail a patient with a previously undescribed anatomic variant of the Abernethy type II malformation: a portosystemic shunt into an interrupted inferior vena cava in which central venous return was provided through the azygous/hemiazygos system.

Abernethy畸形是一种罕见的先天性肝外门静脉系统分流，由胚胎血管在内脏静脉系统中持续存在而引起。有两种已知类型的阿伯内蒂畸形：I型和II型；两者都涉及门静脉血液异常引流到下腔静脉。在这里，我们详细介绍了4例Abernethy畸形的解剖、临床、手术和介入治疗。此外，我们详细介绍了一名患有先前未描述的Abernethy II型畸形解剖变异的患者：门静脉系统分流进入中断的下腔静脉，其中中心静脉通过奇/半奇系统提供回流。

引用次数: 0

Technetium-99m-labeled pyrophosphate uptake in the rectum of a patient with wild-type transthyretin cardiac amyloidosis 锝-99m标记的焦磷酸盐摄取在野生型甲状腺转蛋白心脏淀粉样变性患者的直肠

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-05 DOI: 10.1016/j.radcr.2025.12.003

Koji Takahashi MD, PhD , Daisuke Sasaki MRT , Shuhei Yamamoto MD , Nobuhisa Yamamura MLT , Yushi Utsunomiya MD , Hiroe Morioka MD , Shigeki Uemura MD , Tomoki Sakaue MD, PhD , Katsuji Inoue MD, PhD

Wild-type transthyretin amyloidosis is a disease characterized by deposition of transthyretin amyloid protein in systemic organs and tissues, especially the heart, lungs, tenosynovium, and ligaments. Transthyretin amyloid is also frequently deposited in the gastrointestinal tract. Technetetium-99m-labeled pyrophosphate facilitates imaging of its depositions in the myocardium and extracardiac organs and tissues, such as subcutaneous fat and skeletal muscles. However, few reports have described the uptake of bone-seeking radiotracers in the gastrointestinal tract. This report presents the case of a 90-year-old woman diagnosed with wild-type transthyretin cardiac amyloidosis. The patient had technetetium-99m-labeled pyrophosphate uptake in the myocardium, internal oblique muscle, and rectum, which decreased or disappeared after 22 months of treatment with tafamidis. The patient had a long-standing history of constipation. However, the symptoms persisted after starting tafamidis, and their attribution to wild-type transthyretin amyloidosis was, therefore, uncertain. Technetetium-99m-labeled pyrophosphate scintigraphy can detect transthyretin amyloid deposition in the rectum of patients with wild-type transthyretin cardiac amyloidosis.

野生型甲状腺转蛋白淀粉样变性是一种以甲状腺转蛋白淀粉样蛋白沉积在全身器官和组织，特别是心脏、肺、腱鞘和韧带为特征的疾病。转甲状腺素淀粉样蛋白也常沉积于胃肠道。锝-99m标记焦磷酸盐有助于成像其在心肌和心外器官和组织中的沉积，如皮下脂肪和骨骼肌。然而，很少有报道描述了胃肠道中寻骨放射性示踪剂的摄取。本报告报告了一个90岁的妇女诊断为野生型转甲状腺素心脏淀粉样变的病例。患者心肌、内斜肌和直肠有锝-99m标记的焦磷酸盐摄取，经他法底斯治疗22个月后减少或消失。病人有长期便秘史。然而，在开始使用他法底后，这些症状持续存在，因此，它们是否属于野生型甲状腺转维蛋白淀粉样变尚不确定。锝-99m标记焦磷酸盐闪烁显像可检测野生型转甲状腺素型心脏淀粉样变性患者直肠内转甲状腺素淀粉样沉积。

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引用次数: 0

Iatrogenic hemoperitoneum and sigmoid colon injury from malpositioned apomorphine infusion device in advanced Parkinson’s disease 晚期帕金森病阿波啡输液器放置不当致医源性腹膜和乙状结肠损伤

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-05 DOI: 10.1016/j.radcr.2025.11.073

Connor Hughes MB, BCh, BAO , Timothy Fazio MBBS, MIS, FRACP, FAIDH, CHIA , Callum Umstad MBBS, BBiomed

Apomorphine pumps are increasingly used for the management of patients with advanced Parkinson's Disease. We report a unique case of hemoperitoneum and penetrating colonic injury resulting from malpositioning of a subcutaneous apomorphine device—a complication not previously described in the literature. Seventy-six-year-old man with advanced Parkinson’s Disease presented with acute abdominal pain 3-hours post the re-siting of his apomorphine infusion device. Contrast-enhanced computed tomography (CT) of the abdomen and pelvis revealed high-density fluid (47-67 Hounsfield Units), consistent with hemoperitoneum. Subsequent CT angiography revealed progressive bleeding and identified the infusion device penetrating the anterior sigmoid colon. The infusion set used was inappropriately long for the patient’s anatomy, a major factor contributing to the complication. Patient-specific factors further increased the risk of bowel injury, including severe faecal loading with resultant stercoral colitis, minimal rectus abdominus musculature, and thin subcutaneous and preperitoneal fat, all of which was evident on CT imaging. The patient was managed conservatively based on consideration of comorbidities and frailty status, and made a full recovery. This case revealed a unique and rare iatrogenic injury resulting from a subcutaneous medication delivery device. Careful consideration of anatomical and patient-specific factors, along with appropriate device selection, is critical to preventing such complications.

阿波啡泵越来越多地用于治疗晚期帕金森病患者。我们报告一个独特的病例腹腔积血和穿透性结肠损伤导致的错位皮下阿帕吗啡装置-并发症以前没有在文献中描述。76岁晚期帕金森氏症患者在重新放置阿波啡输注器3小时后出现急性腹痛。腹部和骨盆增强CT显示高密度液体（47-67 Hounsfield单位），与腹膜出血一致。随后的CT血管造影显示进行性出血，并确定输液器穿透前乙状结肠。使用的输液器长度不适合患者的解剖结构，这是导致并发症的主要因素。患者特有的因素进一步增加了肠损伤的风险，包括严重的粪便负荷导致的后珊瑚结肠炎，腹直肌组织极少，皮下和腹膜前脂肪薄，所有这些在CT成像上都很明显。患者在考虑合并症和虚弱状态的基础上进行了保守治疗，并完全康复。这个病例揭示了一个独特的和罕见的医源性损伤造成的皮下给药装置。仔细考虑解剖和患者的具体因素，以及适当的器械选择，对于预防此类并发症至关重要。

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引用次数: 0

Intralobar pulmonary sequestration with aberrant feeding artery aneurysm 伴有异常供血动脉瘤的肺瓣内隔离

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-05 DOI: 10.1016/j.radcr.2025.12.022

Xinyu Gao MD , Ning Ding MD , Jiezhong Hu MD , Zhengyu Jin MD , Daming Zhang MD

Pulmonary sequestration (PS) is a rare congenital lung malformation in which nonfunctioning lung tissue is supplied by systemic arteries without normal bronchial communication. Development of aneurysms within the aberrant feeding artery is exceedingly uncommon and associated with high risk of rupture. Computed tomography angiography (CTA) is the primary modality for diagnosis, offering precise assessment of anomalous systemic supply, venous drainage, and aneurysmal changes, particularly when complemented with 3-dimensional (3D) reconstruction techniques. We report the case of a 67-year-old male with a history of recurrent pneumonia and intermittent hemoptysis. Imaging revealed left lower lobe intralobar sequestration supplied by an aberrant artery originating from the aortic arch, complicated by a 3.0 cm saccular aneurysm. Advanced visualization with 3D printing and Global Illumination Rendering (GIR) provided detailed delineation of vascular anatomy and facilitated multidisciplinary surgical planning. The patient underwent successful endovascular treatment with coil embolization and covered stent placement. At 1.5 years follow-up, the aneurysm remained stable with complete thrombosis and no recurrence of symptoms. This case highlights the clinical importance of recognizing aneurysmal transformation in intralobar sequestration and demonstrates how advanced imaging tools can optimize preoperative planning. Endovascular management offers a minimally invasive and effective alternative to conventional surgical resection in selected patients.

肺隔离（PS）是一种罕见的先天性肺畸形，其中无功能的肺组织由全身动脉供应，没有正常的支气管通讯。动脉瘤在异常供血动脉内的发展是非常罕见的，并且与破裂的高风险相关。计算机断层血管造影（CTA）是诊断的主要方式，可以精确评估异常的全身供应，静脉引流和动脉瘤变化，特别是当与三维（3D）重建技术相结合时。我们报告的情况下，67岁的男性复发性肺炎和间歇性咯血的历史。影像学显示左下叶瓣内隔离由起源于主动脉弓的异常动脉供应，并发3.0厘米的囊状动脉瘤。先进的可视化与3D打印和全局照明渲染（GIR）提供血管解剖的详细描述和促进多学科的手术计划。患者接受了血管内线圈栓塞和覆盖支架置入术的成功治疗。在1.5年的随访中，动脉瘤保持稳定，完全血栓形成，无症状复发。本病例强调了在叶内隔离术中识别动脉瘤转化的临床重要性，并展示了先进的成像工具如何优化术前计划。血管内管理为特定患者提供了一种微创和有效的替代传统手术切除的方法。

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引用次数: 0

Rare spontaneous formation of a dentin bridge post-dental trauma: A cone beam computed tomography-based case report with root canal therapy 牙外伤后自发性牙本质桥的罕见形成：一个基于锥形束计算机断层扫描的根管治疗病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-05 DOI: 10.1016/j.radcr.2025.11.082

Moslem Rostami DDS, MSc , Hengameh Ashraf DDS, MSc , Yaser Safi DDS, MSc , Bita Heydarzadeh DDS

Spontaneous dentin bridge formation in mature teeth without pulp exposure or therapeutic intervention is an exceedingly rare phenomenon. This case report describes a 54-year-old male patient presenting with gray discoloration of the right maxillary central incisor (tooth #11) following dental trauma in 2019. Clinical examination indicated coronal pulp necrosis, while periapical radiography and cone-beam computed tomography (CBCT) confirmed internal resorption in the coronal pulp chamber with a thick, regular dentin bridge formed spontaneously beneath the resorbed area. The dentin bridge preserved the vitality of the apical pulp, as evidenced by a normal apical root canal. Treatment involved root canal therapy limited to the necrotic coronal pulp up to the dentin bridge, followed by internal bleaching to improve tooth color and esthetic restoration with composite resin. A 3-month follow-up radiograph showed treatment stability with no pathological changes. This case highlights the reparative potential of vital apical pulp in traumatized teeth and the critical role of cone-beam computed tomography (CBCT) in diagnosing such rare occurrences. However, the absence of histological confirmation and short follow-up duration limit conclusions on long-term stability.

成熟牙齿在不暴露牙髓或不进行治疗的情况下自发形成牙本质桥是非常罕见的现象。本病例报告描述了一名54岁男性患者，在2019年牙齿创伤后出现右侧上颌中切牙（第11颗牙）变灰。临床检查显示冠状牙髓坏死，而根尖周x线摄影和锥形束计算机断层扫描（CBCT）证实冠状牙髓室内部吸收，在吸收区下方自发形成厚而规则的牙本质桥。牙本质桥保留了根尖髓的活力，根尖根管正常。治疗包括根管治疗，仅限于坏死冠状牙髓直至牙本质桥，然后进行内部漂白以改善牙齿颜色并使用复合树脂进行美观修复。随访3个月的x线片显示治疗稳定，无病理改变。这个病例强调了重要的根尖髓在损伤牙齿中的修复潜力，以及锥形束计算机断层扫描（CBCT）在诊断这种罕见病例中的关键作用。然而，缺乏组织学证实和随访时间短限制了对长期稳定性的结论。

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引用次数: 0

The management of extensive juvenile nasopharyngeal angiofibroma involving the carotid artery: An illustrative case series and literature review original 涉及颈动脉的广泛的青少年鼻咽血管纤维瘤的处理：一个说导性的病例系列和文献回顾

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-04 DOI: 10.1016/j.radcr.2025.11.057

Baqer A. Aldhneen MD , Hussain J. Aljubran MD , Maria R. Alabdulaal MD , Norah A. Almoumen MD , Omar A. Alanzi MD , Abdulrahman G. Alharbi MD , Eman R. Alanazi MD , Ali Almomen MD

Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally invasive tumor arising most often in adolescent males. Although histologically benign, its aggressive growth pattern and tendency to infiltrate surrounding structures, especially near the skull base and internal carotid artery (ICA), make treatment particularly challenging. This series presents 3 illustrative cases of extensive JNA with ICA involvement, focusing on diagnostic imaging, surgical strategies, vascular management, and long-term outcomes. We report 3 cases of extensive JNA with ICA involvement in adolescent males. All patients underwent preoperative embolization followed by endoscopic resection; 2 experienced recurrences requiring adjuvant radiotherapy, while one remained recurrence-free after surgery alone. These cases highlight the surgical challenges posed by vascular involvement, particularly near the ICA, where careful planning, embolization, and use of endoscopic techniques are critical. Recurrence risk remains despite aggressive treatment, especially with complex extensions. Managing extensive JNA requires a multidisciplinary approach combining embolization, endoscopic surgery, and radiotherapy, when necessary, supported by long-term follow-up to monitor for recurrence.

青少年鼻咽血管纤维瘤（JNA）是一种良性但局部侵袭性的肿瘤，最常见于青少年男性。虽然在组织学上是良性的，但其侵袭性的生长模式和浸润周围结构的倾向，特别是在颅底和颈内动脉（ICA）附近，使得治疗特别具有挑战性。本系列报道3例广泛JNA伴ICA累及的病例，重点介绍诊断成像、手术策略、血管管理和长期结果。我们报告了3例青少年男性广泛的JNA伴ICA的病例。所有患者术前均行栓塞后内镜切除；2例复发需要辅助放疗，1例单独手术后无复发。这些病例强调了血管受累带来的手术挑战，特别是在ICA附近，在那里仔细规划，栓塞和使用内窥镜技术是至关重要的。尽管进行了积极的治疗，复发风险仍然存在，尤其是复杂的扩展。治疗广泛的JNA需要多学科的方法，包括栓塞、内窥镜手术和放疗，必要时辅以长期随访监测复发。

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引用次数: 0

Recurrent uterine adenofibroma revealed to be hyperparathyroidism–jaw tumor syndrome: Case report 复发性子宫腺纤维瘤表现为甲状旁腺功能亢进-下颌肿瘤综合征1例

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-04 DOI: 10.1016/j.radcr.2025.12.015

Go Nakai MD, PhD , Takashi Yamada MD, PhD , Tomohito Tanaka MD, PhD , Kazuhiro Yamamoto MD, PhD , Keigo Osuga MD, PhD

Uterine adenofibroma was previously classified as a benign mixed epithelial and mesenchymal tumor, but the WHO removed it from its fifth edition due to diagnostic overlap with low-grade adenosarcoma or benign polyps. We report a case of a 21-year-old woman with a recurrent uterine polypoid tumor initially diagnosed as adenofibroma on biopsy and resected multiple times. MRI revealed heterogeneous intrauterine masses with cystic changes, and PET-CT showed weak FDG uptake. Eventually, hysterectomy confirmed adenofibroma. She also had a prior diagnosis of primary hyperparathyroidism caused by parathyroid adenoma. Due to the early onset and recurrent uterine tumors, hyperparathyroidism–jaw tumor syndrome (HPT-JT) was suspected. Immunohistochemistry showed loss of parafibromin expression in the uterine tumor, supporting the diagnosis. This case highlights the importance of considering genetic syndromes such as HPT-JT in young patients with recurrent uterine tumors, enabling appropriate surveillance for associated neoplasms in the parathyroid, jaw, and kidneys.

子宫腺纤维瘤以前被归类为良性上皮和间质混合肿瘤，但由于与低级别腺肉瘤或良性息肉的诊断重叠，世界卫生组织将其从第五版中删除。我们报告一例21岁女性复发性子宫息肉样瘤，最初诊断为腺纤维瘤活检和多次切除。MRI显示异质性宫内肿块伴囊性改变，PET-CT显示弱FDG摄取。最终，子宫切除术证实为腺纤维瘤。她也曾被诊断为由甲状旁腺瘤引起的原发性甲状旁腺功能亢进。由于子宫肿瘤起病早且反复发作，怀疑为甲状旁腺功能亢进颌肿瘤综合征（HPT-JT）。免疫组化结果显示子宫肿瘤组织中parafibromin表达缺失，支持诊断。本病例强调了在年轻复发性子宫肿瘤患者中考虑遗传综合征（如HPT-JT）的重要性，以便对甲状旁腺、颌骨和肾脏的相关肿瘤进行适当的监测。

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引用次数: 0

Unicystic ameloblastoma of the maxillary anterior region: Clinical challenges and outcomes 上颌前区单囊性成釉细胞瘤：临床挑战和结果

Q4 Medicine

Radiology Case Reports

Pub Date : 2026-01-03 DOI: 10.1016/j.radcr.2025.12.018

Dr. Shanthi Viswanathan MDS

Unilocular radiolucencies involving teeth and adjacent structures represent a wide group of pathologies ranging from odontogenic, non-odontogenic to bone lesions. Ameloblastoma, one of the frequently encountered odontogenic tumors is notable for its diverse clinical and radiographic presentations across different age groups. Cystic ameloblastoma appears radiographically as either unilocular or multilocular radiolucency. When a unilocular radiolucent lesion occurs in the maxillary anterior region, clinicians often consider a common odontogenic cyst rather than the unicystic variant of ameloblastoma, given the rarity of the lesion in this location. Consequently, when a typical cystic appearance arises in an atypical clinical setting, it becomes essential to broaden the differential diagnosis to include both the common and uncommon entities. This distinction is critical, as the choice of treatment and prognosis can vary considerably depending on the underlying pathology.

涉及牙齿和邻近结构的单眼辐射率代表了从牙源性、非牙源性到骨病变的广泛病理组。成釉细胞瘤是一种常见的牙源性肿瘤，其临床表现和影像学表现在不同年龄组中表现各异。囊性成釉细胞瘤影像学表现为单室或多室透光度。当上颌前区出现单眼放射性病变时，鉴于该部位病变的罕见性，临床医生通常认为是常见的牙源性囊肿，而不是单囊性成釉细胞瘤。因此，当一个典型的囊性外观出现在一个非典型的临床环境中，就必须扩大鉴别诊断，包括常见和不常见的实体。这种区别是至关重要的，因为治疗和预后的选择可能因潜在病理而有很大差异。

引用次数: 0

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