Journal of the Belgian Society of Radiology最新文献

Teaching Point: Awareness in radiology reporting of cognitive errors such as the alliterative bias can help minimize the delay to diagnosis and accelerate adequate patient care.

Teaching Point: Computed tomography is the imaging modality of choice to detect the presence of gas within or around the pancreas in emphysematous pancreatitis.

Teaching Point: There are two important signs that could be seen on a non-contrast chest CT scan that can lead to the diagnosis of a pulmonary embolism: the hyperdense pulmonary artery sign and pulmonary infarction.

Objectives: We sought to assess whether there were any parameter(s) on baseline computed-tomography-perfusion (CTP) strongly correlating with final-infarct-volume, and infarct volume progression after endovascular recanalization of acute ischemic stroke (AIS) with primary distal, medium vessel occlusion (DMVO).

Materials and methods: We performed a retrospective analysis of consecutive AIS patients who were successfully recanalized by thrombectomy for DMVO. By comparing baseline CTP and follow-up MRI, we evaluated the correlation between baseline infarct and hypoperfusion volumes, and final infarct volume and infarct volume progression. We also examined their effect on good clinical outcome at 3 months (defined as an mRS score of 0 to 2).

Results: Between January 2018 and January 2021, 38 patients met the inclusion criteria (76% [29/38] female, median age 75 [66-86] years). Median final infarct volume and infarct volume progression were 8.4 mL [IQR: 5.2-44.4] and 7.2 mL [IQR: 4.3-29.1] respectively. TMax > 10 sec volume was strongly correlated with both (r = 0.831 and r = 0.771 respectively, p < 0.0001), as well as with good clinical outcome (-0.5, p = 0.001). A higher baseline TMax > 10 sec volume increased the probability of a higher final-infarct-volume (r² = 0.690, coefficient = 0.83 [0.64-1.00], p < 0.0001), whereas it decreased the probability of good clinical outcome at 3 months (odds ratio = -0.67 [-1.17 to -0.18], p = 0.008).

Conclusion: TMax > 10 sec volume on baseline CTP correlates strongly with final infarct volume as well as with clinical outcome after mechanical thrombectomy for an AIS with DMVO.

Management of hemoptysis begins with an angio-CT to identify the location, the bleeding vessel, mapping of systemic arteries and the cause of the hemoptysis. Endovascular treatment is the first-line therapy, in 90% of cases by embolization of the systemic arteries and in 10% of cases by occlusion of the pulmonary arteries.

Polymyositis (PM) is an uncommon inflammatory disease of unknown cause, but the disease shares many characteristics with autoimmune disorders. In the past, the diagnosis criteria for PM depended primarily on clinical features, blood enzyme levels, an electromyogram, and muscle biopsies. However, there are still imperfections in the diagnostic criteria of PM. The development of muscle imaging led to revisiting not only the PM diagnosis strategy but also the patients' follow-up. Teaching point: PM should be considered and included in the differential diagnosis of a patient with inflammatory signs and muscular pain, and the radiologist should be aware of its imaging features.

Gossypiboma is a rare post-surgical complication comprising a retained surgical gauze surrounded by a foreign body reaction. Although usually presenting on magnetic resonance imaging (MRI) with low T1 signal, high central and low peripheral signal on T2, and bandlike peripheral enhancement, MR appearance is often non-specific. The barium sulphate filament within a surgical gauze presents on MR as a curvilinear thread which is dark on both T1 and T2 sequences. Scrutinizing the MR images is critical to identify the filament and to pinpoint the diagnosis of gossypiboma. Teaching Point: A paraspinal mass on postoperative spine MRI should be carefully searched for a hypointense contorted wire (the barium sulfate filament), as it may be the characteristic finding to evocate the diagnosis of gossypiboma.

Proliferative myositis (PM) is a rare type of inflammatory myositis. It is a benign and self-limiting pathology, but its clinical presentation can simulate malignancy. This pictorial essay illustrates the typical imaging findings of PM on ultrasound (US) and magnetic resonance imaging (MRI) in three patients. Clinical history in all three patients revealed recent vaccination procedures.

Teaching Point: Pseudoangiomatous stromal hyperplasia (PASH) is a rare benign breast condition that can mimic the appearance of breast cancer on imaging studies.