Journal of the Belgian Society of Radiology最新文献

A 47-year-old male with an unremarkable medical history was referred for atypical endodontic pain and treatment of his left upper molars. Clinical and radiographic examinations revealed an extensive, undefined osteolytic area around these teeth. A subsequent bone biopsy diagnosed diffuse large B-cell lymphoma, a high-grade non-Hodgkin's lymphoma. The hematology team prescribed six cycles of chemotherapy, supplemented by two cycles of methotrexate. Practitioners should be alerted by atypical tooth pain to consider 3D imaging to exclude malignant pathology as early as possible. Teaching point: An atypical tooth pain should alert the practitioner and guide them towards 3D imaging to eliminate diagnostic of malignant pathology as early as possible.

Teaching point: Persistent hypoglossal artery is an extremely rare anatomical variant but has diagnostic and therapeutic relevance.

Teaching point: Some genetic syndromes have characteristic features that allow for their diagnosis to be made based on radiological findings.

Silicone gel-filled breast implants are widely used for breast augmentation and reconstruction after mastectomy. However, there are some known complications associated with silicone implants: Leakage and migration of silicone particles from the implant cause a granulomatous reaction. Granulomas may present as masses with features of malignancy on breast MRI. We present a case of a giant breast siliconoma in a woman who had undergone reconstruction with breast prostheses, which were surgically removed because of rupture 8 years ago. Teaching point: Despite increasingly efficient diagnostic tools, siliconoma diagnosis remains challenging.

Teaching point: Aortoenteric fistula, a major complication of aortic surgery, can be identified with certainty on CT scan with opacification of the intestinal tract.

Teaching point: A ruptured aorto-iliac aneurysm, complicated by an iliac arteriovenous fistula, is rare but has a possibly fatal outcome and requires prompt diagnosis and appropriate treatment.

Teaching point: Meningovascular neurosyphilis is a cause of stroke in the young, and the diagnosis could be aided by black-blood MRI sequences.

Objectives: It is clinically relevant to prevent overtreatment of tendinopathy diagnosed solely on imaging. Therefore, the prevalence of presumable asymptomatic signal changes in the common flexor origin, biceps insertion, brachialis insertion, and triceps insertion were assessed.

Materials and methods: Two hundred and five magnetic resonance imaging (MRI) exams of the elbow with coronal and axial fat-saturated fluid-sensitive sequences between January 1, 2018 and July 31, 2022 were retrospectively identified in our center.Two radiology residents reviewed the exams independently. The elbow tendons were given a score from 0 to 4. Score 0: no signal abnormality; score 1: increased T2-weighted signal around the tendon; score 2: increased T2-weighted signal compared to muscle within the tendon; score 3: partial tear; and score 4: complete tear.

Results: The common flexor tendon showed signal alterations in 8% of patients; nine patients had an increased signal around the tendon, and eight patients had an increased signal within the tendon. Three patients (1.5%) had an altered signal intensity in the biceps tendon. All triceps tendons showed a linear hyperintense signal, suggesting that it is physiological. There were no partial or complete tears. No signal abnormalities were noted in the brachialis tendon among all patients.

Conclusion: The prevalence of presumable asymptomatic signal alterations seen in the common flexor origin on MRI is not negligible; therefore, clinical correlation is advised to prevent overtreatment of tendinopathy in these cases. No partial or complete tears were seen.

Teaching point: To emphasize the importance of recognizing mirror image artifacts in musculoskeletal ultrasound to avoid misdiagnosis, unnecessary interventions, and additional diagnostic procedures that can lead to patient anxiety, increased healthcare costs, and potential harm.