Journal of the Belgian Society of Radiology最新文献

Teaching point: A longitudinal intramural fistula is a rare complication of diverticulitis that can be visualised by computed tomography (CT).

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor that can originate in various parenchymatous organs, soft tissue, and bone. Extrahepatic involvement is exceedingly rare. In this case, multifocal disease in the spleen and bone was present. Bone lesions showed a target appearance. Splenic lesions showed delayed enhancement of solid components with persistent rim enhancement. A bone biopsy with CAMTA1 staining confirmed the diagnosis. Teaching point: The presence of multifocal bone and splenic lesions can raise suspicion of EHE when other multifocal diseases are excluded.

The air crescent (AC) is a common radiological sign. Even if its commonest aetiology remains pulmonary aspergillosis, various other causes have been described. In this study, we report four rare causes of ACs seen on chest radiographs that haven't been described in the literature. Teaching point: The differential diagnosis of an air crescent sign on chest radiographs includes oesophageal bezoar, interstitial lung emphysema, central bronchial stenosis and perforated emphysematous cholecystitis.

Spinal cord sarcoidosis is a rare condition that can present as a longitudinally extensive transverse myelitis. Current imaging may suggest this pathology, but the final diagnosis relies on the histologic findings. Teaching point: Considering neurosarcoidosis in the differential diagnosis of longitudinally extensive transverse myelitis.

Teaching point: Prefemoral fat pad impingement syndrome is one of the fat pad impingements of the knee and can be assessed with ultrasonography.

Teaching point: Dendriform pulmonary ossifications (DPO) are a rare form of diffuse pulmonary ossifications, in which these ossifications are organised in dendrite-like lines in the periphery of the bases of the lung, most commonly attributed to underlying interstitial lung disease (ILD), but can also be found in patients with chronic aspiration if no other CT findings of ILD are present.

Teaching point: Twiddler's syndrome is a very rare but potentially disastrous complication after implantation of a neurostimulator or pacemaker, caused by twisting of the generator within the subcutaneous pocket, resulting in dislodgement and/or interruption of the electrodes that should be reported on x-ray.

Teaching points: A coronary artery fistula (CAF) is an uncommon anomaly characterized by a diverse clinical spectrum, ranging from asymptomatic cases to severe complications, including heart failure and myocardial infarction.

Coronary artery fistulas (CAFs) are abnormal communications of coronary arteries whereby venous circuits bypass the normal capillaries within the myocardium. Coronary artery-to-cardiac vein fistula is the third most common type of CAF, accounting for 7% of cases. Electrocardiographic-gated cardiac computed tomographic (CT) angiography has emerged as a noninvasive alternative method of choice for diagnosis due to its high spatial and temporal resolution and short acquisition time. Herein, we aimed to present a left anterior descending coronary artery opened into the greater cardiac vein at the distal level, consistent with a coronary artery-to-cardiac vein fistula in a 77-year-old woman. Teaching point: Coronary artery CT angiography provides a detailed evaluation of the complex anatomy of coronary artery fistula without the need for invasive methods.

Objectives: This study aimed to investigate ultrasound (US) features of thyroid nodules categorized as nondiagnostic (ND) and atypia of undetermined significance (AUS) according to the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) and their potential implications for clinical management.

Materials and methods: A retrospective study was conducted on patients who underwent thyroid nodules FNAC between 2019 and 2023. Nodules falling into the ND and AUS categories were analyzed for US features, nodule size, composition, echogenicity, shape, margin, echogenic foci, the distribution of the American College of Radiology's Thyroid Imaging Reporting and Data System (ACR TI-RADS) categories, and other parameters. The study included a total of 1,199 patients and 1,252 nodules (ND: 1110; AUS: 142).

Results: No significant differences in age, gender, nodule features, echogenicity, shape, margin, echogenic foci, TI-RADS scores, localization, number of nodules, or thyroid parenchymal disease presence were found between the ND and AUS categories (p > 0.05). Also, no statistically significant difference in nodule size (<10 mm vs. ≥10 mm) existed between the ND and AUS categories (p = 0.475). Both showed predominantly solid composition and hyperechoic/isoechoic echogenicity. High proportions of TI-RADS 4 nodules were observed in both groups, with 727 (65.5%) in ND and 95 (66.9%) in AUS.

Conclusion: This study found no statistically significant differences in US characteristics between the ND and AUS categories, indicating potential similarities in their radiological appearances. Also, no significant difference in nodule size (<10 mm and ≥10 mm) was observed between these categories. Clinical management should consider further investigations, including repeat FNAC, due to the diagnostic challenges and malignancy risk in both categories.