Journal of the Belgian Society of Radiology最新文献

Pulmonary carcinoid tumors are rare and may lead to severe paraneoplastic syndromes. A case is reported of an inoperable 78‑year‑old patient with ACTH‑dependent Cushing's syndrome successfully treated with microwave ablation. The procedure resulted in rapid clinical improvement without complications and radiological stability. Teaching point: The role of microwave ablation as a minimally invasive alternative for selected inoperable patients, offering an effective tumor control strategy with minimal morbidity.

Teaching point: Differentiating diaphyseal osteomyelitis and bone infarction in patients with sickle cell disease is challenging and requires meticulous correlation of imaging and clinical findings.

Purpose: To compare balloon-occluded retrograde transvenous obliteration (BRTO) using sodium tetradecyl sulfate and plug-assisted retrograde transvenous obliteration (PARTO), for treating symptomatic gastric varices. Materials and methods: A retrospective review of 51 consecutive patients (age: 63.7 ± 12.1 years; male: 72.6%) who underwent retrograde transvenous obliteration for gastric varices between June 2018 and July 2023 was conducted. Patients underwent BRTO (n = 26) or PARTO (n = 25) according to the preference of the attending interventional radiologist. The primary endpoint was complete obliteration. Secondary endpoints included technical and clinical success, post-embolization syndrome (PES), complications, and recurrent bleeding. Results: Technical success was achieved in 100% of BRTO group and 96% of PARTO group. Clinical success was achieved in all patients with technical success. One major complication in the PARTO group was due to shunt rupture during sheath passage, requiring fluid resuscitation and blood transfusion. In the BRTO group, there was a minor complication involving a balloon rupture, but the patient remained asymptomatic. PES was more frequent in the PARTO group (56%) compared to the BRTO group (23.1%) (p = 0.034). The median follow-up duration was 7 months. Complete obliteration rate was significantly higher in the BRTO group (100%) than in the PARTO group (80%) (p = 0.023). Recurrent bleeding occurred in one patient with remnant varix in the PARTO group. Conclusions: Both techniques achieved high technical and clinical success rates in the treatment of symptomatic gastric varices. However, BRTO demonstrated higher complete variceal obliteration and lower PES, suggesting a clinical advantage over PARTO.

Glenoid component migration is a serious complication in total shoulder arthroplasty, causing 32% of failures and 7% of revisions. Detecting polyethylene loosening is challenging due to its radiolucency. We report a case of a 72-year-old woman with shoulder pain three years post-arthroplasty. Initial radiographs were unremarkable, but CT-arthrography revealed a displaced polyethylene spacer, rotated 90°, thus causing a mechanical block. Retrospective analysis of the X-rays showed the absence of the spacer in the expected position. Surgery restored functionality. This case highlights the diagnostic challenges of radiotransparent components with possible migration in unexplained post-arthroplasty shoulder pain. Teaching point: Verify glenoid component positioning in shoulder arthroplasties.

A 73-year-old patient with a complex sacral fracture underwent stabilising orthopaedic surgery. Postoperative brain CT showed fat droplets in the subarachnoid space and lateral ventricle. These fat droplets migrated into the cerebrospinal fluid by a tear in the sacral thecal sac. Teaching point: Intracranial subarachnoid fat droplets may be observed after spinal surgery.

A 30-year-old male presented with pain and swelling in the left elbow. Multimodal radiologic evaluation revealed an expansile, lytic bone lesion with fluid-fluid levels and surrounding soft tissue edema, localized in the radial head. Histological examination confirmed the diagnosis of a solid variant of aneurysmal bone cyst (SVABC), an anatomically rare site for such lesions. The lesion was managed with curettage, leading to complete clinical resolution. Teaching point: integrating radiologic and histologic findings to an accurate diagnosis and effective management of SVABC, especially when occurring in atypical locations where they may mimic more aggressive neoplasms.

Teaching point: Cardiac computed tomography angiography is particularly valuable in patients with prosthetic valve infective endocarditis who have contraindications to transesophageal echocardiography (TOE), or when TOE is limited by heavy calcifications or the prosthetic valve, offering at least equivalent sensitivity for detecting abscesses and pseudoaneurysms.

Teaching point: To recognize cutis verticis gyrata on MRI and raise awareness of growth hormone therapy as a possible cause.

Teaching point: When hydatid disease in the brain is suspected, thoraco-abdominal imaging is warranted to detect extracranial lesions. When an uncomplicated intra-axial cyst is encountered, hydatid disease should be in differential diagnosis, especially in patients from or with travel history to endemic areas, or with known exposure to dogs, sheep or cattle. Thoraco-abdominal imaging may aid diagnosis as hydatid disease more commonly affects the liver and lungs and only rarely the brain.

Teaching point: Pneumomastia is a rare but benign mammographic finding most often related to recent instrumentation. Typically, it does not require further workup, although it may necessitate repeat imaging when the finding is extensive enough to obscure small lesions or microcalcifications.