Journal of the Belgian Society of Radiology最新文献

Teaching point: Anticoagulation is advised in thrombosed portal vein aneurysm (PVA) without portal hypertension.

Purpose: To determine the prevalence of incidentally detected bladder cancers (BCs) on multiparametric magnetic resonance imaging (mpMRI) of the prostate and to highlight the clinical importance of scoring them according to the Vesical Imaging-Reporting and Data System (VI-RADS).

Materials and methods: VI-RADS scores for incidental bladder lesions on mpMRI of the prostate were collected in 1693 patients with elevated prostate-specific antigen but no hematuria. The study included 19 patients with 28 incidental bladder lesions.

Results: During this period, 39 incidental bladder lesions were found in 30 patients, representing 1.7% of cases. Of the 28 lesions, 11 were categorized by VI-RADS as VI-RADS 1, 14 as VI-RADS 2, 1 as VI-RADS 3, 1 as VI-RADS 4, and 1 as VI-RADS 5. Histopathological examination revealed 1 benign lesion, 24 non-muscle invasive BCs, and 3 muscle-invasive BCs in the 19 patients. Impressively, 97% of the incidental lesions detected by prostate mpMRI and categorized by VI-RADS were BCs without apparent prostate cancer invasion. Notably, 93% of these lesions were consistent with histopathological findings of muscle invasion and extravesical spread.

Conclusion: Our study concludes the prevalence 1% incidental BC in prostate mpMRI. The research underscores a thorough bladder examination during prostate MRI scans. Utilizing mpMRI assists in distinguishing varying BC stages, aiding treatment decisions, and patient outcomes. VI-RADS categorization aligns with histopathological results, enhancing diagnosis, and healthcare communication. Early detection significantly influences patient care by enabling timely interventions and suitable treatment strategies, particularly for low-stage BCs linked to reduced progression and recurrence rates.

Teaching Point: In patients coming from countries with a high prevalence of tuberculosis and presenting with chronic infectious disease, tuberculosis with pulmonary and/or extrapulmonary involvement should be included in the differential diagnosis.

Renal failure is relatively common in children presenting to the emergency department, suggesting that the assumption of normal renal function is not always valid. Although some computed tomography (CT) scans necessitate the use of intravenous contrast, one should probably consider whether a blood test is necessary to assess the patient's renal function and possibly consider other imaging modalities before proceeding. With no pediatric-specific guidelines and no validated pediatric prevention strategies, further research is needed to establish clear recommendations for contrast-enhanced exams in stable and unstable pediatric patients with unknown renal function.

In this case report, we present a 23-year-old patient with complaints of a recurrent plop sound in the left ear. Non-contrast CT and MR imaging revealed an enlargement of the tympanic segment of the facial canal due to venous congestion. A persistent stapedial artery (PSA) and absent foramen spinosum were identified as concomitant factors. This unique combination of anomalies has not been previously reported and knowledge about this condition is essential to avoid unnecessary surgery.

Teaching point: A persistent stapedial artery may be associated with enlargement of the tympanic facial nerve canal due to venous congestion.

Teaching Point: A complete annular pancreas, a rare congenital anomaly, can lead to duodenal obstruction, causing recurrent symptoms like vomiting and often requiring surgical intervention for relief.

Teaching point: Myopericytoma is a rare soft tissue tumor but should be considered in the differential diagnosis of infants with a fast-growing perivascular tumor.

Objectives: The aim of this retrospective study was to evaluate the added value of pre-procedural computed tomography angiography (CTA) prior to bronchial artery embolization for patients presenting with hemoptysis.

Materials and methods: In this retrospective study, we evaluated patients admitted for hemoptysis from 2010 to 2021 and treated by catheter-directed embolization. After establishing quality criteria for pre-procedural computed tomography (CT), patients were divided into two groups depending on their pre-procedural imaging assessment: Quality CT-angiography (QCTA group) and suboptimal pre-procedural imaging (suboptimal CTA, unenhanced or no CT evaluation; control group). Groups were compared based on radiological success, procedure-related complications, and clinical success, including cessation of hemoptysis, recurrence rates, and overall mortality.

Results: We included 31 patients in the QCTA group, and 35 in the control group. Clinical success was n = 24/31 (77.4%) in the QCTA group and n = 27/35 (77.1%) in the control group (p = 0.979). Technical success was n = 37/42 (88.1%) in the QCTA group and n = 39/42 (92.86%) in the control group (p = 0.820). Overall recurrence was 10.6%. Minor complications occurred in 27.3%, and one major complication was reported.The concordance between the affected bleeding lung and the identification of pathological arteries during angiography was better in the QCTA group (p = 0.045).The average number of culprit arteries (bronchial, non-bronchial systemic arteries [NBSA] or pulmonary) in the QCTA group was not significantly higher than that in the control group.

Conclusions: Preprocedural QCTA better identifies the affected bleeding lung and bleeding vessels compared to direct angiography. No difference in clinical success, complications, recurrence rates, or mortality was observed.