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  • 1.

    【2hr】Bisystolic Vertebral Artery: Critical Finding or can be Ignored?

    包量

    机译 双收缩椎动脉：关键发现还是可以忽略？
    摘要：The carotid Doppler imaging findings in three adults presenting with vertigo, transient speech difficulty and for cardiac prebypass graft surgery revealing two systolic peaks in one of the vertebral arteries. In presteal situations, vertebral artery waveform shows two systolic peaks with sharp first and rounded second systolic peak or two systolic peaks with a deep cleft between the two peaks with antegrade flow. With increase in stenosis to more than 80% there is bidirectional flow and later flow reversal. We discuss the types of presteal vertebral artery waveforms, its clinical implications and brief review of literature.
  • 2.

    【2hr】Dilated Appendix: Is There More to It? Case Report and Brief Review of Literature with Radiologic-Pathological Correlation

    包量

    机译 附录附录：还有更多内容吗？病例报告和具有放射病理相关性的文献简介
    摘要：Mucocele of the appendix is rare and represents only the tip of the iceberg of underlying benign and malignant pathological processes. Intraoperative diagnosis is also tricky because the inflammation of the appendix often hides the tumor. The preoperative diagnosis is essential to differentiate appendiceal mucocele from acute appendicitis as the treatment varies from open surgical versus laparoscopic surgical approach and for decreasing intraoperative and postoperative morbidity and mortality rate. We present three cases of appendiceal mucocele. The purpose of this paper is to make the physicians aware of the entity, its associations and the effect on management. This review will provide radiologic and pathologic correlation for the preoperative diagnosis of benign and malignant causative processes and differential diagnostic considerations.
  • 3.

    【2hr】Optimal Ethanol-Ethiodol Emulsion Ratio in Renal Angiomyolipoma Embolization: A Question that Remains Unanswered

    包量

    机译 肾血管平滑肌脂肪瘤栓塞的最佳乙醇-埃塞多醇乳化比：一个尚无定论的问题
    摘要：The authors, a case series of five cases of angiomyolipomas (AMLs), embolized with a high ethanol:ethiodol ratio of 6:1 emulsion at a single tertiary center. Although ethanol as an embolic agent has been reported in the past for AMLs, much higher ratios of ethiodol were used, and administration is typically performed using an occlusion balloon. Two of the patients were incidentally diagnosed, while the other four were diagnosed after hematuria workup. Of the five patients, only one developed postembolization syndrome. Otherwise, no complications, recurrences, or reinterventions are reported. Our higher ratio seems to allow for adequate radio-opacity of the emulsion with minimal negative dilution effect.
  • 4.

    【2hr】Understanding Idiopathic Spinal Cord Herniation – A Comprehensive Review of Imaging and Literature

    包量

    机译 了解特发性脊髓疝–影像学和文献综述
    摘要：Idiopathic spinal cord herniation (ISCH) is displacement of spinal cord through a dural or arachnoidal defect. Most patients present with back pain or myelopathy, paresthesia, and sensory or motor weakness. Imaging findings include anterior displacement of the cord with possible kink, no filling defect on CT myelography, and no restricted diffusion/mass lesion on magnetic resonance imaging. Abrupt kink in the spinal cord or widened cerebrospinal fluid (CSF) space can be caused by a variety of reasons. The differential considerations include arachnoid web, intradural extramedullary epidermoid or arachnoid cyst, abscess or cystic schwannoma. We discuss the features, imaging, differentials, and treatment of ISCH as a rare cause of such kink in the cord. While reading such cases, a radiologist should include the location, segments involved, cord signal abnormality, visible defect, scalpel sign or C–sign, ventral cord kink, nuclear trail sign, the ventral CSF space preservation, or obliteration and the type.
  • 5.

    【2hr】Stroke-Like Migraine Attacks after Radiation Therapy Syndrome: Clinical and Imaging Characteristics

    包量

    机译 放射治疗综合征后的中风样偏头痛发作：临床和影像学特征
    摘要：Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare, reversible phenomenon that occurs several years after radiotherapy in patients treated for intracranial neoplastic lesions. Patients typically present with symptoms of headache, seizures, and other focal neurologic deficits concerning for stroke or disease recurrence. In this report, we describe SMART syndrome in a 70-year-old male who developed a persistent right temporal headache, right-sided neck pain, and new-onset seizures 12 years after surgical resection of a temporal anaplastic ependymoma followed by irradiation. We present this case to highlight typical disease presentation, imaging characteristics, and important differential radiologic considerations. Recognition of this delayed complication of brain tumor radiation is paramount given its self-limited course and favorable response to conservative therapy and to avoid misinterpreting imaging findings as tumor recurrence.
  • 6.

    【2hr】A Case of Ferumoxytol (Feraheme®) Prompting Critical Modification to Our Patient Prebreast Magnetic Resonance Imaging Questionnaire

    包量

    机译 一例Ferumoxytol（Feraheme®）提示对我们的患者乳房磁共振成像问卷进行关键性修改
    摘要：Apparent gadolinium-based contrast enhancement was seen on precontrast-enhanced images on two breast magnetic resonance imaging (MRI) for a patient done 1 week apart. This was caused by ferumoxytol, which is used to treat some anemias. Such nongadolinium-based therapeutics exhibiting unintended MRI contrast-like properties preclude assessment of enhancement kinetics in breast MRI significantly limiting diagnostic interpretation. This case prompted a group discussion and subsequent modification to the patient breast MRI safety screening questionnaire at our institution.
  • 7.

    【2hr】Malignant Rhabdoid Tumor of the Mediastinum: A Case Report and Literature Review

    包量

    机译 纵隔恶性横纹肌瘤：一例报道并文献复习
    摘要：Malignant rhabdoid tumor (MRT) of the mediastinum is an aggressive tumor that is extremely rare. To date, only 24 cases of the mediastinal MRT have been reported in adults and 9 cases in the pediatric age group under the age of 18 years. We report a rare case of such tumor and review the literature on its clinical and imaging features as well as its treatment and prognostic outcomes.
  • 8.

    【2hr】Rare Coexistence of a Cerebellar Hemangioblastoma and Angiomatosis of the Breast without Underlying Phakomatosis

    包量

    机译 小脑血管母细胞瘤和乳房血管瘤病的罕见共存而无基础性细胞瘤病
    摘要：Angiomatosis of the breast is an unusual benign vascular process which may affect middle aged women and simulate carcinoma. We report a unique case of a female patient with cerebellar hemangioblastoma and coexisting breast angiomatosis. We discuss the neuroradiology and breast imaging, illustrating the diagnostic pearls and pitfalls in the setting of this extremely uncommon combination. A 50-year old patient with a history of right-sided cerebellar hemangioblastoma resection 10 years previously presented with a recurrent left sided palpable breast mass. She was referred for triple breast assessment and subsequent ultrasound-guided biopsy. On physical examination, the lesion was hypoechoic, ill-defined and located in the upper outer quadrant as are most breast malignancies. Ultrasound and mammography showed suspicious features. The ipsilateral axilla was normal. Histopathology revealed a diagnosis of breast angiomatosis with no evidence of associated malignancy. Vascular tumors of the breast are very rare, present diagnostic challenges and are prone to local recurrence. Complete excision with clear margins is recommended. Mastectomy is a consideration for diffuse disease that cannot be fully cleared with lumpectomy or Wide local excision. Cerebellar hemangioblastoma and breast angiomatosis is a very unique combination, particularly in the absence of an underlying phacomatosis. Radiological features of angiomatosis mimicking malignancy without pathognomonic imaging signs have been observed. Knowledge of these rare vascular breast tumors is key to making this unusual diagnosis and helps to reduce the number of radical surgical procedures.
  • 9.

    【2hr】Not Every Fat-Containing Lesion on Mammogram is a Benign Finding: Case Report and Review of Breast Malignant Phyllodes Tumor with Heterologous Liposarcomatous Differentiation

    包量

    机译 乳房X光照片上并非每个含脂肪的病变都是良性发现：病例报告和具有异源性脂肉瘤性分化的乳腺恶性毛囊肿瘤的回顾
    摘要：Phyllodes tumors (PTs) are a rare fibroepithelial tumor of the breast. Histopathological confirmation of stromal and epithelial component is required for making the diagnosis of PT, and stromal component carries an increased risk of sarcomatous transformation. We present imaging findings of a histologically proven case of malignant PT with heterologous liposarcomatous transformation of the breast.
  • 10.

    【2hr】Pulmonary Kaposi Sarcoma without Mucocutaneous Involvement: The Role of Sequential Thallium and Gallium Scintigraphy

    包量

    机译 没有粘膜皮肤参与的肺卡波氏肉瘤：hall和镓闪烁显像的作用
    摘要：Kaposi sarcoma (KS) is a vascular-related tumor that has been associated with human immunodeficiency virus (HIV). It commonly involves the skin and lymph nodes, and infrequently involves the lungs. In very rare instances, pulmonary KS can be found in the absence of endobronchial and mucocutaneous involvement. Utilization of sequential thallium and gallium scintigraphy can aid in the diagnosis of pulmonary KS in the absence of mucocutaneous and endobronchial involvement. In this report, we discuss a case of a patient with acquired immunodeficiency syndrome who presented with dyspnea and cough and was found to have subtle pulmonary parenchymal nodular airspace opacities. He underwent negative infectious evaluation, including bronchoscopy. Despite the absence of mucocutaneous findings, sequential positive thallium and negative gallium scintigraphy led to an early diagnosis of pulmonary KS. Pulmonary KS in the absence of mucocutaneous involvement is a rare finding that is exceedingly difficult to diagnose. However, pulmonary KS should be considered in patients with HIV who present with respiratory symptoms even if the typical mucocutaneous manifestations of KS are absent. In such circumstances, sequential thallium and gallium scintigraphy can help differentiate pulmonary KS from other processes such as infections and lymphoma, and assist in establishing an earlier diagnosis.
  • 11.

    【2hr】Tram-line Calcifications in Granulomatosis with Polyangiitis

    包量

    机译 肉芽肿合并多血管炎的 Tram-line钙化
    摘要：Nephrocalcinosis consists of deposition of calcium in the renal parenchyma. Renal cortical calcification is a rare entity in comparison to calcium deposits in the medulla and is seen only in a handful of pathologies with corresponding characteristic patterns on imaging. Thin linear calcifications may get deposited in the peripheral renal cortex suggestive of cortical necrosis due to a vascular insult (vasculitis), and rarely due to glomerulonephritis. This pattern of calcification has also been referred to as the “tramline” or “railroad track” sign.
  • 12.

    【2hr】Phlebosclerotic Colitis – An Enigma Among Ischemic Colitis

    包量

    机译 静脉硬化性结肠炎–缺血性结肠炎之谜
    摘要：Phlebosclerotic Colitis is a rare, potentially life-threatening condition of unclear etio-pathogenesis seen almost exclusively in Asians and people of Asian descent. The condition predominantly affects the right hemicolon and imaging plays a crucial role in its diagnosis. Here we report the only second documented case of phlebosclerotic colitis in North America in a 60-year-old Canadian resident of Vietnamese descent with a history of consuming herbal medication (sanshishi) in soup for 2-3 decades.
  • 13.

    【2hr】Percutaneous Thrombin Injection for Treatment of a Hepatic Arterial Pseudoaneurysm after the Placement of a Transjugular Intrahepatic Portosystemic Shunt

    包量

    机译 经皮穿刺凝血酶注射液治疗经颈静脉肝内门体分流术后的肝动脉假性动脉瘤
    摘要：Transjugular intrahepatic portosystemic shunt (TIPS) is a widely accepted option for treating the complications of portal hypertension. The procedure involves creating a communication between the portal and hepatic venous systems using imaging guidance, thereby diverting the portal venous flow and reducing the portosystemic gradient. However, as with any procedure, TIPS insertion is not without potential complications. We present a case of a 37-year-old female who developed a hepatic artery pseudoaneurysm following the placement of a TIPS which was successfully treated with percutaneous thrombin injection.
  • 14.

    【2hr】Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

    包量

    机译 乳腺综合征计算机断层扫描成像：2例报告。
    摘要：Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.
  • 15.

    【2hr】Pneumocephalus as a Rare Presentation of Acute Sinusitis with Intracranial Extension – Two Cases and a Review of Literature

    包量

    机译 颅脑炎作为急性鼻窦炎伴颅内扩张的罕见表现-两例并文献复习
    摘要：Pneumocephalus is a rare presentation of sinusitis. The purpose of this case series and literature review is to highlight the critical importance of recognizing pneumocephalus on initial brain imaging, since it may serve as the first sign of acute sinusitis with intracranial complication. Although sinusitis is a treatable condition with appropriate and timely antibiotic therapy, failure to recognize intracranial extension and delays to prompt surgical drainage could lead to a dire clinical course.
  • 16.

    【2hr】Round Ligament Varicosity Thrombosis Presenting as an Irreducible Inguinal Mass in a Postpartum Woman

    包量

    机译 圆形韧带静脉曲张性血栓形成为产后妇女不可减少的腹股沟肿块
    摘要：Round ligament varicosities occur almost exclusively in pregnant and postpartum women and present similarly to inguinal hernias clinically, thus posing diagnostic challenges to clinicians. The distinction of the two conditions is important as round ligament varicosities do not require surgery while inguinal hernias do. Rarely, round ligament varicosites may be complicated by thrombosis or hemorrhage. In this case report, we present a rare case of round ligament varicosity (RLV) which has been complicated by thrombosis. The radiological features on ultrasound and contrast computed tomography of a thrombosed RLV are presented.
  • 17.

    【2hr】Ovarian Artery Embolization in a Case of Refractory Obstetric Hemorrhage

    包量

    机译 难治性产科出血一例卵巢动脉栓塞术
    • 作者：Vikash Jain
    • 刊名：Journal of Clinical Imaging Science
    • 2019年第-1期
    摘要：Transcatheteric pelvic artery embolization (PAE) has now become accepted treatment for obstetric hemorrhage providing us the opportunity to control bleeding and avoiding surgical morbidity, preserving uterus, and subsequent fertility. There is little we can offer to the patient if bleeding persists after obstetric hysterectomy and embolization of bilateral uterine and hypogastric arteries. Here in, we present a case of refractory post obstetric hysterectomy hemorrhage where uterine and internal iliac artery embolization failed to control the bleeding. Aortic angiogram showed active contrast extravasation from the ovarian artery, which was successfully embolized with good clinical outcome.
  • 18.

    【2hr】Ovotesticular Disorder of Sex Development: An Unusual Presentation

    包量

    机译 性发育的睾丸疾病：一种不寻常的表现
    摘要：Disorder of sex development is an inclusive term that refers to any problem where the genital organ is atypical in relation to chromosomes or gonads. Ovotesticular disorder of sex development, which is formerly known as “true hermaphroditism,” is the most rare form among all disorders of sex development in humans. It is characterized by the simultaneous presence of both ovarian and testicular tissues in the same individual and characteristically presents with ambiguous genitalia in neonates or infants. Herein, we present an unusual case of a 19-year-old individual with phenotypically nearly normal male genitalia who presented with the complaint of bilateral breast enlargement.
  • 19.

    【2hr】Pressure Recovery in the Left Main Stenosis

    包量

    机译 左主干狭窄中的压力恢复
    摘要：A 76-year-old male patient with dyspnea was referred on a suspicion of coronary artery disease. A coronary computed tomography angiography (CTA) revealed a distal left main (LM) stenosis and in the right (right coronary artery [RCA]), left circumflex (LCX) and left anterior descending (LAD) coronary arteries stenosis could not be excluded. CTA-derived fractional flow reserve (FFRct) was 0.75, 0.72, 0.74, 0.86, and 0.94 in the LM, LAD, LCX, ramus, and RCA, respectively. Invasive coronary angiography confirmed a stenosis in the LM and LAD. FFR was 0.73 and 0.85 in the LCX and ramus, respectively. The patient was referred for coronary artery bypass surgery. The FFR and FFRct values in the ramus demonstrate the phenomenon of pressure recovery. This case shows that preserved FFR and FFRct cannot always be used to exclude the hemodynamic significance of upstream coronary lesions.
  • 20.

    【2hr】Systemic Artery-to-Pulmonary Artery Fistula Mimics Pulmonary Embolus

    包量

    机译 系统性动脉-肺动脉瘘管模拟肺栓子
    摘要：Systemic artery-to-pulmonary artery fistula (SA-PAF) is a rare phenomenon that can resemble a filling defect on computed tomography angiography (CTA). SA-PAF can be due to congenital or acquired etiologies and can alter the hemodynamics of the pulmonary circulation, with the most serious reported complication being hemoptysis, requiring embolization. We describe a case of an unusual SA-PAF between the right inferior phrenic artery and the right lower lobe pulmonary artery that mimicked an unprovoked pulmonary embolus (PE) on standard CTA in a patient with cardiomyopathy. This SA-PAF was interpreted on CTA as PE due to the presence of a filling defect, revealing that not all filling defects are PE. SA-PAF should always be considered when the clinical context or the imaging findings are atypical, specifically with an isolated filling defect visualized in the inferior lower lobe pulmonary artery. The false-positive PE was the result of mixing of systemic non-opacified blood with opacified pulmonary arterial blood.
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