CT, Computed Tomography

CT,计算机断层扫描
  • 文章类型: Journal Article
    未经证实:新生儿颞下颌关节(TMJ)结核是一种罕见的实体。未诊断/管理不善的结核病可以传播并危及患者的生命。目的是介绍一例新生儿TMJ结核性骨髓炎,随访11年。
    未经评估:一个半月大的男性新生儿在过去的20天里表现为左耳前方有强烈的肿胀。超声显示无血管,34*25*25mm的低回声病变。下位骨的不规则边缘可能提示侵蚀。抽吸显示脓液。脓液ZN染色显示结核分枝杆菌。排干脓液后,患者接受了抗结核治疗。他在10岁时因不对称而重访。虽然病人的肺结核治好了,研究结果诊断为髁突发育不全伴同侧冠状突增大。下颌骨的分散改善了面部对称性。
    未经证实:尽管脓液显示存在抗酸杆菌,这是不明显的,直到有一个显著的细菌负荷。诊断TMJ的结核性骨髓炎需要进行更高灵敏度的检查。必须使患者意识到TMJ结核性骨髓炎的可能后遗症,并需要适当的治疗。倾斜截骨的角度和牵引改善了下颌骨的水平和垂直分量,从而改善了对称性。据作者所知,以下是新生儿中第一例原发性TMJ结核,并进行了长期随访。
    UNASSIGNED: Tuberculosis of the Temporomandibular joint (TMJ) in a neonate is a rare entity. Undiagnosed/mismanaged tuberculosis can disseminate and be life-threatening to the patient. The purpose is to present a case of tubercular osteomyelitis of TMJ in a neonate with eleven years of follow-up.
    UNASSIGNED: A one-and-a-half-month-old male neonate presented with a firm swelling in front of the left ear for the past 20 days. Ultrasound presented an avascular, hypoechoic lesion of 34*25*25mm. Irregular margins of underlying bone could suggest erosion. Aspiration revealed pus. ZN staining of pus revealed Mycobacterium tuberculosis. After draining the pus, the patient underwent antitubercular therapy. He revisited at ten years of age with a complaint of asymmetry. Although the patient got cured of his tuberculosis, investigations rose to a diagnosis of condylar hypoplasia with ipsilateral coronoid enlargement. A distraction of the mandible improved facial symmetry.
    UNASSIGNED: Although pus revealed the presence of Acid-fast bacilli, it is not evident until there is a significant bacterial load. Escalation of tests with higher sensitivity is needed to diagnose tubercular osteomyelitis of TMJ. Patients must be made aware of possible sequelae of tubercular osteomyelitis of TMJ and need appropriate management. Oblique osteotomy at the angle and distraction improves both horizontal and vertical components of the mandible and thus improves symmetry. To the best of the author\'s knowledge, the following is the first case of primary tuberculosis of TMJ in a neonate and with such an extended follow-up.
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  • 文章类型: Case Reports
    未经批准:结核病(TB)仍然是发展中国家的常见疾病,其中中耳结核病是罕见的。此外,中耳结核的早期诊断和后续治疗相对困难.所以,有必要报告此案例以供参考和进一步讨论。
    未经评估:我们报告了1例耐多药结核性中耳炎。结核病中耳炎在结核病中很少见;耐多药结核病中耳炎更为罕见。本文分析了可能的原因,成像,分子生物学,病理学,耐多药结核性中耳炎的临床表现。
    未经证实:PCR和DNA分子生物学技术被推荐用于耐多药结核病性中耳炎的早期诊断。早期,有效的抗结核治疗是耐多药结核性中耳炎患者进一步康复的保证。
    UNASSIGNED: Tuberculosis (TB) continues to be a common disease in developing countries, among which middle ear TB is rare. Furthermore, it is relatively difficult to make an early diagnosis and provide follow-up treatment for middle ear TB. So, it is necessary to report this case for reference and further discussion.
    UNASSIGNED: We reported 1 case of multidrug-resistant tuberculosis otitis media. TB otitis media is rare in tuberculosis; multidrug-resistant TB otitis media is even more rare. Our paper analyzes the possible causes, imaging, molecular biology, pathology, and clinical manifestations of multidrug-resistant TB otitis media.
    UNASSIGNED: PCR and DNA molecular biology techniques are highly recommended for the early diagnosis of multidrug-resistant TB otitis media. Early, effective anti-tuberculosis treatment is the guarantee for further recovery for patients with multidrug-resistant TB otitis media.
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  • 文章类型: Case Reports
    由于下腔静脉的异常发育,腔后输尿管是一种罕见的先天性异常。我们的病例描述了一个8岁的男孩,他被称为肾盂成形术后肾盂输尿管连接部梗阻伴持续性肾积水的病例。逆行肾盂造影显示了腔静脉后输尿管的特征,并通过手术对输尿管进行了建设性修复。低临床发病率可能是由于许多无症状病例在患者的一生中没有被诊断出来。
    The retrocaval ureter is an uncommon congenital anomaly due to an abnormal development of the inferior vena cava. Our case describes an 8 year-old boy who was referred to our center as a case of ureteropelvic junction obstruction with persistent hydronephrosis after pyeloplasty. Retrograde pyelogram showed features of retrocaval ureter which was managed surgically with constructive repair of the ureter. The low clinical incidence may be due to a number of asymptomatic cases that are not diagnosed in the patient\'s lifetime.
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  • 文章类型: Case Reports
    输尿管坐骨疝(USH)是输尿管梗阻的相对罕见的原因。我们报告了一例由USH引起并通过输尿管支架置入术治疗的阻塞性尿脓毒症患者。一位83岁的妇女来到我们医院,出现了左腰背部疼痛和发烧的症状。增强计算机断层扫描显示左侧肾积水和输尿管突出穿过坐骨神经大孔。患者被诊断为USH,并接受了经尿道输尿管支架置入术。八个月后,移除输尿管支架.移除输尿管支架6个月后,USH没有复发。
    Ureterosciatic hernia (USH) is a relatively rare cause of ureteral obstruction. We report a case of a patient with obstructive urosepsis caused by USH and treated by ureteral stenting. An 83-year-old woman came to our hospital with symptoms of left lumbar back pain and fever. Enhanced computed tomography showed left hydronephrosis and ureteral protrusion through the greater foramen sciaticum. The patient was diagnosed with USH and underwent transurethral ureteral stenting. Eight months later, the ureteral stent was removed. There has been no recurrence of USH 6 months after removal of the ureteral stent.
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  • 文章类型: Case Reports
    曲霉感染性心内膜炎(IE)是培养阴性心内膜炎的罕见原因。主要危险因素是严重的免疫抑制和人工心脏瓣膜。我们描述了在低剂量皮质类固醇治疗中缓解的自身免疫性肝炎患者在天然二尖瓣上烟曲霉IE的情况。该病例是独一无二的,因为患者最初发生侵袭性真菌病的风险较低,其临床表现和急诊手术和抗真菌治疗的成功管理。经过文献回顾,我们没有发现类似的病例报告。患者由于眼内炎而出现右侧视力恶化。进行玻璃体切除术,并且烟曲霉在培养物中生长。用超声心动图证实了天然二尖瓣上的IE。患者入院后不久出现了急性心力衰竭的迹象,并被诊断出患有几例脓毒性栓子(肾,脾,脾拇指,右股总动脉)。他最初接受了手术瓣膜置换治疗,脂质体两性霉素B(LAmB)和伏立康唑的双重抗真菌治疗和玻璃体切除术,包括玻璃体内两性霉素B的应用。由于肝毒性,无法进行长期三唑治疗。患者在间歇性LAmB上维持12个月,并且在停止治疗后10个月没有复发迹象。曲霉菌可引起自身免疫性肝炎患者低剂量糖皮质激素的侵袭性感染。早期诊断后急诊手术瓣膜置换术和全身抗真菌治疗可改善预后。需要进一步的研究来评估曲霉菌IE后抗菌治疗的替代方法和持续时间。
    Aspergillus infectious endocarditis (IE) is a rare cause of culture-negative endocarditis. The main risk factors are severe immunosuppression and prosthetic heart valve. We describe a case of Aspergillus fumigatus IE on a native mitral valve in a patient with autoimmune hepatitis in remission while on low dose corticosteroids. The case is unique due to the patients\' low initial risk for invasive fungal disease, its clinical presentation and successful management with emergency surgery and antifungal therapy. After literature review we have not found a similar case report. The patient presented with right-sided eyesight deterioration due to endophthalmitis. Vitrectomy was performed and Aspergillus fumigatus grew on culture. IE on a native mitral valve was confirmed with echocardiography. The patient developed signs of acute heart failure soon after hospital admission and was diagnosed with several septic emboli (kidney, spleen, thumb, right common femoral artery). He was initially treated with surgical valve replacement, dual antifungal therapy with liposomal amphotericin B (LAmB) and voriconazole and vitrectomy, including intravitreal amphotericin B application. Long-term triazole therapy was not possible due to hepatotoxicity. The patient was maintained on intermittent LAmB for 12 months and is without signs of recurrence ten months after therapy was discontinued. Aspergillus can cause invasive infection in patients with autoimmune hepatitis on low dose corticosteroids. Early diagnosis followed by emergency surgical valve replacement and systemic antifungal therapy can improve prognosis. Additional studies are needed to evaluate alternative methods and duration of antimicrobial therapy following Aspergillus IE.
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  • 文章类型: Case Reports
    我们在此报告一例急性,由YakesIIb型肠系膜下动脉畸形引起的下消化道大出血,血管内栓塞治疗成功。Yakes动静脉畸形分类提供了基于特定血管结构的治愈性治疗策略,因此在治疗计划中可以作为有价值的指南。我们回顾了1988年至2022年报告的病例,并根据Yakes分类进行了血管结构分析。我们分析了这些报道的病例,以估计手术和栓塞的治疗成功率。
    We herein report a case of acute, massive lower gastrointestinal bleeding caused by Yakes type IIb inferior mesenteric arteriovenous malformation, which was successfully treated with endovascular embolization. The Yakes arteriovenous malformation classification provides curative treatment strategies based on specific angioarchitecture, thus serving as a valuable guide during treatment planning. We reviewed reported cases from 1988 to 2022 and conducted an angioarchitecture analysis based on the Yakes classification. We analyzed these reported cases to estimate the treatment success rates of surgery and embolization.
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  • 文章类型: Case Reports
    放射治疗是治疗许多胸部恶性肿瘤的标准,但它会导致长期的心血管后遗症,如瓣膜疾病。我们描述了一例罕见的严重主动脉和二尖瓣狭窄病例,这是由于先前的放射疗法成功通过经皮主动脉和标签外二尖瓣置换术治疗了巨细胞瘤。(难度等级:中级。).
    Radiation therapy is the standard of care for achieving cure for many thoracic malignancies, but it can result in long-term cardiovascular sequelae such as valve disease. We describe a rare case of severe aortic and mitral stenosis due to prior radiation therapy for giant cell tumor treated successfully with percutaneous aortic and off-label mitral valve replacements. (Level of Difficulty: Intermediate.).
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  • 文章类型: Case Reports
    一名74岁的男子被诊断出患有膀胱癌,并转诊到我们部门。为了明确诊断,经尿道膀胱肿瘤切除术(TURBT).病理结果为尿路上皮癌浆细胞样变异型。随后,机器人辅助根治性膀胱切除术,进行淋巴结清扫和回肠导管,但30天后新出现多发骨转移和主动脉周围淋巴结转移。开始使用吉西他滨和顺铂(GC),在四门课程之后,患者出现部分缓解(PR),并改用Avelumab作为维持治疗。维持治疗1年后,患者仍处于公关状态。
    A 74-year-old man was diagnosed with bladder cancer and referred to our department. For definitive diagnosis, transurethral resection of the bladder tumor(TURBT) was performed. The pathological result showed plasmacytoid variant of urothelial carcinoma. Subsequently, robot-assisted radical cystectomy, lymph node dissection and ileal conduit was performed, but multiple bone metastases and periaortic lymph node metastases newly appeared 30 days later. Gemcitabine and cisplatin (GC) was started, and after 4 courses, the patient became Partial Response (PR), and was switched to Avelumab as maintenance therapy. After about 1 year of maintenance therapy, the patient is still in PR.
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  • 文章类型: Case Reports
    心包囊肿是罕见的先天性异常,通常在临床上沉默,并在成像时偶然发现。然而,心包囊肿患者可能会出现胸痛,呼吸急促,and,很少,心脏压塞继发的症状。超声心动图(经胸或经食道)和胸部计算机断层扫描(CT)增强扫描是心包囊肿患者的首选诊断方式。保守治疗在无症状患者中是合理的,而有症状的患者建议采用手术方法。这里,我们描述了一例12岁男孩,他在2019年冠状病毒病(COVID-19)大流行期间接受了影像学检查,偶然发现患有心包囊肿.
    Pericardial cysts are rare congenital anomalies, often clinically silent and incidentally found on imaging. However, patients with pericardial cysts may present with chest pain, tachypnea, and, rarely, symptoms secondary to cardiac tamponade. Echocardiography (transthoracic or transesophageal) and chest computed tomography (CT) scan with contrast are diagnostic modalities of choice in patients with pericardial cysts. Conservative management is justified in asymptomatic patients, while a surgical approach is recommended in symptomatic patients. Here, we describe the case of a 12-year-old boy who underwent imaging during the coronavirus disease 2019 (COVID-19) pandemic and was incidentally found to have a pericardial cyst.
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  • 文章类型: Case Reports
    虽然在目前的文献中有很好的描述,当医生面对时,神经囊虫病[NCC]仍然是一个谜。这部分是由于中枢神经系统[CNS]上的寄生虫感染的偶然性。这些包括感染的单个或多个解剖部位,寄生虫病阶段,以及由此产生的炎症反应。因此,NCC可以呈现复杂的症状表现,使治疗方案高度个性化。尽管干预,由于感染的性质,治疗后可能会出现其他障碍。我们介绍了一个快速进展的症状性NCC的病例,最初成功治疗,然而,最终会屈服于脑室炎的并发症。
    Although well described in the current literature, Neurocysticercosis [NCC] remains an enigma when confronted by practitioners. This is in part due to the haphazard nature of the parasitic infection on the central nervous system [CNS]. These include single or multiple anatomic sites of infection, stage of parasitosis, and the resultant inflammatory response. As a result, NCC can present with a complex constellation of symptomatic presentations, making therapeutic regiments highly individualized. Despite intervention, other impediments may arise post-therapy due to the nature of the infection. We present a case of rapidly progressive symptomatic NCC that initially was successfully treated, however would eventually succumb to complications of ventriculitis.
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