Imaging features

成像特征
  • 文章类型: Case Reports
    尤文肉瘤(ES)/外周原始神经外胚层肿瘤是一种高度侵袭性的恶性肿瘤,通常存在于骨骼和软组织中。肠道的原发性ES相对罕见,这对通过成像将其与其他原发性小肠肿瘤区分开来提出了挑战。本文详细介绍了起源于肠道的ES的案例研究。计算机断层扫描(CT)成像提示小肠间质瘤,因此,患者接受了小肠和网膜肿瘤切除术。病理结果证实诊断为小肠ES。手术后,病人接受了六个周期的化疗,随访的正电子发射断层扫描-CT显示该疾病广泛扩散并伴有腹膜内转移,最终导致患者死亡。
    Ewing sarcoma (ES)/peripheral primitive neuroectodermal tumor is a highly aggressive malignant tumor that typically presents in bone and soft tissue. Primary ES of the intestine is relatively rare, which poses a challenge in distinguishing it from other primary tumors of the small intestine through imaging. This article details a case study of ES originating in the intestine. Computed tomography (CT) imaging suggested a small intestinal stromal tumor, and so the patient underwent resection of the small bowel and omental tumor. Pathology results confirmed the diagnosis of ES of the small intestine. Following surgery, the patient underwent six cycles of chemotherapy, and a follow-up positron emission tomography-CT revealed widespread dissemination of the disease with intraperitoneal metastasis, ultimately resulting in the death of the patient.
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  • 文章类型: Case Reports
    背景:异位胸膜胸腺瘤和其他胸部肿瘤之间的影像学诊断复杂性很大,同时发生的T细胞淋巴细胞增多和骨转移的情况极为罕见。
    方法:一名51岁女性因呼吸困难和胸痛入院。影像学检查,她被发现左侧弥漫性和结节性胸膜增厚,左肺塌陷,第二胸椎受压。所有病灶18F-FDGPET/CT检查均显示明显的18F-FDG摄取。此外,她的外周血中有T细胞淋巴细胞增多,淋巴结,还有骨髓.排除恶性胸膜间皮瘤(MPM)后,肺癌胸膜转移,和T细胞淋巴瘤,明确诊断为异位胸膜胸腺瘤伴T细胞淋巴细胞增多和骨转移.
    结论:医师需要扩大对异位胸膜胸腺瘤影像学特征的认识。患有T细胞淋巴细胞增多症的病例可能表现出增加的侵袭性并易于发生骨转移。
    BACKGROUND: The diagnostic complexities that arise in radiographic distinction between ectopic pleural thymoma and other thoracic neoplasms are substantial, with instances of co-occurring T-cell lymphocytosis and osseous metastasis being exceedingly rare.
    METHODS: A 51-year-old woman was admitted to our hospital with dyspnea and chest pain. Upon imaging examination, she was found to have diffuse and nodular pleural thickening on the left side, collapse of the left lung and a compression in the second thoracic vertebrae. All lesions showed significant 18F-FDG uptake on 18F-FDG PET/CT examination. Furthermore, she exhibited T-cell lymphocytosis in her peripheral blood, lymph nodes, and bone marrow. After ruling out malignant pleural mesothelioma (MPM), lung cancer with pleural metastasis, and T-cell lymphoma, the definitive diagnosis asserted was ectopic pleural thymoma with T-cell lymphocytosis and bone metastasis.
    CONCLUSIONS: Physicians need to expand their knowledge of the imaging features of ectopic pleural thymoma. Cases with T-cell lymphocytosis may exhibit increased aggressiveness and prone to bone metastasis.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    Urachal肿瘤在临床实践中很少见,其中脐尿管腺癌最为常见。在这项研究中,我们报道了一例罕见的脐尿管血管周围上皮样细胞瘤,以提高我们对该疾病的认识。
    一名26岁男性患者因下腹痛住院。美国在膀胱上部显示出26mm×18mm的低回声肿块。MRI显示膀胱顶部前方有不规则肿块,在中线附近。肿瘤在T1WI上表现为低信号,在T2WI上表现为异质性高信号。此外,对比增强T1加权成像显示肿瘤明显的环形增强。患者接受了脐静脉肿瘤的手术切除,随后的病理检查显示诊断为脐尿管PEComa。手术后,患者接受定期随访评估,三年半后没有观察到复发或转移的证据。
    UrachalPEComa是一种罕见的间叶性肿瘤,通过影像学和临床症状对诊断提出了挑战。明确的诊断依赖于病理和免疫组织化学分析。由于脐带血PEComa的罕见,预后评估需要长期随访和评估更多病例。
    UNASSIGNED: Urachal tumors are rare in clinical practice, among which urachal adenocarcinoma is the most common. In this study, we report a rare case of urachal perivascular epithelioid cell tumor to improve our understanding of the disease.
    UNASSIGNED: A 26-year-old male patient was hospitalized for lower abdominal pain. The US showed a hypoechoic mass measuring 26mm × 18mm in the superior aspect of the bladder. MRI showed an irregular mass located anterior to the bladder roof, near the midline. The tumor exhibited hypointense on T1WI and heterogeneous hyperintense on T2WI. Additionally, contrast-enhanced T1-weighted imaging revealed obvious ring enhancement of the tumor. The patient underwent surgical resection of the urachal tumor, with subsequent pathological examination revealing a diagnosis of urachal PEComa. Following surgery, the patient underwent regular follow-up assessments, with no evidence of recurrence or metastasis observed after three and a half years.
    UNASSIGNED: Urachal PEComa is a rare mesenchymal tumor that presents challenges in diagnosis through imaging and clinical symptoms. Definitive diagnosis relies on pathological and immunohistochemical analysis. Due to the rarity of urachal PEComa, prognosis assessment necessitates long-term follow-up and evaluation of more cases.
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  • 文章类型: Journal Article
    ALK阳性组织细胞增生症是一种非常罕见的组织细胞肿瘤,主要累及神经系统,也可影响皮肤和身体其他部位。先前的相关文献提供了有关该疾病神经系统受累的影像学表现的有限信息。
    我们报告了一例ALK阳性组织细胞增生症并多系统受累。加上全面的文献综述,总结了本病在神经系统的影像学特点。
    一名3岁女孩因腹痛和下床困难在小儿神经内科就诊。根据脑脊液(CSF)中的蛋白质水平升高,最初的诊断是“伴有共济失调的急性小脑炎”。然而,尽管治疗了3个月,她的病情恶化。MRI显示椭圆形,T6-T7水平的髓外硬膜内结节。患者最终被诊断为ALK阳性组织细胞增生症,伴有马尾神经和皮肤受累。文献综述显示,共有23例患者受累于神经系统,并提供了影像学描述。连同我们的案子,成像特征总结如下:计算机断层扫描(CT)上的等密度或略高密度,T2加权成像(T2WI)上的等强度或等信号,在对比增强T1加权成像(T1WI)上,中度均匀增强,轻度/明显点状增强或/和平滑环形增强,扩散加权成像(DWI)的限制扩散,正电子发射断层扫描/计算机断层扫描(PET/CT)上的氟脱氧葡萄糖(FDG)摄取升高。
    ALK阳性组织细胞增生症的多模态影像学表现出明显的特征,熟悉这将提高放射科医师的专业知识,并促进这种疾病的准确诊断。
    UNASSIGNED: ALK-positive histiocytosis is an exceptionally rare neoplasm of histiocytes that predominantly involves the nervous system and can also affect the skin and other parts of the body. Previous relevant literature has provided limited information regarding the imaging manifestations of this disease with neurological involvement.
    UNASSIGNED: We reported a case of ALK-positive histiocytosis with multisystem involvement. Together with a comprehensive literature review, the imaging characteristics of this disease in the nervous system were summarized.
    UNASSIGNED: A 3-year-old girl with abdominal pain and ambulation difficulty checked in at the Department of Pediatric Neurology. The initial diagnosis was \"acute cerebellitis with ataxia\" based on the elevated protein level in the cerebrospinal fluid (CSF). However, despite 3 months of treatment, her condition deteriorated. MRI showed an oval-shaped, intradural extramedullary nodule at the T6-T7 level. The patient was ultimately diagnosed as ALK-positive histiocytosis, accompanied by cauda equina and skin involvement. The literature review showed a total of 23 patients who had involvement of the nervous system and provided imaging descriptions. Together with our case, the imaging features were summarized as follows: iso-dense or slightly hyperdense on computed tomography (CT), isointense or iso-hypointense on T2-weighted imaging (T2WI), moderate homogeneous enhancement with mildly/markedly punctate enhancement or/and smooth ring enhancement on contrast-enhanced T1-weighted imaging (T1WI), restricted diffusion on diffuse weighted imaging (DWI), and elevated fluorodeoxyglucose (FDG) uptake on positron-emission tomography/computed tomography (PET/CT).
    UNASSIGNED: The multimodal imaging findings of ALK-positive histiocytosis exhibit distinct characteristics, familiarity with which will enhance radiologists\' expertise and facilitate accurate diagnosis of this disease.
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  • 文章类型: Case Reports
    胆道腺纤维瘤(BAF)是一种罕见的良性肿瘤,但它有可能恶性转化。术前区分良性和恶性形式的BAF对于临床决策非常重要。我们报告一例BAF伴浸润性癌。该患者没有任何临床症状,但有超过20年的乙型肝炎病毒感染史。磁共振成像(MRI)显示,肝脏II段有4厘米的实性和囊性肿块,在T1加权图像上表现出低信号,在T2加权图像上表现出中至高强度信号。增强扫描显示动脉期有明显的边缘样增强,左肝间动脉作为肿瘤供血动脉,静脉和延迟阶段的冲洗。据我们所知,BAF伴浸润性癌并不常见。基于影像学特征的术前定性诊断可为患者实现最大获益。
    Biliary adenofibroma (BAF) is a rare benign tumor, but it has the potential for malignant transformation. The differentiation between benign and malignant forms of BAF before surgery is of great importance for clinical decision-making. We report a case of BAF with invasive carcinoma. The patient did not present any clinical symptoms but had a history of hepatitis B virus infection for more than twenty years. Magnetic resonance imaging (MRI) revealed a solid and cystic 4 cm mass in segment II of the liver exhibiting hypointense signals on T1-weighted images and intermediate-to-high intensity signals on T2-weighted images. Enhancement scanning revealed markedly rim-like enhancement on the arterial phase, with the left inter-hepatic artery as the tumor-feeding artery, and wash-out on the venous and delayed phases. To the best of our knowledge, BAF with invasive carcinoma is uncommon. Preoperative qualitative diagnosis based on imaging features can achieve the maximum benefit for patients.
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  • 文章类型: Case Reports
    背景:Elizabethkingiamiricola是一种非发酵革兰氏阴性细菌,它于2003年首次从俄罗斯和平空间站的冷凝液中分离出来。对这种细菌的大多数研究都是在实验室进行的,和临床案例研究是罕见的。迄今为止,全世界共报告了6例临床病例。
    方法:我们介绍了首例因MiricolaElizabethkingia引起的脑出血患者术后肺部感染。确定了肺部感染的影像学特征,并讨论了该患者临床治疗方案的制定和选择。
    结论:Elizabethkingiamiricola感染罕见。当发生肺部感染时,计算机断层扫描成像可以显示两个肺中毛玻璃密度阴影的扩散分布,局部区域的含空气的支气管标志,支气管血管束增厚,和胸腔积液.
    BACKGROUND: Elizabethkingia miricola is a non-fermenting gram-negative bacterium, which was first isolated from the condensate of the Russian peace space station in 2003. Most studies on this bacterium have been carried out in the laboratory, and clinical case studies are rare. To date, a total of 6 clinical cases have been reported worldwide.
    METHODS: We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola. The imaging characteristics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed.
    CONCLUSIONS: Elizabethkingia miricola infection is rare. When pulmonary infection occurs, computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs, the air containing bronchial sign in local areas, thickening of bronchial vascular bundle, and pleural effusion.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:尽管非结核性分枝杆菌肺病(NTM-PD)的发病率逐年增加,易误诊为肺结核(PTB)。本研究旨在筛选和鉴定NTM-PD与PTB的免疫学和放射学特征,并构建NTM-PD的鉴别诊断模型。为其鉴别诊断提供新的工具。
    方法:将2019年1月至2023年6月期间诊断为NTM-PD或PTB的住院患者纳入研究。比较两组的免疫学和放射学特征。根据选定的差分特征,使用逻辑回归算法构建NTM-PD的判别诊断模型,并对其诊断性能进行了初步分析。
    结果:NTM-PD患者的年龄明显大于PTB患者,NTM-PD组的结核特异性干扰素-γ释放试验(TB-IGRA)阳性率明显较低。此外,总T淋巴细胞的绝对计数,CD4+T淋巴细胞,CD8+T淋巴细胞,NK细胞,NTM-PD和PTB患者的B淋巴细胞明显低于健康对照组。此外,NTM-PD患者的B淋巴细胞绝对计数明显低于PTB组.放射学分析显示,NTM-PD和PTB患者在腔壁厚度方面存在显着差异,支气管扩张,肺巩固,肺结节大小,肺气肿,肺大疱,淋巴结钙化,胸腔积液,纵隔和肺门淋巴结病,和树在芽中的标志。支气管扩张被确定为NTM-PD的主要危险因素,而TB-IGRA阳性,淋巴结钙化,胸腔积液,纵隔和肺门淋巴结病是保护因素。基于此,我们构建了NTM-PD的判别诊断模型。其接收器工作特性曲线显示出良好的诊断性能,曲线下面积为0.938。在最大Youden指数0.746时,敏感性和特异性分别为0.835和0.911。
    结论:NTM-PD和PTB患者表现出体液和细胞免疫功能受损以及放射学特征的显着差异。构建的NTM-PD诊断模型表现出良好的诊断性能。本研究为NTM-PD的鉴别诊断提供了新的工具。
    BACKGROUND: Although the incidence of non-tuberculous mycobacterial pulmonary disease (NTM-PD) is increasing annually, it is easily misdiagnosed as pulmonary tuberculosis (PTB). This study aimed to screen and identify the immunological and radiological characteristics that differentiate NTM-PD from PTB and to construct a discriminatory diagnostic model for NTM-PD, providing new tools for its differential diagnosis.
    METHODS: Hospitalised patients diagnosed with NTM-PD or PTB between January 2019 and June 2023 were included in the study. Immunological and radiological characteristics were compared between the two groups. Based on the selected differential features, a logistic regression algorithm was used to construct a discriminatory diagnostic model for NTM-PD, and its diagnostic performance was preliminarily analysed.
    RESULTS: Patients with NTM-PD were significantly older than those with PTB and the tuberculosis-specific interferon-gamma release assay (TB-IGRA) positivity rate was significantly lower in the NTM-PD group. Moreover, the absolute counts of total T lymphocytes, CD4+ T lymphocytes, CD8+ T lymphocytes, NK cells, and B lymphocytes were significantly lower in patients with NTM-PD and PTB than in healthy controls. Additionally, patients with NTM-PD had a significantly lower absolute count of B lymphocytes than the PTB group. Radiological analysis revealed significant differences between patients with NTM-PD and PTB in terms of cavity wall thickness, bronchial dilation, lung consolidation, pulmonary nodule size, pulmonary emphysema, lung bullae, lymph node calcification, pleural effusion, mediastinal and hilar lymphadenopathy, and the tree-in-bud sign. Bronchial dilation was identified as the predominant risk factor of NTM-PD, whereas TB-IGRA positivity, lymph node calcification, pleural effusion, and mediastinal and hilar lymphadenopathies were protective factors. Based on this, we constructed a discriminatory diagnostic model for NTM-PD. Its receiver operating characteristic curve demonstrated good diagnostic performance, with an area under the curve of 0.938. At the maximum Youden index of 0.746, the sensitivity and specificity were 0.835 and 0.911, respectively.
    CONCLUSIONS: Patients with NTM-PD and PTB exhibited impaired humoral and cellular immune functions as well as significant differences in radiological features. The constructed NTM-PD diagnostic model demonstrated good diagnostic performance. This study provides a new tool for the differential diagnosis of NTM-PD.
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  • 文章类型: Case Reports
    尿毒症性肿瘤钙质沉着症(UTC)是血液透析治疗的罕见且严重的并发症。UTC中最重要的致病因素是钙磷产物的增加。我们在这里报告了一名因高血压肾病引起的肾衰竭而接受血液透析的患者,该患者在右肩出现多个UTC,左肘和手腕.手术切除后,他们都复发了,左肩有类似的UTC。通过观察整个病例期间各种影像学检查的影像学特征,包括X光片,计算机断层扫描(CT),磁共振成像(MRI),和单光子发射计算机断层扫描(SPECT),我们强调了成像对于评估UTC治疗方案状态的重要性,进一步加深对本病影像学表现及其临床意义的认识。
    Uremic tumoral calcinosis (UTC) is an uncommon and severe complication of hemodialysis therapy. The most important pathogenic factor involved in UTC is an increase in calcium-phosphorus products. We report here a patient undergoing hemodialysis for renal failure caused by hypertensive nephropathy who presented multiple UTCs in the right shoulder, left elbow and wrist. After surgical excision, they all recurred, with a similar UTC in the left shoulder. By observing the imaging features of various imaging examinations during the whole period of this case, including X-ray, computed tomography (CT), magnetic resonance imaging (MRI), and single-photon emission computed tomography (SPECT), we highlight the importance of imaging for evaluating the state of UTC regarding treatment options, further deepening our understanding of the imaging manifestations for this disease and their clinical significance.
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