Tomography

体层摄影术
  • 文章类型: Case Reports
    冠状突增生是一种罕见的改变,其特征是所述过程在数月或数年的时间内发生了夸张和渐进的发展。在高度和体积上,这最终会导致下颌缺乏症。重要的是强调成像对于正确诊断和治疗所述实体的重要性。考虑到可能发生的各种鉴别诊断。在这个意义上,传统的射线照片构成了接近诊断的基本和不可缺少的工具。然而,它实际上是CT扫描提供了最大的精度。介绍了一名14岁男性患者的病例,没有贡献的病史,他因从小就提出渐进式开放限制而被推荐,为此,经过临床和影像学评估,他接受了双侧冠状动脉全切除术,术后随访.可以观察到该实体复发的一年。这个病例证明了正确诊断的重要性,以及病人进行的术后控制和康复计划。
    Hyperplasia of the coronoid process is a rare alteration that is characterized by the exaggerated and progressive development of said process over periods of months or years, both in height and volume, which finally causes mandibular hypomobility. It is important to highlight the importance of imaging for the correct diagnosis and treatment of said entity, taking into consideration the great variety of differential diagnoses that can occur. In this sense, conventional radiographs constitute a basic and indispensable tool for approaching the diagnosis. However, it is actually the CT scan that offers the greatest precision. The case of a 14-year-old male patient is presented, with no contributing medical history, who was referred for presenting progressive opening limitation since childhood, for which, after clinical and imaging evaluation, he was treated with total bilateral coronoidectomy, postoperative follow-up was performed. for a year in which recurrence of said entity could be observed. This case demonstrates the importance of correct diagnosis, as well as postoperative control and the rehabilitation scheme carried out by the patient.
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  • 文章类型: Case Reports
    肾上腺外骨髓脂肪瘤(EAM)是一种罕见的良性肿瘤,由成熟的脂肪和造血组织组成。其病因仍有待阐明,很少有病例报道描述中枢神经系统EAM的临床特征和治疗。本研究介绍了我们在右额叶区域EAM病例的临床管理中的经验和实践。在头部计算机断层扫描(CT)上发现一名56岁的妇女患有占位性右额叶病变。未增强的磁共振成像(MRI)显示约1.5x1.2cm的病变。全腹增强CT显示右侧骶前肿块,直径2.0厘米,有明显的利润。术后组织病理学发现主要为成熟脂肪组织混合髓外造血成分。这证实了(骨)骨髓脂肪瘤的诊断。中枢神经系统髓质脂肪瘤极为罕见。据作者所知,只有两例颅内髓脂肪瘤被报道,本研究介绍了第一例以英语报道的中国患者。然而,当CT显示高密度和MRI显示混合密度在肿瘤区域,即使没有增强,在鉴别诊断中应考虑髓脂肪瘤的可能性。
    Extra-adrenal myelolipoma (EAM) is a rare benign tumor composed of mature adipose and hematopoietic tissues. Its etiology remains to be elucidated and there are few case reports describing the clinical features and treatment of EAMs in the central nervous system. The present study presented our experience and practice in the clinical management of a case of EAM in the right frontal region. A 56-year-old woman was found to have a space-occupying right frontal lesion on computed tomography (CT) of the head. Unenhanced magnetic resonance imaging (MRI) showed a lesion of ~1.5x1.2 cm. Enhanced whole abdominal CT showed a right presacral mass, 2.0 cm in diameter, with clear margins. The postoperative histopathological findings showed mainly mature adipose tissue mixed with extramedullary hematopoietic components. This confirmed the diagnosis of a (bone) marrow lipoma. Myelolipoma of the central nervous system is extremely rare. to the best of the authors\' knowledge, only two cases of intracranial myelolipoma have been reported, and the present study introduced the first case in a Chinese patient reported in English. However, when CT shows high density and MRI shows mixed density in the tumor area even without enhancement, the possibility of myelolipoma should be considered in the differential diagnosis.
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  • 文章类型: Case Reports
    影像学上结节性软组织胸膜增厚高度考虑恶性肿瘤,其中胸膜恶性间皮瘤和转移性疾病有区别。我们介绍了一名71岁男性的病例,该患者在胸膜穿刺术后反复出现左胸腔积液,导致呼吸急促急性恶化。他是前吸烟者,以前曾接触过石棉。进行的计算机断层扫描显示,半胸腔和半膈的左侧胸膜增厚,伴有复杂的胸腔积液。18F-2-脱氧-d-葡萄糖全身PET扫描显示,在多个胸膜肿块中,左半胸广泛摄取。影像学表现及临床病例均为典型的恶性间皮瘤。然而,病理结果提示小细胞肺癌。我们需要认识到常见疾病实体的这种非典型表现。即使所有临床和影像学发现都指向某种诊断,组织病理学评估不容忽视。
    Nodular soft tissue pleural thickening on imaging is highly suggestive of malignancy, of which pleural malignant mesothelioma and metastatic disease are differentials. We present the case of a 71-year-old male who presented with acute worsening of shortness of breath associated with a recurrent left pleural effusion post-pleurocentesis. He was an ex-smoker with previous asbestos exposure. Computed tomography performed demonstrated left-sided pleural thickening in the hemithorax and hemidiaphragm with complex pleural effusion. 18F-2-deoxy-d-glucose whole body PET scan revealed extensive uptake throughout the left hemithorax in multiple pleural masses. The imaging findings and clinical case were typical of malignant mesothelioma. However, histopathology results revealed small cell lung cancer. We need to be cognisant of this atypical presentation of a common disease entity. Even when all clinical and imaging findings point towards a certain diagnosis, histopathological assessment cannot be ignored.
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  • 文章类型: Case Reports
    目的:提高对可以通过断层成像模拟角膜扩张的情况的认识,并描述避免误诊所需的措施。
    方法:我们报告了一个回顾性病例系列,其中7例患者在以色列的两个三级护理中心就诊,假定诊断为圆锥角膜或屈光后扩张。经进一步检查,扩张症的诊断被重新考虑并最终排除.
    结果:包括7例患者的10只眼。病例包括双侧弥漫性Salzmann结节变性,斜视眼肌麻痹,在获取断层扫描图像时无法正确固定,Pentacam参数设置不正确的两种情况,一只眼睛有远视激光辅助原位角膜磨镶术(LASIK)治疗史,而另一只眼睛有近视LASIK治疗史,一例旧的屈光性角膜切除术(PRK)后基质雾霾,和一名后部多形性角膜营养不良患者。
    结论:模拟角膜扩张的断层摄影模式可出现在无扩张病理的患者中。综合眼科医生应该意识到这种情况,因为它们可能会实质性地改变这些患者的治疗过程和预后。
    OBJECTIVE: To raise awareness of conditions that can tomographically mimic corneal ectasia and describe the actions required to avoid misdiagnosis.
    METHODS: We report a retrospective case series of seven patients presenting at two tertiary care centers in Israel with a presumed diagnosis of keratoconus or post-refractive ectasia. Upon further examination, the ectasia diagnosis was reconsidered and eventually ruled out.
    RESULTS: Included were ten eyes of seven patients. Cases included bilateral diffuse Salzmann\'s nodular degeneration, ophthalmoplegia with strabismus which precluded proper fixation during the acquisition of tomography images, two cases of incorrect Pentacam parameter settings, a patient with a history of hyperopic laser-assisted in situ keratomileusis (LASIK) treatment in one eye and myopic LASIK in the fellow eye, a case of old post-photorefractive keratectomy (PRK) stromal haze, and a patient with posterior polymorphous corneal dystrophy.
    CONCLUSIONS: Tomography patterns mimicking corneal ectasia can appear in patients without ectatic pathology. The comprehensive ophthalmologist should be aware of such cases as they may substantially alter the treatment course and prognosis of these patients.
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  • 文章类型: Case Reports
    肝的同步存在,脾,据我们所知,以前在英语文献中没有报道过骨骼血管瘤。在这个案例报告中,我们提出了一个肝脏共存的案例,脾,一名30岁女性的骨骼血管瘤,双侧腰部上下疼痛,无明显既往病史。放射学调查,包括超声和计算机断层扫描和磁共振成像有助于确定肝脏的同步存在,脾,和骨骼血管瘤.患者通过保守管理得到改善,并继续随访。尽管文献中有脾和肝血管瘤共存的报道,根据我们的知识,这是肝脏同步存在的第一份报告,脾,和骨骼血管瘤.
    Synchronous existence of hepatic, splenic, and skeletal hemangiomas has not been reported previously in the English literature to our knowledge. In this case report, we present a case of coexistence of hepatic, splenic, and skeletal hemangiomas in a 30-year-old woman with on and off bilateral lumbar region pain and no significant past medical history. Radiological investigations, including ultrasound and computed tomography and magnetic resonance imaging helped identify the synchronous existence of hepatic, splenic, and skeletal hemangiomas. The patient improved with conservative management and was kept on follow-ups. Although there have been reports of coexistence of splenic and hepatic hemangiomas in the literature, to our knowledge, this is the first report of synchronous existence of hepatic, splenic, and skeletal hemangiomas.
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  • 文章类型: Journal Article
    这次回顾,单中心,病例对照研究评估了计算机断层扫描(CT)引导下微波消融(MWA)治疗右中叶(RML)肺结节的安全性和有效性,一个具有挑战性的位置与高频率的并发症。
    在2020年5月至2022年4月期间,71例RML肺结节患者接受了71次MWA治疗。为了比较,使用倾向评分匹配选择了142例非RML中142例肺结节的患者。技术上的成功,技术功效,并发症,并对相关因素进行分析。还记录了手术时间和消融后住院时间。
    100%的患者获得了技术成功。RML组和非RML组之间的技术有效率没有显着差异(97.2%vs.95.1%,p=0.721)。然而,两者都是主要的(47.9%与19.7%,p<0.001)和次要(26.8%与11.3%,p=0.004)气胸在RML组比非RML组更常见。RML肺结节的MWA被确定为气胸的独立危险因素(p<0.001)。手术持续时间(51.7分钟vs.35.3分钟,p<0.001)和消融后住院时间(4.7天vs.2.8天,p<0.001)在RML组比非RML组更长。
    CT引导的MWA治疗RML肺结节的疗效与其他肺叶相当,但是气胸并发症的风险更高,需要更长的MWA手术时间和延长的住院时间。
    UNASSIGNED: This retrospective, single-center, case-control study evaluated the safety and efficacy of Computed tomography (CT)-guided microwave ablation (MWA) for pulmonary nodules located in the right middle lobe (RML), a challenging location associated with a high frequency of complications.
    UNASSIGNED: Between May 2020 and April 2022, 71 patients with 71 RML pulmonary nodules underwent 71 MWA sessions. To comparison, 142 patients with 142 pulmonary nodules in non-RML were selected using propensity score matching. The technical success, technique efficacy, complications, and associated factors were analyzed. The duration of the procedure and post-ablation hospital stay were also recorded.
    UNASSIGNED: Technical success was achieved in 100% of all patients. There were no significant differences in technique efficacy rates between the RML and non-RML groups (97.2% vs. 95.1%, p = 0.721). However, both major (47.9% vs. 19.7%, p < 0.001) and minor (26.8% vs. 11.3%, p = 0.004) pneumothorax were more common in the RML group than non-RML group. MWA for RML pulmonary nodules was identified as an independent risk factor for pneumothorax (p < 0.001). The duration of procedures (51.7 min vs. 35.3 min, p < 0.001) and post-ablation hospital stays (4.7 days vs. 2.8 days, p < 0.001) were longer in the RML group than non-RML group.
    UNASSIGNED: CT-guided MWA for RML pulmonary nodules showed comparable efficacy compared with other lobes, but posed a higher risk of pneumothorax complications, necessitating longer MWA procedure times and extended hospital stays.
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  • 文章类型: Case Reports
    食管裂孔疝是人群中常见的病理;然而,最常见的食管裂孔疝是I型,发病率高达95%,II型,III,IV频率较低,占5%至15%,甚至更不常见的是巨大的疝气。文献中对巨大疝的定义仍然不准确;一些作者将巨大或巨大的食管裂孔疝定义为疝占据胃的30%以上和/或从其他腹部结构转移到胸部的疝。我们描述了对质子泵抑制剂无反应的胃肠道症状患者的情况,基础恶化需要影像学研究,显示从腹部器官(胃,脾,脾肠系膜脂肪),以及随着胰体和胰尾的上升胃和脾轴的改变,相当于巨大的食管裂孔疝.所说的病理很少见,复发和术后并发症。我们的病人从外科手术中康复,治疗成功。
    Hiatal hernia is a frequent pathology in the population; however, the most frequent hiatal hernia is type I, which accounts for up to 95% incidence, types II, III, and IV being less frequent and representing between 5% and 15%, and even less common are giant hernias. The definition of the giant hernia is still not exact in the literature; some authors define giant or massive hiatal hernia as one in which the hernia occupies more than 30% of the stomach and/or passes from other abdominal structures to the thorax. We describe the case of a patient with gastrointestinal symptomology without response to a proton pump inhibitor, with base exacerbation that required imaging studies, showing a large hernia defect passing to the thorax from abdominal organs (stomach, spleen, mesenteric fat), as well as alteration of the gastric and spleen axis with ascent in pancreatic body and tail, which corresponds to a giant hiatal hernia. Said pathology is very infrequent, with recurrences and postoperative complications. Our patient recovered from the surgical procedure with therapeutic success.
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  • 文章类型: Journal Article
    这项研究旨在检查模仿骨肿瘤并沿连续肋骨内缘形成的非典型胸膜病变的影像学特征和临床意义。这项回顾性分析包括在2021年4月至2023年3月期间接受胸部计算机断层扫描(CT)的13例患者引起的45例非典型胸膜病变。临床特征,CT检查结果,在病理鉴定之前检查放射学诊断。在手术切除的病例中回顾了病理发现。根据并发的典型胸膜斑块的存在进行亚组分析。患者的平均年龄为69.3±8.4岁,其中男性占主导地位(76.9%)。病变主要表现为单侧受累(84.6%),最常位于右中层后部区域。75.6%的病例出现钙化,通常沿肋骨连续看到(82.4%)。28.9%的病例观察到相邻肋骨的改变。这些病变经常被胸部放射科医生误诊为骨软骨瘤或骨刺(55.6%)。随访期间无显著增长(n=11,47±41个月),病理结果与胸膜斑块一致。同时有典型胸膜斑块的患者有更多的不典型胸膜病变,无统计学意义(P=0.071),并且表现出更均匀的分布(P=0.039)。总之,沿着连续肋骨的类似骨肿瘤的非典型胸膜病变代表了胸膜斑块的不同子集。放射科医师应认识到其独特的分布和形态,以避免误解和不必要的干预。
    This study aimed to examine the imaging characteristics and clinical implications of atypical pleural lesions that mimic bone tumors and form along the inner margins of consecutive ribs. This retrospective analysis included 45 atypical pleural lesions arising from 13 patients who underwent chest computed tomography (CT) between April 2021 and March 2023. The clinical features, CT findings, and radiologic diagnoses prior to pathologic identification were examined. Pathological findings were reviewed in the surgically resected case. Subgroup analysis was performed based on the presence of concurrent typical pleural plaques. The mean age of the patients was 69.3±8.4 years with a predominance of males (76.9%). The lesions primarily exhibited unilateral involvement (84.6%), being most frequently located in the right mid-level posterior region. Calcification was present in 75.6% of cases, typically seen continuously along the ribs (82.4%). Adjacent rib changes were observed in 28.9% of cases. These lesions were frequently misdiagnosed as osteochondromas or bony spurs (55.6%) by thoracic radiologists. No significant growth was observed during follow-up (n=11, 47±41 months), and the pathological findings were consistent with pleural plaques. Patients with concurrent typical pleural plaques had more atypical pleural lesions without statistical significance (P=0.071) and showed a more even distribution (P=0.039). In conclusion, atypical pleural lesions resembling bone tumors along consecutive ribs represent a distinct subset of pleural plaques. Their unique distribution and morphology should be recognized by radiologists to avoid misinterpretation and unnecessary interventions.
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  • 文章类型: Journal Article
    背景:由于缺乏相应的临床症状,小钙化胃胃肠道间质瘤(GIST)在临床实践中经常被忽视。因此,定义钙化微胃部GIST的成像特征以促进诊断的需要尚未满足.本研究回顾性分析了经病理证实的钙化微胃GIST的计算机断层扫描(CT)特征。
    方法:病历(胃镜检查,治疗前胃CT成像[造影前后扫描],病理)经内镜粘膜下剥离后经病理证实直径<1cm的钙化胃GIST患者,内镜粘膜下挖除,或内镜全层切除术进行回顾性分析.
    结果:7例患者有8个钙化胃GIST直径<1cm。六名患者有单个病变,1例患者有多个病灶。6例胃底有病变,1例患者的胃体有病变。病变的平均直径为5.2mm(范围,1.3mm~7mm)。未增强CT扫描显示3处粘膜下病变有斑点和高密度结节钙化,固有肌层的2个病变,和3个突出到胃外的浆膜下病变。在8个病灶中,只有两个人在钙化周围有坚实的软组织成分,这两个中的一个显示了固体软组织成分的对比后增强。
    结论:胃GIST的新型CT特征包括:常见于胃窦,小尺寸(直径<1厘米),钙化,很少有坚实的软组织成分,在大多数情况下没有异常增强。
    Due to the lack of corresponding clinical symptoms, small calcified gastric gastrointestinal stromal tumors (GISTs) are often overlooked in clinical practice. Therefore, there is an unmet need to define the imaging features of calcified micro-gastric GISTs to facilitate diagnosis. This study retrospectively analyzed the computed tomography (CT) features of pathologically confirmed calcified micro-gastric GISTs.
    The medical records (gastroscopy, pre-treatment gastric CT imaging [pre- and post-contrast scans], pathology) of patients with calcified gastric GISTs < 1 cm in diameter confirmed pathologically after endoscopic submucosal dissection, endoscopic submucosal excavation, or endoscopic full-thickness resection were retrospectively reviewed.
    Seven patients had 8 calcified gastric GISTs < 1 cm in diameter. Six patients hadsingle lesions, and 1patients had multiple lesions. Six patients had lesions in the gastric fundus, 1 patient had a lesion in the body of the stomach. Lesions had a mean diameter of 5.2 mm (range, 1.3 mm ~ 7 mm). Unenhanced CT scans showed spots and high-density nodular calcifications in 3 submucosal lesions, 2 lesions in the muscularis propria, and 3 subserosal lesions that protruded outside the stomach. Among the 8 lesions, only two had solid soft tissue components surrounding the calcification, with one of these two showing post contrast enhancement of the solid soft tissue component.
    Novel CT features of gastric GISTs included: commonly found in the gastric antrum, small size (< 1 cm in diameter), calcification, few solid soft tissue components, and no abnormal enhancement in most cases.
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  • 文章类型: Case Reports
    环硅酸锆钠(SZC)通常用于治疗高钾血症,因为它可以隔离胃肠钾离子,从而降低血清钾水平。然而,SZC的较少讨论的方面是其在基于X射线的成像技术上的射线不透性。欧洲药品管理局(EMA)只是模糊地解决了这个问题。像SZC这样的不透射线物质会干扰诊断成像,给临床医生和放射科医生带来挑战。我们介绍了一名34岁的意大利男性的案例来说明这些担忧。
    Sodium Zirconium Cyclosilicate (SZC) is commonly used for treating hyperkalemia because it sequesters gastrointestinal potassium ions, thereby reducing serum potassium levels. However, a less-discussed aspect of SZC is its radiopacity on x-ray-based imaging techniques. The European Medicines Agency (EMA) has only vaguely addressed this issue. Radiopaque substances like SZC can interfere with diagnostic imaging, creating challenges for clinicians and radiologists. We present the case of a 34-year-old Italian male to illustrate these concerns.
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