diagnostic imaging

诊断成像
  • 文章类型: Case Reports
    成釉细胞纤维瘤(AFD)是一种罕见的良性牙源性肿瘤,类似于具有发育不良牙本质的成釉细胞纤维瘤。本报告介绍了一名年轻患者的下颌AFD罕见病例,具有影像学特征。全景X线摄影和计算机断层扫描显示明确的病变,内部间隔和钙化灶,导致相邻磨牙的下移位以及颊舌皮质变薄和后下颌骨扩张。病灶通过肿块切除手术切除,受累牙齿在全身麻醉下拔除。在5年的随访期间,未观察到复发的证据.AFD的放射学特征通常显示中度至明确的混合病变,具有不同程度的射线不透性。反映牙本质形成的程度。放射科医师在鉴别诊断中当遇到少有密集射线不透性的多房性病变时,应考虑AFD。特别是如果它与延迟喷发有关,撞击,或者没有受累的牙齿,年轻患者的影像学图像。
    Ameloblastic fibrodentinoma (AFD) is a rare benign odontogenic tumor that resembles an ameloblastic fibroma with dysplastic dentin. This report presents a rare case of mandibular AFD with imaging features in a young patient. Panoramic radiography and computed tomography revealed a well-defined lesion with internal septa and calcified foci, causing inferior displacement of the adjacent molars as well as buccolingual cortical thinning and expansion of the posterior mandible. The lesion was surgically removed via mass excision, and the involved tooth was extracted under general anesthesia. During the 5-year follow-up period, no evidence of recurrence was observed. Radiologic features of AFD typically reveal a moderately to well-defined mixed lesion with varying degrees of radiopacity, reflecting the extent of dentin formation. Radiologists should consider AFD in the differential diagnosis when encountering a multilocular lesion with little dense radiopacity, particularly if it is associated with delayed eruption, impaction, or absence of involved teeth, on radiographic images of young patients.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    背景:这项研究的目的是通过红外热成像确定应用于临床疼痛的运动员的参与训练水平。缝匠肌(SM)损伤的症状类似于股直肌损伤。
    通过热成像诊断确定了一名23岁男性足球运动员的I级SM伤害。在球员训练之前拍摄静止的热图像,报告大腿上部区域疼痛。
    结果:由于两条腿的负载相等,按照我们开发的方法,在具有30-40%电阻的10分钟循环程序之后再次拍摄热图像。分析了训练前和训练后图像中看到的腿部热图。在静息温度成像评估中没有不对称的发现表明受伤,但是在10分钟循环程序后,在重复的热成像成像中获得了显示SM区域损伤的不对称发现。随后通过MRI检测到I级SM损伤。
    结论:即使在有疼痛迹象的足球运动员的静息热像中没有不对称的迹象,受伤的肌肉应该用一个安全的锻炼计划和热图像应该重新拍摄。
    BACKGROUND: The aim of this study was to determine the level of participation in the training of the athlete who applied to the clinic with pain by infrared thermography. Symptoms of sartorius muscle (SM) injury are like rectus femoris injuries.
    UNASSIGNED: Grade I SM injury of a 23-year-old male football player was determined by thermographic diagnosis. Taking a resting thermal image before the training of the player reported a pain in the upper thigh region.
    RESULTS: Since both legs were equally loaded, in accordance with the method we developed, the thermal image was taken again after a 10-min cycling program with 30-40% resistance. The heat maps of legs seen in the pre- and post-training images were analyzed. There was no asymmetrical finding indicating injury in the resting thermographic evaluation, but asymmetric findings showing the injury in the region of SM were obtained in the repeated thermographic imaging after the 10-min cycling program. Grade I SM injury was detected by MRI afterwards.
    CONCLUSIONS: Even if there is no sign of asymmetry in the resting thermography of football players having signs of pain, the injured muscle should be provoked with a safe exercise program and the thermal image should be retaken.
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  • 文章类型: Case Reports
    原发性肾盂腺癌是一种罕见且独特的恶性肿瘤,代表一小部分肾癌,由于其不寻常的表现以及与更常见的排泄道疾病的症状相似,因此构成了重大的诊断挑战。该病例强调了将这种病理与起源于消化道的其他肾肿瘤和转移性腺癌区分开的重要性。
    方法:我们报告了一例34岁无明显病史的男性患者,该患者表现出持续性下背部疼痛,但无血尿,这对肾脏病变是不典型的。初始成像确定右肾盂有30×14mm的增强肿块。通过右肾输尿管切除术进行手术干预,包括切除膀胱袖口.组织病理学检查证实诊断为原发性肠型肾盂腺癌,以坏死性癌增殖为特征,具有不同的结构模式和偶尔的印戒细胞。
    原发性肾盂腺癌的诊断因其非特异性症状和误诊为更常见的尿路上皮癌或转移性消化道来源腺癌而复杂化。免疫组织化学染色支持原发性而非转移性消化道起源。这一案例强调了全面诊断方法的必要性,包括先进的成像和细致的组织病理学分析,有效区分这种罕见的实体从其他肿瘤。
    结论:该病例强调了诊断的复杂性和临床医生对罕见肾癌如原发性肾盂腺癌的认识的迫切需要。它还强调了跨学科合作在此类罕见病例的诊断和管理中的重要性,提高我们的认识,并要求及时和准确的治疗。
    UNASSIGNED: Primary adenocarcinoma of the renal pelvis is a rare and unique malignancy, representing a small fraction of renal cancers and posing significant diagnostic challenges due to its unusual presentation and similarity in symptoms to more common excretory tract disorders. This case emphasizes the importance of distinguishing this pathology from other renal neoplasms and metastatic adenocarcinomas that originate in the digestive tract.
    METHODS: We report the case of a 34-year-old man with no significant medical history who presented persistent lower back pain but no hematuria, which is atypical for renal pathologies. Initial imaging identified a 30 × 14 mm enhancement mass in the right renal pelvis. Surgical intervention was performed through right nephroureterectomy, including excision of the bladder cuff. Histopathological examination confirmed the diagnosis of primary intestinal-type adenocarcinoma of the renal pelvis, characterized by necrotic carcinomatous proliferation with varying architectural patterns and occasional signet ring cells.
    UNASSIGNED: The diagnosis of primary renal pelvis adenocarcinoma is complicated by its nonspecific symptomatology and the potential for misdiagnosis as a more common urothelial carcinoma or a metastatic digestive-origin adenocarcinoma. Immunohistochemical staining supported a primary rather than metastatic digestive tract origin. This case underscores the need for a comprehensive diagnostic approach, including advanced imaging and meticulous histopathological analysis, to effectively differentiate this rare entity from other neoplasms.
    CONCLUSIONS: This case highlights the diagnostic complexities and the critical need to be aware among clinicians about rare renal cancers such as primary adenocarcinoma of the renal pelvis. It also stresses the importance of interdisciplinary collaboration in the diagnosis and management of such rare cases, improving our understanding and requiring timely and accurate treatment.
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  • 文章类型: Case Reports
    背景:本病例报告描述了一例发生在男性腹膜后的苗勒管囊肿。囊肿病变罕见,并发膈疝。苗勒管衍生囊肿是一种罕见的发育障碍,在男性盆腔组织中更为常见,在腹膜后罕见。我们调查了计算机断层扫描(CT)和磁共振成像(MRI)在这种情况的术前诊断和疾病预测中的重要作用。
    方法:一名25岁男性在影像学检查中发现左膈有异常占位病变,通常健康,没有明显的临床症状。X光检查显示圆形,靠近左膜片的高密度阴影。CT扫描显示左侧肾上腺区域类似肿瘤的软组织密度阴影,不规则地伸入胸腔,密度不均匀。MRI检查显示左肾上腺区有不规则细长的T1和T2信号阴影。T2脂肪抑制显示高信号强度,扩散不受限制。机器人辅助腹腔镜手术显示左侧腹膜后肿瘤切除。患者术后恢复良好,出院随访后无复发。
    结论:年轻男性腹膜后苗勒管囊肿并发膈疝的临床前症状难以区分,并且很难通过影像学检查来诊断其他类似的囊肿。CT和MRI联合诊断的方法指导内窥镜机器人辅助微创手术切除囊肿,实现此类疾病的准确诊断和治疗。
    BACKGROUND: This case report describes a case of Müllerian duct cyst that occurred in a male retroperitoneum. The cyst lesion is rare and complicated with diaphragmatic hernia. Müllerian duct-derived cyst is a rare developmental disorder that is more common in male pelvic tissues and rare in the retroperitoneum. We investigated the important role of computerized tomography (CT) and magnetic resonance imaging (MRI) in preoperative diagnosis and disease prediction of this condition.
    METHODS: A 25-year-old male was found to have an abnormal occupying lesion in the left diaphragm in imaging examinations, usually healthy with no obvious clinical symptoms. X-ray examination showed a circular, high-density shadow near the left diaphragm. CT scan showed a soft tissue density shadow resembling a tumor in the left adrenal area, irregularly protruding into the chest cavity, with uneven density. MRI examination showed an irregular elongated T1 and T2 signal shadow in the left adrenal area. T2 fat suppression showed high signal intensity with unrestricted diffusion. Robotic-assisted laparoscopic surgery showed left retroperitoneal tumor resection. The patient recovered well postoperatively and had no recurrence after discharge follow-up.
    CONCLUSIONS: The preclinical symptoms of retroperitoneal Müllerian cysts complicated by diaphragmatic hernia in young men are difficult to distinguish, and it is difficult to diagnose other similar cysts with imaging. The method of combined CT and MRI diagnosis guides the endoscopic robot-assisted minimally invasive surgery for excision of cysts to achieve accurate diagnosis and treatment of such diseases.
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  • 文章类型: Journal Article
    远程放射学是解释在非现场位置获取的医学图像的实践。远程放射学已在世界各地广泛使用,以满足亚专业覆盖的需求,工作负载平衡,并作为人员不足的解决方案。这项研究旨在评估沙特阿拉伯放射科医师对远程放射学的看法,调查他们可能面临的任何挑战,并探索有助于缓解这些挑战的策略。
    进行了一项使用自我管理电子问卷的横断面研究,以收集在沙特阿拉伯执业或实践过远程放射学的放射科医生的回答。问卷于2023年1月至6月进行,分析中包括105份答复。使用卡方检验对反应进行分析,以调查影响放射科医师看法的因素。
    远程放射学最常见的挑战是获取患者的健康记录,访问之前的成像检查,以及对图像质量保证的担忧。大约74%的参与者认为远程放射学对地理有益,下班后,和亚专业覆盖。远程放射学也被认为有助于减少放射学解释的周转时间。与转诊医生和技术人员进行更好的沟通被视为帮助改善远程放射学服务的一种方式。
    研究结果表明,对远程放射学的挑战和益处的看法可能不会受到经验的影响,workplace,或亚专业。应强调远程获取的图像的质量保证的重要性。解决与获取患者健康记录相关的问题和挑战对于确保远程放射学在该国的成功实施也至关重要。
    UNASSIGNED: Teleradiology is the practice of interpreting medical images acquired in an off-site location. Teleradiology has been utilized widely around the world to address the needs for subspecialty coverage, workload balancing, and as a solution for understaffing. This study aims to assess the perceptions of teleradiology among radiologists in Saudi Arabia, investigate any challenges they might face, and explore strategies that would help mitigate those challenges.
    UNASSIGNED: A cross-sectional study using a self-administered electronic questionnaire was conducted to collect responses from radiologists practicing or having practiced teleradiology in Saudi Arabia. The questionnaire was conducted from January to June 2023, and 105 responses were included in the analysis. The responses were analyzed using chi-squared testing to investigate factors affecting the radiologists\' perceptions.
    UNASSIGNED: The most common challenges for teleradiology were access to patients\' health records, access to prior imaging exams, and concerns about image quality assurance. Around 74% of participants perceived teleradiology to be beneficial for geographic, after-hour, and subspecialties coverage. Teleradiology was also perceived to help reduce the turn-around time of radiology interpretations. Better communication with referring physicians and technologists was seen as a way to help improve teleradiology services.
    UNASSIGNED: The findings suggest that the perception of teleradiology\'s challenges and benefits may not be influenced by experience, workplace, or subspecialty. Emphasis should be placed on the importance of quality assurance of images acquired remotely. Addressing the concerns and challenges related to access to patients\' health records is also crucial to ensuring the successful implementation of teleradiology in the country.
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  • 文章类型: Case Reports
    副神经节瘤是由副神经节引起的罕见神经内分泌肿瘤,它们是与自主神经系统相关的神经内分泌细胞簇。这些肿瘤常见于肾上腺髓质,但也可发生在肾上腺以外的其他位置。这里,我们提供了一例60岁男性的左颈部副神经节瘤伴脊柱转移缓慢生长的病例报告。该病例强调了在颈部肿块的鉴别诊断中考虑神经节旁肿瘤的重要性,以及早期诊断和治疗以防止潜在并发症的必要性。重要的是,在确定治疗计划时,这些肿瘤的临床表现和解剖位置都很重要.
    Paragangliomas are rare neuroendocrine tumors that arise from the paraganglia, which are clusters of neuroendocrine cells associated with the autonomic nervous system. These tumors are commonly found in the adrenal medulla but can also occur in other locations outside the adrenal gland. Here, we present a case report of a slow-growing paraganglioma in the left neck with spinal metastasis in a 60-year-old man. This case highlights the importance of considering paraganglion tumors in the differential diagnosis of neck masses and the need for early diagnosis and management to prevent potential complications. Importantly, both the clinical picture and anatomical location of these tumors is important when determining treatment plans.
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  • 文章类型: Case Reports
    手,脚,和口蹄疫一般发生在儿童。在极少数情况下,手,脚,口病会影响睾丸。
    一名29岁的男子在手发作后几天因睾丸疼痛出现在我们的急诊科,脚,和口病。超声检查显示右睾丸有低回声肿块样区域。观察到轻度炎症反应,肿瘤标志物和尿液数据正常,感染检测结果均为阴性。开始使用抗生素,并在随后的每次检查中进行超声检查。睾丸疼痛6个月后消失。
    我们遇到了一个罕见的与手有关的睾丸病变,脚,和成功治疗的口蹄疫。仔细选择年轻成年男性睾丸疼痛和阴囊增大的治疗方法,如手术和对症治疗,根据他们的病史和实验室检查结果,很重要。
    UNASSIGNED: Hand, foot, and mouth disease generally occurs in children. In rare cases, hand, foot, and mouth disease affects the testicles.
    UNASSIGNED: A 29-year-old man presented to our emergency department with testicular pain for several days after the onset of hand, foot, and mouth disease. Ultrasonography revealed hypoechoic mass-like areas in the right testis. A mild inflammatory response was noted, tumor markers and urinary data were normal, and tests for infection were all negative. Antibiotics were initiated and ultrasonography was performed in every subsequent examination. Testicular pain disappeared 6 months later.
    UNASSIGNED: We encountered a rare case of a testicular lesion related to hand, foot, and mouth disease that was successfully treated. The careful selection of treatment for testicular pain and scrotal enlargement in young adult males, such as surgery and symptomatic treatment, based on their medical history and laboratory findings, is important.
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  • 文章类型: Case Reports
    直肌鞘血肿(RSH)是妊娠期急性腹痛的罕见但重要原因,在诊断和治疗方面都具有挑战性。它通常是由上腹部血管破裂引起的,并且与抗凝治疗和先前的腹部手术等因素有关。误诊,由于非特异性症状,经常导致不必要的手术,对孕产妇和胎儿健康构成重大风险。
    方法:我们介绍了一个32岁的多胎妇女,在妊娠31周时,经历右侧腹痛和不规则收缩。有四次足月分娩史,最近没有外伤,她的检查显示血流动力学稳定,但在运动时出现疼痛,左腹部区域出现明显的蓝色变色。在实验室测试中观察到中度贫血。经超声和MRI确诊为RSH。由于症状恶化和血红蛋白水平下降,治疗方法从保守转向手术。
    这个案例突出了RSH在怀孕期间的罕见性和严重性。其非特异性症状使鉴别诊断复杂化,强调需要及时和精确的诊断,以避免不必要的手术干预。虽然在稳定病例中,保守管理是首选,在不稳定或血肿生长的情况下需要手术。
    结论:RSH是妊娠合并急性腹痛患者的重要考虑因素。早期发现和量身定制的管理对于减轻手术风险并确保母亲和孩子的安全至关重要。这种情况加强了警惕和系统的患者评估的重要性,以改善结果并最大程度地减少不必要的外科手术。
    UNASSIGNED: Rectus sheath hematoma (RSH) is an uncommon but significant cause of acute abdominal pain in pregnancy, challenging in both diagnosis and treatment. It often arises from ruptured epigastric vessels and is associated with factors like anticoagulation therapy and previous abdominal surgery. Misdiagnosis, due to nonspecific symptoms, frequently leads to unnecessary surgeries, posing substantial risks to maternal and fetal health.
    METHODS: We present a case of a 32-year-old multiparous woman at 31 weeks of gestation, experiencing right-sided abdominal pain and irregular contractions. With a history of four full-term deliveries and no recent trauma, her examination showed hemodynamic stability but featured pain upon movement and a notable blue discoloration in the left abdominal area. Moderate anemia was observed in lab tests. The diagnosis of RSH was confirmed via ultrasound and MRI. The treatment approach shifted from conservative to surgical due to deteriorating symptoms and falling hemoglobin levels.
    UNASSIGNED: This case highlights the rarity and seriousness of RSH in pregnancy. Its non-specific symptoms complicate differential diagnosis, underscoring the need for prompt and precise diagnosis to avoid unwarranted surgical interventions. While conservative management is preferred in stable cases, surgical action is required in situations of instability or hematoma growth.
    CONCLUSIONS: RSH is a critical consideration in pregnant patients with acute abdominal pain. Early detection and tailored management are essential to mitigate surgical risks and ensure the safety of mother and child. This case reinforces the importance of vigilant and systematic patient evaluation to improve outcomes and minimize unnecessary surgical procedures.
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  • 文章类型: Journal Article
    背景:变性人和性别多样化(TGD)个体面临障碍,包括骚扰和歧视,在获得医疗保健服务时。医疗成像程序需要共享个人信息,例如上次月经周期的日期和/或怀孕状态;一些影像学检查也是侵入性的或亲密的。术语基于二元性,创造了一种固有的顺式异形规范环境。TGD患者害怕被淘汰,并且经常感到有必要充当教育者和倡导他们的护理。纳入与TGD人群相关的包容性医疗保健课程是教育新的健康提供者的有效手段,并在医疗保健环境中促进更安全和更具包容性的空间。教育者面临阻碍TGD内容创建和实施的障碍。这项研究的目的是研究教育工作者在医学成像课程中创建和提供TGD内容时所面临的影响。
    方法:对加拿大一所专科学校的医学影像项目进行了案例研究。数据是通过对教师的半结构化访谈收集的。战略计划等相关机构文件,政策/程序,网站,并访问了能力档案。采用框架分析法对数据进行分析。
    结果:该研究发现了影响TGD课程发展的七个主题:对课程和内容变更过程的熟悉程度和舒适度;与其他医疗保健计划的合作;教学专业知识;课程工作量和相关管理。职责;与TGD社区的联系;了解所需的TGD内容和课程中现有的差距;以及获得支持的途径。
    结论:了解教育者的观点可以增强他们在未来创建和纳入TGD课程的能力。许多大专院校正在将包容性的镜头纳入教育计划;这项研究可用于未来的课程设计项目。目标是改善TGD人群的医学成像体验。
    BACKGROUND: Transgender and gender diverse (TGD) individuals face barriers, including harassment and discrimination, when accessing healthcare services. Medical imaging procedures require personal information to be shared, such as date of last menstrual cycle and/or pregnancy status; some imaging exams are also invasive or intimate in nature. Terminology is based on binary sex creating an inherently cis-heteronormative environment. TGD patients fear being outed and often feel a need to function as educators and advocates for their care. Incorporation of inclusive healthcare curriculum related to TGD populations is an effective means of educating new health providers and promotes safer and more inclusive spaces in healthcare settings. Educators face barriers which hinder the creation and implementation of TGD content. The purpose of this study was to examine the impacts educators are faced with when creating and delivering TGD content in their medical imaging curriculum.
    METHODS: A case study of medical imaging programs at a Canadian post-secondary institute was undertaken. Data was collected via semi-structured interviews with faculty. Relevant institutional documents such as strategic plans, policies/procedures, websites, and competency profiles were accessed. Framework analysis was used to analyze the data.
    RESULTS: The study found seven themes that influence the development of TGD curriculum as follows: familiarity and comfort with the curriculum and content change process; collaboration with other healthcare programs; teaching expertise; management of course workload and related. duties; connections to the TGD community; knowledge of required TGD content and existing gaps in curriculum; and access to supports.
    CONCLUSIONS: Understanding educators\' perspectives can lead to an increased sense of empowerment for them to create and incorporate TGD curriculum in the future. Many post- secondary institutions are incorporating an inclusive lens to educational plans; this research can be used in future curriculum design projects. The goal is improved medical imaging experiences for the TGD population.
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