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
    脑室内神经细胞瘤是一种发病率较低的中枢神经系统肿瘤。它主要影响年轻人,没有明显的性别偏好。主要症状包括头痛,恶心和呕吐。这些是由于脑脊液流阻塞引起的脑积水。关于诊断成像,可以通过一些特征怀疑神经细胞瘤,如周围囊肿,分叶状轮廓和桥接心室壁的隔片,给出一个“扇形”的外观。还有其他特征,但它们对诊断的特异性较低。神经细胞瘤的非典型变体甚至更罕见,并导致最坏的预后。非典型神经细胞瘤发展由Ki-67生物标志物鉴定的更高的增殖潜力和更高的复发率。关于非典型神经细胞瘤的影像学特征的研究较少。在这一点上,没有可靠的区别特征来区分非典型神经细胞瘤,尤其是由于其发病率低。我们介绍了一名20岁的女性患者,其症状为脑内高血压。大脑的CT和MRI显示一个肿块占据了左心室的身体,靠近Monro的孔.肿块主要为实性,周围有离散的囊肿和一些扇形区域。它还显示了幕上梗阻性脑积水的迹象。由于出血和血管结构受损,部分切除了肿瘤。免疫组织化学显示突触素阳性,Ki-67升高(7%),血管数量增加和中度核异型。手术后,病人持续有颅内高压的迹象,没有改善临床管理和需要积极的外科手术。虽然罕见,非典型神经细胞瘤需要更好的表征,尤其是通过成像,优化即时管理并探索新的治疗方案。
    Intraventricular neurocytoma is a low incidence central nervous system tumor. It predominantly affects young adults with no apparent gender predilection. The main symptoms include headache, nausea and vomiting. These result from hydrocephalus due to the obstruction of cerebrospinal fluid flow. On diagnostic imaging, neurocytoma can be suspected by some features, such as peripheral cysts, lobulated contours and septa that bridge the ventricular wall, giving a \"scalloped\" appearance. There are other characteristics, but they are less specific for the diagnosis. The atypical variant of neurocytoma is even rarer and leads to a worst prognosis. Atypical neurocytomas develop higher proliferative potential identified by the Ki-67 biomarker and higher recurrence rate. There are few studies about the imaging characteristics of atypical neurocytomas. At this point, there are no reliable distinctive features to differentiate atypical neurocytomas, especially due to their low incidence. We present the case of a 20-year-old female patient with symptoms of intracraneal hypertension. CT and MRI of the brain revealed a mass occupying the body of the left lateral ventricle, adjacent to the foramen of Monro. The mass was primarily solid with discrete peripheral cyst and a few scalloped areas. It also showed signs of supratentorial obstructive hydrocephalus. The tumor was partially removed because of bleeding and compromise of vascular structures. Immunohistochemistry revealed positive synaptophysin, elevated Ki-67 (7%), increased number of blood vessels and moderate nuclear atypia. After surgery, the patient persisted with signs of intracranial hypertension, not improving with clinical management and requiring aggressive surgical procedures. While rare, atypical neurocytoma requires a better characterization, especially through imaging, to optimize immediate management and explore new therapeutic options.
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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: Journal Article
    叶状肿瘤是一种罕见的乳腺纤维上皮肿瘤,组织学分类为良性,边界线,或恶性。准确的术前诊断允许正确的手术计划和避免再次手术。
    描述叶状肿瘤的临床表现和影像学特征,并区分良性和非良性(交界性和恶性)组。
    一项回顾性研究,对57例诊断为叶状肿瘤的患者进行了术前影像学检查(乳房X线摄影,超声,或CT胸部)和组织学确认。数据收集时间为2011年6月1日至2021年9月30日。根据ACRBI-RADS词典的第5版描述了叶状肿瘤的影像学特征。为了比较两组之间的差异,学生t检验,Wilcoxon秩和检验,卡方检验,和Fisher精确检验用于统计分析。采用logistic回归分析预测非良性叶状肿瘤。
    来自57名患者,病理结果良性43例,非良性叶状肿瘤14例。良性和非良性组之间的乳房X线照相和CT特征没有区别。非良性叶状肿瘤的绝经状态具有统计学意义,整个乳房受累,肿瘤大小大于10厘米,单变量分析和异质回波。经过多变量分析,绝经后状态(奇数比值=13.79,p=0.04)和多普勒超声检查发现边缘有血管(奇数比值=16.51,p=0.019)或无血管(奇数比值=8.45,p=0.047)均显著增加非良性叶状肿瘤的可能性.
    绝经期状态、边缘血管存在或多普勒超声检查血管缺失是非良性叶状肿瘤诊断的重要预测因子。
    UNASSIGNED: Phyllodes tumor is a rare fibroepithelial neoplasm of the breast, which is classified histologically as benign, borderline, or malignant. Accurate preoperative diagnosis allows the correct surgical planning and reoperation avoidance.
    UNASSIGNED: To describe the clinical presentation and radiologic features of phyllodes tumors and differentiate between benign and non-benign (borderline and malignant) groups.
    UNASSIGNED: A retrospective study of 57 patients with a diagnosis of phyllodes tumor who had preoperative imaging (mammography, ultrasound, or CT chest) and histological confirmation. The data was collected from 1 June 2011 to 30 September 2021. The imaging features of the phyllodes tumors were described according to the 5th edition of the ACR BI-RADS lexicon. For comparing between two groups, the student t-test, Wilcoxon rank sum test, Chi-square test, and Fisher\'s exact test were used for statistical analyses. The logistic regression analysis was calculated for non-benign phyllodes tumor prediction.
    UNASSIGNED: From 57 patients, the pathologic results were benign for 43 cases and non-benign phyllodes tumors for 14 cases. There was no differentiation of mammographic and CT features between benign and non-benign groups. Non-benign phyllodes tumors had the statistical significance of menopausal status, entire breast involvement, tumor size larger than 10 cm, and heterogeneous echo on univariable analysis. After multivariable analysis, menopausal status (odd ratios=13.79, p=0.04) and presence of vessels in the rim (odd ratios=16.51, p=0.019) or absent vascularity (odd ratios=8.45, p=0.047) on doppler ultrasound were significantly increased possibility of non-benign phyllodes tumor.
    UNASSIGNED: Menopausal status and presence of vessels in the rim or absent vascularity on Doppler ultrasound were important predictors for the diagnosis of non-benign phyllodes tumor.
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  • 文章类型: Journal Article
    大多数导管原位癌(DCIS)病变早期表现为钙化,可能是良性或恶性的.DCIS和良性乳腺疾病中可疑钙化的分类组对于早期评估患者的危险因素和计划治疗方案具有重要的临床意义。
    比较DCIS和良性乳腺疾病可疑钙化的影像学特征。
    2011年6月至2020年10月在Thammasat大学医院进行了101个可疑钙化的回顾性研究。通过乳房X线照相术引导的金属丝定位手术切除钙化。根据美国放射学会第五版乳腺成像报告和数据系统词典,对可疑钙化的乳房X线特征进行了审查。为了比较两组之间的差异,学生t检验,采用Fisher精确检验和Mann-WhitneyU检验进行统计分析。对DCIS预测进行logistic回归分析。
    101例可疑钙化灶的病理结果均为DCIS(30例)和良性乳腺疾病(71例)。线性形态和节段分布与DCIS显著相关(分别为p=0.003和p=0.024)。经过多变量分析,细线性钙化仍然显著升高DCIS的风险(奇数比率,51.72[95%置信区间:2.61,1022.89],p值为0.01),然而,预测DCIS的几率在任何分布之间均无统计学差异.
    与良性乳腺疾病相比,导管原位癌钙化具有对比的形态和分布特征。钙化描述符被认为是早期诊断的重要工具,可将DCIS与其他良性乳腺疾病区分开来。
    钙化描述符被认为是早期诊断和区分DCIS与其他良性乳腺疾病的重要手段。
    UNASSIGNED: Most ductal carcinoma in situ (DCIS) lesions manifest early as calcifications, which could be benign or malignant. The classified group of suspicious calcifications among DCIS and benign breast disease is clinically important to early evaluate patient risk factors and plan treatment options.
    UNASSIGNED: To compare imaging features of suspicious calcifications between DCIS and benign breast disease.
    UNASSIGNED: A retrospective study of 101 suspicious calcifications was performed at Thammasat University Hospital from June 2011 to October 2020. The calcifications were surgically excised by mammography-guided wire localisation. The mammographic features of the suspicious calcifications were reviewed according to the fifth edition of the American College of Radiology Breast Imaging-Reporting and Data System lexicon. For comparing between two groups, the student t-test, Fisher\'s exact test and Mann-Whitney U test were used for statistical analyses. The logistic regression analysis was calculated for DCIS prediction.
    UNASSIGNED: The pathologic results of all 101 suspicious calcifications were DCIS (30 cases) and benign breast disease (71 cases). Linear morphology and segmental distribution correlated significantly with DCIS (p = 0.003 and p = 0.024, respectively). After multivariable analysis, fine linear calcification still significantly elevated the risk of DCIS (odd ratios, 51.72 [95% confidence interval: 2.61, 1022.89], p-value of 0.01), however, the odds of predicting DCIS was not statistically significant different among any distribution.
    UNASSIGNED: Ductal carcinoma in situ calcification has contrasting morphology and distribution features compared to benign breast disease. The calcification descriptor is considered an important implement for early diagnosis and distinguishes DCIS from other benign breast conditions.
    UNASSIGNED: Calcification descriptor is considered an important implement for early diagnosis and distinguishment of DCIS from other benign breast conditions.
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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
    肺上皮样血管内皮瘤(PEH)是一种罕见的血管肿瘤,其早期诊断仍然具有挑战性。本研究旨在全面分析PEH的成像特征,并建立预测PEH的模型。
    对我们中心的PEH患者(n=25)和已发表病例(n=71)的影像学表现进行了回顾性和汇总分析。分别。提取相关计算机断层扫描(CT)图像,并将其用于构建深度学习模型,以识别PEH并与其他疾病区分。
    在这项研究中,双侧多发结节/肿块(n=19)似乎更常见,大多数结节小于2cm。除了常见的类型和功能,混合型(n=4)和孤立结节(n=4)的模式,还观察到点状钙化(5/25)和淋巴结肿大(10/25)。胸腔积液的存在与PEH的不良预后相关。深度学习模型,受试者工作特征曲线下面积(AUC)为0.71[95%置信区间(CI):0.69-0.72],训练集和测试集的区分精度分别为100%和74%。
    这项研究证实了PEH中成像发现的异质性,并显示了几种以前未描述的类型和特征。当前基于CT的深度学习模型具有临床应用潜力,未来需要进一步探索。
    UNASSIGNED: Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumour, and its early diagnosis remains challenging. This study aims to comprehensively analyse the imaging features of PEH and develop a model for predicting PEH.
    UNASSIGNED: Retrospective and pooled analyses of imaging findings were performed in PEH patients at our center (n=25) and in published cases (n=71), respectively. Relevant computed tomography (CT) images were extracted and used to build a deep learning model for PEH identification and differentiation from other diseases.
    UNASSIGNED: In this study, bilateral multiple nodules/masses (n=19) appeared to be more common with most nodules less than 2 cm. In addition to the common types and features, the pattern of mixed type (n=4) and isolated nodules (n=4), punctate calcifications (5/25) and lymph node enlargement were also observed (10/25). The presence of pleural effusion is associated with a poor prognosis in PEH. The deep learning model, with an area under the receiver operating characteristic curve (AUC) of 0.71 [95% confidence interval (CI): 0.69-0.72], has a differentiation accuracy of 100% and 74% for the training and test sets respectively.
    UNASSIGNED: This study confirmed the heterogeneity of the imaging findings in PEH and showed several previously undescribed types and features. The current deep learning model based on CT has potential for clinical application and needs to be further explored in the future.
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  • 文章类型: Journal Article
    多毛症是一种相对常见的疾病,影响约5%至15%的女性。它的定义是女性的终毛过度生长,主要影响依赖雄激素的地区,比如脸,腹部,臀部,和大腿。多毛症可以由多种病因引起,通常不会危及生命。然而,在某些情况下,多毛症可能是更严重的潜在病理的指标,比如肿瘤,这可能需要通过成像进一步阐明。在腹部和骨盆内,肾上腺和卵巢病变是首要考虑因素。本手稿的目的是回顾多毛症的各种腹内和骨盆内原因的病因和影像学特征。
    Hirsutism is a relatively common disorder which affects approximately 5% to 15% of women. It is defined by excessive growth of terminal hair in women, which primarily affects areas dependent on androgens, such as the face, abdomen, buttocks, and thighs. Hirsutism can be caused by a variety of etiologies, which are most often not lifethreatening. However, in some cases, hirsutism can be an indicator of more serious underlying pathology, such as a neoplasm, which may require further elucidation with imaging. Within the abdomen and pelvis, adrenal and ovarian pathologies are the primary consideration. The goal of this manuscript is to review the etiologies and imaging features of various intra-abdominal and intra-pelvic causes of hirsutism.
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  • 文章类型: Meta-Analysis
    创伤性脑损伤(TBI)后挫伤(HPC)的出血进展是创伤患者死亡的重要原因之一。这项荟萃分析的目的是评估TBI后计算机断层扫描(CT)成像特征对HPC的预测作用。使用PubMed进行了全面的系统搜索,EMBASE,和WEBOFSCIENCE数据库来识别所有相关文献。本荟萃分析共纳入8项研究,涉及2543例患者。Meta分析显示蛛网膜下腔出血(OR3.28;95%CI2.57-4.20),硬膜下出血(OR4.35;95%CI3.29-5.75),硬膜外出血(OR1.47;95%CI1.15-1.89),对比剂外渗(OR11.81;95%CI4.86-28.71)对HPC的发生具有预测作用.颅骨骨折(OR1.64;95%CI0.84-3.19)无统计学意义,中线位移>5mm(OR4.66;95%CI1.87-11.62)显示高度异质性。这项荟萃分析的结果表明,某些影像学特征是TBI后HPC的有效预测因素。需要精心设计的前瞻性研究来更准确地评估TBI后HPC的有效预测因子。
    The hemorrhagic progression of a contusion (HPC) after Traumatic brain injury (TBI) is one of the important causes of death in trauma patients. The purpose of this meta-analysis was to evaluate the predictive effect of imaging features of Computed tomography (CT) on HPC after TBI. A comprehensive systematic search was performed using PubMed, EMBASE, and WEB OF SCIENCE databases to identify all relevant literature. A total of 8 studies involving 2543 patients were included in this meta-analysis. Meta-analysis showed that subarachnoid hemorrhage (OR 3.28; 95% CI 2.57-4.20), subdural hemorrhage (OR 4.35; 95% CI 3.29-5.75), epidural hemorrhage (OR 1.47;95% CI 1.15-1.89), contrast extravasation (OR 11.81; 95% CI 4.86-28.71) had a predictive effect on the occurrence of HPC. Skull fracture (OR 1.64; 95% CI 0.84-3.19) showed no statistical significance, and midline displacement > 5 mm (OR 4.66; 95% CI 1.87-11.62) showed high heterogeneity. The results of this meta-analysis showed that some imaging features were effective predictors of HPC after TBI. Well-designed prospective studies are needed to more accurately assess the effective predictors of HPC after TBI.
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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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