Cystic Adventitial Disease of the Popliteal Artery

Cystic adventitial disease of the popliteal artery should be remembered when a young patient presents with intermittent claudication and no evidence of atherosclerosis elsewhere. The use of arteriography may distinguish the condition from embolisation, atheroma or popliteal entrapment syndrome, unless complete occlusion of the vessel has occurred. Surgical treatment in the form of cyst evacuation or arterial resection with vein grafting provides good results.     

Localised Popliteal Artery Abnormalities in Otherwise Fit Young Adults

Popliteal artery entrapment and cystic adventitial disease of the popliteal artery are uncommon conditions which have received little attention in the radiology literature. In both conditions, a resting AP arteriogram may be normal and extra techniques are required to demonstrate or exclude abnormality. To show popliteal entrapment a normal or equivocal arteriogram should be repeated with forced extension of the knee and forced plantar flexion of the ankle, and to demonstrate cystic adventitial disease a lateral view may be needed. Failure to perform these views may lead to misdiagnosis and inadequate treatment, with potentially serious consequences. A case of each abnormality is presented and both conditions are described, with a brief review of the literature.     

Popliteal pseudoaneurysm simulating soft-tissue sarcoma: complication of osteochondroma resection

Pseudoaneurysm complicating osteochondroma is extremely rare. We describe a pseudoaneurysm in the popliteal fossa of a 21-year-old man, occurring 5 years after apparently incomplete resection of an osteochondroma at that site. We found magnetic resonance imaging and magnetic resonance angiography to be of great diagnostic value. Resection of the pseudoaneurysm and anastomosis of the popliteal artery were successful, with no recurrence detected for almost 7 years since the operation. Received: July 19, 2000 / Accepted: November 30, 2000     

Surgical indication and technical considerations in the management of benign brain stem gliomas

Summary The treatment of brain stem gliomas has evolved over the last few decades, reflecting advances in imaging (MR), microsurgical techniques and biological understanding. The aim of this chapter is to provide a preoperative classification for intrinsic brain stem lesions that will predict histopathology and biological behavior from the clinical syndrome and the MR appearance. Such a classification system may help selecting children with brain stem tumors that can benefit from surgery. Technical considerations, potential surgical complications, and the ways to avoid them are discussed.     

腹痛、多发血栓、嗜酸粒细胞增多综合征

以腹痛起病,伴多器官栓塞、嗜酸粒细胞增多病例骨髓检查嗜酸粒细胞比例增高。皮肤活检：嗜酸粒细胞浸润。抗中性粒细胞胞浆抗体阴性,FIP1L1/PDGFRα融合基因阴性的嗜酸粒细胞增多综合征,属骨髓增殖型疾病。骨髓活检及受累组织器官的病理检查对鉴别诊断有重要价值。需重视以腹痛为首发、伴血栓形成的类似病例,如有2个器官受累时需高度警惕该疾病及更多器官受累。     

Retrograde transpopliteal salvage of the failed antegrade transfemoral angioplasty

Following unsuccessful conventional antegrade transfemoral angioplasty (six occlusions, one stenosis) seven patients underwent retrograde transpopliteal catheterization to retrieve the situation. The procedure was successful in five patients. The other two patients had small calibre popliteal arteries that went into spasm on attempted puncture. Provided the popliteal artery is of adequate calibre, the procedure is a relatively straightforward technique recommended for retrieval of failed antegrade angioplasty.     

Sporadically occurring functional pancreatic endocrine tumors: review of recent literature

PURPOSE OF REVIEW: Pancreatic neuroendocrine tumors are rare neoplasms often associated with a clinical syndrome. Their rarity makes a comprehensive study difficult at any single institution, while their uniqueness makes them desirable for investigation. This review summarizes recent information and advancements concerning pancreatic neuroendocrine tumor diagnosis, imaging characteristics, treatment algorithms, and staging. RECENT FINDINGS: Insulinomas and gastrinomas comprise the majority of functional pancreatic neuroendocrine tumors. Advances in their identification and diagnostic evaluation, imaging techniques, and treatment algorithms are presented. Furthermore, a new staging classification system has been proposed which may significantly improve the ability to conduct future multi-institutional investigations on pancreatic neuroendocrine tumors. SUMMARY: Although rare, a thorough understanding of pancreatic neuroendocrine tumors is essential for all physicians due to the wide variety of symptoms with which patients present. Currently, patients are often misdiagnosed for extended periods of time. This review summarizes the recently published literature about diagnosis, imaging, treatment, and staging of pancreatic neuroendocrine tumors.     

Clinical importance and surgical management of sentinel lymph nodes in the popliteal fossa of melanoma patients

Background and purposePatients with a primary melanoma below the knee may have lymphatic drainage to a sentinel node (SN) in the popliteal fossa. The purpose of this study was to analyze lymphatic drainage to this site and to describe clinical features and surgical management of SNs in the popliteal fossa.MethodsPatients with a primary melanoma below the knee presenting to Melanoma Institute Australia between 1992 and 2013 were analyzed. Those found to have a popliteal SN were evaluated. Data on imaging, SN biopsy, completion lymph node dissection, morbidity and follow-up were analyzed.ResultsLymphoscintigraphy showed drainage to a popliteal SN in 176 of 3902 cases of melanoma below the knee (4.5%). In 96 of these patients (55%) a popliteal SN biopsy was attempted. The procedure failed to identify the node(s) in seventeen of them (18%). Thirteen of the 79 patients (17%) had a positive popliteal SN and in eight (10%) this was the only positive node. The tumor stage of ten patients (13%) changed as a result of the popliteal node biopsy. A positive popliteal node was associated with an increased risk of recurrence and diminished overall survival. Popliteal SN biopsy did not improve regional control or survival.ConclusionMelanomas below the knee infrequently drain to lymph nodes in the popliteal fossa. Although popliteal SN biopsy can be challenging, it is worthwhile, providing improved staging and guiding subsequent management.     

Popliteal Aneurysms

Five patients with popliteal aneurysms are presented, together with the radiological appearances. All five appear to have been atherosclerotic in origin and three have shown to be bilateral. The value of arteriography in popliteal aneurysms is discussed.     

Nerve entrapments associated with postmastectomy lymphedema

Ninety females underwent mastectomy for breast cancer and were thereafter investigated to determine whether nerve entrapments were responsible for some of the disabling symptoms in their arms. The majority of these patients suffered from fullness (edema), numbness, paraesthesia, weakness and pain of the arm on the mastecotmized side. Lymphedema of varying degrees found in 50% of these patients was associated with brachial plexus entrapment and carpal tunnel syndrome (CTS). 28% of the patients has CTS, and 28% suffered from brachial plexus entrapment of the arm on the mastecotmized side, as compared with 8% and 5%, respectively, on the nonoperated side. 12% of the patients suffered from both types of entrapment. Thus we consider that brachial plexus entrapment and carpal tunnel syndrome should be added to the list of complications following mastectomy, with lymphedema playing an active part in their development.     

胶质瘤恶性程度分级的功能性磁共振成像研究进展

胶质细胞瘤是最常见的颅内恶性肿瘤,其生长特点为浸润性生长,与正常脑组织无明显界限,偏良性者生长缓慢,病程较长,恶性者瘤体生长快,病程短。因此,对于临床治疗而言,胶质瘤的准确分级是非常必要的。目前,随着影像学技术的快速发展,功能磁共振成像不仅可为临床提供精细解剖信息,还可以提供肿瘤功能及代谢等方面的信息。因此,该文综述了扩散加权成像（DWI）、磁共振波谱成像（MRS）、扩散张量成像（DTI）、灌注加权成像（PWI）、磁敏感加权成像（SWI）等功能MRI技术在胶质瘤恶性程度分级诊断中的应用,从而更准确地指导临床个体化治疗。     

Carpal tunnel syndrome associated with the use of aromatase inhibitors in breast cancer

Aromatase inhibitors (AI) inhibit peripheral conversion of androgens to estradiol and are commonly used as hormonal therapy for postmenopausal women with hormone receptor-positive breast cancer in the metastatic and adjuvant settings. Joint-related symptoms, however, are seen in a significant proportion of patients. Carpal tunnel syndrome (CTS) is a common nerve entrapment disorder affecting the median nerve. We describe 6 patients with newly diagnosed CTS after initiation of adjuvant AI therapy. Aromatase inhibitors were discontinued in several patients secondary to this toxicity with some switching to tamoxifen and most subsequently experiencing relief of their symptoms. Potential pathophysiologic roles of hormonal manipulation with AIs and other risk factors that might contribute to CTS are discussed. Aromatase inhibitors might accentuate the occurrence of CTS and potentially other nerve entrapment syndromes, and a more systematic approach should be used to better understand the clinical significance and incidence of these symptoms.     

Retrograde venography and colour Doppler imaging of a popliteal venous aneurysm

Popliteal venous aneurysms are rare and usually manifest with formation of thrombus and embolization to the lungs. The radiological features of a popliteal venous aneurysm, without thrombus, initially identified by ultrasound with colour Doppler imaging and further investigated with retrograde venography is described.     

The role of anatomic and functional staging in myeloma: description of Durie/Salmon plus staging system

Staging is the cornerstone of baseline myeloma evaluation. New imaging techniques such as magnetic resonance imaging (MRI), whole body FDG-PET scanning and whole body CT (combined with PET directly or by fusion) offer the opportunity to precisely stage patients by anatomic and functional techniques. The new Durie/Salmon PLUS staging system integrates these new imaging techniques into a new generation of anatomic and functional myeloma staging. It is possible to discriminate between the impact of tumour burden (myeloma cell mass) and other prognostic factors. This refined classification by stage and prognostic category is increasingly important in clinical trials. The value of clinical staging in patient management is emphasized both in discrimination of early disease status and clearer identification of poorer risk of Stage II and III disease. Wider use of newer imaging will undoubtedly enhance analysis of new trials incorporating novel agents.     

^18F-FDG PET/CT显像对肾细胞癌分级和临床分期及预后预测的价值

目的：评价PET/CT显像对于肾细胞癌恶性程度分级、临床分期及预后的价值。方法：回顾性分析46例临床诊断为肾细胞癌患者的PET/CT显像结果,与其他影像资料结果相比较,探讨其与肾细胞癌分级、临床分期及预后的关系。结果：46例患者中,经手术病理确诊为肾细胞癌者37例,其余9例因PET/CT显像发现有转移病灶放弃手术。PET/CT检查结果真阳性41例,假阴性5例,敏感度为89.1%,其他影像资料敏感度为84.8%。37例手术患者中,3级肾细胞癌病理分组间SUV差异均有统计学意义,P值分别为0.034、0.012和0.021。17例死亡病例,平均生存期为9个月,最大SUV越高,患者的生存期相对就越短。结论：PET/CT显像结果与肾细胞癌分级有关,分级越高,阳性率越高;PET/CT显像对于肾细胞癌临床分期及预后亦有重要价值。     

Cystic Myxomatous Degeneration of the Popliteal Artery

The disease is a rare one of dubious pathogenesis. The clinical presentation is usually one of the sudden onset of intermittent claudication in a young adult male. Arteriography may reveal a stenosis, with or without displacement, or complete occlusion of the popliteal artery, which otherwise appears normal. Treatment is either by incision of the cysts with extrusion of their contents in stenotic lesions or resection of the artery with autogenous vein replacement in complete occlusion. A search of the literature has revealed 31 documented cases of the disorder, and this paper describes two further cases.     

Craniofacial mucormycosis following assault: An unusual presentation of an unusual disease

A case of craniofacial mucormycosis following assault is discussed. A female diabetic developed peri‐orbital cellulitis adjacent to a scalp wound which progressed to a necrotizing fasciitis. This did not respond to treatment. Subsequently the patient developed a hemiparesis, with CT imaging showing peri‐orbital and paranasal sinus inflammatory changes, evidence of cavernous sinus invasion and development of a middle cerebral artery territory infarction. The patient died shortly afterwards. The imaging findings and their relationship to the pathological spread of mucor infection are discussed.     

功能影像和生物靶区:实验与临床研究进展

功能影像已经逐渐应用于靶区勾画，并导致了生物靶区及生物适形调强放疗等概念的产生。本文对生物靶区和生物适形调强放疗的研究进展进行了综述，着重介绍了葡萄糖显像、氨基酸显像、核酸显像、乏氧显像、基因显像及分子影像的现状，探讨和展望了功能影像和生物适形调强放疗的发展方向。     

18F-FDG PET/CT显像对肾细胞癌分级和临床分期及预后预测的价值

目的:评价PET/CT显像对于肾细胞癌恶性程度分级、临床分期及预后的价值。方法:回顾性分析46例临床诊断为肾细胞癌患者的PET/CT显像结果,与其他影像资料结果相比较,探讨其与肾细胞癌分级、临床分期及预后的关系。结果:46例患者中,经手术病理确诊为肾细胞癌者37例,其余9例因PET/CT显像发现有转移病灶放弃手术。PET/CT检查结果真阳性41例,假阴性5例,敏感度为89.1%,其他影像资料敏感度为84.8%。37例手术患者中,3级肾细胞癌病理分组间SUV差异均有统计学意义,P值分别为0.034、0.012和0.021。17例死亡病例,平均生存期为9个月,最大SUV越高,患者的生存期相对就越短。结论:PET/CT显像结果与肾细胞癌分级有关,分级越高,阳性率越高;PET/CT显像对于肾细胞癌临床分期及预后亦有重要价值。