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1.
A longitudinal insufficiency fracture of the tibia in association with a healed chronic osteomyelitis 总被引:3,自引:0,他引:3
Feydy A Carlier R Mutschler C Bernard L Leriverend V Vallée C 《European radiology》2000,10(12):1929-1931
Longitudinal stress fracture of the tibia often present with an atypical clinical presentation which can be mistaken for
osseous tumor or osteomyelitis. We present a case of longitudinal stress fracture of the tibia which occurred in a patient
with healed chronic osteomyelitis of the tibia. Magnetic resonance imaging failed to make the correct diagnosis. Accurate
diagnosis was only obtained by helical CT which showed the longitudinal fracture line. Magnetic resonance imaging showed only
non-specific signs of bone marrow edema, suggesting recurrence of osteomyelitis. Magnetic resonance imaging can be misleading
in the absence of direct visualization of the fracture line.
Received: 30 September 1999; Revised: 26 April 2000; Accepted: 2 May 2000 相似文献
2.
Compressive vertebral haemangiomas (VHs) are rare. Correct preoperative diagnosis is useful both for operative planning (since
compressive VHs are extremely vascular lesions) and to allow preoperative embolisation. Numerous radiological signs for VHs
have been described, but compressive VHs frequently have atypical features. In particular, magnetic resonance features are
not well established. We present imaging features in three cases of compressive VH and review the imaging findings in an additional
106 previously published cases. Findings were typical in 52 of 80 plain film (65 %), 33 of 41 computed tomography (80 %) and
13 of 25 magnetic resonance examinations (52 %). The prevalence of previously described imaging features is reported. Awareness
of the range of magnetic resonance features is important since this is frequently the initial investigation in patients presenting
with symptoms of neural compression. Since computed tomography is typical in 80 % of cases, this is a useful confirmatory
test if magnetic resonance features are suspicious but not diagnostic of compressive VH.
Received: 6 August 1999; Revised: 4 November 1999; Accepted: 4 November 1999 相似文献
3.
Local recurrence of rectal cancer: MR imaging before and after oral superparamagnetic particles vs contrast-enhanced computed tomography 总被引:2,自引:0,他引:2
The aim of this study was to compare three imaging strategies for the diagnosis of local recurrence of rectal cancer: (a) MR imaging; (b) MR imaging after administration of enteral superparamagnetic particles (Ferristene); and (c) contrast-enhanced CT. Seventeen patients with previous surgery for rectal cancer were examined, 12 patients with local tumour recurrence in the pelvis and 5 patients with postoperative changes. Pelvic multi-coil MR imaging before and after oral administration of superparamagnetic contrast medium [Abdoscan (Ferristene USAN), Nycomed-Amersham, Liding?, Sweden] as well as abdominal and pelvic CT was performed in all patients. The examinations were independently evaluated by three different radiologists. The general effect of the oral MR contrast medium, the delineation of normal and pathological structures as well as confidence in the diagnosis were registered on a visual analog scale (VAS). The diagnosis according to MR before and after oral contrast medium, and CT, was compared, in 16 patients, with the final diagnosis which was verified by biopsy (n = 3), surgery (n = 6), clinical follow-up (n = 4) and by follow-up with MR or CT (n = 3). No significant improvement in MR image quality was found after enteral contrast medium. The post-contrast MR diagnosis was not changed in any of the patients. The diagnosis on MR correlated with the final diagnosis in 12 of 16 patients (sensitivity 91%, accuracy 62%) and the diagnosis on CT in 11 of 16 patients (sensitivity 82 %, accuracy 56 %). The radiologists' "confidence" in the diagnosis and the degree of accordance with the final diagnosis did not score higher on MR after than before oral contrast administration; however, the accordance with the final diagnosis scored better on MR than on CT. No advantages of orally administered superparamagnetic contrast medium were observed in the examined patient group. Magnetic resonance is preferable to CT in diagnosing local tumour recurrence. 相似文献
4.
Boudiaf M Soyer P Pelage JP Kardache M Nemeth J Dufresne AC Rymer R 《European radiology》2000,10(6):920-925
Because of improvement in survival rate of patients with abdominal cancer, gastrointestinal complications following external
radiation therapy are becoming more frequent. Thus, an increased number of patients are commonly investigated with imaging
because of suspected radiation-induced injury of the gastrointestinal tract. This pictorial review highlights the spectrum
of CT and barium study manifestations of radiation-induced injury of the gastrointestinal tract. The major role of CT in the
evaluation and management of patients with radiation injury of the gastrointestinal tract is highlighted. Emphasis is placed
on CT imaging signs that may help in distinguishing between radiation-induced injury and recurrent disease.
Received: 19 October 1999; Accepted: 15 November 1999 相似文献
5.
Henry Foster Bradley Schiff Jacqueline Bello Keivan Shifteh 《Radiology Case Reports》2021,16(12):3698
A left maxillary sinus soft tissue mass was discovered on computed tomography in a 70-year-old woman who had been experiencing blood-tinged mucus for 2 years. The lesion demonstrated mild enhancement, and bony destruction. Magnetic resonance imaging displayed a cerebriform appearance of the mass, which mimicked the appearance of inverted papilloma. However, histology and staining identified the lesion as ameloblastoma. Resection of the tumor was successful with no recurrence 1 month later on follow-up computed tomography. This case represents an unusual imaging presentation of ameloblastoma, and an opportunity to avoid the misdiagnosis of inverted papilloma in similar future cases. 相似文献
6.
Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging 总被引:1,自引:0,他引:1
Kröncke TJ Taupitz M Kivelitz D Scheer I Daberkow U Rudolph B Hamm B 《European radiology》2000,10(7):1095-1100
The aim of this study was to describe the MR appearance of multifocal nodular fatty infiltration of the liver (MNFIL) using
T1-weighted in-phase (IP) and opposed-phase (OP) gradient-echo as well as T2-weighted turbo-spin-echo sequences with fat suppression
(FSTSE) and without (HASTE). Magnetic resonance imaging examinations at 1.5 T using T1-weighted IP and OP-GRE with fast low
angle shot (FLASH) technique, and T2-weighted FSTSE, T2-weighted HASTE of 137 patients undergoing evaluation for focal liver
lesions were reviewed. Five patients were identified in whom CT indicated metastatic disease; however, no liver malignancy
was finally proven. Diagnosis was confirmed by biopsy (n = 3), additional wedge resection (n = 1) or follow-up MRI 6–12 months later (n = 5). Regarding the identified five patients, the number of focal liver lesions was 2 (n = 2) and more than 20 (n = 3). The MR imaging characteristics were as follows: OP-image: markedly hypointense (n = 5); IP image: isointense (n = 2) or slightly hyperintense (n = 3); T2-weighted FSTSE-image: isointense (n = 5); T2-weighted HASTE image isointense (n = 1); slightly hyperintense (n = 4). On OP images all lesions were sharply demarcated and of almost spherical configuration (n = 5). Further evaluation by histology or follow-up MR imaging did not give evidence of malignancy in any case. Histology
revealed fatty infiltration of the liver parenchyma in three patients. Magnetic resonance follow-up showed complete resolution
in two patients and no change in three patients. Multifocal nodular fatty infiltration can simulate metastatic disease on
both CT and MR imaging. The combination of in-phase (IP) and opposed-phase (OP) gradient-echo imaging can reliably differentiate
MNFIL from metastatic disease.
Received: 15 September 1999 Revised: 3 February 2000; Accepted: 7 February 2000 相似文献
7.
Gleno-humeral instabilities 总被引:4,自引:1,他引:3
The purpose of this review is to highlight the most efficient imaging exploratory techniques depicting shoulder instability,
to describe its various forms and to point out the findings which can simulate instability. In anterior recurrent dislocation,
surgery is indicated and the procedure essentially depends on the importance of glenoid rim lesions. In this case, a standard
X-ray evaluation is usually sufficient. The CT arthrography or MRI techniques give more specific details as to the severity
of the lesions, particularly soft tissues alterations; however, these data do not alter standard therapeutic protocol. In
fixed posterior dislocations, CT scan represents the most pertinent technique to evaluate the size of the humeral head defect
and to determine the therapeutic follow-up. In subtle forms of instability, diagnosis or instability direction are not clearly
assessed clinically and standard X-ray evaluation is usually unremarkable. In this case, further exploration, such as CT arthrography,
MR imaging or MR arthrography, are recommended to confirm the diagnosis of instability and to evaluate its direction. The
technique of choice is undoubtedly MR arthrography. Atraumatic voluntary painless subluxations associated with hyperlaxity
of the shoulder do not require any specific exploratory method because the findings are generally limited to a capacious axillary
pouch.
Received: 28 September 1998; Revised: 21 January 1999; Accepted: 22 March 1999 相似文献
8.
Congenital abnormality of the aortic arch is a diagnosis made most of the time incidentally in childhood, unless dysphagia
or respiratory disorders occur before. A case of a complex aortic arch anomaly with an aneurysm of the right subclavian artery
presenting as an isolated Horner's syndrome in an adult is reported herein. Magnetic resonance imaging led to this very unusual
diagnosis.
Received: 17 March 1999; Revised: 15 July 1999; Accepted: 13 August 1999 相似文献
9.
MR imaging of pituitary hyperplasia in a child with growth arrest and primary hypothyroidism 总被引:5,自引:0,他引:5
Papakonstantinou O Bitsori M Mamoulakis D Bakantaki A Papadaki E Gourtsoyiannis N 《European radiology》2000,10(3):516-518
Magnetic resonance imaging of pituitary hyperplasia has been rarely described in children with primary hypothyroidism. We
report a case of pituitary hyperplasia in a child presented with significant growth arrest and laboratory evidence of hypothyroidism.
Magnetic resonance imaging revealed symmetrical pituitary enlargement simulating macroadenoma. After thyroid hormone replacement
therapy, the child's height increased and pituitary enlargement regressed to normal. Awareness of MRI appearance of pituitary
hyperplasia in children with laboratory evidence of hypothyroidism might avoid misdiagnosis for pituitary tumor, which may
also manifest as growth disorder, obviating unnecessary surgery.
Received: 4 March 1999; Revision received: 4 June 1999; Accepted: 7 June 1999 相似文献
10.
Gallstone ileus: CT findings 总被引:6,自引:0,他引:6
Gallstone ileus is a rare complication of recurrent gallstone cholecystitis. The classic radiographic triad of small bowel
obstruction, pneumobilia and ectopic gallstone on abdominal plain radiograph is described with CT imaging. Because of the
better resolution of CT compared with abdominal radiography and its recent accession to emergency use, radiologists should
be aware of CT findings of gallstone ileus. We report a case in which gallstone ileus was initially diagnosed by CT.
Received: 30 July 1999; Revised: 18 October 1999; Accepted: 18 October 1999 相似文献
11.
Vanrietvelde F Lemmerling M Mespreuve M Crevits L De Reuck J Kunnen M 《European radiology》2000,10(4):576-578
The clinical, biochemical and magnetic resonance imaging findings of two patients with cerebrotendinous xanthomatosis are
reported. This is a rare hereditary disease. Early recognition of this entity is important in view of the existing treatment
possibilities. Magnetic resonance imaging findings typically include a bilateral and almost symmetrical increase of the signal
intensity on the T2-weighted images in the cerebellar and periventricular cerebral white matter, the basal ganglia, the dentate
nuclei and the brainstem as well as cerebellar and cerebral atrophy.
Received: 18 January 1999; Revised: 3 June 1999; Accepted: 7 June 1999 相似文献
12.
Savnik A Amris K Røgind H Prip K Danneskiold-Samsøe B Bojsen-Møller F Bartels EM Bliddal H Boesen J Egund N 《European radiology》2000,10(10):1655-1659
Falanga is an ancient form of punishment or torture but is still commonly reported by our refugees. The late result of caning
the heel and ball of the foot is a chronic painful condition with few clinical signs. The aim of the present study was to
assess, by MRI, possible morphologic characteristics of the heel and ball of the foot, related to falanga and pain in correlation
to clinical findings. Magnetic resonance imaging of the foot was obtained in 12 victims exposed to falanga torture and 9 healthy
volunteers. Sagittal T1-weighted spin-echo images (TR 616–840 ms, TE 20 ms), T2-weighted spin-echo images (TR 1900 ms, TE
90 ms), and short tau inversion recovery (STIR) images (TR 1200 ms, TE 15 ms, TI 100 ms) were performed. The central portion
of the plantar aponeurosis was generally significantly thicker in victims exposed to falanga torture as compared with that
of controls (P < 0.05). In all except one of the victims, MRI demonstrated two layers of the thickened plantar aponeurosis: a deeper portion
with normal homogeneous low signal intensity (SI) appearance, and a superficial layer with characteristic areas of mixed SI
on both T1- and T2-weighted images. There were no signs of chronic muscular compartment syndromes, and the thickness of the
plantar pad did not differ between the two groups. Magnetic resonance imaging may demonstrate morphologic characteristics
of the plantar aponeurosis which may confirm falanga torture. Further imaging with more specific sequences is warranted to
demonstrate the supposed injuries in the compartmental fat tissue chambers and the vascularity of the ball pad of the foot.
Received: 25 November 1999; Revised: 8 February 2000; Accepted: 6 April 2000 相似文献
13.
Primary hepatic angiosarcoma is a rare mesenchymal tumor of the liver that usually presents with nonspecific symptoms in
elderly men. We present four cases of hepatic hemangiosarcoma and discuss the imaging characteristics of this entity. Our
series shows that this tumor is not uncommon in younger patients with no associated risk factors such as previous exposure
to thorotrast or vinyl chloride. Our experiences on a limited number of patients suggests that the combined use of angiography
and dual-phase helical CT provides a better identification of the tumor and its complications. Analysis of imaging studies
in patients with hepatic hemangiosarcoma reveals hypervascular lesions. Common complications were portal vein thrombosis,
Budd-Chiari syndrome, as well as arterio-venous or arterio-portal shunts. Due to the vascularity of the tumor, percutaneous
liver biopsy is hazardous.
Received: 20 November 1998; Revised: 2 March 1999; Accepted: 12 April 1999 相似文献
14.
The purpose of this study was to determine the value of MR imaging for the demonstration of masses in the tongue and floor
of the mouth. Nine patients were prospectively examined with MR imaging after physical examination. Imaging protocol included
T2 and contrast-enhanced and non-contrast-enhanced T1-weighted turbo spin-echo sequences, and the findings were compared with
surgical and histopathological results. Histopathological examination revealed four squamous cell carcinomas, one adenoid
cystic carcinoma, two tongue abscesses, and one chronic inflammatory change. The other case was diagnosed as hemangioma depending
on clinical and imaging findings alone. In cases with squamous cell carcinoma, staging was done on the basis of MR imaging
findings, and was found to be T4 in two cases, T3 in one case, and T2 in another. The primary role of MR imaging of the tongue
and oropharynx is not to make a tissue diagnosis. Multiple deep biopsies are mandatory for the differentiation of other inflammatory
and neoplastic lesions. Magnetic resonance imaging produces coronal and sagittal image planes to assess the volume and spread
of the lesion and helps the surgeon determine the direction in which the biopsy should be performed.
Received: 4 October 1999; Revised: 31 January 2000; Accepted: 6 April 2000 相似文献
15.
Pancreatitis: computed tomography and magnetic resonance imaging 总被引:9,自引:1,他引:8
The value of CT in management of severe acute pancreatitis is well established. Some, but not all, experimental studies suggest
a detrimental effect of intravenous iodinated contrast agents in acute pancreatitis, but although initial clinical data tends
to support this, the positive advantages of enhanced CT outweigh the possible risks. Magnetic resonance imaging has been shown
to be as effective as CT in demonstrating the presence and extent of pancreatic necrosis and fluid collections, and probably
superior in indicating the suitability of such collections for percutaneous drainage. Image-guided intervention remains a
key approach in the management of severely ill patients, and the indications, techniques and results of radiological intervention
are reviewed herein. Both CT and MRI can be used to diagnose advanced chronic pancreatitis, with the recent addition of MRCP
as a viable alternative to diagnostic endoscopic retrograde cholangiopancreatography (ERCP). Both MRCP and CT/MR imaging of
the pancreatic parenchyma still have limitations in the recognition of the earliest changes of chronic pancreatitis – for
which ERCP and tests of pancreatic function remain more sensitive – but the clinical significance of these minor changes remains
contentious.
Received: 12 February 1998; Revision received: 17 June 1998; Accepted: 22 June 1998 相似文献
16.
A 21-year-old woman with tuberous sclerosis presented with abdominal distension and flank pain. Imaging studies, including
CT and MR imaging, revealed bilateral renal mass lesions, containing fat and suggesting the diagnosis of tuberous sclerosis.
However the imaging characteristics of one of these lesions differed from the others with no radiologically detectable fat
tissue in this solid lesion suggesting renal cell carcinoma. Histopathological examination of this lesion in the left kidney
revealed an angiomyolipoma with minimal fat tissue. The radiological diagnosis of angiomyolipomas with minimal fat tissue
remains difficult and the differential diagnosis is discussed.
Received: 5 October 1998; Revised: 22 December 1998; Accepted: 7 June 1999 相似文献
17.
Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP? 总被引:14,自引:0,他引:14
The aim of this study was to evaluate the diagnostic potential of virtual endoscopy (VE) and to compare it with axial CT
slices, multiplanar reconstructions (MPR), minimal intensity projections (mIP), and bronchoscopy in patients diagnosed with
bronchogenic carcinoma. Thirty patients underwent a spiral CT. Axial CT images were transferred to an Onyx workstation (Silicon
Graphics, Sun Microsystems, Mountain View, Calif.) for performing virtual endoscopy. Accuracy for this procedure was tested
by three radiologists on a monitor in comparison with axial CT slices, MPR, mIP, and bronchoscopy concerning the localization
and degree of stenoses. Endoluminal tumors were identified by virtual bronchoscopy with no statistically significant difference
of localization or grading of stenosis in comparison with bronchoscopy, axial CT slices, MPR and mIP. Axial CT slices, MPR,
and mIP showed poorer results with over- or underestimation of stenoses compared with VE and bronchoscopy. Passing of stenoses
was only possible with VE in 5 patients. Virtual endoscopy is a non-invasive method for identification of endoluminal tumors
and is comparable to real bronchoscopy.
Received: 18 March 1999; Revised: 21 May 1999; Accepted: 22 July 1999 相似文献
18.
Maleux G van Steenbergen W Stockx L Vanbeckevoort D Wilms G Marchal G 《European radiology》2000,10(7):1127-1129
We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis.
Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior
mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by
transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any
recurrent bleeding.
Received: 18 June 1999; Revised: 13 October 1999; Accepted: 15 October 1999 相似文献
19.
Imaging in ureteral complications of renal transplantation: value of static fluid MR urography 总被引:3,自引:0,他引:3
Schubert RA Göckeritz S Mentzel HJ Rzanny R Schubert J Kaiser WA 《European radiology》2000,10(7):1152-1157
Ureteral obstruction is an infrequent complication after renal transplantation that may cause rapid loss of transplant function.
We tested static fluid MR urography for determining the cause of graft hydronephrosis. Magnetic resonance urography was performed
in nine transplants with dilated collecting systems on ultrasound. A heavily T2-weighted 3D turbo spin-echo sequence on a
1.5-T scanner was used and maximum intensity projections were obtained. The patients also underwent excretory urography (n = 1), renal scintigraphy (n = 1), antegrade pyelography (n = 3), voiding cystourethrography (n = 4), and non-enhanced CT (n = 2). Six patients had pathologic conditions including ureteral stricture, compression by lymphoceles, implantation stenosis,
vesicoureteral reflux, and late-occurring transitional cell carcinoma at the implantation site. Static MRU was able to diagnose
or exclude a dilation of the graft collecting system. It visualized the course of the ureters and localized the obstruction
site in four of five obstructed transplants. In one case the ureter was obscured by lymphoceles, which were demonstrated by
hydrographic MRU as well. The definite cause for obstruction was provided in only 2 of 5 cases. Dilation due to vesicoureteral
reflux could not be differentiated. The current multimodality approach to renal transplant imaging already provides comprehensive
assessment of graft hydronephrosis. Static MRU may be useful in some cases since complications associated with intravenous
iodinated contrast or antegrade pyelography can be avoided. Its main drawback, the lack of functional information, may be
overcome by combining it with contrast-enhanced MRU.
Received: 18 February 1999; Revised: 23 July 1999; Accepted: 18 November 1999 相似文献
20.
D. Kihiczak R. A. Novelline J. N. Lawrason T. Ptak J. T. Rhea R. Sacknoff 《Emergency radiology》2001,8(5):276-278
Magnetic resonance (MR) imaging is not routinely used to exclude ligamentous and other soft tissue injury in the unconscious
trauma patient. In order to determine the frequency and types of soft tissue injuries detected by MR imaging but not by computed
tomography (CT), we performed a retrospective investigation comparing the MR findings in 59 trauma patients, either alert
or unconscious, who previously had undergone a negative clearance multislice CT study of the cervical spine. Six patients
had abnormalities not identified on the CT studies, including four cases of ligamentous injury. 相似文献