MR imaging of pericallosal lipoma

Early pathologic reports of corpus callosal lipoma described a consistent relationship between the lipoma and the dorsal surface of the corpus callosum, particularly when the lipoma is not associated with corpus callosal agenesis. MR imaging, especially T1-weighted sagittal acquisitions, exquisitely demonstrated this anatomic relationship in three relatively asymptomatic patients. Therefore, in most cases, a lipoma of the corpus callosum is more accurately described as a pericallosal lipoma. In one individual, common associated findings (partial agenesis of the corpus callosum and choroid plexus lipoma) were also noted. Surgical therapy is usually not indicated because symptoms are generally not related and the anterior cerebral artery is often encased by the lipoma.     

Segmental testicular infarction: report of seven new cases and literature review

Segmental testicular infarction is a relatively rare acute or subacute condition which is infrequently thought of in the differential diagnosis for testicular pain. However, missing or misdiagnosing this entity on clinical evaluation and/or imaging has significant implications for patients as they may undergo unnecessary surgery for suspected testicular torsion or tumor. Knowledge and recognition of the features of segmental testicular infarction on ultrasound and MRI will aid in the diagnosis of this disease early in the patient's course. The common imaging features of segmental testicular infarction and the clinical literature are reviewed, with an emphasis on ultrasound, utilizing seven recent cases from three institutions.     

Intraosseous lipoma: report of 35 new cases and a review of the literature

OBJECTIVE: To identify the common imaging features of intraosseous lipomas on radiographs, magnetic resonance imaging (MRI) and computed tomography (CT), and review their histological features. DESIGN AND PATIENTS: Thirty-five previously unreported cases of intraosseous lipoma were reviewed and a meta-analysis was performed of another 110 cases identified from the English language literature. RESULTS: The mean age at presentation is 43 years. Sex distribution is nearly equal. Lipomas occur most frequently in the lower limb (71% overall), particularly in the os calcis (32%). Other common sites include the metaphyses of long bones, where lesions are typically eccentric. Lipomas are usually well defined, but marginal sclerosis is commoner in lesions of the os calcis (61%) than at other sites (38%). Calcification is also more frequent in the os calcis (62%), and almost invariably centrally located. Calcification at other sites is less common (30%), and is more variable in appearance. Bone expansion is less common (30%), and usually minimal. Fat necrosis and cyst formation identified on MRI is common (67%), and more frequent in the os calcis. CONCLUSIONS: Although there is correlation between the histological and radiological features of intraosseous lipomas in general, some discrepancies occur in the radiological appearances of lipomas in different sites. The evidence that these lesions are true benign tumours of fat is controversial. Several aetiological factors have been implicated in their development. The constant location of os calcis lesions at the critical angle suggests an aetiology that may be related to biomechanical lines of stress. In other instances it is possible that involution of pre-existing lesions may lead to the development of lipomas.     

Prenatal and immediate postnatal ultrasonographic diagnosis of ureterocele

We report three patients in whom hydronephrosis was diagnosed by ultrasonography in utero. In two fetuses, ureteroceles were detected prenatally and these proved to be the cause of obstruction. In the third, bilateral simple ureteroceles were discovered immediately after birth. In the last patient, failure to see ureteroceles in utero may have been related to the phenomenon of ureterocele eversion and prolapse into the ureter. Ultrasonographers should be aware of this prolapse phenomenon as a potential pitfall for both the in utero and postpartum diagnosis of ureterocele.     

Prenatal diagnosis of umbilicoportosystemic shunts: report of 11 cases and review of the literature

OBJECTIVE: The objective of our study was to classify, understand, and illustrate abnormalities of the embryologic development of the umbilical vein and the portal system resulting in umbilicoportosystemic shunts. According to our data and a review of the literature, we propose an anatomic, biometric, and hemodynamic assessment of umbilicoportosystemic shunts. CONCLUSION: Umbilicoportosystemic shunts encompass different congenital vascular abnormalities that should be recognized because they may interfere with fetal growth and circulation.     

Computed tomography of lipoma of corpus callosum and choroid plexus lipoma: report of two cases

Lipoma of corpus callosum and choroid plexus lipoma are rare developmental anomalies arising as a result of maldifferentiation of primitive meningeal tissue. Two cases are reported along with a brief review of literature. The first case presented with chronic headache, and a large lipoma of corpus callosum associated with choroid plexus lipoma was discovered. The second case had no symptoms before the discovery of corpus callosal lipoma on computed tomography, which was done for a head injury. None of the lipomas showed any calcification.     

Radiation therapy for exophthalmos: report of seven cases.

Five of 7 cases of exophthalmos showed improvement within three months with 2,000 rads of 6 MeV radiation. A new technique of X-ray beam localization employing a direct measurement 12 mm posterior to the anterior extent of the cornea was used and found more accurate than using a fixed point (external canthus). All cases should be treated bilaterally. Retreatment after radiation failure is not recommended. There were no complications. Improvement is usually rapid as orbital irradiation, not including the pituitary, causes rapid destruction of the massive collection of lymphocytes and a reduction in the bulky mass and edema of the orbit.     

Gastric lymphoma: diagnosis and follow-up of chemotherapy-induced changes using real-time ultrasonography: a report of three cases

Three cases of secondary gastric lymphoma are presented in which diagnosis was suggested by ultrasound (US) and confirmed by endoscopy and microscopical examination. Three different US patterns are illustrated and compared with endoscopy. US findings paralleled endoscopy during follow-up under antiblastic treatment: both improvement and lack of change in the gastric lesions were reliably predicted by US.     

Imaging findings in Mazabraud's syndrome: seven new cases

OBJECTIVE: To present seven new cases of Mazabraud's syndrome with particular observations on the magnetic resonance imaging findings and a review of the literature. DESIGN AND PATIENTS: A multi-institutional retrospective review was performed on seven patients with confirmed Mazabraud's syndrome. The patient group was composed of six women and one man, ranging in age from 39 to 65 years, with a mean age of 53 years. RESULTS: Fibrous dysplasia was more often polyostotic ( n=6) and right-sided ( n=4). Fibrous dysplasia involved the femur in five cases. The soft tissue myxomas were multiple in four cases and were intramuscular in origin. The most commonly affected location was the thigh ( n=4). On computed tomography, myxomas were well-circumscribed, low-attenuation masses. On magnetic resonance images, the lesions were significantly low in signal intensity on T1-weighted images and high in signal intensity on T2-weighted images relative to adjacent skeletal muscle. Enhancement of the myxomas was heterogeneous with irregular, peripheral rim enhancement, and a variable degree of central enhancement depending on the abundance of solid myxoid tissue and bridging fibrous septa. CONCLUSIONS: Knowledge of Mazabraud's syndrome and the imaging appearance of intramuscular myxoma is important in order to avoid unnecessary biopsies of the osseous and soft tissue lesions. The unique features of this disorder allow discrimination from soft tissue malignancies such as sarcoma.     

Hydrometrocolpos: diagnosis and follow-up by ultrasound--a case report

Hydrometrocolpos is accumulation of secretions in the vagina and uterus, caused by excessive intrauterine stimulation of the infant's cervical mucous glands by maternal oestrogen in the presence of an intact hymen (Wilson et al 1978). Hydrocolpos is dilatation of the vagina proximal to a congenital obstruction. If the uterus is also dilated, the condition is called hydrometrocolpos. Most cases of hydrocolpos are associated with an imperforate hymen that forms a thin bulging membrane between the labia. Though many cases of hydrometrocolpos have been reported in literature, there is no case report which shows classical ultrasound findings and follow up ultrasound scans to show the involuted uterus. We are presenting a case report whose diagnosis was established on ultrasound. This case highlights the value of ultrasound in diagnosing this condition and excluding other associated renal anomalies.     

双胎反向动脉灌注序列征的MRI产前诊断（附4例报告及文献复习）

目的：探讨双胎反向动脉灌注序列征（TRAP）的 MRI表现及其诊断价值。方法：回顾性分析本院83例不同的胎儿畸形的 MRI资料,MRI扫描均采集单次激发快速自旋回波序列（SSFSE）、厚层重T2加权成像 SSFSE 序列、三维稳态进动快速成像（3D-FIESTA）序列,其中胎儿引产尸检及随访证实其中的TRAP有4例。分析其 MRI图像、临床资料及妊娠结局,总结TRAP的 MRI影像学特征。结果：4例TRAP 初次确诊的孕周为12～31周。4例TRAP 中每例无心胎儿均缺乏或无正常的心脏,且伴发各种不同的严重畸形。4例TRAP中1例于孕28周5天早产,双胎死亡;2例引产;1例无心胎儿于孕24周超声检查时发现无心胎儿死胎,继续妊娠至37周剖腹产分娩,泵血胎儿结局良好。结论：产前 MRI检查对于TRAP的早期诊断、预后判断、治疗方案及分娩时机的选择都有着重要的应用价值,MRI 是超声外对TRAP 的重要补充检查方法。     

Endobronchial lipoma: CT diagnosis

Computed tomography was performed in two patients with endobronchial lipomas. Bronchoscopy was inconclusive, but CT provided the definitive diagnosis by demonstrating fat within the endobronchial tumor.     

产前超声诊断胎儿单侧手残缺畸形1例

孕妇 27岁,孕1产0,孕26周.夫妻双方身体健康,无先天性畸形及遗传性疾病.常规来我院行产前超声检查.超声所见:单胎,头位,双顶径6.7cm,头围24.8cm,腹围19.2cm,股骨长径4.6cm,胎儿颅内结构未见明显异常,脊柱排列整齐,胸腹腔脏器及颜面部器官未见明显异常.胎儿四肢扫查,右手掌未见显示,右上肢末端仅见3节长短不一残缺手指;实时三维显示胎儿右手残缺不全.胎盘位于后壁,成熟度Ⅰ级,羊水指数16.6cm.超声提示:①单胎中期妊娠;②胎儿右手残缺畸形.引产一死男婴,可见右上肢末端仅3节手指,长短不一,较大的手指可触及手指骨.     

结肠脂肪瘤影像学诊断(附9例分析)

结肠脂肪瘤很少见,其临床症状不典型,X线钡灌肠及CT扫描是本病术前诊断的最佳检查手段。本文收集9例经X线钡灌肠、CT检查及手术病理证实的结肠脂肪瘤进行报道分析。1材料与方法本组9例患者,男1例,女8例,年龄为45~60岁,平均51岁。临床表现腹痛有9例,其中伴有呕吐2例,黏液性血便2例。体检腹部均有不同程度的压痛,5例扪及包块。9例均作常规X线钡灌肠,其中1例同时作CT平扫。2结果9结肠脂肪瘤位于黏膜下,回盲部5例、横结肠近段4例。X线钡灌肠表现:①充盈相均为肠腔内大小不等的卵圆形充盈缺损(图1),边缘光滑锐利7,轻度分叶状2例;②加压检查充…