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1.
Pneumatosis intestinalis is a potential cause of asymptomatic pneumoperitoneum without peritonitis. The disease can be managed conservatively and presents a clinical scenario where pneumoperitoneum does not necessitate surgical management. This case illustrates the importance of acknowledging the condition and its variable presentation, allowing for increased awareness and avoidance of invasive procedures when not indicated.  相似文献   

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Ossicles located in the acetabular fossa may confuse diagnostic and therapeutic work-up. An accessory ossification centre may persist unfused as an os acetabuli centrale which is surrounded by intact hyaline cartilage representing an anatomic variant. Bone islands located in the pillars of the acetabulum can project into the acetabular fossa simulating acetabular ossicles. Osteochondrosis dissecans, posttraumatic articular bodies, degenerative disease and other rare lesions may be responsible for clinical symptoms and are of similar appearance than anatomic variants. Plain film radiography, X-ray tomography, CT and MRI are used to categorize these lesions. MRI is very valuable to assess cartilage integrity in a noninvasive way, but arthro-CT or arthro-MRI have to be used in unclear cases. Therefore the purpose of this presentation is to discuss the appearance, the possible etiology and the differential diagnosis of acetabular ossicles and how they can be evaluated to avoid an unnecessary arthrotomy. Received: 22 December 1998; Revised: 28 May 1999; Accepted: 8 July 1999  相似文献   

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Angiomyolipoma is a well-known rare soft tissue tumor involving the kidneys, liver and other organs. Long believed to be a benign hamartoma, angiomyolipoma is now considered a neoplasm that arises from perivascular epithelioid cell. Epithelioid angiomyolipoma is a rare variant of angiomyolipoma characterized by epithelioid cells that mimic renal cell carcinoma and is potentially malignant. Immunoreactivity with HMB45 is helpful for its identification. We report the computed tomographic and histologic findings in a 36 years old woman with epithelioid angiomyolipoma and lymph node involvement.  相似文献   

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Objective To describe the radiological findings of “Bizarre parosteal osteochondromatous proliferation”(BPOP)—otherwise known as Nora’s lesion, to describe the natural evolution of BPOP and to assess radiologically if BPOP is indeed part of a spectrum of reactive lesions including florid reactive periostitis and turret exostosis.Design Four experienced musculoskeletal radiologists studied plain radiographs and other imaging documents of histologically-proven Nora’s lesions, looking for soft-tissue changes, periosteal reaction/calcification and calcified/ossified pseudotumours, and compared those findings with findings on pathology reviewed by a peer group of pathologists.Patients Twenty-four Nora’s lesions originating from a series of 200 consecutive, histologically-verified bone (pseudo)tumours of the hand, seen by the “Netherlands Committee on Bone Tumours” for review and second opinion.Results Nora’s lesions have a recognised presentation on radiographs without specific MR characteristics. Natural evolution could be assessed retrospectively in four cases. Recurrent lesions were seen in seven cases and are difficult to differentiate from primary lesions.Conclusions Nora’s lesion, defined as a “well-marginated mass of heterotopic mineralization arising from the periosteal aspect of an intact cortex, without medullary changes” has a distinct radiological presentation and is part of a spectrum of reactive lesions which includes florid reactive periostitis and turret exostosis. As it has a distinct radiological appearance, differential diagnosis of malignant lesions such as osteosarcoma and chondrosarcoma should be clear. It does not require immediate biopsy unless the natural evolution is unspecific.  相似文献   

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Hippocampal malrotation with normal corpus callosum: a new entity?   总被引:3,自引:1,他引:2  
Among 527 MRI examinations of patients with a suspicion of epilepsy in 5 years, we found 32 cases of hippocampal malrotation (HIMAL). The characteristic features are: incomplete inversion of the hippocampus with and abnormally round shape; unilateral involvement of the whole hippocampus; normal signal intensity and size; blurred internal structure; an abnormal angle of collateral sulcus; abnormal position and size of the fornix; normal size of the temporal lobe; enlargement and particular configuration of the temporal horn, typical of corpus callosum agenesis; and a normal corpus callosum. In 7 cases (22 %) HIMAL occurred together with developmental disorders. It was predominantly seen in men. The clinical features were varied. Based on some MRI features, the presence of developmental disorders, the male predominance, the frequently positive family history, and a review of the literature, we think HIMAL may be the consequence of a mild hemisphere developmental disorder. It is probably not the basic cause of epilepsy in such varied clinical setting, but may be a sign of a developmental disorder and can help in selecting patients for more meticulous investigation. It also may give some new understanding of brain development. Received: 22 October 1998/Accepted: 6 November 1999  相似文献   

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Abstract. Although its metabolic basis has not yet been clarified, we report a progressive white-matter disease in a Turkish girl, starting in the cerebellum and spreading to supratentorial white matter. The onset was at the age of 2.5 years with diabetes insipidus, followed by ataxia and pyramidal signs resulting in loss of walking. Aqueduct stenosis was first recognised at the age of 8 years. To our knowledge, this MRI and clinical pattern does not correspond to a recognised, well-defined white-matter disease and may indicate a separate entity.  相似文献   

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Objective

In this study, transthoracic echocardiography and cardiac magnetic resonance were compared in terms of the detection, localization, characterization and extra cardiac association of cardiac lesions to specify the value of adding CMR to TTE in diagnosing benign intracardiac lesions.

Materials and methods

Twenty nine patients ranging in age between 7 months and 80 years were enrolled in the study. Twenty five patients with suspected intracardiac lesions by TTE, in addition four patients with accidentally discovered thrombi on CMR were added to the study.

Results

CMR detected 17 non neoplastic lesions and 11 neoplastic lesions. CMR changed the diagnosis made by TTE in five cases, showed additional findings to TTE in three cases and was superior to TTE in detecting four cases of cardiac thrombi.

Conclusion

CMR is superior to TTE in characterization of intracardiac lesions, detecting its site, size, vascularity, hemodynamics and multiplicity of the lesion with high tissue contrast. Thus it should be performed in all cases suspicious of cardiac masses as it could aid in patient management and guide for surgery. Moreover it can prevent unneeded cardiac surgery in cases of benign non-neoplastic lesions or in benign tumors with no hemodynamic significance.  相似文献   

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Introduction  

Intracranial developmental venous anomalies (DVAs) are considered benign vascular dispositions; they are asymptomatic in the vast majority of cases. They represent extreme variations of the venous drainage and may rarely be responsible for focal venous ischemia leading to neurological dysfunction. The aim of the study is to analyze a group of patients with symptomatic DVAs with capillary stain at angiography.  相似文献   

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Total parenteral nutrition (TPN) using a central line is an invasive and widely used procedure associated with several complications. Pleural effusion secondary to the leakage of alimentation into the pleural cavity is a rare but encountered complication of central-line TPN administration. This case study focuses on a postmortem examination of an 84-year-old woman, hospitalized due to malnutrition and dysphagia. The left internal jugular vein was cannulated, with no post-procedural x-ray check-up of the catheter tip position. An autopsy revealed 800 ml of milky-white fluid in the left pleural cavity, raising the issue of whether the pleural effusion was of chylous or TPN origin. The aim of this case study was to describe the postmortem diagnostic approach of the fluid analysis. Suspecting chylothorax, we first analyzed the triglyceride (TG) levels in the fluid, which, according to the literature, is the best parameter to detect chyle when lipoprotein electrophoresis (chylomicron %) is unavailable. Biochemistry showed increased levels of TG, which can be found in both chylous and TPN fluid. We then added glucose and potassium to the biochemical analysis, again showing increased levels at 46 mmol/L and 22 mmol/L, respectively. We had no information about the given TPN, and thus, comparing the final chemical results with the TPN composition was impossible. The presence of increased levels of triglycerides, glucose, and potassium in the white fluid more strongly resembled a standard TPN than chyle. Hence, by using these three measurements, we concluded that the milky-white fluid was a leakage of TPN.  相似文献   

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