Cerebral CT and MRI findings in cervicocephalic artery dissection

Purpose: To explore the frequency and patterns of brain infarction and other brain manifestations in cervicocephalic artery dissection (CCAD) and to evaluate the correlation between vessel wall findings and infarctions.

Material and Methods: The medical records and films of 136 consecutive CCAD patients diagnosed in Oulu University Hospital during the 20-year period since 1982 were reviewed. Five patients with no brain imaging were excluded.

Results: One-hundred-and-twenty-seven patients underwent cerebral CT and four patients MRI. Brain infarction was detected in 73 patients (56%), 43 of whom had cerebral infarction associated with anterior circulation dissection and 30 cerebellar infarction associated with posterior circulation dissection. Occlusion of the dissected vessel was accompanied by infarction in 76%, irregular stenosis in 40%, and other findings in 12%. Of the anterior circulation infarctions, territorial and subcortical infarctions and territorial infarctions with fragmentation, which are considered embolic, accounted for 95%, while only 5% were in the watershed area and considered hemodynamic. Intracranial posterior circulation dissection rarely caused infarction (in 1/11 of the dissected vessels), whereas intracranial anterior circulation dissection resulted in infarction more commonly (9/12). Altogether 23% of patients with intracranial CCAD had subarachnoid hemorrhage. Hemorrhagic transformation was present in five patients.

Conclusions: More than half of CCAD patients have cerebral or cerebellar infarction at CT or conventional MR imaging. Occlusion of the dissected vessel is accompanied by infarction more often than other vessel wall abnormalities. Most cerebral infarctions caused by arterial dissections are of embolic origin. Intracranial dissections cause subarachnoid hemorrhage in more than 20% of patients.     

MR and CT findings in pulmonary artery sarcoma

Pulmonary artery sarcomas are a rare and frequently forgotten cause of pulmonary artery occlusion. We present a case report that details magnetic resonance and new CT findings, which may help establish early diagnosis of this infrequently encountered tumor.     

Spontaneous isolated dissection of the celiac artery: CT findings in adults

OBJECTIVE: Our objective was to describe the CT features of spontaneous isolated celiac artery dissection in a series of six otherwise healthy patients with acute abdominal pain. CONCLUSION: Although once believed rare, isolated spontaneous celiac artery dissection should be considered in the diagnosis of acute abdominal pain, especially in middle-aged adults.     

Aortic dissection and aberrant right subclavian artery: CT and MR findings

A case of aortic dissection extending to an aberrant right subclavian artery seen at CT and MRI is reported. The clinical and imaging patterns of this rare disease are described and compared with those of the literature. Multiplanar views are, in this particular case, very useful for a precise assessment of the involved aberrant artery.     

肺真菌病的CT影像学表现的探讨

近年来由于广谱抗生素、免疫抑制剂、肾上腺皮质激素、细胞毒药物等的广泛使用,以及器官移植的日趋普及,真菌感染逐渐地增多。肺真菌病的致病菌繁多,不同菌种有不同的影像学表现,也有相似的影像学表现,特异性征像较少,常常因误诊为结核、其他菌种感染或漏诊而延误治疗,     

CT findings of pulmonary nocardiosis

OBJECTIVE: Nocardiosis is an opportunistic infection that primarily affects the lungs. Most infected patients have deficits in cell-mediated immunity such as those with AIDS, transplant recipients, and those receiving corticosteroid therapy. We review the various CT appearances of pulmonary nocardiosis and discuss the differential diagnosis. CONCLUSION: Common CT findings include lung consolidation and nodules and masses. Cavitation may occur. Chest wall involvement develops in a small number of patients.     

Pulmonary artery dissection: MR findings.

We report a case of pulmonary artery dissection imaged by MR. Dissection of a markedly dilated pulmonary artery is a rare and usually fatal complication of chronic pulmonary arterial hypertension. The diagnosis is made at autopsy, with only two cases having previously been documented (by Doppler echocardiography) during life. The hallmark of an arterial dissection is the finding of an intimal flap and a false lumen. In our case, spin echo MR imaging failed to show either the intimal flap or any intraluminal signal defects. The dissection was presumably obscured by nonhomogeneous intraluminal signal caused by the slow blood flow associated with severe pulmonary arterial hypertension. Cine MR imaging, however, demonstrated different signal intensity within the true and false lumens of the dissection, thereby outlining the intimal flap between the two channels.     

Echinococcus of the pulmonary artery: CT, MRI and MRA findings.

The location of echinococcal cysts inside pulmonary artery is extremely rare. The cause is usually rupture of intracardiac cysts. We report a case of a 67-year-old patient with known lung hydatid disease whose main clinical presentation was dyspnea. The patient did not have any surgery in the past. The importance of the present case lies in the demonstration of the MR angiographic findings.     

侵袭性肺曲菌病的CT表现

目的 探讨侵袭性肺曲菌病（ＩＰＡ）的ＣＴ表现。方法 经病理及临床证实的ＩＰＡ８例,均行常规ＣＴ扫描,２例４周后ＣＴ复查。结果 ＣＴ表现为肿块样浸润（３例）;炎症样病变（３例）;多发结节（２）。结论 ＩＰＡ的早期ＣＴ征象有肿块,多发结节,实变;ＣＴ“晕轮征”的出现强烈提示的早期诊断。     

原发性肺淀粉样变的CT表现

淀粉样变性是一组蛋白质以异常的纤维结构沉积于细胞之间,该类纤维接触硫和碘会出现和淀粉一样的反应,故命名为淀粉样变性.原发性呼吸系统淀粉样变是指在无系统淀粉样变的情况下,淀粉样物质在呼吸系统沉着.本病为少见疾病,临床表现多种多样且无明显特征性,本文收集原发性肺淀粉样变5例,并结合文献,探讨其影像学表现.     

原发性肺肉瘤样癌的病理亚型及其CT表现

目的 探讨原发性肺肉瘤样癌各亚型的临床病理特征及CT表现,以提高对本病的认识.方法 回顾性分析14例经手术病理证实为原发性肺肉瘤样癌患者的临床病理资料及CT表现.所有病例术前均行CT检查,其中10例行CT增强扫描.结果 14例中周围型13例,中央型1例,肿瘤直径2.5～9.5 cm,病变位于右肺上叶5例、中叶2例、下叶4例,左肺上叶3例.14例表现为肺内实质性肿块,3例肿瘤内可见偏心性不规则空洞,肿块边界光整6例、模糊2例、分叶4例、毛刺3例,另1例因中央型肿块伴阻塞性肺炎致边界不清.10例CT增强扫描患者均显示肿块周边厚薄不均的环形强化,肿块中央强化不明显或不均匀强化.7例侵及胸膜或胸壁组织,4例可见肺门和(或)纵隔淋巴结肿大,2例有远处转移.手术病理诊断为多形性癌7例,梭形细胞癌2例,巨细胞癌3例,肺母细胞瘤2例.结论 原发性肺肉瘤样癌的CT表现有一定特征,最终诊断有赖于组织病理及免疫组织化学检查.     

肺硬化性血管瘤的CT表现(附10例报告)

目的：探讨肺硬化性血管瘤（PSH）的CT表现,旨在提高对该病的认识及诊断水平。方法：回顾性分析经手术病理证实的t0例PSH患者,其中男1例,女9例,年龄47～68岁,平均57．6岁。10例均行胸部CT检查,其中1例仅行CT平扫,9例行CT平扫及增强扫描。结果：病灶部位：右肺3例,其中上叶1例,中叶2例;左肺7例,其中上叶4例,下叶3例。病灶形态：10例均为圆形、类圆形肺内肿块或结节,境界清晰．分叶不明显（4例有浅分叶）、无毛刺、胸膜牵拉凹陷、卫星病灶及血管集束征等征象。病灶大小：均为单发,最大径1．7～5．1cm,其中〈3cm者6例。病灶密度：CT平扫4例密度较均匀,6例见斑片状稍低密度区,4例见点状或粗大点片状钙化;CT增强均匀强化3例,不均匀强化6例,9例中7僻呈延迟强化。特征性的征象：空气新月征1例、贴边血管征10例、尾征3例、晕征7例。结论：空气新月征、贴边血管征、尾征、晕征等CT征象具有一定的特征性。有助于PsH的术前诊断。     

CT findings of pulmonary infections]

Although many pulmonary infections are diagnosed using chest radiographs in combination with clinical findings and are treated empirically with antibiotics, there are situations in which chemotherapy is not effective and further examinations are necessary. In those cases, CT, especially high-resolution CT (HRCT), can provide additional information about detailed morphological changes of the lung that are sometimes indicative of the causative organisms of pneumonia, such as pulmonary tuberculosis. Although it is true that the same organism can present a wide spectrum of radiological findings, it is also important for differential diagnosis to understand the basic features of pathological changes of the lung and the CT findings caused by each of the various organisms. Such CT information would also be useful in differentiating infectious pneumonia from noninfectious pneumonia. This review article presents the principal CT findings of pulmonary infections and their pathological correlations with various pneumonias, including bacterial, tuberculous, fungal, and viral pneumonias.     

非典型肺转移瘤的CT表现

目的:分析非典型肺转移瘤的CT表现形式,以提高对本病的诊断准确性。方法:回顾性分析42例经临床、手术及病理证实的非典型肺转移瘤的CT表现,探讨其与原发肿瘤的关系。结果:本组病例显示非典型肺转移瘤CT表现:空洞型转移12例,钙化型转移9例,肺炎型转移8例,孤立型转移6例,转移瘤内支气管充气征5例,自发性气胸2例。结论:肺转移瘤可以表现多种不典型征象,熟悉这些征象对临床诊断和治疗有重要意义。     

Vertebral artery dissection diagnosed with CT.

Vertebral artery dissection after neck manipulation has been well described. A case of bilateral vertebral artery dissection diagnosed with dynamic CT scanning of the neck is reported. The CT appearances and correlative angiographic and MR findings are presented.     

Persistent stapedial artery: CT findings

CT of a patient with conductive hearing loss showed a small vascular structure leaving the carotid canal and passing through the stapes to join the facial nerve canal. The small bony channel paralleled the anterior tympanic segment of the facial nerve, continuing beyond the geniculate ganglion into the middle cranial fossa. Otoendoscopic photography documented the presence of a persistent stapedial artery.     

CT findings after uterine artery embolization

Asymptomatic uterine leiomyoma can be detected on routine computed tomography (CT) of the pelvis. Leiomyomas have been described as low attenuation masses that can disrupt the smooth contour of a normal uterus. Four women underwent uterine artery embolization for the treatment of uterine leiomyoma. CT findings include initial retention of contrast in fibroids the day of the procedure and central necrosis of the fibroid with subsequent cavitation as early as 1 month postprocedure.     

CT findings in primary pulmonary lymphomas

PURPOSE: To describe the CT findings of pathologically confirmed primary pulmonary lymphomas. MATERIALS AND METHODS: The CT examinations of 11 patients with pathologically proven primary pulmonary lymphoma (9 BALT lymphomas and 2 non-BALT lymphomas) were retrospectively reviewed by three radiologists. Evaluated findings included morphology (consolidation, mass, nodule), number and distribution of lesions. Other CT findings such as air bronchogram, lymphadenopathy, atelectasis and pleural effusion were also assessed. RESULTS: Pulmonary lesions were depicted as airspace consolidation (pneumonia-like) in 5 patients (45%), tumour-like rounded opacity in 4 (36%), and nodules in 4 (36%). Multiple and bilateral lung lesions were seen in 3 patients (27%). Air bronchogram was present in 7 patients (63%), lymphadenopathy in 3 (27%), atelectasis in 4 (36%) and pleural effusion in only 1 (9%). CONCLUSIONS: Our results agree with previous studies regarding lesion patterns and their relative frequency. A smaller number of nodules and multiple lesions were found compared with some previous studies. The most frequent pattern was airspace consolidation.     

Spontaneous dissection of the vertebral artery: MR findings

Spontaneous (nontraumatic) dissection of the carotid and vertebral arteries, once thought to be rare, is being recognized and reported more frequently. We report one case of spontaneous dissection of the vertebral artery initially diagnosed by magnetic resonance imaging and subsequently confirmed by angiography.