Fluid–fluid level in peripheral nerve schwannoma: report of a case with histological correlation

Fluid–fluid level was observed in an unusual case of a 74-year-old man with peripheral nerve schwannoma of the lower extremity. To our knowledge, we found that schwannomas with imaging findings of fluid–fluid level had rarely been reported in the literature, and these tumors were all intracranial. Fluid–fluid level seen in peripheral nerve schwannoma has never been reported. In this case, MRI signal characteristics are those of blood and histological analysis of the fluid–fluid level suggests cystic degeneration with presence of intratumoral hemorrhage.     

Well-differentiated liposarcoma of the retroperitoneum with a fat–fluid level: US, CT, and MR appearance

We report a case of retroperitoneal liposarcoma with a fat–fluid level that has not been previously described. A 36-year-old man presented with abdominal distension. Ultrasonography, CT, and MR imaging showed a tumor with a fat–fluid level; nondependent fluid was characteristic of fat. Liposarcoma should be included in the differential diagnosis of tumors exhibiting a fat–fluid level. Received 27 February 1997; Revision received 21 May 1997; Accepted 26 May 1997     

Extra-osseous fat fluid level: a specific sign for osteomyelitis

Osteomyelitis may pose as a diagnostic dilemma on various imaging modalities and may be confused with neoplasms and other pathology. Although a rare finding, extra-osseous fat fluid level, especially when associated with spongy bone destruction, can be considered a specific sign of osteomyelitis. Previously, only two cases of extra-osseous fat fluid level in osteomyelitis have been reported, one on computed tomography (CT) and the other on magnetic resonance imaging (MRI). The former was a case of septic arthritis with intra-articular fat fluid level. A case of osteomyelitis is presented with the demonstration of extra-osseous fat fluid level. Our case is unique in providing exquisite CT and MRI correlation.     

Magnetic resonance imaging of fluid levels in an aneurysmal bone cyst and in anticoagulated human blood

Magnetic resonance imaging (MRI) demonstrated a fluid level within an aneurysmal bone cyst (ABC). Since the ABC contained gross blood at operation, an anticoagulated human blood sample was studied by MRI also, and a fluid level was again clearly visible. MRI pulse sequences emphasizing T₁ contrast showed the fluid levels most clearly in both the ABC and the blood. Sequences emphasizing T₂ contrast showed homogeneous, bright signals in the ABC and in the blood, with no visible fluid level in the ABC and a nearly invisible one in the blood. In the blood sample, the calculated plasma T₁ value was 1585 ms, and that of the red cells was 794 ms.     

创伤性膝关节积脂血症的CT及MRI诊断

目的 分析创伤性膝关节积脂血症的CT及MRI表现特点.方法 回顾性分析50例创伤性膝关节积脂血症患者的CT及MRI的影像学特征,所有患者于受伤后1h～7天内行MRI或CT检查.结果 CT和MR成像50例关节积脂血症患者均有关节内骨折,关节积脂血症CT和MRI表现为关节囊内单液-液平面或双液-液平面.其中36例表现为单液-液平面积液征象,14例表现为双液-液平面积液征象.单液-液平面及双液-液平面的不同成份在CT和MRI上密度和信号不同,但上层均为脂肪.结论 关节积脂血症在CT和MRI上具有特征性表现,可做出明确诊断,关节积脂血症均与关节内骨折并存,可作为关节内骨折的可靠间接征象.     

Acetabular pneumatocyst containing air–fluid level

The presence of intraosseous gas most commonly occurs in osteomyelitis, vacuum phenomenon, and postsurgery or posttraumatic states. Several cases of subchondral gas-filled lesions, called pneumatocysts, have also been described in the sacroiliac joint and clavicle, none of them with intralesional air–fluid level. These pneumatocysts are innocuous lesions of uncertain origin. We describe one case of acetabular pneumatocyst containing air–fluid level in a 62-year-old man with long-standing ankylosing spondylitis involving hip joint. To our knowledge, this is the first reported case of a pneumatocyst in an acetabular location containing air–fluid level. Received: 15 June 1998; Revision received: 4 November 1998; Accepted: 11 December 1998     

Diagnosis and triage of a patient with an extra-osseous fat fluid level

Extra-osseous fat fluid level is rarely seen in osteomyelitis, with only three magnetic resonance imaging (MRI) cases previously reported in the literature. The rarity of this finding is probably secondary to the extensive necrosis of bone marrow that needs to occur at a rapid phase for the fat to accumulate. However, an extra-osseous fat fluid level is a specific diagnostic sign of osteomyelitis in cases with otherwise equivocal imaging findings and should be reported as such, especially when associated with medullary bone destruction and in the absence of trauma.     

Effects of dehydration and fluid ingestion on cognition

The effects of exercise-induced dehydration and fluid ingestion on men's cognitive performance were assessed. Eleven young men attended separate sessions in which each individual cycled in a controlled environment at 60 % of V.O (2max) for periods of 15, 60, or 120 min without fluid replacement or 120 min with fluid replacement. Immediately following the assigned submaximal exercise period, the participant completed a graded exercise test to voluntary exhaustion. An executive processing test and a short-term memory test were performed prior to and immediately following exercise. Choice-response times during the executive processing test decreased following exercise, regardless of the level of dehydration. Choice-response errors increased following exercise, but only on trials requiring set shifting. Short-term memory performance improved following exercise, regardless of the level of dehydration. Changes in cognitive performance following exercise are hypothesized to be related to metabolic arousal following strenuous physical activity.     

MR imaging of intracranial fluid levels

Six patients with seven intracranial fluid levels were evaluated with both CT and MR at 1.5 T. A surgical diagnosis was obtained in six of the seven instances. MR was found to be superior to CT in detecting intracranial fluid levels, and the MR signal characteristics were helpful in identifying their contents. These cases demonstrate the necessity for a slightly different approach to lesions with fluid levels. In one patient, imaging in the prone position allowed detection of a solid component; in several others, detection of the fluid level was dependent on the selection of nonroutine windows and levels. Fluid levels are classified with respect to their components and MR features. MR is superior to CT in imaging fluid levels. The appearance of fluid levels on MR varies with their composition, the ratio of the components, the sequence parameters, and the position of the patient.     

Cerebrospinal fluid leakage after lumbar puncture in neonates: incidence and sonographic appearance

OBJECTIVE: The purpose of this article is to review the incidence and sonographic appearance of cerebrospinal fluid leakage after lumbar puncture in the neonatal period. Thirty-three neonates underwent spinal sonography after diagnostic lumbar puncture. A total of 21 of these patients showed cerebrospinal fluid leakage into the epidural space extending from the level of the cauda equina to the lumbar (n = 9), the thoracic (n = 8), or the cervical (n = 4) region. In eight patients, the subarachnoid space was markedly compressed by the epidural fluid collection. CONCLUSION: Cerebrospinal fluid leakage into the epidural space is a frequent complication of lumbar puncture in neonates and has a characteristic appearance on sonograms. Leakage after lumbar puncture must be differentiated from cerebrospinal fluid leakage due to perinatal meningeal injury. If cerebrospinal fluid leakage at the puncture site compresses the subarachnoid space, sonography assists in the performance of subsequent lumbar puncture.     

功能性消化不良胃动力学类型与胃液一氧化氮水平的关系

目的　探讨功能性消化不良 (FD)胃动力类型与胃液一氧化氮 (NO)水平间的关系。方法　通过胃镜检查 ,把FD的胃窦动力状态区分为胃窦弛缓型 (Ⅰ型 )、胃窦紧张型 (Ⅱ型 )、返流型 (Ⅲ型 )及正常型 (Ⅳ型 )。抽取胃液 ,采用Greiss法检测胃液NO水平。结果　Ⅰ ,Ⅱ ,Ⅲ ,Ⅳ型胃液NO测定值 (μmol/ml)分别为 2 8.80± 2 .16 ,17.72± 2 .4 0 ,2 2 .2 4±1.94 ,2 0 .18± 2 .34,Ⅰ型的胃液NO水平最高 ,与其他各型比较 ,差异显著 (P <0 .0 5 )。结论　FD患者胃液NO水平与胃动力学类型间存在相关性 ,检测胃液NO值可为初步判定FD患者胃动力学类型提供参考依据     

The differential retrocardiac air-fluid level: a sign of intrathoracic gastric volvulus

A single retrocardiac air-fluid level on a chest radiograph typically implies the presence of a sliding hiatal hernia. A differential retrocardiac fluid level (two air-fluid interfaces at different heights) suggests not a simple sliding hiatal hernia but rather an intrathoracic gastric volvulus. Simultaneous fluid levels above and below the diaphragm are not required to make the diagnosis. We have seen four patients with chronic gastric volvulus confirmed by upper gastrointestinal barium examination. Each case was diagnosable on the basis of the chest radiographs obtained on admission, using the radiographic sign described above. We draw attention to this sign because chronic gastric volvulus has the potential to progress to acute volvulus and gastric ischemia or infarction.     

Inflight intravenous therapy: a new dimension.

This Inflight Infusion System was designed to meet an urgent operational requirement for accurate administration of intravenous (I.V.) fluid therapy to acutely ill patients while in flight. Aircraft cabin pressure changes affect the flow of intravenous fluids. The discharge rate of I.V. fluids may become excessive during ascent to 2438 m (8000 ft) the level at which both commercial and military aircraft are commonly pressurized, or during loss of cabin pressure, such as may take place at higher altitudes. During descent, the flow rate becomes insufficient or stop until ground level pressure is reached. A method for carefully controlling intravenous fluid intake during all phases of flight with an inflight infusion system that utilizes a modified precision roller pump was developed by the USAF School of Aerospace Medicine. This technique assures carefully controlled fluid intake that is not possible by using the conventional gravity method.     

Juxtapapillary diverticulum: findings on CT and MRI

The purpose of this study was to evaluate the computed tomography (CT) and magnetic resonance imaging (MRI) features of juxtapapillary diverticulum. CT and/or MRI examinations of 12 patients were evaluated. The size, location of the diverticula and imaging findings of associated pancreaticobiliary disease were assessed. On CT, oral contrast air level was the characteristic imaging feature. On MRI, T2-weighted images demonstrated the air fluid level with hyperintense fluid and signal void air level above. Associated imaging findings were dilated common bile duct (CBD), cholecystitis, cholecystolithiasis and chronic pancreatitis.     

Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid,diphenhydramine, and ethanol

A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid–fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone.     

new method of thoracocentesis using CT guidance in patients with a small amount of pleural fluid

A new technique of CT-guided diagnostic thoracocentesis (CT-TC) for patients with a small amount of pleural fluid was performed in 52 patients. More than 10 ml of pleural fluid was obtained successfully without any complications in all cases; 14 patients were found to have malignant cells in the pleural fluid. The main points of the CT-TC procedure are as follows: (1) The patient is placed supine with two radiolucent blocks underneath the shoulders and hips in order to make space for inserting the needle from the back (below). (2) Serial CT images are obtained to determine the insertion route and to measure the depth of the fluid level below the skin. (3) The needle is bent at the appropriate angle and length and is advanced upward slowly from the skin entry point on the back. CT-TC can also be used therapeutically in debilitated patients who can not maintain a sitting position or when the pleural fluid needs to be drained completely.     

Procalcitonin and C-reactive protein in pericardial fluid for postmortem diagnosis of sepsis

The aim of this study was to investigate the presence and concentrations of procalcitonin and C-reactive protein in pericardial fluid and compare these levels to those found in the postmortem serum obtained from the femoral blood. Two groups were formed, a sepsis-related fatalities group and a control group. Postmortem native CT scans, autopsies, histology, neuropathology and toxicology as well as other postmortem biochemistry investigations were performed in all cases. Pericardial fluid procalcitonin levels were significantly different between the cases of sepsis-related fatalities and those of the control group. Postmortem serum procalcitonin levels below the detection limit were also reflected in undetectable pericardial fluid levels. Similarly, a large increase in postmortem serum procalcitonin levels was reflected in a large increase of procalcitonin pericardial fluid levels. Based on these findings, pericardial fluid could be an alternative to postmortem serum for the determination of procalcitonin levels in cases where postmortem serum is not available and measurements of procalcitonin are required to circumstantiate the pathogenesis of death.     

X-ray computed tomographic aspects of spinal aneurysmal cysts in children

The interest of CT imaging in a case of aneurysmal bone cyst of the posterior arch of the 6th cervical vertebra in a 10 y.o. child is underlined. The value of intra tumoral densities which are relatively low, inferior to 100 Hounsfield unit is stressed but the most contributory feature in this case was the presence of a fluid level inside the cyst due to different densities of fluid components into the cyst.     

Postmortem intravascular high-density fluid level (hypostasis): CT findings

PURPOSE: To evaluate postmortem CT (PMCT) finding of hypostasis. METHODS: PMCT examinations were performed within 2 hours of death in 126 patients who arrived at our institution in nontraumatic cardiopulmonary arrest. RESULTS: PMCT showed hypostasis as high-density fluid level in the lumen of the heart or great vessels in 66 of 126 patients (52%). CONCLUSION: Hypostasis is observed as an intravascular high-density fluid level on PMCT.