RESUMEN
UNLABELLED: Stemocleidomastoid tumor of infancy (SCMTI) is a rare cause of benign neck masses in neonates and infants. It has to be differentiated from other congenital space-occupying lesions in the cervical region. PATIENTS AND METHODS: The files of 13 infants with a mean age of 6 weeks, presenting with a lateral neck mass at Sahloul University Hospital in Sousse (Tunisia) between 2007 and 2009 were retrospectively studied. All of them underwent physical and ultrasonographic examination. MRI was performed in only one case. RESULTS: Ultrasonography (US) showed a soft tissue mass of sternocleidomastoid muscle (SCMM), or a homogenously enlarged muscle without any focal mass. MRI revealed a fusiform enlarged muscle. Diagnosis of SCMTI was established in all cases. Conservative treatment was recommended in all cases with physiotherapy in 2 cases. CONCLUSION: US is the best imaging modality for the diagnosis of SCMTI and the first one to be performed. Additional diagnostic imaging modalities are unnecessary in most of the cases.
Asunto(s)
Neoplasias de Cabeza y Cuello/diagnóstico , Músculos del Cuello/patología , Diagnóstico Diferencial , Femenino , Neoplasias de Cabeza y Cuello/etiología , Humanos , Lactante , Imagen por Resonancia Magnética , Masculino , Músculos del Cuello/diagnóstico por imagen , UltrasonografíaRESUMEN
We report a case of herpetic encephalitis in a 2-year-old girl. Diagnosis was made at 1st by clinical symptoms and MRI and confirmed by lumbar puncture. Forty days later, new neurologic symptoms appeared and MRI diagnosed acute disseminated encephalomyelitis. MRI better demonstrates CNS abnormalities in herpetic encephalitis and may play a major role as a 1st step in early diagnosis, in particular for acute disseminated encephalomyelitis.
Asunto(s)
Encefalitis por Herpes Simple/diagnóstico , Encefalomielitis Aguda Diseminada/diagnóstico , Imagen por Resonancia Magnética , Preescolar , Femenino , HumanosRESUMEN
OBJECTIVE: To describe the MRI features of liposarcomas of the extremities and correlate them with data from the histologic subtypes. MATERIAL AND METHODS: Retrospective study of 20 cases of liposarcoma of the extremities identified on MRI, surgically removed and confirmed at pathology. On MRI examination, T1- and T2-weighted fat-suppressed and non-fat-suppressed images were acquired then gadolinium-enhanced fat-suppressed T1-weighted images were obtained in at least two orthogonal planes. RESULTS: Sixteen female and four male patients aged 12 to 77 years old at presentation, in 16 cases, with a slowly enlarging painless mass (demonstrating no associated local or general inflammatory components), located in the lower extremity (16 cases) and predominantly located in the thigh (13 cases). Pathologic examination revealed three cases of well-differentiated liposarcoma, 12 cases of myxoid liposarcoma one of which with round cells, three cases of pleomorphic liposarcoma, one case of dedifferentiated liposarcoma and one case of mixed-type liposarcoma. MR images mostly showed well-circumscribed tumors (19 cases) . Well-differentiated liposarcomas typically demonstrated a very specific diagnostic appearance as a predominantly adipose mass containing nonlipomatous components seen as thick septa that may show nodularity. Other subtypes of liposarcoma demonstrated a small amount of adipose tissue thus producing a marbled textural pattern on T1-weighted images particularly in myxoid liposarcomas (9 cases), or even nonlipomatous elements in high-grade liposarcomas (in round cell liposarcoma and in two out of three pleomorphic liposarcomas). The myxoid subtype has also a relatively characteristic appearance as a low signal intensity noted on T1-weighted images and a marked high signal intensity on T2. The dedifferentiated liposarcoma has a very specific radiologic appearance as a nonlipomatous component within a predominantly adipose mass, simulating that of well-differentiated liposarcomas. CONCLUSION: MRI of extremity liposarcomas is a highly reliable and sensitive method to characterize liposarcomas. Besides its value in the diagnosis of liposarcoma and locoregional extension control, it allows proper identification of the specific histologic subtypes of liposarcoma. LEVEL OF EVIDENCE: Level IV. Rétrospective diagnostic study.
Asunto(s)
Extremidades , Procesamiento de Imagen Asistido por Computador , Liposarcoma/diagnóstico , Liposarcoma/patología , Imagen por Resonancia Magnética , Neoplasias de los Músculos/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/patología , Adolescente , Adulto , Anciano , Niño , Extremidades/cirugía , Femenino , Humanos , Liposarcoma/cirugía , Liposarcoma Mixoide/diagnóstico , Liposarcoma Mixoide/patología , Liposarcoma Mixoide/cirugía , Masculino , Persona de Mediana Edad , Neoplasias de los Músculos/patología , Neoplasias de los Músculos/cirugía , Músculo Esquelético/patología , Músculo Esquelético/cirugía , Estudios Retrospectivos , Sensibilidad y Especificidad , Neoplasias de los Tejidos Blandos/cirugía , Tejido Subcutáneo/patología , Tejido Subcutáneo/cirugía , Adulto JovenRESUMEN
The presence of gas in the spinal canal or pneumorachis is a rare imaging finding, typically incidental. Pneumorachis may be due to several degenerative, traumatic, infectious, tumoral or iatrogenic etiologies. We report three cases of pneumorachis in patients with lumbar back pain. A case occurred in a patient with advanced degenerative disk disease. Another was in a patient with posterior facet synovial cyst. The last was in a patient with locally advanced rectal carcinoma complicated by perforation. Pneumorachis was detected on MRI in two cases and on CT in all three cases.
Asunto(s)
Enfisema/etiología , Canal Medular/patología , Enfermedades de la Columna Vertebral/etiología , Carcinoma/complicaciones , Femenino , Humanos , Degeneración del Disco Intervertebral/complicaciones , Perforación Intestinal/complicaciones , Dolor de la Región Lumbar/etiología , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades del Recto/complicaciones , Neoplasias del Recto/complicaciones , Quiste Sinovial/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
We report 3 cases of primary oxalosis with nephrocalcinosis and severe renal failure. Extrarenal involvement was noted in bones in 3 cases, the heart in 2 cases, the central nervous system in 2 cases, the skin in 1 case and the eye in 1 case. The 3 patients presented with acute digestive disorders. Ultrasonography and CT scans showed digestive wall calcifications in addition to the classic appearance of primary oxalosis such as nephrocalcinosis or bone involvement. Primary hyperoxaluria is characterized by a calcium deposit in different tissues, mainly in kidneys. Digestive wall involvement has never been reported in the literature. Primary oxaluria should be considered in the presence of such a deposit in the gut wall.
Asunto(s)
Enfermedades del Sistema Digestivo/inducido químicamente , Hiperoxaluria Primaria/diagnóstico , Nefrocalcinosis/diagnóstico , Tomografía Computarizada por Rayos X , Ultrasonografía , Dolor Abdominal/etiología , Oxalato de Calcio/metabolismo , Niño , Sistema Digestivo/patología , Femenino , Humanos , Hígado/patología , Masculino , Músculo Liso/patología , Músculo Liso Vascular/patología , Adulto JovenRESUMEN
We report MR imaging features in 3 cases of spontaneous spinal epidural hematoma, a potential neurosurgical emergency.
Asunto(s)
Hematoma Espinal Epidural/diagnóstico , Imagen por Resonancia Magnética/métodos , Adolescente , Adulto , Vértebras Cervicales , Femenino , Estudios de Seguimiento , Hematoma Espinal Epidural/diagnóstico por imagen , Hematoma Espinal Epidural/cirugía , Humanos , Laminectomía , Vértebras Lumbares , Masculino , Persona de Mediana Edad , Vértebras Torácicas , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
OBJECTIVES: Illustrate the specific and nonspecific aspects of myositis ossificans circumscripta (MOC) in standard imaging, cross-sectional imaging (sonography, CT, and MRI), and bone scintigraphy. PATIENTS AND METHODS: Eight patients presenting with MOC (three men and five women) were explored using standard radiography (eight cases), sonography (seven cases), scintigraphy (four cases), CT (six cases), and MRI (four cases). RESULTS: Standard x-rays and sonography of the soft tissue showed a well-defined mass containing calcifications in 75% of the cases. The CT scan diagnosed MOC in four cases, showing calcified masses separated from the adjacent bone by a clear radiotransparent border or afferent peripheral tumoral calcifications highly suggestive of MOC. MRI was nonspecific. Bone scintigraphy showed hyperfixation in the four cases imaged. CONCLUSION: Standard x-rays were useful to demonstrate the calcifications of MOC and to identify their relation with the subjacent bone. Sonography and bone scintigraphy were interesting in monitoring the lesion's maturation. In addition to early detection of calcifications, CT can precisely localize the lesion before surgical ablation. MRI is a very sensitive technique in detecting small lesions at an early stage, but it is nonspecific and does not remove the necessity of biopsy to eliminate the possibility of a malignant disease.
Asunto(s)
Miositis Osificante/diagnóstico , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Miositis Osificante/diagnóstico por imagen , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
OBJECTIVE: Discoid meniscus is a rare congenital pathology affecting mainly the lateral meniscus. Radiological diagnosis, initially based on arthrographic findings, is now established on well defined MRI criteria. In this study, ultrasonography (US) was the modality proposed for diagnosing discoid meniscus and compared to the normal sonographic meniscal pattern. Subjects and methods. 8 children aged from 6 to 11 years, with a symptomatology highly suggestive of meniscal pathology, were investigated by US of both knees, followed by MRI in 3 and arthroscopy in all cases. RESULTS: In all 8 cases, a meniscus was diagnosed as discoid when it no longer had its normal triangular shape, was abnormally elongated and thick and demonstrated a heterogeneous central pattern. Associated lesions (fracture, cystic degeneration) were well demonstrated on US. The lateral meniscus was involved in all 8 cases, the pathology was bilateral in 5 cases and MRI/US correlation was good in 3 cases. Arthroscopy confirmed US findings in all cases. CONCLUSION: US, a more widely available imaging modality, is a reliable technique for the diagnosis of discoid meniscus in children.
Asunto(s)
Meniscos Tibiales/anomalías , Artroscopía , Enfermedades de los Cartílagos/diagnóstico por imagen , Niño , Quistes/diagnóstico por imagen , Femenino , Fracturas del Cartílago/diagnóstico por imagen , Humanos , Articulación de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética , Masculino , Meniscos Tibiales/diagnóstico por imagen , Reproducibilidad de los Resultados , UltrasonografíaRESUMEN
Renal cell carcinoma is rare in children and is usually found in late childhood. The authors report on an exceptional case of renal cell carcinoma in a 10-year-old girl. The radiological aspect is misleading and has not been previously reported in the literature. Renal cortex was thin because of congenital megalo-ureter, so the tumor developed entirely into excretory cavities (to the proximal ureter), while a primitive urothelial disease (tumoral or inflammatory) was first evoked. The atrophied cortex was the tumoral starting point which prolapsed into excretory cavities, upraising the urothelial epithelium.
Asunto(s)
Carcinoma de Células Renales/diagnóstico por imagen , Neoplasias Renales/diagnóstico por imagen , Enfermedades Ureterales/diagnóstico por imagen , Edad de Inicio , Atrofia , Niño , Diagnóstico Diferencial , Femenino , Humanos , Corteza Renal/patología , Radiografía , Enfermedades Ureterales/etiologíaRESUMEN
Cerebral hytatid cysts (HC) are extremely rare, forming 2% of all intra cranial space occupying lesions even in counties where the disease is endemic. HC diagnosis is usually based on a pathognomonic computed tomography (CT) pattern. In order to assess the value of MR we reviewed the CT (n=25) and magnetic resonance (MR, n=4 including diffusion and proton magnetic resonance spectroscopy in 1) imaging of 25 patients with pathologically confirmed cerebral hydatid disease. 19 HC were seen in children under 16 years. All were supra tentorial with 22 in the middle cerebral artery territory. HC was solitary in 18 cases, unilocular in 23 and multi-vesicular in 2 with heavily calcified pericyst in 1. 2 cysts were intra ventricular and 1 intra aqueducal. The most typical features were well defined, smooth thin walled spherical or oval cystic lesions of CSF density and/or signal with considerable mass effect (20/25). Surrounding oedema with complete or incomplete rim enhancement was seen in 3 cases which were labelled as complicated and/or infected cysts. Although CT is diagnostic of hydatid disease in almost all cases (22/25), MRI including diffusion and spectroscopy precisely demonstrate location, number, cyst capsule, type of signal and enhancement and allows diagnosis of atypical or complicated HC and appears more helpful in surgical planning.
Asunto(s)
Encefalopatías/diagnóstico , Encefalopatías/parasitología , Equinococosis/diagnóstico por imagen , Equinococosis/patología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.
Asunto(s)
Equinococosis/diagnóstico , Equinococosis/patología , Húmero/patología , Húmero/parasitología , Adulto , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Diagnóstico Diferencial , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
Two cases of esophageal mucocele in pediatric patients are reported: two children of 5 and 9 years respectively underwent surgical isolation of the esophagus and esophagocoloplasty for caustic stenosis related to accidental ingestion of caustic soda. Clinical pattern of mediastinal compression was proved with cervical fistulous tract in one case. In both cases, thoracic computed tomography was a sensitive imaging method to demonstrate the mucocele and its extension. Esophageal mucocele is rarely described in children, especially following esophageal corrosive stricture.
Asunto(s)
Quemaduras Químicas/complicaciones , Enfermedades del Esófago/etiología , Estenosis Esofágica/inducido químicamente , Estenosis Esofágica/complicaciones , Mucocele/etiología , Niño , Preescolar , Enfermedades del Esófago/diagnóstico por imagen , Humanos , Masculino , Mucocele/diagnóstico por imagen , RadiografíaRESUMEN
We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.
Asunto(s)
Abdomen , Actinomicosis/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
The authors report a case of mesenteric tuberculous lymphadenitis which mimic a pancreatic cystadenoma. They emphasize ultrasound and CT scan features which lead to the recognition of tuberculosis and permit a percutaneous fine needle biopsy. Laparotomy seems the most reliable method for a positive diagnosis. The place of different imaging methods is discussed.
Asunto(s)
Mesenterio , Peritonitis Tuberculosa/diagnóstico , Tomografía Computarizada por Rayos X , Tuberculosis Ganglionar/diagnóstico , Ultrasonografía , Adulto , Biopsia con Aguja , Cistoadenoma/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Mesenterio/patología , Neoplasias Pancreáticas/diagnósticoRESUMEN
A young 17-year-old man was injured on the external orbital canthus and developed a tumefaction which remained stable. After 2 years the tumefaction with exophthalmia and visual troubles. Radiological investigations suggested two diagnosis: Organized hematoma or a lacrimal gland tumor. Surgical exploration found an apparently benign tumor but histologically it was a cystic adenoid carcinoma.
Asunto(s)
Carcinoma Adenoide Quístico/etiología , Neoplasias del Ojo/etiología , Enfermedades del Aparato Lagrimal/etiología , Aparato Lagrimal/lesiones , Órbita/lesiones , Adolescente , Calcinosis/diagnóstico por imagen , Carcinoma Adenoide Quístico/diagnóstico por imagen , Carcinoma Adenoide Quístico/cirugía , Diagnóstico Diferencial , Exoftalmia/etiología , Neoplasias del Ojo/diagnóstico por imagen , Neoplasias del Ojo/cirugía , Estudios de Seguimiento , Hematoma/diagnóstico por imagen , Humanos , Enfermedades del Aparato Lagrimal/diagnóstico por imagen , Enfermedades del Aparato Lagrimal/cirugía , Masculino , Recurrencia Local de Neoplasia , Radioterapia Adyuvante , Tomografía Computarizada por Rayos X , Trastornos de la Visión/etiologíaRESUMEN
BACKGROUND: Nephroblastoma' the most common renal tumor in children between 1 and 5 years, occurs rarely in the oldest child. CASE REPORT: A 16-year-old teenager suffered from acute pyelonephritis caused by Klebsiella pneumoniae. Renal ultrasonography showed a left subcapsular hematoma; the CT scan confirmed the finding and also showed renal scarring. However, a second CT scan showed pulmonary nodules suggestive of metastasis, a diagnosis that was confirmed by needle biopsy of pulmonary lesions. Recovery was obtained after chemotherapy and nephrectomy with a 3-year-follow-up. CONCLUSION: This nephroblastoma was particular because its development in an adolescent, its association with acute pyelonephritis and subcapsular hemorrhage.
Asunto(s)
Hematoma/etiología , Enfermedades Renales/etiología , Neoplasias Renales/complicaciones , Pielonefritis/etiología , Tumor de Wilms/complicaciones , Adolescente , Factores de Edad , Femenino , Humanos , Neoplasias Renales/diagnóstico , Neoplasias Renales/terapia , Tomografía Computarizada por Rayos X , Tumor de Wilms/diagnóstico , Tumor de Wilms/terapiaRESUMEN
Spontaneous subcapsular renal hematoma is rare and essentially associated with malignant, or benign tumor vascular diseases, inflammatory processes. In few cases, no cause was detected. We observed one additional case in a diabetic women. She presented fever, and bilateral flank pain. Ultrasonography showed bilateral subcapsular hematoma. Computed tomography confirmed these findings and demonstrated multiple area of acute focal pyelonephritis.
Asunto(s)
Hematoma/etiología , Pielonefritis/complicaciones , Enfermedad Aguda , Adulto , Femenino , Hematoma/diagnóstico por imagen , Humanos , Enfermedades Renales/diagnóstico por imagen , Pielonefritis/diagnóstico por imagen , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Malignant fibrous histiocytoma (MFH) is a rare and potentially highly malignant sarcoma. The authors report 6 cases of MFH in various sites: two in the chest wall, one in the pelvis, two in the gluteal zones and one on the scalp. Ultrasonography and computed tomography were the main imaging methods used in the assessment of the structure and extension of the tumor. A poor prognosis was noted in four cases: death within a few months in the two thoracic sites, recurrence in the pelvic and scalp lesions, radical surgery allowed recovery in two cases. A review of the literature showed that MRI and CT are complementary in the initial staging and follow-up of these patients.