Duodenal Emphysema Complicated with Superior Mesenteric Artery Syndrome in a Patient with Cerebral Paralysis: A Case Report.

Superior mesenteric artery syndrome (SMAS) is characterized by an arteriomesenteric duodenal compression commonly resulting from significant weight loss. Vomiting is the most frequent symptom. SMAS can be complicated by massive gastric dilatation. Patients with cerebral palsy have various factors that can predispose them to SMAS. In this paper, we report a rare case of SMAS complicated by duodenal, peritoneal and retroperitoneal emphysema in a patient with cerebral paralysis, referring to the relevant literature. In this case, severe vomiting associated with epilepsy and weight loss may have contributed to the development of duodenal emphysema.

Evaluation of Renal Artery Anomalies Associated with Horseshoe Kidney Using CT Angiography.

PURPOSE: To evaluate the incidence of supernumerary renal arteries in horseshoe kidney (HSK) patients, focusing on number and diameters using computed tomographic angiography (CTA). MATERIAL AND METHODS: Thirty-nine patients with HSK and 103 patients with normal kidney (NK) underwent 64 or 128 multidetector CT. Based on 2-dimensional CT, including multiplanar reconstruction, maximum intensity projection, and volume-rendered images with a 0.5-mm reconstruction interval on CTA, we assessed the incidence of supernumerary renal arteries, and large ( > 3 mm in diameter) supernumerary renal arteries, and compared the results between the HSK and NK patients using a chi-square test. RESULT: The mean number of renal arteries was 3.87 in HSK patients and 2.41 in the NK patients. The incidence rates of supernumerary arteries and supernumerary arteries greater than 3 mm were 92.3 %, 69.2 % in HSK patients and 33%, 8.7% in NK patients. Supernumerary and large supernumerary renal arteries had significantly higher incidence rates in the HSK patients than in the NK patients on CTA (p = 0.003, < 0.001). CONCLUSION: Supernumerary and large supernumerary renal arteries were frequently found among the HSK patients on CTA.

Congenital pericardial defect: a case of right pericardial partial absence with normal parietal pleura [corrected].

Congenital pericardial defect (CPD) is a rare cardiovascular anomaly. A right-sided CPD is much rarer than left-sided defects. Usually both the pericardium and parietal pleura are absent. We report a rare case of a right partial CPD involving the right atrial appendage, suspected by computed tomography and cine magnetic resonance imaging, and confirmed by thoracoscopy, which also demonstrated a normal parietal pleura.

Natural course of hypovascular nodules detected on gadoxetic acid-enhanced MR imaging: presence of fat is a risk factor for hypervascularization.

PURPOSE: Hypovascular nodules that exhibit hypointensity in hepatocyte-phase images of gadoxetic acid-enhanced magnetic resonance (MR) imaging are frequently encountered in clinical practice. We investigated risk factors for the development of these nodules into hypervascular hepatocellular carcinoma (HCC). METHODS: We retrospectively reviewed our institutional database and identified 302 patients who underwent gadoxetic acid-enhanced MR imaging for suspected or confirmed HCC from February 1, 2008 to January 30, 2011. We excluded patients who were examined for metastasis of other malignancies or for other hepatic tumors, such as focal nodular hyperplasia. We identified hypovascular nodules that were hypointense in hepatocyte-phase images, recorded their characteristics, and calculated the cumulative hypervascularization rate for nodules that were followed up. RESULTS: Of the 302 patients, 82 had hypovascular nodules (178 nodules; mean size, 9.3 mm). Sixty nodules were followed up for over 6 months, and eight progressed to hypervascular HCC. Hypervascularization occurred more frequently in nodules with fat than those without (P<0.01). The cumulative hypervascularization rate was 5.1% over a year. CONCLUSION: The presence of intralesional fat was found to be a risk factor for hypervascularization of hypovascular nodules that exhibited hypointensity in the hepatocyte-phase images of gadoxetic acid-enhanced MR imaging.