Radiological diagnosis and therapy of pulmonary arteriovenous fistulae in a patient with an atypical clinical history: a case report.

Pulmonary arteriovenous fistulae were first managed nonsurgically by Porstmann in 1977 with homemade metallic coils (1). During the intervening twenty years better catheterization techniques have been developed and our understanding of the clinical outcomings of these lesions has improved. This report discusses the natural history of pulmonary arteriovenous fistulae, including the neurological and other complications, the importance of family screening in the detection of asymptomatic family members, the diagnostic strategy and the description of improved techniques for embolotherapy with stainless steel coils.

Transient focal fatty liver infiltration mimicking liver metastasis.

The case of a 76-year-old woman presenting with focal liver lesions suggesting liver metastasis on CT is reported. A control CT performed one week later showed a normal liver. Biopsy revealed the diagnosis of focal liver steatosis. The final diagnosis of transient focal steatosis is proposed.

MR imaging of a diverticulum in a female urethra.

The case of a 44-year-old woman with urethral diverticulum is described. The lesion was initially detected by ultrasonography. MRI proved to be very sensitive in localising and delineating the urethral diverticulum and could differentiate it from lesions arising from the vagina or bladder.

MRI of extrapancreatic gastrinomas.

Preoperative diagnosis of gastrinoma--especially extrapancreatic gastrinoma--is very difficult. At the moment octreotide scintigraphy is considered the method of choice to detect gastrinomas. However, MRI may play a major role in the diagnostic imaging of gastrinoma.

Popliteal cysts in children: prevalence, appearance and associated findings at MR imaging.

OBJECTIVE: The purpose of this study was to determine the prevalence of Baker's cysts on MR images in a paediatric orthopaedic population, to investigate the association of Baker's cyst with joint fluid and joint disorders in children, and to compare the MR appearance of Baker's cysts in children with that previously reported in adults. MATERIALS AND METHODS: Reports from 393 MR studies of the knee performed in children aged from 1 to 17 years were retrospectively reviewed for the presence of a Baker's cyst, joint effusion, meniscal tear, anterior cruciate ligament tear, or any other joint disorder. RESULTS: A Baker's cyst was identified in 6.3 % (25/393) of patients. The MR images and clinical charts of patients with a Baker's cyst were reviewed. None of the 25 patients with a Baker's cyst had an associated anterior cruciate ligament tear or meniscal tear. Two patients had osteochondritis dissecans and two others had synovial disease (infection and juvenile rheumatoid arthritis). Joint fluid was demonstrated in 16 % (4/25) of patients with a Baker's cyst. There was no statistically significant association between presence of a Baker's cyst and presence of joint fluid. CONCLUSIONS: Baker's cyst is less prevalent in a paediatric orthopaedic population than in an adult population. In children, it seems that Baker's cyst is seldom associated with joint fluid, meniscal tear, or anterior cruciate ligament tear. On MR images, a communication between the Baker's cyst and the joint was not demonstrated in any of the patients. In addition, the presence of debris and cyst leakage was not observed.

Diffusion-weighted MRI in cyclosporin A neurotoxicity for the classification of cerebral edema.

Cyclosporin A, an immunosuppressive agent, is known to have neurotoxic effects, but until now, there has not been agreement on the underlying mechanism. Our report suggests, by using diffusion-weighted MRI, that the brain lesions caused by cyclosporin A, are probably related to vasogenic edema. This may explain the complete recovery of the lesions on imaging when cyclosporine therapy is stopped.

A vein of Galen aneurysm with an abnormal drain system: MRI findings.

The case of a premature girl with a vein of Galen aneurysm is reported. The lesion was detected by ultrasonography. MRI provided complete anatomical information, obviating the need for initial angiography for preoperative evaluation of the malformation. Venous drainage through a persistent embryonic falcine sinus and associated atresia of the straight sinus could be identified, while venous thrombosis and parenchymal damage could be excluded.

Rib fractures induced by coughing: an unusual cause of acute chest pain.

We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.