http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 15 May 2013 15:12:12 +0000 http://www.hindawi.com/crim/radiology/2013/647850/ Endovascular recanalization of chronic total aortoiliac occlusion is technically challenging. Inability to reenter the true aortic lumen, following retrograde iliac recanalization, is one of the most common causes of failure. We describe a case of a total aortoiliac occlusion where balloon occlusion of the right common iliac artery, following its recanalization from a brachial approach, was used to facilitate antegrade recanalization of the occluded contralateral left common iliac artery. Abdel Aziz A. Jaffan Copyright © 2013 Abdel Aziz A. Jaffan. All rights reserved. Mon, 13 May 2013 10:43:31 +0000 http://www.hindawi.com/crim/radiology/2013/180735/ We present the case of a 56-year-old double lung transplant recipient with chest pain who underwent an attempted endovascular retrieval of what was described as a retained guide wire in the azygos vein. After successfully grasping the tip, the object further migrated to the right pulmonary artery complicating the retrieval. It was realized that the “wire” was extravasated methyl methacrylate from a recent percutaneous kyphoplasty. This is believed to be the first report of attempted endovascular retrieval of extravasated methyl methacrylate in the azygos system. We include the details of this case and briefly review the current literature on the management of extravasated methyl methacrylate from vertebral augmentation procedures. Extravasated methyl methacrylate in the venous system is a common finding after vertebral augmentation procedures and any radiopaque stripe arising from a cemented vertebral body should be first described as probable cement leakage. Kevin C. Ching, Avinash Medsinge, Vikas Agarwal, Robert F. Short, and Nikhil B. Amesur Copyright © 2013 Kevin C. Ching et al. All rights reserved. Sat, 27 Apr 2013 15:56:48 +0000 http://www.hindawi.com/crim/radiology/2013/560758/ The most severe complication of yttrium-90 therapy is gastrointestinal ulceration caused by extrahepatic dispersion of microspheres. Standard pretreatment planning requires extensive angiographic evaluation of the hepatic circulation and embolization of hepatoenteric collaterals; however, in patients with severe renal insufficiency, this evaluation may lead to acute renal failure. In order to minimize iodinated contrast utilization in a patient with preexisting severe renal insufficiency, the authors describe the use of a balloon catheter for temporary occlusion of the common hepatic artery to induce transient redirection of flow of the hepatoenteric arteries towards the liver, in lieu of conventional coil embolization. Justin Smith, Ravi Murthy, Amit Lahoti, Bruno Odisio, Rony Avritscher, Beth Chasen, and Armeen Mahvash Copyright © 2013 Justin Smith et al. All rights reserved. Wed, 10 Apr 2013 16:06:25 +0000 http://www.hindawi.com/crim/radiology/2013/638270/ Amyand’s hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand’s hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis. Suat Keskin, Cihan Şimşek, and Zeynep Keskin Copyright © 2013 Suat Keskin et al. All rights reserved. Thu, 04 Apr 2013 14:43:01 +0000 http://www.hindawi.com/crim/radiology/2013/493752/ Plexiform neurofibromas are essentially pathognomonic for neurofibromatosis type 1 (NF1), occurring when there is diffuse involvement along a nerve segment and its branches. Transformation into a malignant peripheral nerve sheath tumour (MPNST) is a major cause of mortality in NF1 patients. These tumours are highly aggressive and particularly difficult to diagnose in NF1 patients due to the clinical overlap between benign and malignant lesions. We present a case of a plexiform neurofibroma and discuss the typical imaging characteristics on ultrasound, CT, and MRI, including the target sign and continuity with the parent nerve. Certain imaging features should raise suspicion for malignancy however, these modalities may not always reliably differentiate between benign and malignant lesions. Recent studies show a very high negative predictive value for FDG-PET making it quite useful in excluding malignancy. In positive scans, PET/CT aids in guiding biopsy to the most metabolically active area of the tumour. Maria Gosein, Anthony Ameeral, Renee Banfield, and Murrie Mosodeen Copyright © 2013 Maria Gosein et al. All rights reserved. Wed, 03 Apr 2013 15:22:49 +0000 http://www.hindawi.com/crim/radiology/2013/802352/ We report the case of a 42-year-old patient with hypertrophic cardiomyopathy (HCM) who presented to the emergency department with severe shortness of breath one week following uneventful cesarean delivery. Thoracic CT ruled out pulmonary embolus and confirmed pulmonary edema. Asymmetric interventricular septal thickening was clearly identified, demonstrating that the heart may be evaluated even on a non-ECG gated study. Acute pulmonary edema in the postpartum period is an unusual clinical presentation of HCM. Kate Hanneman, Elsie T. Nguyen, and Andrew M. Crean Copyright © 2013 Kate Hanneman et al. All rights reserved. Sun, 31 Mar 2013 18:40:03 +0000 http://www.hindawi.com/crim/radiology/2013/479120/ We report imaging techniques in the definition of the therapeutic planning of a 65-year-old man with a diagnosis of Pancoast tumor. Computed Tomography has a pivotal role in the assessment of nodes involvement and distant metastasis. Magnetic Resonance allows a detailed study of locoregional extension for its high soft tissue resolution. We particularly highlight the actual importance of Magnetic Resonance Neurography, Diffusion-Weighted Imaging, and Magnetic Resonance Angiography techniques in the assessment of the superior sulcus vascular and nervous structures involvement. Their integrity has been showed in our patient with a complete surgical excision of the lesion. Guglielmo Manenti, Mario Raguso, Silvia D'Onofrio, Simone Altobelli, Angela Lia Scarano, Erald Vasili, and Giovanni Simonetti Copyright © 2013 Guglielmo Manenti et al. All rights reserved. Sat, 30 Mar 2013 17:18:36 +0000 http://www.hindawi.com/crim/radiology/2013/940160/ Burkitt's lymphoma is a rare non-Hodgkin's lymphoma which can occasionally involve the ovary and may cause confusion for the clinician since its presentation might mimic other much more frequent tumors. We present a case of a 23-year-old woman with sporadic Burkitt’s lymphoma presented as advanced ovarian cancer with bilateral ovarian masses, peritoneal carcinomatosis, ascites, and marked elevation of CA-125. Liver involvement and atypical bone lesions, such as the cranial vault and the iliac wing, were also detected without evidence of lymphadenopathy. We describe the MRI and CT findings of simultaneous ovarian and bone lesions, which have never been reported in literature in a patient with Burkitt's lymphoma, before and after one cycle of chemotherapy. In evaluating any ovarian neoplasm in a young woman, Burkitt's lymphoma should be considered as a possibility, particularly if associated with bone lesions. MRI is the most useful tool to characterize the ovarian lesions and suggest the diagnosis before the histopathological results. Lucia Manganaro, Silvia Bernardo, Maria Eleonora Sergi, Paolo Sollazzo, Valeria Vinci, Alessandra De Grazia, Anna Clerico, Maria Giovanna Mollace, and Matteo Saldari Copyright © 2013 Lucia Manganaro et al. All rights reserved. Sat, 30 Mar 2013 17:08:07 +0000 http://www.hindawi.com/crim/radiology/2013/206235/ Mammary Paget’s disease is a rare presentation of breast cancer. At clinical examination, it is characterized by skin lesions of the nipple-areola complex, almost always a sign of malignancy. In fact, it is often associated with an underlying mammary ductal carcinoma in situ (DCIS) or invasive carcinoma. An underlying carcinoma is also common in women with negative mammography and ultrasound (US); in these cases, magnetic resonance imaging (MRI) is a diagnostic tool useful in the detection of occult cancer. We described an unusual case of mammary Paget’s disease with underlying DCIS, in a patient without nipple-areola complex alterations and/or palpable lump. On suspicion of Paget’s disease, the patient underwent MRI examination that proved useful for an accurate diagnosis. Biopsy confirmed dynamic MRI findings. Eleonora Gaspari, Aurora Ricci, Valeria Liberto, Angela Lia Scarano, Maria Fornari, and Giovanni Simonetti Copyright © 2013 Eleonora Gaspari et al. All rights reserved. Thu, 28 Mar 2013 12:38:07 +0000 http://www.hindawi.com/crim/radiology/2013/595341/ A 53-year-old male presented with complaints of abdominal pain and weight loss. On physical exam he was noted to have mucocutaneous pigmentation around his lips and oral mucosa. Radiologic and endoscopic investigations demonstrated an obstructing mass in the second portion of the duodenum along with additional smaller soft tissue masses throughout the bowel. Histology of biopsied specimens revealed architectural disorganization without dysplasia, suggestive of Peutz-Jeghers hamartomatous polyps. Brian S. Bentley and Hassan M. Hal Copyright © 2013 Brian S. Bentley and Hassan M. Hal. All rights reserved. Wed, 27 Mar 2013 13:26:46 +0000 http://www.hindawi.com/crim/radiology/2013/160653/ Purpose. Interventional treatment strategies for patients with encephalopathy due to splenorenal shunt remain controversial. Portosplenic blood flow separation by occluding the splenic vein could avoid the complication of severe portal hypertension, but it would require repeated reintervention due to recurrence of symptoms. This paper describes occlusion of the splenic vein using coil anchors and prophylactic embolization of a collateral hepatofugal vessel with no recurrence of hyperammonemia. Materials and Methods. A 51-year-old woman with severe cirrhosis had hepatic encephalopathy due to a large splenorenal shunt. The serum ammonia level was 132 μg/dL. Via a transileocolic approach, the splenic vein was completely embolized with 0.035-inch metallic coils using coil anchors while preserving the splenorenal shunt. In addition, one of the collateral vessels of the portal vein, the retrogastric vein, was also embolized prophylactically. Results. After this procedure, the serum ammonia level decreased immediately to 24 μg/dL. The portal venous pressure increased by only 1.5 mmHg. Hepatic encephalopathy had not been observed for 25 months after the procedure, and neither retention of ascites nor worsening of esophageal varices and liver function was observed. Conclusion. This procedure appears to be safe and effective for hepatic encephalopathy caused by a splenorenal shunt. Masayoshi Inoue, Toshihiro Tanaka, Hiroyuki Nakagawa, Tetsuya Yoshioka, and Kimihiko Kichikawa Copyright © 2013 Masayoshi Inoue et al. All rights reserved. Thu, 14 Mar 2013 13:20:50 +0000 http://www.hindawi.com/crim/radiology/2013/356109/ We will discuss a potential role of percutaneous vertebroplasty (PVP) in the management of a patient with immobilization syndrome due to paraplegia and vertebral osteoporotic fractures. While PVP is commonly used for the treatment of osteoporotic thoracolumbar vertebral compression fractures, its role in vertebral stabilization in patient with immobilization syndrome has not been reported in the literature. A 73-year-old woman affected by immobilization syndrome due to paraplegia and vertebral osteoporotic fractures was treated with PVP of vertebrae D12, L1, and L4. After PVP, the patient did not need any antalgic therapy, and there was a significant improvement regarding mobilization, performance of physiological functions, daily management of personal care, and treatment of decubitus ulcers, increasing life quality and psychological well-being. Salvatore Masala, Eros Calabria, Marco Nezzo, Dominique De Vivo, Luca Neroni, and Giovanni Simonetti Copyright © 2013 Salvatore Masala et al. All rights reserved. Sun, 10 Mar 2013 10:59:59 +0000 http://www.hindawi.com/crim/radiology/2013/415873/ Diagnosis of progressive multifocal leukoencephalopathy is usually based on the clinical presentation, on the demonstration of the brain lesions at the magnetic resonance imaging examination, and on the detection of the JC virus DNA in the cerebrospinal fluid with high sensitive polymerase chain reaction. The role of magnetic resonance imaging specifically in natalizumab-associated progressive multifocal leukoencephalopathy is strengthening, and it is gaining importance not only as an irreplaceable diagnostic tool but also as a surveillance and risk stratifying tool in treated patients. While other imaging techniques such as computed tomography lack sensitivity and specificity, magnetic resonance performed with morphological and functional sequences offers clinicians the possibility to early identify the stage of the disease and the emergence of an immune reconstitution inflammatory syndrome after natalizumab blood removal plasmapheresis. Guglielmo Manenti, Simone Altobelli, Marco Nezzo, Marco Antonicoli, Erald Vasili, Luca Neroni, Roberto Floris, and Giovanni Simonetti Copyright © 2013 Guglielmo Manenti et al. All rights reserved. Thu, 28 Feb 2013 14:30:42 +0000 http://www.hindawi.com/crim/radiology/2013/869793/ Lung cancer associated with neurofibromatosis type I is considered very rare, and only a few case reports have been described in the literature. There is some evidence that a genetic linkage between neurofibromatosis and carcinogenesis in the lung may exist. We present a 42-year-old female, lifetime nonsmoker with a known history of neurofibromatosis type I, free of respiratory symptoms, who underwent a low-dose HRCT of the lungs to investigate any occult interstitial lung changes. A solitary ill-defined nodule of a ground-glass opacity was detected incidentally in the middle lobe with no associated lymphadenopathy or metastatic disease. Several thin-walled lung cysts were also seen in the lower lobes. Histological analysis of the nodule after middle lobectomy revealed well-differentiated adenocarcinoma. The patient did not receive systemic chemotherapy or radiotherapy. She was free of disease on 18-month followup. Anastasia Oikonomou, Dimitrios Mikroulis, Paraskevi Mintzopoulou, Lawal Lukman, and Panos Prassopoulos Copyright © 2013 Anastasia Oikonomou et al. All rights reserved. Thu, 28 Feb 2013 09:11:27 +0000 http://www.hindawi.com/crim/radiology/2013/258352/ We report a case of mixed capillary venous hemangioma of the retroperitoneum in a 61-year-old man. Abdominal ultrasonography showed a mass to be hypoechoic with increased flow in color Doppler imaging. Dynamic contrast-enhanced computed tomography revealed a centripetal filling-in of the mass, located anterior to the left psoas muscle at the level of sacroiliac joint. On the basis of imaging features, preoperative diagnosis of hemangioma was considered and the mass was excised by laparoscopic method. Immunohistochemical studies were strongly positive for CD31 and CD34, and negative for calretinin, EMA, WT1, HMB45, Ki67, synaptophysin, and lymphatic endothelial cell marker D2–40. Histologically, the neoplasm was diagnosed as mixed capillary venous hemangioma. Mohit Godar, Qinghai Yuan, Rukeshman Shakya, Yang Xia, and Pengguo Zhang Copyright © 2013 Mohit Godar et al. All rights reserved. Thu, 21 Feb 2013 10:06:45 +0000 http://www.hindawi.com/crim/radiology/2013/191375/ Cerebral phaeohyphomycosis is often a fatal disease that typically takes a hematogenous spread after inhalation or accidental skin inoculation of pathogens. We present a patient with a history of heavy marijuana smoking while being on chronic steroid therapy for treatment of neurosarcoidosis who was found to have multiple brain abscesses from Curvularia sp. This is a ubiquitous soil-dwelling dematiaceous fungus that is generally thought to affect solely plants, but there is increasing evidence in the literature of it affecting humans and animals. We review the radiographic findings of neurosarcoidosis and cerebral phaeohyphomycosis as well as the pathophysiology of dematiaceous fungi infections. Preetam Gongidi, Debkumar Sarkar, Eric Behling, and Joshua Brody Copyright © 2013 Preetam Gongidi et al. All rights reserved. Mon, 11 Feb 2013 16:03:37 +0000 http://www.hindawi.com/crim/radiology/2013/214804/ Paget-Schroetter syndrome (PSS) is a rare form of thoracic outlet syndrome caused by axillosubclavian vein thrombosis which typically presents in healthy young adults. Prompt therapy, traditionally by means of catheter-directed thrombolysis (CDT) prior to definitive surgery, can prevent the subsequent onset of postthrombotic syndrome (PTS) and considerable disability. As CDT is associated with major haemorrhage and high overall treatment cost, pharmacomechanical thrombectomy (PMT) seems to be an attractive alternative which combines pharmacological thrombolysis with mechanical clot disruption. The Trellis-8 peripheral infusion catheter is an example of such a treatment which provides topical thrombolysis in an isolated zone. We describe the use of the Trellis-8 PMT system in the successful management of three patients with PSS. Elli Papantoniou, Luke Morgan-Rowe, Edward Johnston, Duncan Brennand, Jowad Raja, and Julian Hague Copyright © 2013 Elli Papantoniou et al. All rights reserved. Mon, 11 Feb 2013 15:33:38 +0000 http://www.hindawi.com/crim/radiology/2013/584925/ There have been several case reports documenting acute appendicitis complicated by perforation presenting with retroperitoneal abscess formation. To date, there are no case reports of acute appendicitis in which the only sign for retroperitoneal perforation is the presence of retroperitoneal air as detected by computed tomography (CT). In the case presented, an 18-year-old male presented to the emergency department with clinical symptoms of acute appendicitis. CT exam demonstrated an inflamed appendix with multiple collections of air in the retroperitoneum, without abscess. Laparotomy revealed perforation of a retrocecal appendix into the retroperitoneum. Behrang Litkouhi, Alicia S. Huang, David J. Lundy, and Maria Solis Copyright © 2013 Behrang Litkouhi et al. All rights reserved. Mon, 11 Feb 2013 14:51:46 +0000 http://www.hindawi.com/crim/radiology/2013/854686/ Gall bladder (GB) may be found in a variety of abnormal positions. Most of them are due to arrested development of embryonic growth at different stages. A 63-year-old female patient was admitted to our radiology unit for magnetic resonance imaging (MRI) of the liver for the lesions identified in abdominal ultrasonography (US) and computed tomography (CT). MRI showed that there was a lobulated heterogenous mass in the left lobe of the liver and a smaller one in the right lobe of the liver with the same appearance. The inferior pole of the liver was located in the pelvic space, and the GB, which contained sludges and stones, was lying down to the upper pelvic space. Hepatic masses were considered to be hemangiomas, and GB was diagnosed as ptotic GB with luminal sludge and stones. In this case, especially, MR imaging helped the surgeon to plan a proper approach to the GB in abnormal localization. Hasan Aydin, Z. Banu Aydin, Baki Hekimoğlu, and Ayşe Görmeli Copyright © 2013 Hasan Aydin et al. All rights reserved. Wed, 06 Feb 2013 15:48:32 +0000 http://www.hindawi.com/crim/radiology/2013/397514/ Stab injury of the thoracic aorta is a rare condition with high mortality rate. Patients must be evaluated carefully, and the diagnosis usually should be confirmed by radiological modalities. In this case, we report a 37-year-old man presented with a penetrating stab injury to the upper back and the thoracic aorta, and the diagnostic role of computed tomography is discussed. Seyma Yildiz, Huseyin Toprak, Asli Serter, and Ercan Kocakoç Copyright © 2013 Seyma Yildiz et al. All rights reserved. Mon, 04 Feb 2013 16:07:54 +0000 http://www.hindawi.com/crim/radiology/2013/190856/ We present an interesting case of focal amyloidosis of the left breast which was intermixed with ductal carcinoma in situ (DCIS). On subsequent staging bilateral breast magnetic resonance imaging (MRI), the patient was found to have an additional suspicious enhancing mass with spiculated borders within the left breast. This mass was biopsy proven to represent pleomorphic invasive lobular carcinoma. A pulmonary nodule within the lingula was also noted on the staging bilateral breast MRI and was biopsy proven to represent extranodal Castleman’s disease. Therefore, it is believed that our patient had secondary amyloidosis due to Castleman’s disease. David Chiang, Michael Lee, Pauline Germaine, and Lydia Liao Copyright © 2013 David Chiang et al. All rights reserved. Mon, 21 Jan 2013 10:37:12 +0000 http://www.hindawi.com/crim/radiology/2013/635391/ Purpose. We report a novel technique which aided recanalization of an occluded portal vein for transjugular intrahepatic portosystemic shunt (TIPS) creation in a patient with symptomatic portal vein thrombosis with cavernous transformation. Some have previously considered cavernous transformation a contraindication to TIPS. Case Presentation. 62-year-old man with chronic pancreatitis, portal vein thrombosis, portal hypertension and recurrent variceal bleeding presents with melena and hematemesis. The patient was severely anemic, hemodynamically unstable, and required emergent portal decompression. Attempts to recanalize the main portal vein using traditional transjugular access were unsuccessful. After percutaneous transhepatic right portal vein access and navigation of a wire through the occluded main portal vein, an angioplasty balloon was inflated at the desired site of shunt takeoff. The balloon was targeted and punctured from the transjugular approach, and a wire was passed into the portal system. TIPS placement then proceeded routinely. Conclusion. Although occlusion of the portal vein increases difficulty of performing TIPS, it should not be considered an absolute contraindication. We have described a method for recanalizing an occluded portal vein using a combined transhepatic and transjugular approach for TIPS. This approach may be useful to relieve portal hypertension in patients who fail endoscopic and/or surgical therapies. Natanel Jourabchi, Justin Pryce McWilliams, Edward Wolfgang Lee, Steven Sauk, and Stephen Thomas Kee Copyright © 2013 Natanel Jourabchi et al. All rights reserved. Mon, 21 Jan 2013 10:16:40 +0000 http://www.hindawi.com/crim/radiology/2013/235209/ Traumatic optic neuropathy is an uncommon, yet serious, result of facial trauma. The authors present a novel case of a 59-year-old gentleman who presented with an isolated blunt traumatic left optic nerve hematoma causing vision loss. There were no other injuries or fractures to report. This case highlights the importance of early recognition of this rare injury and reviews the current literature and management of traumatic optic neuropathy. R. Parab, C. I. Fung, and Gerrit Van Der Merwe Copyright © 2013 R. Parab et al. All rights reserved. Wed, 16 Jan 2013 11:00:31 +0000 http://www.hindawi.com/crim/radiology/2013/239258/ This study focuses on CT and MR studies of adult patient with giant lesion of the posterior cranial fossa associated with micro- and macroaccumulations with density and signal like “fat” at the level of the cortical and cisternal cerebral spaces. This condition is compatible with previous asymptomatic ruptured dermoid cyst. Histological findings confirm the hypothesis formulated using the imaging. We also integrate elements of differential diagnosis by another giant lesion of the posterior cranial fossa. Alessandro D'Amore, Alessandro Borderi, Rita Chiaramonte, Giorgio Conte, Ignazio Chiaramonte, and Vincenzo Albanese Copyright © 2013 Alessandro D'Amore et al. All rights reserved. Mon, 14 Jan 2013 10:16:53 +0000 http://www.hindawi.com/crim/radiology/2013/607012/ We present a rare case of continuous, extensive aortic dissection (AD) involving the bilateral common carotid arteries, the ascending, thoracic, and abdominal aorta, and bifurcation of the right common iliac artery. A 61-year-old man with history of chronic hypertension presented with a one-day history of chest pain, vertigo, left facial drooping, and left hemiparesis. Despite the presence of bilateral carotid bruits, doppler ultrasound of the neck was postponed, and the patient was treated with thrombolytic therapy for a presumed ischemic stroke. The patient's symptoms began to resolve within an hour of treatment, at which time treatment was withheld. Ultrasound performed the following day showed dissection of bilateral common carotid arteries, and CT angiography demonstrated extensive AD as described earlier. The patient subsequently underwent cardiovascular surgery and has been doing clinically well since then. AD has a myriad of manifestations depending on the involvement of aortic branches. Our paper illustrates the importance of having a high index of suspicion for AD when a patient presents with a picture of ischemic stroke, since overlapping signs and symptoms exist between AD and stroke. Differentiating between the two conditions is central to patient care as thrombolytic therapy can be helpful in stroke, but detrimental in AD. E. W. Lee, N. Jourabchi, S. C. Sauk, and D. Lanum Copyright © 2013 E. W. Lee et al. All rights reserved. Sun, 30 Dec 2012 13:30:15 +0000 http://www.hindawi.com/crim/radiology/2012/402768/ The purpose of this paper is to present sonographic and CT imaging findings of xanthogranulomatous cholecystitis (XGC) presented as Bouveret’s syndrome, a very rare cause of gastric obstruction. While the patient’s physical examination, upper GI endoscopy, and radiological findings all pointed to Bouveret’s syndrome, CT differential diagnosis suggested either XGC or gallbladder carcinoma, and the final diagnosis was done histopathologically. Our paper aims to increase awareness in radiologically diagnosing XGC cases by introducing the possibility of existence of Bouveret’s syndrome. Ayşegül Solmaz Tuncer, Safiye Gürel, Zeliha Coşgun, Ahmet Büber, Rıdvan Çakmaz, and Oğuz A. Hasdemir Copyright © 2012 Ayşegül Solmaz Tuncer et al. All rights reserved. Wed, 26 Dec 2012 14:23:37 +0000 http://www.hindawi.com/crim/radiology/2012/919603/ We report the imaging findings of a patient with adrenocortical carcinoma who showed pelvic tumor thrombosis extending from sacral bone metastasis. Contrast-enhanced computed tomography demonstrated extensive intraluminal filling defects in the pelvic veins. A lytic lesion in the sacrum was also noted and continuity between the sacral lesion and the filling defect in the branch of pelvic veins was indicated. The filling defects showed increased uptake on positron emission tomography with 18F-fluorodeoxyglucose and single-photon emission computed tomography with 131I-iodomethylnorcholesterol, and fusion images with computed tomography aided the localization of the increased uptake areas. Multimodality imaging may be beneficial for the characterization and localization of lesions in patients suspected of having metastatic adrenocortical carcinoma. Kenichiro Ishida, Yusuke Inoue, Reiko Woodhams, Yuji Asano, and Toshimasa Hara Copyright © 2012 Kenichiro Ishida et al. All rights reserved. Mon, 24 Dec 2012 16:48:28 +0000 http://www.hindawi.com/crim/radiology/2012/616905/ Congenital high airway obstruction syndrome is a rare but life-threatening condition. Therefore, prenatal diagnosis is important. The obstruction can be due to laryngeal/tracheal atresia or external compression. While a differential diagnosis with congenital cystic adenomatoid malformation (CCAM) type III may be difficult, it is still possible with ultrasonography. In this study, we report a case of bilateral echogenic lungs with hydrops fetalis. After the prenatal diagnosis of laryngeal atresia, the couple opted to have an elective termination of pregnancy performed at 20 weeks of gestation. The diagnosis was confirmed by a complete pathological examination. Piya Chaemsaithong, Tharintorn Chansoon, Boonsri Chanrachakul, Suchin Worawichawong, Sansanee Wongwaisayawan, and Patama Promsonthi Copyright © 2012 Piya Chaemsaithong et al. All rights reserved. Mon, 17 Dec 2012 15:53:44 +0000 http://www.hindawi.com/crim/radiology/2012/146540/ Over the past decade, irinotecan has become one of the first-line chemotherapeutic agents used in the treatment of metastatic colorectal cancer. Recently, irinotecan has been administered transarterially in order to perform chemoembolization in the liver. In the limited number of reports available to date using this approach, serious adverse effects have not yet been reported. In this paper, we describe the formation of an intercostal artery pseudoaneurysm after transarterial chemoembolization with irinotecan-eluting beads in a patient with spinal metastasis from colorectal cancer. Natanel Jourabchi, Steven Sauk, Cheryl Hoffman, Edward Wolfgang Lee, and Stephen Thomas Kee Copyright © 2012 Natanel Jourabchi et al. All rights reserved. Mon, 17 Dec 2012 15:15:57 +0000 http://www.hindawi.com/crim/radiology/2012/273027/ Intra-abdominal hemorrhage caused by omental artery rupture is a rare condition. There are few reports on the treatment of omental artery rupture with only transcatheter arterial embolization (TAE). A 27-year-old man presented to our emergency room with upper abdominal pain that suddenly occurred during sleep. Abdominal computed tomography (CT) revealed fluid collection in the peritoneal cavity and a left subphrenic hematoma with extravasation. Celiac angiography revealed extravasation from the omental artery, which arose from the proximal left gastroepiploic artery. A microcatheter was advanced into the left gastroepiploic artery and around the culprit artery bifurcation, which was embolized by inserting coils. The postoperative course was uneventful without worsening of anemia or abdominal symptoms. The patient was discharged after the absence of extravasation was confirmed by contrast-enhanced CT. Although surgical therapy has often been performed for omental bleeding, TAE, which is less invasive and has the advantage of simultaneous diagnosis and treatment, should be attempted as the first-choice therapy. Masamichi Takahashi, Yujiro Matsuoka, Tsuyoshi Yasutake, Hiroyuki Abe, Kazuhiro Sugiyama, and Kazuyuki Oyama Copyright © 2012 Masamichi Takahashi et al. All rights reserved.