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Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

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Nội dung chi tiết: Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2trates two geographic hypo-attenuating areas in the spleen. Axial T2-WI (B l shows an additional round lesion more inferiorly, which lias bright signa

l. On the fat-suppressed axial Tl -Wl (C). one lesion has a Spontaneously bright curvilinear central area. No enhancement IS seen on the gadolmiurn-en Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

hanced. fat-suppressed axial TI-WI (D).DIFFERENTIAL DIAGNOSIS splenic laceration, fracture.DIAGNOSIS Splenic infarcts.DISCUSSION There are multiple ca

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

uses for splenic infarcts, including emboli, hematologic diseases, portal hypertension, and iatrogenic causes. In patients younger than 40 years, hemo

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2e-shaped defect to focal round lesions and ill-dctincd areasof low attenuation. Tliese lesions are best demonstrated on CECT image. During the acute s

tage, infarcts are ill-dctined and heterogeneously hyperdense due to areas of hemorrhage within them. MR1 best shows the internal hemorrhage on the Tl Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

-Wl. as in this case. As an infarct begins to fibrose, it will appear better demarcated and may cause contraction of the surrounding normal spleen. W

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

hen serial CT scans demonstrate progressive liquefaction and necrosis with outward extension, developing subcapsular hemorrhage, and free peritoneal h

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2 images, they may appear round, as in this case, depending on how the wedge-shaped area is ■■cut" on the image: this is more commonly seen in infarcts

in the superior and inferior aspects of the spleen. Coronal or sagittal reformatted images would show best the tiue wedge-shaped configuration of the Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

abnormality.103CASE81CLINICAL HISTORY 37-ycar-old woman presenting with known sieatohepatitis and alcohol abuse.Figure 81AFigure 81CFigure 810Figure

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

81BFINDINGS Axial MRI demonstrate marked enlargement of the lateral segment of the left lobe of the liver and concomitant decrease in the size of the

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2I (A), decreased signal intensity on the fat-suppressed axial TI-WI (B). and delayed enhancement on gadolinium-enhanced. fat-suppressed axial TI-WI (C

and D). Hepatic vessels are seen traversing through this region without the evidence of distortion. Also note the capsular retraction adjacent to the Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

abnormal area.DIFFERENTIAL DIAGNOSIS Hepatocellular carcinoma, intrahepatic cholangiocarcinoma.DIAGNOSIS Confluent hepatic fibrosis.DISCUSSION Conflu

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

ent hepatic fibrosis can present as a masslike area (14%) in patients with underlying cirrhosis, especially primary sclerosing cholangitis. It typical

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2nce, but in some patients, the entire segment might be involved. Tile typical appearance of confluent hepatic fibrosis is an area of low signal intens

ity on TI-WI and high signal intensity on T2-WI. It usually demonstrates delayed enhancement on gadolimum-enhanced images. "ITie typical geographic pa Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

ttern of involvement and retraction of the overlying hepatic capsule can be helpful in diagnosing this condition. Possible explanations for the hyperi

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

ntense appearance of confluent fibrosis on T2-WI are a relative reduction in the signal of the remaining liver parenchyma due to increased iron deposi

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2with abdominal pain and tenderness.Figure 82AFigure 82CFigure 82 BFigure 82DFINDINGS Axial CECT images (A-D) demonstrate high-density ascites as well

as a thick enhancing peritoneum. There arc also omental and retroperitoneal lymph nodes.DIFFERENTIAL DIAGNOSIS Peritoneal carcinomatosis, malignant me Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

sothelioma.DIAGNOSIS Tuberculosis peritonitis and omentitis.DISCUSSION Although tuberculosis is unusual in Western countries, there has been an increa

Ebook CT and MRI of the abdomen and pelvis - A teaching file (3rd edition): Part 2

sed incidence of tuberculosis due to the large number of chronically immunosupprcssed patients due to transplantation. HIV infection, and other causes

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

CAS80CLINICAL HISTORY 34-ycar-old man presenting with left upper quadrant pain.Figure 80CFigure 80AFigure 80BFigure 80DFINDINGS Axial CECT (A) demonst

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