We reviewed the clinical and radiological features in eight patients with spontaneous rectus sheath hematoma (RSH). The diagnosis was confirmed at surgery in four patients, and spontaneous resolution occurred in the other four. All patients were elderly adults. Acute abdominal pain and a palpable mass after muscular strain, such as coughing or twisting, were features highly suggestive of RSH. Sonographically, these hematomas may be confused with abdominal wall tumors. On CT scans, a hyperdense mass posterior to the rectus abdominis muscle with ipsilateral anterolateral muscular enlargement is considered characteristic of acute RSH, although chronic RSH may be isodense or hypodense relative to the surrounding muscle. MRI is very useful in the diagnosis of RSH, which is demonstrated as a high signal intensity area on both T1- and T2-weighted images, especially when the CT findings are not specific for RSH.

Abdomen, Acute↗

PubMedDate not supplied

Clinical significance of anti-citrullinated peptide antibody in Japanese patients with established rheumatoid arthritis.

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Arthritis, Rheumatoid↗

PubMedDate not supplied

Traction injuries of the brachial plexus: signal intensity changes of the posterior cervical paraspinal muscles on MRI.

PURPOSE: Our goal was to evaluate MR signal intensity change of the posterior cervical paraspinal muscles in brachial plexus traction injuries to determine the value of this finding in the diagnosis of nerve root avulsion. METHOD: MR images of 11 consecutive patients, 7 with nerve root avulsion and 4 without nerve root avulsion, were retrospectively analyzed, focusing on the signal intensity of the paraspinal muscles. RESULTS: Among the seven patients with nerve root avulsion, T2- or T2*-weighted MR images showed increased signal intensity in the deep posterior paraspinal muscles in five and traumatic meningocele in four. The signal intensity of the posterior paraspinal muscles was normal in all patients without nerve root injuries. CONCLUSION: MR signal intensity change in the deep posterior cervical paraspinal muscles is related to denervation and suggests the presence of nerve root avulsion.

Accidents, Traffic↗

PubMedDate not supplied

Fate of intramural hematoma of the aorta: CT evaluation.

PURPOSE: Our goal was to investigate the fate of intramural hematoma of the aorta. METHOD: In 32 patients with intramural hematoma of the aorta, we reviewed CT (n = 32) and MR (n = 22) findings. The diagnosis was established by CT, and regular follow-up studies were performed. RESULTS: All intramural hematomas decreased in size. Ulcer-like projections (ULPs) were identified at the initial study in 6 patients and during the follow-up period in 14 patients. The ULPs progressed to saccular aneurysm in 12 patients (mean 47.0 days), while fusiform aneurysm developed in 6 patients (mean 347.7 days) without ULP. In two patients, the affected aorta progressed to overt aortic dissection. CONCLUSION: Intramural hematoma itself usually decreases in size. However, the affected aorta can progress to aneurysm or overt aortic dissection. Development of saccular aneurysm from ULPs can be considered an early complication. In cases without ULP, fusiform aneurysm may develop as a late complication. All intramural hematomas need to be followed since it seems to be difficult to predict the exact fate of intramural hematoma from the initial imaging findings.

Adult↗

PubMedDate not supplied

Peripheral nerve intraneural ganglion cyst: MR findings in three cases.

We present MR findings of three cases of surgically proved intraneural ganglion cysts involving the common peroneal nerve (two patients) and ulnar nerve (one patient). The lesions were located along the course of the involved nerve and situated close to a joint. MRI demonstrated the cystic nature and extent of the lesions with clear definition of the anatomic relationship of the lesions to the surrounding structures.

Adult↗

PubMedDate not supplied

MR assessment of meniscal movement during knee flexion: correlation with the severity of cartilage abnormality in the femorotibial joint.

PURPOSE: The purpose of this study was to assess the degree of meniscal movement during knee flexion on MR images and to correlate it with the severity of cartilage damage in the femorotibial joint. METHOD: Sagittal MR images were obtained at extension and 45 degrees of flexion in 35 knees. A shortening ratio in the distance between the anterior and posterior horns at 0-45 degrees of knee flexion was calculated in each meniscus and was correlated with the degree of cartilage abnormality in the femorotibial joint. RESULTS: The shortening ratio of the meniscus was reduced in knees with cartilage abnormality in the femorotibial joint. The shortening ratio of the medial meniscus was inversely correlated with the degree of cartilage abnormality in the medial femoral condyle and with that in the medial tibial plateau. CONCLUSION: Restricted shortening ratio of the meniscus may be related to cartilage damage in the femorotibial joint.

Adult↗

PubMedDate not supplied

Complications associated with transcatheter arterial embolization for hepatic tumors.

Transcatheter arterial embolization (TAE) is widely used in the treatment of hepatic tumors. A total of 2,300 TAE procedures were performed with a 2-15-mL injection of a mixture or suspension of anticancer drugs and iodized oil, followed by administration of gelatin sponge particles. One or two chemotherapeutic drugs, including doxorubicin hydrochloride (10-30 mg), epirubicin hydrochloride (10-30 mg), mitomycin C (10-20 mg), and cisplatin (25-100 mg), were used for each procedure. Complications were encountered in 4.4% of cases (n = 102) and were related to the use of chemoembolic agents or the manipulation of a catheter or guide wire. These complications included acute hepatic failure (n = 6), liver infarction (n = 4) or abscess (n = 5), intrahepatic biloma (n = 20), multiple intrahepatic aneurysms (n = 6), cholecystitis (n = 7), splenic infarction (n = 2), gastrointestinal mucosal lesions (n = 5), pulmonary embolism or infarction (n = 4), tumor rupture (n = 1), variceal bleeding (n = 3), and iatrogenic dissection (n = 35) or perforation (n = 4) of the celiac artery and its branches. Knowledge of these complications is important for correct diagnosis and appropriate management.

Angiography↗

PubMedDate not supplied

Digital subtraction angiography in Takayasu arteritis.

The usefulness and limitation of digital subtraction angiography (DSA) in Takayasu arteritis were investigated in 32 patients. Intravenous DSA was particularly useful in the follow-up of patients with an established diagnosis of Takayasu arteritis. Pulmonary arterial involvement could also be demonstrated with intravenous DSA as obstructive arterial changes and lack of accumulation of contrast medium in the pulmonary parenchyma. Detailed information concerning the site and extent of vascular involvement and development of collateral vessels were obtained with intraarterial DSA. Thickening of the thoracic aortic wall, however, could not be recognized with either intravenous or intraarterial DSA. Conventional angiography of the descending thoracic aortal is still required as an initial examination, particularly when there is no aortic arch involvement. However, there is no doubt that DSA has the potential to become the diagnostic procedure of choice in Takayasu arteritis.

Adolescent↗