ABSTRACT
Objective To summarize the MSCT signs and the key points of differential diagnosis of sclerosing mesenteritises (SM) which were misdiagnosed by clinical and CT,to reduce the misdiagnosis rate.Methods Clinical and MSCT data of 23 misdiagnosed SM patients were analyzed retrospectively.The misdiagnosed diseases,misdiagnosed causes,and differential diagnosis were analyzed.Results SM were mainly misdiagnosed as tumor and infective inflammation.The main causes of misdiagnosis and differential diagnostic features were listed as follows.(1)SM didn't have specific clinical manifestations.(2)The density of the adipose tissue in mesentery increasedmisty mesentery.A clear demarcation between the lesion and the surrounding normal fatty tissue could be differentiated from infective inflammation.(3)The mass-like false capsule had space-occupying effect of displacement of the surrounding structures.However, the blood vessels were encapsulated by the mass-like false capsule with fat ring around, which could be differentiated from fat-containing tumors.(4)The soft mass was formed at the root of the mesentery.The fat halo sign and mild enhancement of the mass can be differentiated from lymphoma and carcinoid.Conclusion SM is easily misdiagnosed both in clinical practice and medical imaging.Recognition of differential diagnostic features of MSCT can reduce the misdiagnosis rate.
ABSTRACT
Objective To analyze MSCT characteristics of septic pulmonary embolism (SPE) caused by intravenous drug and to improve diagnosis. Methods The MSCT findings of 16 patients of SPE induced by intravenous drug were analyzed retrospectively from March, 2001 to September, 2008. Results Peripheral or sub-pleural zones were commonly affected mainly within upper lung. Patchy, nodular and cavity shadows were detected respectively in 9 (56.25%), 12 (75.00%) and 8 patients (50.00%), while pulmonary cysts in 14 patients (87.50%). Six patients underwent CTPA, and pulmonary arteries filling defect was found in 2 patients. Pleural effusion and pneumothorax were also found in 10 and 3 patients, respectively, whereas miscellaneously shaped lesions were deteced in all 16 patients. Conclusion MSCT is an important method for diagnosing SPE caused by intravenous drug abuse. Pulmonary arteries filling defect is the direct sign and the cysts and nodular shadow with or without cavity in peripheral or sub-pleural pulmonary zones are characteristic findings.
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Objective To analyse CT and DSA appearances of intrahepatic cholangiocarcinoma,and to improve understanding of intrahepatic cholangiocarcinoma.Methods Plain and enhanced CT scanning were performed in 17 patients with intrahepatic cholangiocarcinoma pathollogically proved,6 patients(6/17) performed dynamic CT scanning,5 performed DSA examinations.Results Pre-contrast CT scanning was a single low density lesions in all patients,post-contrast CT scanning showed slightly inhomogeneous enhancement in 17 patients,3 patients(3/17) showed low density unenhancement area with margin enhancement,2 patients delayed enhancement;Intrahepatic billary delatation was found in 15 patients and was within the lesion in 10 patients(10/15);On DSA,5 patients showed enlaragement increasment and rigidity of supplying arteries and tumour stain.Conclusion CT scanning and DSA were important,investigative methods for intrahepatic cholangiocarcinoma,the billary dilatations with slightly inhomogeneous enhancement lesions is important sign in diagnosising intrahepatic cholangiocarcinoma.