Abernethy malformation: beware in cases of unexplained hepatic encephalopathy in adults-case report and review of the relevant literature.

The Abernethy malformation consists of a congenital extrahepatic portosystemic shunt and is believed to be extremely rare in humans. The potential implications of abnormal portovenous shunting and decreased hepatic portal flow are numerous and potentially serious. Although congenital extrahepatic portosystemic shunts are increasingly suspected and diagnosed in specialized centres, much of their clinical presentation and natural history is not fully understood. Symptoms of portosystemic shunt are mainly caused by increased levels of ammonia, which lead to signs of encephalopathy. Therapeutic options depend on the type of shunt and its clinical course, so the classification of the congenital portosystemic shunt is a key finding in these patients.

Middle patellar tendon to posterior cruciate ligament (PT-PCL) and normalized PT-PCL: New magnetic resonance indices for tibial tubercle position in patients with patellar instability.

BACKGROUND: To demonstrate whether the distance between the middle point of the patellar tendon and posterior cruciate ligament (PT-PCL) calculated on a single axial MR image could be an alternative measure to tibial tubercle-PCL (TT-PCL) distance for TT lateralization without the need of imaging processing. To show that normalization of PT-PCL (nPT-PCL) against the maximum diameter of the tibial plateau may help to identify patients with patellar instability (PI). METHODS: MR scans of 30 patients (13 females, age 32 ±â€¯13 years) with known PI and 60 patients (31 females, age 39 ±â€¯19 years) with no history of PI were reviewed. Two operators calculated TT-PCL, and PT-PCL nPT-PCL. Intraclass correlation coefficient, Student's t-test, Receiver Operator Characteristic curves, Spearman's Rho and McNemar's test were used. RESULTS: Interobserver reproducibility was 0.894 for PT-PCL for TT-PCL (95% CI = 0.839-0.930) and 0.866 for TT-PCL (95% CI = 0.796-0.912). The PT-PCL was 23.5 ±â€¯3.8 mm in patients and 20.0 ±â€¯2.7 mm in controls (P < 0.001). The TT-PCL was 22.9 ±â€¯3.9 mm in patients and 20.5 ±â€¯2.7 mm in controls (P = 0.002). Correlation between the PT-PCL and TT-PCL was R = 0.838, P < 0.001. The PT-PCL had 66.6% (95% CI = 0.542-0.790) diagnostic yield. The nPT-PCL was significantly higher in patients (0.302 ±â€¯0.03) than controls (0.271 ±â€¯0.03; P < 0.001) with 73.9% (95% CI = 0.628-0.851) diagnostic yield. CONCLUSION: The PT-PCL correlated with TT-PCL, with 66.6% diagnostic yield. The nPT-PCL may represent an additional index, with 73.9% diagnostic yield.

New Insights about Pulmonary Epithelioid Hemangioendothelioma: Review of the Literature and Two Case Reports.

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare neoplasm of vascular origin. There are three different major imaging patterns identified in thoracic manifestation of epithelioid hemangioendothelioma: (1) multiple pulmonary nodules; (2) multiple pulmonary reticulonodular opacities; and (3) diffuse infiltrative pleural thickening. Radiographically, presence of bilateral multiple nodules is the most common pattern of presentation. The diagnosis is made on the basis of histopathological findings and confirmed by positive immunohistochemistry staining. Although the prognostic factors for PEH have not yet been well established, a better prognosis is usually associated with the multinodular pattern. We report two different imagological presentations of this rare disease, based on two institutional experiences, along with a review of the relevant literature.

Adult Acute Scrotal Edema - When Radiologists Can Help to Avoid Unnecessary Surgical Treatment.

Acute idiopathic scrotal edema is a commonly painless self-limiting condition causing scrotal swelling, and is usually seen in children. In some cases, this condition is difficult to differentiate it from other causes of acute scrotum. In the right clinical scenario, ultrasonography has been used to confirm the diagnosis. We describe the ultrasound and CT findings of acute idiopathic scrotal edema in a 72-year-old male with coexistent involvement of the inferior abdominal wall.