The Safety of Maternal and Fetal MRI at 3 T.

OBJECTIVE. The purpose of this study was to evaluate the effects of clinical 3-T MRI during pregnancy on fetal growth and neonatal hearing in neonates at low risk of congenital hearing impairment or of brain or chromosomal abnormalities. MATERIALS AND METHODS. This single-center retrospective case-control study included consecutively born healthy neonates exposed in utero to 3-T MR during MRI for maternal or fetal indications and born between January 2008 and March 2015. Each exposed neonate was randomly matched 1:2 by birth date to healthy control neonates who had not been exposed to MR. Infant birth weights were compared by unpaired t test. Hearing impairment between groups was compared by Fisher exact test. RESULTS. There was no significant difference in mean birth weight between the MR-exposed (3398 g) and control (3510 g) neonates (p = 0.06). There was no significant difference in prevalence of hearing impairment (p = 0.55) between the MR-exposed (0% [0/81]) and control (1.8% [3/162]) groups. CONCLUSION. This study showed no adverse effects with regard to neonatal hearing or fetal growth in healthy neonates who were variably exposed to 3-T MR in utero during MRI for various clinical maternal or fetal indications at any gestational age.

Upper extremity deep venous thrombosis.

The patient was a 34-year-old man currently serving in the military who was referred to a physical therapist by his primary care physician for a chief complaint of worsening right shoulder pain and paresthesias of the first, second, and third digits of his right hand, as well as right upper extremity swelling. Doppler ultrasonography was performed, and the presence of an occlusive thrombus in the right distal subclavian and axillary veins was revealed.

Snapping pes anserine syndrome.

The patient was a 25-year-old man who was serving in the military. He was referred to a physical therapist for a progressively worsening painful snapping sensation in the posteromedial left knee region. Prior magnetic resonance imaging for the left knee was interpreted as normal, except for a mild fluid signal about the left pes anserine bursa. The patient was diagnosed with snapping pes anserine syndrome. However, despite 6 weeks of physical therapist intervention, the patient did not improve. A dynamic real-time ultrasound examination was then ordered, which demonstrated that the pes anserine tendons changed position as the knee moved from flexion to extension, sliding across a heterogeneous rounded mass in the posteromedial knee.

A case of bronchobiliary fistula in the setting of adult polycystic kidney and liver disease, with a review of the literature.

A case of bronchobiliary fistula (BBF) was demonstrated in the setting of polycystic kidney and liver disease (PCKLD) by hepatobiliary scintigraphy. High-resolution noncontrast computed tomography through the liver showed a polycystic liver. A calcified cyst adjacent to the dome of the liver appeared to have a fistulous connection with the lung on coronal reconstructions. Hepatobiliary scan confirmed the fistulous connection. In a review of the literature, BBF has been associated with hydatid cyst disease, trauma, postsurgical states, and malignancy. As demonstrated by this case, BBF is difficult to diagnose and requires a high clinical index of suspicion. Hepatobiliary scintigraphy is the imaging modality of choice to confirm BBF, and PCKLD should be added to the list of antecedent etiologies.