RSNA
ImageInterpretationSession
Abdomen:GI
History
?66year-oldmalewithchronicabdominalpain
?Acuteexacerbation
?Chronicmedicalhistory,includes
–Gout
–Hypertension
–“Congenitalemphysema”:Rxinhalersandprnsteroids
?Recurrentpneumothoraces
?Recurrentinfections
?Chronicallyshortofbreath
History
?RelevantSurgicalhistory
–Bilateralcarpaltunnelreleases;rightside’s
–Bilateralfingeramputations:etiology?
–Hxofintussusception:smallbowelresection
?RelevantSurgicalhistory
?Bilateralcarpaltunnelreleases;rightside’s
?Bilateralfingeramputations:etiology?
Findings:X-ray
?Thirdfingeramputation
?Macrodactyly(disproportionateovergrowth)
?Coursetrabeculationofenlargedphalanxes
?Softtissuehypertrophy(metacarpusandaroundseconddigit)
?Abnormallycalcifiedconnectivetissue
Findings:MR
?Soft-tissuefibroticlesion(lowsignalonT1/T2),i.e.fibroushamartoma
?Bonecysticlesions
Findings
?Overgrowthofconnectivetissues(bone,fat)
?Progressivedisease
?Onsetatyoungage
Findings
?“Congenitalemphysema”:Rxinhalersandprnsteroids
?Recurrentpneumothoraces
?Recurrentinfections
?Chronicallyshortofbreath
Findings
?ChestX-ray
?Asymmetrichemithoraces;hyperinflationofleft
lung
?Redistributionofbloodflowtotheupperlung
zoneswithabnormalenlargementoftheupper
lobevessels
?Prominenthilawithreticularandstreaky
densitiesinbothperihilarareas
Findings
?LungCT
?Hyperinflationoftheleftlung
?Emphysematouschanges
?Areasofscarringandcysticchangesintheleftlowerlobe
History
?Hxofintussusception:smallbowelresection
Findings
?Multipleencapsulatedlipomasinthestomach,duodenumandjejunum
?Fattyovergrowthintheomentum
?Lipohypoplasiaofsubcutaneousfat
?Dysregulatedadiposetissue
?Splenomegaly
??Thickwalloftherightventricle
DIFFERENTIALDIAGNOSIS
?Macrodystrophialipomatosa
?Multiplesymmetriclipomatosis(Madelungdisease)
?CLOVE(CongenitalLipomatousOvergrowth,Vascularmalformations,andEpidermalnevi,Skeletal)syndrome
?Proteussyndrome
与往年一样，医学影像学英语
