RSNA2018：Wednesday Case of the Day（Unknown Cases）

RSNA2018每日病例挑战（4）

Wednesday Case of the Day

Breast Imaging

Authors: Chandni Bhimani, DO, Alexander Sevrukov, MD

Thomas Jefferson University, Philadelphia, PA

History: 74-year-old woman with a history of small cell lung cancer presented for surveillance with CT chest.

Figure #1: CT Chest with contrast (left: soft tissue window and right: lung window).

Wednesday Case of the Day

Cardiac

Author: Fernando U. Kay, M.D. Ph.D.

Department of Radiology, UT Southwestern Medical Center, Dallas, TX, USA

History: 78-year-old female with worsening dyspnea on exertion and lower   extremity edema

Video 1: Transesophagealechocardiogram, zoomed mid-esophageal 4-chamber view, B-mode (a) with color Doppler overlay (b)

Video 2: Cardiac magnetic resonance (CMR), cine 

3-chamber view, steady-state free-precession 

Wednesday Case of the Day

CHEST

Author: Pamela Lombardi, MD 

Department of Radiology, Northwestern Medicine, Chicago, IL

History: 54 year old man with dyspnea for about one year.

Figure 1: Chest radiograph (a); Axial CT (b) and Sagittal reformat CT (c) images.

Wednesday Case of the Day

Category: ER

Authors: Nicholas Beckmann MD, Manickam Kumaravel MD

UTHealth-McGovern School of Medicine

History: 36-year-old male with incomplete cord injury after MVA.

Wednesday Case of the Day

Gastrointestinal

Authors: Owen JW1, Lee JT1, Hanaoka MM1, Ayoob AR1

 1University of Kentucky, Lexington, KY USA  

History: 51 year-old man presents with unintentional weight loss, nausea, and intermittent vomiting

(A) Lateral view from a double contrast upper GI fluoroscopic study

(B) Axial CT images at the level of the mid abdomen from an intravenous contrast enhanced CT

Genitourinary Wednesday Case of the Day

Authors: John Renfrew MD & Matthew Heller MD, FSAR

Mayo Clinic Arizona

History: 26 year old female with history of HPV infection presents for evaluation of an enlarging mass that originated on the vulva.

Wednesday Case of the Day

Vascular and Interventional

Authors: * Ji Buethe, MD, Dan Scher, MD, Resmi Charalel, MD, SailenG. Naidu,  MD, and Robert Liddell, MD

*Johns Hopkins Hospital, Baltimore, MD

History: 49 year old female presents with chronic right leg swelling and buttock discoloration since birth..

Figure 1: Photograph of bilateral lower extremities – posterior view

Figure 2: coronal MR TWIST venogram post-subtraction MIP image

Wednesday Case of the Day: Molecular Imaging

Authors: Kiran Sargar, MD1, Akash Sharma, MD, MBA2, ManojJain, MD2, Ephraim Parent, MD, PhD2.

Authors affiliation: 1Geisinger Healthcare, Danville PA, 2Mayo Clinic in Florida, Jacksonville FL

History: A 75 year-old patient with cognitive decline and movement disorder  

Wednesday Case of the Day MSK

Sara R. Eckloff, MD and Andrew Z. Chow, MD

Mayo Clinic Health System

History: 76-year-old with 6 months of right anteromedial knee pain

Wednesday Case of the Day

Neuroradiolgy

Authors: Rami Eldaya, MD; Hilary LP Orlowski, MD; Matthew S. Parsons, MD

Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO

History: 44-year-old male presenting as a referral to our institution with history of wide-based gait and altered sensation for one month. Extensive imaging, blood work, and CSF analysis work up at outside institution was negative except for abnormal brain and total spine MRI.

Figure 1: Axial MRI post contrast

Figure 2: Coronal MRI post contrast

Figure 3: Sagittal cervical spine MRI post contrast

Wednesday Case of the Day

Category Nuclear Medicine

Andrew Kaiser, Tarun Jindal, Yashesh Shah, Monica Gerst, Levi Sokol,  Richard K.J. Brown

Michigan Medicine, Department of Radiology

History: 66-year-old female, history of metastatic breast cancer; restaging.

Wednesday Case of the Day

Obstetrical imaging

Authors: Ann T. Packard, Rodrigo Ruano, MD, PhD, Amy B. Kolbe MD, and Douglas (Rusty) Brown, MD. 

Mayo Clinic

Rochester, MN

History: 29 year old G2P1 presents at 19 weeks due to vaginal bleeding. Ascites was seen on ultrasound prompting a formal fetal anatomy scan.

Wednesday Case of the Day

Pediatric

David Dansie, MD1, Ting Y. Tao, MD, PhD2, Alisa Kanfi, MD3, Michael Aquino, MD, MS4, Arnold C. Merrow, MD5, Luke L. Linscott, MD1

1Primary Children’s Hospital, 2Cardinal Glennon Children’s Hospital, 3University of Cincinnati Medical Center, 4Toronto Hospital for Sick Children, 5Cincinnati Children’s Hospital Medical Center 

History: 15 year-old male with five months of cervical spine pain.

Figure 1: Axial contrast-enhanced neck CT

Figure 2: Sagittal STIR MRI cervical spine

Wednesday Case of the Day

Physics

Authors: Raja Subramaniam, Ph.D., Laurie Margolies, M.D.

Icahn School of Medicine at Mount Sinai Medical Center, New York, NY

HistoryShown here are the 2D FFDM image and C-view synthesized image for the same patient.  A streak artifact as indicated is seen in the 2D FFDM image.  The artifact is missing in the synthesized image.  What is the artifact due to?  Why is it not seen in the synthesized image?

A. Patient motion 

B. Foreign object on the paddle

C. Focal spot artifact

D. Image processing artifact

Wednesday Case of the Day

Category Ultrasound

Authors: Mujtaba Z. Naveed, MD1 and Shuchi K. Rodgers , MD1 

Authors affiliation: Department of Radiology, Einstein Medical Center, Philadelphia, PA1

History: 29 year-old-female presents to the emergency room with pelvic pain. Ultrasound ordered to rule out ovarian torsion. What is the diagnosis?

Figure 1: (A) Sagittal grayscale ultrasound of the uterus (B) Sagittal grayscale ultrasound of the pelvis (C) Sagittal ultrasound cine of the pelvis

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FROM：http://archive.rsna.org/2018/Final%20Unknown%20Cases%2011.12.18.pdf