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Axial CT scan demonstrates arachnoid pit lateral to sphenoid sinus (black arrow). An approximately 9-mm size defect in the left superolateral wall of the sphenoid sinus (white asterisk) just lateral to foramen rotundum, with a soft tissue density mass filling the adjacent part of the sphenoid sinus. Notice the pneumatization of most far lateral recesses of sphenoid sinus (white arrow).
Source publication
Lateral sphenoid encephalocele, especially within the lateral aspect of the sphenoid sinus, when the sphenoid sinus has pneumatized extensively into the pterygoid recess, are considered exceedingly rare. We report a rare case of lateral intrasphenoidal encephalocele with spontaneous cerebral spinal fluid (CSF) rhinorrhea. Computed tomography demons...
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Background
Aspiration pneumonitis is an inflammatory disease of the lungs which is difficult to diagnose accurately. Large-volume aspiration of oropharyngeal or gastric contents is essential for the development of aspiration pneumonitis. The role of cerebrospinal fluid (CSF) rhinorrhea is often underestimated as a rare etiological factor for aspira...
The most common cause of cerebrospinal fluid (CSF) rhinorrhoea is damage to the skull base with a dura mater’s rupture due to an accident or an iatrogenic injury. This applies to over 96% of cases. Other possibilities that can lead to CSF leakage are neoplasms of the nasal cavity, paranasal sinuses, and nasopharynx. Although prostate cancer spreads...
Objective: To present a case of a non-traumatic cerebrospinal fluid (CSF) rhinorrhea from a midline sphenoid sinus roof that presented as a persistent postnasal drip and was previously managed as allergic rhinitis for 43 years.
Methods:
Design: Case Report
Setting: Tertiary Private University Hospital
Participants: One
Results: A 58-year-old o...
We experienced a case of sphenoid sinus type meningoencephalocele manifesting as severe cerebrospinal fluid (CSF) rhinorrhea. A 35-year-old man became aware of serous nasal discharge 1 year previously, which had gradually worsened. The nasal discharge was diagnosed as CSF rhinorrhea. Head computed tomography (CT) showed several small depressions in...
Background: Spontaneous cerebrospinal fluid (CSF) rhinorrhea in the pediatric population is an exceedingly rare condition that occurs when the dura mater is breached, resulting in CSF drainage from the subarachnoid space into surrounding sinonasal tissue. Objective: This work delineates a step-by-step surgical approach to visually demonstrate the f...
Citations
Background:
Magnetic resonance imaging plays an important role in identification of any underlying structural cause in spontaneous cerebrospinal fluid (CSF) leaks-either rhinorrhea or otorrhea. Sphenoid bone defects have been reported in those presenting as idiopathic intracranial hypertension with or without CSF rhinorrhea. Sphenoid lateral recess defect with intrasphenoidal encephalocele is one of the uncommon causes of spontaneous CSF leakage. Many classifications of basal encephaloceles have been used along with associated predisposing anatomic factors for the CSF leak.
Case description:
We report 2 cases of spontaneous CSF rhinorrhea in 2 middle-aged females and had intrasphenoidal encephalocele on imaging using 3-dimensional magnetic resonance cisternography and computed tomography.
Conclusions:
We discuss the various classification systems of sphenoidal encephaloceles and review the terminology and comprehensive imaging details to be included in reporting such cases for appropriate treatment planning.
A quantitative characterization of the soft tissues composing the human breast is achieved by means of a monochromatic CT phase-contrast imaging system, through accurate measurements of their attenuation coefficients within the energy range of interest for breast CT clinical examinations. Quantitative measurements of linear attenuation coefficients are performed on tomographic reconstructions of surgical samples, using monochromatic X-ray beams from a synchrotron source and a free space propagation setup. An online calibration is performed on the obtained reconstructions, in order to reassess the validity of the standard calibration procedure of the CT scanner. Three types of healthy tissues (adipose, glandular, and skin) and malignant tumors, when present, are considered from each sample. The measured attenuation coefficients are in very good agreement with the outcomes of similar studies available in the literature, although they span an energy range that was mostly neglected in the previous studies. No globally significant differences are observed between healthy and malignant dense tissues, although the number of considered samples does not appear sufficient to address the issue of a quantitative differentiation of tumors. The study assesses the viability of the proposed methodology for the measurement of linear attenuation coefficients, and provides a denser sampling of attenuation data in the energy range useful to breast CT.
At the end of April 2016, a 29-year-old female patient came to our MRI unit, as an out-hospital patient, for a brain MRI. Her only symptom was headache: non-specific diffuse headache during several years, sometimes on daily basis.
The increasing use of computed tomography (CT) in acute appendicitis makes recognising the radiological hallmarks of the condition and its mimics vital. The differential diagnosis includes both appendiceal and nonappendiceal pathologies. The correlation between pre-appendectomy CT and post-appendectomy histopathology was audited retrospectively. Cases of clinico-histopathological discrepancy underwent blind peer-review, and possible improvements were discussed in the context of the medical literature. A grade for discrepancy was given based on the RADPEER scoring system, and interesting or discrepant cases were examined more closely to identify targets for education. Of the 199 procedures, 4 appendectomies were negative (histologically normal), 182 were positive (primary appendicitis) and 13 were incidental (another primary process caused inflammation). The positive predictive value for pre-appendectomy CT was 91.5 %, and the negative appendectomy rate was 2 %. There were many secondary pathologies, including neoplasia, tuberculosis and endometriosis. Although no CT reports missed a diagnosis that should be made "almost all of the time" and in 96 % of cases, the second, blinded radiologist agreed with the initial assessment, in 3 cases, a missed diagnosis altered clinical management; 2 were "understandable" misses but 1 was not. In five cases, a discrepancy was "understandable" but clinically insignificant. Overall, in comparison to the medical literature, the degree of clinico-histopathological correlation was good. Although identifying areas for improvement was challenging, after a pictorial review of four cases and a discussion of the medical literature, we present our audit results and some valuable learning points for use in the CT assessment of suspected acute appendicitis.
To assess the influence of metallic posts in the detection of simulated vertical root fractures (VRFs) using the following imaging exams: 2 cone-beam computed tomography (CBCT) systems (CBCT1: NewTom 3G and CBCT2: i-CAT Next Generation) and film and digital radiographs. Additionally, the influence of the orientation of the fracture line in the detection of VRFs was evaluated.
100 human single-rooted premolars endodontically treated, were divided into 5 groups (Group 1: with posts and bucco-lingual VRFs, Group 2: with posts and mesio-distal VRFs, Group 3: without posts and with bucco-lingual VRFs, Group 4: without posts and with mesio-distal VRFs, and Group 5: with posts and without VRFs). The premolars were placed in human mandibles and imaged using the four exam modalities. The sensitivity and the specificity of each exam in the experimental groups were calculated. The data were analyzed using Student's t-test.
The presence of metallic posts reduced the sensitivity of the CBCT1 system (p = 0.0244). Digital radiographs and the CBCT1 and CBCT2 systems had a higher sensitivity in detecting bucco-lingual fractures in teeth with posts, whereas film and digital radiographs had a higher sensitivity in detecting bucco-lingual fractures in teeth without posts (p <0.05). The CBCT1 exam demonstrated the lowest specificity (p <0.05).
The presence of metallic posts did not influence the sensitivity of most of the exams, excluding the CBCT1 system. The fracture line orientation may influence the VRFs detection.
