Case of the Week From 3/31/24
History: Abdominal pain.
What are the findings on these mages? Defect in the posterior wall of the aorta with turbulent flow extending into the defect and not external to the artery.
What is the most likely diagnosis, and why? Ruptured plaque- penetrating ulcer because of the lack of adjacent blood products or extension of abnormality.
How is this usually treated? Hypertensive medications. Annual follow-up can be suggested to ensure no progression to a dissection. If the symptoms are more severe, endograft stenting can be performed.
Case of the Week From 3/24/24
History: Abnormal EEG findings.
What are the visual findings on these mages? Significantly decreased uptake at the lateral left temporal lobe. More mild decreased at the left precuneus.
What is the most likely diagnosis, and why? Mesial temporal sclerosis commonly affects the temporal lobes, causing decreased uptake/metabolism in the interictal phase.
How does the quantitative analysis on the right affect the read? Improves intraobserver variability and specificity of findings.
Case of the Week From 3/17/24
History: Febrile for two weeks.
What are the findings? Multiple hypodense lesions within the spleen. Some subtle peripheral nodular enhancement is adjacent to the splenic lesions. No significant inflammatory change/stranding adjacent to the spleen
What is the most likely diagnosis, and why? Multiple hemangiomas are common, and they typically have this appearance.
What would you recommend doing next, and why? There should be no further workup if the clinical suspicion for abscess is low. If there is high clinical suspicion, you can perform a contrast-enhanced MRI.
Case of the Week From 3/10/24
History: Recently diagnosed prostate cancer.
What kind of scan is this? PMSA PET scan
What are the types of agents that are currently approved for this indication? Currently can use F18 PMSA and Ga-68 PMSA
What are the findings? Intense uptake at the right peripheral prostate gland.
What is the differential diagnosis? Residual disease and/or post intervention changes at the prostate gland.
Case of the Week From 3/3/24
History: Status post car accident. Chest pain.
What is the diagnosis? Comminuted nondisplaced sternal fracture.
What are the associated complications? Pneumothorax, mediastinal hematoma/vascular injury, cardiac contusion/injury/tamponade, rib fractures
Are there any other imaging tests that might be helpful? In addition to plain film and CT scan, echocardiography may be helpful to detect cardiac contusion/injury
