Infestation in soft tissue by Echinococcus granulosus is not a common disease, and its diagnosis is based on clinical, laboratory data and radiological findings. The aim of our retrospective study is to give an overview of the different signs and patterns shown by MRI that can be useful in characterizing soft tissue hydatid disease. The MRI images obtained in seven patients with soft tissue and subcutaneous hydatidosis were reviewed. Typical signs of hydatidosis were multivesicular lesions with or without hypointense peripheral ring ("rim sign"). Related to the presence and absence, respectively,of viable scolices in the microscopic exam, daughter cysts were presented either as high signal intensity or low signal intensity on T2-weighted images. Low-intensity detached layers within the cyst and peripheral enhancement with gadolinium-DTPA were also presented. Atypical signs were presented in an infected muscular cyst, a subcutaneous unilocular cyst and several unilocular cysts. Knowledge of the different patterns in MRI of soft tissue hydatid disease can be useful in diagnosing this entity. We observed that the "rim sign" is not as common as in other locations, and in addition, MRI seems to be of assistance when evaluating the vitality of the cysts.

Background Large skull reconstruction, with the use of customized cranial implants, restores cerebral protection, physiologic homeostasis, and one's preoperative appearance. Cranial implants may be composed of either bone or a myriad of alloplastic biomaterials. Recently, patient-specific cranial implants have been fabricated using clear polymethylmethacrylate (PMMA), a visually transparent and sonolucent variant of standard opaque PMMA. Given the new enhanced diagnostic and therapeutic applications of clear PMMA, we present here a study evaluating all outcomes and complications in a consecutive patient series. Methods A single-surgeon, retrospective, 3-year study was conducted on all consecutive patients undergoing large cranioplasty with clear PMMA implants (2016–2019). Patients who received clear PMMA implants with embedded neurotechnologies were excluded due to confounding variables. All outcomes were analyzed in detail and compared with previous studies utilizing similar alloplastic implant materials. Results Fifty-five patients underwent cranioplasty with customized clear PMMA implants. Twenty-one (38%) were performed using a single-stage cranioplasty method (ie, craniectomy and cranioplasty performed during the same operation utilizing a prefabricated, oversized design and labor-intense, manual modification), whereas the remaining 34 (62%) underwent a standard, 2-stage reconstruction (craniectomy with a delayed surgery for cranioplasty and minimal-to-no implant modification necessary). The mean cranial defect size was 101.8 cm2. The mean follow-up time was 9 months (range, 1.5–39). Major complications requiring additional surgery occurred in 7 patients (13%) consisting of 2 (4%) cerebrospinal fluid leaks, 2 (4%) epidural hematomas, and 3 (4%) infections. In addition, 3 patients developed self-limiting or nonoperative complications including 2 (4%) with new onset seizures and 1 (2%) with delayed scalp healing. Conclusions This is the first reported consecutive case series of cranioplasty reconstruction using customized clear PMMA implants, demonstrating excellent results with regard to ease of use, safety, and complication rates well below published rates when compared with other alloplastic materials. Clear PMMA also provides additional benefits, such as visual transparency and sonolucency, which is material specific and unavailable with autologous bone. Although these early results are promising, further studies with multicenter investigations are well justified to evaluate long-term outcomes.

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We report our experience in B-mode ocular ultrasonography, focusing on its contribution when the clinical examination proves to be difficult, mainly due to the existence of intraocular opacities of the ocular fundus or diagnostic doubts. We revise the ocular ultrasound technique, its indications and contraindications, comparing to the other imaging techniques. In our experience ultrasonography revealed pathological findings which confirmed the clinical suspicion in most of cases or provide additional information. With understanding of the indications for ultrasonography and proper examination technique, one can gather a vast amount of information not possible with clinical examination alone.Keywords Ophthalmic ultrasonography Á Cataract Á Hyphema Á Hypopyon Á Hemovitreous Á Vogt-Koyanagi-Harada Sommario Riportiamo la nostra esperienza di ecografia oculare in B-mode, concentrandoci sul suo contributo quando l'esame clinico si riveli difficile, principalmente per l'esistenza di opacità intraoculari del fondo o in presenza di dubbi diagnostici. Rivediamo la tecnica ecografica, le sue indicazioni e controindicazioni, anche a confronto con le altre tecniche di imaging. Nella nostra esperienza l'ecografia ha rilevato reperti patologici che, nella maggior parte dei casi, hanno confermato il sospetto clinico, o fornito informazioni aggiuntive. Limitando le indicazioni ed eseguendo l'esame con tecnica corretta, si possono raccogliere una grande quantità d'informazioni che non è possibile avere con il solo esame clinico.