No abstract

Cesarean scar implantation represents a rare, though growing subset of potentially life-threatening ectopic pregnancy. Because of the global increase in cesarean sections as well as the improved diagnostic abilities of transvaginal ultrasound, incidence rates have continued to rise since the first reported case in 1978. Uterine rupture and catastrophic hemorrhage can ensue when diagnosis is delayed. Additionally, a higher rate of concurrent trophoblastic myometrial invasion may increase the incidence of retained products of conception or post procedural bleeding. Endovaginal ultrasound has a reported sensitivity of 85 % for detection. In difficult cases, magnetic resonance imaging is often useful as a problem solving exam in confirming diagnostic suspicions and guiding therapeutic decisions. We present a series of five illustrative cases illustrating the range of clinical and imaging findings.Keywords Ectopic Á Cesarean section Á Pregnancy Á Ultrasound Sommario La cicatrice da taglio cesareo rappresenta nella gravidanza ectopica una rara seppur crescente concausa potenzialmente pericolosa per la vita. L'aumento su scala globale della pratica del taglio cesareo, nonostante il supporto dell'applicazione dell'ecografia trans-vaginale sempre più precisa, ha visto crescere i tassi di incidenza a partire dal primo caso riportato nel 1978. Quando la diagnosi è tardiva ne può derivare la rottura dell'utero con conseguente grave emorragia. Inoltre, il verificarsi concomitante di invasione trofoblastica a livello del miometrio potrebbe aumentare l'incidenza dei residui da concepimento o delle emorragie post intervento. L'ecografia trans vaginale ha una capacità diagnostica dell'85 %. Nei casi più difficili, la RM è spesso utile come esame risolutore nel confermare i sospetti diagnostici e guidare quindi verso la terapia appropriata. Vi presentiamo 5 casi esemplificativi che illustrano la varietà di dati clinici ed imaging.

High-resolution sonography has a growing role in both the diagnosis and management of traumatic and atraumatic peripheral nerve pathology. Sonography not only affords a cost-effective and time-efficient approach to interrogating long segments of peripheral nerves but also possesses unique advantages in terms of its dynamic, real-time nature with few clinical contraindications and limitations. In this review, we will initially discuss imaging techniques and characteristics of normal neural sonohistology, then address specific features and pitfalls pertaining to the spectrum of post-traumatic peripheral nerve injury. Additionally, we will highlight the more common sonographic applications in the clinical work-up of patients presenting with symptoms of dynamic neural impingement and entrapment. Finally, illustrative and clinical features of the more frequently encountered peripheral neural neoplastic pathologies will be addressed.

Voriconazole, first commercially approved in 2002 as a second-generation antifungal agent, is commonly used in the immunocompromised setting as both a therapeutic and prophylactic agent. Since 2009, scattered case reports and small case series have detailed a secondary drug-related hyperfluorosis-induced painful periostitis that can occur in the treated patient population. We present a pictorial review of the thoracic imaging manifestations utilizing 3 illustrative cases in the setting of both solid organ and bone marrow transplantation. Knowledge of the relatively characteristic radiographic appearance and distribution, when coupled with the appropriate clinical context and associated laboratory findings, is important in narrowing an otherwise relatively broad differential diagnosis.

Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for emergency visits and hospitalizations among young and adult female patients. Though gynecologic evaluation and sonography constitute the mainstay of diagnosis, multidetector CT imaging of the abdomen and pelvis is not uncommonly performed, often as the initial imaging modality, due to the frequently vague and indeterminate clinical presentation. As such, knowledge and attenuation to the often subtle early imaging features of PID afford the radiologist a critical chance to direct and expedite appropriate pathways of patient care, minimizing the risk for secondary complications, including infertility, ectopic pregnancy, and enteric adhesions. In this paper, we will review the pathophysiology, clinical presentation, early and late imaging features of PID as well as potential secondary complications and treatment options. Additionally, we will discuss published data metrics on CT performance regarding sensitivity and specificity for diagnosis as well as potential imaging differential diagnostic considerations.