Twiglike MCA: A Not-So-Common Cerebral Vascular Anomaly

Congenital anomalies of the MCA are rare compared with the rest of the intracranial vasculature. An aplastic MCA, known as a twiglike MCA, is the result of replacement of MCA trunk by a plexiform network of small vessels. In this report, we aim to review the radiologic features of a twiglike MCA and its differential diagnosis, helping the reader differentiate this entity from more common pathologies to avoid unnecessary further investigation.

Right destroyed lung due to tuberculosis in a Nigerian child: Case report and review of the literature

Destroyed Lung Syndrome (DLS) is total lung destruction from recurrent and chronic infections especially Tuberculosis (TB). It is rare in children and associated with chronic morbidity. It presents with chronic cough, progressive difficulty in breathing, hemoptysis and progressive respiratory failure. The pathology of DLS includes lung fibrosis, collapse, tracheal and mediastinal shift. We report the case of a 9 years old girl referred after three courses of anti-TB treatment for suspected TB reinfection with worsening clinical and radiologic features. Investigations revealed a destroyed right lung. Genexpert was initially positive and subsequently along with TB culture was negative. She improved on antibiotics and chest physiotherapy. Destroyed lung though rare in children should be considered in those who despite TB treatment present with worsening clinical and radiologic features. Early diagnosis and multi- disciplinary approach will prevent irreversible lung damage.

Rickets in Children: An Update

Rickets refers to a deficient mineralization of the growth plate cartilage, predominantly affecting longer bones. Despite the fact that preventive measures are available, it is still a common disease worldwide; nutritional rickets, due to vitamin D deficiency or dietary calcium inadequate intake, remains the most common form. Medical history, physical examination, radiologic features and biochemical tests are essential for diagnosis. Although recent studies suggest hypophosphatemia as the leading alteration, rickets is classically divided into two categories: calcipenic rickets and phosphopenic rickets. Knowledge of this categorization and of respective clinical and laboratory features is essential for rapid diagnosis and correct management. The aim of this review is to analyze the epidemiological, pathogenetic, clinical, and therapeutic aspects of the different forms of rickets, describing the novelties on this “long-lived” disease.

Comparison of Diagnostic Performance of Spread Through Airspaces of Lung Adenocarcinoma Based on Morphological Analysis and Perinodular and Intranodular Radiomic Features on Chest CT Images

ObjectSTAS is associated with poor differentiation, KRAS mutation and poor recurrence-free survival. The aims of this study are to evaluate the ability of intra- and perinodular radiomic features to distinguish STAS at non-contrast CT.Patients and MethodsThis retrospective study included 216 patients with pathologically confirmed lung adenocarcinoma (STAS+, n = 56; STAS−, n = 160). Texture-based features were extracted from intra- and perinodular regions of 2, 4, 6, 8, 10, and 20 mm distances from the tumor edge using an erosion and expansion algorithm. Traditional radiologic features were also analyzed including size, consolidation tumor ratio (CTR), density, shape, vascular change, cystic airspaces, tumor–lung interface, lobulation, spiculation, and satellite sign. Nine radiomic models were established by using the eight separate models and a total of the eight VOIs (eight-VOI model). Then the prediction efficiencies of the nine radiomic models were compared to predict STAS of lung adenocarcinomas.ResultsAmong the traditional radiologic features, CTR, unclear tumor–lung interface, and satellite sign were found to be associated with STAS significantly, and the AUCs were 0.796, 0.677, and 0.606, respectively. Radiomic model of combined tumor bodies and all the distances of perinodular areas (eight-VOI model) had better predictive efficiency for predicting STAS+ lung adenocarcinoma. The AUCs of the eight-VOI model in the training and verification sets were 0.907 (95%CI, 0.862–0.947) in the training set, and 0.897 (95%CI, 0.784–0.985) in the testing set, and 0.909 (95%CI, 0.863–0.949) in the external validation set, and the diagnostic accuracy in the external validation set was 0.849.ConclusionRadiomic features from intra- and perinodular regions of nodules can best distinguish STAS of lung adenocarcinoma.