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Traditionally, the presence of air within the hepatic portal venous system has been considered a rather ominous sign as it has been associated with conditions of increased associated morbidity and mortality such as bowel ischemia and intraabdominal sepsis. However, benign conditions, not requiring any particular intervention, have been implemented in the etiology, as well. In the present report, we present the case of the accidental ingestion of white spirit as a rather unusual cause of hepatic portal vein gas. A 32-year-old, otherwise healthy, male was admitted to the emergency department following the accidental ingestion of a “sip,” approximately 15 ml, of white spirit. The patient was complaining of nausea and upper abdominal pain that started soon after the ingestion of caustic agent. An imaging investigation with a computed tomography scan (CT) of the abdomen revealed the presence of hepatic portal vein gas along with a diffuse edema of the gastric wall at the site of the lesser curvature. A follow-up CT, 2 days after the admission, revealed no evidence of hepatic portal venous gas. Based on the patient's good general condition, an expectant management was decided. No intervention was required, oral feeding was recommenced after 6 days of fasting and the patient was discharged 8 days after the admission. Hepatic portal venous gas is a very impressive imaging finding with remarkably diverse etiology and prognostic correspondence. Irrespective of the cause, an approach of managing patients with hepatic portal venous gas according to their clinical condition appears reasonable.

Accurate diagnosis and timely intervention are key to addressing common knee conditions effectively. In this work, we aim to identify textural changes in knee lesions based on bone marrow edema (BME), injury (INJ), and osteoarthritis (OST). One hundred and twenty-one MRI knee examinations were selected. Cases were divided into three groups based on radiological findings: forty-one in the BME, thirty-seven in the INJ, and forty-three in the OST groups. From each ROI, eighty-one radiomic descriptors were calculated, encoding texture information. The results suggested differences in the texture characteristics of regions of interest (ROIs) extracted from PD-FSE and STIR sequences. We observed that the ROIs associated with BME exhibited greater local contrast and a wider range of structural diversity compared to the ROIs corresponding to OST. When it comes to STIR sequences, the ROIs related to BME showed higher uniformity in terms of both signal intensity and the variability of local structures compared to the INJ ROIs. A combined radiomic descriptor managed to achieve a high separation ability, with AUC of 0.93 ± 0.02 in the test set. Radiomics analysis may provide a non-invasive and quantitative means to assess the spatial distribution and heterogeneity of bone marrow edema, aiding in its early detection and characterization.

Our study evaluated the role of the T2–fluid-attenuated inversion recovery (FLAIR) mismatch sign in detecting isocitrate dehydrogenase (IDH) mutations based on a mixed sample of 24 patients with low- and high- grade gliomas. The association between the two was realized using univariate and multivariate logistic regression analysis. There was a substantial agreement between the two raters for the detection of the T2–FLAIR mismatch sign (Cohen’s kappa coefficient was 0.647). The T2–FLAIR mismatch sign when co-registered with the degree of tumor homogeneity were significant predictors of the IDH status (OR 29.642; 95% CI 1.73–509.15, p = 0.019). The probability of being IDH mutant in the presence of T2–FLAIR mismatch sign was as high as 92.9% (95% CI 63–99%). The sensitivity and specificity of T2–FLAIR mismatch sign in the detection of the IDH mutation was 88.9% and 86.7%, respectively. The T2–FLAIR mismatch sign may be an easy to use and helpful tool in recognizing IDH mutant patients, particularly if formal IDH testing is not available. We suggest that the adoption of a protocol based on imaging and histological data for optimal glioma characterization could be very helpful.