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Portal vein aneurysm (PVA) is rarely encountered, and published papers describing this etiology in adults and children typically include only case reports or small case series. We present a clinical case of PVA in a child associated with severe complications, including diffuse thrombosis of the portal venous system. A 10-year-old boy presented with abdominal pain and vomiting, resulting in an initial diagnosis of pancreatic head tumor based on suspicious images on abdominal grayscale ultrasound. Contrast-enhanced computed tomography confirmed a diagnosis of occlusive PVA thrombosis (36 × 37 × 95 mm). Lacking drastic symptoms, the patient was treated with conservative anticoagulant therapy. On follow-up, the thrombosis appeared to shrink gradually and disappeared at 6 months based on Doppler ultrasound imaging. The PVA was reduced in size, and hepatopetal flow was restored. Surgeons and radiologists should be aware of this rare entity to ensure that a precise diagnosis can be established and to provide suitable treatment.

Ocular adnexal lymphoma accounts for approximately 1%-2% of non-Hodgkin lymphomas and 8% of extranodal lymphomas. Lacrimal gland lymphoma, especially bilateral lacrimal gland lymphoma, is rare, and imaging is often utilized to differentiate lacrimal lymphoma from other types of masses that involve the lacrimal gland and the fossa. We describe a 74-year-old male patient presenting with bilateral eye proptosis, lachrymose without pain, and no changes in eyesight. Brain-orbit magnetic resonance imaging revealed bilateral lacrimal fossa masses with regular contours, moderate enhancement, and restriction on diffusion imaging, consistent with a lymphoma diagnosis, which was confirmed by histopathological results. Positron emission tomography-computed tomography was used to determine lymphoma grading. MRI, especially diffusion imaging, can be useful for guiding clinicians in the diagnosis and differentiation of lacrimal gland lymphoma from other lesions.

Colon lipoma is a rare benign disease in the gastrointestinal tract with an incidence rate of approximately 0.035%-4.4%. The disease is often asymptomatic, so it is frequently discovered incidentally through endoscopy, computed tomography , or autopsy. When the tumor is over 2 cm in size, symptoms such as abdominal pain, bowel disorders, and bowel obstruction are common. Surgery is considered the mainstay of treatment for colonic lipomas. Furthermore, surgical (rather than endoscopic) resection is preferred for lipomas >2 cm to avoid complications such as bleeding and perforation. We report on a 61-year-old female patient who was diagnosed with a 4-cm descending colonic fat tumor detected by endoscopy and computed tomography and confirmed by pathology.

Tuberculosis remains prevalent in developing countries. Central nervous system tuberculosis often occurs secondary to pulmonary tuberculosis, transmitted through the bloodstream, and has a high mortality rate. Meningitis is the most common presentation of central nervous system tuberculosis, followed by tuberculoma, tuberculous brain abscess, and miliary tuberculosis. In this report, we present a case of miliary tuberculosis in a 3 month-old boy. The patient had a fever and was breathless for 1 month. The patient appeared cyanotic, experienced a seizure, and became comatose. Chest computed tomography scan suggested a pulmonary miliary tuberculosis abscess in the right lung and mediastinal lymph node tuberculosis. Brain magnetic resonance imaging showed the lesions were homogeneously enhancing tiny 2-3 mm nodules characteristic of miliary TB. Polymerase chain reaction of the cerebrospinal fluid and sputum samples confirmed tuberculosis. The patient died 1 month after diagnosis.

An encephalocele may be congenital or acquired and is characterized by the herniation of cranial contents through a skull bone defect. Most congenital encephaloceles occur in the occipital area, and temporal bone encephaloceles in children are rare. Congenital encephaloceles can be diagnosed either prenatally or after birth. We describe the case of a congenital temporal bone encephalocele in a 2-month-old boy that was diagnosed after birth. The patient presented with seizures and a bulging mass in the right neck that was detected by his mother during the second month after birth. The combined results from brain magnetic resonance imaging, computed tomography, and histological analysis confirmed the diagnosis of encephalocele. Although the surgical repair was offered, the family declined.

Peripheral arteriovenous malformations (AVMs) are rare, congenital anomalies resulting from developmental genetic defects of the vasculature and cause significant disturbances in daily activities. AVMs can affect any part of the body and are rarely observed in the calcaneal region. Here, we describe two cases of Yakes type IV calcaneal AVMs managed by ethanol sclerotherapy at our institute.

Determining the cause of gastrointestinal bleeding is critical to determining appropriate treatment. Upper gastrointestinal bleeding from the pancreas, referred to hemosuccus pancreaticus, is a rare entity that can cause massive and life-threatening bleeding. Diagnosis remains challenging, and the mortality rate of hemosuccus pancreaticus remains high, ranging from 9.6%–90%. In this article, we present a case that was successfully diagnosed and treated at the Department of General Surgery, Hanoi Medical University Hospital, and a review of the available literature regarding this rare disease.

Mesenchymal hamartoma of the chest wall is a rare benign tumor that usually occurs in infants and children. The clinical presentations and imaging features are atypical and difficult to differentiate from malignant tumors. In this article, we present a case with a large mesenchymal hamartoma tumor of the chest wall. A large right-sided chest wall mass was discovered in a 6-month-old boy by his mother. Chest X-ray revealed a thoracic mass with well-defined margins on the right side that expanded into the right ribs. Chest computed tomography showed that the mass originated from the thoracic wall. The patient underwent complete removal of the mass, and histopathology results confirmed a mesenchymal hamartoma.

Nguyen Ngoc Cuong,1 Pham Hong Canh,1 Le Tuan Linh,1,2 Nguyen Minh Duc,2– 4 Thieu Thi Tra My,1,2 Le Hoan5 1Diagnostic Imaging and Interventional Radiology Center, Hanoi Medical University Hospital, Ha Noi, Vietnam; 2Department of Radiology, Hanoi Medical University, Ha Noi, Vietnam; 3Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 4Department of Radiology, Children’s Hospital 2, Ho Chi Minh City, Vietnam; 5Respiratory Medicine Department, Hanoi Medical University Hospital, Hanoi, VietnamCorrespondence: Le HoanRespiratory Medicine Department, Hanoi Medical University Hospital, Hanoi, VietnamTel +84 372286666Email lehoan.hmu@gmail.comPurpose: This article described intranodal lymphangiography and embolization of patients with lymphatic leak post-operation of the groin region for various aetiologies (lymph node resection, femoral artery exposure).Materials and Methods: A retrospective analysis from 2018 to 2020 was performed and twelve consecutive patients underwent intranodal lymphangiography and intranodal lymphatic embolization to treat lymphorrhea or lymphocele post-operation of the groin. All the lymph nodes around the wound were punctured for lymphangiography. If the extravasation was found from the lymph node, the glue N-butyl cyanoacrylate (NBCA) diluted with lipiodol (ratio of 1:4) was injected to occlude the lymphatic vessel laceration.Results: All the lymph nodes around the wound were punctured with the median number of two lymph nodes for each patient (range from one to four lymph nodes); there were three patients with two leakage points. Intranodal lymphatic embolization was performed by glue NBCA diluted 1:4 with lipiodol. Additional treatment includes sclerotherapy (n=5) and percutaneous muscular flap operation (n=1). Clinical successful was achieved in twelve patients (100%) with no major complications. One patient experienced lymphedema which was was treated by compression stockings and rehabilitation therapy.Conclusion: Intranodal lymphangiography and embolization are effective methods to treat iatrogenic lymphatic leak while all the lymph nodes around the wound should be punctured to avoid missing lesions from other lymphatic vessels.Keywords: intranodal lymphangiography, intranodal lymphatic embolization, groin lymphatic leak, lymphorrhea

A ruptured blister-like aneurysm of the internal carotid artery is a rare event with a high risk of recurrence and mortality. Selecting an appropriate treatment modality remains challenging due to a lack of consensus or specific recommendations in the literature. In this article, we present the case of a 68-year-old man who presented with ruptured blister-like aneurysms in the supraclinoid portion of the internal carotid artery. The patient was diagnosed and successfully managed using an endovascular coil embolization technique at our hospital. We aim to illustrate and share our experiences with this rare occurrence, which may assist in the treatment of similar cases in the future.

Ischiopagus conjoined twinning is a rare congenital defect. The surgical separation of conjoined twins is difficult because of the complex anatomy and physiology. Careful preoperative assessment, planning, and effective surgical teams are critically important for achieving a good outcome. We describe the successful separation of ischiopagus tetrapus conjoined twins as a representative case demonstrating the growth of pediatric surgery in southern Vietnam.

Anaplastic astrocytoma, a diffusely infiltrating, malignant, astrocytic, primary brain tumor, is most commonly observed between 30 and 50 years of age. Anaplastic astrocytomas are now classified as WHO grade III lesions, with imaging characteristics and prognosis between diffuse low-grade astrocytomas (WHO grade II) and glioblastomas (WHO IV). Anaplastic astrocytoma can appear mostly in the cerebrum followed by cerebellum. However, it is rarely observed in the fourth ventricle. In this article, we aimed to describe an uncommon case of a pediatric, fourth-ventricular, anaplastic astrocytoma. A 9-year-old male who underwent MRI brain then adopted gross-total tumor eradication. The final histopathology findings were consistent with an anaplastic astrocytoma.

Mucoepidermoid carcinoma (MEC) is a common type of salivary gland malignancy; however, rarely, MEC can arise from the lung. This disease has a non-specific presentation and is often overlooked. Histologically, MEC can be classified into low-grade and high-grade forms. Surgical resection is the optimal treatment for low-grade tumors. In this article, we report a case of MEC in a 5-year-old girl who was initially misdiagnosed with pneumonia. The histological results revealed MEC. Thus, clinicians and radiologists should consider the possibility of this rare entity in patients who fail to respond to antibiotic treatments, even among the pediatric population.

Lymphoma with cardiac involvement is a high-risk lesion, especially in children. We report a rare clinical case of multifocal precursor B-cell lymphoblastic lymphoma in a child with cardiac involvement. A 4-year-old boy presented to the Vietnam National Children's Hospital with a vague headache, but magnetic resonance imaging of the head was normal. After 1 week, the patient showed symptoms of chest pain, fatigue, dyspnea, and abdominal pain. On transthoracic echocardiography and multislice computed tomography of the thorax, a mass was detected in the right atrial wall. Abdominal ultrasound showed a small bowel intussusception, multiple nodules in the intestinal wall, and mesenteric lymph nodes. Histopathology of the bowel confirmed the diagnosis of multifocal precursor B-cell lymphoblastic lymphoma. The patient responded to 3 cycles of chemotherapy for lymphoma. Therefore, combining multiple imaging methods allowed for early diagnosis and improved treatment.

Chordoid gliomas are uncommon neoplasms located within the anterior portion of the third ventricle. In this article, we aimed to describe the clinical presentation, magnetic resonance imaging characteristics, histological findings, and surgical treatment applied to a case of chordoid glioma. Chordoid gliomas are typically observed as solid masses within the anterior segment of the third ventricle, characterized by homogenous and vivid enhancement. Despite being classified as a low-grade neoplasm, the outcome of choroid glioma is often uncertain.

Chylous leakage after thyroidectomy is rare, and almost all patients with this complication can be treated conservatively. However, in patients with high-flow leakage, treatments can be complicated. In this study, we report a case that was successfully treated by disrupting the thoracic duct using two sessions of percutaneous interventions. The first intervention was a thoracic duct embolization, and the second intervention was a sclerosing injection to the thoracic duct under computed tomography guidance.

Wilms’ tumor is the most common malignant kidney tumor found in children. The Horseshoe kidney is the most common renal fusion malformation. However, Wilms’ tumor is rarely identified in horseshoe kidney patients. Multimodal treatments in Wilms’ tumor can play important roles in increasing the survival rate. In this study, we report the case of a 6-year-old boy in whom a Wilms’ tumor was identified in a horseshoe kidney. The tumor was successfully treated with preoperative chemotherapy, followed by surgical resection.

Adrenocortical carcinoma (ACC) is a rare malignancy that arises from the adrenal cortex and can be classified as either non-functioning or functioning. A patient with non-functioning ACC may present no specific symptoms. Imaging analysis can provide some information to a clinician who suspects ACC, such as tumor size, density, washout, necrosis, hemorrhage, and calcification. Histopathology is used to confirm and determine the origin of the malignancy and can provide relevant prognostic information. Microscopic findings can be used to obtain information such as the Weiss score, resection surface features, Ki-67 proliferative index, and the degree of capsular and vascular invasion. Surgery can be curative for localized tumors, and adjuvant therapy using mitotane and cytotoxic chemotherapy is often employed for advanced-stage tumors. We describe a case report of a 32-year-old man with a non-functioning ACC that highlights the importance of radiological and pathological features in the diagnosis of ACC and their use as prognostic factors.

Acute renal failure due to primary renal Burkitt lymphoma in children is extremely rare. We report a case with acute secondary renal failure in a 4-year-old boy who presented with abdominal pain, anorexia, and vomiting. Abdominal computed tomography scans showed bilateral nephromegaly with multiple hypoenhancing regions. Renal biopsy confirmed Burkitt lymphoma. There was no lymphadenopathy or evidence of other solid organ involvement. The patient was responsive to treatment using the EPOCH-R protocol (etoposide, prednisone, vincristine, cyclophosphamide , doxorubicin, and rituximab). Here, we describe the clinical and imaging features associated with this rare entity.

Introduction: Neurocysticercosis (NCC), a major contributor to the burden of seizure disorders and epilepsy in the world, is one of the most common parasitic infections of the central nervous system, which is usually located in the brain. Medical therapy for NCC should initially cover appropriate symptom control and then the use of antiparasitic agents should be considered. Antiparasitic treatment is of benefit in most cases of viable and degenerating NCC. Nevertheless, cysticercosis of the spinal cord is very uncommon. Case series: In this article, we recorded 5 cases of extramedullary-intradural lumbar spinal cysticercosis, in which one case displayed cystic lesions in both brain and spine, one case showed an independent cystic lesion in the spine, and three remaining cases showed diffuse lesions in the spinal canal. Conclusion: Thus, in any case of single or numerous cystic lesions or dispersed lesions entering the spinal canal, spinal cysticercosis should be considered.

Transurethral resection of bladder tumor (TURBT) is one possible treatment approach for bladder tumors. Bladder wall perforation is one potential complication of TURBT. Signs of perforation include abdominal distension, the inability to distend the bladder, and the low retrieval of irrigation fluids. Peritonitis may occur if a perforation diagnosis is delayed. Early detection and diagnosis are crucial for the prevention of severe complications, such as peritonitis and sepsis. Here, we describe a case of a 69-year-old male with a bladder rupture secondary to TURBT.

Hypovascular pancreatic neuroendocrine tumors are uncommon pancreatic tumors and commonly misdiagnosed as pancreatic ductal adenocarcinoma or chronic mass-forming pancreatitis. The liver is the organ most commonly affected by neuroendocrine tumor metastases but hepatic neuroendocrine tumor metastases are quite difficult to discriminate from other hepatic metastases and primary hepatic tumors. We describe a case of a 47-year-old man with incidentally detected multiple hepatic lesions on ultrasound. On further imaging technique including computed tomography and magnetic resonance imaging, the patient had an abnormal hypoenhancing lesion at the pancreatic tail and multiple hyperenhancing hepatic metastases that were diagnosed as hypovascular pancreatic well-differentiated neuroendocrine tumor Grade 2 with multiple hypervascular hepatic metastases after liver biopsy and surgery. Neuroendocrine tumor is a rare etiology among hypoenhancing pancreatic tumors, and must be considered to discriminate from pancreatic adenocarcinomas in cases there are multiple hyperenhancing hepatic metastases on the arterial phase without typical washout on the portal venous phase.

Lipomatous pseudohypertrophy of the pancreas is a rare disease with unknown etiology, and the pancreas parenchyma is replaced by pancreatic parenchyma by fat tissue. In this article, we aimed to report the case of a 26-year-old male patient admitted to hospital with loss of appetite for 6 months. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) scans showed diffuse enlargement and fatty replacement over the whole pancreas, with scattered remnants of pancreatic parenchyma. Histologic results defined lipomatous pseudohypertrophy of the pancreas. To summarize, this case report is to put forward this extremely rare presentation and to sensitize clinicians that this entity can be a cause of exocrine pancreatic insufficiency, which requires patient follow-up for the appropriate treatment.

Pleuropulmonary blastoma is a rare, aggressive, malignant tumor of the lungs or pleura that primarily affects children. Pleuropulmonary blastoma is classified into 3 types based on morphology, including cystic (type I), mixed (type II), or solid (type III). These morphological types correlate with prognosis. In this article, we present a case of type III pleuropulmonary blastoma in a 2-year-old girl. The patient was treated with tumoral resection and chemotherapy; however, she experienced local recurrence and spinal metastasis after 5 months of treatment.

Pericallosal artery aneurysm (PAA) is a relatively uncommon type of intracranial aneurysm that tends to rupture more frequently and cause higher mortality rates than other types of cerebral aneurysms. Surgery to address PAA is difficult due to its deep-seated location, the size of the aneurysmal sac, and the limited surgical field. In recent years, with the development of percutaneous interventions, endovascular treatment has become the preferred, minimally invasive intervention method for the treatment of pericallosal aneurysms. In this article, we present a case of PAA that was successfully treated with flow diversion therapy in a 51-year-old male.

Nguyen Duy Hung,1,2,* Vuong Kim Ngan,3 Nguyen Minh Duc4,5,* 1Department of Radiology, Hanoi Medical University, Hanoi, Vietnam; 2Department of Radiology, Viet Duc Hospital, Hanoi, Vietnam; 3Department of Radiology, Vinmec Times City International Hospital, Hanoi, Vietnam; 4Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 5Department of Radiology, Children’s Hospital 2, Ho Chi Minh City, Vietnam*These authors contributed equally to this workCorrespondence: Nguyen Minh DucDepartment of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, VietnamEmail bsnguyenminhduc@pnt.edu.vnBackground: Craniopharyngiomas are common lesions that occur in the suprasellar region; however, strictly intrinsic third ventricular craniopharyngiomas are rare.Case Series: We aimed to describe the magnetic resonance imaging features observed in five cases of strictly intrinsic third ventricular papillary craniopharyngiomas, including two cases of mixed cystic and solid tumors and three cases of pure solid masses.Conclusion: Among the adult population, intrinsic third ventricular papillary craniopharyngiomas should be considered when either solid or mixed cystic and solid masses are observed, in which the solid component shows heterogeneous intensity, heterogeneous and strong enhancement, and is strictly located in the third ventricle.Keywords: strictly intrinsic third ventricle, craniopharyngioma, magnetic resonance imaging

Malignant tumors that originate from the mesenchymal tissue of the mammary gland, known as breast sarcomas, are very rare and can be divided into 2 types: primary and secondary (therapy-related development). Breast sarcomas are aggressive tumors associated with a poor prognosis. Treatment options include the coordination of surgery, chemotherapy, and radiotherapy. We present a case of a 51-year-old female who presented to the hospital after noticing a palpable mass in the left breast and bloody nipple discharge. These symptoms lasted for more than 4 months. Postoperative histopathology revealed an undifferentiated pleomorphic breast sarcoma. After 8 months of treatment, the patient experienced metastasis to the brain and lungs.

IgG4-related sclerosing cholangitis (IgG4-SC) is a relatively newly identified disease that is frequently associated with autoimmune pancreatitis. The differential diagnosis between cholangiocarcinoma, primary sclerosing cholangitis, and IgG4-SC can be challenging due to significant overlap among the clinical and imaging characteristics. We report the case of a 71-year-old woman who was diagnosed with IgG4-related disease based on increased serum IgG4 levels, imaging, and clinical presentation, which showed systemic involvement, including sclerosing cholangitis and kidneys. The patient presented with chronic jaundice. Magnetic resonance imaging revealed bile duct strictures and the dilatation of upstream bile ducts, smooth wall thickening with uniform enhancement in the delayed phase, and no vascular infiltration. Multiple low-density, wedge-shaped areas were identified in both kidneys, which were hypointense on T2-weighted images and hyperintense on diffusion-weighted images. The serum IgG4 levels of this patient were elevated to nearly 10-fold the normal upper limit. A diagnosis of IgG4-SC associated with IgG4-related kidney was made. Based on this case, pre-surgery IgG4 serum treatment in patients with non-malignant bile duct stenosis was recommended to exclude IgG4-SC.

Gestational choriocarcinoma (GC) is an uncommon malignant tumor consisting of trophoblastic cells. The lungs, liver, and central nervous system are the most common metastatic sites for this disease. However, splenic metastasis is unusual and might result in spontaneous rupture. Symptoms associated with splenic rupture may be the first presentation of malignancy. A thorough medical history and examination are necessary to detect the primary lesion. Herein, we present a case of a 23-year-old female who had splenic rupture secondary to choriocarcinoma metastasis. Although the emergency condition had been solved, the patient died 1 month after due to brain metastasis. The goal of this article was to report a new case of spontaneous splenic rupture caused by choriocarcinoma metastasis and to review the existing literature on splenic metastases associated with GC, including the epidemiology and etiology.

Introduction The distinction of medulloblastomas and ependymomas plays an important role in the care plans and prognosis of children. We aimed to investigate the role of magnetic resonance spectroscopy (MRS) in the differentiation between medulloblastomas and ependymomas in children. Materials and methods The institutional review board approved this prospective study. The brain magnetic resonance imaging protocol including axial multivoxel spectroscopy with a TE of 144 ms was assessed in 49 patients, who were divided into 2 groups: 40 patients with medulloblastomas and 9 patients with ependymomas. Receiver operating characteristic (ROC) curve analysis and the Youden index were utilized to determine the best cut-off, sensitivity, specificity, and area under the curve (AUC) values of the independent spectroscopy parameters. Results The choline level (Cho) and the choline/creatine (Cho/Cr) and choline/N-acetyl aspartate (Cho/NAA) ratios of medulloblastomas were significantly higher than those of ependymomas (p < 0.05). A Cho/NAA cut-off value of 1.24 to predict the diagnosis of medulloblastoma yielded the highest AUC and sensitivity of 80.3% and 97.5%, respectively, while a Cho cut-off value of 4.64 produced the highest specificity value of 88.9%. Conclusions Our findings suggest that Cho and Cho/NAA derived from MRS could serve as differential factors between paediatric medulloblastomas and ependymomas. Among those, a Cho/NAA cut-off value of 1.24 to predict the diagnosis of medulloblastoma generated the highest accuracy.

Highlights • Enlarged accessory spleens are often misdiagnosed as neoplasms. • Imaging features and histopathology of accessory and normal spleens are similar. • Accessory spleen should be considered in differential diagnosis of abdominal tumors., Introduction An accessory spleen (AS), a common condition, is usually located in the hilar region of the spleen. ASs are not often large; however, after splenectomy, the initially inactive AS may become reactive and hypertrophic. Therefore, an AS can be misdiagnosed as a neoplastic tumor and removed unnecessarily. An undiagnosed abdominal mass located in the spleen site in a patient who has had a splenectomy must be managed carefully. Computed tomography (CT) scanning and magnetic resonance imaging (MRI) may provide useful information for the diagnosis, preventing unnecessary surgery. Case presentation Herein, we report the case of a 38-year-old female with an enlargement of AS after splenectomy that was misdiagnosed as a primary tumor of the pancreas and managed by a nonessential surgery. Conclusion An AS should be added to the differential diagnosis of a pancreatic tail tumor for patients with prior splenectomy in order to avoid nonessential surgery to ensure the patient’s safety.

Background Most fetal abnormalities can be detected on ultrasound, the evaluation of fetal CNS abnormalities can be limited by various factors, including obesity, polyhydramnios, multiple pregnancies, and increased cranial ossification during the third trimester. Objective This study aimed to evaluate the ability to detect fetal central nervous system (CNS) anomalies using in utero magnetic resonance imaging (iuMRI) and ultrasound (US) techniques. Methods This prospective study was approved by the institutional review board (Ref: 2968/QĐ-ĐHYHN dated 11 July 2019), and the requirement to obtain the informed consent of patients was waived. This study included 66 fetuses with diagnosed or suspected CNS abnormalities based on the results of a prenatal screening US performed at the antenatal diagnosis center of the Central Obstetrics and Gynecology Hospital. All pregnant women with a suspected diagnosis of abnormal fetal CNS on US underwent 1.5-Tesla iuMRI within 14 days of the US at Hanoi Medical University Hospital between June 2019 and June 2020. Cohen's kappa coefficient (κ) was used to determine the agreement between US and iuMRI findings. Results A total of 66 pregnant women were examined, including 66 fetuses, for which 79 abnormalities were detected by US and 98 abnormalities were detected by iuMRI. The average gestational age was 29 weeks and 6 days. The comparison of iuMRI and US findings revealed similar diagnoses for 71 abnormalities (67%) and different diagnoses for 35 abnormalities (33%). The level of agreement between US and iuMRI was almost perfect for ventriculomegaly and cystic lesions, with κ values 0.87 and 0.84, respectively. The level of agreement between US and iuMRI was the weakest for hemorrhage, with a κ value 0 (no agreement), and cortical abnormalities, with a κ value of 0.46 (weak agreement). Conclusion The level of agreement between US and iuMRI diagnoses was almost perfect for the detection of ventriculomegaly and was weakest for the detection of hemorrhage and cortical abnormalities, which were abnormalities detected by iuMRI but not by ultrasound.

Hepatic mesenchymal hamartoma is an uncommon tumor composed of myxoid mesenchymal tissue with fluid accumulation. Here, we report a case of hepatic mesenchymal hamartoma in a 3-year-old patient who was referred to the hospital with abdominal pain and a slight fever. An abdominal ultrasound suggested a liver abscess; however, computed tomography revealed a mass with both cystic and solid components. Liver biopsy confirmed hepatic mesenchymal hamartoma, and this patient underwent the complete removal of this tumor.

Spontaneous cerebrospinal fluid (CSF) rhinorrhea is rare and may develop secondary to inner ear malformation. A possible diagnosis of CSF leak should be considered in any pediatric patient who presents with hearing impairment, rhinorrhea, or otorrhea. Temporal bone computed tomography should be performed in children with hearing impairments. We describe a case of congenital inner ear anomaly in a 12-month-old girl who presented with intermittent rhinorrhea after birth and detected hearing problems when she was 6 months. After diagnosis, the CSF leak was surgically repaired without complications.

Ependymoblastoma is an uncommon, exceedingly malignant brain neoplasm that adversely influences children’s quality of life. Ependymoblastoma represents a subtype of primitive neuroectodermal tumors, categorized as grade IV, according to the 2007 World Health Organization (WHO) classification of central nervous system tumors. Ependymoblastomas are often located in the supratentorial zone and often associated with the ventricular system. Histopathological sections of the tumor revealed uniform, primitive, small blue cells, with multi-layered rosettes, accompanied by abundant mitoses. The clinical and imaging features of ependymoblastomas are not specific, which can result in misdiagnosis as other brain neoplasms. In this paper, we described the identification of a fourth-ventricular ependymoblastoma that was misdiagnosed as pilocytic astrocytoma, despite the utilization of advanced magnetic resonance imaging (MRI) protocols.

For certain clinical circumstances, the differentiation between cerebellar medulloblastoma and brainstem glioma is essential. We aimed to evaluate the role played by the apparent diffusion coefficient (ADC) values in the differentiation between cerebellar medulloblastomas and brainstem gliomas in children. The institutional review board approved this prospective study. Brain magnetic resonance imaging (MRI), including diffusion-weighted imaging (DWI) and ADC, was assessed in 32 patients (median age: 7.0 years), divided into two groups, a medulloblastoma group (group 1, n = 22) and a brainstem glioma group (group 2, n = 10). The Mann&ndash, Whitney U test was utilized to compare tumor ADCmax, ADCmin, ADCmean, and ADCsd values, and their ratios with the parenchyma values between the two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were used to calculate the cut-off value, along with the area under the curve (AUC), sensitivity, and specificity. The median ADCmax, ADCmin, and ADCmean values were significantly higher in group 2 than in group 1 (p &lt, 0.05). The median ratios of ADCmin and ADCmean to the parenchyma were significantly higher in group 2 than in group 1 (p &lt, 0.05). The ROC analysis showed that the AUC for the ADCmean ratio was the highest among these parameters, at 98.2%. The ADCmean tumor to parenchyma ratio was a significant and effective parameter for the differentiation between pediatric medulloblastomas and brainstem gliomas.

Purpose This study аims to explore cement leаkаge аs а complication of percutаneous vertebroplаsty (PVP) in the treаtment of multiple osteoporotic vertebrаl compression frаctures (MOVF). Patients and methods This prospective study wаs cаrried out on 32 consecutive pаtients with osteoporotic frаctures of аt leаst two vertebrаe (VB). Аll pаtients were over 50 yeаrs old аnd women аccounted for 29 out of the 32 pаtients (90.6%). PVP wаs performed under digitаl subtrаction аngiogrаphy (DSА) of аt leаst three VB, аnd 97 collаpsed VB аnd 105 VB were exаmined by PVP. Аll pаtients hаd postoperаtive computerized tomogrаphy (CT) to diаgnose аnd clаssify the complicаtions. Results One hundred аnd five vertebrаe were exаmined with PVP, аnd 36/105 (34.3%) exhibited complicаtions of cement leаkаge. Type B cement leаkаge wаs the most common complicаtion, with 19/105 (18.1%) cаses; type C аccounted for 8/105 (7.6%) cаses; аnd type S аccounted for 9/105 (8.6%) cаses. There wаs only one (0.95%) cаse of cement leаkаge moving to the pulmonаry аrtery. Аll complicаtions hаd no clinicаl symptoms аnd did not require treаtment. Conclusion Cement leаkаge is quite а common complicаtion, but it usuаlly hаs no clinicаl symptoms аnd does not require treаtment. Therefore, PVP is а sаfe аnd successful technique for the treаtment of multiple osteoporotic vertebrаl compression frаctures.

Background: This study aimed to evaluate the diagnostic function of 3-Tesla (T) magnetic resonance imaging (MRI) during the assessment of brachial plexus injury (BPI), in comparison with intraoperative findings. Methods: A retrospective study was performed on 60 patients (47 men and 13 women), who had clinical manifestations of BPI, underwent 3T MRI of the brachial plexus, and were surgically treated at the Viet Duc and Vinmec Times City hospitals, in Hanoi, Vietnam, from March 2016 to December 2019. Preganglionic and postganglionic lesion features were identified on MRI. The diagnostic function of MRI features for the determination of BPI was evaluated and correlated with intraoperative findings. Results: The root avulsion and pseudomeningocele preganglionic injuries were observed in 57% and 43% of MRIs, respectively, and were commonly observed at the C7 and C8 roots. Nerve disruption and never edema were observed in 47.56% and 33.53% of MRIs, respectively, and were commonly observed at the C5 and C6 roots. The sensitivity, specificity, accuracy, positive prognostic value, and negative prognostic value of 3T MRI were 64.12%, 92.90%, 80.33%, 87.50%, and 76.96%, respectively, for the diagnosis of total avulsion, and 68.52%, 83.33%, 80.67%, 47.44%, and 92.34%, respectively, for the diagnosis of nerve disruption. Conclusion: MRI offers valuable details regarding the location, morphology, and severity of both preganglionic and postganglionic injuries during the preoperative diagnosis of BPI. However, this modality played a moderate diagnostic role. Therefore, 3T MRI should be used as a supplemental evaluation, coupled with clinical tests and electromyography, to determine the most appropriate treatment strategies for BPI patients.

Background The differentiation between medulloblastomas and ependymomas plays an important role in treatment planning and prognosis for children. This study aims to investigate the role of T1-perfusion parameters during the differentiation between medulloblastomas and ependymomas in children. The institutional review board approved this prospective study. The brain magnetic resonance imaging (MRI) protocol, including axial T1-perfusion, was assessed in 26 patients, divided into a medulloblastoma group (group 1, n = 22) and an ependymoma group (group 2, n = 4). The quantified region of interest (ROI) values for tumors and the tumor to parenchyma ratios were collected and compared between the two groups. Receiver operating characteristic (ROC) curve analysis and the Youden index were utilized to identify the best cut-off, sensitivity, specificity, and area under the curve (AUC) values for the independent T1-perfusion parameters. Results The relative enhancement, maximum enhancement, maximum relative enhancement, time to peak, and AUC values for medulloblastomas were significantly higher than those for ependymomas (p < 0.05). Furthermore, the maximum enhancement and maximum relative enhancement for medulloblastoma to parenchyma ratios were also significantly higher than those for ependymomas. A cut-off maximum enhancement value of 100.25 was identified as sufficient to discriminate between medulloblastoma and ependymoma and resulted in a sensitivity of 90.9%, a specificity of 100%, and an AUC of 94.3%. Conclusion A cut-off maximum enhancement value of 100.25 derived from T1-perfusion was able to discriminate between medulloblastoma and ependymoma, with high sensitivity, specificity, and accuracy values.

Introduction: Extragonadal germinomas rarely emerge from the brain stem; however, proper diagnosis and treatment can result in favorable prognosis. Unfortunately, the preoperative diagnosis of medulla oblongata germinoma is difficult due to insufficient clinical signs and symptoms that are specific to this diagnosis. Case Representation: We present a 12-year-old male patient with an intra-fourth-ventricular germinoma, derived from the medulla oblongata, with no abnormalities in the supratentorial region. The germinoma was initially assessed by advance MRI sequences, including diffusion-weighted imaging, T1 perfusion, and spectroscopy. Conclusion: In summary, although existing imaging technologies cannot completely distinguish germinomas from other primary brain neoplasms in the fourth ventricle, in patients aged between 12 and 40 years, a small mass on the dorsal side of medulla oblongata that emerges into the fourth ventricle and is characterized by homogeneous contrast enhancement, the absence of calcification and hemorrhage, and the lack of hydrocephalus should be considered for a potential medulla oblongata germinoma diagnosis.