Torsion of a uterine leiomyoma is an extremely rare, albeit life-threatening surgical emergency. A 28-year-old woman presented with acute abdominal pain. Imaging revealed a torsed subserosal uterine leiomyoma which was managed surgically and the diagnosis confirmed intraoperatively as well as on histopathology. CONTRIBUTION: While intraoperative findings remain the primary means of diagnosis, radiologists should be familiar with the potential imaging findings of leiomyoma torsion as timely intervention can greatly improve patient outcome

The mesentery is a broad fan-shaped fold of peritoneum that suspends the loops of small intestine from the posterior abdominal wall. Although primary neoplasms arising in the mesentery are rare, the mesentery is a major avenue for the dissemination of tumours, which can spread through hematogenous, lymphatic, direct or peritoneal seeding. Imaging helps in the diagnosis of these tumours and aids in directing appropriate treatment by assessing their size, extent and relationship with adjacent structures. The aim of this article is to describe the spectrum of imaging findings of the various mesenteric lesions using ultrasound and CT. CONTRIBUTION: Evaluation of the mesentery is often neglected during routine ultrasound (US) because of inadequate training and unfamiliarity with the common US features encountered with mesenteric disease. CT plays an essential role in the diagnosis of mesenteric disease. Knowledge of imaging characteristics of various mesenteric lesions helps in timely diagnosis and management.

Scar endometriosis usually affects the abdominal wall or the perineum. Virtually all cases are linked with some form of surgical manipulation. Although the clinical diagnosis of scar endometriosis may be straightforward with classical symptomology, imaging with ultrasound and MRI are important for the determination of its extent, which is imperative for adequate preoperative planning. In addition, assessment of perineal scar endometriosis also requires the identification of anal sphincter complex involvement, which can significantly impact the surgical approach. Radiology plays a vital role in its diagnosis in atypical clinical scenarios. CONTRIBUTION: This series of four cases describes the morphology and highlights the importance of imaging in the surgical management of scar endometriosis; three with abdominal wall involvement and one with the involvement of perineum.

Resumo Objetivo: Descrever o espectro dos achados de ressonância magnética (RM) em pacientes com manifestações neurológicas de dengue. Materiais e Métodos: Foram incluídos nove pacientes com dengue (três do sexo feminino e seis do sexo masculino; faixa etária: 9–30 anos), todos com manifestações neurológicas. Os exames de RM, realizados em aparelhos de 1,5 T ou 3 T, incluíram sequências ponderadas em T1 e em T2, assim como fluid-attenuated inversion recovery (FLAIR). Também foi empregada a imagem ponderada em difusão com mapeamento de coeficientes de difusão aparente. Além disso, foram obtidas sequências gradiente-eco ponderadas por suscetibilidade e em fast low-angle shot, bem como imagens ponderadas em T1 pós-contraste, para avaliar o realce parenquimatoso. As imagens de RM foram analisadas quanto à distribuição de lesões e características de imagens. Resultados: Todos os pacientes apresentaram áreas de intensidade de sinal alteradas que apareceram como hiperintensidade em sequências ponderadas em T2 e sequências FLAIR. O local mais comumente afetado foi o complexo gânglios basais-tálamo. Outros locais afetados foram o cerebelo, o córtex cerebral, a substância branca e o tronco encefálico. Em todos os casos observamos áreas irregulares de difusão restrita e áreas focais de hemorragia. Conclusão: A encefalite por dengue geralmente afeta os gânglios basais, o tálamo, o cerebelo, o córtex cerebral e a substância branca. Portanto, a RM deve ser uma parte indispensável da avaliação de pacientes com complicações neurológicas da dengue.

Abstract Objective: To describe the spectrum of magnetic resonance imaging (MRI) findings in patients with neurological manifestations of dengue. Materials and Methods: We included nine patients with dengue fever (three females and six males; age range, 9–30 years), all of whom presented with neurological manifestations. The MRI examinations, performed in 1.5 T or 3 T scanners, included T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion-weighted imaging with apparent diffusion coefficient mapping was also employed. Fast low-angle shot and susceptibility-weighted gradient-recalled echo sequences, as well as contrast-enhanced T1-weighted scans, were also obtained in order to assess parenchymal enhancement. MRI scans were analyzed for lesion distribution and imaging features. Results: All patients showed areas of altered signal intensity that appeared as hyperintensity on T2-weighted and FLAIR sequences. The most commonly affected site was the basal ganglia-thalamus complex. Other affected sites were the cerebellum, cerebral cortex, white matter, and brainstem. In all cases, we observed patchy areas of restricted diffusion and focal areas of hemorrhage. Conclusion: Dengue encephalitis commonly affects the basal ganglia, thalamus, cerebellum, cerebral cortex, and white matter. Therefore, MRI should be an indispensable part of the evaluation of patients with neurological complications of dengue fever.