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      Retroperitoneal bronchogenic cyst in suprarenal region treated by laparoscopic resection: A case report

      case-report

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          Abstract

          BACKGROUND

          Bronchogenic cysts (BCs) are benign congenital foregut malformations that are mostly present in the mediastinum and pulmonary parenchyma but rarely seen in the retroperitoneum.

          CASE SUMMARY

          We report the case of 17-year-old girl who complained of epigastric pain. A cystic lesion was found in the left suprarenal region on spectral computed tomography. The ovoid, well-defined, and homogeneous cystic lesion revealed slightly enhancement on conventional imaging but no enhancement on 40 KeV virtual mono-energetic images. The iodine density value of the lesion was 0.001 mg/mL and the Z-effective value was 7.25, which were close to those of fluid material in in vitro experiments. Magnetic resonance imaging revealed a cystic mass of intermediate signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging. A laparoscopic surgery was carried out. Intraoperatively, a cystic lesion with a smooth surface was found in the left retroperitoneum. And the cystic wall was completely resected after intracystic fluid was suctioned. The histopathological examination findings of the lesion were compatible with BC. The patient recovered uneventfully without sighs of recurrence during a 10-mo follow-up period.

          CONCLUSION

          Radiological examinations play a significant role in the diagnosis of suprarenal BCs and spectral images offer additional spectral parameters. Accurate preoperative diagnoses of retroperitoneal BCs based on thorough imaging examinations are beneficial to the operation of laparoscopic resection.

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          Most cited references16

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          Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications.

          In x-ray computed tomography (CT), materials having different elemental compositions can be represented by identical pixel values on a CT image (ie, CT numbers), depending on the mass density of the material. Thus, the differentiation and classification of different tissue types and contrast agents can be extremely challenging. In dual-energy CT, an additional attenuation measurement is obtained with a second x-ray spectrum (ie, a second "energy"), allowing the differentiation of multiple materials. Alternatively, this allows quantification of the mass density of two or three materials in a mixture with known elemental composition. Recent advances in the use of energy-resolving, photon-counting detectors for CT imaging suggest the ability to acquire data in multiple energy bins, which is expected to further improve the signal-to-noise ratio for material-specific imaging. In this review, the underlying motivation and physical principles of dual- or multi-energy CT are reviewed and each of the current technical approaches is described. In addition, current and evolving clinical applications are introduced.
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            Detector-based spectral CT with a novel dual-layer technology: principles and applications

            Detector-based spectral computed tomography is a novel dual-energy CT technology that employs two layers of detectors to simultaneously collect low- and high-energy data in all patients using standard CT protocols. In addition to the conventional polyenergetic images created for each patient, projection-space decomposition is used to generate spectral basis images (photoelectric and Compton scatter) for creating multiple spectral images, including material decomposition (iodine-only, virtual non-contrast, effective atomic number) and virtual monoenergetic images, on-demand according to clinical need. These images are useful in multiple clinical applications, including- improving vascular contrast, improving lesion conspicuity, decreasing artefacts, material characterisation and reducing radiation dose. In this article, we discuss the principles of this novel technology and also illustrate the common clinical applications. Teaching points • The top and bottom layers of dual-layer CT absorb low- and high-energy photons, respectively. • Multiple spectral images are generated by projection-space decomposition. • Spectral images can be generated in all patients scanned in this scanner.
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              Dual-energy CT: a phantom comparison of different platforms for abdominal imaging.

              Evaluation of imaging performance across dual-energy CT (DECT) platforms, including dual-layer CT (DLCT), rapid-kVp-switching CT (KVSCT) and dual-source CT (DSCT).
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                26 August 2021
                26 August 2021
                : 9
                : 24
                : 7245-7250
                Affiliations
                Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
                Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
                Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
                Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China
                Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, Hubei Province, China. cjr.hanping@ 123456vip.163.com
                Author notes

                Author contributions: Wu LD acquired the data, performed the literature review, and drafted, reviewed, and edited the manuscript; Wen K took radiological images and made the radiological diagnosis; Cheng ZR performed the surgery and contributed to manuscript editing and revising; Alwalid O revised the grammar of manuscript; Han P revised the manuscript for the important content; all authors have read and approved the manuscript.

                Corresponding author: Ping Han, MD, Full Professor, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan 430000, Hubei Province, China. cjr.hanping@ 123456vip.163.com

                Article
                jWJCC.v9.i24.pg7245
                10.12998/wjcc.v9.i24.7245
                8409186
                34540985
                235f21dc-8289-426b-95a5-ef9aa4442c82
                ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 20 April 2021
                : 3 June 2021
                : 2 July 2021
                Categories
                Case Report

                bronchogenic cysts,suprarenal region,spectral computed tomography,laparoscopic resection,case report

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