Brain capillary telangiectasia is an incidental vascular malformation found usually in pons and sometimes in extra- pontine sites. Typical MRI features are enhancement on post contrast T1 weighted images and signal loss...Brain capillary telangiectasia is an incidental vascular malformation found usually in pons and sometimes in extra- pontine sites. Typical MRI features are enhancement on post contrast T1 weighted images and signal loss on gradient echo images. We evaluated 10 patients with various MR techniques. Susceptibility weighted imaging was superior to GRE T2 in showing decreased signal due to susceptibility effects. Diffusion weighted imaging and diffusion tensor imaging proved not useful in the diagnosis.
Mucocele of the appendix is a descriptive term of a distended, mucus-filled appendix caused by various conditions, both benign and malignant. Computed tomography is the imaging modality of choice. Correct pre-operative d...Mucocele of the appendix is a descriptive term of a distended, mucus-filled appendix caused by various conditions, both benign and malignant. Computed tomography is the imaging modality of choice. Correct pre-operative diagnosis is important because of the possibility of peroperative rupture and subsequent development of pseudomyxoma) peritonei. It is the task of the radiologist to alert the clinician and surgeon to the presence of this entity, the potential associated complications and possible signs of malignancy.
PURPOSE: To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values to the characterization of breast lesions and differentiation of benign a...PURPOSE: To evaluate the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) using apparent diffusion coefficient (ADC) values to the characterization of breast lesions and differentiation of benign and malignant lesions. MATERIALS AND METHODS: Thirty-seven women (mean age, 38 years) with 37 enrolled in the study. DWI and ADC maps in the axial plane were obtained using a 1.5 Tesla MRI device. Mean ADC measurements were calculated among cysts, normal fibroglandular tissue, benign lesions and malignant lesions were evaluated. RESULTS: Out of 37 women, 4 had normally breast MRI findings. The diagnosis of remaining 33 patients with 37 breast lesions were as follows; malign lesions (n = 23), benign lesions (n = 10) and simple breast cyst (n = 4). The ADC values were as follows (in units of 10(-3) mm2/s): Normal fibroglandular tissue (range: 1.39-2.06; mean: 1.61 ± 0.23), benign breast lesions (range: 1.09-1.76; mean: 1.47 ± 0.25), cyts (range: 2.27-2.46, mean: 2.37 ± 0.07) and malignant breast lesions (range: 0.78-1.26, mean: 0.96 ± 0.25). The mean ADC obtained from malignant breast lesions was statistically different from that observed in benign solid lesions (p < < 0.01) and normal fibroglandular breast tissue (p < 0.01). Furthermore, the mean ADC values of benign breast lesions was not statistically different from cyst (p ≥ 0.01) and normal fibroglandular breast tissue (p ≥ 0.01). A ADC value of 1.1 x 10(-3) mm'/s as a treshold value provided differantiation for malign and benign lesions, with a sensitivity of 91.3% and a specificity of 85.7% compared with conventional breast MRI values. CONCLUSION: DWI with quantitative ADC measurements is a reliable tool for differentiation of benign and malignant breast lesions.
AIM: The aim of the present study was to compare the success and complication rates of pediatric renal biopsy procedures between the angled tangential approach and the traditional approach. METHODS: From 2004 to 2009 we...AIM: The aim of the present study was to compare the success and complication rates of pediatric renal biopsy procedures between the angled tangential approach and the traditional approach. METHODS: From 2004 to 2009 we prospectively enrolled pediatric patients who had undergone real time ultrasound guided renal biopsy with angled tangential approach. For comparison, we retrospectively reviewed pediatric patients who had undergone traditional renal biopsy between 2002 and 2004. Adequacy of renal tissue histopathological samples and the complication rates were compared between groups. RESULTS: One hundred twenty-eight patients underwent traditional renal biopsy (Group A) while 166 patients underwent biopsy performed with angled tangential approach (Group B).The rate of inadequate material was higher in Group A compared to Group B (6.3% vs. 0.6%, p = 0.006). In four cases (three in Group A and one in Group B) renal biopsies revealed normal renal tissue. While a major complication (hemoperitoneum requiring transfusion) occurred in one case in Group A, no major complications were seen in Group B. CONCLUSION: Compared with the traditional technique, the angled tangential approach resulted in a higher adequate material rate and lower complication rate.These findings indicate that angled tangential approach could be considered for pediatric percutaneous renal biopsies.
OBJECTIVE: To determine the sensitivity and specificity of MRI features of sacroiliitis in spondyloarthritis (SpA). MATERIALS AND METHODS: A retrospective study reviewed MRI of the sacroiliac (SI) joints in 517 patients...OBJECTIVE: To determine the sensitivity and specificity of MRI features of sacroiliitis in spondyloarthritis (SpA). MATERIALS AND METHODS: A retrospective study reviewed MRI of the sacroiliac (SI) joints in 517 patients with inflammatory back pain. Sensitivity, specificity, positive and negative likelihood ratios of active and structural lesions of sacroiliitis with final clinical diagnosis as golden standard was calculated. RESULTS: MRI showed active inflammation in 42% of patients (bone marrow oedema (BMO) (41.5%), capsulitis (3.3%), enthesitis (2.5%)) and structural changes in 48.8% of patients (erosion (25%), fat infiltration (31.6%), sclerosis (32%) and ankylosis (7.6%)). BMO was the MRI feature with the highest sensitivity (65.1%) for diagnosis of SpA. Capsulitis (99%), enthesitis (98.4%), ankylosis (97.4%) and erosion (94.8%) had a high specificity for diagnosis of SpA, whereas BMO (74.3%), sclerosis (75.8%) and fat infiltration (84.0%) were less specific. BMO concomitant with enthesitis, capsulitis or erosions increased the specificity. Concomitant presence of BMO and sclerosis or fat infiltration decreased the specificity. CONCLUSION: BMO is moderately sensitive and specific for diagnosis of SpA in patients with inflammatory back pain. BMO concomitant with enthesitis, capsulitis, ankylosis or erosion increases the specificity. Concomitant fat infiltration or sclerosis decreases the specificity for diagnosis of SpA. Of all lesions, erosion had by far the highest positive likelihood ratio for diagnosis of SpA.
PURPOSE: To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients underg...PURPOSE: To evaluate the safety and long-term outcome of percutaneous cholecystostomy (PC) under radiologic guidance for acute calculous cholecystitis (ACC) and acute acalculous cholecystitis (AAC) in all patients undergoing that procedure at our institution. MATERIALS AND METHODS: We performed a retrospective analysis of 111 patients who underwent PC from 2004 to 2012. Patients were divided into two groups: AAC and ACC. For all patients, comorbidity and American Society of Anesthesiologists (ASA) classification were determined. The indications, complications, recurrence rate and long-term outcome for both groups were analysed. The mean follow-up was 55 months. RESULTS: Twenty-four patients with AAC and 87 patients with ACC underwent PC. The most common sonographic findings of ACC and AAC were gallbladder wall thickening (90.9%) and hydrops (72.9%). Twelve of 24 patients with AAC (50%) were hospitalized at the Intensive Care Unit (ICU). Overall, the procedure failed in 2 (1.8%) patients. There were 4 (3.6%) abscesses and 2 (1.8%) fistulas post PC. Drain dislodgment was found without sequelae in 8 (7.2%) patients. Elective cholecystectomy was performed in 35/111 (31.5%). Fifty-one of 87 (58.6%) patients with gallstones underwent cholecystectomy; 36/87 (41.3%) did not undergo surgery due to a too short follow-up or death of nonbiliary disease. In the AAC group, there was no recurrent cholecystitis in 17/24 (70.8%) patients; 3/24 (12.5%) underwent surgery and 4/24 (16.6%) patients died in the ICU. CONCLUSION: PC is a minimally invasive treatment with low complication rate for patients with acute cholecystitis whom considered being at high-risk for urgent cholecystectomy. Good selection (ASA III and IV) and indication is needed in patients with ACC before PC because the majority will be operated later on. AAC can be managed nonoperatively and further treatment might not be needed.
We report a rare case of early onset type Trocar Site Hernia (TSH) producing in the right lower abdominal quadrant of a 64-year old obese woman. The patient was admitted in the emergency room for abdominal pain producing...We report a rare case of early onset type Trocar Site Hernia (TSH) producing in the right lower abdominal quadrant of a 64-year old obese woman. The patient was admitted in the emergency room for abdominal pain producing four days after laparoscopic adnexectomy. The hernia atypically externalized in two-steps creating two superposed concentric small bowel strangulating hernias producing through two distinctive superposed orifices. A precise and complete anatomic diagnosis was made by contrast enhanced 64-row multidetector computed tomography (MDCT). The imaging features are presented with a short review of the literature. The case emphasizes the high performances of MDCT for the early diagnosis of Trocar Site Hernias.
Chondrosarcoma of the synovium is rare. It may arise de novo from the synovium or pre-existing synovial chondro- matosis may undergo malignant transformation into chondrosarcoma. Diagnosing a malignant transformation of...Chondrosarcoma of the synovium is rare. It may arise de novo from the synovium or pre-existing synovial chondro- matosis may undergo malignant transformation into chondrosarcoma. Diagnosing a malignant transformation of the synovium remains a big challenge. It is based on the correlation of clinical findings, imaging and histology, as illustrated in this case report.
Inflammatory myofibroblastic tumor (IMT) is a rare tumor, classified by WHO of intermediate biological potential with tendency for local recurrence and small risk for distant metastasis. Histologically IMT is a mixture o...Inflammatory myofibroblastic tumor (IMT) is a rare tumor, classified by WHO of intermediate biological potential with tendency for local recurrence and small risk for distant metastasis. Histologically IMT is a mixture of inflamma- tory cells and myofibroblastic spindle cells proliferation. To our knowledge there is no MRI description of mesenteric IMT in the literature. We would like to emphasize the correlation between medical imaging and anatomical pathology based on our experience of a mesenteric IMT in a 28-year-old patient.
Solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm rarely described in the kidney. Usually occurring in the pleura, it has also been described in various extrapleural sites. We report a rare case of SFT of...Solitary fibrous tumor (SFT) is an unusual spindle cell neoplasm rarely described in the kidney. Usually occurring in the pleura, it has also been described in various extrapleural sites. We report a rare case of SFT of the kidney fortuitously found in a 55-year-old patient. The imaging features are illustrated. The definite diagnosis was made through histological and immunohistochemical study after radical nephrectomy.