Clinical Imaging - Articles in Press

CT virtual colonoscopy in displaying excavated colon lesions - Corrected Proof

Wu Xing-wang, Liu Bin, Wang Wan-qin, Xu Jian-ming — 2010-07-26

Abstract: The aim of this study was to evaluate the relative values of 2D plane view and 3D intracavity view of CT virtual colonoscopy in displaying colon excavated lesions. Cleaned porcine colon with ulcerative lesion was scanned with multidetector CT. The data were reconstructed and reviewed using 2D plane view and 3D volume-rendered images on a GE AW4.2 workstation. The 3D volume-rendered images showed superiority in displaying excavated lesions.

Corrected Proof

Jean Noël Bruneton — 2010-07-26

This book of 224 pages and 376 illustrations is a component of the series “Rad Cases” and comprises 12 other books covering the subspecialties of Radiology. The book is divided into two parts: in the first one, the images of the musculoskeletal of 100 cases are presented and discussed; the second part offers the possible study “online” of a further 150 cases.

Corrected Proof

Antonio F. Govoni — 2010-07-26

This atlas is a large-book edition of the third volume of the series “Pocket Atlas Sectional Anatomy” by the same authors and publisher, which appeared in 2007, and was dedicated to the imaging of the spine, extremities and joints.

Corrected Proof

Krishna Juluru — 2010-07-26

Pediatric Imaging: The Fundamentals can be considered the second edition of a popular text by the same author entitled, Fundamentals of Pediatric Radiology (2001). The book contains a few more pages than its predecessor, but is otherwise organized into the same eight chapters: (1) Special Considerations in Pediatric Imaging, (2) Airway, (3) Chest, (4) Cardiac, (5) Gastrointestinal, (6) Genitourinary, (7) Musculoskeletal, and (8) Neuro.

Corrected Proof

Aldo Morra — 2010-07-26

Interventional radiology is establishing more and more its role as a valid support to the surgeon and as a therapeutic substitute for surgery. Its use in gynecology, arid in the pathological processes involving more frequently women, albeit in its early stages vis-à-vis the classic interventional radiology, represents an important development by transferring the experience gained from the classic interventional procedures to those clinical situations which call for a different therapeutic outlook, especially regarding the women in their fertile age.

Corrected Proof

Antonio F. Govoni — 2010-07-26

This textbook, in its 3rd Edition, will be welcomed by the junior radiology residents and likewise by the radiologic technologists. Since the previous edition significant changes have been made regarding the text itself, the number of illustrations has increased, and most of the questions have been amended.

Mucinous colloid adenocarcinoma of the lung with lymph node metastasis showing numerous punctate calcifications - Corrected Proof

2010-07-21

Abstract: Mucinous colloid adenocarcinoma (MC) of the lung represents a rare but distinctive variant of primary pulmonary adenocarcinoma, which usually shows favorable prognosis. We describe the case of a 70-year-old man who had a well-demarcated mass with numerous punctuate calcifications in the right middle lobe. Four months after surgery, multiple bone metastases were found and the poor prognosis was suggested. This is the first case of primary pulmonary MC with the characteristic imaging findings and the rare aggressive clinical feature.

The relationship between MRI invasive features and expression of EMMPRIN, galectin-3, and microvessel density in pituitary adenoma - Corrected Proof

Yinian Zhang, Ning He, Junlin Zhou, Yaqing Chen — 2010-07-21

Abstract: This study aimed to investigate the relationship between the expression of the molecular markers, extracellular matrix metalloproteinase inducer (EMMPRIN), galectin-3, and microvessel density (MVD) with MRI invasive features in invasive and noninvasive pituitary adenomas. MRI was performed preoperatively in 34 patients with histologically verified pituitary adenomas. The expression of EMMPRIN, galectin-3, and MVD was determined by using immunohistochemical techniques on excised surgical specimen from all patients. Correlative analyses between invasive MRI features and expression of EMMPRIN, galectin-3, and MVD were determined between invasive and noninvasive pituitary adenomas. Among MRI invasive features, adenoma crossing the lateral line (LL) of the internal carotid artery (ICA), percentage of intracavernous ICA encasement by the tumor over 50%, sphenoidal sinus invasion, irregular tumor shape, and bilateral ICA asymmetry correlated with increased expression of EMMPRIN and galectin-3 (P .05). The invasive MRI features did not correlate with MVD expression. This study demonstrated that EMMPRIN and galectin-3 were associated with aggressiveness and invasion by pituitary adenoma. Furthermore, EMMPRIN and galectin-3 were two potential molecular markers for assessing the invasive potential of pituitary adenoma and may provide useful targets for molecular therapeutic strategy against invasive pituitary adenomas.

Superficial siderosis of the central nervous system: MR findings with susceptibility-weighted imaging - Corrected Proof

Jin Wang, Xiangyang Gong — 2010-07-21

Abstract: We report three cases of superficial siderosis of the central nervous system examined with MR susceptibility-weighted imaging (SWI) technique additional to the conventional SE sequence. Deposition of hemosiderin on SWI images is thicker and far more conspicuous compare with conventional T2-weighted images. Additional intracerebral bleeds are evidenced on susceptibility-weighted images in all three cases, which provide possible clues to the underlining etiology of superficial siderosis.

Corrected Proof

Lawrence H. Schwartz — 2010-07-21

This textbook written by three principal authors, Rummeny, Reimer, and Heindel, and published by Thieme is an extremely well done, comprehensive review of magnetic resonance imaging (MRI) of the body. It begins with a listing of abbreviations and acronyms which is quite thorough, not only for MRI but for all imaging. The basic principles of MRI are well covered in four chapters, including an excellent review of imaging artifacts.

Corrected Proof

Antonio F. Govoni — 2010-07-21

This pocketsize book joins the other 12 similar books, of the Dx Series, in covering the entire range of radiological subspecialties, from brain imaging to vascular imaging. The book is divided into 13 chapters: Congenital Disorders; Disorders of the Airways; Occupational Diseases; Infections; Idiopathic Interstitial Pneumonia; Collagen Disease and Vasculitis; Immune Disorders and Disorders of Uncertain Etiology; Bronchopulmonary Neoplasms; Disorders of the Pulmonary Circulation System; Mediastinal Disorders; Chest Wall and Pleura; Chest Trauma; Sequelae of Therapy. In the opening page, the presentation of the case follows this format: DEFINITION: in which the epidemiology, etiology, pathophysiology, and pathogenesis of the pathological process are given. In IMAGING SIGNS, the reader is given the modality of choice (i.e., radiographs, CT, CTA, MRI, nuclear medicine, etc.); the radiographic, CT, MRI, etc., findings; and the pathognomonic findings. In CLINICAL ASPECTS, the following are reviewed: typical presentation, the therapeutic options, the course and prognosis, and a significant recommendation: “What Does the Clinician Want to Know?” The radiographic images of the case are presented in the following page where the DIFFERENTIAL DIAGNOSIS is discussed, and very useful “Tips and Pitfalls” are given. The presentation concludes with selected references. The images presented for each case are of high quality.

Meeting and courses - Corrected Proof

Antonio F. Govoni — 2010-07-21

T1 hyperintensity of bladder urine at prostate MRI: frequency and comparison with urinalysis findings - Corrected Proof

2010-07-14

Abstract: Objective: The purpose of this study was to assess the possible clinical significance of bladder urine T1 hyperintensity based upon comparison with urinalysis findings, using a cohort of patients who underwent prostate MRI and urinalysis at a similar point in time during preoperative work-up.Methods: We identified 56 patients who underwent prostatectomy at our institution who obtained prostate MRI and urinalysis within 1 day of each other preoperatively. A control group of 160 consecutive adult men who underwent pelvic MRI during the same time period for other indications was also identified. Two radiologists independently and in consensus reviewed the T1-weighted images to assess the frequency of bladder urine T1 hyperintensity in both groups. The urinalyses in the 56 men undergoing prostatectomy were reviewed, with the results compared between patients with and without bladder urine T1 hyperintensity.Results: Four (7.1%) of 56 men with prostate cancer exhibited T1 hyperintense bladder urine, compared with six (3.8%) of 160 patients exhibiting this finding in the control group (P=.288). Of the four prostate cancer patients with this finding, all exhibited a normal urinalysis. An abnormal urinalysis was identified for four of the prostate cancer patients, all of whom exhibited normal urine T1 signal intensity.Conclusion: Bladder urine T1 hyperintensity may be seen occasionally in patients with prostate cancer but is not associated with abnormal urinalysis and therefore should not be regarded as a sign of acute urinary pathology.

Lateral ankle ligaments: MR arthrography with anatomic correlation in cadavers - Corrected Proof

Mayura Boonthathip, Lina Chen, Debra Trudell, Donald Resnick — 2010-07-12

Abstract: Objective: The purpose of our study was to use magnetic resonance (MR) imaging and MR arthrography to demonstrate the anatomy of the lateral ankle ligaments using standard and oblique imaging planes in cadavers.Material and methods: MR imaging of ten cadaveric ankles was performed before and after intra-articular administration of contrast solution. Proton-density MR images were acquired in standard and oblique imaging planes. MR imaging was correlated with anatomic sections. Measurements using oblique imaging planes were obtained to characterize the morphology of the lateral ligaments.Results: The anterior talofibular ligament (ATFL) had a variable number of bands in all specimens, separated by fat signal oriented obliquely parallel to the long axis of the ligament. The fibular attachment of ATFL was located in close proximity to the fibular attachment of the distal band of the anterior tibiofibular ligament (AITFL). The angle formed by the calcaneofibular ligament (CFL) and the fibular shaft varied with different ankle positions. Special axial oblique plane best demonstrated the CFL. The posterior talofibular ligament (PTFL) was multi-fasciculated in appearance. Dorsiflexion of the ankle joint helped elongate the PTFL and best depicted this ligament in its entirety in the axial plane.Conclusion: Oblique imaging planes parallel to the long axis of the individual ligaments may improve visualization of the anatomy of the lateral ankle ligaments. The orientation of the lateral ankle ligaments is affected by the position of the talocrural and subtalar joints. Understanding the morphology of the lateral ankle ligaments can help radiologists diagnose abnormalities of these ligaments.

Solitary intraperitoneal fibrous tumor: report of three cases - Corrected Proof

2010-07-12

Abstract: The solitary intraperitoneal fibrous tumor is a rare lesion, almost exclusively benign. We report on three cases with different ultrasound, computed tomography and magnetic resonance imaging findings, related to the fibrous and/or cellular histological composition of the tumor. Because of the minimal, but real, possibility of a recurrence after the surgical intervention, a follow-up by radiological imaging is recommended.

Lung CT findings of angiostrongyliasis cantonensis caused by Angiostrongylus cantonensis - Corrected Proof

Yun Cui, Ming Shen, Shujing Meng — 2010-07-12

Abstract: Angiostrongyliasis cantonensis is a parasitic disease caused by human infection with Angiostrongylus cantonensis. Fifteen cases were enrolled in our study. Chest CT scanning was performed with MSCT in all cases. The chest CT images demonstrated that pulmonary nodular lesions and ground-glass opacity lesions located in the subpleural area are the characteristic signs of the disease. With the development of the disease, ground-glass opacity lesions disappear and pleural indentation occurs.

Cervical meningocele associated with subependymal nodular heterotopia - Corrected Proof

M. Lotfi, P. Iranpour, K. As'adi — 2010-07-09

Abstract: Heterotopia is a subgroup of migration abnormalities, recognized by arrest of radial migration of neuroblasts. Being a well-known cause for developmental delay, mental retardation, and epilepsy, association of heterotopia with some other conditions has also been proposed. There are several case reports regarding the concurrence of heterotopia and encephalocele; however, no such association has been reported with cervical meningocele. Herein, we present the first case of periventricular nodular heterotopia associated with cervical meningocele. Our case further emphasizes the role of brain MRI in the evaluation of those with neural tube defects. Recognition of possible associated heterotopia is important for planning proper treatment and genetic counseling.

Computed tomographic criteria for the discrimination of subcentimeter lung nodules in patients with soft-tissue sarcomas - Corrected Proof

2010-07-09

Abstract: The aim of this study was to identify criteria for nodule characterization on chest computed tomography in patients with soft tissue sarcomas. In 195 patients, a total of 194 benign and 117 malignant subcentimeter lung nodules were retrospectively analyzed according to lesion size, shape, margins, density, and localization. Benign lesions more frequently displayed complex shape and were of ground-glass density (P<.0001, respectively). In contrast, round shape and solid density were more frequently found in malignant lesions (P<.0001, respectively).

Relationship between peripheral lung cancer and the surrounding bronchi, pulmonary arteries, pulmonary veins: a multidetector CT observation - Corrected Proof

Yong Wang, Kun-ru Liang, Xue-guo Liu, Jin-an Wang, Jiang-he Kang, Ming-zhu Liang — 2010-06-25

Abstract: Aim: This study aimed to investigate the relationship between peripheral lung cancer and the surrounding pulmonary vessels and bronchi using contrast-enhanced multidetector computed tomography (MDCT) and to analyze associated factors such as pathology types, stage, size, density, and location of peripheral lung cancer.Materials and Methods: A total of 93 patients with solitary peripheral lung cancers underwent contrast-enhanced MDCT before thoracotomy were enrolled. Multiplanar reconstruction, maximal intensity projection, and volume rendering were used for demonstrating the patterns of the tumor–bronchi (Br), tumor–pulmonary artery (PA) and tumor–pulmonary vein (PV) relationship, respectively. Five subtypes were identified: Type1 (Br1, PA1 and PV1), Br, PA, or PV was erupted at the edge of nodule; Type2 (Br2, PA2, and PV2), erupted at the center of nodule; Type3 (Br3, PA3 and PV3), penetrated through the nodule; Type4, (Br4, PA4 and PV4), contacting the nodule but stretched or encased; Type5 (Br5, PA5, and PV5), contacting the nodule but smoothly compressed.Results: Both bronchi and PA were interrupted in 70 (Type 1+2); both narrowed in 9 (Type 3+4). The bronchi and PA changes surrounding the lung cancer had positive relations (χ2=12.3918, r=0.7524, P<.01). Br1 and PA1 were more often seen in the group of solid, ≥2.0 cm, and Stage II–IV focal lesions, while Br2 and PA2, more often in the group of part-solid, non-solid, <2.0 cm, and Stage I focal lesions. PV2 was more often seen in the part-solid and non-solid focal lesions group, while PV (4+5), more often in solid focal lesions group.Conclusion: MDCT can demonstrate and subtype relationships among peripheral lung cancer and the bronchi, pulmonary arteries and pulmonary veins. This can be the basis for further clinical research and differential diagnosis.

Traumatic trapped penis: ultrasonography and CT findings - Corrected Proof

2010-06-25

Abstract: We report the case of an 18-year-old man who presented with traumatic trapped penis after a motorcycle accident. Ultrasonography (US) and CT scan disclosed a trapped penis buried within the prepubic fat. Imaging findings of the traumatic trapped penis and the role of imaging study for this rare clinical condition are discussed.

Subchondral insufficiency fracture of the femoral head in young adults - Corrected Proof

2010-06-25

Abstract: A subchondral insufficiency fracture of the femoral head (SIF) is generally observed in elderly women. In addition, SIF has been reported to occur in young military trainees, which are considered to be due to a fatigue stress fracture. This report reviewed five cases of SIF in young adults without any history of overexertion or antecedent trauma. The clinical findings, time to the initial radiograph, time to the initial magnetic resonance imaging (MRI), and follow-up period were investigated. Radiographs and MRI were obtained in both hips. Bone mineral density and bone scintigram were performed. Measurements of a bone mineral density indicated presence of osteopenia in three patients. MRI disclosed a discontinuous irregular-shaped low-intensity band surrounded by bone marrow edema in all cases. After conservative treatments, one patient's condition resolved, while four patients underwent femoral head collapse resulting in surgical treatment. In these four patients, the diagnosis of SIF was histologically confirmed. In addition, the histological findings showed thin disconnected bone trabeculae, thus indicating the presence of some degree of osteopenia. These patients were considered to demonstrate an insufficiency fracture rather than a fatigue stress fracture based on both clinical findings and histological findings. SIF needs to be considered in patients presenting with hip pain even in young cases.

Contrast behavior of high-spatial-resolution T1-weighted MR imaging at 3.0 T vs. 1.5 T - Corrected Proof

2010-05-31

Abstract: Twenty-four volunteers were examined at T1-weighted images with thin sections using gradient-based sequences with a possible short and same TR at 3.0 and 1.5 T. Pancreas-to-spleen contrast measurements and scores for visual assessments of image contrast were significantly worse at 3.0 T than at 1.5 T on both sequences. The image contrast of high-spatial-resolution T1-weighted images at 3.0 T is decreased compared to that of images with the same and possible short TR at 1.5 T.

PET/CT artifacts - Corrected Proof

2010-05-26

Abstract: There are several artifacts encountered in positron emission tomography/computed tomographic (PET/CT) imaging, including attenuation correction (AC) artifacts associated with using CT for AC. Several artifacts can mimic a 2-deoxy-2-[18F] fluoro-d-glucose (FDG) avid malignant lesions and therefore recognition of these artifacts is clinically relevant. Our goal was to identify and characterize these artifacts and also discuss some protocol variables that may affect image quality in PET/CT.

Pulmonary nodules: a quantitative method of diagnosis by evaluating nodule perimeter difference to approximate oval using three-dimensional CT images - Corrected Proof

Hisashi Kamiya, Sadayuki Murayama, Yasumasa Kakinohana, Tetsuhiro Miyara — 2010-05-26

Abstract: The purpose of this study was to investigate whether maximum nodule perimeter to the approximate oval could discriminate benign nodules from malignancy.Measurement of maximum nodule perimeter difference to the approximate oval was performed using volume-rendering images of three directions of each pulmonary nodule. The margin was then traced manually and our custom software delineated the approximate oval automatically.The maximum nodule perimeter difference was 26.5±23.3 mm for malignant and 16.6±16.9 mm for benign nodules, showing an almost statistically significant difference (P=.07).This study suggests that the maximum nodule perimeter difference to the approximate oval of the malignant nodules has a tendency to be longer than benign nodules.

Unusual diffuse pulmonary amyloidosis in systemic lupus erythematosus: computed tomography findings - Corrected Proof

Sung Shine Shim, Eun Mi Chun, Sun Hee Sung — 2010-05-20

Abstract: Pulmonary involvement is a common feature in systemic lupus erythematosus (SLE) patients. This may include pleuritis, pneumonitis, and pulmonary hemorrhage. However, the presence of diffuse consolidation on chest radiographs is less common, and is usually interpreted as pneumonia. Moreover, consolidations with massive calcifications are a relatively rare manifestation. The association of pulmonary amyloidosis and SLE seems quite unusual, and has rarely been described. We report a patient with SLE and massive multiple calcified consolidations on radiologic images, which were confirmed as secondary amyloidosis.

Broncheoalveolar carcinoma associated with pulmonary lymphangioleiomyomatosis and Tuberous Sclerosis Complex: case report - Corrected Proof

Cláudia Carneiro, Narainder Gupta — 2010-05-19

Abstract: Lymphangioleiomyomatosis (LAM) is a rare disorder that predominantly affects the lung parenchyma of young women and it's characterized by pulmonary cyst. Tuberous sclerosis complex (TSC) is a rare genetic disorder presenting with hamartomas and neurologic symptoms. The two renal pathologies most commonly seen in TSC are angiomyolipomas and cysts; less commonly, TSC co-exist with polycystic kidney disease. In this report is described an uncommon case of a patient with broncheoalveolar carcinoma, pulmonary LAM and TSC with polycystic kidney disease.

Use of coronary anatomy and late enhancement information both derived from contrast-enhanced whole-heart coronary MRA at 3 T for the assessment of ischemic left ventricular dysfunction - Corrected Proof

2010-05-14

Abstract: Recognizing the etiology of patients with left ventricular dysfunction (LVD) is essential for the risk stratification and treatment selection. We report the case of a 59-year-old man suspected of ischemic LVD with non acute symptoms studied with whole-heart cardiac magnetic resonance imaging including noninvasive coronary angiography and in whom we obtained comprehensive information of both coronary artery stenosis and myocardial tissue damage.

Multiple intra-abdominal venous thrombosis in ulcerative colitis: role of MDCT for detection - Corrected Proof

2010-05-14

Abstract: Patients with ulcerative colitis are at increased risk for venous thrombosis. We report herein the case of a 28-year-old woman who developed multiple intraabdominal venous thrombosis, including partial Budd–Chiari syndrome in association with intracranial venous thrombosis and pulmonary embolism during the relapse of a known ulcerative colitis. Multidetector-row computed tomography (MDCT) allowed depiction of multiple intraabdominal sites of thrombosis including right and medial hepatic veins, left portal vein, splenic vein and left ovarian vein and demonstrated complete resolution of the multiple thrombi after anticoagulant therapy. The association of partial Budd–Chiari syndrome with other thrombi involving portal, splenic and ovarian veins in association with ulcerative colitis, has, to our knowledge never been reported yet. In addition, the potential role of MDCT in the detection of possible multiple thrombosis in patients with ulcerative colitis has never been emphasized.

CT of unusual renal masses invading the pelvicaliceal system: potential mimics of upper tract transitional cell carcinoma - Corrected Proof

2010-05-10

Abstract: Two patients with renal cell carcinoma and one patient with metastasis to the kidney from colorectal cancer are reported because all three cases manifested at computed tomography (CT) as a renal mass invading the pelvicaliceal system and radiologically simulating transitional cell carcinoma. Recognition that the CT finding of a renal mass with invasion of the pelvicaliceal system is not always indicative of a transitional cell carcinoma broadens the differential diagnosis in this setting and might potentially alter the diagnostic and therapeutic approach.

Does direct MR galactography have the potential to become an alternative diagnostic tool in patients with pathological nipple discharge? - Corrected Proof

2010-05-05

Abstract: Purpose: To compare direct magnetic resonance galactography (dMRG) and conventional galactography (CGal).Materials and methods: Thirty women underwent CGal and dMRG. Duct localization and the depth of the assumed underlying pathology in CGal and dMRG were analyzed.Results: Comparing CGal and dMRG, there was no significant difference regarding sector localization, but for depth of pathology (P=.023).Conclusion: Duct localization with dMRG was possible with the same reliability as with CGal. Thus, dMRG may have the potential to become an alternative method to CGal.

Celiac artery trunk thrombosis: an unusual complication of pancreatitis diagnosed on MRI - Corrected Proof

Elizabeth Kagan Arleo, Kevin Mennitt — 2010-04-26

Abstract: Celiac artery trunk thrombosis is a rare complication of pancreatitis. Only two other cases have been reported in the English-language literature. Here, we present the clinical and multimodality imaging findings for a woman with pancreatitis who had continued pain after normalization of pancreatic enzyme levels and was unexpectedly found to have occlusion of her celiac trunk on follow-up MRI. She was managed as an outpatient and had spontaneous resolution 2 weeks later.

MRI findings of choroid plexus tumors in the cerebellum - Corrected Proof

Ti-Jiang Zhang, Qiang Yue, Su Lui, Qi-Zhu Wu, Qi-Yong Gong — 2010-04-26

Abstract: Choroid plexus tumors (CPTs) are uncommon primary intracranial tumors. Here, we describe two patients with CPTs of the cerebellum: one had a choroid plexus papilloma located in the left cerebellar hemisphere that presented as an irregular, lobulated and solid–cystic mass, whereas the other had a choroid plexus carcinoma that exhibited a poorly defined, mixed-intensity mass associated with invasion of adjacent brain parenchyma. Contrast-enhanced MR imaging showed prominent heterogeneous enhancement. CPTs should be considered in the differential diagnosis for irregular, heterogeneous and intensely enhancing masses that occur in the cerebellum.

Radiological assessment of mesenteric and retroperitoneal cysts in adults: is there a role for chemical shift MRI? - Corrected Proof

Anoop P. Ayyappan, Kartik S. Jhaveri, Masoom A. Haider — 2010-04-16

Abstract: Objective: The purpose of this study was to assess the potential role for chemical shift magnetic resonance imaging (MRI) in identifying lymphangiomas from other cystic mesenteric and retroperitoneal masses.Materials and methods: A retrospective search of radiology database identified 24 consecutive patients with mesenteric and retroperitoneal cysts (nine men, 15 women; mean age, 41 years; age range, 19–75 years) who had undergone MR which included in-phase and opposed-phase chemical shift imaging. Signal intensity (SI) decrease between in-phase and opposed-phase MR images of the cyst was evaluated qualitatively by two radiologists. Ultrasound (US), computed tomography (CT), and MRI findings of the morphological appearances of all the cystic lesions that demonstrated significant signal drop on chemical shift MR were also recorded.Results: Of mesenteric and retroperitoneal cysts, 33% (8/24) revealed qualitative decrease in intensity on opposed-phase MR images relative to that seen on in-phase images. On ultrasound, these cysts demonstrated anechoic simple fluid. Their mean CT attenuation was 13 HU (range: 5–20 HU). Signal loss on fat-suppressed T1-weighted sequences was displayed only by a single cyst. None of the lesions with qualitative SI decrease on opposed-phase MR showed suggestion of lipid on US and CT.Conclusion: The presence of intra cystic lipid detected by chemical shift MR may not be overt on cross-sectional imaging such as US and CT. Chemical shift MRI provides additional sensitivity and specificity as an imaging test for demonstration of lipid within mesenteric and retroperitoneal cysts enabling a higher diagnostic yield for lymphangioma leading to more appropriate patient management.

Radiology-Pathology Conference: mature teratoma arising from an intra-abdominal undescended testis in a 7-month-old infant - Corrected Proof

2010-04-16

Abstract: We report a rare case of an intra-abdominal testicular mature teratoma in a 7-month-old male infant presenting with a palpable abdominal mass and unilateral undescended testis. We describe the pathology, clinical presentation, and imaging findings of this entity. Clinical features accompanied by characteristic radiologic findings guide a provisional diagnosis that is confirmed by histologic analysis following surgical removal of the tumor. The pathogenesis and radiologic findings of testicular mature teratomas in the prepubertal population share many similarities to that of mature ovarian teratomas commonly seen in females of reproductive age. Awareness of this entity will permit the radiologist to suggest timely diagnosis and intervention when presented with a similar case.

High signal intensity in the dural sinuses on 3D-TOF MR angiography at 3.0 T - Corrected Proof

2010-04-05

Abstract: Purpose: The objective of this study was to examine the frequency of high signal intensity in the dural sinuses of normal subjects upon magnetic resonance (MR) angiography using 3.0-T scanners.Methods: A total of 748 consecutive healthy subjects underwent three-dimensional time-of-flight MR angiography at 3.0 T. Sixteen subjects were excluded. MR angiographic source images were retrospectively reviewed for the presence of high signal intensity in the inferior petrosal sinus, pterygoid sinus, or sigmoid sinus.Results: Of the 732 examinations, 10 (1.3%) showed high signal intensity in the dural sinuses (left inferior petrosal sinus, n=4; left pterygoid sinus, n=3; left sigmoid sinus, n=6). High signal intensity in the dural sinuses was observed only on the left side. The minimum diameter of the left brachiocephalic vein was significantly smaller in subjects with high signal intensity than in the control group.Conclusion: In our study with healthy subjects at 3.0 T, the frequency of high signal intensity in the dural sinuses is as low as 1.3%. Retrograde flow due to physiological stenosis of the left brachiocephalic vein may be one of the causes of this phenomenon.

F-18 FDG PET/CT findings in postradiation pelvic insufficiency fracture - Corrected Proof

2010-04-01

Abstract: We retrospectively identified eight patients who underwent F-18 FDG PET/CT and had diagnostic findings of postradiation pelvic insufficiency fracture. The fractures had a median SUVmax of 2.5 (range, 1.6 to 6.0) and were initially interpreted as possible metastases in six patients. A new bone lesion developing in the sacrum, pubic ramus, or acetabulum after radiation for pelvic malignancy is likely to be a postradiation pelvic insufficiency fracture, even if associated with increased FDG uptake at PET.

Giant phyllodes tumors of the breast: imaging findings with clinicopathological correlation in 14 cases - Corrected Proof

Jin Chung, Eun Ju Son, Jeong-Ah Kim, Eun-Kyung Kim, Jin Young Kwak, Joon Jeong — 2010-04-01

Abstract: Purpose: To describe imaging features in giant phyllodes tumors (GPTs) with radiology–pathologic correlations.Materials and Methods: Surgically confirmed 14 GPTs of the breast were retrospectively reviewed with ultrasound, mammograms, computed tomography, magnetic resonance imaging, and positron emission tomography.Results: The most GPTs showed circumscribed and lobulated masses with cystic necrosis. Five cases of core needle biopsy results were benign other than GPTs.Conclusion: Radiology–pathologic correlation in GPTs is essential, due to differences of pathologic results (5/14 in our study) between core biopsy and surgical pathology.

Kikuchi–Fujimoto disease with spontaneous subdural hematoma in a middle-aged Hispanic male - Corrected Proof

2010-03-24

Abstract: Kikuchi–Fujimoto disease (KFD) is an uncommon disorder that usually presents in young adults of Asian descent with fever and cervical lymphadenopathy. Clinically, this disease is often misdiagnosed as lymphoma or tuberculosis, and biopsy is needed for confirmation. The authors report an unusual case of KFD in a Hispanic male presenting with a subacute subdural hematoma, whose care was complicated by extranodal features not typically associated with KFD. The clinical, histopathologic, and radiographic manifestations of KFD are discussed.

Infiltrating syringomatous adenoma presenting as microcalcification in the nipple on screening mammogram: case report and review of the literature of radiologic features - Corrected Proof

2010-03-19

Abstract: Infiltrating syringomatous adenoma (ISA) of the nipple, first described by Rosen in 1983 (Am J Surg Pathol, 1983, 7, 739–745), is a rare benign tumor that can be misdiagnosed as a malignancy. ISA is characterized by its specific location in the subareolar region, its distinct histologic appearance resembling sweat duct or syringomatous tumors, and its locally infiltrating growth. We describes a case of ISA of the nipple presenting as microcalcification that was found on screening mammography. We also reviewed previously reported radiologic features of ISA.

CAD in full-field digital mammography—influence of reader experience and application of CAD on interpretation of time - Corrected Proof

2010-03-11

Abstract: Aim: To assess time expenditure using the influence of computer-assisted detection (CAD) system in the interpretation of the dependence of early research and benign and malignant mammograms on readers' experience.Materials and Methods: CAD (Image Checker V2.3; R2 Technology, Los Altos, CA, USA) was prospectively applied on digital mammograms of 303 patients [early research (n=103), benign (n=102), and malignant group (n=98)]. Mammograms were analyzed by three readers with varying experience in evaluating mammograms (medical student, resident and attending) according to the BI-RADS classification. Time was stopped and recorded. All images were presented randomly with and without the influence of CAD and from the different patient groups. To evaluate the statistical significance, the corresponding P value for time to read the mammograms in addition to different patient groups, application of CAD, readers' experience, and interaction of reader was calculated.Results: The attending needs, independent of CAD application, the least time, followed by the medical assistant and the student. In all three patient groups, CAD adoption elongates reading time of the student and the resident. The medical specialist needs with and without CAD median the same time. In the early research group, no significant differences were registered (P=.1343). Concerning readers' experience, there is an explicit significant difference (P<.0001). The application of CAD correlates with the corresponding readers' experience and also provides a not significant result. In comparison, the P value for the malignant and benign groups shows significant interactions between the readers' experiences as well as CAD application.Conclusion: The future role of CAD application depends on whether sensitivity can be increased and time expenditure caused by false-positive marks can be decreased. In the future, second reading could be substituted by a CAD system if the reader has a wide professional experience.

Radiological features of acute gastric volvulus in adult patients - Corrected Proof

Hassan Al-Balas, Mohammed Bani Hani, Hamzi Z. Omari — 2010-03-11

Abstract: Objective: To evaluate the radiological features of acute gastric volvulus in adults and correlate these features with operative findings.Materials and Methods: The clinical, radiological and operative findings of five adult patients (four males and one female with mean age of 50.4 years) who presented or referred to King Abdullah University hospital over 4 year’s period with symptoms of acute gastric volvulus were reviewed retrospectively. All patients underwent upper gastrointestinal barium study and two of them had computed tomographic (CT) scans preoperatively. The radiological features demonstrated on upper gastrointestinal barium exams and CT scans were analyzed and compared with operative findings.Results: Radiological and operative findings revealed organo-axial gastric volvulus in all patients in our study. All of them had associated diaphragmatic defect or hiatal hernia. The upper gastrointestinal barium studies demonstrated the classic radiological features of organo-axial volvulus. CT done on two of our patients confirmed the diagnosis.Conclusion: Upper gastrointestinal barium study is an accurate way to diagnose and characterize acute gastric volvulus in adult patients. CT scan can also be used to diagnose this clinical entity.

Imaging features of bilateral breast abnormalities - Corrected Proof

2010-03-11

Abstract: There are various-causes, broad-spectrum, heterogeneous groups with various biologic profiles, and imaging features of bilateral breast abnormalities. As imaging modalities continue to be developed, the ability to detect subtle or tiny abnormalities is improved in the contralateral breast of patients already diagnosed with unilateral breast disease, especially in breast cancer patients when using magnetic resonance imaging. Furthermore, some diseases involved bilateral breast, simultaneously. The purpose of this review is to describe imaging features of the bilateral breast abnormalities—common diseases and simultaneously involving diseases. In order to provide adequate treatment and to prevent misdiagnosis, a complete understanding of the imaging and clinical features of bilateral breast abnormalities of common diseases as well as those of simultaneously involving diseases is necessary.

Non-Hodgkin's lymphoma of the bone and the liver without lymphadenopathy revealed on FDG-PET/CT - Corrected Proof

Gang Cheng, Sabah Servaes, Wichana Chamroonrat, Jianing Li, Hongming Zhuang — 2010-03-11

Abstract: Primary extranodal lymphomas are much less frequent than nodal lymphomas. Osseous and hepatic lymphomas commonly present with additional nodal lesions. Primary lymphoma of the bone or of the liver without nodal disease is uncommon. We describe a case of extranodal non-Hodgkin's lymphoma with numerous osseous and hepatic lesions without any lymph node involvement on FDG-PET/CT images. This is the first report of the coexistence of both osseous and hepatic lymphoma in the same patient without any lymph node involvement.

CT Imaging findings of malignant neoplasms arising in the epigastric region in children - Corrected Proof

Claudia Martinez Rios Arellano, Supika Kritsaneepaiboon, Edward Y. Lee — 2010-02-24

Abstract: The purpose of this article was to review the spectrum of common and rare malignant neoplasms arising in the epigastric region in children and to illustrate their characteristic computed tomography (CT) imaging features. Understanding the characteristic CT appearance of various malignant neoplasms, which can occur in the epigastric region in children, aids in accurate diagnosis and optimizes pediatric patient care.

Three-tesla diffusion tensor imaging of Meyer's loop by tractography, color-coded fractional anisotropy maps, and eigenvectors - Corrected Proof

Matthew L. White, Yan Zhang — 2010-02-22

Abstract: The aim of this study was to evaluate Meyer's loop by 3-T MRI with fiber tractography, color-coded fractional anisotropy maps, and eigenvector maps. The anteroposterior distance from the anterior bundle of the Meyer's loop to temporal pole ranged from 26.3 to 34 mm, overlapping with the previously published anatomical dissection studies. Diffusion tensor imaging with fiber tractography, color-coded FA maps, and color maps of the principal eigenvector at 3 T appear to be promising techniques for the virtual dissection of Meyer's loop.

Do all mucocele-like lesions of the breast require surgery? - Corrected Proof

2010-02-22

Abstract: Aim: The objective of this study is to review the imaging features and percutaneous biopsy findings of mucocele-like lesions (MLLs) of the breast and correlate these with histopathology at surgical excision (SE), where available, to determine whether all MLLs of the breast require surgery for management.Materials and Methods: A search of two pathology databases was performed to identify 44 patients who had been diagnosed with MLL of the breast and who had corresponding imaging findings available for review. These patients' medical records were reviewed to determine patient age at diagnosis, site of disease/affected breast, symptoms at diagnosis, mammographic and sonographic findings and methods used for histopathologic diagnosis (percutaneous biopsy and/or SE).Results: The mean age of all patients was 56 years (range, 35–76 years). Sixteen patients had MLLs diagnosed by core needle biopsy (CNB) or fine needle aspiration biopsy followed by SE. Eighteen patients had CNB without SE and had clinical and imaging follow-up. Ten patients had MLL diagnosed at SE without prior percutaneous biopsy. In total, 29 patients (66%) had MLLs without atypia, while 10 patients had MLLs associated with atypical ductal hyperplasia (ADH) (23%) and five patients had MLLs associated with ductal carcinoma in situ (DCIS) (11%). Findings were upgraded at SE following the percutaneous biopsy from ADH to DCIS in 19% (3/16) of patients.Conclusion: Surgical excision following the identification of MLL is warranted to exclude coexisting in situ carcinoma in specific situations where CNB detects the presence of associated ADH or where a mass with indistinct or irregular margins is shown by mammography or sonography.

Polysplenia syndrome accompanied with situs inversus totalis and annular pancreas in an elderly patient - Corrected Proof

Arda Kayhan, Hatice Lakadamyali, Jacob Oommen, Aytekin Oto — 2010-02-11

Abstract: Polysplenia syndrome (PS) is rarely encountered in elderly. It is characterized by multiple spleens associated with various cardiac and gastrointestinal abnormalities including partial or complete agenesis of dorsal pancreas. Situs inversus totalis (SIT) is a rare congenital anomaly with mirror image of viscera combined with dextrocardia. Occurrence of SIT and PS in the same patient is exceedingly rare. We present the first case of adult PS with SIT accompanied with annular pancreas.

Sonography in the 29th Olympic and Paralympic Games: a retrospective analysis - Corrected Proof

Wen He, Dong-ying Xiang, Jian-ping Dai — 2010-01-27

Abstract: Objective: The purpose of this study was to evaluate the application of sonography at the polyclinic of the Olympic/Paralympic village during the Olympic/Paralympic Games.Methods: We retrospectively reviewed 759 consecutive patients who underwent sonography at the ultrasound division of the polyclinic in the Olympic/Paralympic village from July 20, 2008, to September 20, 2008. Prevalence of emergency sonography after sports injury and non-sports-related urgent conditions during the games was analyzed. The benefit of sonographic services in large sporting events was discussed.Results: There were 759 patients (484 athletes, 101 coaches, 88 team officials, and 86 volunteers; 462 men and 297 women) in the ultrasound division at the polyclinic. The indications for sonography included abdominal pain (315 cases, 41.50%), muskuloskeletal disorders (228 cases, 30.04%), gynecology related (104 cases, 13.70%), cardiac conditions (49 cases, 6.46%), small parts (29 cases, 3.82%), and vascular problems (34 cases, 4.48%). The rates of positive findings on sonography were 46.03% in the abdomen, 70.17% in musculoskeleton, 41.34% in gynecology, 10.20% in the heart, 75.86% in small parts, and 38.24% in vessels, respectively.Conclusion: Sonography plays an important role in the medical services at the polyclinic in the Olympic/Paralympic village. The benefits of sonography in such large sporting events are accuracy, fast result, portability, and noninvasiveness.

Appearance of primary lymphoid malignancies on lymphotropic nanoparticle-enhanced magnetic resonance imaging using ferumoxtran-10 - Corrected Proof

2010-01-15

Abstract: Patients with pathologically confirmed lymphoma/leukemia were retrospectively identified from a large single-institution phase III clinical trial with ferumoxtran-10. Five (2.3%) of 220 patients had lymphoid malignancies involving lymph nodes. A subset of patients (n=27) with biopsy-proven nodal metastases from genitourinary or breast cancer was selected as control group. Ferumoxtran-10 enhancement patterns and signal-to-noise ratios of lymph nodes involved by metastases and lymphoid malignancy were assessed. Like nodal metastases, nodes involved by lymphoid malignancies demonstrate persistent high T2*-signal intensity on lymphotropic nanoparticle-enhanced magnetic resonance imaging.

Solid-pseudopapillary neoplasm of the pancreas: spectrum of findings on multidetector CT - Corrected Proof

2010-01-15

Abstract: Solid-pseudopapillary neoplasms of the pancreas are uncommon and usually occur in young women. They are generally large, encapsulated masses with mixture of solid, cystic, and hemorrhagic components. Some cases have atypical features; for example, they can form a small predominantly solid mass and produce dilatation of the main pancreatic duct. In this article we discuss and illustrate the spectrum of the appearances of this distinctive neoplasm on multidetector CT.