AIM:To clarify features of hepatic hemangiomas on gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared with enhanced computed tomography (CT). METH...AIM:To clarify features of hepatic hemangiomas on gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared with enhanced computed tomography (CT). METHODS:Twenty-six patients with 61 hepatic hem- angiomas who underwent both Gd-EOB-DTPA-enhanced MRI and enhanced CT were retrospectively reviewed. Hemangioma appearances (presence of peripheral nodular enhancement, central nodular enhancement, diffuse homogenous enhancement, and arterioportal shunt during the arterial phase, fill-in enhancement during the portal venous phase, and prolonged enhancement during the equilibrium phase) on Gd-EOB-DTPA-enhanced MRI and enhanced CT were evaluated.The degree of contrast enhancement at the enhancing portion within the hemangioma was visually assessed using a five-point scale during each phase. For quantitative analysis, the tumor-muscle signal intensity ratio (SIR), the liver-muscle SIR, and the attenuation value of the tumor and liver parenchyma were calculated. The McNemar test and the Wilcoxon's signed rank test were used to assess the significance of differences in the appearances of hemangiomas and in the visual grade of tumor contrast enhancement between Gd-EOB-DTPA-enhanced MRI and enhanced CT. RESULTS:There was no significant difference between Gd-EOB-DTPA-enhanced MRI and enhanced CT in the presence of peripheral nodular enhancement (85% vs 82%), central nodular enhancement (3% vs 3%), diffuse enhancement (11% vs 16%), or arterioportal shunt (23% vs 34%) during arterial phase, or fill-in enhancement (79% vs 80%) during portal venous phase. Prolonged enhancement during equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than on enhanced CT (52% vs 100%, P < 0.001). On visual inspection, there was significantly less contrast enhancement of the enhancing portion on Gd-EOB-DTPA-enhanced MRI than on enhanced CT during the arterial (3.94 ± 0.98 vs 4.57 ± 0.64, respectively, P < 0.001), portal venous (3.72 ± 0.82 vs 4.36 ± 0.53, respectively, P < 0.001), and equilibrium phases (2.01 ± 0.95 vs 4.04 ± 0.51, respectively, P < 0.001). In the quantitative analysis, the tumor-muscle SIR and the liver-muscle SIR observed with Gd-EOB-DTPA-enhanced MRI were 0.80 ± 0.24 and 1.28 ± 0.33 precontrast, 1.92 ± 0.58 and 1.57 ± 0.55 during the arterial phase, 1.87 ± 0.44 and 1.73 ± 0.39 during the portal venous phase, 1.63 ± 0.41 and 1.78 ± 0.39 during the equilibrium phase, and 1.10 ± 0.43 and 1.92 ± 0.50 during the hepatobiliary phase, respectively. The attenuation values in the tumor and liver parenchyma observed with enhanced CT were 40.60 ± 8.78 and 53.78 ± 7.37 precontrast, 172.66 ± 73.89 and 92.76 ± 17.92 during the arterial phase, 152.76 ± 35.73 and 120.12 ± 18.02 during the portal venous phase, and 108.74 ± 18.70 and 89.04 ± 7.25 during the equilibrium phase, respectively. Hemangiomas demonstrated peak enhancement during the arterial phase, and both the SIR with Gd-EOB-DTPA-enhanced MRI and the attenuation value with enhanced CT decreased with time. The SIR of hemangiomas was lower than that of liver parenchyma during the equilibrium and hepatobiliary phases on Gd-EOB-DTPA-enhanced MRI. However, the attenuation of hemangiomas after contrast injection was higher than that of liver parenchyma during all phases of enhanced CT. CONCLUSION:Prolonged enhancement during the equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than enhanced CT, which may exacerbate differentiating between hemangiomas and malignant tumors.展开更多
Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury（SCI）. Ectopic adiposity is characterized by the storag...Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury（SCI）. Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging（MRI） has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue（IMAT） and intramuscular adipose tissue（Intra MAT） or intramuscular fat（IMF）. It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.展开更多
BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult b...BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult because of their nonspecific findings on computed tomography(CT)/magnetic resonance imaging(MRI).CASE SUMMARY An 88-year-old woman was suffering from a progressively enlarging mass in the manubrium.Chest CT images showed an osteolytic and expansile lesion with cortical destruction.Vascular malformation was suspected after CT-guided biopsy.On the dynamic MRI scans,the mass showed a bright signal on the T2-weighted image,peripheral nodular enhancement on the early-phase images and progressive centripetal fill-in on the delayed-phase images.Cavernous hemangioma was suspected preoperatively based on the MRI features and finally confirmed by histopathologic analysis.CONCLUSION This uncommon case demonstrates the possible characteristic features of manubrium cavernous hemangioma on dynamic MRI scans;knowledge about these features may prevent patients from developing catastrophic complications,such as rupture or internal hemorrhage,caused by biopsy or surgery.展开更多
Objective To investigate the correlation of magnetic resonance imaging （MRI） with histopathologica changes, and to evaluate T2 mapping in assessing muscle trauma in a rabbit model of muscle injury. Methods We divide...Objective To investigate the correlation of magnetic resonance imaging （MRI） with histopathologica changes, and to evaluate T2 mapping in assessing muscle trauma in a rabbit model of muscle injury. Methods We divided 35 rabbits into seven groups that each represented a different time point after intramuscular hemorrhage and muscle injury. Hemorrhage was created by injecting autologous blood into the left legs, and muscle injury was created by scalpel incision of the biceps femoris of the right legs. At different time points, the rabbits underwent Tl-weighted imaging and T2-weighted imaging （TzWl and T2Wl） and T2 mapping. T2 relaxation times were measured, and the corresponding samples were evaluated for pathological changes. Results After 2 h, the intramuscular hemorrhage model demonstrated an increased signal intensity on both TlWl and T2Wl. Histological examination showed erythrocytes within the muscle bundle. On days 1 and 3, the MRI signals were decreased, and there were no significant changes after day 7. From 2 h to 3 days, the muscle-injury model showed a high signal on both TzWl and T2Wl. Corresponding pathological changes included rupture and edema of muscle fibers, and inflammation. The abnormal signals were reduced on day 7. After day 14, the T2Wl intensity remained high. TlWl showed no abnormal changes, but some models showed a high signal, representing fresh bleeding and fatty tissue. T2 relaxation times were significantly different between the central and marginal regions, and between the marginal and normal regions. Conclusion MRI clearly demonstrates intramuscular hemorrhage and muscle injury, which correlate well with histopathological changes. Tz mapping is useful in assessing the extent of injury.展开更多
Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology we...Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology were reviewed. The characteristics of MRI were analyzed and correlated with pathological characteristics of spinal cord cavernous hemangioma. Results In 4 cases, the tumors were located in thoracic segment of the spinal cord and 2 in cervical cord. All lesions were solitary and the spinal cords were normal or a little thicker. The MRI showed that the images of focus were ball-like popcorn or mulberry with mixed signal,with short T2 signal around the focus. Under microscope, the hemangioma was composed of highly expanded blood sinusoids and its wall was thin and consisted of flat epithelial cells. There were some red blood cells in the cavity of the sinusoid and a little fibrous tissue in the diazoma between blood sinusoids. And also some fresh and old hemorrhages could be seen in the specimen. Conclusion MRI has high sensitivity and specificity in the diagnosis of spinal cavernous hemangioma.展开更多
AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive...AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10<sup>-3</sup> ± 0.2186 cm<sup>2</sup>/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.展开更多
Magnetic resonance imaging is considered the ＂gold standard＂ technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in p...Magnetic resonance imaging is considered the ＂gold standard＂ technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men（18–50 years old） with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were（threshold： 170.71 ± 38.67; manual： 169.45 ± 38.27 cm2） 0.74%, subcutaneous adipose tissue（threshold： 65.99±30.79; manual： 62.68 ± 30.22） 5.2%, whole muscle（threshold： 98.18 ± 20.19; manual： 98.20 ± 20.08 cm2） 0.13%, femoral bone（threshold： 6.53 ± 1.09; manual： 6.53 ± 1.09 cm2） 0.64%, bone marrow fat（threshold： 3.12 ± 1.12; manual： 3.1 ± 1.11 cm2） 0.36%, knee extensor（threshold： 43.98 ± 7.66; manual： 44.61 ± 7.81 cm2） 1.78% and % intramuscular fat（threshold： 10.45 ± 4.29; manual： 10.92 ± 8.35%） 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.展开更多
BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to ...BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.CASE SUMMARY We describe a male patient,age 18,who presented with a pCH.Computed tomography,magnetic resonance imaging,and ultrasound showed cystic space in the tail of the pancreas.A dark spot sign on the T2 weighted image sequence was observed.Clinically,a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging,and the operative indication was clear.The patient underwent a distal pancreatic tumor resection under laparoscopic control.Immunohistochemical staining for CD31 and CD34 was positive;D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells;and calcium-binding protein was negative.The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage.No complications or recurrences were observed during the follow-up period.CONCLUSION Chronic spontaneous hemorrhage may occur in pCH,which may greatly influence the accuracy of diagnosis using imaging modalities.Surgical resection for uncertain pCH seems reasonable with a good outcome.展开更多
This report details the CT and MR imaging findings of a primary orbital Ewing＇s sarcoma case involving the middle cranial fossa in a 13-year old boy. CT showed an ill-circumscribed homogeneous soft-tissue density mas...This report details the CT and MR imaging findings of a primary orbital Ewing＇s sarcoma case involving the middle cranial fossa in a 13-year old boy. CT showed an ill-circumscribed homogeneous soft-tissue density mass with needle-like bone reaction. On MRI, the mass showed homogeneous iso-intensity on T1WI, heterogeneous hyper- intensity on T2WI, and marked homogeneous enhancement. Meanwhile, the mass was hyper-intense on DWI, and ADC alue was 575x10-6 mm2/s. The mass showed as high rCBV and rCBF, prolonged MTT based on DCS- PWI, and wash-out pattern of TIC derived from the DCE-MRI. Our case suggests that functional MRI modalities, including DWI, DSC-PWI or DCE-MR, could provide additional information for differential diagnoses. Both CT and MRI should be performed and comprehensively analyzed for limiting differential diagnoses, determining lesion extension and facilitating operative approach.展开更多
文摘AIM:To clarify features of hepatic hemangiomas on gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) compared with enhanced computed tomography (CT). METHODS:Twenty-six patients with 61 hepatic hem- angiomas who underwent both Gd-EOB-DTPA-enhanced MRI and enhanced CT were retrospectively reviewed. Hemangioma appearances (presence of peripheral nodular enhancement, central nodular enhancement, diffuse homogenous enhancement, and arterioportal shunt during the arterial phase, fill-in enhancement during the portal venous phase, and prolonged enhancement during the equilibrium phase) on Gd-EOB-DTPA-enhanced MRI and enhanced CT were evaluated.The degree of contrast enhancement at the enhancing portion within the hemangioma was visually assessed using a five-point scale during each phase. For quantitative analysis, the tumor-muscle signal intensity ratio (SIR), the liver-muscle SIR, and the attenuation value of the tumor and liver parenchyma were calculated. The McNemar test and the Wilcoxon's signed rank test were used to assess the significance of differences in the appearances of hemangiomas and in the visual grade of tumor contrast enhancement between Gd-EOB-DTPA-enhanced MRI and enhanced CT. RESULTS:There was no significant difference between Gd-EOB-DTPA-enhanced MRI and enhanced CT in the presence of peripheral nodular enhancement (85% vs 82%), central nodular enhancement (3% vs 3%), diffuse enhancement (11% vs 16%), or arterioportal shunt (23% vs 34%) during arterial phase, or fill-in enhancement (79% vs 80%) during portal venous phase. Prolonged enhancement during equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than on enhanced CT (52% vs 100%, P < 0.001). On visual inspection, there was significantly less contrast enhancement of the enhancing portion on Gd-EOB-DTPA-enhanced MRI than on enhanced CT during the arterial (3.94 ± 0.98 vs 4.57 ± 0.64, respectively, P < 0.001), portal venous (3.72 ± 0.82 vs 4.36 ± 0.53, respectively, P < 0.001), and equilibrium phases (2.01 ± 0.95 vs 4.04 ± 0.51, respectively, P < 0.001). In the quantitative analysis, the tumor-muscle SIR and the liver-muscle SIR observed with Gd-EOB-DTPA-enhanced MRI were 0.80 ± 0.24 and 1.28 ± 0.33 precontrast, 1.92 ± 0.58 and 1.57 ± 0.55 during the arterial phase, 1.87 ± 0.44 and 1.73 ± 0.39 during the portal venous phase, 1.63 ± 0.41 and 1.78 ± 0.39 during the equilibrium phase, and 1.10 ± 0.43 and 1.92 ± 0.50 during the hepatobiliary phase, respectively. The attenuation values in the tumor and liver parenchyma observed with enhanced CT were 40.60 ± 8.78 and 53.78 ± 7.37 precontrast, 172.66 ± 73.89 and 92.76 ± 17.92 during the arterial phase, 152.76 ± 35.73 and 120.12 ± 18.02 during the portal venous phase, and 108.74 ± 18.70 and 89.04 ± 7.25 during the equilibrium phase, respectively. Hemangiomas demonstrated peak enhancement during the arterial phase, and both the SIR with Gd-EOB-DTPA-enhanced MRI and the attenuation value with enhanced CT decreased with time. The SIR of hemangiomas was lower than that of liver parenchyma during the equilibrium and hepatobiliary phases on Gd-EOB-DTPA-enhanced MRI. However, the attenuation of hemangiomas after contrast injection was higher than that of liver parenchyma during all phases of enhanced CT. CONCLUSION:Prolonged enhancement during the equilibrium phase was observed less frequently on Gd-EOB-DTPA-enhanced MRI than enhanced CT, which may exacerbate differentiating between hemangiomas and malignant tumors.
基金supported in part by Grant-in-Aid for JSPS Research Fellow
文摘Ectopic adiposity has gained considerable attention because of its tight association with metabolic and cardiovascular health in persons with spinal cord injury（SCI）. Ectopic adiposity is characterized by the storage of adipose tissue in non-subcutaneous sites. Magnetic resonance imaging（MRI） has proven to be an effective tool in quantifying ectopic adiposity and provides the opportunity to measure different adipose depots including intermuscular adipose tissue（IMAT） and intramuscular adipose tissue（Intra MAT） or intramuscular fat（IMF）. It is highly important to distinguish and clearly define these compartments, because controversy still exists on how to accurately quantify these adipose depots. Investigators have relied on separating muscle from fat pixels based on their characteristic signal intensities. A common technique is plotting a threshold histogram that clearly separates between muscle and fat peaks. The cut-offs to separate between muscle and fat peaks are still not clearly defined and different cut-offs have been identified. This review will outline and compare the Midpoint and Otsu techniques, two methods used to determine the threshold between muscle and fat pixels on T1 weighted MRI. The process of water/fat segmentation using the Dixon method will also be outlined. We are hopeful that this review will trigger more research towards accurately quantifying ectopic adiposity due to its high relevance to cardiometabolic health after SCI.
文摘BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult because of their nonspecific findings on computed tomography(CT)/magnetic resonance imaging(MRI).CASE SUMMARY An 88-year-old woman was suffering from a progressively enlarging mass in the manubrium.Chest CT images showed an osteolytic and expansile lesion with cortical destruction.Vascular malformation was suspected after CT-guided biopsy.On the dynamic MRI scans,the mass showed a bright signal on the T2-weighted image,peripheral nodular enhancement on the early-phase images and progressive centripetal fill-in on the delayed-phase images.Cavernous hemangioma was suspected preoperatively based on the MRI features and finally confirmed by histopathologic analysis.CONCLUSION This uncommon case demonstrates the possible characteristic features of manubrium cavernous hemangioma on dynamic MRI scans;knowledge about these features may prevent patients from developing catastrophic complications,such as rupture or internal hemorrhage,caused by biopsy or surgery.
基金supported by the National Natural Science Foundation of China (Grant No.81071131)the "215" program (Grant No.2009-2-03)
文摘Objective To investigate the correlation of magnetic resonance imaging （MRI） with histopathologica changes, and to evaluate T2 mapping in assessing muscle trauma in a rabbit model of muscle injury. Methods We divided 35 rabbits into seven groups that each represented a different time point after intramuscular hemorrhage and muscle injury. Hemorrhage was created by injecting autologous blood into the left legs, and muscle injury was created by scalpel incision of the biceps femoris of the right legs. At different time points, the rabbits underwent Tl-weighted imaging and T2-weighted imaging （TzWl and T2Wl） and T2 mapping. T2 relaxation times were measured, and the corresponding samples were evaluated for pathological changes. Results After 2 h, the intramuscular hemorrhage model demonstrated an increased signal intensity on both TlWl and T2Wl. Histological examination showed erythrocytes within the muscle bundle. On days 1 and 3, the MRI signals were decreased, and there were no significant changes after day 7. From 2 h to 3 days, the muscle-injury model showed a high signal on both TzWl and T2Wl. Corresponding pathological changes included rupture and edema of muscle fibers, and inflammation. The abnormal signals were reduced on day 7. After day 14, the T2Wl intensity remained high. TlWl showed no abnormal changes, but some models showed a high signal, representing fresh bleeding and fatty tissue. T2 relaxation times were significantly different between the central and marginal regions, and between the marginal and normal regions. Conclusion MRI clearly demonstrates intramuscular hemorrhage and muscle injury, which correlate well with histopathological changes. Tz mapping is useful in assessing the extent of injury.
文摘Objective To investigate the characteristics of magnetic resonance image (MRI) of spinal cord cavernous hemangioma. Methods Six cases of spinal cord cavernous heman-gioma diagnosed by MRI and confirmed by pathology were reviewed. The characteristics of MRI were analyzed and correlated with pathological characteristics of spinal cord cavernous hemangioma. Results In 4 cases, the tumors were located in thoracic segment of the spinal cord and 2 in cervical cord. All lesions were solitary and the spinal cords were normal or a little thicker. The MRI showed that the images of focus were ball-like popcorn or mulberry with mixed signal,with short T2 signal around the focus. Under microscope, the hemangioma was composed of highly expanded blood sinusoids and its wall was thin and consisted of flat epithelial cells. There were some red blood cells in the cavity of the sinusoid and a little fibrous tissue in the diazoma between blood sinusoids. And also some fresh and old hemorrhages could be seen in the specimen. Conclusion MRI has high sensitivity and specificity in the diagnosis of spinal cavernous hemangioma.
文摘AIMTo elucidate the clinical, magnetic resonance imaging (MRI), pathological features of these lesions and asses the incremental value of diffusion-weighted imaging (DWI) in diagnosing them. METHODSFifteen consecutive patients (11 females and 4 males; mean age 40.93 years; age range 13-63 years) with cavernous sinus hemangiomas (CSH) who underwent examination between November 2008 and May 2016 were included for the analysis. MRI, clinical and surgical findings of each patient was retrospectively reviewed. DWI were also analysed and mean-apparent diffusion coefficient (ADC) value was calculated. Eleven patients underwent surgical removal of the lesion and 2 patients had biopsy only. Diagnosis of CSH was confirmed histologically in 13 patients. RESULTSEleven patients (73%) presented with headaches and 10 (66%) had cranial nerve involvement. Extra cavernous sinus extension was noted in 14 (94%). Surgery was performed in 13 (87%) and post-operative radiation was given to 4 (28%) patients. Thirteen patients remained asymptomatic on follow up. Three conspicuous imaging features were highly suggestive of the diagnosis: Lack of diffusion restriction (100%), homogeneous hyperintensity on T2 weighted image sequences (93.3%) and intense post-contrast enhancement (100%). The mean ADC was 1.82 × 10<sup>-3</sup> ± 0.2186 cm<sup>2</sup>/s. CONCLUSIONT1-weighted hypointensity with homogeneous hyperintensity on T2-weighted sequences, intense enhancement and absence of hemosiderin within the lesion on GRE sequence favour the diagnosis. Facilitated diffusion on DWI differentiates CSH from other solid cavernous sinus lesions and significantly improves the diagnostic accuracy, a critical factor for planning surgery.
基金supported by the Department of Veteran Affairs,Veteran Health Administration,Rehabilitation Research and Development Service(B7867-W)DoD-CDRMP(W81XWH-14-SCIRP-CTA)(to ASG)
文摘Magnetic resonance imaging is considered the ＂gold standard＂ technique for quantifying thigh muscle and fat cross-sectional area. We have developed a semi-automated technique to segment seven thigh compartments in persons with spinal cord injury. Thigh magnetic resonance images from 18 men（18–50 years old） with traumatic motor-complete spinal cord injury were analyzed in a blinded fashion using the threshold technique. The cross-sectional area values acquired by thresholding were compared to the manual tracing technique. The percentage errors for thigh circumference were（threshold： 170.71 ± 38.67; manual： 169.45 ± 38.27 cm2） 0.74%, subcutaneous adipose tissue（threshold： 65.99±30.79; manual： 62.68 ± 30.22） 5.2%, whole muscle（threshold： 98.18 ± 20.19; manual： 98.20 ± 20.08 cm2） 0.13%, femoral bone（threshold： 6.53 ± 1.09; manual： 6.53 ± 1.09 cm2） 0.64%, bone marrow fat（threshold： 3.12 ± 1.12; manual： 3.1 ± 1.11 cm2） 0.36%, knee extensor（threshold： 43.98 ± 7.66; manual： 44.61 ± 7.81 cm2） 1.78% and % intramuscular fat（threshold： 10.45 ± 4.29; manual： 10.92 ± 8.35%） 0.47%. Collectively, these results suggest that the threshold technique provided a robust accuracy in measuring the seven main thigh compartments, while greatly reducing the analysis time.
文摘BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.CASE SUMMARY We describe a male patient,age 18,who presented with a pCH.Computed tomography,magnetic resonance imaging,and ultrasound showed cystic space in the tail of the pancreas.A dark spot sign on the T2 weighted image sequence was observed.Clinically,a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging,and the operative indication was clear.The patient underwent a distal pancreatic tumor resection under laparoscopic control.Immunohistochemical staining for CD31 and CD34 was positive;D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells;and calcium-binding protein was negative.The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage.No complications or recurrences were observed during the follow-up period.CONCLUSION Chronic spontaneous hemorrhage may occur in pCH,which may greatly influence the accuracy of diagnosis using imaging modalities.Surgical resection for uncertain pCH seems reasonable with a good outcome.
文摘This report details the CT and MR imaging findings of a primary orbital Ewing＇s sarcoma case involving the middle cranial fossa in a 13-year old boy. CT showed an ill-circumscribed homogeneous soft-tissue density mass with needle-like bone reaction. On MRI, the mass showed homogeneous iso-intensity on T1WI, heterogeneous hyper- intensity on T2WI, and marked homogeneous enhancement. Meanwhile, the mass was hyper-intense on DWI, and ADC alue was 575x10-6 mm2/s. The mass showed as high rCBV and rCBF, prolonged MTT based on DCS- PWI, and wash-out pattern of TIC derived from the DCE-MRI. Our case suggests that functional MRI modalities, including DWI, DSC-PWI or DCE-MR, could provide additional information for differential diagnoses. Both CT and MRI should be performed and comprehensively analyzed for limiting differential diagnoses, determining lesion extension and facilitating operative approach.
