MR findings of sclerosing cervicitis.

The MR appearance of sclerosing cervicitis in the case presented is that of a fusiform mass arising in the lateral neck with vascular encasement. The mass is mildly hyperintense to skeletal muscle on the T1- and T2-weighted images.     

Subacute sclerosing panencephalitis findings at MR imaging, diffusion MR imaging, and proton MR spectroscopy

A case of subacute sclerosing panencephalitis in a 2-year-old boy is reported. In addition to asymmetric lesions in the parietotemporal lobes, right thalamus, and globus pallidus, symmetric patterns were notable in the brain stem, middle cerebellar pedincles, and dentate nuclei. Proton MR spectroscopy revealed markedly decreased N-acetylaspartate peaks and normal choline and myo-inositol levels in the lesions. Diffusion MR imaging revealed an elevated diffusion pattern manifested with high apparent diffusion coefficient values (1.14-1.60 x 10(-3) mm(2)/s) compared with those in normal-appearing brain tissue (0.65-1.00 x 10(-3) mm(2)/s) and subtle high signal intensity characteristics on diffusion-weighted images obtained at b = 1000 s/mm(2).     

MR findings in a rare case of sclerosing mesenteritis of the mesocolon

Sclerosing mesenteritis is a rare, usually benign disorder of the mesentery. Depending on the predominant tissue component (inflammation, fat, or fibrosis), it is known as mesenteric panniculitis or retractile mesenteritis. We present a rare case of retractile mesenteritis of the mesocolon as a cause of severe abdominal pain. US, CT, and MRI were the imaging modalities used. We emphasize the MR finding of a fibrous capsula in retractile mesenteritis, as this is to our knowledge the first study to describe this entity. This finding may be valuable for establishing a diagnosis of sclerosing mesenteritis, as well as for differentiating this disease from other mesenteric diseases.     

Autoimmune pancreatitis associated with primary sclerosing cholangitis: MR imaging findings

Autoimmune pancreatitis is a relatively rare type of chronic pancreatitis that may be associated with other autoimmune disorders. The imaging features of this entity may be misleading and suggest the presence of a malignant tumour. We present a case in which MR imaging allowed us to diagnose autoimmune pancreatitis associated with primary sclerosing cholangitis, which is another autoimmune-related disease. Typical MR characteristics of autoimmune pancreatitis include focal or diffuse enlargement of the pancreas, the absence of parenchymal atrophy and significant dilation proximal to the site of stenosis, the absence of peripancreatic spread, the clear demarcation of the lesion and the presence of a peripancreatic rim.     

Primary sclerosing cholangitis: MR imaging findings with pathologic correlation.

OBJECTIVE: The purpose of this study was to evaluate MR imaging findings of primary sclerosing cholangitis, to compare them with histopathologic findings, and to determine if these findings help differentiate primary sclerosing cholangitis from other disorders that result in end-stage liver disease. MATERIALS AND METHODS: MR imaging was performed in 40 patients (27 men, 13 women; age range, 13-72 years; mean, 47 years) with primary sclerosing cholangitis over a 9-year period. In 16 patients who underwent orthotopic hepatic transplantation and in seven patients who underwent needle biopsy, correlation was made between MR imaging and pathologic findings. RESULTS: Focal signal changes in the liver parenchyma were seen on T2-weighted images as peripheral wedge-shaped zones of increased signal intensity in 29 patients (72%), as a reticular pattern in 15 patients (38%), and as periportal edema in 16 patients (40%). Lobar atrophy involved the right lobe in three patients (8%) and the left lobe in 11 patients (28%); hypertrophy of the caudate lobe was seen in nine patients (23%). Features of portal hypertension were seen in 14 patients (35%). Histologic assessment showed zones of segmental atrophy and scarring on the periphery of the liver. CONCLUSION: Peripheral wedge-shaped areas of high T2 signal intensity and dilatation of bile ducts are characteristic MR features of primary sclerosing cholangitis. Pathologic correlation suggests that these features may be related to underlying perfusion changes and bile duct inflammation in patients with primary sclerosing cholangitis.     

Ultrasound findings in injuries of dorsal extensor hood: Correlation with MR and follow-up findings

Objective

The aim of this study was to use ultrasound to examine the dorsal hood in nine patients with a clinical suspicion of dorsal hood injuries.

Material and methods

Clinical and imaging files from interesting case logbooks of nine patients were reviewed. Ultrasound was performed by one of the three radiologists experienced in musculoskeletal ultrasound. The examinations were also performed in flexion and in flexion with resistance. MR correlation was obtained in six patients. One patient underwent surgery. To obtain anatomical correlation of the normal dorsal hood 2 embalmed hand specimens were dissected.

Results

The sagittal bands were easily depicted in the transverse plane on ultrasound images and presented as hypoechoic bands on both sides of the extensor communis tendons. Injuries of the sagittal bands were seen on ultrasound as hypoechoic thickening of the sagittal bands at the side of the extensor tendons. The normal shape of the sagittal bands was also no longer recognizable. Subluxations or dislocations of the extensor tendons were also seen. When the injuries were located in the fibrous slips between the extensor indicis and the extensor communis of the second finger, subluxations with an increased distance between these 2 tendons were seen, especially in flexion, or in flexion with resistance.

Conclusion

Ultrasound is a valuable tool for the assessment of the injuries of the dorsal hood and is an easily available method for the diagnosis of the fine soft tissue components of the dorsal hood region.     

Ultrasound and MR findings in tumor and tumor-like lesions of the fingers

Finger lesions are a frequent problem because of their functional significance and their small size. Because of this, the radiologist has an important role to play in the correct presurgical diagnosis. The aim of this article is to describe the anatomy and the characteristic US and MR findings of the most common tumor and tumor-like lesions of the fingers, and to discuss the differential diagnosis in cases of unspecific or non-diagnostic findings. We present representative cases selected from 62 patients evaluated at our institution, with pathologic correlation. Electronic Publication     

Pancreatic changes in patients with primary sclerosing cholangitis: MR cholangiopancreatography and MRI findings

Purpose

To evaluate the possible pancreatic changes and their frequencies in patients with primary sclerosing cholangitis (PSC) on MR cholangiopancreatography (MRCP), and conventional abdominal MRI.

Materials and Methods

Patient group consisted of 29 PSC (13 male, 16 female) cases, whereas cohort 1 consisted of 12 female patients with primary biliary cirrhosis, and cohort 2 consisted of 17 patients (6 male, 11 female) with non-immune chronic liver disease. Two radiologists retrospectively evaluated the MR examinations paying special attention to the pancreatic size (atrophy or enlargement), T1- and T2-signal intensity of the pancreas, focal pancreatic lesion, capsule-like rim, peripancreatic edema or fluid, fascial thickening, and pancreatic ducts (dilatation or narrowing). The results are expressed as percentages. Three groups were compared using Pearson chi-square test for each feature. However, only p-value for “dilatation of the pancreatic duct” was determined, whereas p-value could not be calculated because of the insufficient number of subjects/sequences for the other features.

Results

Twelve PSC patients (41.3%) had pancreatic abnormalities. The most common pancreatic changes in PSC patients were decreased T1-signal intensity (44%) and dilatation of the pancreatic duct (13.8%), respectively. Increased T2-signal intensity was also shown in 2 PSC patients (6.9%).

Conclusion

Even PSC patients without any sign of pancreatitis, can show MR changes in the pancreatic parenchyma or the pancreatic duct. The etiologies of these changes, and whether they are unique to PSC, are still controversial. Histopathological studies bringing light to these pancreatic changes are needed.     

MR and MRCP in the evaluation of primary sclerosing cholangitis: current applications and imaging findings

Primary sclerosing cholangitis is a progressive cholestatic disease of unknown etiology leading to cirrhosis and liver failure. Several imaging modalities have been used to study this disease, including ultrasonography, computed tomography and hepatobiliary scintigraphy, but accurate diagnosis was found to be best made with endoscopic retrograde cholangiopancreatography or direct cholangiography. However, these 2 methods are invasive and may produce serious complications. Magnetic resonance cholangiopancreatography is a noninvasive imaging technique that has become very useful for diagnosing primary sclerosing cholangitis. Contrast enhanced magnetic resonance imaging provides pertinent information of extraductal abnormalities in addition to biliary ductal changes.     

Subcutaneous epidermal inclusion cysts: Ultrasound (US) and MR imaging findings

Objective  

To describe the characteristic US and MR findings of subcutaneous epidermal inclusion cysts.     

Computed tomography and magnetic resonance imaging findings of soft tissue perineurioma

Soft tissue perineurioma is an uncommon benign peripheral nerve sheath tumor, although it is the most common subtype of perineuriomas. We present a case of soft tissue perineurioma in the left groin of a 48-year-old man. Precontrast computed tomography showed a homogeneous hypodense mass that showed faint enhancement. The mass appeared with hypointensity on T1-weighted magnetic resonance (MR) images and heterogeneous hyperintensity on T2-weighted MR images. Slight contrast uptake was noted on enhanced T1-weighted MR images with fat suppression. Although these CT and MR imaging findings were nonspecific, the overall imaging features are similar to those of schwannomas.     

左髂骨硬化性上皮样纤维肉瘤一例

患者男,20岁.腰部、臀区疼痛1年余.2003年全身多发性骨折,2006年外院MRI 2次诊断为强直性脊柱炎、椎间盘突出;2007年给予激素治疗3个月.体检:肥胖体型,体力差,身高缩短(从175 cm缩至165 cm);实验室检查:碱性磷酸酶8.4 μmol·s-1/L.外院检查:甲状旁腺素106 ng/L(正常值:15～88 ng/L);甲状腺CT扫描末见异常.     

硬化性肠系膜炎的CT诊断

目的：探讨CT对硬化性肠系膜炎的诊断价值.方法：回顾性分析11例经病理证实的硬化性肠系膜炎的CT表现.结果：11例硬化性肠系膜炎均起自系膜根部.围绕系膜血管,肠系膜密度增高,平扫CT值为-45～-35 HU,明显高于腹膜后正常脂肪密度（-120～-100 HU）,差异有统计学意义（P〈0.01）.增强扫描动脉期、静脉期示肠系膜无明显强化.9例肠系膜周围有软组织肿块形成;8例病变内可见小结节、有明显强化;6例肠系膜血管周围有脂肪存在,形成脂肪环征（6/11）,5例无此征象;肠系膜血管被软组织包绕;8例可见到假肿瘤包膜.结论：CT检查是诊断硬化性肠系膜炎非常有价值的影像手段.     

MR findings in mannosidosis

Summary MR findings are reported in three patients presenting mannosidosis. Among a family of 8 children, 4 presented typical clinical and biological abnormalities related to mannosidosis. Brain MR examinations including sagittal T1 and axial T2 sections were obtained in three patients of this family (one 25-year-old male, one 34-year-old female, and one 35-year-old female). MR scans demonstrate seven types of modifications: (1) brachycephaly, (2) thick calvaria, (3) verticalization of the chiasmatic sulcus, (4) poor pneumatization of the sphenoid body, (5) partial empty sella turcica (6) cerebellar atrophy, and (7) white matter signal modifications. High signal abnormalities involving the parieto-occipital white matter are identified on axial T2-weighted scans in the three patients and are probably related to demyelination and associated gliosis as described previously by several authors on specimens.     

MR findings in leukodystrophy

Summary Up to 5 years ago, the radiological diagnosis of leukodystrophy was based on computed tomography (CT). More recently, magnetic resonance imaging (MRI) has been used to study pathology of the white matter with great success. The abnormalities in eight patients with different types of leukodystrophy are described, using high-field MRI. CT and MRI show comparable sensitivity in detecting the pathological changes of leukodystrophy. MRI seems to be superior in visualizing the extent of the lesions, their precise anatomical location and any involvement of the brain stem and cerebellum. Differential diagnosis among the three types of leukodystrophy by MRI is difficult but may be attempted by some features. Specific diagnosis can be achieved only by laboratory examination or histology. The role of MRI should be to suggest the proper biochemical test at an earlier stage.     

MR imaging vs CT in subacute sclerosing panencephalitis

The MR findings in three patients with subacute sclerosing panencephalitis were reviewed and compared with CT findings in the same patients. Long-T2 lesions were demonstrated in each case, although their distribution varied with the clinical stage of the disease. MR, especially T2-weighted imaging, appears to be of great utility in the assessment of subacute sclerosing panencephalitis.     

肺硬化性血管瘤的CT表现(附10例报告)

目的：探讨肺硬化性血管瘤（PSH）的CT表现,旨在提高对该病的认识及诊断水平。方法：回顾性分析经手术病理证实的t0例PSH患者,其中男1例,女9例,年龄47～68岁,平均57．6岁。10例均行胸部CT检查,其中1例仅行CT平扫,9例行CT平扫及增强扫描。结果：病灶部位：右肺3例,其中上叶1例,中叶2例;左肺7例,其中上叶4例,下叶3例。病灶形态：10例均为圆形、类圆形肺内肿块或结节,境界清晰．分叶不明显（4例有浅分叶）、无毛刺、胸膜牵拉凹陷、卫星病灶及血管集束征等征象。病灶大小：均为单发,最大径1．7～5．1cm,其中〈3cm者6例。病灶密度：CT平扫4例密度较均匀,6例见斑片状稍低密度区,4例见点状或粗大点片状钙化;CT增强均匀强化3例,不均匀强化6例,9例中7僻呈延迟强化。特征性的征象：空气新月征1例、贴边血管征10例、尾征3例、晕征7例。结论：空气新月征、贴边血管征、尾征、晕征等CT征象具有一定的特征性。有助于PsH的术前诊断。