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1.
We present a case of concurrence of ectopic adrenal cortex with a renal cell carcinoma. The diagnosis of the accessory adrenal
tissue was made by CT-guided biopsy. With this case report, we draw attention to a specific differential diagnostic problem,
policy and to the MR characteristics of ectopic adrenal cortex.
Received: 10 August 1999; Revised: 21 October 1999; Accepted: 27 October 1999 相似文献
2.
Hottya GA Péterfy CG Uffmann M Häckl FO LeHir P Rédei J Gindele AU Dion E Genant HK 《European radiology》2000,10(3):467-475
The purpose of this review is to provide illustrative examples of diseases of the foot and ankle when imaged with a low-field
MR imaging system. A retrospective review of 268 foot and ankle examinations, performed in our institution within the past
3 years with a 0.2-T (Artoscan Esaote, Genoa, Italy) dedicated extremity MR system was done. Additionally, illustrative comparison
with conventional radiography and high-field MR imaging is presented in patients in whom these examinations were also performed.
Although motion artifact limited the value of a few studies, in the majority of examinations low-field MR imaging provided
diagnostic image quality for the full spectrum of disorders affecting the foot and ankle and seemed to be a feasible alternative
to high-field MR imaging in establishing an accurate diagnosis.
Received: 23 November 1998; Revision received: 8 February 1999; Accepted: 4 June 1999 相似文献
3.
Role of radiology in the diagnosis of neurosarcoidosis 总被引:2,自引:0,他引:2
Clinical studies report a rate of 5 % and autopsy results a rate of 25 % of brain involvement in sarcoidosis. The aim of
this study was to evaluate the role of radiology in the diagnosis of patients with neurosarcoidosis. The chest radiographs
and MRI brain scans of 22 patients with sarcoidosis were retrospectively reviewed, along with the information that was provided
in the request form and clinical charts. All patients had neurological signs and symptoms; 21 patients were examined with
contrast enhancement. Facial nerve paralysis was the most common clinical manifestation identified in 10 patients. A wide
spectrum of MR findings was noted: periventricular high-signal lesions on T2-weighted images (46 %); multiple supratentorial
and infratentorial brain lesions (36 %); solitary intra-axial mass (9 %); solitary extra-axial mass (5 %); and leptomeningeal
enhancement (36 %). Neurological signs and symptoms can be significant manifestations of sarcoidosis. Magnetic resonance imaging
shows a wide spectrum of brain abnormalities associated with neurosarcoidosis. The patient's history and chest X-ray are helpful
in arriving at the correct diagnosis, but in selected cases with isolated brain involvement biopsy may still be required.
Received: 21 June 1999; Revised: 27 August 1999; Accepted: 15 October 1999 相似文献
4.
We report a 48-year-old woman with a left posterior temporal extra-axial mass that had the imaging characteristics of a meningioma
on preoperative CT, MRI and angiography. However, a biopsy diagnosis of sarcoidosis was made. This case illustrates that dural-based
sarcoid masses can be very vascular and radiographically indistinguishable from meningiomas. Characteristic imaging features
of extra- and intra-axial sarcoid lesions are discussed.
Received: 4 March 1999/Accepted: 11 June 1999 相似文献
5.
A 21-year-old woman with tuberous sclerosis presented with abdominal distension and flank pain. Imaging studies, including
CT and MR imaging, revealed bilateral renal mass lesions, containing fat and suggesting the diagnosis of tuberous sclerosis.
However the imaging characteristics of one of these lesions differed from the others with no radiologically detectable fat
tissue in this solid lesion suggesting renal cell carcinoma. Histopathological examination of this lesion in the left kidney
revealed an angiomyolipoma with minimal fat tissue. The radiological diagnosis of angiomyolipomas with minimal fat tissue
remains difficult and the differential diagnosis is discussed.
Received: 5 October 1998; Revised: 22 December 1998; Accepted: 7 June 1999 相似文献
6.
MR imaging of lumbar facet joint synovial cysts 总被引:5,自引:0,他引:5
The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial
cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence
of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated
finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience
of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes
for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation
of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used
to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive
review of the existing literature is presented.
Received: 22 September 1998; Revised: 29 June 1999; Accepted: 30 June 1999 相似文献
7.
To prove the usefulness of a simple laser marker system (LMS) in target definition as well as examination procedure for CT-guided
interventions, 130 cases of diagnostic biopsies and lumbal sympathectomies were compared. In 75 cases LMS and in 55 cases
a simple crossgrid was used. Taking advantage of the LMS, the parameters of intervention (cutaneous location, length, and
angle) can be planned, exactly demonstrated, and it is possible to check the needle position during the whole procedure. Thus,
the number of necessary control scans decreased to 30 %, and corrections of needle location were reduced to approximately
30 %. Moreover, the average target deviation of the needle decreased below 5 mm in 50 % of cases, and the duration of interventional
procedure was reduced considerably. It can be concluded that LMSs are recommended in CT-guided interventions for quality assurance,
dose reduction, and improvement of handling. It will be especially advantageous in cases of small target volume, oblique needle
path, and tilted gantry.
Received: 1 July 1999; Revised: 19 October 1999; Accepted: 25 October 1999 相似文献
8.
Image-guided automated needle biopsy of 106 thoracic lesions: a retrospective review of diagnostic accuracy and complication rates 总被引:4,自引:1,他引:3
We reviewed the diagnostic accuracy and complication rates of transthoracic needle biopsy (TNB) with an automated 18-gauge
core biopsy needle and gun, using either fluoroscopic or CT guidance. One hundred six lesions were biopsied in 103 patients
between 1992 and 1998. Hard-copy images, imaging reports, pathology reports and clinical notes were reviewed. In 3 patients
it was not possible to establish the lesion as either malignant or benign from the available follow-up, so these were removed
from the analysis of diagnostic accuracy. Adequate samples for histological diagnosis were obtained in 104 of 106 (98 %) biopsies.
There were 75 of 85 (88 %) true-positive core biopsies for malignant lesions and a specific cell type was identified in 70
of 85 (82 %) cases. A specific histological diagnosis was obtained in 12 of 18 (66 %) biopsies. There was a 19 % rate of pneumothorax
with only 2.4 % requiring drainage. Minor haemoptysis occurred in 3.8 % of procedures. The TNB technique with an automated
core biopsy needle provides a high level of diagnostic accuracy, effectively distinguishes cell type in malignancy and provides
a definite diagnosis in benign disease more frequently than fine needle aspiration (FNA). There is no increased complication
rate compared with FNA.
Received: 26 January 1999; Revision received: 1 July 1999; Accepted: 2 July 1999 相似文献
9.
Castleman's disease, a lymphoproliferative disease of unknown etiology, rarely causes a neck mass and may mimic granulomatous,
inflammatory and metastatic lymph nodes, or lymphoma with its nonspecific imaging findings. Definitive diagnosis and treatment
is possible with complete surgical resection. Imaging findings of a case with Castleman's disease detected during multinodular
goiter surgery and later verified through excisional biopsy are presented. This report, as far as we know, is the first evaluation
of the disease with sonography, Doppler sonography, CT, MR imaging, and digital subtraction angiography (DSA) findings.
Received: 31 August 1999; Revised: 30 November 1999; Accepted: 23 December 1999 相似文献
10.
A patient with neurofibromatosis type 1 was found to have an enhancing mass in the hypothalamus and in the anterior optic
pathway. A 3-month MR study showed a reduction in the size and enhancement of the mass. At a 9-month MR follow-up the mass
disappeared and ceased to enhance. This report shows the unusual behaviour of a hypothalamic/chiasmatic mass confirming that
in such asymptomatic cases the conservative management can be considered the treatment of choice.
Received: 27 July 1999; Revised: 20 October 1999; Accepted: 19 November 1999 相似文献
11.
The purpose of this study was to determine the value of MR imaging for the demonstration of masses in the tongue and floor
of the mouth. Nine patients were prospectively examined with MR imaging after physical examination. Imaging protocol included
T2 and contrast-enhanced and non-contrast-enhanced T1-weighted turbo spin-echo sequences, and the findings were compared with
surgical and histopathological results. Histopathological examination revealed four squamous cell carcinomas, one adenoid
cystic carcinoma, two tongue abscesses, and one chronic inflammatory change. The other case was diagnosed as hemangioma depending
on clinical and imaging findings alone. In cases with squamous cell carcinoma, staging was done on the basis of MR imaging
findings, and was found to be T4 in two cases, T3 in one case, and T2 in another. The primary role of MR imaging of the tongue
and oropharynx is not to make a tissue diagnosis. Multiple deep biopsies are mandatory for the differentiation of other inflammatory
and neoplastic lesions. Magnetic resonance imaging produces coronal and sagittal image planes to assess the volume and spread
of the lesion and helps the surgeon determine the direction in which the biopsy should be performed.
Received: 4 October 1999; Revised: 31 January 2000; Accepted: 6 April 2000 相似文献
12.
Objective: Neck masses are common in children. Although there is a low incidence of therapeutically significant pathology,
biopsy is occasionally required for evaluation. Open biopsy or fine needle aspiration may be used to obtain tissue. Open biopsy
provides material suitable for histological analysis but requires general anaesthesia. Cytological material obtained by fine
needle aspiration is often inconclusive. A core of histological material may also be obtained by percutaneous cutting-needle
biopsy, a recognised procedure at other anatomical sites, usually performed under local anaesthesia.? Materials and Methods:
There are few accounts using cutting needles in adult neck masses and no previous paediatric series. We present our experience
of ultrasound-guided core biopsies of neck masses in 15 children ranging in age from three months to 16 years.? Results: Thirteen
biopsies were easily performed without sedation as an outpatient procedure under topical and injected local anaesthetic. In
all fifteen cases the procedure was well tolerated and a tissue successfully obtained.? Conclusion: Ultrasound guided cutting
needle biopsies of head and neck masses of children can be performed under local anaesthesia in the majority of cases.
Received: 2 October 1998; Revision received: 6 July 1999; Accepted: 6 July 1999 相似文献
13.
Two-dimensional thick-slice MR digital subtraction angiography for assessment of cerebrovascular occlusive diseases 总被引:2,自引:0,他引:2
Aoki S Yoshikawa T Hori M Ishigame K Nambu A Kumagai H Araki T 《European radiology》2000,10(12):1858-1864
Although spatial resolution of current MR angiography is excellent, temporal resolution has remained unsatisfactory. We evaluated
clinical applicability of 2D thick-slice, contrast-enhanced subtraction MR angiography (2D-MR digital subtraction angiography)
with sub-second temporal resolution in cerebrovascular occlusive diseases. Twenty-five patients with cerebrovascular occlusive
diseases (8 moyamoya diseases, 10 proximal internal carotid occlusions, and 2 sinus thromboses ) were studied with a 1.5-T
MR unit. The MR digital subtraction angiography (MRDSA) was performed per 0.97 s continuously just after a bolus injection
of 15 ml of gadolinium chelates up to 40 s in sagittal (covering hemisphere) or coronal planes. Subtraction images were generated
at a workstation. We evaluated imaging quality and hemodynamic information of MRDSA in comparison with those of routine MR
imaging, non-contrast MR angiography, and X-ray intra-arterial DSA. Major cerebral arteries, all of the venous sinuses, and
most tributaries were clearly visualized with 2D MRDSA. Also, pure arterial phases were obtained in all cases. The MRDSA technique
demonstrated prolonged circulation in sinus thromboses, distal patent lumen of proximal occlusion, and some collateral circulation.
Such hemodynamic information was comparable to that of intra-arterial DSA. Two-dimensional thick-slice MRDSA with high temporal
resolution has a unique ability to demonstrate cerebral hemodynamics equivalent to that of intra-arterial DSA and may play
an important role for evaluation of cerebrovascular occlusive diseases.
Received: 16 November 1999; Revised: 27 June 2000; Accepted: 29 June 2000 相似文献
14.
The role of MR imaging in invasive cervical carcinoma 总被引:6,自引:0,他引:6
In this article the role of MR imaging in the management of cervical cancer is reviewed and illustrated. The appearance of
the normal uterine cervix and of cervical carcinoma is shown. Important factors for optimal MR imaging of cervical carcinoma
are reviewed. The value of MR imaging in the staging of cervical carcinoma is illustrated by showing parametrial invasion
and lymph node involvement. Finally, the value of MR imaging staging is compared with clinical staging, CT staging, and surgical
findings. The role of new imaging techniques, such as fast dynamic enhanced MR imaging, is described.
Received: 12 April 1999; Revised: 13 July 1999; Accepted: 14 July 1999 相似文献
15.
Villeirs G Van Damme S Heydanus R Serreyn R Kunnen M Mortier M 《European radiology》2000,10(3):527-530
Fat necrosis of the breast is a well-known complication following trauma, surgery, or radiotherapy. The present paper describes
a rare case of fat necrosis after heparin-induced thrombocytopenia. The mammographic, sonographic, and MR evaluation and pathologic
correlation after a 1-year follow-up period are reported.
Received: 21 January 1999; Revision received: 3 June 1999; Accepted: 5 July 1999 相似文献
16.
A rare case of primary seminoma in the retroperitoneum is described. Ultrasound detected a huge hypoechoic mass and correlative
computed tomography showed a midline, homogeneous, lobulated mass in a man who presented for anuria.
Received: 1 April 1999; Revised: 28 June 1999; Accepted: 27 July 1999 相似文献
17.
A 53-year-old-man underwent US-guided percutaneous thermal ablation with a cooled-tip needle of three liver metastases from
gastric cancer. Six days later, the patient was re-admitted for melena, scleral jaundice, and anemia. Abdominal US disclosed
echogenic material in the gallbladder lumen (hemobilia) and a focal lesion with mixed echotexture in segment III (hepatic
hematoma). On day 5 portal cavernomatosis was diagnosed at US and confirmed by color Doppler and a helical CT exam. The case
described emphasizes that radio-frequency interstitial hyperthermia may cause not only traumatic injury of the liver parenchyma
but also thermally mediated damage of vascular structures.
Received: 14 January 1999; Revised: 21 May 1999; Accepted: 9 June 1999 相似文献
18.
The aim of this study was to evaluate the efficacy of contrast-medium (CM)-enhanced MR imaging of operated pituitary macroadenomas
with reduced dose of gadopentetate dimeglumine. In a prospective study 18 patients were examined with coronal T1-weighted
MR imaging prior to and following intravenous CM injections. Two sets of contrast-enhanced coronal images were obtained in
each patient; the first set after 50 % of the recommended dose of 0.1 mmol/kg body weight (b. w.) had been administered, and
the second set immediately after additional CM had been given to make up a total dose of 0.1 mmol/kg b. w. The images were
evaluated by three neuroradiologists. The SIPAP classification system was used to evaluate tumour extension, whereas tumour
margin conspicuity was scored using an arbitrary scale of 1–5 (1 = indistinct, 5 = well defined). Signal intensity measurements
obtained from the most enhancing part of the adenomas demonstrated increased enhancement with increased CM dose. Tumour delineation
scores were significantly better on the reduced- and full-dose images than on pre-CM injection images, but, with one exception,
tumour extension was identified as the same on all imaging sequences. Postoperative MR imaging of large macroadenoma residues
can routinely be performed without intravenous CM. When CM is indicated a reduced dose of gadopentetate dimeglumine should
provide sufficient diagnostic information.
Received: 29 June 1999; Revised: 2 December 1999; Accepted: 14 March 2000 相似文献
19.
Mortelé B Lemmerling M Mortelé K Verstraete K Defreyne L Kunnen M Vandekerckhove T 《European radiology》2000,10(6):967-969
A case of cervical chordoma in a 36-year-old white man with hypoesthesia in the neck and right shoulder, neck pain, and restricted
neck mobility is presented. Plain radiographs of the cervical spine showed radiolucency of the body of C2 on the right side
and enlargement of the right intervertebral foramen at C2–C3 level. Tumor encasement of the vertebral artery was demonstrated
by MR imaging and confirmed by conventional arteriography. This proved to be particularly important for preoperative assessment.
Received: 8 February 1999; Revised: 26 October 1999; Accepted: 18 November 1999 相似文献
20.
MR imaging findings in granular cell tumor of the neurohypophysis: a difficult preoperative diagnosis 总被引:1,自引:0,他引:1
Granular cell tumor is a rare neoplasm arising within the neurohypophysis. We describe the MR imaging findings in two symptomatic
patients. In one patient with history of panhypopituitarism, MR images showed a large sellar and suprasellar mass. The other
patient presented with acute loss of vision in her left eye, and MR images showed a suprasellar mass with compression of the
optic chiasm.
Received: 18 November 1999; Revised: 5 April 2000; Accepted: 10 April 2000 相似文献