CT and MR imaging findings of xanthogranulomatous cholecystitis: correlation with pathologic findings

The aim of this study was to evaluate CT and MRI findings in xanthogranulomatous cholecystitis (XGC) and to correlate the imaging findings with various pathologic parameters. The study included 13 patients with histopathologically confirmed XGC. The CT (n=13) and MRI (n=5) obtained in these patients were evaluated retrospectively. On CT, low-attenuation areas in the wall of XGC correlated with foam and inflammatory cells or necrosis and/or abscess in XGC. Areas of iso- to slightly high signal intensity on T2-weighted images, showing slight enhancement at early phase and strong enhancement at last phase on dynamic study, corresponded with areas of abundant xanthogranulomas. Areas with very high signal intensity on T2-weighted images without enhancement corresponded with necrosis and/or abscesses. Luminal surface enhancement (LSE) of gallbladder wall represented preservation of the epithelial layer. The early-enhanced areas of the liver bed on dynamic CT and MR images corresponded with accumulation of inflammatory cells and abundant fibrosis. Our results indicate that CT and MRI findings correlate well with the histopathologic findings of XGC.     

Perineal angiomyofibroblastoma: CT and MR findings with pathologic correlation.

We present a case of a perineal angiomyofibroblastoma (AMFB) arising in the right perirectal fossa in a middle-aged woman, documented with CT and MRI. Compounding the rarity of the entity, this case is unique as it is the first radiological report illustrating the CT and MR features of this recently clinicopathologically described neoplasm.     

Brachial plexus: correlation of MR imaging with CT and pathologic findings

Thirty-two patients with symptoms referable to the brachial plexus were evaluated with magnetic resonance (MR) imaging. Sixteen patients had undergone concurrent computed tomography (CT). MR imaging demonstrated normal findings in 16, 12 neoplasms, three cases of trauma, and one case of possible neural edema. Of the 16 patients with normal findings on MR images, eight had CT scans that were also normal. In one patient, MR images showed that the "mass" seen on CT was actually a tortuous blood vessel. In six of the 12 cases of neoplasm in which CT scans were available, MR imaging revealed more extensive disease. In the other six cases of tumor, MR imaging provided sufficient clinical information to obviate the need for CT or any other imaging modality. MR imaging provided definitive diagnoses in the three cases of trauma without further imaging. In one patient with paresthesia, MR imaging showed high signal intensity of the nerves on T2-weighted images, which was compatible with neural edema. A concurrent CT scan was normal.     

Cortical atrophy in Parkinson disease: correlation between clinical and CT findings with special emphasis on prefrontal atrophy

Thirty-seven patients with Parkinson disease were evaluated clinically and with computed tomography in order to determine the incidence of prefrontal atrophy. An age-matched healthy control group was also scanned. The computed tomographic criteria used were the width of cortical sulci and ventriculocerebral indices. Parkinsonian patients with frontal cortical atrophy represent only one patient out of three. They are much older than parkinsonian patients with normal computed tomographic scans, and the onset of their illness occurs later. No significant difference was found according to gender, parkinsonian clinical triad, psychomotor study, or mean duration of illness and/or dopatherapy to the time of computed tomography. This work seems to separate two Parkinson diseases: one beginning before 65 years and damaging the nigrostriate system, and another beginning after 65 years and damaging both the nigrostriate system and the cortex, particularly the frontal cortex.     

Dermoids of the eustachian tube: CT and MR findings with histologic correlation.

Two patients with congenital dermoids of the eustachian tube presented with recurrent otitis media and chronic otorrhea resistant to antimicrobial therapy. CT demonstrated fat density, homogeneous lesions, filling and expanding the eustachian tube. On MR, signal from the lesions was consistent with fat, and the relationship with the internal carotid artery was better delineated than by CT. Microscopically, the masses consisted of a conglomeration of ectodermal and mesodermal elements.     

Infarcted regenerative nodules in cirrhosis: CT and MR imaging findings with pathologic correlation

OBJECTIVE. The purpose of this article is to present the imaging findings and correlative pathologic findings of infarcted regenerative nodules in the cirrhotic liver. CONCLUSION. Infarcted regenerative nodules exhibit a spectrum of imaging appearances in the cirrhotic liver and can resemble hypovascular hepatocellular carcinoma or other neoplasms on CT and MR imaging. Although uncommon, this abnormality must be included in the differential diagnosis of focal liver lesions in patients with cirrhosis, particularly in patients with a history of substantial gastrointestinal bleeding. Serial imaging may help differentiate these lesions from malignant tumors.     

MR imaging of the corpus callosum: normal and pathologic findings and correlation with CT

The MR appearance of the corpus callosum was investigated in 80 normal volunteers. Normal variations in appearance were recorded with regard to age, gender, and handedness. The MR studies of 47 patients with a wide spectrum of callosal disease were also reviewed. Abnormalities included trauma, neoplasia, congenital abnormalities, vascular lesions, and demyelinating and inflammatory conditions. The information provided by MR was compared with that obtained from other radiographic examinations, particularly CT and angiography. In all cases MR provided as much, and frequently more, information than was obtained by other imaging techniques. We believe that MR should be the primary imaging technique for the evaluation of corpus callosal disease.     

Intraarticular osteoid osteoma: sonographic findings in three patients with radiographic, CT, and MR imaging correlation.

OBJECTIVE: Intraarticular osteoid osteoma often has subtle radiographic findings and nonspecific clinical features; further diagnostic workup of unexplained joint pain may involve musculoskeletal sonography. We describe the sonographic features of intraarticular osteoid osteoma in three consecutive patients with radiographic, CT, and MR imaging correlation. CONCLUSION: The sonographic findings of painful cortical irregularity and focal synovitis should raise the possibility of intraarticular osteoid osteoma, prompting the search for characteristic findings on correlative imaging studies.     

Elastofibroma: CT and MR findings

Two cases of elastofibroma of the chest wall are reported. Each patient was investigated with CT and, in 1 case, MR imaging was also performed. Elastofibroma appears like a mass in the subscapular region and often presents problems of differential diagnosis. The contribution of MR imaging is reported.     

Telangiectatic focal nodular hyperplasia: US,CT, and MR imaging findings with histopathologic correlation in 13 cases

PURPOSE: To review the ultrasonographic (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in 13 patients with telangiectatic focal nodular hyperplasia (FNH) and to compare imaging features with histopathologic results from resected specimens. MATERIALS AND METHODS: US, helical multiphasic CT, and MR images in 13 patients with pathologically proven telangiectatic FNH were reviewed retrospectively. Two abdominal radiologists evaluated lesions for number, size, heterogeneity, surface characteristics, presence of a central scar, presence of a pseudocapsule, US appearance, attenuation at CT, signal intensity at MR imaging, and presence of associated lesions. Imaging and pathologic findings were compared. RESULTS: Sixty-one lesions (5-140 mm in diameter) were seen at imaging. Lesions were multiple in eight of 13 (62%) patients. Imaging characteristics were heterogeneity in 26 of 61 lesions (43%), well-defined margins in 43 of 61 (70%), lack of a central scar in 56 of 61 (92%), presence of a pseudocapsule in three of 61 (5%), hyperintensity on T1-weighted MR images in 17 of 32 (53%), strong hyperintensity on T2-weighted MR images in 24 of 54 (44%), and persistent enhancement on delayed contrast material-enhanced CT or T1-weighted MR images in 23 of 38 (61%). No specific US pattern was noted. Two patients had additional lesions: One had classic FNH, and the other had a cavernous hemangioma. Hyperintensity on T1-weighted MR images was due to sinusoidal dilatation. Hyperintensity on T2-weighted MR images correlated well with the presence of inflammation. CONCLUSION: Telangiectatic FNH differs from typical FNH at imaging: Atypical FNH features often observed with telangiectatic FNH are lack of a central scar, lesion heterogeneity, hyperintensity on T1-weighted MR images, strong hyperintensity on T2-weighted MR images, and persistent contrast enhancement on delayed contrast-enhanced CT or T1-weighted MR images.     

Mediastinal imaging in myasthenia gravis: correlation of chest radiography, CT, MR, and surgical findings

Chest radiographs and CT and MR images of the mediastinum were studied in 16 patients with myasthenia gravis who underwent thymectomy (two with a final diagnosis of thymoma, seven with hyperplasia, and seven with a normal thymus). The anterior mediastinum was analyzed on imaging studies for thymic morphology and the presence of mass lesions, and the findings were then correlated with the results of surgical resection and pathologic examination. The chest radiographs detected an anterior mediastinal mass in two patients consistent with thymoma on subsequent CT and MR examinations. Chest radiographs in the other 14 patients were normal. In seven patients with a final diagnosis of thymic hyperplasia, both CT and MR demonstrated normal thymic morphology in five, an enlarged thymus in one, and a small thymus in one that was easily identified on CT but was difficult to define on MR. In the other seven patients with a normal thymus on pathologic examination, both CT and MR showed an involuted thymus in four, a normal thymus in two, and an enlarged thymus in one. While both CT and MR were superior to chest radiography for studying the thymus, CT provided better spatial resolution and thymic definition in a much shorter scanning time than MR did. This study suggests that CT should remain the procedure of choice when further imaging of the thymus is needed after the initial chest radiographs in patients with myasthenia gravis.     

Biparietal thinning: correlation with CT findings

A typical case of thinning of the parietal bones in an elderly female patient is reported. Frontal CT sections adequately demonstrate the disappearance of the diplo? and the flattening of the outer table.     

Cryptococcosis associated with sarcoidosis: CT and MR findings

Two cases of cryptococcal abscesses were identified in patients with sarcoidosis. The diagnostic imaging tests were not specific for cryptococcus prior to needle aspiration of the abscesses, but they did enable successful biopsy for diagnosis and treatment.     

Aortitis with antiphospholipid antibodies: CT and MR findings

Two cases of aortitis associated with the presence of antiphospholipid antibodies (APAs) are reported. Only CT and MR imaging were able to show these unusual form of aortitis preferentially affecting the outer aortic tunics. We conclude that aortitis could be a new manifestation of primary antiphospholipid syndrome (APS) and the initial pathological process before the development of aortic thrombosis, reported as a classical complication of APS. Received 11 August 1997; Revision received 8 January 1998; Accepted 4 February 1998     

Intraductal papillary mucinous tumors of the pancreas: spectrum of CT and MR findings with pathologic correlation

The reports of intraductal papillary mucinous tumors (IPMT) of the pancreas are increasingly more frequent in the literature. The diagnosis by means of cross-sectional imaging of these tumors is not easy, especially in the early stages, when they can mimic an inflammatory disease of the pancreas. Prompt identification of the disease is nevertheless extremely important, especially in the case of tumors originating from the collateral branches, since its recognition can modify the management of the patient, in some cases obviating recourse to surgery.