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1.
Salivary gland tumors: pretherapy evaluation with PET 总被引:4,自引:0,他引:4
Keyes JW Jr; Harkness BA; Greven KM; Williams DW rd; Watson NE Jr; McGuirt WF 《Radiology》1994,192(1):99
2.
Hiroki Kato Masayuki Kanematsu Haruo Watanabe Keisuke Mizuta Mitsuhiro Aoki 《Neuroradiology》2014,56(9):789-795
Introduction
The purpose of this study was to assess computed tomography (CT) and magnetic resonance (MR) imaging findings of salivary gland tumors of the parotid gland with emphasis on intratumoral cystic components.Methods
Seventy-two histopathologically confirmed salivary gland tumors of the parotid gland (44 benign and 28 malignant), which underwent both CT and MR imaging including contrast-enhanced study, were included in this study. We retrospectively reviewed images for the presence, number, occupying rate, margin characteristics, distribution, and predominant MR signal intensity of intratumoral cystic components.Results
The prevalence of cystic components was greater in malignant than benign tumors (79 vs. 50 %, p?0.05). The number and occupying rate were similar between benign and malignant tumors. The irregular margins were more frequent in malignant than benign tumors (73 vs. 27 %, p?0.01). The frequency of eccentric location was greater in benign than malignant tumors (91 vs. 55 %, p?0.01), whereas the frequency of centric location was greater in malignant than benign tumors (32 vs. 0 %, p?0.01). On T1-weighted images, the frequency of hyperintensity was greater in benign than malignant tumors (50 vs. 9 %, p?0.01), whereas that of isointensity was greater in malignant than benign tumors (50 vs. 0 %, p?0.01). Multiple logistic regression analysis showed that the absence of irregular margins of cystic components only was significantly correlated with the presence of benign salivary gland tumors (p?0.01).Conclusion
Imaging features of intratumoral cystic components may help to differentiate benign from malignant tumors of the parotid salivary gland. 相似文献3.
The aim of the present study is to determine imaging criteria for differentiating tuberculosis from primary tumors in the adrenal gland on contrast-enhanced CT. Non-contrast and contrast-enhanced CT features in 108 patients with adrenal tuberculosis (n=34) and primary tumor (n=74) were retrospectively assessed for the location, size, calcification and enhancement patterns. The primary tumors included 41 adenomas, 11 pheochromocytomas, 4 carcinomas, 3 lymphomas, 6 myelolipomas, 6 ganglioneuromas, 2 neurilemmomas and 1 ganglioneuroblastoma. Biochemical investigation was performed for all patients. Of the tuberculosis cases, 31 (91%) invaded with bilateral involvement, while 7 (9%) of the primary tumors invaded with bilateral involvement (P<0.001). Tuberculosis often showed calcification (20 of 34; 59%), whereas primary tumors infrequently showed calcification (6 of 74; 8%; P<0.001). Low attenuation in the center with peripheral rim enhancement was more commonly seen in tuberculosis (16 of 34; 47%) than in primary tumors (7 of 74; 9%; P<0.001). In the determination of tuberculosis, the highest sensitivity (91%) and accuracy (91%) were obtained with bilateral involvement, and the highest specificity (99%) was obtained with the contour preserved. In the determination of primary tumors using a combination of having unilateral involvement and being mass-like, the outcome was a sensitivity of 91%, specificity of 94% and accuracy of 92%. CT findings can differentiate tuberculosis from a primary tumor of the adrenal glands with high sensitivity and an acceptable specificity when combined with the endocrinological examination. 相似文献
4.
Intratemporal vascular tumors: evaluation with CT 总被引:1,自引:0,他引:1
Lo WW; Horn KL; Carberry JN; Solti-Bohman LG; Wade CT; Brackmann DD; Waluch V 《Radiology》1986,159(1):181-185
Eleven patients each with a benign intratemporal vascular tumor (hemangioma or vascular malformation) were assessed with computed tomography (CT). Clinical, surgical, and histologic correlations were also available. On CT scans, most of the 11 tumors were smaller than 10 mm. Four occurred in or around the internal acoustic canal, six at the geniculate ganglion, and one at the posterior genu. The involved bone margins were often unsharp, and "honeycomb" bone or intratumoral bone spicules were sometimes present. Intratemporal vascular tumors cause profound nerve deficits despite their small size and must be resected early to salvage nerve function. 相似文献
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6.
Detection of small pancreatic tumors with multiphasic helical CT 总被引:7,自引:0,他引:7
Bronstein YL Loyer EM Kaur H Choi H David C DuBrow RA Broemeling LD Cleary KR Charnsangavej C 《AJR. American journal of roentgenology》2004,182(3):619-623
OBJECTIVE: The purpose of this study was to evaluate the sensitivity and specificity of helical CT in the detection of adenocarcinomas of the pancreas measuring 2 cm or smaller at pathologic examination. MATERIALS AND METHODS: Thin-section triple phase (20, 40, and 70 sec after the start of injection) contrast-enhanced helical CT scans of the abdomen in 18 patients with a pancreatic carcinoma that was 2 cm or smaller and 18 patients with a normal pancreas were retrospectively reviewed by two senior radiologists who specialized in oncologic abdominal imaging. Discrepancies were resolved by consensus. The observers were unaware of the clinical information. CT scans were evaluated for the presence of a pancreatic mass, bile, and pancreatic duct stricture. The location and size of tumors as determined on CT were compared with pathologic findings. The CT results were also compared with the prospective CT interpretations derived from the radiology reports and with the endoscopic sonographic reports when available. RESULTS: The sensitivity of thin-section triple-phase helical CT in the detection of small pancreatic masses was 77%, and the specificity was 100% for the two experienced observers. The sensitivity and specificity were 72% and 100%, respectively, for the prospective interpretations done by 10 observers. There was no correlation between the tumor size at pathology and the CT measurements. CONCLUSION: Thin-section contrast-enhanced helical CT is sensitive and highly specific for the detection of pancreatic tumors measuring 2 cm or smaller. Improvement in the detection rate of this technique compared with previous techniques lies in the optimization of parenchymal enhancement during the pancreatic phase and the decrease in slice thickness. 相似文献
7.
Salivary gland tumors: diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation 总被引:22,自引:0,他引:22
PURPOSE: To evaluate the diagnostic value of gadolinium-enhanced dynamic magnetic resonance (MR) imaging of salivary gland tumors and correlate the MR imaging and histopathologic findings. MATERIALS AND METHODS: Thirty-three salivary gland tumors in 29 patients were examined preoperatively at gadolinium-enhanced dynamic MR imaging. There were 22 benign and 11 malignant tumors. Dynamic contrast material-enhanced MR images were obtained for 5 minutes. Time of peak enhancement (T(peak)) and washout ratio (WR) were determined from time-signal intensity curves (TICs). Microvessel count and cellularity-stromal grade were evaluated histopathologically. The strengths of correlations between T(peak) and microvessel count and between WR and cellularity-stromal grade were statistically analyzed. Statistical analysis was also performed to determine whether any differences among the various histopathologic tumor types existed [corrected]. In a validation study, 13 salivary gland tumors in 13 patients were examined consecutively. RESULTS: At a T(peak) of 120 seconds, malignant tumors could be differentiated from pleomorphic adenomas but not from Warthin tumors. A WR of 30%, however, enabled differentiation between malignant and Warthin tumors. Classification of TICs on the basis of a T(peak) of 120 seconds and a WR of 30% had high sensitivity (91%) and specificity (91%) in the differentiation of benign and malignant tumors. Correlations between T(peak) and microvessel count (P <.0001, rho = -0.800) and between WR and cellularity-stromal grade (P =.0105, rho = 0.572) were significant. The validation study also yielded high sensitivity (100%) and specificity (80%) in the differentiation between benign and malignant tumors. CONCLUSION: Gadolinium-enhanced dynamic MR imaging is useful for differentiating benign from malignant salivary gland tumors. 相似文献
8.
Acute pancreatitis represents one of the more commonly encountered etiologies of acute abdominal pain. Many complications
can present emergently, including pancreatic abscess, necrosis, and hemorrhage. The purpose of this pictorial essay is to
educate the reader about the spectrum of CT findings in patients with complications from pancreatitis. Emphasis is placed
on evaluation with helical CT, stressing optimal technique and the imaging parameters essential for accurate diagnosis. 相似文献
9.
Salivary gland stones: US evaluation in shock wave lithotripsy 总被引:1,自引:0,他引:1
Ottaviani F; Capaccio P; Rivolta R; Cosmacini P; Pignataro L; Castagnone D 《Radiology》1997,204(2):437
10.
Salivary gland tumors at in vivo proton MR spectroscopy 总被引:7,自引:0,他引:7
PURPOSE: To prospectively evaluate whether proton magnetic resonance (MR) spectroscopy can be used to characterize salivary gland tumors (SGTs). MATERIALS AND METHODS: Ethics committee approval and informed consent were obtained. Hydrogen 1 ((1)H) MR spectroscopy was performed with echo times of 136 and 272 msec at 1.5 T in both SGTs and normal parotid glands. Spectra were analyzed in the time domain by using prior knowledge in the fitting procedure to obtain peak amplitudes of choline (Cho), creatine (Cr), and unsuppressed water. Mean Cho/Cr and Cho/water ratios for each subgroup of SGTs were obtained, and results were compared by using a nonparametric t test. RESULTS: Successful spectra were acquired in 56 patients (35 men, 21 women; mean age, 56 years) with a total of nine malignant tumors and 47 benign SGTs (24 Warthin tumors, 22 pleomorphic adenomas, one oncocytoma). At an echo time of 136 msec, Cho/Cr ratios were obtained in 26 (47%) of 55 spectra, with a mean value (+/- standard deviation) of 1.73 +/- 0.47, 5.49 +/- 1.86, 3.46 +/- 0.84, and 2.45 for malignant tumors, Warthin tumors, pleomorphic adenomas, and oncocytoma, respectively. Differences were significant between Warthin tumors and pleomorphic adenomas (P = .028) and between benign SGTs and malignant tumors (P < .001). At an echo time of 272 msec, Cho/Cr ratios were obtained in 16 (30%) of 53 spectra, with a mean value of 2.27 +/- 0.69, 6.92 +/- 1.47, and 3.67 +/- 1.23 for malignant tumors, Warthin tumors, and pleomorphic adenomas, respectively. Differences were also significant between Warthin tumors and pleomorphic adenomas (P = .041) and benign SGTs and malignant tumors (P = .004). There was a significant difference in mean Cho/water ratio for Warthin tumors versus pleomorphic adenomas at echo times of 136 msec (P = .003) and 272 msec (P = .002) but not for benign SGTs versus malignant tumors. CONCLUSION: (1)H MR spectroscopy may be used to characterize SGTs, but a larger study is required to validate these initial results. 相似文献
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12.
Intraductal papillary mucinous tumors of the pancreas: helical CT with histopathologic correlation 总被引:13,自引:0,他引:13
Taouli B Vilgrain V Vullierme MP Terris B Denys A Sauvanet A Hammel P Menu Y 《Radiology》2000,217(3):757-764
PURPOSE: To evaluate the accuracy of preoperative computed tomography (CT) in predicting the location and type of ductal involvement and malignant transformation in intraductal papillary mucinous (IPM) pancreatic tumors and to determine the predictive factors for malignancy at CT. MATERIALS AND METHODS: The helical CT scans obtained in 36 operated on patients with a diagnosis of IPM pancreatic tumor were retrospectively assessed. CT-histopathologic correlation was then performed. RESULTS: The final diagnoses of IPM tumor were combined type (n = 26) and branch duct type (n = 10) lesions. Histologic analysis revealed adenocarcinoma (n = 9), hyperplasia (n = 8), low-grade dysplasia (n = 12), and high-grade dysplasia (n = 7). The lesions were located mainly in the head or uncinate process (n = 20) or were diffuse or multifocal (n = 12). In 12 patients (13 cases), CT-histopathologic correlation was poor, including that in the evaluation of ductal involvement (n = 7), evaluation of lesion location (n = 2), and diagnosis of malignant transformation (n = 4). The most specific predictive signs of malignancy were presence of diabetes and, at CT, a solid mass, main pancreatic duct dilatation greater than 10 mm, diffuse or multifocal involvement, and attenuating or calcified intraluminal content. CONCLUSION: The main causes of poor CT-histopathologic correlation were related to evaluation of main pancreatic duct involvement and diagnosis of malignant transformation. The association between diabetes and specific CT criteria was highly suggestive of malignancy. 相似文献
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14.
Andersson M Kostic S Johansson M Lundell L Asztély M Hellström M 《Acta radiologica (Stockholm, Sweden : 1987)》2005,46(1):16-27
PURPOSE: To establish the diagnostic accuracy of MRI including MR cholangiopancreatography (MRCP) compared with helical CT in the differentiation of malignant and benign lesions in the periampullary region. MATERIAL AND METHODS: Fifty-one patients (27 M, 24 F, mean age 66 years, range 39-86 years) with obstructive jaundice and sonographic evidence of intra- and extrahepatic bile duct dilatation (n=31) or suspicion of periampullary tumor, based on previously performed ultrasound and/or CT examination (n=20), were studied. MRI with MRCP and helical CT were reviewed blindly under standardized conditions. Lesion status (differentiation of malignant versus benign) was rated on a 5-point diagnostic confidence scale. Reference standards for comparison were findings at surgery or laparoscopy and/ or the clinical outcome. The predictive value of imaging findings was determined with multivariate logistic regression analysis. RESULTS: The areas under the receiver operating characteristic curve were 0.96 for MRI with MRCP and 0.81 for CT (P <0.05). Multivariate analysis of eight imaging variables at MRI indicated that a stricture with malignant characteristics at MRCP was the best predictor of malignancy. CONCLUSION: MRI with MRCP was significantly more accurate than CT in differentiating between malignant and benign lesions in patients with suspected periampullary tumors, mainly due to the information obtained on the MRCP images of the biliary and pancreatic duct anatomy. 相似文献
15.
We performed two-phase helical CT in 31 patients with juxtasellar region and cerebellopontine angle tumours to evaluate its
usefulness in differentiating meningiomas from neurogenic tumours. After the intravenous injection of 90 ml contrast medium
at 3 ml/s, axial helical images were obtained with delays of 30 and 120 s. After the delayed axial images, we acquired coronal
images. Changes in attenuation were assessed visually and quantitatively (by comparing the attenuation in Hounsfield units).
There were 17 meningiomas and 14 neurogenic tumours, all pathologically proven. Two-phase helical CT showed a decrease in
attenuation in 15 (88 %) meningiomas and an increase in 14 (100 %) neurogenic tumours from early to delayed axial images.
Coronal images showed a decrease in attenuation in all 17 meningiomas and an increase in 13 (93 %) of the neurogenic tumours.
The mean HU and their ratios were significantly different between meningiomas and neurogenic tumours.
Received: 22 August 2000 Accepted: 13 October 2000 相似文献
16.
Múnera F Soto JA Palacio DM Castañeda J Morales C Sanabria A Gutiérrez JE García G 《Radiology》2002,224(2):366-372
PURPOSE: To report an experience with helical computed tomographic (CT) angiography as the initial procedure to rule out arterial lesions caused by penetrating neck injuries. MATERIALS AND METHODS: During 27 months, 175 patients were referred for helical CT angiography of the neck because of clinical suspicion of arterial injuries. The protocol included a 100-mL bolus of nonionic contrast material injected at 4.5 mL/sec, with 11-second scanning delay, 3-mm collimation, and pitch of 1.3-2.0. CT images were interpreted prospectively by the emergency radiologist, and two radiologists retrospectively interpreted studies with consensus. Outcome was determined with examination of patients and their charts. The sensitivity, specificity, and positive and negative predictive values were calculated. RESULTS: Studies in two patients were considered inadequate for diagnosis; these patients were referred for conventional arteriography and had normal findings. In 27 patients (15.6%), arterial lesions were detected. One patient had two arterial injuries. Lesions demonstrated with helical CT angiography were arterial occlusion (n = 14), pseudoaneurysm (n = 8), pseudoaneurysm and arteriovenous fistulae (n = 4), and partial thrombosis (n = 2). The remaining 146 patients had normal arteries. On the basis of these findings, patients were treated with surgery (n = 21), endovascular intervention (n = 7), and observation alone (n = 146). CONCLUSION: Results indicate that helical CT angiography can be used as the initial method for evaluation in patients with possible arterial injuries of the neck. 相似文献
17.
肠间质瘤是胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的一种,本文对2002年7月~2011年11月在本院经手术病理证实的16例十二指肠间质瘤的临床及CT征象作一分析,以期提高该肿瘤的认识.
1 材料与方法
1.1临床资料
本组病例1 6例,男性9例,女性7例,年龄41~73岁,平均年龄56岁.所有病例均有CT检查资料.主要临床表现为间断性上腹疼痛6例,体检腹部包块5例,上腹疼痛伴黑便5例,恶性呕吐不全梗阻症状者1例,黄疸1例.实验室检查:粪潜血(+)6例,血红蛋白、红细胞均有不同程度降低. 相似文献
18.
Múnera F Morales C Soto JA Garcia HI Suarez T Garcia V Corrales M Velez G 《Radiology》2004,231(2):399-405
PURPOSE: To assess helical computed tomography (CT) with contrast material administered intravenously, orally, and rectally (triple contrast helical CT)) in the prospective evaluation of stable patients with abdominal gunshot wounds in whom there is no clinical indication for immediate exploratory laparotomy. MATERIALS AND METHODS: The study was conducted for 19 months. All patients met the following inclusion criteria: age of 16 years or older, hemodynamic stability, no clinical signs of peritoneal irritation, and signed consent to participate. Patients with obvious indications for laparotomy, such as gastrointestinal bleeding or evisceration, were excluded from the study. Forty-seven patients fulfilled the criteria and underwent abdominal triple-contrast helical CT. CT findings were evaluated by one of four radiologists for evidence of peritoneal penetration and injury to solid organs or hollow viscera. Patients were followed up clinically for 13 weeks. CT findings were compared with those at surgery and/or clinical follow-up. RESULTS: CT demonstrated abnormalities in 27 (57%) patients. Laparotomy was performed in 11 (23%) patients; 10 procedures were therapeutic and one was nontherapeutic. The remaining 20 patients had a negative CT scan. These patients were treated conservatively. One injury was missed at CT. For prediction of the need for laparotomy, sensitivity of CT was 96%; specificity, 95%; positive predictive value, 96%; negative predictive value, 95%; and accuracy, 96%. CONCLUSION: In stable patients with gunshot wounds to the abdomen in whom there is no indication for immediate surgery, triple-contrast helical CT can help reduce the number of cases of unnecessary or nontherapeutic laparotomy (negative laparotomy) and can help identify patients with injuries that may be safely treated without surgery. 相似文献
19.
Intraductal papillary mucinous tumors of the pancreas: thin-section helical CT findings 总被引:14,自引:0,他引:14
Fukukura Y Fujiyoshi F Sasaki M Inoue H Yonezawa S Nakajo M 《AJR. American journal of roentgenology》2000,174(2):441-447
OBJECTIVE: The purpose of this study was to evaluate the thin-section helical CT findings of intraductal papillary mucinous tumors and to investigate whether helical CT could distinguish between malignant and benign intraductal papillary mucinous tumors. MATERIALS AND METHODS: Twenty-seven patients (nine with malignant and 18 with benign intraductal papillary-mucinous tumors) underwent thin-section (3- or 5-mm) helical CT. Two-phase enhanced CT was started 30 and 60-70 sec after injection of contrast material at 3 ml/sec. RESULTS: In six patients (22.2%), a bulging papilla was depicted on CT. Twenty-five patients (92.6%) had a dilated main pancreatic duct. Cystic lesions were seen in 25 patients (92.6%). Thirteen lesions (48%) were located in the uncinate process, seven (25.9%) were in the head, two (7.4%) were in the body, and three (11%) were in the tail. The cystic lesion was unilocular in five patients (18.5%) and multilocular with a lobulated margin in 20 patients (74%). Communication between the main pancreatic duct and the cystic lesion was depicted in 19 patients (70.4%). The papillary projections corresponding to 3-mm or larger papillary neoplasms were depicted in five patients (18.5%). The bulging papilla was more often observed in malignant than in benign intraductal papillary mucinous tumors (p < 0.05). The caliber of the main pancreatic duct was significantly larger in patients with malignant intraductal papillary mucinous tumors (p > 0.001). CONCLUSION: The most frequently found feature of intraductal papillary mucinous tumors was a lobulated multilocular cystic lesion located in the uncinate process and in contiguity with the dilated main pancreatic duct. In some patients, a bulging papilla and papillary projections in the ducts, which were specific findings, were visualized on CT. The bulging papilla and the caliber of the main pancreatic duct helped differentiate malignant from benign intraductal papillary mucinous tumors. 相似文献
20.
Hepatic hemangioma: findings with two-phase CT 总被引:24,自引:0,他引:24