Xanthogranulomatous prostatitis: multiparametric MRI appearances

Granulomatous prostatitis is an unusual form of prostatitis, and xanthogranulomatous prostatitis (XGP) is an even rarer granulomatous inflammation. Very few XGP cases have been reported in the literature. The reports concerning MRI features of XGP are even less. The present two cases of XGP in our report have different appearances from previous reports and are accompanied by abscess. We also exhibit the magnetic resonance spectroscopy and dynamic contrast-enhanced MRI characteristics, which have never been reported.     

非特异性肉芽肿性前列腺炎的MRI表现

目的：探讨非特异性肉芽肿性前列腺炎的MRI表现特点。方法：8例经病理证实的非特异性肉芽肿性前列腺炎患者行T1WI、T2WI、扩散加权成像（DWI）及增强检查,回顾性分析其临床及影像学表现特点。结果：8例患者病灶均为结节灶,以右侧前列腺中部外周带多见（5／8）。病灶在T。wI上呈低、稍低及等信号,T2WI上主要为低及稍低信号,DWI上表现为高及稍高信号,表观扩散系数（ADC）图上呈局灶性低信号。4例患者行动态增强MRI检查,病灶明显强化,时间一信号强度曲线呈Ⅰ型（1例）或Ⅱ型强化（3例）。结论：非特异性肉芽肿性前列腺炎的常规MRI检查缺乏特异性,而动态增强扫描可能有助于该病的诊断及鉴别诊断。     

Grey scale ultrasound appearances in hepatocellular carcinoma.

Thirty patients with histologically proven hepatocellular carcinoma were examined ultrasonically. All except two of these cases were reported ultrasonically as having a solid mass. Forty-three per cent of these lesions appeared multiple and 90% had irregular walls or boundaries. Stretching or distortion of the inferior margin of the liver is considered significant and 53% of cases demonstrated this feature. Just over two-thirds (67%) of the lesions were echogenic and under one-third (27%) were mixed lesions with echogenic and transonic areas. These transonic areas are considered to be due to the necrosis within the tumour. Most patients presented late and died within three months. Ninety per cent had clinical hepatomegaly or an epigastric mass. So far the main benefits of ultrasonography have been the recognition or exclusion of treatable disease such as liver abscess, cysts and congestive conditions of the liver, which may also present with unexplained hepatomegaly or epigastric masses. The possibility of a recognisable echo pattern for hepatocellular carcinoma emerged from this study. By conducting selective ultrasonic surveys in endemic areas and by employing the ultrasonic criteria described early diagnosis may be possible. Aspects of management and research may be assisted.     

经直肠经阴道超声在体检中对膀胱偶发癌的价值分析

目的:探讨应用经直肠经阴道超声体检在早期发现无症状性膀胱癌中的使用价值.方法:在膀胱少许充盈状态下,用5.0～7.5MHz的探头对8695名健康体检的人员进行常规经直肠经阴道膀胱检查,对可疑病例建议做膀胱镜检查及随诊.结果:15例可疑膀胱偶发癌患者经手术和病理证实,均为早期膀胱移行细胞癌.15例术后随访1～5年,均生存.1例复发,复发率为6.7%.所检出的癌症患者占全部受检者的0.17%(15/8695).结论:经直肠经阴道超声检查在健康体检中对膀胱偶发癌的早期发现,早期诊断及早期治疗具有重要价值,应作为健康体检的常规检查项目.     

Intratesticular haematoma: differentiation from tumour on clinical history and ultrasound appearances in two cases

Intratesticular haematoma is not well described in the ultrasound literature and may be mistaken for a primary testicular malignancy if a detailed clinical history and careful ultrasound examination are not performed. We report two cases of intratesticular haematoma (one complicated by the presence of microlithiasis), describe the ultrasound appearances and document the natural history of the haematomas. A clinical history coupled with Doppler ultrasound features is crucial for conservative management.     

MRI differentiation of recurrent nasopharyngeal carcinoma from postradiation fibrosis

A prospective study was performed to determine the usefulness of magnetic imaging (MRI) in differentiating local recurrence versus post-irradiation fibrosis in 72 patients after radiotherapy of nasopharyngeal carcinoma (NPC). All patients had a soft-tissue mass in the nasopharynx demonstrated by computed tomography. A total of 29 patients had tumor recurrence; 40 patients had only radiation fibrosis; 1 patient had postradiation edema and 2 patients had inflammatory changes. Based on the differences in signal intensity on T2-weighted Images, MRI may be promising as a noninvasive method for differentlating radiation fibrosis from local recurrent NPC. However, the signal intensity pattern of the tumor is not specific and may be seen in radiation edema and infection.     

Diffusion MRI predicts transrectal ultrasound biopsy results in prostate cancer detection

Purpose

To evaluate the ability of diffusion tensor imaging (DTI) to predict the transrectal ultrasound (TRUS) biopsy outcomes in persons who have no history of previous TRUS biopsy and present with elevated prostate‐specific antigen (PSA) levels.

Materials and Methods

Thirty‐seven participants underwent DTI, followed by 12‐core TRUS‐guided needle biopsy within 2 weeks. DTI was performed using endorectal coils on a 1.5 Tesla scanner at 1‐mm³ spatial resolution. By comparing with the TRUS biopsy results, the optimum thresholds of the trace apparent diffusion coefficient (tADC) and of the nodular size were investigated. The diagnostic performance of both criteria, the tADC threshold (Criteria A) and the tADC threshold combined with nodular size threshold (Criteria B), were evaluated.

Results

The optimum tADC threshold was 1.0 μm²/ms. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of prostate cancer (PCA) detection for Criteria A were 98%, 89%, 73%, 99%, and 91%, respectively, and were 97%, 98%, 92%, 99% and 98% for Criteria B.

Conclusion

Owing to high negative predictive value, the tADC threshold could be used to exclude subjects with clinically undetectable PCA. Adding the nodular size threshold, the combined threshold could identify the tADC‐positive segments that are likely to yield positive biopsy results. J. Magn. Reson. Imaging 2011;33:356–363. © 2011 Wiley‐Liss, Inc.     

Adrenocortical carcinoma: the range of appearances on CT and MRI

OBJECTIVE: Adrenocortical carcinoma (ACC) is a rare, aggressive tumor arising from the adrenal cortex that typically presents late with a large mass. The increased use of cross-sectional imaging for unrelated reasons has led to a greater number of ACCs being detected incidentally at an earlier stage. Recognition of the typical clinical, biochemical, and imaging findings is imperative for rapid diagnosis, prompt intervention, and early use of the appropriate therapy. CONCLUSION: Cross-sectional imaging with CT and MRI is essential for determining the extent of local and distant tumor spread. Complete surgical resection is currently the only potentially curative treatment of ACC, and the information attained from CT and MRI is important to guide surgery and further patient management.     

Papillary lesions of the breast: MRI, ultrasound, and mammographic appearances

OBJECTIVE: The purpose of this article is to describe the different imaging appearances of benign and malignant papillary lesions of the breast as well as to point out potential errors of interpretation that can lead to misdiagnosis. CONCLUSION: There is a wide spectrum of appearances of papillary lesions of the breast on MRI, ultrasound, and mammography. This variable appearance of papillary lesions makes differentiation of benign from malignant pathologies difficult on imaging, and tissue sampling is usually warranted.     

肝肺吸虫病的MRI表现

目的探讨肝肺吸虫病的MRI表现。方法对11例经临床或病理证实的肺吸虫病的肝脏MRI征象进行回顾性分析。结果单发病灶2例,多发病灶9例。病灶均分布在肝包膜下或门脉分支周围肝实质内,呈不规则形或条形,部分病灶在右肝后段可见“隧道征”;MRIT,wI呈等信号6例,呈稍高信号5例,TzwI呈稍高信号9例,稍低信号2例;动态增强扫描,多发病灶在动脉期及门脉期可见斑片状强化,延迟期病灶呈等信号,单发病灶可见周围环形强化,动脉期显示最清。结论肝肺吸虫病的MRI表现有一定特征,MRI对该病有较高的诊断价值。     

原发性肝透明细胞癌的 CT 及 MRI 表现

目的：评价 CT 和 MRI 对原发性透明细胞型肝癌(PCCCL)的诊断价值。方法回顾性分析38例经手术病理证实的PCCCL 的 CT 和 MRI 表现。26例行 CT 检查,23例行 MRI 检查,其中11例同时进行了 CT 及 MRI 检查。结果CT 平扫表现为低密度(n=24,92.3%)、稍高密度(n=2,7.7%)。MR T1 WI 呈低信号(n=19,82.6%)或混杂高信号(n=4,17.4%),脂肪抑制后信号均有不同程度下降。T2 WI 病灶为高或稍高信号(n=22,95.7%),1例为等低信号(n=1,4.3%),CT/MR 动态增强后动脉期所有病灶均强化(n=38),门静脉期病灶呈相对低密度(n=35,92.1%)或稍高密度/高信号(n=3,7.9%)。肿瘤内结节状强化共14例。环形包膜样强化26例(26/38,68.4%)。结论PCCCL 既有普通型肝癌“快进快出”的强化方式和包膜样强化的特征,又有自身特点即肿瘤内结节状强化和瘤内脂肪成分。     

不同级别少突胶质细胞肿瘤的MRI表现

目的探讨不同级别少突胶质细胞肿瘤的MRI表现特点。方法回顾性分析33例少突胶质细胞肿瘤的MRI表现,并结合病理结果分析。结果均为单发病灶,其中Ⅱ级21例,Ⅲ级12例。肿瘤好发于幕上大脑白质区,以额叶最常见,63.6%病灶发生钙化,MRI上T2WI多呈高信号、T1WI像多呈等低信号、T2WI-FLAIR多呈高信号、DWI呈稍高信号,可见囊变、出血信号,增强后强化方式各异,可为轻中度强化或为明显强化。Ⅲ级病灶在部位、大小、囊变、占位效应、瘤周水肿、强化方式的上较Ⅱ级有一定的差异,而钙化及MRS未见明显差别。结论不同级别少突胶质细胞肿瘤的MRI表现上有一定差异,可提高分级的准确性,为临床诊断提供帮助。     

超声诊断浸润型胃癌与增厚型胃炎

浸润型胃癌以胃壁增厚改变为主,且在胃壁内浸润扩展。增厚型胃炎超声下胃壁增厚明显时,则需与浸润型胃癌鉴别。如何运用超声区分两者的声像图改变,本组进行了观察分析,以期从两组增厚胃壁及胃排空运动方面的改变,提供鉴别诊断依据。     

MRI appearances of ovarian dysgerminoma

This report concerns a 40-year-old woman case of ovarian dysgerminoma presenting the MRI findings of predominantly hemorrhagic multilocules with papillary projections and irregular septa.     

MRI-经直肠超声融合靶向穿刺对有临床意义前列腺癌的检出价值

目的探讨MRI-经直肠超声(TRUS)融合靶向穿刺对有临床意义前列腺癌(PCa)的检出价值。方法前瞻性收集2015年9月至2017年6月苏州大学附属第一医院临床疑诊的PCa患者168例。对多参数MRI(mpMRI)上的可疑病灶进行第二版前列腺图像报告和数据系统(PI-RADS V2)评分。所有患者均行TRUS引导下前列腺系统穿刺,其中108例PI-RAD V2评分≥3分的患者行MRI-TRUS融合靶向穿刺。以穿刺病理结果为金标准,采用χ2检验比较两种穿刺方法对PCa及有临床意义癌的检出率。结果168例中,PCa患者86例101个病灶,非PCa患者82例91个病灶。TRUS系统穿刺检出PCa 78例(46.43%,78/168),MRI-TRUS靶向穿刺检出PCa 63例(58.33%,63/108),二者间差异有统计学意义(χ2=3.73,P=0.035)。168例患者共穿刺2300针,其中经MRI-TRUS靶向穿刺的单针阳性率(51.76%,147/284)高于TRUS系统穿刺(19.64%,396/2016),差异有统计学意义(χ2=142.38,P<0.05)。在所有穿刺阳性病灶中,MRI-TRUS靶向穿刺阳性率(68.69%,147/214)高于TRUS系统穿刺组(38.37%,396/1032),差异有统计学意义(χ2=66.27,P<0.05)。MRI-TRUS靶向穿刺组检出有临床意义PCa占所有阳性病例穿刺针数的69.74%(106/152),TRUS系统穿刺检出有临床意义PCa为54.50%(351/644),两组间差异有统计学意义(χ2=11.67,P<0.05)。结论MRI-TRUS靶向穿刺与PI-RADS V2相结合较系统穿刺可有效提高前列腺的穿刺阳性率,并且能够提高有临床意义PCa的检出率。     

肝脏血管平滑肌脂肪瘤的CT及MRI征象分析

目的 分析13例肝脏血管平滑肌脂肪瘤（AML）的CT及MRI表现,进一步提高诊断准确性。方法 所有病例均经手术病理证实。12例经CT检查,其中6例做过MRI检查,仅1例只做MRI检查。平扫后行增强动脉期和门脉期扫描,5例做了延迟期扫描。MRI检查行SE T1WI、快速自旋回波（FSE）T2WI和快速多层面干扰梯度回波（FMPSPGR）序列横断面动态多期增强扫描。结果 CT平扫11个病灶为低密度,1个为略高密度。动脉期所有病灶均有强化表现,8个病灶见到中心血管影。门脉期8个病灶有持续强化,有6个病灶见到中心血管影。MR T1WI上5个病灶为混杂信号,T2WI上所有病灶均为高信号,但信号强度各不相同。MR增强动脉期6个病灶有强化,1个病灶强化不明显。门脉期4个病灶有持续强化,3个为低信号。MR增强扫描中也有4个病灶显示中心血管影。结论 CT和MRI检查均可显示AML的特征,特别是病灶中脂肪成分和血管影高度提示AML的诊断。MR SE序列加脂肪抑制显示脂肪成分比CT更加敏感。CT和MR动态增强多期扫描可充分反映AML的强化特征,有助于提高AML的诊断准确性。     

MRI appearances of pelvic malakoplakia

We report the MRI appearances in a patient with parametrial malakoplakia. The patient complained of pelvic pain and vaginal discharge. Physical examination revealed a "frozen" pelvis suggestive of malignancy. MRI showed bilateral parametrial "infiltration", but no overt primary pelvic tumour. The combination of these findings together with the inflammatory symptoms suggested an inflammatory condition. Malakoplakia was confirmed at resective biopsy.     

卵泡膜细胞瘤的MRI表现

卵巢卵泡膜细胞瘤是来源于卵巢性索间质的功能性肿瘤.临床少见,多为良性,仅占全部卵巢肿瘤的0.5％～1％[1-2],术前常不能做出正确影像诊断.现将本院收治6例患者的临床资料、MRI表现归纳总结,结合病理对照分析,旨在提高对本病的认识.1资料与材料1.1 一般资料 收集本院2008-01-2010-12经手术及病理证实的卵泡膜细胞瘤患者6例,年龄50～85岁,平均59岁.主要临床表现:无症状体检发现腹部包块1例,下腹隐痛并坠胀感1例,闭经多年后阴道流血4例.6例患者均接受了MRI平扫和增强检查.